Pain in platin-induced neuropathies: A systematic review and meta-analysis

INTRODUCTION: Platin-induced peripheral neuropathy (PIPN) is a common cause of PN in cancer patients. The aim of this paper is to systematically review the current literature regarding PIPN, with a particular focus on epidemiological and clinical characteristics of painful PIPN, and to discuss relevant management strategies. METHODS: A systematic computer-based literature search was conducted on the PubMed database. RESULTS: This search strategy resulted in the identification of 353 articles. After the eligibility assessment, 282 articles were excluded. An additional 24 papers were identified by scanning the reference lists. In total, 95 papers met the inclusion criteria and were used for this review. The prevalence of neuropathic symptoms due to acute toxicity of oxaliplatin was estimated at 84.6%, whereas PN established after chemotherapy with platins was estimated at 74.9%. Specifically regarding pain, the reported prevalence of pain due to acute toxicity of oxaliplatin was estimated at 55.6%, whereas the reported prevalence of chronic peripheral neuropathic pain in PIPN was estimated at 49.2%. CONCLUSION: Peripheral neuropathy is a common complication in patients receiving platins and can be particularly painful. There is significant heterogeneity among studies regarding the method for diagnosing peripheral neuropathy. Nerve conduction studies are the gold standard and should be performed in patients receiving platins and complaining of neuropathic symptoms post-treatment

Seed size influence on germination responses to light and temperature of seven pioneer tree species from the Central Amazon

In Amazon secondary forests are dominated by pioneer species that typically produce large amounts of small and dormant seeds that are able to form a persistent soil seed bank. Seed dormancy in this group of species is overcome by environmental conditions found in open areas, such as high irradiation or alternating temperatures. Nevertheless, a variety of germination responses to environmental factors is known among pioneers; some of them may germinate in diffuse light or in darkness condition at constant temperature. Seed mass can be considered as one of the factors that promotes this variety. Regarding species with very small seeds, it seems that the trigger for germination is light and for larger seeds temperature alternation may be a more important stimulus. In this study we established a relationship between seed mass and germination response to light and alternating temperature for a group of seven woody pioneer species from the Amazon forest. We found that an increase in seed mass was followed by a decrease in the need for light and an increase in the tolerance to alternating temperatures. Understanding germination strategies may contribute with the knowledge of species coexistence in high diverse environments and also may assist those involved in forest management and restoration.Na Amazônia as florestas secundárias são dominadas por espécies pioneiras que, normalmente, produzem grandes quantidades de sementes pequenas, dormentes e capazes de formar bancos de sementes no solo. A dormência neste grupo de espécies é superada pelas condições ambientais de áreas abertas, como alta irradiação ou alternância de temperaturas. No entanto, uma variedade de respostas de germinação aos fatores ambientais é conhecida entre as pioneiras; algumas germinam em luz difusa ou no escuro sob temperatura constante. Um dos fatores promotores desta variedade é a massa das sementes. Parece que para as espécies com sementes muito pequenas, o estímulo para que ocorra germinação é a luz e, para sementes maiores, a alternância de temperatura pode ser um estímulo mais importante. Neste estudo, estabeleceu-se uma relação entre a massa das sementes e a resposta de germinação à luz e temperatura para sete espécies pioneiras arbóreas da floresta amazônica. Descobrimos que o aumento na massa da semente foi acompanhado por diminuição da necessidade por luz e aumento da tolerância à alternância de temperatura. Compreender estratégias de germinação pode contribuir para os conhecimentos sobre a coexistência de espécies em ambientes altamente diversos e também pode ajudar aos pesquisadores envolvidos no manejo e restauração florestal

Carpal tunnel syndrome in the elderly: nerve conduction parameters Síndrome do túnel do carpo em idosos: parâmetros de condução nervosa

OBJECTIVE: To establish nerve conduction parameters for carpal tunnel syndrome (CTS) electrodiagnosis in the elderly. METHOD: Thirty healthy subjects (65-86 years), 9 male and 21 female, were studied. Routine median and ulnar sensory and motor nerve conduction studies, median mixed palmar latency, comparative latency techniques median to ulnar (sensory, mixed and motor lumbrical-interossei), median to radial (sensory), and combined sensory index (CSI) were performed in both hands. RESULTS: The upper limits of normality (97.5%) were: median sensory distal latency 3.80 ms (14 cm); median motor distal latency 4.30 ms (8 cm); median palmar latency 2.45 ms (8 cm); lumbrical-interossei latency difference 0.60 ms (8 cm); comparative median to radial 0.95 ms (10 cm); comparative median to ulnar 0.95 ms (14 cm); comparative palmar median to ulnar 0.50 ms (8 cm); and CSI 2.20 ms. Sensory and mixed latencies were measured at peak. CONCLUSION: Our results establish new nerve conduction parameters for mild CTS electrodiagnosis in the elderly and will be helpful to reduce the number of false positive cases in this age.<br>OBJETIVO: Estabelecer parâmetros de condução nervosa para o eletrodiagnóstico da síndrome do túnel do carpo (STC) em idosos. MÉTODO: Foram estudadas 30 pessoas idosas (65-86 anos) saudáveis. Foi realizado estudo de condução nervosa sensitiva e motora rotineira dos nervos mediano e ulnar, latência palmar mista do mediano, técnicas de comparação de latências mediano-ulnar (sensitivo, misto e motor lumbrical-interósseo) e mediano-radial (sensitivo) e índice sensitivo combinado (ISC) em ambas as mãos. RESULTADOS: Os limites superiores de normalidade, 97,5% foram: latência distal sensitiva do mediano 3,80 ms (14 cm); latência distal motora do mediano 4,30 ms (8 cm), latência palmar do mediano 2,45 ms (8 cm), diferença de latência lumbrical-interósseo 0,60 ms (8 cm), comparação mediano-radial 0,95 ms (10 cm), comparação mediano-ulnar 0,95 ms (14 cm), comparação mediano-ulnar palmar 0,50 ms (8 cm) e ISC 2,20 ms. As latências sensitivas e mistas foram medidas no pico. CONCLUSÃO: Nossos resultados estabelecem novos valores de condução nervosa para o eletrodiagnóstico da STC leve em idosos