Prevalence of Upper Limb Pain in Spinal Cord Injury: A Systematic Review

A systematic review was undertaken to evaluate and critically appraise literature pertaining to prevalence and treatment of upper limb pain in the spinal cord injured (SCI) population using manual wheelchair. Data extraction tables were compiled, then an in-depth data on the types of injury, level of injury, type of wheelchair used, type of treatment sought and the impact on Activities of Daily Living were recorded. A Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies tool was used to critically appraise the quality of studies included in this review. 994 papers in total were screened, 46 full text studies were assessed with 14 studies included in the final synthesis: four cohort studies and ten cross-sectional studies. Shoulder pain was the most common type of pain reported (30–71%) followed by wrist, hand, and elbow. Functional limitations reported because of upper limb pain included interference with mobilizing, transferring, and Activities of Daily Living, primarily personal care tasks. There is clear evidence that upper limb pain is prevalent in the SCI manual wheelchair using population which impacts on functional tasks. Further research is required to explore the perceptions of those with upper limb pain and techniques used to manage pain

Biomolecule Damage (DNA and Lipid) is Elevated in Patients with Type 1 Diabetes with and without Diabetic Complications

There is strong evidence that oxidative stress is involved in the aetiology and pathogenesis of diabetes and its complications. Increased production of reactive oxygen species in vivo can lead to cellular biomolecule damage, such as lipid peroxidation and DNA damage.The aim of this study was to determine the extent of this damage by measuring in vivo antioxidant status, levels of lipid peroxidation, and levels of neutrophil DNA damage in 50 participants with type 1 diabetes and 50 age- and sex-matched, healthy controls.Gylcaemic control (%HbA1c) was relatively good with a group mean of 7.71% which increased to 8.12 % in those with complications. Compared to the control group there were significantly elevated levels of neutrophil DNA damage (% tail DNA, p<0.0001) and plasma MDA levels (p<0.05) in the Type 1 group as a whole, this significance rose to p<0.01 in those with complications. There were significant alterations in markers of antioxidant status including, reduced levels of superoxide dismutase (p<0.0001), uric acid (p<0.05) and Vitamin C (p<0.05) and elevated levels of catalase (p<0.001).These results indicate that even with acceptable glycaemic control significant oxidative damage still occurs and this damage increases, in some indices, with the onset of complications