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Archive for the ‘Neuropathy’ Category

Suffering From Diabetic Neuropathy? Beware of These Complications –

Wednesday, February 12th, 2020

Diabetic neuropathy is a complication that occurs due to prolonged excessive blood sugar level. It basically damages the nerves present in legs and hands. Depending on the nerves, diabetic neuropathy has affected, you feel the symptom ranging from pain and numbness in legs to digestive problems, and cardiovascular issues.

If you are suffering from diabetes and is not able to control the blood sugar level, the walls of your blood vessels may become weak and get damaged. Apart from diabetes, a combination of factors including smoking, drinking alcohol, genetics, and inflammation in nerves can cause nerve damage. In case of non-availability of timely treatment, the condition may aggravate and lead to various complications. Here, we tell you about them.

Also known as a neuropathic joint, Charcot joint is a progressive joint disorder that causes discomforting pain sensation. It causes joints to deteriorate that shows symptoms including swelling in joints, instability, and joint deformity.

If diabetic neuropathy damages the nerves controlling your bladder, you wont be able to empty it completely. This can lead to the accumulation of bacteria in the bladder and kidneys. This is what is called urinary tract infection. This can make you disable to control the muscles that release urine and feel urination. This can further lead to leakage and unwanted embarrassment.

In case diabetic neuropathy leads to the damage of the nerves controlling the functions of your digestive tract, you will experience constipation, diarrhoea or both. Nerve damage associated with diabetes has been found to cause a condition called gastroparesis in which your stomach either empties too fast or not at all. This can lead to an excessive increase in blood sugar level.

Nerve damage has been found to affect the functions of your sweat gland and thus makes it problematic to control body temperature. If you have autonomic neuropathy, you will experience too much sweating. Notably, too little or no sweating can be debilitating.

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Suffering From Diabetic Neuropathy? Beware of These Complications -


Flex Wheeler Battles Through Nerve Damage, Hits the Gym to Train Back –

Wednesday, February 12th, 2020

Flex Wheeler has gone through a considerable amount over the past several months. It appears that his leg amputation was only one of the hardships that the bodybuilding legend has been going through physically. Now it appears that Flex Wheeler has been afflicted with another ailment.

The veteran bodybuilder has apparently been dealing with neuropathy. But rather than let this nerve damage diagnosis get him down, Flex Wheeler is once again showing the heart and resolve of a champion.

If a leg amputation couldnt keep Flex Wheeler out of the gym then you can bet a little nerve damage isnt going to stop the legend. Here he is hitting the gym to work back like a true savage.

From what everything Flex Wheeler has been through, it appears that nothing can hold this IFBB legend back.

For more news and updates, follow Generation Iron on Facebook, Twitter, and Instagram.

Managing Editor at Generation Iron, Jonathan Salmon is a writer, martial arts instructor, and geek culture enthusiast. Check out his Instagram, Twitter, Facebook, and Sound Cloud for in-depth MMA analysis.

Header image courtesy of Instagram

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Flex Wheeler Battles Through Nerve Damage, Hits the Gym to Train Back -


News from NANS: 10kHz safe and effective for treating painful diabetic neuropathy, multicentre study finds – NeuroNews International

Saturday, February 8th, 2020

A multicentre study across 18 centres finds 10kHz safe and effective for the treatment of painful diabetic neuropathy. Sensory improvements were observed in many patients who underwent stimulation with these parameters, as well improvements in quality of life measures. Erika Petersen, University of Arkansas for Medical Sciences, Little Rock, USA, presented these data at the North American Neuromodulation Societys (NANS) annual meeting (2326 January, Las Vegas, USA) and told delegates that the study is due to run through 24 months, with later evaluations of health economics and pain medication usage.

Our clinical trial is the largest randomised controlled trial to date, involving 216 patients randomised 1:1 to conventional medical management [n=103] alone or conventional medical management plus high frequency 10kHz stimulation [n=113], explained Petersen.

She added that all patients were evaluated by independent medical monitors before they were enrolled in study, and were required to have at least 5 of 10cm of the visual analogue scale (VAS) as well as a BMI <45 to be included. When looking at the demographics of the two arms, Petersen said, they are identical; no significant differences were observed in terms of duration of diabetes, duration of time of painful diabetic neuropathy, gender, and other factors.

Lead location was T8T11. Petersen posited that this is the typical location for addressing lower limb and lower extremity pain. She further emphasised that one of the endpoints of the study was safety. For the stimulation group, 19 adverse events [occurred] in 15 patients, two of which were rated as a serious adverse event, she acknowledged, adding that one arose due to infection, while the other was acquired at plantation.

I want to highlight our infection rate, Petersen said. People worry about diabetics having a higher risk of infection. But, what we can see for this population, is a 1.8% rate, which is comparable to the majority of studies in the literature for this population.

For the primary endpoint analysis, Petersen and her co-investigators looked at a composite of safety and effectiveness, in terms of pain reduction at three months. Those with 50% pain relief without a worsening neurological deficit from baseline were characterised at responders. Of the patients receiving SCS stimulation, 86% were considered responders at three months, compared to only 5% of patients in the conventional medicine management arm, reported Petersen, adding that the team observed a trial stimulation success rate of 94%.

She alluded to the reduction in VAS scores, which decreased from 7.6 (lower limb VAS) at baseline to 2.4 at one month, and 1.7 at three months. I hope to be able to show you think maintained at 24 months when we present those data in the future, Petersen noted. Moreover, through looking at individual pain relief between the stimulator and the conventional management group, it was revealed that 77% of stimulation patients achieved pain relief, compared to only 5% of controls.

Part of the assessment was to have each investigator assess sensory changes within the patients, Petersen explained. The team had asked patients to draw out subjective diagrams of where they perceived numbness, both at baseline and three months. We were able to perceive what seemed to be a change in sensation in the stimulator population in 72% of those patients, Petersen confirmed.

But pain relief is nothing without improving quality of life, said Petersen, alluding to the fact that investigators examined three measures of sleep, each of which saw significant improvements. They also implemented a six-minute walking test as a means of achieving an objective measure of functional improvement. Compared to the conventional medical management group, the stimulator patients walked further in six minutes at the three-month time point. When you look at this by individuals, Petersen discussed, you can see that it is not across all patients, but the average and median change allows for a longer distance walked [of 39 metres; a 17% increase] in the same amount of time.

In terms of impression of change, both patients themselves as well as the clinicians evaluating them were asked to assess their improvement. In total, 67% of the stimulator population said they are better/a great deal better than baseline, compared to a mere 2% of controls. These findings were reflected throughout a multitude of other functional indicator questionnaires, noted Petersen.

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News from NANS: 10kHz safe and effective for treating painful diabetic neuropathy, multicentre study finds - NeuroNews International


Current and Prospective Treatment Options for Waldenstrm Macroglobulinemia – Hematology Advisor

Saturday, February 8th, 2020

Waldenstrm macroglobulinemia (WM) is a rare lymphoplasmacytic lymphoma that mainly affects elderly patients. Complications of the disease are usually attributable to tumor load or the presence of monoclonal immunoglobulin M (IgM). With limited approved treatment options by the US Food and Drug Administration (FDA), the demand for new therapies is high.

In a review published in Blood, Meletios A Dimopoulos, MD, and Efstathios Kastritis, MD, of the department of clinical therapeutics at the University of Athens in Greece, summarized current literature surrounding the treatment of WM.1 They also reviewed several example cases using clinical data from their institution.

Diagnostic Workup and Indication for Therapy

If the presence of IgM is confirmed by immunofixation electrophoresis, and a bone marrow biopsy reveals infiltration with clonal lymphoplasmacytic cells, a diagnosis of WM is established. Indolent cases are defined as those with less than 10% clonal infiltrate, but there is no established threshold for the amount of clonal cell infiltrate required for diagnosis. Although variation in clonal morphology is high, established cell morphology and immunophenotypic criteria aid in differential diagnosis among other conditions that exhibit a similar phenotype.1

During the initial workup, ruling out other causes of presenting symptoms is important. At initial presentation, the most common symptoms are anemia and cytopenias (42%), B symptoms (25%), and hyperviscosity (17%). As a result, additional laboratory parameters should be measured, including iron studies, serum albumin, lactate dehydrogenase, and beta-2 microglobulin. The measurement of monoclonal IgM levels is also necessary, as hyperviscosity syndrome, a key marker of symptomatic disease, is related to elevated IgM levels; however, this relationship is not linear.1

Another common complication of the disease is peripheral neuropathy, which in many cases is the sole indication for treatment in asymptomatic patients. WM-associated neuropathy is often slowly progressing, sensory, and symmetrical in nature. Hence, rapidly progressing peripheral neuropathy may indicate an unrelated cause.

Because of a prolonged asymptomatic period, often exceeding 5 to 10 years, it is crucial to ensure patients have an indication for therapy. Though some clinical and laboratory indications have been proposed, clinical judgment is often necessary. Monoclonal IgM levels alone are insufficient to determine an indication for therapy. Currently, there are no data to help guide clinical decision making on whether to delay or commence therapy in asymptomatic patients. In these cases, enrollment into a clinical trial may be a suitable option.

