Journal of pain research
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Journal of pain research · Jan 2019
Ameliorative Effects Of N-Acetylcysteine As Adjunct Therapy On Symptoms Of Painful Diabetic Neuropathy.
Painful diabetic neuropathy (PDN) is a variant of diabetic peripheral neuropathy which is highly prevalent and distressing in diabetic patients. Despite its high burden, the optimal treatment of PDN has remained a clinical challenge. To explain the emergence and maintenance of PDN, increasing attention has been focused on dimensions of inflammation and oxidative toxic stress (OTS). Accordingly, the aim of this study was to investigate the effects of oral N-acetylcysteine (NAC), an agent with known anti-oxidant and anti-inflammatory effects, as an adjunct therapy in patients suffering from PDN. ⋯ The pattern of results suggests that compared to placebo and over a time period of 8 weeks, adjuvant NAC is more efficacious in improving neuropathic pain associated with diabetic neuropathy than placebo. Ameliorative effects of NAC on OTS biomarkers demonstrated that NAC may alleviate painful symptoms of diabetic neuropathy, at least in part by its antioxidant effects.
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Journal of pain research · Jan 2019
Best cut-off point of the cervical facet joint area as a new morphological measurement tool to predict cervical foraminal stenosis.
Purpose: One of the main factor of cervical foraminal stenosis (CFS) is the hypertrophic change of the cervical facet joint. In order to analyze the connection between CFS and the facet joint hypertrophy, we devised a new morphological parameter, called the cervical facet joint cross-sectional area (CFJA). The CFJA has not yet been investigated for its association with CFS. ⋯ In the CFS group, the best cut off-point was 113.14 mm2, with sensitivity =70.6%, specificity =68.6%, and AUC =0.72 (95% CI, 0.66-0.77). Conclusions: CFJA high values were closely associated with a possibility of CFS. We concluded CFJA is easy to use, fast, and useful new morphological parameter to predict CFS.
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Journal of pain research · Jan 2019
ATHENA: A Phase 3, Open-Label Study Of The Safety And Effectiveness Of Oliceridine (TRV130), A G-Protein Selective Agonist At The µ-Opioid Receptor, In Patients With Moderate To Severe Acute Pain Requiring Parenteral Opioid Therapy.
Pain management with conventional opioids can be challenging due to dose-limiting adverse events (AEs), some of which may be related to the simultaneous activation of β-arrestin (a signaling pathway associated with opioid-related AEs) and G-protein pathways. The investigational analgesic oliceridine is a G-protein-selective agonist at the µ-opioid receptor with less recruitment of β-arrestin. The objective of this phase 3, open-label, multi-center study was to evaluate the safety and tolerability, of IV oliceridine for moderate to severe acute pain in a broad, real-world patient population, including postoperative surgical patients and non-surgical patients with painful medical conditions. ⋯ NCT02656875.
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Journal of pain research · Jan 2019
Aggregation properties of triamcinolone acetonide injection in human serum: considerations when performing epidural steroid injections.
Morbidity has been reported as a sequelae of crystalline steroid epidural steroid injections (ESIs), and particulate steroid size, aggregation, and embolization in brain and spinal cord may be the mechanism related to these neurologic effects. ⋯ Fewer large triamcinolone aggregates were noted in the presence of serum when compared to the non-serum control groups. However, when compared to previously studied particulate steroids, it had the largest aggregates when added to serum.
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Journal of pain research · Jan 2019
Case ReportsNear-resolution of persistent idiopathic facial pain with low-dose lumbar intrathecal ziconotide: a case report.
Persistent idiopathic facial pain (PIFP) is a poorly defined and debilitating chronic pain state with a challenging and often inadequate treatment course. This is the first case report identifying the novel use of low-dose lumbar intrathecal ziconotide to successfully treat PIFP with nearly complete resolution of pain and minimal to no side effects. ⋯ This is the first case report describing the use of a single-shot lumbar intrathecal trial of ziconotide and subsequent placement of lumbar (as opposed to thoracic) intrathecal ziconotide pump for PIFP. A single-injection intrathecal trial is a low-risk, viable option for patients with this debilitating and frustrating pain condition. Successful trials and subsequent intrathecal pump placement with ziconotide may supplant multimodal medication management and/or invasive orofacial surgical intervention for PIFP.