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Light-Chain Amyloidosis: The Great Impostor.

Light-chain amyloidosis (AL) is a disease of protean manifestations due to a wide spectrum of organs that can be affected. The disorder is caused by the deposition of an extracellular amorphous material, the amyloid, which is produced by malignant plasma cells. The latter usually reside in the bone marrow; plasma cell infiltration is often low, in sharp contrast to what we observe in multiple myeloma. The disease may run below the physician's radar for a while before clinical suspicion is raised and targeted tests are performed. In this short review, we try to answer most of the questions that

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… Gabapentin or pregabalin have a place in management of neuropathic pain. Furthermore, nutritional support and adequate caloric intake are important in order for albumin to be maintained at a satisfactory level [ 56 ]. 6. Novel Therapies Q21. Are there antibodies that target amyloid deposits? …

Evaluating Acupuncture for Chemotherapy-Induced Peripheral Neuropathic Pain: A Narrative Review of Clinical Evidence and Mechanistic Perspectives.

BACKGROUND/OBJECTIVES: Despite the high prevalence of chemotherapy-induced peripheral neuropathic pain (CIPNp), its management remains challenging, and reliable preventive strategies are still lacking. Current treatment is largely symptomatic and often provides only modest benefits, as available pharmacological therapies have shown limited and inconsistent efficacy. In this context, acupuncture has been investigated as a non-pharmacological intervention, but the certainty and clinical applicability of the available evidence remain unclear. This critical narrative review examines the clinical e

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… Other commonly prescribed medications, including tricyclic antidepressants (e.g., amitriptyline), serotonin–noradrenaline reuptake inhibitors other than duloxetine, and gabapentinoids (gabapentin and pregabalin), have failed to demonstrate significant or sustained benefit in CIPNp in randomized trials …

Research trends of acupuncture therapy for painful peripheral nervous system diseases from 2004 to 2023: a bibliometric and meta-analysis.

BackgroundPeripheral nervous system diseases (PNSD) have represented a major global health burden, leading to significant economic impacts and diminished productivity. This bibliometric analysis was performed to summarize the current research trends and hotspots over the past two decades, aiming to provide a comprehensive perspective for future research.MethodsAll data were sourced from the Web of Science Core Collection (WoSCC) on March 1, 2024, for publications between January 1, 2004, and December 31, 2023. Data visualization and analyses, including descriptive statistics, co-occurrence map

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… Clinical study on concurrent use of electro-acupuncture or Chuna manual therapy with pregabalin for chemotherapy-induced peripheral neuropathy: safety and effectiveness (open-labeled, parallel, randomized controlled trial, assessor-blinded) a study protocol . …

Radiotherapy and cytokines: A systems view of immunotherapy and toxicity (Review).

Radiotherapy (RT) is increasingly recognized as a system‑level immunomodulator capable of reshaping cytokine networks across spatial, temporal and dosimetric dimensions. This review synthesizes existing evidence on RT parameters, key signaling axes, major effector cells, organ‑specific contexts and clinical translation. It describes how the cyclic GMP‑AMP synthase/stimulator of interferon genes (STING)/IFN‑I, NF‑κB and TGF‑β pathways coordinate immune activation and immune suppression after irradiation. It then summarizes macrophage‑centered regulatory circuits and chemokine axes, including C‑

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… In models driven by microglial inflammation and neuronal loss, pregabalin has shown neuroprotective effects by blocking HMGB1-mediated TLR2, TLR4 and RAGE/NF-κB signaling and by reducing the production of IL-6, IL-1β and TNF-α ( 179 ). …

Impact of physical exercise in cancer survivors during and after antineoplastic treatments.

Cancer patients experience symptoms and adverse effects of treatments that may last even after the end of treatments. Exercise is a safe, non-pharmacological and cost-effective therapy that can provide several health benefits in cancer patient and survivors, reducing cancer symptoms and cancer treatment side effects. The purpose of this review is to describe how the physical exercise is capable to reduce cancer symptoms and cancer treatment side effects. We realized a pragmatic classification of symptoms, dividing them into physical, psychological and psycho-physical aspects. For each symptom

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… Other drugs used for the treatment of CIPN are venlafaxine (another SNRI), tricyclic antidepressants (such as nortriptyline/amitriptyline) and antiepileptic agents (such as gabapentin and pregabalin) commonly used for the management of neuropathic pain syndromes. … Antidepressants (tricyclic antidepressants, SNRI) and anticonvulsants (gabapentin and pregabalin) are used to treat neuropathic pain, while bisphosphonates plays an important role in the management of cancer related bone pain [ 103 ]. …

Животные модели периферической нейропатии, вызванной химиотерапией, для гематологических заболеваний: обзор.

