Articles Tagged With: treatment
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The Neural Pathways of Pain Treatment Response in Small-Fiber Neuropathy
Pain in peripheral neuropathy, referred to as neuropathic pain, is thought to result from overexpression of pain receptors, regeneration of hypersensitive nerve sprouts, and denervation hypersensitivity of neurons in the sensory ganglia. Additionally, activation of the pain pathways appears to induce secondary structural and functional changes in the brain that contribute to pain perception, persistence, and response.
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Is the Long-Term Use of Low-Dose Opioids for the Treatment of Refractory RLS Safe and Effective?
A review of two-year longitudinal data regarding efficacy and dose stability in refractory restless legs syndrome (RLS) patients treated with low-dose opioids shows that patients do not escalate their opiate dosage and that there is clinical and therapeutic stability in the treatment of RLS with this therapeutic regimen. Methadone is the preferred opiate for the treatment of RLS because of its single-dose, long-acting profile and lack of euphoric effects.
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Stroke Prevention in Nonvalvular Atrial Fibrillation: A Review of the Past, Present, and Future
Nonvalvular atrial fibrillation is a highly prevalent cardiac arrhythmia in the United States and often can be complicated by a thromboembolic phenomenon, the most concerning of which is stroke. This article reviews the current evidence for the use of various anticoagulants, surgical techniques, and the left atrial appendage occlusion devices currently available for stroke prevention in atrial fibrillation.
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An Effective Oral Regimen for Rifampin-Resistant Tuberculosis
A multicenter, randomized, controlled, noninferiority clinical trial found a 24-week, all-oral regimen (bedaquiline, pretomanid, linezolid, and moxifloxacin) to be safe and effective for patients aged 15 years and older with rifampin-resistant tuberculosis.
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Efficacy and Safety of Leriglitazone in Patients with Friedreich Ataxia
Friedreich ataxia (FRDA) is an autosomal, recessive, multisystemic disease characterized by progressive weakness, ataxia, and dysarthria starting in childhood and resulting in severe morbidity and premature death. There are no approved treatments for FRDA. With recent preclinical studies suggesting potential benefit of PPARPγ agonists in motor function and reduced radiographic disease activity, the current study explores the effect of leriglitazone, a PPARPγ agonist, in patients with moderate to severe FRDA.
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Do Spinal Cord Stimulators Really Help for Chronic Pain?
A comprehensive analysis of a large clinical database regarding treatment of patients with chronic low back pain did not support the benefit of spinal cord stimulators compared to conventional medical management for chronic pain.
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New Treatments for Uterine Fibroids
In this prospective, open-label, single-arm trial of 149 individuals with heavy menstrual bleeding and uterine leiomyomas, daily relugolix combination therapy (relugolix 40 mg, estradiol 1 mg, and norethindrone acetate 0.5 mg) resulted in a mean menstrual blood loss reduction of 90%, and 70% of the participants achieved amenorrhea by the end of the 52-week period. Similar results were found for other arms of the trial among women who crossed over from placebo and relugolix-only therapy to relugolix combination therapy.
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When More Is Not Better: Treatment of Prosthetic Valve Endocarditis Due to Staphylococci
Clear evidence of benefit from adjunctive administration a β-lactam and/or a glycopeptide in the treatment of prosthetic valve endocarditis due to staphylococci is lacking. Current guidelines need to be reassessed.
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Is IVIG Treatment Really Better than Natural Recovery in Patients with Guillain-Barré Syndrome?
In this controversial report comparing patients with Guillain-Barré syndrome treated with intravenous immunoglobulin vs. no treatment, the group that appears to have fared the best were patients who had an acute demyelinating syndrome, and not an axonal variant. This was an observational study and not a randomized treatment trial.
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Intravenous Immunoglobulin in Dermatomyositis
Treatment of dermatomyositis with intravenous immunoglobulin (IVIG) resulted in overall better clinical improvement after 16 weeks compared to patients treated with placebo. However, there was a significant number of thromboembolic adverse events in the treatment group. The group of patients treated was a heterogeneous group. However, IVIG now is U.S. Food and Drug Administration-approved for the treatment of dermatomyositis.