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Neuropathy, peripheral neuropathy, pain management in neuropathy, pain management

Farnaz Ebrahimi, Mohammad Hosein Farzaei, Roodabeh Bahramsoltani, Mojtaba Heydari, Kiana Naderinia, Roja Rahimi
Neuropathy is defined as the damage to the peripheral or central nervous system accompanied by pain, numbness, or muscle weakness, which can be due to congenital diseases or environmental factors such as diabetes, trauma, or viral infections. As current treatments are not sufficiently able to control the disease, studies focusing on the identification and discovery of new therapeutic agents are necessary. Natural products have been used for a long time for the management of different neurological problems including neuropathies...
February 15, 2019: Reviews in the Neurosciences
James E McKinley, Allen Perkins
Peripheral neuropathies (PNs) are a group of conditions caused by damage to the peripheral nervous system. PN is a condition commonly seen in the family medicine setting and can lead to reduced quality of life due to pain, ulceration, and falls. More than 100 etiologies of PN have been identified; the most common are metabolic, drug-related, and systemic etiologies. Common treatable etiologies include diabetes and other medical conditions. Screening is recommended only for patients with suspected diabetic PN...
February 2019: FP Essentials
Johann S de Bono, Nicole Concin, David S Hong, Fiona C Thistlethwaite, Jean-Pascal Machiels, Hendrik-Tobias Arkenau, Ruth Plummer, Robert Hugh Jones, Dorte Nielsen, Kristian Windfeld, Srinivas Ghatta, Brian M Slomovitz, James F Spicer, Jeffrey Yachnin, Joo Ern Ang, Paul Morten Mau-Sørensen, Martin David Forster, Dearbhaile Collins, Emma Dean, Reshma A Rangwala, Ulrik Lassen
BACKGROUND: Tisotumab vedotin is a first-in-human antibody-drug conjugate directed against tissue factor, which is expressed across multiple solid tumour types and is associated with poor clinical outcomes. We aimed to establish the safety, tolerability, pharmacokinetic profile, and antitumour activity of tisotumab vedotin in a mixed population of patients with locally advanced or metastatic (or both) solid tumours known to express tissue factor. METHODS: InnovaTV 201 is a phase 1-2, open-label, dose-escalation and dose-expansion study done at 21 centres in the USA and Europe...
February 7, 2019: Lancet Oncology
Ling-Chun Lu, Shiow-Luan Tsay, Sou-Yi Chang, Chung-Ming Chen, Chieh-Yu Liu
Chemotherapy-induced peripheral neuropathy (CIPN) with restriction of daily activity (RDA) was common consequence of oxaliplatin-based chemotherapy in colorectal cancer patients. CIPN with RDA and negative mood may impact the quality of life (QoL). However, the relationships among RDA, mood, and QoL remain unclear. This was a cross-sectional relative study in which four instruments were used: the Neuropathic Pain Symptom Inventory was used to measure the severity of CIPN; the Screening of Activity Limitation and Safety Awareness scale was used to evaluate RDA; the Profile of Mood States Short Form was used to assess negative mood; and the Functional Assessment Cancer Center Therapy-Colorectal scale version 4 was used to evaluate QoL...
February 11, 2019: Cancer Medicine
Amir Dolev, Dror Robinson, Mustafa Yassin
Introduction: Common causes for foot drop are peroneal mono-neuropathy or sciatic neuropathy and lumbar root compression. Central nervous system pathologies leading to isolated drop foot are rare etiologies with unknown incidence. Case Report: Our patient had a brain tumor manifested as acute onset foot drop accompanied by low back pain, leading us to look for a lumbar pathology. In this case study, we describe the clinical management from the first encounter to diagnosis...
September 2018: Journal of Orthopaedic Case Reports
Elisabetta Buscarini, Luisa Maria Botella, Urban Geisthoff, Anette D Kjeldsen, Hans Jurgen Mager, Fabio Pagella, Patrizia Suppressa, Roberto Zarrabeitia, Sophie Dupuis-Girod, Claire L Shovlin
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is a multisystemic inherited vascular dysplasia that leads to nosebleeds and visceral arteriovenous malformations (AVMs). Anti-angiogenic drugs thalidomide and bevacizumab have been increasingly used off-label with variable results. The HHT working group within the ERN for Rare Multisystemic Vascular Diseases (VASCERN), developed a questionnaire-based retrospective capture of adverse events (AEs) classified using the Common Terminology Criteria for Adverse Events...