Химиотерапия это one основные виды лечения гематологовых магнестов. Однако периферическая нейропатия, вызванная химиотерапией (CIPN) one Наиболее часто встречающиеся долгосрочные токсичные реакции в химиотерапии, а также случаи CIPN влияют на качество жизни пациентов и могут приводить к прерыванию химиотерапии в тяжелых случаях, снижая тем самым эффективность химиотерапии. В настоящее время мы резюмируем существующие зверские модели CIPN, включая характеристики нескольких общих животных моделей, таких, как периферическая нейропатия, вызванная бортезомибами, периферическая нейропатия, вызванная

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… Currently, for the management of neuropathic pain, multimodal analgesia is recommended, including opioids (morphine or codeine, etc.), antiepileptic drugs (gabapentin, pregabalin, etc.) and some antidepressants (amitriptyline, venfalacine, or imipramine, etc.) 4 , 5 , 108 , 109 Traditional Chinese medicine …

Pain Management in Patients with Multiple Myeloma: An Update.

Most patients with multiple myeloma (MM) suffer from chronic pain at every stage of the natural disease process. This review focuses on the most common causes of chronic pain in MM patients: (1) pain from myeloma bone disease (MBD); (2) chemotherapy-induced peripheral neuropathy as a possible consequence of proteasome inhibitor therapy (i.e., bortezomib-induced); (3) post-herpetic neuralgia as a possible complication of varicella zoster virus reactivation because of post-transplantation immunodepression; and (4) pain in cancer survivors, with increasing numbers due to the success of antiblasti

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… Current guidelines on neuropathic pain suggest as first-line treatment, in monotherapy, gabapentin (1200–3600 mg daily), pregabalin (300–600 mg daily), duloxetine (60–120 mg daily), venlafaxine (150–225 mg daily), and tricyclic antidepressants (TCAs) (25–150 mg daily). …

Assessment and monitoring of patients receiving chemotherapy for multiple myeloma: strategies to improve outcomes.

Improved understanding as to the biology of multiple myeloma (MM) and the bone marrow microenvironment has led to the development of new drugs to treat MM. This explosion of new and highly effective drugs has led to dramatic advances in the management of MM and underscores the need for supportive care. Impressive and deep response rates to chemotherapy, monoclonal antibodies, and small molecule drugs provide hope of a cure or prolonged remission for the majority of individuals. For most patients, long-term, continuous therapy is often required to suppress the malignant plasma cell clone, thus

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… chemotherapy agents is necessary For moderate loss of sensation, weakness, or pain, chemotherapy must be held and decreased once acute symptoms resolve • Secondary causes of neuropathy, such as vitamin B deficiency, are common and must be ruled out Pain medications, anticonvulsive agents (gabapentin, pregabalin …

Продуктирует ли анальгезия в тригеминальной невралгии? Обновленный системный обзор и метаанализ.

Предыстория/цели: Тригеминальная нейронгия (ТН) представляет собой излучающееся состояние, которое в основном регулируется в рамках первичной медико-санитарной помощи, где карбамазепин остается единственной рекомендуемой терапией первой линии. Предварительные метаанализы сообщают о сокращении боли в конце лечения с помощью иглоукалывания, но не приводят к стратифицированным результатам в силу риска предвзятости, проверяют качество отчетности о результатах боли или изучают вопрос о том, сохраняются ли последствия анальгезии после периода лечения. В рамках этого обновленного систематического обз

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… When first-line therapy fails, second-line oral options including gabapentin, pregabalin, baclofen, and lacosamide are frequently used [ 11 ]. Surgical alternatives carry risks of sensory loss and recurrence [ 12 ]. …

Нейрогенная желудочно-кишечная, мочевая и сексуальная дисфункция при множественном склерозе: многодисциплинарная основа для клинической практики.

Нейрогенные желудочно-кишечные, мочевые и сексуальные симптомы широко распространены у людей с множественным склерозом и существенно ухудшают качество жизни, повседневное функционирование и психосоциальное благополучие. Несмотря на их частотность и клиническую актуальность, управление по-прежнему носит разрозненный характер по различным специальностям, тесная взаимосвязь между этими симптомами зачастую игнорируется, а у клинических работников отсутствует прагматическая основа, адаптированная к различным условиям здравоохранения. Этот обзор преобразует нынешние данные в прагматичную модель уход

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… Among neuropathic pain medications, gabapentin is less frequently associated with sexual dysfunction, while pregabalin effects on sexual function seem to be dose independent. Combined oral contraceptive pills can decrease libido and a pill switch can be tried. …

Leiomyosarcomas of the Great Saphenous Vein: Diagnostic and Therapeutic Strategies to Prevent Unplanned Excisions and Improve Oncologic, Functional, and Psychological Outcomes.