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Current and Prospective Treatment Options for Waldenstrm Macroglobulinemia - Hematology Advisor


How integrative medicine is changing the way cancer is treated – Fox Baltimore

Saturday, February 8th, 2020

Cancer has an impact on every part of a patient's life. At GBMC Healthcare, the fight against cancer is about more than treating the disease. Delia Chiaramonte, M.D., Medical Director of Integrative and Palliative Medicine at GBMC, is leading the charge on integrative cancer care.

"It's not just about treating the cancer. It's also about how the person is coping, what side effects they may have from the disease itself or from the treatment, and how those symptoms make their life harder to manage," she says. "Treating the whole person is a really important part of cancer care."

These symptoms can be caused by a variety of internal and external sources, and Dr. Chiaramonte says it's important to get to the root of the cause of the symptom to better treat the patient.

"We hear the patient's symptoms then make an evidence-supported treatment plan that's different for every person, based on what their symptom is and why we think their symptom is happening," she explains.

For example, one person may not be sleeping well because of a physical reaction to chemotherapy. Another may not be getting good sleep because their mind is filled with anxious thoughts about their diagnosis.

Dr. Chiaramonte says there are three main causes of symptoms, and the Integrative Medicine Program makes it easier for patients to get an evidence-based, effective treatment plan and to receive those treatments at the Sandra & Malcolm Berman Cancer Institute at GBMC.

"We pull out all the causes and then address them with the treatment that is likely to work on that particular person, and often it's not just one cause," she explains.

The mind-body connection

The sympathetic nervous system directs our body's "fight or flight" response, which can be caused by both external factors and our own thoughts.

"Because the mind and body are connected, our anxious thinking can generate the 'fight-or-flight' response, and that can result in all kinds of physical symptoms, including increased pain, palpitations, changes in GI function, sleep, and nausea," Dr. Chiaramonte says.

According to Dr. Chiaramonte, there are a variety of ways to help decrease the sympathetic nervous response system, including craniosacral therapy (a light-touch manual therapy technique that works to balance and facilitate healing in the body) and massage. These methods reduce patients' anxiety.

Cancer treatment symptoms

It's no secret that chemotherapy and radiation can be taxing on the body. Nausea, fatigue, and neuropathy (nerve pain caused by damaged nerves) are just some of the side effects of cancer treatments that integrative modalities can help alleviate.

"Some energy medicine has been shown to help chemo-induced peripheral neuropathy," Dr. Chiaramonte says. "Many people come in with fatigue, usually from a combination of poor sleep and treatments. Acupuncture, meditation and guided imagery, reiki (a stress reduction and relaxation technique involving a trained practitioner), and yoga have all been shown to help fatigue."

Physical pain

Dr. Chiaramonte reiterates that the Integrative Palliative Medicine Program is just that: an integrative medicine program and not an alternative to standardized cancer care.

"I treat pain with medicines, with different kinds of opiates and complementary medications," she says. "But acupuncture has been shown to decrease pain. Meditation and guided imagery have been shown to decrease pain. Reiki has been shown to decrease pain. Depending on the person, we may use multiple modalities to help them manage their pain."

Massage is also an oft-used modality for physical pain.

"Often, when something hurts in our body, the muscles around it contract and tighten to try to protect it, and over time it can become the actual contraction of the muscle that hurts, not necessarily the underlying factor," Dr. Chiaramonte says.

She explains this can also tie into the mind-body connection because "if you're generating a lot of anxious thinking, you're more likely to continue to have this muscle tension, and massage can help."

Integrative treatment plans will vary by patient, which Dr. Chiaramonte says is the key to taking care of the mind, body, and spirit of every individual.

"We find out the 'why' behind each patient's symptoms, pull out the causes, and then come up with a plan for that particular patient, using all the tools that work."

For more information Integrative Medicine at GBMC HealthCare, click here.

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How integrative medicine is changing the way cancer is treated - Fox Baltimore


Neuropathy Pain Treatment Market 2020 Industry Sahre, Growth, Top Manufacturers, Globally Development and Forecast to 2025 –

Saturday, February 8th, 2020 has published an innovative statistics of the market titled as Neuropathy Pain Treatment Market. To clarify the various aspects, the analyst studies and elaborates the terms by using qualitative and quantitative research techniques. Finance teams can use a variety of corporate planning applications to fulfil the budgeting, planning & financial modelling, needs of their organization, whatever its size, industry and location.

Graphs, tables, bar graphs and pie charts have been represented in sophisticate manner for the clients to better understand the analysis. To enlarge the businesses, customers get increased rapidly through Neuropathy Pain Treatment industry techniques.

Download Exclusive Sample of Neuropathy Pain Treatment Markets Premium Report @ #request-sample

Leading Establishments (Key Companies):PfizerDepomedEndoGrnenthal GroupArbor PharmaceuticalsEli Lilly

Different regions, such as Americas, United States, Canada, Mexico, Brazil, APAC, China, Japan, Korea, Southeast Asia, India, Australia, Europe, Germany, France, UK, Italy, Russia, Spain, Middle East & Africa, Egypt, South Africa, Israel, Turkey and GCC Countries are focused to give the summarized data about the production of Neuropathy Pain Treatment market.

The global Neuropathy Pain Treatment Market is served as a backbone for the enlargement of the enterprises. To address the challenges, the report examines different key factors such as drivers and opportunities. Restraints are considered for evaluation of risk in market.

Segments covered in the report

This report forecasts revenue growth at a global, regional & country level, and analyses the market trends in each of the sub-segments from 2015 to 2025. For the purpose of this study, VertexMarketInsights have segmented the Neuropathy Pain Treatment market on the basis of type, end-user and region:

Type Outlook (Revenue in Million USD; 20152025):Calcium channel alpha 2-delta ligandsSerotonin-norepinephrine reuptake inhibitors

End Use Outlook (Revenue in Million USD; 20152025):Retail PharmaciesHospitals

Neuropathy Pain Treatment Market Summary: This report includes the estimation of market size for value (million US$) and volume. Estimation methodology validate the market size of Neuropathy Pain Treatment industry, to estimate the size of various other dependent submarkets in the overall market. Secondary research is used to identify the top players in the market, and their market shares have been determined through primary and secondary research. Each type is studied based on classification as Sales, Neuropathy Pain Treatment Market Share (%), Revenue (Million USD), Price and Gross Margin.

If You Have Any Query, Ask Our Experts @ #inquiry-before-buying

Report Objectives:

Target Audience:

Table of Content:

Global Neuropathy Pain Treatment Market Research Report 2020-2025

Chapter 1: Industry Overview

Chapter 2: Neuropathy Pain Treatment Market International and China Market Analysis

Chapter 3: Environment Analysis of Market.

Chapter 4: Analysis of Revenue by Classifications

Chapter 5: Analysis of Revenue by Regions and Applications

Chapter 6: Analysis of Neuropathy Pain Treatment Market Revenue Market Status.

Chapter 7: Analysis of Industry Key Manufacturers

Chapter 8: Conclusion of the Neuropathy Pain Treatment Market Industry 2025 Market Research Report.

Continued to TOC

For more detailed Pdf Copy of Table of Content Describing Current Value and Volume of the Market with All Other Essential Information click @ #table-of-contents

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Tags: Global Neuropathy Pain Treatment IndustryGlobal Neuropathy Pain Treatment MarketGlobal Neuropathy Pain Treatment Market growthGlobal Neuropathy Pain Treatment Market ShareNeuropathy Pain Treatment

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Neuropathy Pain Treatment Market 2020 Industry Sahre, Growth, Top Manufacturers, Globally Development and Forecast to 2025 -


On the track to recovery: Pole vaulters talk about their returns from injuries – The Lafayette

Saturday, February 8th, 2020

After facing months of rehab due to injury, pole vaulters Arielle Sclar 22 and Lulu Knowles 21 recently returned to the track and field team with the support of their teammates, coaching staff, and the sports medicine department.

In the winter of my senior year of high school I was at a pole vault meet, and I landed poorly and tore my ACL and meniscus, Sclar said. I waited the full year to come back which is protocol for ACL surgery, and then there were complications, and I had a second surgery at the start of [the] fall [2019] semester.

Sclar said that it was difficult getting back into pole vaulting after her knee injury since she was not able to do any cardio exercises during rehab. She described her recovery process as long and intensive, but noted the consistent support from her teammates.

Ive never felt disconnected from the team, she said, despite being out for most of last season.

Knowles was injured at the end of her freshman year. Her injuries led her to switch from triple jump to pole vault.

I shattered my kneecap when I was still a triple jumper, she said. I really wanted to be part of the team, and since I was a gymnast, my coach asked if I would pole vault. Sophomore year I had ulnar neuropathy, which I trained and competed through for a while, but then it got really dangerous and I had to get surgery. Ulnar neuropathy, according to Medical News Today, affects the nerve the runs along the arm along the elbow and into the fingers on the outside of the hand.

