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Prevalence and risk factors of clinical diabetic polyneuropathy in a Portuguese primary health care population.

OBJECTIVE: Distal symmetrical polyneuropathy in diabetics (DPN) has a variable prevalence around 30% and increases the risk for foot ulcers and amputations. We aimed at evaluating the prevalence of clinical DPN and associated risk factors in patients followed in primary care centers. MATERIAL AND METHODS: 101 type 2 diabetics were evaluated and 8 were excluded due to the presence of other causes of neuropathy. The remaining 93 had a mean age of 65.4 +/- 10.1 years and a mean diabetes duration of 10.1 +/- 11.1 years, 60.2% were women and 39.8% men. DPN was defined as the presence of both alter

Caspase-mediated cleavage of actin and tubulin is a common feature and sensitive marker of axonal degeneration in neural development and injury.

BACKGROUND: Axon degeneration is a characteristic feature of multiple neuropathologic states and is also a mechanism of physiological neurodevelopmental pruning. The vast majority of in vivo studies looking at axon degeneration have relied on the use of classical silver degeneration stains, which have many limitations including lack of molecular specificity and incompatibility with immunolabeling methods. Because Wallerian degeneration is well known to involve cytoskeletal disassembly and because caspases are recently implicated in aspects of this process, we asked whether antibodies directed

Neuronal and non-neuronal TRPA1 as therapeutic targets for pain and headache relief.

The transient receptor potential ankyrin 1 (TRPA1), a member of the TRP superfamily of channels, has a major role in different types of pain. TRPA1 is primarily localized to a subpopulation of primary sensory neurons of the trigeminal, vagal, and dorsal root ganglia. This subset of nociceptors produces and releases the neuropeptide substance P (SP) and calcitonin gene-related peptide (CGRP), which mediate neurogenic inflammation. TRPA1 is characterized by unique sensitivity for an unprecedented number of reactive byproducts of oxidative, nitrative, and carbonylic stress and to be activated by

Linezolid-induced rare triad of hypoglycaemia, bone marrow suppression and hyponatraemia in elderly.

WHAT IS KNOWN AND OBJECTIVE: Linezolid, a member of the oxazolidinone class of antibacterial drugs, is approved by the US Food and Drug Administration (FDA) for the treatment of vancomycin-resistant Enterococcus faecium infections, nosocomial and community-acquired pneumonia, as a part of anti tubercular regimen and complicated and uncomplicated skin and soft tissue infections, including diabetic foot infections. Linezolid has potential adverse effects like bone marrow suppression, peripheral neuropathy and hyponatremia. One of the extremely rare reported adverse effects of the drug is hypogly

Fracture patterns and associated risk factors in pediatric and early adulthood type 1 diabetes: Findings from a nationwide retrospective cohort study.

PURPOSE: People with pediatric and early adulthood type 1 diabetes (T1D) might have a higher fracture risk at several sites compared to the general population. Therefore, we assessed the hazard ratios (HR) of various fracture sites and determined the risk factors associated with fractures among people with newly diagnosed childhood and adolescence T1D. METHODS: All people from the UK Clinical Practice Research Datalink GOLD (1987-2017), below 20 years of age with a T1D diagnosis code (n = 3100) and a new insulin prescription, were included and matched 1:1 by sex, age, and practice to a contro

Cocaine addiction as a neurological disorder: implications for treatment.

Clinical and preclinical studies provide convincing evidence for persistent neurological/psychiatric impairments and possible neuronal degeneration associated with chronic cocaine/stimulant abuse. These impairments include multifocal and global cerebral ischemia, cerebral hemorrhages, infarctions, optic neuropathy, cerebral atrophy, cognitive impairments, and mood and movement disorders. These findings may encourage the placement of stimulant addiction into the category of organic brain disorders. Functional and microanatomical anomalies in the frontal and temporal cortex as well as other brai

Non-opioid analgesics and the risk of restless leg syndrome-a spurious association?