Background/objectivesThere are very few publications on unplanned excisions of great saphenous vein leiomyosarcomas (GSV-LMS), and their impact on the prognosis of the disease is not well known. The objective of this study is to present a series of nine new leiomyosarcomas of the great saphena vein (LMS-GSV) cases, with the aim of increasing diagnostic awareness and proposing guidelines for therapeutic management.MethodsThis is a prospective single-centre study of a series of nine GSV-LMS in thigh (stage IIIA AJCC), knee and proximal leg (IB, 1 II and 3 IIIA), and ankle (2 IIIB and 1 II). Eigh

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… Case 3 had neuropathic pain that required treatment with pregabalin and duloxetine prescribed by the Pain Unit. Currently, she has improved and reports tolerable pain that only requires occasional analgesics. …

Cannabinoids: an Effective Treatment for Chemotherapy-Induced Peripheral Neurotoxicity?

Chemotherapy-induced peripheral neurotoxicity (CIPN) is one of the most frequent side effects of antineoplastic treatment, particularly of lung, breast, prostate, gastrointestinal, and germinal cancers, as well as of different forms of leukemia, lymphoma, and multiple myeloma. Currently, no effective therapies are available for CIPN prevention, and symptomatic treatment is frequently ineffective; thus, several clinical trials are addressing this unmet clinical need. Among possible pharmacological treatments of CIPN, modulation of the endocannabinoid system might be particularly promising, espe

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… recruiting) status registered at ClinicalTrials.gov Clinical trial description, as reported in ClinicalTrial.gov | Status Pharmacological treatments (other than cannabinoids, n = 16) | Study of nicotine for pain associated with chemotherapy-induced peripheral neuropathy | Recruiting Memantine XR and pregabalin …

A novel nonlive, adjuvanted herpes zoster subunit vaccine: a report on the emerging clinical data and safety profile.

Herpes zoster (HZ) is an acute vesicular dermatitis with a typical dermatomal distribution, caused by the varicella zoster virus (VZV), often preceded and accompanied by prodromal pain or pruritus. HZ may be related to several complications such as postherpetic neuralgia (PHN). The incidence and severity of the disease increase with aging, due to immunosenescence and in particular to the decline of the specific cell-mediated immunity (CMI). The impact of HZ in terms of morbidity and short- and long-term complications, the availability of suboptimal treatment options to date, and the high costs

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… Treatment of this complication is difficult and is based on symptomatic drugs (lidocaine and capsaicin for local use, gabapentin and pregabalin, and tricyclic antidepressants). …

Bortezomib in the management of multiple myeloma.

Multiple myeloma (MM) is a B-cell malignancy characterized by clonal expansion of plasma cells within the bone marrow, the presence of a serum and/or urine monoclonal protein, lytic bone lesions, and anemia. On a cellular level, the disease is characterized by complex interactions between tumor cells and the surrounding bone marrow microenvironment. Understanding of the relationship between malignant plasma cells and the microenvironment has sparked ongoing efforts to develop targeted therapeutic agents for treatment of this disease. The successful development of the first-in-class small-molec

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… Options that have proven effective in this respect include the anticonvulsants gabapentin and pregabalin; serotonin-norepinephrine reuptake inhibitors such as duloxetine; tricyclic antidepressants amitriyptyline and desipramine; and opioids such as oxycodone, morphine sulfate, and hydrocodone. 63 Table …

Role of lysophosphatidic acid and its receptors in health and disease: novel therapeutic strategies.

Lysophosphatidic acid (LPA) is an abundant bioactive phospholipid, with multiple functions both in development and in pathological conditions. Here, we review the literature about the differential signaling of LPA through its specific receptors, which makes this lipid a versatile signaling molecule. This differential signaling is important for understanding how this molecule can have such diverse effects during central nervous system development and angiogenesis; and also, how it can act as a powerful mediator of pathological conditions, such as neuropathic pain, neurodegenerative diseases, an

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… production. 135 , 136 Moreover, acting through LPAR1, LPA mediates dorsal root demyelination, which has also been related to neuropathic pain-behaviors and LPAR1 signaling upregulates Ephrin B1 and the α2δ1 calcium channel subunit (CA V α2δ1) in the DRG. 125 , 138 , 139 Interestingly, gabapentinoids (e.g., pregabalin … This potentially provides an advantage to duloxetine and pregabalin, two of the most common pharmacological agents used to treat neuropathic pain symptoms, and that preferentially act by suppressing the symptoms related to the activity of non-TRPV1-expressing neurons. …

Neuroinflammatory Process Involved in Different Preclinical Models of Chemotherapy-Induced Peripheral Neuropathy.