Track and field head coach Michele Curcio witnessed their recovery and said that they really embraced their rehab.

Sports medicine did a great job of making sure they were ready, Curcio said. Sometimes the student athlete gets ahead of themselves. As an athlete, you think youre going to be able to do things quicker than the normal person.

Both athletes added that not being able to physically participate on the team was challenging at times.

Sometimes its really frustrating watching people do the sport you love when you cannot take part in it, Knowles said. I had contemplated just quitting, I had so many injuries. But sitting out made me realize how much I loved being part of a team and competing. Pole vault definitely gives me that thrill that I love and being out made me love the sport even more.

Its not a great feeling watching everyone else be healthy and doing what you wish you could be doing, Sclar added. But it was easier for me when thinking of how exciting it would be to be back.

While Knowles suffered her injury in a different field event, returning to the same exercise that initially caused the injury, as was the case with Sclar, presented an additional obstacle to their recovery.

The hardest thing is to come back [and] to do that thing that made you hurt, Curcio said. You have to bring them back slowly and break that mental barrier.

The support and positive energy of their teammates played a big role in their recovery and mental toughness.

Every team member here appreciates each other and being on the team, and a lot of them have gone through the same things, so I think that type of support before and after [an injury] is important, Curcio said.

Both Knowles and Sclar are now back with the team and competed last weekend at the DeSchriver Invitational. Knowles and Sclar placed fifth and sixth, respectively, in the pole vault with marks of 2.90 and 2.75 meters. Being back with the team full-time is already having an impact on both women.

People dont recognize how many things go on to make the whole track team be functional and do well, Sclar said. Everyones coming from a very different place to make a common goal as a team unit.

I love our team dynamic, especially this year because we have some freshman who joined and brought great positive energy, Knowles added. Everyone has a different major and a different story, you just get to talk to so many different people.

Knowles, Sclar and the rest of the track and field team return to action today at the University of Albany winter classic in Staten Island, N.Y.

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On the track to recovery: Pole vaulters talk about their returns from injuries - The Lafayette


Kannalife, Inc. CEO Recaps 2019 Advances and Potential Ahead – Yahoo Finance

Wednesday, January 29th, 2020

DOYLESTOWN, Pa., Jan. 28, 2020 (GLOBE NEWSWIRE) -- Kannalife, Inc. (Kannalife or the Company) (KLFE), a biopharmaceutical company specializing in the research and development of cannabinoid therapeutics, announced today that it has issued a letter to its shareholders providing commentary on the Companys recent initiatives and corporate updates.

The Companys Chief Executive Officer, Dean Petkanas, commented: 2019 was a milestone year for Kannalife. Its nice to see dedicated shareholders, management, employees and trusted partners and collaborators bring a small enterprising 10-year-old startup company to the cusp of expansion and commercialization efforts in 2020. With limited resources over the past decade, we have been truly blessed as we have built an impressive track record in the cannabinoid therapeutics space. We can now share the potential of our science with investors as a publicly traded company. We hope our existing and future shareholders will join us in our excitement as Kannalife continues to execute on innovative new technologies in the biotech and pharmaceutical arena.

Highlights of the letter include:

To read the Letter to Shareholders in full, please visit:

About KLS-13019KLS-13019 is Kannalifes leading proprietary investigational CBD-like product for the potential treatment of a range of neurodegenerative and neuropathic pain disorders, beginning with chemotherapy-induced peripheral neuropathy (CIPN). KLS-13019 has not been reviewed or approved for patient use by the U.S. Food and Drug Administration (FDA) or any other healthcare authority in the world. Its safety and efficacy have not been confirmed by FDA-approved research.

About Kannalife, Inc.Kannalife, Inc. is a biopharmaceutical company focused on the development of proprietary and patented cannabidiol (CBD) and CBD-like molecules for patients suffering from unmet medical needs of neurodegenerative disorders - including chemotherapy-induced peripheral neuropathy (CIPN), a chronic neuropathy caused by toxic chemotherapeutic agents; hepatic encephalopathy (HE), a neurotoxic brain-liver disorder caused by excessive concentrations of ammonia and ethanol in the brain; mild traumatic brain injury (mTBI), a disorder associated with single and repetitive impact injuries; and chronic traumatic encephalopathy (CTE) a disease associated with highly repetitive impact injuries in professional and amateur sports.

The Company's family of proprietary molecules focuses on treating oxidative stress-related diseases such as HE, chronic pain from neuropathies like CIPN, and neurodegenerative diseases like CTE. Kannalife conducts its research and development efforts at the Pennsylvania Biotechnology Center of Bucks County in Doylestown, PA.

For more information about Kannalife, Inc., visit and visit the Companys Twitter page at @Kannalife.

Forward-Looking StatementsThis press release may contain certain forward-looking statements and information, as defined within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934 and is subject to the Safe Harbor created by those sections. This press release contains statements about expected future events, the companys business plan, plan of operations, the viability of the companys drug candidates, and/or financial results that are forward-looking in nature and subject to risks and uncertainties. Such forward-looking statements, by definition, involve risks and uncertainties. The company does not sell or distribute any products that are in violation of the United States Controlled Substances Act.


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Kannalife, Inc. CEO Recaps 2019 Advances and Potential Ahead - Yahoo Finance


Health News 2 Use: Customized therapy helps patients recover –

Wednesday, January 29th, 2020

TULSA, Okla. Cancer treatment is more than surgery, radiation and chemotherapy.

Physical and occupational therapy are also important tools in a patient's fight for a normal life.

Merideth Metz used customized therapy to recover from the side effects that can occur with treatment.

When a doctor told Metz to give up after her colon cancer diagnosis, she left and went to Cancer Treatment Centers of America in Tulsa about a year and a half ago.

"No active cancer as of last September, confirmed in October, and now, I'm here for my first three month check," Metz said.

Once her chemotherapy was done, she needed physical therapy, speech therapy and occupational therapy to help with neuropathy that's common after chemo.

"Our job is to focus on the patient's wants," said Barry Calvert, an occupational therapist with CTCA. "Trying to help them stay actively participating in those as best they can throughout the course of their treatment."

Calvert came up with a creative option, like art to document her journey towards healing.

Now, Metz is looking forward to her next effort in the new year.

To learn more about Cancer Treatment Centers of America, click here.

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Health News 2 Use: Customized therapy helps patients recover -


Veteran who died after Montrose-area fire remembered as witty, kind –

Wednesday, January 29th, 2020

MONTROSE TWP, MI The 83-year-old man who died following a fire at a Montrose Township home is being remembered by family as kind.

Firefighters were called out around 6:50 p.m. Jan. 24, to a blaze at the Riverside Mobile Home Park located at the corner of Virginia and Joan drives.

A man inside the home died in the fire. He has been identified by family as Ellis Paul Kuykendall, 83.

Man found dead at scene of Montrose mobile home fire

Lisette McKiernan, Kuykendalls granddaughter, said he was originally from Tennessee but grew up in Las Vegas.

McKiernan took care of Kuykendall for the last decade prior to him moving in with her son Matthew Price several months ago.

Theyd lived in the mobile home park for approximately three weeks before the fire.

Kuykendall was a U.S. Air Force veteran, serving two years of active duty.

He was just a very witty man, said McKiernan. He had a good sense of humor. He was just a very kind individual."

Kuykendall enjoyed playing word searches and rummy. McKiernan kidded that his nurses had to learn the game in order to get in some games.

Hed been diagnosed with neuropathy in his legs that left him wheelchair-bound, McKiernan said.

No other injuries took place in the fire, but McKiernan said her son and two grandchildren -- a 4-year-old boy and a 6-year-old girl -- lost their home.

Were just pretty much devastated right now, she said.

Community members have reached out to Price with donations.

Thank you to the community for reaching out and all their support, said McKiernan. Matthew appreciates everything the community has provided for them.

A GoFundMe page has been set up to help the family transport Kuykendall back to Las Vegas and help Price get back on his feet.

The cause of the fire remains under investigation.

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Veteran who died after Montrose-area fire remembered as witty, kind -


Gene therapy zeroes in as LHON treatment – Ophthalmology Times

Wednesday, January 29th, 2020

Abstract / Synopsis:

Gene therapy for Leber's hereditary optic neuropathy appears highly promising for increasing the best-corrected visual acuity in this patient population.

This article was reviewed by Jiajia Yuan, PhD

Gene therapy for Lebers hereditary optic neuropathy (LHON) seems to be the first promising treatment for the disease.

LHON, a maternally inherited disease, causes optic nerve atrophy that in most cases results in simultaneous or sequential bilateral visual loss. Disease onset typically happens in patients between 14 to 21 years of age.

The most frequently occurring offending mutation is ND4 that appears in about 90% of Chinese patients and in about 50% to 60% of U.S. patients, according to Jiajia Yuan, PhD, Tongjl Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

No treatment is currently available for this disease.