February 4, 2019: Orphanet Journal of Rare Diseases
Amanda C Randolph, Yu-Li Lin, Elena Volpi, Yong-Fang Kuo
BACKGROUND/OBJECTIVES: Peripheral neuropathy is a common diabetes complication that can increase fall risk. Regarding fall risk, the impact of pain management using tricyclic antidepressants (TCAs) or γ-aminobutyric acid (GABA) analogs is unclear because these medications can also cause falls. This study investigates the impact of these drugs on fall and fracture risk in older diabetic peripheral neuropathy (DPN) patients. DESIGN: Historical cohort study with 1-to-1 propensity matching of TCA/GABA-analog users and nonusers...
January 29, 2019: Journal of the American Geriatrics Society
Igho J Onakpoya, Elizabeth T Thomas, Joseph J Lee, Ben Goldacre, Carl J Heneghan
OBJECTIVE: To assess the benefits and harms of pregabalin in the management of neuropathic pain. DESIGN: Rapid review and meta-analysis of phase III, randomised, placebo-controlled trials. PARTICIPANTS: Adults aged 18 years and above with neuropathic pain defined according to the International Association for the Study of Pain criteria. INTERVENTIONS: Pregabalin or placebo. PRIMARY AND SECONDARY OUTCOME MEASURES: Our primary outcomes were pain (as measured using validated scales) and adverse events...
January 21, 2019: BMJ Open
Bei-Yu Wu, Chun-Ting Liu, Yu-Li Su, Shih-Yu Chen, Yung-Hsiang Chen, Ming-Yen Tsai
INTRODUCTION: Chemotherapy-induced peripheral neuropathy (CIPN) is a progressive, prolonged, and often irreversible side effect of many chemotherapeutic agents. The development of neuropathic pain is still poorly managed by clinically available drugs at present. METHODS: In this mini-review, we summarized the current knowledge of pathobiology for CIPN, and selected evidence on the application of complementary therapies in experimental studies. RESULTS: Medicinal plants are considered to be the most common complementary therapy modalities for CIPN...
February 2019: Complementary Therapies in Medicine
Kijung Sung, Wanlin Yang, Chengbiao Wu
Nerve growth factor (NGF) is a powerful trophic factor that provides essential support for the survival and differentiation of sympathetic and sensory neurons during development. However, NGF also activates nociceptors contributing significantly to inflammatory pain and neuropathic pain after tissue injury. As such anti-NGF based therapies represent a promising strategy for pain management. Because of dose-dependent serious side effects such as back pain, injection site hyperalgesia, clinical trials of using NGF to treat various disorders such as diabetic neuropathies, chemotherapy-induced and human immunodeficiency virus-associated peripheral neuropathies were all discontinued...
April 2019: Neural Regeneration Research
Carley E Johnson, Jody K Takemoto
The American Diabetic Association standards of medical care for diabetic patients recommends moderate intensity exercise to help manage diabetes; however, this recommendation may be unmanageable for patients who have become inactive or unable to reach this intensity. The purpose of this review is to determine if low-intensity exercises demonstrate improvement in diabetic peripheral neuropathy symptoms in order to utilize these exercises as a starting point for inactive patients. Studies in low-intensity exercises from 2013 to May 2018 were systematically searched in PubMed, SCOPUS, and Cochrane Library databases...
2019: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
Santiago Ponce, Ana Yuste, Ana Esquivias, Ana Leal, Jesús Villoria
OBJECTIVE: The reason cancer pain remains prevalent and hard to classify may be partially explained by the failure to identify neuropathic mechanisms. The objective of this research was to identify the syndromes of cancer pain that may be particularly hard to manage due to their mixed pathophysiology. DESIGN: A series of 384 patients who had cancer of any type, at any stage, and suffered from chronic pain (symptom onset > 3 months) were assessed during a routine return visit in Spain...
December 18, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Hailey W Bulls, Aasha I Hoogland, Brittany Kennedy, Brian W James, Bianca L Arboleda, Sachin Apte, Hye Sook Chon, Brent J Small, Brian D Gonzalez, Heather S L Jim
OBJECTIVE: Increasing age has been associated with higher risk of chemotherapy-related toxicities, often resulting in treatment disruptions or discontinuations. Age has also been evaluated as a potential risk factor for chemotherapy-induced peripheral neuropathy (CIPN), but current understanding of recovery from CIPN in older adults after treatment is limited. The goal of the current study was to: 1) evaluate longitudinal change in patient-reported CIPN symptoms from the start of chemotherapy to one year post-chemotherapy; and 2) examine treatment modifications in older (≥65 years) and younger patients (<65 years)...
December 14, 2018: Gynecologic Oncology
Khaled F Al-Massri, Lamiaa A Ahmed, Hanan S El-Abhar
Peripheral neuropathy is a common adverse effect observed during the use of paclitaxel (PTX) as chemotherapy. The present investigation was directed to estimate the modulatory effect of bone marrow derived mesenchymal stem cells (BM-MSCs) on pregabalin (PGB) treatment in PTX-induced peripheral neuropathy. Neuropathic pain was induced in rats by injecting PTX (2 mg/kg, i.p) 4 times every other day. Rats were then treated with PGB (30 mg/kg/day, p.o.) for 21 days with or without a single intravenous administration of BM-MSCs...
