Diabetic Neuropathy: a Critical, Narrative Review of Published Data from 2019

Prelabour rupture of membranes (PROM) refers to the disruption of foetal membranes before the onset of labour, resulting in the leakage of amniotic fluid. PROM complicates 3% and 8% of preterm and term pregnancies, respectively. Accurate and timely diagnosis is crucial for effective management to prevent adverse maternal- and foetal-outcomes. The diagnosis of equivocal PROM cases with traditional methods often becomes challenging in current obstetrics practice; therefore, various novel biochemical markers have emerged as promising diagnostic tools. This narrative review is sought to review the published data to understand the current and emerging trends in diagnostic modalities in term and preterm pregnancies complicated with PROM and the potential role of various markers for predicting preterm PROM (pPROM) and chorioamnionitis in women with pPROM.

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Diabetic foot care within the context of rehabilitation: keeping people with diabetic neuropathy on their feet. A narrative review

Physical Therapy Reviews ◽

10.1080/10833196.2017.1353750 ◽

2017 ◽

Vol 22 (3-4) ◽

pp. 177-185

Author(s):

Robert W.M. van Deursen ◽

Everdien F.H. Bouwman

Keyword(s):

Diabetic Neuropathy ◽

Diabetic Foot ◽

Narrative Review ◽

Foot Care

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Current Pharmacological Treatment of Painful Diabetic Neuropathy: A Narrative Review

Medicina ◽

10.3390/medicina56010025 ◽

2020 ◽

Vol 56 (1) ◽

pp. 25 ◽

Cited By ~ 3

Author(s):

Valeriu Ardeleanu ◽

Alexandra Toma ◽

Kalliopi Pafili ◽

Nikolaos Papanas ◽

Ion Motofei ◽

...

Keyword(s):

Neuropathic Pain ◽

Diabetic Neuropathy ◽

Pharmacological Treatment ◽

Selective Serotonin Reuptake Inhibitors ◽

Pain Treatment ◽

Narrative Review ◽

Sensory Loss ◽

Cochrane Library ◽

First Choice ◽

Distal Symmetrical Polyneuropathy

Background and Objectives: Distal symmetrical polyneuropathy (DSPN) is one of the most common chronic complications of diabetes mellitus. Although it is usually characterized by progressive sensory loss, some patients may develop chronic pain. Assessment of DSPN is not difficult, but the biggest challenge is making the correct diagnosis and choosing the right treatment. The treatment of DSPN has three primary objectives: glycemic control, pathogenic mechanisms, and pain management. The aim of this brief narrative review is to summarize the current pharmacological treatment of painful DSPN. It also summarizes knowledge on pathogenesis-oriented therapy, which is generally overlooked in many publications and guidelines. Materials and Methods: The present review reports the relevant information available on DSPN treatment. The search was performed on PubMed, Cochrane, Semantic Scholar, Medline, Scopus, and Cochrane Library databases, including among others the terms “distal symmetrical polyneuropathy”, “neuropathic pain treatment”, “diabetic neuropathy”, “diabetes complications”, ”glycaemic control”, “antidepressants”, “opioids”, and “anticonvulsants”. Results: First-line drugs include antidepressants (selective serotonin reuptake inhibitors and tricyclic antidepressants) and pregabalin. Second- and third-line drugs include opioids and topical analgesics. While potentially effective in the treatment of neuropathic pain, opioids are not considered to be the first choice because of adverse reactions and addiction concerns. Conclusions: DSPN is a common complication in patients with diabetes, and severely affects the quality of life of these patients. Although multiple therapies are available, the guidelines and recommendations regarding the treatment of diabetic neuropathy have failed to offer a unitary consensus, which often hinders the therapeutic options in clinical practice.