OBJECTIVES: The aim of this study was to evaluate the prevalence and risk factors of restless leg syndrome in a secondary care patient population maintained on tricyclic and serotonin re-uptake inhibiting antidepressants. STUDY DESIGN: Prospective observational study. STUDY POPULATION: Two hundred and forty-three patients of a single practice specializing in the treatment of affective and anxiety disorders. Patients younger than 30 years and those with neurologic diseases such as Parkinson's disease, multiples sclerosis and dementia were excluded, as well as those with schizophrenia or other

Herbal medicinal products or preparations for neuropathic pain.

BackgroundNeuropathic pain is a consequence of damage to the central nervous system (CNS), for example, cerebrovascular accident, multiple sclerosis or spinal cord injury, or peripheral nervous system (PNS), for example, painful diabetic neuropathy (PDN), postherpetic neuralgia (PHN), or surgery. Evidence suggests that people suffering from neuropathic pain are likely to seek alternative modes of pain relief such as herbal medicinal products due to adverse events brought about by current pharmacological agents used to treat neuropathic pain. This review includes studies in which participants w

Effectiveness and safety of modified fully oral 9-month treatment regimens for rifampicin-resistant tuberculosis: a prospective cohort study.

BACKGROUND: In 2020, WHO guidelines prioritised the use of a standard fully oral short treatment regimen (STR) consisting of bedaquiline, levofloxacin or moxifloxacin, ethionamide, ethambutol, high-dose isoniazid, pyrazinamide, and clofazimine for the management of rifampicin-resistant tuberculosis. A high prevalence of resistance to constituent drugs precluded its widespread use by countries in the WHO European region. We evaluated three 9-month fully oral modified STRs (mSTRs) in which ethionamide, ethambutol, isoniazid, and pyrazinamide were replaced by linezolid, cycloserine, or delamanid

AGA Clinical Practice Update on Diagnosis and Management of Acute Hepatic Porphyrias: Expert Review.

DESCRIPTION: The acute hepatic porphyrias (AHP) are rare, inborn errors of heme-metabolism and include acute intermittent porphyria, hereditary coproporphyria, variegate porphyria, and porphyria due to severe deficiency of 5-aminolevulinic acid dehydratase. Acute intermittent porphyria is the most common type of AHP, with an estimated prevalence of patients with symptoms of approximately 1 in 100,000. The major clinical presentation involves attacks of severe pain, usually abdominal and generalized, without peritoneal signs or abnormalities on cross-sectional imaging. Acute attacks occur mainl

Prevalence of Chemotherapy-Induced Peripheral Neuropathy in Multiple Myeloma Patients and its Impact on Quality of Life: A Single Center Cross-Sectional Study.

Bortezomib is a pivotal drug for the management of multiple myeloma. However, bortezomib is a neurotoxic anticancer drug responsible for chemotherapy-induced peripheral neuropathy (CIPN). CIPN is associated with psychological distress and a decrease of health-related quality of life (HRQoL), but little is known regarding bortezomib-related CIPN. This single center, cross-sectional study assessed the prevalence and severity of sensory/motor CIPN, neuropathic pain and ongoing pain medications, anxiety, depression, and HRQoL, in multiple myeloma patients after the end of bortezomib treatment. Pap

Clinical practice guidelines on addressing cognitive impairment in treatable dementias.

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B12 as a Treatment for Peripheral Neuropathic Pain: A Systematic Review.

Neuropathic pain describes a range of unpleasant sensations caused by a lesion or disease of the somatosensory nervous system. The sensations caused by neuropathic pain are debilitating and improved treatment regimens are sought in order to improve the quality of life of patients. One proposed treatment for neuropathic pain is vitamin B12, which is thought to alleviate pain by a number of mechanisms including promoting myelination, increasing nerve regeneration and decreasing ectopic nerve firing. In this paper, the evidence for B12 as a drug treatment for neuropathic pain is reviewed. Twenty

Совпадение в полном тексте источника
… When looking into peripheral polyneuropathy of specific aetiologies, the same level of evidence (III) applies to diabetic polyneuropathy and alcoholic neuropathy. …

Case Report: Application of ex-vivo drug sensitivity testing to identify personalized treatment options for an adolescent with diffuse midline glioma.

