BACKGROUND: Peripheral nerve injury is associated with a spinal microglial response that has been correlated with the development of behaviours reflective of neuropathic pain. METHODS: To examine whether this phenomenon is generalizable to neuropathic pain of non-traumatic aetiology, this study investigated the association between spinal microgliosis and behavioural measures of ...

Neuropathic pain (NeuP) is challenging to diagnose and manage, despite ongoing improved understanding of the underlying mechanisms. Many patients do not respond satisfactorily to existing treatments. There are no published guidelines for diagnosis or management of NeuP in South Africa. A multidisciplinary expert panel critically reviewed available evidence to provide ...

ABSTRACT: We analysed GCH1 in symptomatic HIV-associated sensory neuropathy (HIV-SN) in Southern Africans including a 'pain protective' 3-SNP haplotype and 6 SNPs, analysed individually and in a 6-SNP haplotype. The 'pain protective' 3-SNP haplotype and a 6-SNP haplotype containing these alleles associated with a reduced risk of pain. Another 3-SNP ...

Current reports on human immunodeficiency virus (HIV) pain are limited to epidemiological data on neuropathic pain in HIV and most studies were conducted before the availability of highly active antiretroviral therapy. Complex pain was reported to be highly prevalent and associated with advanced disease. The authors conducted a retrospective review ...

We investigated the prevalence and intensity of pain, factors associated with having pain, and analgesic medications employed in a population consisting predominantly of Black African and female human immunodeficiency virus (HIV)-positive individuals attending outpatient clinics in a rural (n = 125; 79% female; 100% Black African) and a metropolitan (n = 396; 75% female; ...

Neuropathic pain is caused by the peripheral or central nervous system structure damage or dysfunction. VEGF is involved in nociception and inflammation. VEGF may target VEGF receptor-2 (VEGFR-2) on the surface of neurons. P2X(2/3) receptors play a crucial role in facilitating pain transmission at the spinal sites. Chronic constriction injury ...

Different types of behavioural, dietary, interventional, pharmacologic, and surgical therapies have been used to treat painful bladder syndrome/interstitial cystitis (PBS/IC). Because of the paucity of randomised placebo-controlled studies on different treatments, an evidence-based management approach has not yet been developed. To critically review and synthesize data from a wide range ...

To explore the roles of pain and urgency in the nocturia of patients with interstitial cystitis/painful bladder syndrome (IC/PBS). In a longitudinal study of incident IC/PBS cases, we assessed the associations of the presence and severity of nocturia with the presence and severity of pain and urgency, using multivariate analyses ...

The first-line treatment of obstructive sleep apnea (OSA) is positive airway pressure (PAP). If PAP fails to adequately treat the OSA, oral appliances that enlarge the airway (mandibular advancement devices primarily, or the tongue retaining device if the patient has no dentition) are the next line of therapy. The third-line ...

Neonatal care is advancing to levels where more neonates are now offered more invasive interventions, exposing them to more prolonged hospital care. Consequently, the provision of effective and consistent management of pain in these neonates has become a pressing challenge. Advances in neonatal care have not only increased the number ...

The synthesis and SAR of a series of indazole TRPV1 antagonists leading to the discovery of 21 (ABT-116) is described. Biological studies demonstrated potent in vitro and in vivo activity for 21, as well as suitable physicochemical and pharmacokinetic properties for advancement to clinical development for pain management.

BACKGROUND.: The management of bisphosphonate-related osteonecrosis of the jaws (BRONJ) is challenging and controversial. At present, there is no established medication treatment for the disease. METHODS.: A 78-year-old osteoporotic woman with osteonecrosis of the mandible related to alendronate therapy was referred for treatment. The disease was unresponsive to conservative therapy, ...

Critical limb ischemia (CLI) continues to form a substantial burden on Western health care. Despite recent advances in surgical and radiological vascular techniques, a large number of patients is not eligible for these revascularisation procedures and faces amputation as their ultimate treatment option. Growth factor therapy and stem cell therapy ...

Spine surgery has made radical advancements in the last two decades and provision has expanded a great deal. The history of the technical development is briefly reviewed. To analyze trends in utilization and to assess the macroeconomic demand for spine surgery, the incidence of all spine surgery per capita is ...

Total pain theory. Describe total pain theory and apply it to research and practice in advanced heart failure (HF). Total pain theory provides a holistic perspective for improving care, especially at the end of life. In advanced HF, multiple domains of well-being known to influence pain perception are adversely affected ...

Recent therapeutic advances have the potential to improve outcomes of mucormycosis. Lipid formulations of amphotericin B (LFAB) have evolved as the cornerstone of primary therapy for mucormycosis. Posaconazole may be useful as salvage therapy, but it cannot be recommended as primary therapy for mucormycosis on the basis of available data. ...

With the advent of cell-based therapies, biologics, and pharmaceuticals for the potential treatment of osteonecrosis, it is important to conduct evaluations using scientifically accepted outcomes measures. For the treatment of osteonecrosis, most studies have focused on pain relief, surgery, or the need for surgery, disease progression (advancing stage), and change ...

