Antiepileptic drugs for the treatment of neuropathic pain : a systematic review

Many therapies have been proposed for the management of neuropathic pain, and they include the use of different antiepileptic drugs. However, the lack of high quality studies indicates that results on the different neuropathic disorders under study do not recommend a particular drug treatment. This study makes a systematic review of the published literature on the use of several antiepileptic drugs to treat neuropathic pain, and has the objective of considering both its clinical characteristics and pharmacological use, which will depend on their level of scientific evidence and will follow the principles of evidence-based dentistry. The articles were stratified according to their scientific evidence using the SORT criteria (Strength of Recommendation Taxonomy), and it included those articles that only have level 1 or 2. Randomized clinical trials were stratified according to their level of quality using the JADAD scale, an instrument described by Jadad et al . (7) . to assess the quality of clinical trials, while studies with a level below 3 were discarded. Recently, type A or B recommendations are given in favor or against the use of antiepileptic drugs to treat neuropathic pain on the basis of their scientific quality

The additive value of CA19.9 monitoring in a pancreatic cyst surveillance program

Background:Surveillance of pancreatic cysts focuses on the detection of (mostly morphologic) features warranting surgery. European guidelines consider elevated CA19.9 as a relative indication for surgery. We aimed to evaluate the role of CA19.9 monitoring for early detection and management in a cyst surveillance population. Methods: The PACYFIC-registry is a prospective collaboration that investigates the yield of pancreatic cyst surveillance performed at the discretion of the treating physician. We included participants for whom at least one serum CA19.9 value was determined by a minimum follow-up of 12 months.Results: Of 1865 PACYFIC participants, 685 met the inclusion criteria for this study (mean age 67 years, SD 10; 61% female). During a median follow-up of 25 months (IQR 24, 1966 visits), 29 participants developed high-grade dysplasia (HGD) or pancreatic cancer. At baseline, CA19.9 ranged from 1 to 591 kU/L (median 10 kU/L [IQR 14]), and was elevated (≥37 kU/L) in 64 participants (9%). During 191 of 1966 visits (10%), an elevated CA19.9 was detected, and these visits more often led to an intensified follow-up (42%) than those without an elevated CA19.9 (27%; p &lt; 0.001). An elevated CA19.9 was the sole reason for surgery in five participants with benign disease (10%). The baseline CA19.9 value was (as continuous or dichotomous variable at the 37 kU/L threshold) not independently associated with HGD or pancreatic cancer development, whilst a CA19.9 of ≥ 133 kU/L was (HR 3.8, 95% CI 1.1–13, p = 0.03). Conclusions: In this pancreatic cyst surveillance cohort, CA19.9 monitoring caused substantial harm by shortening surveillance intervals (and performance of unnecessary surgery). The current CA19.9 cutoff was not predictive of HGD and pancreatic cancer, whereas a higher cutoff may decrease false-positive values. The role of CA19.9 monitoring should be critically appraised prior to implementation in surveillance programs and guidelines.</p

The nutrigenetic influence of the interaction between dietary vitamin E and TXN and COMT gene polymorphisms on waist circumference: a case control study

Background: Abdominal obesity (AO) is a common modifiable risk factor for certain non-communicable diseases associated with enhanced oxidative stress (OS). The objective of this work was to investigate whether the interaction between antioxidant vitamin intake and OS-related polymorphisms modulates gene-associated anthropometry in a Spanish population. Methods: A total of 246 subjects with AO, and 492 age and gender matched non-AO subjects were included in the study. Anthropometric, biochemical, and OS parameters, and antioxidant dietary intake data were assessed using validated procedures. DNA from white blood cells was isolated and the genotype of seven polymorphisms from genes involved in OS (pro-oxidant and antioxidant) were analyzed using the SNPlex system. The effects of the c.-793T > C polymorphism on promoter activity and thus thioredoxin (TXN) activity were examined using reporter assays. Results: The AO group had higher 8-Oxo-2′-deoxyguanosine levels and took in less vitamin A and vitamin E compared to the non-AO group. Logistic regression analysis revealed that the rs2301241 polymorphism in TXN and rs740603 in catechol-O-methyltransferase (COMT) were associated with waist circumference (WC) and AO. Moreover, these polymorphisms were more strongly associated with variations in WC in subjects with low vitamin E intakes. A promoter assay revealed that the T to C conversion at c.-793 (rs2301241) induced a more than two fold increase in reporter gene expression. Conclusions: WC is associated both with dietary vitamin E intake and genetic variants of TXN and COMT suggesting that existence of a complex nutrigenetic pathway that involves regulation of AO

Consumer trust in the dairy value chain in China: The role of trustworthiness, melamine scandal, and media