Related:Gene therapy offering hope for retinal, corneal patients

LHON treatmentDr. Yuan and colleagues initially treated nine patients with LHON with gene therapy in 2011. With this first attempt, she reported seven of the nine patients had a significant improvement of 0.3 logarithm of the minimum angle of resolution (logMAR) VA at 36 months in the best-corrected visual acuity (BCVA).

We saw a durable response in six of these patients out to 75 to 90 months after treatment, she said. In addition, a bilateral improvement was achieved, as also was observed by other groups investigating gene therapy.

Gene therapy trialThese promising results prompted a second multicenter gene therapy trial that began in 2017 that include 149 Chinese patients and 10 Argentinian patients.

According to Dr. Yuan, the patients, who ranged in age from 7 to 45 years, received a fixed dose of 1 x 1010 mg/eye for all patients, regardless of age, Dr. Yuan explained.

Related: Research targets precision data for gene, cell therapy

Promising resultsThe treatment was found to be well tolerated and no severe adverse effects occurred, she said.

Keratitis developed in one eye at one month and anterior inflammation in one eye at three months that were both considered to be unrelated to the treatment.

Ocular hypertension was the most common adverse event that developed in 27.04% of eyes that decreased slowly over time after cessation of the steroid.

A significant improvement in the BCVA occurred in 63.21% (67 of 106 patients) at 12 months. The rest of the patients had not reached the 12-month time point at the time of this report. Similar to the initial study, the patients showed bilateral improvement.

This is a real-world study, in that there was no specific patient selection, Dr. Yuan explained. The patients ages spanned a wide range as did the time of disease onset and the pretreatment BCVA.

An evaluation of only the Argentinian patients showed that all had improvement in the BCVA.

These patients fared better overall than the other patients in the group, with the average improvement in the treated eye was 0.6 logMAR and the average improvement in the untreated eye was 0.9 logMAR, Dr. Yuan pointed out.

Related: Gene therapy for LHON: Deciphering phase III data

Importantly, this improvement in the BCVA is highly relevant for the ability of patients to function well during everyday tasks.

And the researchers saw results with the patients that were treated.

Dr. Yuan related that three months after treatment, a patient was able to cook and watch sporting events on the computer.

Dr. Yuan noted that gene therapy is a promising approach for patients with LHON.

Nine patients were treated in 2011 to 2012 and we continue to follow them, she concluded. This is the longest term data from human gene therapy to date.

Related: Gene therapy focus of Schepens lectures at AAO 2019

ConclusionsAccording to Dr. Yuan, nearly two-third of 106 patients who reached the 12-month follow-up point achieved a clinically significant improvement in the BCVA.

Importantly, no serious adverse events occurred in the real-world studies, she said. We are very excited about the potential impact of gene therapy on this disease.

Read more by Lynda Charters

Jiajia Yuan, PhDE: [emailprotected]This article is based on Dr. Yuan's presentation at the American Academy of Ophthalmology's 2019 annual meeting. Dr. Yuan has no financial interest in any aspect of this report.

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Gene therapy zeroes in as LHON treatment - Ophthalmology Times


Medical Foods Market Scope, Segmented By Company, Application and Region, Forecast To 2025 – Science of Change

Wednesday, January 29th, 2020

Global Medical Foods Market: Overview

One of the key factors boosting the growth of the global medical foods market is the rising awareness among the people regarding medical foods. The rising focus of the regulatory bodies on the manufacturing and labelling of medical foods will also be a key factor fuelling the growth of the medical foods market. In addition to this, the high focus by manufacturers on developing disease-specific formulas effective patients nutrition or diet care are also anticipated to result in the growth of the global medical foods market.

The report also enlists various factors which are anticipated to pose a challenge for the growth of the market. The current trends in the market and those that are anticipated to shape the future of the market have been discussed in detail in the report.

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By product, the medical food market is segmented into powder, pill, and others. Of these the powder segment has held a key share in the market as many medical food products are manufactured in powdered form and consumed in a semi solid or liquid form. By application, the global medical foods market is segmented into depression, diabetic neuropathy, ADHD, Alzheimers disease, and nutritional deficiency. Of these, diabetic neuropathy has been accounting for key shares within the market. The risk of neuropathy is boosted with age, diet changes, and unhealthy lifestyle.

In the years to come, it is anticipated that the nutritional deficiencies segment will develop a strong CAGR, as patients being treated for ADHD, autoimmune diseases, and cancer are likely to have high nutritional requirements, which is subsequently anticipated to boost the demand for medical foods.

Global Medical Foods Market: Snapshot

The global medical foods market has become increasingly important in the healthcare sector in recent years due to the rising awareness about its importance in complementing the treatment. Medical food comprises diets designed specifically to overcome the nutritional deficiencies caused by some diseases or to fulfill the specific dietary needs in the management of some diseases. The global medical foods market is likely to receive steady support from the healthcare sector in the coming years due to the rising prevalence of diseases such as Alzheimers among the elderly and ADHD among children, as these diseases are among the prime diseases that necessitate specific diet plans.

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Global Medical Foods Market: Key Trends

The rising geriatric population is a major driver for the global medical foods market. Old people are more likely to develop nutritional disorders as well as to fall prey to other diseases that affect their ability to absorb nutrients from their diet. Nutrition deficiency disorders are also more common among the geriatric demographic than in other patient classes, leading to the geriatric population becoming a key consumer segment for the global medical foods market.

The increasing prevalence of diabetes across the world is another key driver for the global medical foods market. Diabetic neuropathy is the leading application of the global medical foods market and is likely to retain dominance in the coming years. Diabetic neuropathy is becoming common among diabetic patients due to their often unhealthy lifestyles, with close to three-quarters of all diabetes likely to also suffer from some form of neuropathy. This is a key driver for the global medical food market, as the rising prevalence of diabetes in emerging regions has, in conjunction with the rising investment in the healthcare sector, created a conducive environment for growth of the market.

The rising prevalence of ADHD among children is also likely to remain a key driver for the global medical foods market. The growing prevalence of the disease has led to intensive research into its causation and treatment. The role of nutrition in the management of psychological problems such as ADHD has thus come under the scanner. On the opposite end of the spectrum, the rising prevalence of neurodegenerative conditions among the geriatric population is also likely to remain a key driver for the global medical foods market in the coming years.

Global Medical Foods Market: Market Potential

The global medical foods market is likely to witness a steady shift towards pills and away from powders. While powders can be easily mixed with various types of food, many patients dont enjoy their taste. This has led to pills becoming a preferred mode of delivery for many, and are thus likely to rise in demand in the global medical foods market in the coming years.

Apart from leading diseases such as diabetic neuropathy and Alzheimers, other diseases such as phenylketonuria (PKU) are also likely to come under the ambit of the medical food market in the coming years. In April 2017, PKU Sphere, a new medical food for patients of PKU was launched. PKU Sphere is claimed to contain a balanced mix of amino acids and glycomacropeptide, a protein essential for patients of PKU, who cant digest phenylalanine and have to fulfill their protein requirements in alternate ways.

Global Medical Foods Market: Geographical Dynamics

North America is likely to remain the leading regional contributor to the global medical foods market in the coming years due to the ready availability of advanced healthcare technology and a solid database regarding the dietary needs of patients suffering from various diseases. The rising prevalence of diabetes in North America, due primarily to the unhealthy lifestyle practiced by citizens in developed countries such as the U.S., is also likely to be crucial for the medical foods market in North America in the coming years.

Global Medical Foods Market: Competitive Dynamics

The leading players in the global medical foods market include Abbott, Fresenius Kabi AG, Targeted Medical Pharma Inc., Danone, and Primus Pharmaceuticals Inc. The steady support to development of sophisticated disease-specific formulas is likely to benefit the medical foods market in the coming years.

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Medical Foods Market Scope, Segmented By Company, Application and Region, Forecast To 2025 - Science of Change


Peripheral Neuropathy: Causes, Symptoms and Treatments

Tuesday, January 28th, 2020

Your peripheral nervous system connects the nerves from your brain and spinal cord, or central nervous system, to the rest of your body. This includes your:

The job of these nerves is to deliver signals about physical sensations back to your brain.

Peripheral neuropathy is a disorder that occurs when these nerves malfunction because theyre damaged or destroyed. This disrupts the nerves normal functioning. They might send signals of pain when theres nothing causing pain, or they might not send a pain signal even if something is harming you. This can be due to:

The disorder is uncomfortable, but treatments can be very helpful. The most important thing to determine is whether peripheral neuropathy is the result of a serious underlying condition.

More than 100 different types of peripheral neuropathy exist. Each type has unique symptoms and specific treatment options. Peripheral neuropathies are further classified by the type of nerve damage involved. Mononeuropathy occurs when only one nerve is damaged. Polyneuropathies, which are more common, occur when multiple nerves are damaged.

The three types of peripheral nerves are:

Peripheral neuropathy can affect one nerve group or all three.

The symptoms of peripheral neuropathy include:

These symptoms can also indicate other conditions. Make sure you tell your doctor about all of your symptoms.