Diffuse midline glioma (DMG) is a pediatric brain cancer that has a dismal prognosis with limited treatment options. We present the treatment course and outcome of an adolescent male diagnosed with a thalamic DMG carrying a histone H3.3 K27M (H3K27M) alteration. Tumor biopsies were taken at diagnosis for histological analysis, molecular profiling, and ex vivo drug sensitivity testing (DST). Seven months after diagnosis, the patient had recurrent/progressive disease after radiotherapy and an ineffective molecular-guided therapy based on tumor molecular profiling. The patient then started a nove

Small-Fiber Neuropathy: An Etiology-Oriented Review.

BackgroundSmall-fiber neuropathy (SFN), affecting Aδ or C nerve fibers, is characterized by alterations of pain and temperature sensation, as well as autonomic dysfunction. Its diagnosis may still remain challenging as methods specifically assessing small nerve fibers are not always readily available, and standard techniques for large-fiber neuropathies, such as electroneuromyography, yield negative results. Still, skin biopsy for epidermal innervation and quantitative sensory testing allow for diagnosis in the presence of a congruent clinical picture.ObjectivesMany different etiologies may un

Lumbar Sympathicolysis Attenuates Refractory Chemotherapy-Induced Peripheral Neuropathy in the Lower Extremities: A Prospective, Real-World Study.

PurposeCurrently, there are limited effective treatment strategies available for refractory chemotherapy-induced peripheral neuropathy (CIPN). Lumbar sympathicolysis is a minimally invasive therapy and may offer an option for CIPN. This single-center, prospective, observational study aimed to evaluate the efficacy and safety of CT-guided lumbar sympathicolysis in alleviating multiple symptoms of refractory CIPN in the lower extremities.MethodsThis single-arm study conducted at Henan Cancer Hospital from September 2022 to July 2024,twenty-five patients with refractory CIPN in both lower extremi

Metformin-Associated Functional Vitamin B12 Deficiency Presenting as Subacute Combined Degeneration in a 57-Year-Old Man With Diabetes Mellitus.

BACKGROUND Functional vitamin B12 deficiency, also known as metformin-associated cobalamin deficiency, can occur in patients receiving metformin due to impaired gastrointestinal absorption of vitamin B12. This condition can coexist with diabetic neuropathy and may result in impaired myelin formation in the spinal cord and peripheral nerves, leading to subacute combined degeneration of the spinal cord. This report describes a patient with diabetes mellitus and metformin-associated functional vitamin B12 deficiency who presented with subacute combined degeneration of the spinal cord and gastroin

Case Report: Case of subacute combiled deгенерация спинного мозга в связи с хроническим атрофическим гастритом, макроцитической анемией и положительными антисульфатидом IgM и IgG антителами.

Антисульфатидные антитела являются автоантиорганизмами, связанными с различными неврологическими расстройствами. Они были выявлены в нескольких условиях, включая синдром Гильен-Барре, множественный склероз и хронический подстрекательский демиелинизирующий полинропат. Субакустическое комбинированное дегенерирование спинного мозга вызвано главным образом дефицитом витамина В12. Хроническая атрофическая гастритис — сложное состояние, характеризующееся атрофацией и воспалением желудочно-кишечной слизи. На сегодняшний день не было зарегистрировано ни одного случая, когда пациенты с субакутальным ко

Serving Vietnam Veterans Hospitalized Outside the VA System: A Scoping Review of Presumptive Service-Related Illnesses and Presentations.

BackgroundRecent legislation, the MISSION Act and the PACT Act, expanded access to and utilization of non-Department of Veterans Affairs (VA) health care; more Veterans now receive care from non-VA healthcare providers. Hospitalists outside the VA may be less familiar with Veterans' service-related exposures and presumptive service-related conditions. We aimed to summarize research findings on service-related exposures and conditions among Vietnam War Veterans.MethodsUsing Arksey and O'Malley's methodological framework for scoping reviews, we searched PubMed, EMBASE, and Web of Science databas