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Introduction: Few treatment programs for chronic pain nowadays take a dietary pattern or adipose status into account. Areas covered: An important role of neuroinflammation in chronic pain is now well established, at least in part due to increased central nervous system glial activation. Based on preclinical studies, it is postulated that the interaction between nutrition and central sensitization is mediated via bidirectional gut–brain interactions. This model of diet-induced neuroinflammation and consequent central sensitization generates a rationale for developing innovative treatments for patients with chronic pain. Methods: An umbrella approach to cover the authors’ expert opinion within an evidence-based viewpoint. Expert opinion: A low-saturated fat and low-added sugar dietary pattern potentially decreases oxidative stress, preventing Toll-like receptor activation and subsequent glial activation. A low-saturated fat and low-added sugar diet might also prevent afferent vagal nerve fibers sensing the pro-inflammatory mediators that come along with a high-(saturated) fat or energy-dense dietary pattern, thereby preventing them to signal peripheral inflammatory status to the brain. In addition, the gut microbiota produces polyamines, which hold the capacity to excite N-methyl-D-aspartate receptors, an essential component of the central nervous system sensitization. Hence, a diet reducing polyamine production by the gut microbiota requires exploration as a therapeutic target for cancer-related and non-cancer chronic pain.

Purpose: Unrefreshing sleep and lowered physical activity are commonly observed in chronic fatigue syndrome (CFS) patients, but how they might influence each other remains unexplored. Therefore, this study simultaneously examined the exercise capacity, sleep characteristics and physical activity in CFS patients. Methods: Handgrip strength and cycle exercise capacity were assessed in 42 female CFS patients and 24 inactive control subjects. During four consecutive days and nights, energy expenditure, activity and sleep-wake pattern were objectively registered using a Sensewear Armband. Results: Exercise capacity was significantly lower in CFS patients. In both groups VO2peak correlated with the time subjects were physically active. In CFS patients only, VO2peak correlated negatively with sleeping during the day whilst physical activity level and energy expenditure correlated negatively with sleep latency and lying awake at night. Conclusions: In the present study, CFS patients with higher VO2peak tend to sleep less over day. Occupation in physical activities was negatively associated with sleep latency and lying awake at night. Increased physical activity potentially has beneficial effects on sleep quality in CFS. However, a close monitoring of the effects of increasing physical activity is essential to avoid negative effects on the health status of patients. Implications for Rehabilitation Female patients with chronic fatigue syndrome (CFS) have normal sleep latency and sleep efficiency, but sleep more and spent more time in bed as compared to healthy inactive women. Female CFS patients have lower exercise capacity, and a lower physical activity level as compared to healthy inactive women. CFS patients appear to be more sensitive for sleep quality (sleep latency and lying awake at night), which is associated with a low physical activity level.

The aim of the present study was to evaluate the influence of a single corticosteroid application on stratum corneum hydration. Hydration of the skin was estimated by measuring the stratum corneum capacitance while colour measurements were employed for the estimation of the potency of die applied formulations. Two corticosteroids were tested: clobetasol-17-propionate and halcinonide. We used different halcinonide concentrations (ranging from 0.005% to 0.200%) to evaluate the influence of the active ingredient concentration. We also evaluated the influence of the quantity applied (3 and 10 mg/cm2), of the application time (2 and 12 h) and of a humectant in the formulation (5% urea). We found a significant drying effect after application of the clobetasol-17-propionate formulation, while the stratum corneum hydration remained unaffected after application of the different halcinonide formulations, irrespective of the concentration used, the applied quantity or die application time. The addition of urea to th...