People who have a family history of peripheral neuropathy are more likely to develop the disorder. However, a variety of factors and underlying conditions may also cause this condition.

Nerve damage caused by diabetes is one of the most common forms of neuropathy. This leads to numbness, pain, and a loss of sensation in the extremities. The risk of neuropathy increases for people who:

According to the University of Chicagos Center for Peripheral Neuropathy (UCCPN), nearly 60 percent of people with diabetes have some sort of nerve damage. This damage is often due to high blood sugar levels.

Other chronic diseases that may cause nerve damage include:

Physical trauma is the most common cause of injury to the nerves. This can include car accidents, falls, or fractures. Inactivity, or holding still too long in one position, can also cause neuropathy. Increased pressure on the median nerve, a nerve in the wrist that supplies feeling and movement to the hand, causes carpal tunnel syndrome. This is a common type of peripheral neuropathy.

Alcohol can have a toxic effect on nerve tissue, putting people with severe alcoholism at a higher risk of peripheral neuropathy.

Exposure to toxic chemicals like glue, solvents, or insecticides, either through chemical abuse or in the workplace, can also cause nerve damage. Additionally, exposure to heavy metals such as lead and mercury can also cause this condition.

Certain viruses and bacteria directly attack nerve tissue.

Viruses such as herpes simplex, varicella-zoster virus, which causes chickenpox and shingles, and Epstein-Barr virus damage sensory nerves and cause intense episodes of shooting pain.

Bacterial infections such as Lyme disease can also cause nerve damage and pain if they arent treated. People with HIV or AIDS can also develop peripheral neuropathy.

Autoimmune diseases like rheumatoid arthritis and lupus affect the peripheral nervous system in various ways. Chronic inflammation and damage to tissues throughout the body, as well as pressure caused by inflammation, can all lead to severe nerve pain in the extremities.

Certain medications may also cause nerve damage. These include:

Recent research in The Journal of Family Practice also suggests that statins, a class of drugs used to lower cholesterol and prevent cardiovascular disease, may also cause nerve damage and increase the risk for neuropathy.

First, your doctor will perform a physical exam and ask about your medical history. If they still cant tell whether your symptoms are due to peripheral neuropathy, other tests to perform include:

Electromyography can show problems with how your bodys nerve signals move to your muscles. For this test, your doctor will place a small needle into your muscle. Your doctor will then ask you to move your muscle gently. Probes in the needle will measure the amount of electricity moving through your muscle. This test may feel like youre receiving a shot. Sometimes the area becomes sore for a few days afterward.

In a nerve conduction study, your doctor places electrodes on your skin. They then pulse tiny amounts of electricity through your nerves to see if the nerves are transmitting signals properly. This procedure is slightly uncomfortable while its happening, but it shouldnt hurt afterward.

The treatment is based on treating the underlying disorder. If diabetes is the cause, making certain that the blood glucose is controlled is important. If a vitamin deficiency is causing the problem, then correcting the deficiency is the treatment. Many treatments can bring relief and help you return to your regular activities. Sometimes a combination of treatments works best.

Over-the-counter (OTC) pain medications like acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen, can be very helpful in controlling moderate pain. If you take them in excess, these drugs can affect your liver or stomach function. Its important to avoid using them for an extended period, especially if you drink alcohol regularly.

Many prescription pain medications can also help to control the pain of this condition. These include narcotics, some antiepileptic medicines, and some antidepressants. Other helpful prescription medicines include:

Prescription drugs for sexual dysfunction in men include:

Your doctor can use several medical treatments to control the symptoms of this condition. Plasmapheresis is a blood transfusion that removes potentially irritating antibodies from your bloodstream. If you get a nerve block, your doctor will inject an anesthetic directly into your nerves.

Transcutaneous electronic nerve stimulation (TENS) doesnt work for everyone, but many people like it because its a drug-free therapy. During TENS, electrodes placed on the skin send small amounts of electricity into the skin. The goal of this treatment is to disrupt nerves from transmitting pain signals to the brain.

Ergonomic casts or splints can help you if your neuropathy affects your:

These casts provide support for the part of your body thats uncomfortable. This can relieve pain. For example, a cast or splint that holds your wrists in a proper position while you sleep can relieve the discomfort of carpal tunnel syndrome.

In addition to OTC pain relievers, many people have found relief for peripheral neuropathy through:

Moderate, regular exercise can also help lessen discomfort.

If you drink alcohol or smoke, consider cutting back or stopping. Both alcohol and tobacco aggravate nerve pain and can cause nerve damage when used for long periods.

If you have peripheral neuropathy, youre potentially at greater risk for accidents in the home. You can do the following to improve your safety:

If your neuropathy is due to an underlying, treatable condition, you may be able to stop your peripheral neuropathy by treating the larger problem. However, if this isnt the case for you, you can successfully manage the symptoms of your peripheral neuropathy. Speak with your doctor to determine the best medical treatment for you, and explore alternative and self-care options that can supplement your medical care.

Even if you have a family history of this disorder, you can help prevent its onset by doing the following:

You can lower your risk of peripheral neuropathy by:

If you have diabetes, take special care of your feet. Wash and inspect your feet daily, and keep the skin moist with lotion.

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Peripheral Neuropathy: Causes, Symptoms and Treatments


Peripheral Neuropathy Fact Sheet | National Institute of …

Tuesday, January 28th, 2020

What is peripheral neuropathy?

Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system, the vast communication network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body. Peripheral nerves send many types of sensory information to the central nervous system (CNS), such as a message that the feet are cold. They also carry signals from the CNS to the rest of the body. Best known are the signals to the muscles that tell them to contract, which is how we move, but there are different types of signals that help control everything from our heart and blood vessels, digestion, urination, sexual function, to our bones and immune system. The peripheral nerves are like the cables that connect the different parts of a computer or connect the Internet. When they malfunction, complex functions can grind to a halt.

Nerve signaling in neuropathy is disrupted in three ways:

Symptoms can range from mild to disabling and are rarely life-threatening. The symptoms depend on the type of nerve fibers affected and the type and severity of damage. Symptoms may develop over days, weeks, or years. In some cases, the symptoms improve on their own and may not require advanced care. Unlike nerve cells in the central nervous system, peripheral nerve cells continue to grow throughout life.

Some forms of neuropathy involve damage to only one nerve (called mononeuropathy). Neuropathy affecting two or more nerves in different areas is called multiple mononeuropathy or mononeuropathy multiplex. More often, many or most of the nerves are affected (called polyneuropathy).

More than 20 million people in the United States have been estimated to have some form of peripheral neuropathy, but this figure may be significantly highernot all people with symptoms of neuropathy are tested for the disease and tests currently dont look for all forms of neuropathy. Neuropathy is often misdiagnosed due to its complex array of symptoms.


More than 100 types of peripheral neuropathy have been identified, each with its own symptoms and prognosis. Symptoms vary depending on the type of nervesmotor, sensory, or autonomicthat are damaged.

Most neuropathies affect all three types of nerve fibers to varying degrees; others primarily affect one or two types. Doctors use terms such as predominantly motor neuropathy, predominantly sensory neuropathy, sensory-motor neuropathy, or autonomic neuropathy to describe different conditions.

About three-fourths of polyneuropathies are length-dependent, meaning the farthest nerve endings in the feet are where symptoms develop first or are worse. In severe cases, such neuropathies can spread upwards toward the central parts of the body. In non-length dependent polyneuropathies, the symptoms can start more toward the torso, or are patchy.


Symptoms are related to the type of nerves affected.

Motor nerve damage is most commonly associated with muscle weakness. Other symptoms include painful cramps, fasciculations (uncontrolled muscle twitching visible under the skin) and muscle shrinking.

Sensory nerve damage causes various symptoms because sensory nerves have a broad range of functions.

Autonomic nerve damage affects the axons in small-fiber neuropathies. Common symptoms include excess sweating, heat intolerance, inability to expand and contract the small blood vessels that regulate blood pressure, and gastrointestinal symptoms. Although rare, some people develop problems eating or swallowing if the nerves that control the esophagus are affected.

There are several types of peripheral neuropathies, the most common of which is linked to diabetes. Another serious polyneuropathy is Guillain-Barre syndrome, which occurs when the bodys immune system mistakenly attacks the nerves in the body. Common types of focal (located to just one part of the body) mononeuropathy include carpal tunnel syndrome, which affects the hand and the wrist, and meralgia paresthetica, which causes numbness and tingling on one thigh. Complex regional pain syndrome is a class of lingering neuropathies where small-fibers are mostly damaged.


Most instances of neuropathy are either acquired, meaning the neuropathy or the inevitability of getting it isnt present from the beginning of life, or genetic. Acquired neuropathies are either symptomatic (the result of another disorder or condition; see below) or idiopathic (meaning it has no known cause).

