scholarly journals Persistent Idiopathic Dentoalveolar Pain. Literature Review and Clinical Case Treated with Intraoral Application of Botulinum Toxin

2021 ◽  
pp. 207-215
Author(s):  
Andrés R. Cervantes-Chavarría
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Differential Diagnosis ◽  
Botulinum Toxin ◽  
Side Effects ◽  
Clinical Case ◽  
Adjunctive Treatment ◽  
Diagnostic Process ◽  
Interdisciplinary Management

Persistent Idiopathic   Dentoalveolar Pain (PIDAP) is an orofacial neuropathic pain, which can be difficult to diagnose and is usually accompanied by increasing anxiety from both the patient and the treating dentist. A case of a 38-year-old female patient is presented, and it is shown the diagnostic process and therapeutic approach. The interdisciplinary management accompanied by several pharmacological lines is highlighted: Botulinum toxin was used as an adjunctive treatment allowing it to decrease systemically administered medications dosing and therefore its possible side effects. This condition usually affects psychosocial aspects of the patient and has a major impact on his quality of life. It is very important before initiating an invasive clinical treatment, obtaining a clear differential diagnosis and assessing in some cases the presence of non-odontogenic pain, such as PIDAP.

scholarly journals Buprenorphine: Far Beyond the “Ceiling”

Biomolecules ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 816
Author(s):  
Rosmara Infantino ◽  
Consalvo Mattia ◽  
Pamela Locarini ◽  
Antonio Luigi Pastore ◽  
Sabatino Maione ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Neuropathic Pain ◽  
Drug Abuse ◽  
Side Effects ◽  
National Health System ◽  
Analgesic Drugs ◽  
Third Line ◽  
Dynamic Profile

Chronic pain, including neuropathic pain, represents an untreated disease with important repercussions on the quality of life and huge costs on the national health system. It is well known that opioids are the most powerful analgesic drugs, but they represent the second or third line in neuropathic pain, that remain difficult to manage. Moreover, these drugs show several side effects that limit their use. In addition, opioids possess addictive properties that are associated with misuse and drug abuse. Among available opioids compounds, buprenorphine has been suggested advantageous for a series of clinical reasons, including the effectiveness in neuropathic pain. Some properties are partly explained by its unique pharmacological characteristics. However, questions on the dynamic profile remain to be answered. Pharmacokinetics optimization strategies, and additional potentialities, are still to be explored. In this paper, we attempt to conceptualize the potential undiscovered dynamic profile of buprenorphine.

Patient perspectives

2010 ◽  
pp. 181-187
Author(s):  
S. Jos Closs
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Suicidal Ideation ◽  
Side Effects ◽  
Focus Group ◽  
Drug Treatment ◽  
Sleep Disturbance ◽  
Focus Group Research ◽  
The Impact

The impact of neuropathic pain on quality of life has been under-researched and poorly understood though survey and focus group research is helping to gain better insights into what patients suffer Neuropathic pain can result in significant sleep disturbance, fatigue, and low mood (that sometimes leads to suicidal ideation), and side-effects from drug treatment are common...

scholarly journals The use of botulinum toxin for the treatment of patients with overactive bladder

2019 ◽  
Vol 65 (4) ◽  
Author(s):  
Agnieszka Licow ◽  
Sylwester Ciećwież ◽  
Magdalena Ptak ◽  
Dariusz Kotlęga ◽  
Andrzej Starczewski ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Botulinum Toxin ◽  
Side Effects ◽  
Overactive Bladder ◽  
Therapeutic Option ◽  
Great Promise ◽  
Social Psychological ◽  
Cholinergic Drugs