March 15, 2019: Behavioural Brain Research
Song Cai, Shreya Sai Bellampalli, Jie Yu, Wennan Li, Yingshi Ji, E M Kithsiri Wijeratne, Angie Dorame, Shizhen Luo, Zhiming Shan, May Khanna, Aubin Moutal, John M Streicher, A A Leslie Gunatilaka, Rajesh Khanna
For an affliction that debilitates an estimated 50 million of U.S. adults, the current chronic pain management approaches are inadequate. The Centers for Disease Control and Prevention have called for a minimization in opioid prescription and use for chronic pain conditions, and thus, it is imperative to discover alternative non-opioid based strategies. For the realization of this call, a library of natural products was screened in search of pharmacological inhibitors of both voltage-gated calcium channels and voltage-gated sodium channels, excellent targets due to their well-established roles in nociceptive pathways...
December 7, 2018: ACS Chemical Neuroscience
Robert Knoerl, Edie Weller, Barbara Halpenny, Donna Berry
BACKGROUND: Impaired physical function due to chemotherapy-induced peripheral neuropathy (CIPN) symptoms may lead to diminished quality of life. However, even with the knowledge of the effects of CIPN on physical function, clinicians infrequently assess and manage CIPN. Interventions that prioritize the early identification of CIPN to provide prompt treatment may reduce the impact of CIPN on physical function. The purpose of this paper is to compare self-reported physical function in individuals receiving neurotoxic chemotherapy between Electronic Symptom Assessment-Cancer (ESRA-C) intervention group (e...
December 4, 2018: BMC Cancer
Kohei Godai, Keiya Takahashi, Yuta Kashiwagi, Ching-Hang Liu, Hyun Yi, Shue Liu, Chuanhui Dong, David A Lubarsky, Shuanglin Hao
BACKGROUND: Chronic pain is one of the most common complaints in patients with human immunodeficiency virus (HIV)-associated sensory neuropathy. Ryanodine receptor (RyR) and mitochondrial oxidative stress are involved in neuropathic pain induced by nerve injury. Here, we investigated the role of RyR and mitochondrial superoxide in neuropathic pain induced by repeated intrathecal HIV glycoprotein 120 (gp120) injection. METHODS: Recombinant HIV glycoprotein gp120MN was intrathecally administered to induce neuropathic pain...
November 30, 2018: Anesthesia and Analgesia
Raquel Tonello, Sang Hoon Lee, Temugin Berta
Chemotherapy-induced peripheral neuropathy (CIPN) is a disabling condition accompanying several cancer drugs, including the front-line chemotherapeutic agent paclitaxel. Although CIPN can force dose reduction or even discontinuation of chemotherapy affecting survival in cancer patients, there is no FDA-approved treatment for CIPN. CIPN in mice is characterized by neuropathic pain (e.g., mechanical allodynia) in association with oxidative stress and neuroinflammation in dorsal root ganglia (DRGs), as well as retraction of intraepidermal nerve fibers...
November 21, 2018: Journal of Pain: Official Journal of the American Pain Society
Elena Elez, Carlos Gomez-Roca, Arturo Soto Matos-Pita, Guillem Argiles, Thibaud Valentin, Cinthya Coronado, Jorge Iglesias, Teresa Macarulla, Sarah Betrian, Salvador Fudio, Katrin Zaragoza, Josep Tabernero, Jean-Pierre Delord
Background Plocabulin (PM060184) is a novel marine-derived microtubule inhibitor that acts as an antitumor agent. This first-in-human study evaluated dose-limiting toxicities (DLT) to define the maximum tolerated dose (MTD) and phase II recommended dose (RD) of plocabulin given as a 10-min infusion on Day (D) 1, D8 and D15 every four weeks. Patients and methods Forty-four patients with advanced solid tumors received plocabulin following an accelerated titration design. Results Plocabulin was escalated from 1...
November 9, 2018: Investigational New Drugs
Ayman Saeed, Nitisha Narayan, Ankur Pandya
Objective: Subdermal contraceptive implants are a well-established method of contraception. Aside from common side effects such as irregular menstrual periods, headaches, and weight gain, rarer complications related to their insertion and removal have been reported. These include traumatic peripheral neuropathy after procedures to remove nonpalpable implants. Only 2 cases of ulnar neuropathy after insertion of a contraceptive implant have been described in the literature, one which resolved spontaneously and another in which postoperative recovery was not described...
2018: Eplasty
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