PURPOSE OF REVIEW: Examines the effects of bariatric surgery on adolescent obesity. RECENT FINDINGS: The risks and outcomes of bariatric surgery in adolescence are presently being defined and may be somewhat different from those in adults. Adolescents may have a greater risk of weight regain, and greater risk of noncompliance ...

In the advancing era of molecular therapy of solid tumours, emergency treatment of complications, such as bowel perforation, haemorrhage, and tumour rupture, is likely to evolve into one of the main challenges of surgical oncology. These complications might be caused by disease progression from resistance to therapy, side-effects of therapy ...

In this report, we describe a case of bilateral non-syndromic hereditary lymphedema praecox of lower legs. The patient was diagnosed at age 16. Ten years later, he was unable to ambulate due to increased bilateral lower leg volume, continuous pain, and recurrent episodes of cellulitis. He was treated at our ...

BACKGROUND: The transient receptor potential (TRP) superfamily of ion channels are a large and diverse group that have received increased attention in recent years. The sub-family of thermo-TRPs which are regulated by temperature, among other physical and chemical stimuli, are of particular interest for the development of potential pain therapeutics. ...

INTRODUCTION: Chondrosarcomas and chordomas are usually chemoresistant bone tumors and may have a poor prognosis when advanced. They are usually associated with worsening pain difficult to control. PATIENTS AND METHODS: Zoledronic acid was used in a 63-year-old man with metastatic chondrosarcoma and in a 66-year-old woman with a diagnosis of ...

French law 2005-370 of April 22, 2005 (Leonetti's law) brings new rights to patients and clarifies medical practices regarding end of life care. This new law prohibits unreasonable obstinacy in investigations or therapeutics and authorizes the withholding or withdrawal of treatments when they appear "useless, disproportionate or having no other ...

The vanilloid receptor TRPV1 is a homotetrameric, non-selective cation channel abundantly expressed in the nociceptors (c-fibers). TRPV1 is considered as a highly validated pain target because, i) its agonists such as capsaicin cause desensitization of TRPV1 channels that relieves pain behaviors in preclinical species, and ii) its antagonists relieve pain ...

The development of therapies for T1D has been neglected in favor of efforts in advancing therapies for the larger T2D population. Pharmaceutical companies have also been deterred by lack of clarity around the regulatory expectations for such therapies. The prospects for therapy for new-onset T1D have brightened in some respects ...

PURPOSE OF REVIEW: The purpose of this review is to provide an overview of recent advances in the development of histone deacetylase inhibitors (HDACi) for the treatment of cancer. RECENT FINDINGS: Recently, there has been a dramatic expansion of HDACi clinical investigation. There are now 11 HDACi in clinical trial, ...

PURPOSE OF REVIEW: To review the current standard of care in the diagnosis and treatment of idiopathic intracranial hypertension (IIH). We also discuss recent advances in the understanding of the pathogenesis of IIH with emerging trends in management of this syndrome. RECENT FINDINGS: There has been increasing literature suggesting a ...

Children represent a unique group of patients who are likely to greatly benefit from minimally invasive surgery (MIS). The promise of less postoperative pain, smaller scars, shorter hospital stays, and a faster return to school continues to drive growth in this area. The development of pediatric-specific techniques and documentation of ...

Numerous studies referring to conventional chemotherapy for aggressive fibromatosis with the use of doxorubicin, cyclophosphamide, vincristin, vinblastine and other drugs have been published. Imatinib mesylate is a recently developed oral anticancer agent designed to selectively inhibit tyrosine kinases implicated in oncogenesis and it seems to represent a promising opportunity (also ...

PURPOSE OF REVIEW: To give a summary of recent advances in argon plasma coagulation (APC) therapy in gastroenterology. RECENT FINDINGS: APC has gained importance in gastrointestinal endoscopy during the last decade, and APC technology has improved over time. Recently published studies, mainly consisting of case series, have shown that APC ...

Cushing disease is most frequently caused by pituitary adenomas that secrete adrenocorticotrophic hormone. Transsphenoidal surgery is the treatment of choice in patients with these tumors because of reported remission rates of 69-93%. More challenging for neurosurgeons and endocrinologists, however, is management of the remaining patients whose Cushing disease is refractory ...

With the introduction of percutaneous local ablation therapy (PLAT) including radiofrequency ablation and percutaneous ethanol injection in clinical settings, the treatment of small hepatocellular carcinoma (HCC) has dramatically changed. In this article, we review recent evidence regarding the treatment of small HCC based on articles published after January 2003. Twenty-five ...

BACKGROUND: Recent surgical advances have resulted in fetal surgery becoming an option for children with myelomeningocele (MMC). However, there is little information about the parents' attitudes towards such therapy. METHODS: Following a lecture on the current status and problems of fetal surgery for MMC, a 12-item questionnaire was administered to ...

