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Marine Algae in Diabetes and Its Complications
Published in Se-Kwon Kim, Marine Biochemistry, 2023
Peripheral neuropathy leads to predominant sensory impairment, and its symptoms are hyperesthesia, pain, and a gradual loss of sensation due to the loss of nerve fibers. When hypoalgesia occurs, trauma and mechanical irritation cannot be noticed; as a result, foot ulcers and gangrene may occur, leading to amputation of the lower limbs (Pop-Busui et al., 2017). Diabetic neuropathy is a multifactorial disease. The probable etiology comprises hyperglycemia, non-enzymatic glycation of proteins, activation of a polyol pathway, free radicals and oxidative stress, a decrease in nitric oxide (NO) levels, and activation of protein kinase C-β (PKC-β) (Feldman et al., 2019; Pop-Busui et al., 2017; Martin et al., 2006; Galer et al., 2000). Studies show that these factors perform synergistically (Feldman et al., 1997).
Sensory Examination
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Pain sensation (algesia):Analgesia: Absence of pain appreciationHypoalgesia: Decrease of pain appreciationHyperalgesia: Exaggeration of pain appreciation, which is often unpleasant
Hypnosis
Published in Eli Ilana, Oral Psychophysiology, 2020
In deep hypnosis, sight, hearing, smell, taste, and touch can be influenced by suggestion, and the subject’s perception through any senses affected. Probably the most dramatic effect, that most often used in medicine, is on the perception of pain. Under deep hypnosis, sensations of hypoalgesia and analgesia can be induced without pharmaceutical agents. The patient’s ability to experience numbness and a sensation of anesthesia in a specific region has been used to perform nonpainful surgical and dental treatments (e.g., in patients suspected of suffering from hypersensitivity to local anesthetic agents).
Physical activity, self-efficacy and quality of life in patients with chronic pain, assessed during and 1 year after physiotherapy rehabilitation – a prospective follow-up study
Published in Disability and Rehabilitation, 2022
Emma Varkey, Angelica Dahlbäck, Monica Thulin, Mats Börjesson, Daniel Arvidsson, Jonatan Fridolfsson, Paulin Andréll
Since the current recommendations for PA are based on studies using self-reported data, our use of objective measurements should be interpreted with caution. Self-reported PA and objectively assessed PA generally show low to moderate agreement [41]. Nonetheless fewer than half of our patients reported adherence to the recommendations. This highlights the importance of improving the level of PA in patients with chronic pain to reduce the risk of both morbidity and mortality from many chronic diseases [10], and also to reduce secondary effects of pain such as depression, anxiety and sleeping disturbance [4]. In addition, exercise therapy over 8–12 weeks may induce clinically relevant reductions in pain in patients with osteoarthritis [42]. Further, a single session of exercise might induce hypoalgesia in persons without pain (exercise-induced hypoalgesia). In patients with chronic pain, the response can vary between hypoalgesia, reduced hypoalgesia, and, the opposite effect, hyperalgesia (i.e., increased sensitivity to pain), depending on the pain condition [11]. This may also explain why the evidence is inconsistent regarding the effects of improved pain severity after a period of exercise in chronic pain conditions [4].
Spinal and supraspinal modulation of pain responses by hypnosis, suggestions, and distraction
Published in American Journal of Clinical Hypnosis, 2021
Bérengère Houzé, Anouk Streff, Mathieu Piché, Pierre Rainville
Pain-evoked responses were also reduced to a comparable extent following suggestions of hypoalgesia without hypnosis. This contrasts with a previous report of larger analgesic effects of suggestions under hypnosis (De Pascalis et al., 2008) but is in line with previous works reporting little advantage of hypnotic induction in responding to suggestions (Braffman & Kirsch, 1999; Meyer & Lynn, 2011; Milling, Kirsch, Allen, & Reutenauer, 2005). Our results are therefore in line and contribute to Kirsch et al.’s thesis that the effect of hypnosis is largely derived from effects of suggestions (Kirsch et al., 2007). By delivering the very same suggestions with and without hypnosis induction, the relative contribution of hypnosis and suggestions was adequately evaluated in the present study (Kirsch et al., 2007; Rainville, 2008). The effectiveness of suggestions may be explained by imaginative suggestibility, response expectancies and motivation (Braffman & Kirsch, 1999; Meyer & Lynn, 2011; Milling et al., 2005). However, it is possible that the context of the study itself had an effect. Although the hypnotic and non-hypnotic sessions were randomized, participants knew that they were participating in a hypnosis study. This context effect could have resulted in similar modulation of pain responses when suggesting hypoalgesia with and without hypnosis (Milling et al., 2005). Further studies are needed to elucidate the conditions under which psychophysiological responses to suggestions are enhanced by hypnosis.
Perineural injection of botulinum toxin-A in painful peripheral nerve injury – a case series: pain relief, safety, sensory profile and sample size recommendation
Published in Current Medical Research and Opinion, 2019
Christine H. Meyer-Frießem, Lynn B. Eitner, Miriam Kaisler, Christoph Maier, Jan Vollert, Andrea Westermann, Peter K. Zahn, Carla A. Avila González
Contrasting the previous results after sBONT injection, possibly due to the injection location, pBONT-A did not show analgesic effects predominantly in patients with eminent hyperalgesia, whereas sBONT-A was more effective in patients with preserved small fiber function and hyperalgesia11,35. It is comprehensible that the efficacy of drugs corresponds with a specific site of action (e.g. with either capsaicin or sodium channel blockers, such as oxcarbazepine, efficacy varies in patients both with and without preserved small fiber function, e.g. thermal perception)44. However, this must be confirmed in a placebo-controlled study. There are two common sensory phenotypes in patients suffering from PNI: (i) painful hypoesthesia/hypoalgesia and (ii) preserved thermal sensory function with signs of a mechanical hyperalgesia24. Patients of the first group are considered to have a poor prognostic outcome, as most phenotype-specific treatment lately showed efficacy rather for hyperalgesic phenotypes47. Our data suggest that pBONT-A seems to be equally effective in patients showing sensory deficits without hyperalgesia, which would significantly improve outcome perspective for these patients. Still, this was a case series and the extrapolation potential is therefore highly limited, and we hope that these findings will inform future prospective trials. For these, we provide a first primer on how to plan sample size in a pBONT-A trial.