Overactive bladder affects 12–17% of the population, and mainly women, and its incidence increases with age. Diagnosis of this condition is based mainly on the patients’ complaints. These symptoms significantly affect the quality of life of millions of patients, involving considerable social, psychological, professional, physical and sexual problems. The wide incidence of this condition makes it necessary to find new medical substances in order to effectively eliminate the symptoms. Neurotoxins are a group of medical drugs that hold great promise for the future. Botulinum toxin is currently being used to treat  symptoms related to overactive bladder. It can constitute an appropriate therapeutic option, in  particular with regard to patients for whom the use of standard anti-cholinergic drugs is unsatisfactory or leads to severe side effects. Numerous research studies confirm that botulinum toxin can be  efficiently used in the treatment of overactive bladder. The properties of this neurotoxin allow selective  deactivation of overactive muscles. The use of botulinum toxin can be a method of treatment that significantly improves patient quality of life.Keywords: botulinum toxin; overactive bladder; urinary incontinence; quality of life.

scholarly journals Botulinum toxin type A in chronic neuropathic pain in refractory leprosy

2019 ◽  
Vol 77 (5) ◽  
pp. 346-351 ◽  
Author(s):  
Emanuel de Jesus Soares de Sousa ◽  
Gustavo Celeira de Sousa ◽  
Vitor Ferreira Baia ◽  
Danusa Neves Somensi ◽  
Marília Brasil Xavier
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Botulinum Toxin ◽  
Therapeutic Option ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Chronic Neuropathic Pain ◽  
Specific Protocol

ABSTRACT Neuropathic pain is a chronic syndrome that is difficult to treat and often affects patients with leprosy. Recommended treatment includes the the use of analgesic drugs, codeine, tricyclic antidepressants, neuroleptics, anticonvulsants and thalidomide, but without consensus on uniform dose and fully satisfactory results. Objective: To analyze botulinum toxin type A (BoNT-A) effectiveness in treatment of chronic neuropathic pain in refractory leprous patients, as well as evaluate and compare the quality of life of patients before and after using the medication. Methods: We used a specific protocol including clinical, demographic, DN4 protocol, analogue scale (VAS), sensory evaluation and evaluation of the WHOQOL-BREF. Therapeutic intervention was performed with BOTOX® BTX-A 100U administered subcutaneously. Fifteen patients were evaluated on days 0, 10 and 60. Results: Patients on VAS showed pain between 5 and 10, in one case there was complete pain relief in 60 days, while others showed improvement in the first week with the return of symptoms with less intensity after this period. WHOQOL-BREF's domains Quality of Life and Physical to have a significant increase in QOL. Conclusion: BoNT-A proved to be a good therapeutic option in relieving pain with improved quality of life for these patients.

Failure of long-term nerve root stimulation to improve neuropathic pain

2008 ◽  
Vol 108 (5) ◽  
pp. 921-925 ◽  
Author(s):  
Ralf Weigel ◽  
Hans-Holger Capelle ◽  
Joachim K. Krauss
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Side Effects ◽  
Nerve Root ◽  
Daily Living ◽  
Short Term ◽  
Test Stimulation ◽  
Root Stimulation

Object Stimulation of dorsal nerve roots or dorsal root ganglia was reported to alleviate neuropathic pain in selected patients during the early postoperative period. A prospective study was initiated to investigate long-term outcome in patients with neuropathic pain of the lower extremities or groin who were treated with selective nerve root stimulation. Methods The study included patients with dermatomally distributed neuropathic pain who were > 18 years of age and in whom the pain was refractory to medical treatment. The patients were prospectively evaluated using a visual analog scale (VAS) for pain and ratings for quality of life, activities of daily living, and depression preoperatively, and after defined intervals postoperatively. Implantation of electrodes was performed via foraminotomy or interlaminar fenestration in an awake procedure. An implantable pulse generator (IPG) was implanted in a second operation after successful test stimulation performed over several days. Results Three patients were included in the study before it was stopped. The mean maximum pain score preoperatively was 9.3. All patients had successful test stimulation with > 50% pain relief prior to implantation of the IPG (mean maximum VAS Score 3.6). The beneficial effect, however, was lost within the next few months despite adjustment of stimulation settings. With higher amplitudes, side effects such as pain attacks or motor phenomena occurred. They disappeared after stopping stimulation, but neuropathic pain recurred to its full extent. The study was stopped 18 months after the first implantation, when the third and last IPG of this series was explanted. Due to the overall short-term effect of stimulation, no relevant changes in ratings for quality of life, activities of daily living, or depression were detected. Conclusions Spinal nerve root stimulation proved to be effective on short-term follow-up in 3 patients with neuropathic pain in a dermatomal distribution. Long-term stimulation, however, was disappointing because of the loss of effectiveness and the occurrence of side effects.