Causes of symptomatic acquired peripheral neuropathy include:

Genetically-caused polyneuropathies are rare. Genetic mutations can either be inherited or arise de novo, meaning they are completely new mutations to an individual and are not present in either parent. Some genetic mutations lead to mild neuropathies with symptoms that begin in early adulthood and result in little, if any, significant impairment. More severe hereditary neuropathies often appear in infancy or childhood. Charcot-Marie-Tooth disease, also known as hereditary motor and sensory neuropathy, is one of the most common inherited neurological disorders.

The small-fiber neuropathies that present with pain, itch, and autonomic symptoms also can be genetic. As our understanding of genetic disorders increases, many new genes are being associated with peripheral neuropathy.


The bewildering array and variability of symptoms that neuropathies can cause often makes diagnosis difficult. A diagnosis of neuropathy typically includes:

Additional tests may be ordered to help determine the nature and extent of the neuropathy.

Physiologic tests of nerve function

Neuropathology tests of nerve appearance

Autonomic testing

Radiology imaging tests

Muscle and nerve ultrasound is a noninvasive experimental technique for imaging nerves and muscles for injury such as a severed nerve or a compressed nerve. Ultrasound imaging of the muscles can detect abnormalities that may be related to a muscle or nerve disorder. Certain inherited muscle disorders have characteristic patterns on muscle ultrasound.


Treatments depend entirely on the type of nerve damage, symptoms, and location. Your doctor will explain how nerve damage is causing specific symptoms and how to minimize and manage them. With proper education, some people may be able to reduce their medication dose or manage their neuropathy without medications. Definitive treatment can permit functional recovery over time, as long as the nerve cell itself has not died.

Addressing neuropathys causes. Correcting underlying causes can result in the neuropathy resolving on its own as the nerves recover or regenerate. Nerve health and resistance can be improved by healthy lifestyle habits such as maintaining optimal weight, avoiding toxic exposures, eating a balanced diet, and correcting vitamin deficiencies. Smoking cessation is particularly important because smoking constricts the blood vessels that supply nutrients to the peripheral nerves and can worsen neuropathic symptoms. Exercise can deliver more blood, oxygen, and nutrients to far-off nerve endings, improve muscle strength, and limit muscle atrophy. Self-care skills in people with diabetes and others who have an impaired ability to feel pain can alleviate symptoms and often create conditions that encourage nerve regeneration. Strict control of blood glucose levels has been shown to reduce neuropathic symptoms and help people with diabetic neuropathy avoid further nerve damage.

Inflammatory and autoimmune conditions leading to neuropathy can be controlled using immunosuppressive drugs such as prednisone, cyclosporine, or azathioprine. Plasmapheresisa procedure in which blood is removed, cleansed of immune system cells and antibodies, and then returned to the bodycan help reduce inflammation or suppress immune system activity. Agents such as rituximab that target specific inflammatory cells, large intravenously administered doses of immunoglobulins, and antibodies that alter the immune system, also can suppress abnormal immune system activity.

Specific symptoms can usually be improved

Medications recommended for chronic neuropathic pain are also used for other medical conditions. Among the most effective are a class of drugs first marketed to treat depression. Nortriptyline and newer serotonin-norepinephrine reuptake inhibitors such as duloxetine hydrochloride modulate pain by increasing the brains ability to inhibit incoming pain signals. Another class of medications that quiets nerve cell electrical signaling is also used for epilepsy. Common drugs include gabapentin, pregabalin, and less often topiramate and lamotrigine. Carbamazepine and oxcarbazepine are particularly effective for trigeminal neuralgia, a focal neuropathy of the face.

Local anesthetics and related drugs that block nerve conduction may help when other medications are ineffective or poorly tolerated. Medications put on the skin (topically administered) are generally appealing because they stay near the skin and have fewer unwanted side effects.

Lidocaine patches or creams applied to the skin can be helpful for small painful areas, such as localized chronic pain from mononeuropathies such as shingles. Another topical cream is capsaicin, a substance found in hot peppers that can desensitize peripheral pain nerve endings. Doctor-applied patches that contain higher concentrations of capsaicin offer longer term relief from neuropathic pain and itching, but they worsen small-fiber nerve damage. Weak over-the-counter formulations also are available. Lidocaine or longer acting bupivicaine are sometimes given using implanted pumps that deliver tiny quantities to the fluid that bathes the spinal cord, where they can quiet excess firing of pain cells without affecting the rest of the body. Other drugs treat chronic painful neuropathies by calming excess signaling.

Narcotics (opioids) can be used for pain that doesnt respond to other pain-control medications and if disease-improving treatments arent fully effective. Because pain relievers that contain opioids can lead to dependence and addiction, their use must be closely monitored by a physician. One of the newest drugs approved for treating diabetic neuropathy is tapentadol, which has both opioid activity and norepinephrine-reuptake inhibition activity of an antidepressant.

Surgery is the recommended treatment for some types of neuropathies. Protruding disks (pinched nerve) in the back or neck that compress nerve roots are commonly treated surgically to free the affected nerve root and allow it to heal. Trigeminal neuralgia on the face is also often treated with neurosurgical decompression. Injuries to a single nerve (mononeuropathy) caused by compression, entrapment, or rarely tumors or infections may require surgery to release the nerve compression. Polyneuropathies that involve more diffuse nerve damage, such as diabetic neuropathy, are not helped by surgical intervention. Surgeries or interventional procedures that attempt to reduce pain by cutting or injuring nerves are not often effective as they worsen nerve damage and the parts of the peripheral and central nervous system above the cut often continue to generate pain signals (phantom pain). More sophisticated and less damaging procedures such as electrically stimulating remaining peripheral nerve fibers or pain-processing areas of the spinal cord or brain have largely replaced these surgeries.

Transcutaneous electrical nerve stimulation (TENS) is a noninvasive intervention used for pain relief in a range of conditions. TENS involves attaching electrodes to the skin at the site of pain or near associated nerves and then administering a gentle electrical current. Although data from controlled clinical trials are not available to broadly establish its efficacy for peripheral neuropathies, in some studies TENS has been shown to improve neuropathic symptoms associated with diabetes.


The best treatment is prevention, and strategies for reducing injuries are highly effective and well tested. Since medical procedures ranging from casting fractures to injuries from needles and surgery are another cause, unnecessary procedures should be avoided. The new adjuvanted vaccine against shingles prevents more than 95 percent of cases and is widely recommended for people over 50, including those who have had previous shingles or vaccination with the older, less effective vaccine. Diabetes and some other diseases are common preventable causes of neuropathy. People with neuropathy should ask their doctors to minimize use of medications that are known to cause or worsen neuropathy where alternatives exist. Some families with very severe genetic neuropathies use in vitro fertilization to prevent transmission to future generations.


The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world.

NINDS-funded research ranges from clinical studies of the genetics and the natural history of hereditary neuropathies to discoveries of new cause and treatments for neuropathy, to basic science investigations of the biological mechanisms responsible for chronic neuropathic pain. Together, these diverse research areas will advance the development of new therapeutic and preventive strategies for peripheral neuropathies. Understanding the causes of neuropathy provides the foundation for finding effective prevention and treatment strategies.

Genetic mutations have been identified in more than 80 distinct hereditary neuropathies. NINDS supports studies to understand the disease mechanisms of these conditions and to identify other genetic defects that may play roles in causing or modifying the course of disease. The Inherited Neuropathies Consortium (INC)a group of academic medical centers, patient support organizations, and clinical research resources dedicated to conducting clinical research in Charcot-Marie-Tooth disease and improving the care of people with the diseaseseeks to better characterize the natural history of several different forms of neuropathy and to identify genes that modify clinical features in these disorders. Knowing which genes are mutated, and what their normal function is, permits precise diagnosis and leads to new therapies that prevent or reduce nerve damage. INC is also developing and testing biomarkers (signs that can indicate the diagnosis or progression of a disease) and clinical outcome measures that will be needed in future clinical trials to determine whether individuals respond to candidate treatments.

Rapid communication between the peripheral nervous system and the central nervous system often depends on myelination, a process through which special cells called Schwann cells create an insulating coating around axons. Several NINDS-funded studies focus on understanding how myelin protein and membrane production and maintenance in Schwann cells is regulated and how mutations in genes involved in these processes cause peripheral neuropathies. Schwann cells play a critical role in the regeneration of nerve cell axons in the peripheral nervous system. By better understanding myelination and Schwann cell function, researchers hope to find targets for new therapies to treat or prevent nerve damage associated with neuropathy.

Other efforts focus on immune system peripheral nerve damage. In inflammatory peripheral neuropathies such as Guillain-Barre Syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP), the bodys immune system mistakenly attacks peripheral nerves, damaging myelin and weakening signaling along affected nerves. NINDS-supported researchers hope to better understand how antibodies to cell membrane components cause peripheral nerve damage and how the effects of these antibodies can be blocked. Researchers are also studying how mutations in the Autoimmune Regulator (AIRE) gene in a mouse model of CIDP cause the immune system to attack peripheral nerves. NINDS research has helped discover that some types of small-fiber polyneuropathy appear to be immune-caused, particularly in women and children.