Acute renal failure (ARF) is one of the most common complications of leptospirosis although the causal mechanisms are still unclear. Diverse mechanisms are implicated in leptospiral nephropathy and new data supports the role of peculiar ion transport defects. Besides antibiotic therapy, ARF management in leptospirosis requires dialytic therapy which is ...

Practical procedures for treatment of fractures and dislocations have been used since the time of Hippocrates in fourth century BC. Orthopaedic surgery became a recognized part of surgical treatment since the mid-nineteenth century, but saw major developments with the invention of x-rays and antibiotics in the early part of the ...

Infantile hemangiomas are the most common tumors of infancy and commonly last 7 to 9 years. Although their pathophysiology is not completely understood, recent studies have provided useful information regarding differential diagnosis, assessment approaches, and management options. To enhance understanding of infantile hemangiomas and highlight recent advances in knowledge of ...

The inflammatory reaction is normally tightly regulated, and as soon as the original insult has been cleared, a resolution phase starts that aims at leading the tissues back to a normal physiological state. However, after intestinal inflammation, a number of patients develop postinflammatory hypersensitivity symptoms, which can be defined as ...

Transient receptor potential vanilloid 1 (TRPV1) channel antagonists may have clinical utility for the treatment of chronic nociceptive and neuropathic pain. We recently advanced a TRPV1 antagonist, 3 (AMG 517), into clinical trials as a new therapy for the treatment of pain. However, in addition to the desired analgesic effects, ...

PURPOSE OF REVIEW: To review recent evidence that can assist clinicians facing the challenging question of when to offer brain surgery for epilepsy. RECENT FINDINGS: The most robust recent evidence pertains to temporal lobe epilepsy. We focus on this syndrome to assess the main issues pertaining to early surgery, which ...

The surgical management of gastrointestinal stromal tumors (GISTs) has been impacted by the development of tyrosine kinase inhibitors (TKIs), advances in surgical technique, and a better understanding of the natural history of this unique disease. In this article, we review the technical aspects of the operations, the expanding role of ...

PURPOSE OF REVIEW: Despite late modifications and enhancements, traditional penetrating glaucoma surgery is not without complications and is reserved for patients in whom pharmacologic treatment and/or laser trabeculoplasty do not suffice to control the intraocular pressure. This article critically reviews recent advances in penetrating glaucoma surgery with particular attention paid ...

Although positive airway pressure is the most efficacious treatment for obstructive sleep apnea (OSA), its clinical effectiveness is limited by its obtrusive interface. Two alternative treatment modalities used in clinical practice are mandibular advancement devices (MADs) and positional therapy. The goals in treatment of OSA are to prevent obstructive apneas ...

PURPOSE OF REVIEW: The nasal valve is a complex structure that can be weakened from effects of aging, surgery, and trauma. A variety of methods have been described to strengthen the nasal valve region and prevent or treat nasal obstruction, such as batten grafts, spreader grafts, butterfly grafts, flare sutures, ...

Chronic pain is a highly prevalent condition that impacts adversely on individual quality of life, imposes substantial costs on the healthcare system and a considerable burden on society. Advances in the understanding of pain mechanisms have opened the way for the development of new treatment strategies. The continuous delivery of ...

BACKGROUND: Nabilone has been approved to treat chemotherapy-induced nausea and vomiting. Recent studies have explored cannabinoids in pain management. OBJECTIVES: To review the evidence for the use of cannabinoids in general and nabilone in particular; i) in managing chemotherapy-induced nausea and vomiting; and ii) in treating pain. METHOD: A systematic ...

Pain palliation can be challenging in patients with metastases to the musculoskeletal system, and conventional therapy can be less than optimal for pain management. Recent advances in technology have allowed for the addition of image-guided ablation to the armamentarium for treating musculoskeletal metastases. This article focuses on one such technique, ...

There is virtually no literature on the effect of correction of syndromal faciocraniosynostosis with monobloc advancement on the palpebral fissure shape. Using image processing software, we measured the effect of monobloc advancement on the position of the upper and lower eyelids as well as the palpebral fissure slant in a ...

This report reviews international vacation and holiday laws and finds that the United States is the only advanced economy that does not guarantee its workers any paid vacation or holidays. As a result, one in four U.S. workers do not receive any paid vacation or paid holidays. The lack of ...

The National Cancer Institute-sponsored Advanced Technology Quality Assurance (QA) Consortium, which consisted of the Image-Guided Therapy QA Center, Radiation Therapy Oncology Group, Radiological Physics Center, Quality Assurance Review Center, and Resource Center for Emerging Technologies, has pioneered the development of an infrastructure and QA method for advanced technology clinical trials ...

This tribute article to Professor Barry J. Sessle summarizes the 6 presentations delivered at the July 1, 2008 symposium at the University of Toronto. The symposium honored 3 "giants" in orofacial neuroscience, Professors B. J. Sessle, J. P. Lund, and A. G. Hannam. The 6 presentations paying tribute to Sessle ...