scholarly journals Differentiated approach to the choice of PPI in a patient with GERD in the practice of an outpatient (with a clinical case)

2020 ◽  
pp. 20-26
Author(s):  
I. G. Pakhomova ◽  
M. V. Malko-Skroz
Keyword(s):  
Quality Of Life ◽  
Differential Diagnosis ◽  
Gastrointestinal Tract ◽  
Clinical Case ◽  
Preventive Measures ◽  
Rational Approach ◽  
Functional Disorders ◽  
Pathogenetic Therapy ◽  
Dual Mechanism

In recent years, functional disorders of the gastrointestinal tract (GIT) are quite common. The most significant functional disorders are functional dyspepsia (FD), which is widespread in the population. In addition, in the clinical practice of outpatient doctors, the proportion of combined variants or overlap of several types of functional disorders or a combination of functional disorders with organic pathology has increased. So, according to systematic reviews, the combined course of gastroesophageal reflux disease (GERD) and FD occurs in at least one third of patients. At the same time, the combined functional pathology of the gastrointestinal tract changes the clinical picture of GERD, which complicates differential diagnosis, leads to inadequate and multiple prescription of drugs and often low effectiveness of the prescribed therapy. All this negatively affects the quality of life of patients. The tactics of managing patients with the combined course of GERD and FD sometimes presents certain difficulties, since there are no available recommendations for pathogenetic therapy and preventive measures. To date, possible links in the pathogenesis of both GERD and FD have been studied and described, which predetermine certain approaches to the treatment of various variants of these two diseases. Drug therapy for GERD includes the appointment of proton pump inhibitors (PPIs), antireflux drugs. In FD therapy, prokinetics and/or PPIs are effective. A rational approach in the treatment of the intersection of GERD and FD is the appointment of a drug with a dual mechanism of action, which contains both a prokinetic and a PPI. An example of this approach is the appointment of omeprazole and domperidone. The use of this drug is presented in a clinical case.

The effects of botulinum toxin type A injection on pain symptoms, quality of life, and sleep quality of patients with diabetic neuropathy: A randomized double-blind clinical trial

2019 ◽  
Author(s):  
Hossein Salehi ◽  
Moein Moussaei ◽  
Zahra Kamiab ◽  
Alireza Vakilian
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Botulinum Toxin ◽  
Diabetic Neuropathy ◽  
Sleep Quality ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Double Blind ◽  
Sf 36

Background: Neuropathic pain is one of the most common problems in patients with diabetes mellitus (DM). In this study, the effect of botulinum toxin type A (BTX-A) on neuropathic pain, quality of sleep, and quality of life of diabetic patients with sensorimotor polyneuropathy was studied. Methods: This randomized placebo-controlled trial study was carried out in a double-blind (patientresearcher) method. The study was performed on 32 patients with type 2 DM. Neuropathy was confirmed by Douleur Neuropathique 4 (DN4) Questionnaire and nerve conduction study (NCS). The patients were randomly assigned to two intervention and control groups based on the random numbers table. After selecting the subjects, we used 36-Item Short Form Health Survey (SF-36), Neuropathic Pain Scale (NPS),  Visual Analogue Scale (VAS), and Pittsburgh Sleep Quality Index (PSQI) questionnaires before and after 3 months of 100 units BTX-A injection (as intervention group) or same amount of chloride sodium (as control group) to the subjects' feet. The data were analyzed by SPSS software using independent twosample t-test, chi-square test, and one-way repeated measures analysis of variance (ANOVA). Results: 12 male and 20 female patients participated in this study. There was a significant difference in the mean VAS, PSQI, physical dimension of the SF-36, and some NPS indices over time (12 weeks) (P < 0.001). Conclusion: The results of this study showed that BTX-A reduced neuropathic pain and improved the quality of life and sleep in people with diabetic neuropathy.  