NINDS-supported researchers are also exploring the use of tissue engineered from the cells of humans with peripheral neuropathy as models to identify specific defects in the transport of cellular components along axons and the interactions of nerves with muscles. Such tissue engineering approaches may eventually lead to new therapeutics for peripheral neuropathies.

In addition to efforts to treat or prevent underlying nerve damage, other NINDS-supported studies are informing new strategies for relieving neuropathic pain, fatigue, and other neuropathy symptoms. Researchers are investigating the pathways that carry pain signals to the brain and are working to identify substances that will block this signaling.


For more information on neurological disorders or research programs funded by NINDS, contact the Institute's Brain Resources and Information Network (BRAIN) at:

BRAINP.O. Box 5801Bethesda, MD 20824800-352-9424

Information also is available from the following organizations:

Foundation for Peripheral Neuropathy485 Half Day RoadSuite 200Buffalo Grove, IL

Charcot-Marie-Tooth Association (CMTA)P.O. Box 105Glenolden, PA

Muscular Dystrophy Association2200S. Riverside Plaza, Suite 1500Chicago, IL

American Diabetes Association2451 Crystal Drive, Suite 900Arlington, VA

National Diabetes Information Clearinghouse (NDIC)National Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of Health1 Information WayBethesda, MD for patients, professionals, and researchers hosted by Harvard University)

"Peripheral Neuropathy Fact Sheet", NINDS, Publication date: August 2018.

NIH Publication No.18-NS-4853

Back toPeripheral Neuropathy Information Page

See a list of all NINDS disorders

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Neuropata Perifrica

Prepared by:Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

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Neuropathy Signs, Symptoms, and Diagnosis | Everyday Health

Tuesday, January 28th, 2020

If you think youre having these symptoms, consult a physician. A variety of tests can be done to diagnose neuropathy. There are certain patterns of complaints that suggest neuropathy, says Dr. Williams, so taking down a patient history that includes a description of the complaints is an important first step.

After that, your doctor can do a physical examination, checking motor and sensory function, checking deep tendon reflexes, as well as looking for symptoms such as allodynia and hyperalgesia, Williams says. Then we can also perform electrodiagnostic testing; the most common being electromyography and nerve conduction testing, where we can stimulate nerves and record responses, calculate the speed at which signals are being transmitted and see if there are any areas where nerves are not transmitting signals normally, Williams continues.

With needle examinations, Williams says, We can put small needles into individual muscles, and, based on what we see and hear with the needle in the muscle, get information about how the nerves supplying that muscle are functioning. So there are a number of different tests that could be helpful to identifying neuropathy, as well as localizing where the abnormality is most likely to be coming from.

Frequently, blood tests can check for elevated blood sugar (to see if your symptoms may be related to type 2 diabetes), vitamin deficiencies, toxic elements, hereditary disorders, and evidence of an abnormal immune response. (11)

Your doctor may also do a nerve biopsy, which usually entails removing a small portion of a sensory nerve to look for abnormalities, or a skin biopsy to see if there is a reduction in nerve endings. (12)

To give yourself the best chance of an accurate diagnosis and relief of your symptoms be prepared to describe your symptoms in detail, when you experience them, how long an episode lasts, and the amount of discomfort, pain or loss of sensation or movement you experience. The more specific you can be about the symptoms you are experiencing, the easier it will be for your doctor to understand what is going on.

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Neuropathy Signs, Symptoms, and Diagnosis | Everyday Health


Peripheral Neuropathy Symptoms, Causes, Treatment & Prognosis

Tuesday, January 28th, 2020

What is peripheral neuropathy?

Peripheral neuropathy is a disorder of nerve(s) apart from the brain and spinal cord. Patients with peripheral neuropathy may have tingling, numbness, unusual sensations, weakness, or burning pain in the affected area. Oftentimes, the symptoms are symmetrical and involve both hands and feet. Because the symptoms are often present in the areas covered by gloves or stockings, peripheral neuropathy is often described as having a "glove and stocking" distribution of symptoms.

Peripheral neuropathy can involve different nerve types, including motor, sensory, and autonomic nerves. Peripheral neuropathy can also be categorized by the size of the nerve fibers involved, large, or small.

Neuropathy can present with many differing symptoms, including numbness, pain of different types, weakness, or loss of balance, depending on the type of nerve involved. Because the autonomic nerves control bodily functions that we do not consciously think of, such as heart rate, digestion, and emptying of the bowel and bladder, autonomic neuropathy manifests with symptoms affecting the loss of control of these functions. Symptoms may include problems with blood pressure, voiding, passage of stools (diarrhea, or constipation), heart rate, or sweating.

Cranial neuropathy is similar to peripheral neuropathy, except that the cranial nerves are involved. Any of the cranial nerves can be involved. One of the more common causes of cranial neuropathy is loss of blood flow from the optic artery to the optic nerve, causing ischemic optic neuropathy. Amyloidosis is one of the more common causes of this rare disorder.

Specific nerves can be involved in neuropathy. When a specific nerve is involved, the symptoms are limited to the distribution of that nerve. The most commonly involved peripheral nerve is the median nerve at the wrist in carpal tunnel syndrome. Essentially any peripheral nerve can become entrapped and cause the signs and symptoms of neuropathy. The ulnar nerve is commonly entrapped at the elbow. The peroneal nerve is exposed at the outer part of the knee. The pudendal nerve can cause pain in the perineum and is relieved by sitting on a toilet seat or an inflatable donut. Entrapment of the lateral femoral cutaneous nerve at the waist, called meralgia paresthetica, causes numbness at the outer part of the thigh.

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Peripheral Neuropathy Symptoms, Causes, Treatment & Prognosis


A 40-Year-Old Man With Dizziness, Confusion, and Neuropathy – Medscape

Tuesday, January 28th, 2020

Editor's Note:The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.

A 40-year-old man is referred for neurologic evaluation after presenting with peripheral neuropathy. Three years ago, he noted numbness, burning pain, and reduced temperature sensation in his feet. For the past 2 years, he has had dry eyes and dry mouth; urinary retention that requires self-catheterization; gastrointestinal symptoms, including alternating diarrhea and constipation; and nausea. His weight has decreased by 40 lb (18.1 kg) over 12 months. He has noticed decreased sweating.

For several months, he has had frequent syncopal episodes triggered by positional change. In hindsight, he reports intermittent dizziness associated with a "daydreaming" feeling that began 8 years ago; however, these spells were not associated with loss of consciousness. He was also recently diagnosed with Sjgren syndrome.

He reports no chest pain, palpitations, shortness of breath, or edema. A review of systems is otherwise unremarkable. His past medical history is notable for hypothyroidism. His family history is notable for a grandfather who had gastrointestinal problems and a sister who has palpitations. His parents are alive and have no neurologic symptoms. He takes no medications or supplements.

Medscape2020WebMD, LLC

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Amanda Kennedy,Jeffrey Kaplan,Dianna Quan.A 40-Year-Old Man With Dizziness, Confusion, and Neuropathy-Medscape-Jan21,2020.

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A 40-Year-Old Man With Dizziness, Confusion, and Neuropathy - Medscape


Fighting the Fire: Battling Rare Neuropathy, San Juan Hills’ Efstathiou Coaches with New Perspective – Capistrano Dispatch

Tuesday, January 28th, 2020

By Zach Cavanagh

It started about a year ago.

San Juan Hills boys basketball coach Jason Efstathioustarted to notice some things in his body last January. By March of last year,he found himself barely able to walk, and then by the summer, he was in bed fornearly 12 hours a day.

I was like a burn victim on the inside, Efstathiou said.

From May until late December and his full return asStallions head coach on Jan. 3, Efstathiou was out battling an extremely rareform of neuropathy. Efstathiou, who is a type-one diabetic, said the diseaseattacks your nerves and affects 1% of diabetics.

Most neuropathies see the victim lose sensation in theirnerves, but Efstathious neuropathy was the opposite with a hypersensitivityand burning sensation.

For three months, they didnt know what I had, Efstathiousaid. I was going to MRIs and CT scans and all that kind of stuff.

Over those months, Efstathiou had been getting daily treatmentswith doctors and nerve therapists. Treatments consisted of machines that sentsignals to his nerves.

Efstathiou said he had lost 35 pounds at one point, and withbeing out of work officially since May, the San Juan Hills parents andcommunity held a fundraiser in September to support their sidelined coach.

It sounds dramatic, Efstathiou said, but I was really bad, like almost died, thats how bad I was. They all knew about it. People were being very supportive. Im very grateful to the coaches. The coaches and parents in the program had my back big time.

Over time, Efstathious condition improved, and he returnedto practices in September in a limited capacity. Efstathiou spends most ofpractice sitting on a stool near midcourt and relays instructions through hisassistant coaches.

I still limp around, Efstathiou said. I cant demonstatestuff. When I coach or teach I have to sit down. Ive given my bench guysassignments. I dont have a loud voice again yet. I use a whistle now. Idnever used a whistle before.