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The patient needing prolonged mechanical ventilation: a narrative review

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2018.104 ◽

2019 ◽

Vol 13 ◽

Author(s):

Nicolino Ambrosino

Keyword(s):

Mechanical Ventilation ◽

Intensive Care ◽

Medical Training ◽

Prolonged Mechanical Ventilation ◽

Narrative Review ◽

Optimal Time ◽

Published Data ◽

Main Body ◽

Term Survival

Background: Progress in management has improved hospital mortality of patients admitted to the intensive care units, but also the prevalence of those patients needing weaning from prolonged mechanical ventilation, and of ventilator assisted individuals. The result is a number of difficult clinical and organizational problems for patients, caregivers and health services, as well as high human and financial resources consumption, despite poor long-term outcomes. An effort should be made to improve the management of these patients. This narrative review summarizes the main concepts in this field. Main body: There is great variability in terminology and definitions of prolonged mechanical ventilation. There have been several recent developments in the field of prolonged weaning: ventilatory strategies, use of protocols, early mobilisation and physiotherapy, specialised weaning units. There are few published data on discharge home rates, need of home mechanical ventilation, or long-term survival of these patients. Whether artificial nutritional support improves the outcome for these chronic critically ill patients, is unclear and controversial how these data are reported on the optimal time of initiation of parenteral vs enteral nutrition. There is no consensus on time of tracheostomy or decannulation. Despite several individualized, non-comparative and non-validated decannulation protocols exist, universally accepted protocols are lacking as well as randomised controlled trials on this critical issue. End of life decisions should result from appropriate communication among professionals, patients and surrogates and national legislations should give clear indications. Conclusion: Present medical training of clinicians and locations like traditional intensive care units do not appear enough to face the dramatic problems posed by these patients. The solutions cannot be reserved to professionals but must involve also families and all other stakeholders. Large multicentric, multinational studies on several aspects of management are needed.

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Medication-Related Osteonecrosis of the Jaw: A Critical Narrative Review

Journal of Clinical Medicine ◽

10.3390/jcm10194367 ◽

2021 ◽

Vol 10 (19) ◽

pp. 4367

Author(s):

Alejandro I. Lorenzo-Pouso ◽

José Bagán ◽

Leticia Bagán ◽

Pilar Gándara-Vila ◽

Cintia M. Chamorro-Petronacci ◽

...

Keyword(s):

Relevant Literature ◽

Osteonecrosis Of The Jaw ◽

Narrative Review ◽

Therapeutic Options ◽

Current Understanding ◽

Published Data ◽

Paradoxical Reaction ◽

Current Trends ◽

Orofacial Region

Background: Nearly two decades have passed since a paradoxical reaction in the orofacial region to some bone modifying agents and other drugs was recognized, namely medication-related osteonecrosis of the jaw (MRONJ). Purpose: The aim of this manuscript was to critically review published data on MRONJ to provide an update on key terminology, concepts, and current trends in terms of prevention and diagnosis. In addition, our objective was to examine and evaluate the therapeutic options available for MRONJ. Methods: The authors perused the most relevant literature relating to MRONJ through a search in textbooks and published articles included in several databases for the years 2003–2021. Results and conclusions: A comprehensive update of the current understanding of these matters was elaborated, addressing these topics and identifying relevant gaps of knowledge. This review describes our updated view of the previous thematic blocks, highlights our current clinical directions, and emphasizes controversial aspects and barriers that may lead to extending the accumulating body of evidence related to this severe treatment sequela.

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Frontal Fibrosing Alopecia: A Review

Journal of Clinical Medicine ◽

10.3390/jcm10091805 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1805

Author(s):

María Librada Porriño-Bustamante ◽

María Antonia Fernández-Pugnaire ◽

Salvador Arias-Santiago

Keyword(s):

Narrative Review ◽

Published Data ◽

Reductase Inhibitors ◽

Scarring Alopecia ◽

Histopathologic Findings ◽

5 Alpha Reductase Inhibitors

Frontal fibrosing alopecia is a scarring alopecia, the prevalence of which is increasing worldwide since its first description in 1994. The reason for this emerging epidemic may be a higher exposure to an unknown trigger, although its aethiology and pathogenesis still remain enigmatic. Clinical, trichoscopic, sonographic, and histopathologic findings are allowing clinicians to understand more aspects about this type of cicatricial alopecia. Several treatments have been used in frontal fibrosing alopecia, although the 5-alpha reductase inhibitors seem to be the most promising. The aim of this report is to provide a compilation about the published data regarding frontal fibrosing alopecia in a narrative review.

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