scholarly journals A step closer in the management of uncontrolled neuropathic pain: gabapentin-nortriptyline combination

2020 ◽  
Vol 6 (6) ◽  
pp. 1365
Author(s):  
Manish Nilkanth Maladkar ◽  
Chitra Mohan Tekchandani ◽  
Raveena Kanyalal Bajaj
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Side Effects ◽  
Pain Relief ◽  
Combination Therapy ◽  
Sleep Disturbances ◽  
Spinal Injury ◽  
Current Treatment ◽  
Walking Ability

<p class="abstract">Neuropathic pain is extremely distressing as it significantly hampers the performance of daily activities and impedes overall quality of life. A large number of illnesses are linked with neuropathic pain like radiculopathy, sciatica, diabetes, herpes infection, spinal injury, stroke, etc. Treating neuropathic pain is challenging as response to the treatment is at times uncertain and associated with undesirable side effects. Uncontrolled neuropathic pain is observed in large group of patients receiving current treatment regimen. Almost half of the neuropathic pain patients need more than two drugs for pain relief. Various clinical trials have demonstrated better efficacy of combination therapy in reducing pain than monotherapy. Utilizing drug combination with different mechanism of action or acting on two different sites has demonstrated superior analgesic effect in painful neuropathic condition. The first tier agents recommended by various guidelines are calcium channel alpha-2-delta ligands and tricyclic antidepressants that act on different pain pathways. A clinical trial has shown enhanced pain relief with no increase in side effects with the administration of gabapentin and nortriptyline combination in patients suffering from neuropathic pain. Moreover, symptoms associated with neuropathic pain like sleep disturbances, altered mood, decreased walking ability, depression and quality of life were also significantly improved. Hence, combination therapy of gabapentin and nortriptyline offers a pivotal modality in the management of uncontrolled neuropathic pain.</p>

Clinical case of a comorbid patient with arterial hypertension

2020 ◽  
pp. 31-39
Author(s):  
Ella Polozova ◽  
Vsevolod Skvortsov ◽  
Olga Radaykina ◽  
Mariya Narvatkina ◽  
Anastasiya Seskina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Arterial Hypertension ◽  
Clinical Picture ◽  
Clinical Case ◽  
Diagnosis And Treatment ◽  
The Moment

The widespread prevalence of comorbid pathology determines the relevance of this problem. Comorbid pathology due to the interaction of diseases, drug pathomorphism, age characteristics of the patient, significantly changes clinical picture and course of the main nosology, affects severity of complications and their nature, significantly affects quality of life and prognosis of patients. Diagnosis and treatment of many diseases is complicated in the conditions of comorbidity. The article presents a clinical case of a comorbid patient with arterial hypertension from the moment of exposure to risk factors and ending with the formation of many concomitant diseases, as an example of trans-nosological comorbidity.

Proton Pump Inhibitors in 2021: Pros, Cons, and Everything in Between

2021 ◽  
pp. 263451612110217
Author(s):  
Joshua A. Sloan ◽  
Philip O. Katz
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Events ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Drug Class ◽  
Life Threatening

The medical and lay literature has exploded with reports of adverse events associated with proton pump inhibitors over the last 10 to 15 years. The dissemination of these reports to patients and clinicians have created substantial concerns regarding what has been an exceptionally valuable drug class, dramatically improving patient quality of life, and in many cases preventing life threatening side effects of other medication. Patients are more frequently seeking to avoid these medications, and practitioners are reducing or discontinuing them to the patient’s detriment due to a misunderstanding of the data. This review will discuss the data regarding the most commonly publicized adverse events and attempt to put them in perspective.

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