Peripheral neuropathies are characterized by nerves damage and axonal loss, and they could be classified in hereditary or acquired forms. Acquired peripheral neuropathies are associated with several causes, including toxic agent exposure, among which the antineoplastic compounds are responsible for the so called Chemotherapy-Induced Peripheral Neuropathy (CIPN). Several clinical features are related to the use of anticancer drugs which exert their action by affecting different mechanisms and structures of the peripheral nervous system: the axons (axonopathy) or the dorsal root ganglia (DRG) ne

Курс химиотерапии, вызванной периферической нейропатией (CIPN) у гематологических пациентов, проходящих лечение винкристином, бортезомидомидом или линалидомидом: исследование НОВИТ.

Для оценки и описания периферической нейропатии, вызванной химиотерапией (CIPN), широко известное осложнение лечения рака с использованием различных методологий у гематологов. В это исследование были включены методы лечения с помощью винкристина, бортезомида или линалидомида. Пациенты осматривались до начала лечения (базового) перед каждым циклом химиотерапии, one через месяц после окончания лечения и one Год после исходного показателя с использованием результатов, сообщенных пациентами (Функциональная оценка раковых заболеваний/гинекологическая онкология) Group-Ntx-13 (ФАКТ/GOG-Ntx-13) и резу

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… Other treatment options included exercise therapy, acupuncture, scrambler therapy, gabapentin/pregabalin, tricyclic antidepressant, and venlafaxine. However, the utility of the latter options all requires further validation. …

Therapies in Stiff-Person Syndrome: Advances and Future Prospects Based on Disease Pathophysiology.

Among the glutamic acid decarboxylase (GAD)-antibody-spectrum disorders, the most common phenotypic subset is the stiff-person syndrome (SPS), caused by impaired GABAergic inhibitory neurotransmission and autoimmunity characterized by very high titers of GAD antibodies and increased GAD-IgG intrathecal synthesis. If not properly treated or untreated because of delayed diagnosis, SPS progresses leading to disability; it is therefore fundamental to apply the best therapeutic schemes from the outset. This article is focused on the rationale of specific therapeutic strategies based on the SPS path

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… Pregabalin, which structurally is similar to GABA, does not bind GABA but binds to voltage gated calcium channel; it helps the pain but not the spasms, and it is less preferable. …

Complication avoidance, rehabilitation, pain therapy and palliative care for patients with metastatic spine tumors: WFNS spine committee recommendations.

ObjectiveThis review aims to formulate the most current, evidence-based recommendations regarding complication avoidance, rehabilitation, pain therapy and palliative care for patients with metastatic spine tumors.MethodsA systematic literature search in PubMed and MEDLINE, and was performed from 2013 to 2023 using the search terms "complications" + "spine metastases", "spine metastases" + + "rehabilitation", "spine metastases" + "pain therapy" + "palliative care". Screening criteria resulted in 35, 15 and 56 studies respectively that were analyzed. Using the Delphi method and two rounds of vot

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… Recommendation for NCP treatment as monotherapy exists for gabapentin, pregabalin, duloxetine and TCA (doses ≤ 75 mg/day) with, n case of insufficient analgesia, an opioid switching concept, which contains use of adjuvant drugs such as gabapentinoids,, and antidepressants (amitriptyline) as well as methadone …

Recent Advances in the Treatment and Supportive Care of POEMS Syndrome.

POEMS is a rare clonal plasma cell disorder characterized by multi-systemic features that include demyelinating peripheral neuropathy, organomegaly, endocrinopathy, presence of monoclonal proteins (M-protein), and skin changes. Even though the pathophysiology is poorly understood, recent studies suggest that both clonal and polyclonal plasmacytosis leading to the production of pro-inflammatory cytokines and angiogenic mediators play the central role. These mediators including vascular endothelial growth factor (VEGF) are the driving forces of the syndrome. The diagnosis of POEMS is not always

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… To alleviate the pain of neuropathy, different drugs can be used: gabapentin, pregabalin, amitriptyline, duloxetine, topical lidocaine patches, topical ketamine, lidocaine, etc. [ 44 , 114 , 115 ]. …