Efstathiou said hes still healing, and his doctors andnerve therapist feel that Efstathiou will keep getting better. The amount ofimprovement hes seen makes Efstathiou feel that it will go away, even if ittakes another year or two.

On coaching, Efstathiou said the experience has changed himand has given him a new perspective.

Im more focused on the big picture than living and dyingwith each game, Efstathiou said. I dont get as gnarly. (With the players,)Im trying to be more like understand the situation, understand when somethinggets taken away. I feel fortunate to be here and coaching you guys. You guysshould be grateful to be on a high school basketball team. Theres so many kidsthat never make it to their high school varsity team.

Efstathiou also said the ordeal has bettered his sidelinedemeanor.

Its keeping me calmer, Efstathiou said. The more intenseI get then I start to get more burning. In my mind, I just have to staycalmer.

With Efstathiou returning just before the start of Sea ViewLeague play, keeping calm is a taller task some nights more than others, but sofar, the Stallions have been good with those things for their coach.

San Juan Hills (9-14, 3-1) won its first three league gamesin strong fashion with victories over Laguna Hills by 29 points, Dana Hills byeight points and El Toro by five points.

I told them the way weve been starting games playing withintensity, Efstathiou said, were going to be tough. A lot of teams wesurprise them a little bit. I think if you come out and play intense, and Ithink our guys are a little inspired right now, as long as we execute, I thinktheres a good opportunity.

Efstathiou got more fired up in San Juan Hills Wednesdaymatch-up as the Stallions battled league-favorite Tesoro for the league lead.The Stallions gave the Titans all they could handle and held a five-point leadin the fourth quarter. However, San Juan Hills couldnt execute down thestretch, and Tesoro took advantage of a foul-filled physical game by making itsfinal 14 points on free throws in a 65-57 win.

San Juan Hills still sits in second place in the Sea ViewLeague, and the Stallions will get another shot at Tesoro.

In the broad perspective, Efstathiou and San Juan Hills are right where they want to be.

Zach Cavanagh

Zach Cavanagh is the sports editor for Picket Fence Media. Zach is aCalifornia Journalism Award winner and has covered sports in Orange County since 2013. Follow him on Twitter and Instagram @ZachCav and follow our sports coverage on Twitter @SouthOCSports. Email Zach at

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Fighting the Fire: Battling Rare Neuropathy, San Juan Hills' Efstathiou Coaches with New Perspective - Capistrano Dispatch


NeuroMetrix Reports Q4 and Full Year 2019 Financial Results – BioSpace

Tuesday, January 28th, 2020

WOBURN, Mass., Jan. 27, 2020 (GLOBE NEWSWIRE) -- NeuroMetrix, Inc., (Nasdaq: NURO) today reported financial and business highlights for the quarter and year ended December 31, 2019.

The Company develops and commercializes diagnostic and therapeutic neurostimulation-based medical devices. The Company has three commercial products. DPNCheck is a point-of-care diagnostic test for peripheral neuropathies including diabetic peripheral neuropathy (DPN). ADVANCE is a point-of-care diagnostic test primarily used for carpal tunnel syndrome. Quell is a wearable neurostimulation device that is available over-the-counter for symptomatic relief of chronic pain.

Q4 2019 Highlights:

"Although we were disappointed by the overall drop in revenue from the year-ago period, we expected this outcome given our large reduction in operating expenses, attention to improved gross margins and overall focus on long term growth and profitability. We believe we made important progress against these objectives. We experienced strong demand for DPNCheck during the fourth quarter which is typically our slowest period. This momentum should carry into 2020 as new Medicare Advantage accounts come on board and we expect a rebound in international sales. Our enthusiasm for the DPNCheck business is reflected in our investment in the next generation device to be launched in late 2020, said Shai N. Gozani, M.D., Ph.D., President and Chief Executive Officer of NeuroMetrix. Our Quell business is focused on cost-efficient advertising combined with an exclusively direct-to-consumer model via our website and exploration of new markets. We believe this technology is unique and represents an attractive long term opportunity for the Company. Finally, we are actively engaged with the Federal Trade Commission(FTC) to resolve the previously disclosed matter which is centered on earlier Quell advertising.

Financials:Regarding the fourth quarter 2019, total revenues were $1.7 million, down 54% from $3.7 million in the prior year period. Gross margin was $1.1 million versus $1.7 million in Q4 2018. The gross margin rate of 62.2% improved from 46.9% in Q4 2018. Operating expenses were $2.7 million, a reduction of $1.9 million from $4.6 million in Q4 2018. Collaboration income of $0.6 million was recognized in Q4 2019. Net loss was $1.1 million compared to $2.8 million in Q4 2018. Net cash usage from operations was $.7 million, a reduction from $2.7 million in Q4 2018. The Company ended the quarter with cash of $3.1 million.

Regarding the full year 2019, total revenues were $9.3 million, down from $16.1 million in 2018. Gross margin was $2.2 million after inventory-related write-downs of $2.6 million. 2018 gross margin was $7.4 million. Operating expenses were $13.8 million versus $19.7 million in 2018. Income from the GSK collaboration was $7.7 million in comparison with $12.3 million in 2018. Net loss was $3.8 million versus net income of $24 thousand in 2018.

Company to Host Live Conference Call and WebcastNeuroMetrix will host a conference call at 8:00 a.m. Eastern today, January 27, 2020. The call may be accessed in the United States at 844-787-0799, international at 661-378-9630 using confirmation code 6728609. A replay will be available starting two hours after the call at 855-859-2056 United States and 404-537-3406 international using confirmation code 6728609. It will remain available for one week. The call will also be webcast and accessible at under "Investor Relations".

About NeuroMetrixNeuroMetrix is a leading developer of diagnostic and therapeutic neurostimulation-based medical devices. DPNCheck is a point-of-care diagnostic test for diabetic neuropathy, which is the most common long-term complication of Type 2 diabetes. ADVANCE is a point-of-care nerve conduction study that evaluates multiple nerves including the median nerve, which is affected in carpal tunnel syndrome. Quell is a wearable neurostimulation device for symptomatic relief of chronic pain that is available over-the-counter. For more information, please visit

Safe Harbor StatementThe statements contained in this press release include forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, including, without limitation, statements regarding the companys or managements expectations regarding the business, as well as events that could have a meaningful impact on the companys revenues and cash resources. While the company believes the forward-looking statements contained in this press release are accurate, there are a number of factors that could cause actual events or results to differ materially from those indicated by such forward-looking statements, including, without limitation, estimates of future performance, the ability to successfully develop, receive regulatory clearance, commercialize and achieve market acceptance for any products, and the final outcome of the ongoing Federal Trade Commission civil investigative demand enforcement action involving Quell. There can be no assurance that future developments will be those that the company has anticipated. Such forward-looking statements involve known and unknown risks, uncertainties and other factors including those risks, uncertainties and factors referred to in the companys most recent Annual Report on Form 10-K, Quarterly Reports on Form 10-Q, as well as other documents that may be filed from time to time with the Securities and Exchange Commission or otherwise made public. The company is providing the information in this press release only as of the date hereof, and expressly disclaims any intent or obligation to update the information included in this press release or revise any forward-looking statements.

Source: NeuroMetrix, Inc.

Thomas T. HigginsSVP and Chief Financial

NeuroMetrix, Inc.Statements of Operations(Unaudited)

Condensed Balance Sheets(Unaudited)

See the article here:
NeuroMetrix Reports Q4 and Full Year 2019 Financial Results - BioSpace


The health benefits of lemon water | News – WPSD Local 6

Tuesday, January 28th, 2020

(KPRC)Many people drink lemon water because they think it tastes good, or they think it has some health benefits.

Heres a look at what makes it so great.

The majority of women are walking around dehydrated. Adding lemon to your water might be the motivation you need to drink more.

In doing so, you can reduce sugar cravings and get good antioxidants. And that citrus fruit is packing the potential to decrease your risk of kidney stones or reduce diabetic neuropathy.

Dietitian Erin Gussler with the Whole Health Center in Houston, Texas, says she knows this because of studies done in mice.

And in humans, she says it can relieve morning sickness.

"There was a study that showed that drinking lemon water during pregnancy actually can decrease nausea and vomiting so the study showed that consuming lemon water for 4 days actually decrease nausea and vomiting by 33%, Gussler says.

But there's a catch. To get these benefits you might need lots and we mean lots of lemon. Think one-half to two whole lemons a day!

"Some of the studies were like an obscene amount of lemon. Like, like cups of lemon, Gussler says.

While the amount matters more than anything, the temperature only slightly matters. Warm lemon water can help with constipation more than cold water but be careful not to get essential oils too hot.

"There are some studies that show heating those oils to high can break down so thinking about getting a mix of hot and cold and playing with that just to get maximum benefit of both, Gussler says.

Dentists warn patients not to drink too much lemon since the acidity can damage enamel.

They say to lessen that potential damage, you can try drinking through a straw.

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The health benefits of lemon water | News - WPSD Local 6


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