This study provides a deep insight into Chinese consumer trust in the Chinese dairy value chain, as a lack of trust due to the 2008 melamine scandal has been widely recognized as a barrier to the development of the domestic dairy industry in China. Based on face-to-face interviews with 954 Chinese consumers in Beijing, Shanghai, and Shijiazhuang, this study measured consumer trust in farmers, manufacturers, retailers, the government, and third parties. Consumer trust was studied by measuring the effect of beliefs on the trustworthiness of actors (i.e., competence, benevolence, integrity, credibility, and openness), and current experiences regarding the melamine scandal and the media. The results showed that the level of trust in dairy chain actors varied. The government and third parties were relatively highly trusted, whereas retailers were considered less trustworthy. The importance of consumer beliefs about trustworthiness are different among actors. Consumer belief of competence determines trust in farmers and manufacturers. For retailers, the government, and third parties, respectively, benevolence, credibility, and openness are the most important factors. Trust in dairy chain actors is still strongly negatively affected by current experiences regarding the melamine scandal, even though it occurred more than 10 years ago. Using social media to directly provide more information and establish continuous daily communication with consumers could help manufacturers and third parties to strengthen consumer trust

Power spectral analysis of heart rate in hyperthyroidism

The aim of the present study was to evaluate the impact of hyperthyroidism on the cardiovascular system by separately analyzing the sympathetic and parasympathetic influences on heart rate. Heart rate variability was evaluated by autoregressive power spectral analysis. This method allows a reliable quantification of the low frequency (LF) and high frequency (HF) components of the heart rate power spectral density; these are considered to be under mainly sympathetic and pure parasympathetic control, respectively. In 10 newly diagnosed untreated hyperthyroid patients with Graves' disease, we analyzed power spectral density of heart rate cyclic variations at rest, while lying, and while standing. In addition, heart rate variations during deep breathing, lying to standing, and Valsalva's maneuver were analyzed. The results were compared to those obtained from 10 age-, sex-, and body mass index-matched control subjects. In 8 hyperthyroid patients, the same evaluation was repeated after the induction of stable euthyroidism by methimazole. Heart rate power spectral analysis showed a sharp reduction of HF components in hyperthyroid subjects compared to controls (lying, 13.3 +- 4.1 vs. 32.0 +- 5.6 normalized units (NU; P lt 0.01); standing, 6.0 +- 2.7 vs. 15.0 +- 4.0 NU (P lt 0.01); mean +- SEM). On the other hand, LF components were comparable in the 2 groups (lying, 64.0 +- 6.9 vs. 62.0 +- 6.5 NU; standing, 77.0 +- 6.5 vs. 78.0 +- 5.4 NU). Hence, the LF/HF ratio, which is considered an index of sympathovagal balance, was increased in hyperthyroid subjects while both lying (11.3 +- 4.5 vs. 3.5 +- 1.1; p lt 0.05) and standing (54.0 +- 12.6 vs. 9.8 +- 2.6; P lt 0.02). This parameter was positively correlated with both T-3 (r = 0.61; P lt 0.05) and free T-4 (r = 0.63; P lt 0.05) serum levels. Among traditional cardiovascular autonomic tests, the reflex response of heart rate dunng lying to standing was significantly lower in hyperthyroid patients than in controls (1.12 +- 0.03 vs. 1.31 +- 0.04; P lt 0.002). No statistically significant difference in reflex responses between the two groups was found in deep breathing or Valsalva's maneuver. In the 8 patients reexamined after methimazole treatment, we observed complete normalization of altered cardiovascular parameters, with slight predominance of the vagal component compared with controls. These results suggest that thyroid hormone excess may determine reduced parasympathetic activity and, thus, a relative hypersympathetic tone

Functional response of novel bioprotective poloxamer-structured vesicles on inflamed skin

[EN] Resveratrol and gallic acid, a lipophilic and a hydrophilic phenol, were co-loaded in innovative, biocompatible nanovesicles conceived for ensuring the protection of the skin from oxidative-and inflammatory-related affections. The basic vesicles, liposomes and glycerosomes, were produced by a simple, one-step method involving the dispersion of phospholipid and phenols in water or water/glycerol blend, respectively. Liposomes and glycerosomes were modified by the addition of poloxamer, a stabilizer and viscosity enhancer, thus obtaining viscous or semisolid dispersions of structured vesicles. The vesicles were spherical, unilamellar and small in size (similar to 70 nm in diameter). The superior ability of the poloxamer-structured vesicles to promote the accumulation of both phenols in the skin was demonstrated, as well as their low toxicity and great ability to protect fibroblasts from chemically-induced oxidative damage. The in vivo administration of the vesicular phenols on TPA (phorbol ester)-exposed skin led to a significant reduction of oedema and leukocyte infiltration. (C) 2017 Elsevier Inc. All rights reserved.This work was partially supported by grants BIO2014-52872-R (Ministerio de Economia y Competitividad, Spain), which included FEDER funds, and 2014-SGR-938 (Generalitat de Catalunya, Spain).Caddeo, C.; Manca, M.; Matos, M.; Gutierrez, G.; Díez-Sales, O.; Esteban Peris, J.; Usach, I.... (2017). Functional response of novel bioprotective poloxamer-structured vesicles on inflamed skin. Nanomedicine Nanotechnology Biology and Medicine. 13(3):1127-1136. https://doi.org/10.1016/j.nano.2016.12.017S1127113613