30 results on '"NEUROPATHY"'
Search Results
2. Transdermal Magnesium for the Treatment of Peripheral Neuropathy in Chronic Kidney Disease: A Single-Arm, Open-Label Pilot Study.
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Athavale, Akshay, Miles, Natividad, Pais, Riona, Snelling, Paul, and Chadban, Steven J.
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THERAPEUTIC use of magnesium , *CHRONIC kidney failure , *PILOT projects , *PERIPHERAL neuropathy , *ACADEMIC medical centers , *AEROSOLS , *CLINICAL trials , *TRANSDERMAL medication , *DRUG administration , *TREATMENT effectiveness , *MAGNESIUM - Abstract
Introduction: Peripheral neuropathy is common in chronic kidney disease (CKD) and may be multifactorial in origin, resulting from uremia, hyperkalemia, and diabetes. Previous studies have suggested that magnesium plays a crucial role in chronic pain. Studies evaluating magnesium in neuropathy have demonstrated mixed results. Aims: To provide preliminary data on the effectiveness of transdermal magnesium in treating peripheral neuropathy related to CKD. Methods: Twenty participants with advanced CKD were enrolled from a major teaching hospital clinic in Sydney, Australia. Each participant was provided with a spray bottle containing magnesium chloride and instructed to apply five sprays to each limb affected by neuropathy daily for 12 weeks. Participants completed the Neuropathy Total Symptom Score-6 (NTSS-6) every 4 weeks during follow-up. Serum magnesium concentrations were measured at 4-week intervals. Results: Twenty participants were recruited, of which 14 completed the 12-week follow-up period. Mean age was 78.90 years, 80.00% were female and mean estimated glomerular filtration rate was 9.78 mL/min/1.73 m2. With intention to treat analysis (mean [95% confidence interval]), NTSS-6 was significantly reduced at weeks 8 (4.04 [2.43–5.65]) and 12 (4.26 [2.47–6.05]), compared with baseline (6.92 [5.29–8.55]), p < 0.05. Serum magnesium concentration did not change significantly during the study. Conclusion: This pilot study suggests that transdermal magnesium may be beneficial in reducing frequency and severity of peripheral neuropathic symptoms in patients with advanced CKD. Trial Registration: australianclinicaltrials.gov.au. Identifier: ACTRN12621000841875. Date first registered January 7, 2021. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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3. Evaluation of recurrent laryngeal neuropathy in domestic and feral horse populations in Australia using histologic and immunohistochemical analysis: A pilot study.
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Lean, Natasha E., Franklin, Samantha H., Steel, Cate, Woolford, Lucy, White, Jason, and Ahern, Benjamin J.
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WILD horses , *IMMUNOHISTOCHEMISTRY , *RECURRENT laryngeal nerve , *HISTOLOGICAL techniques , *NERVOUS system regeneration , *PRESSURE ulcers , *SCIATIC nerve injuries - Abstract
Background: Little is known about potential differences in the left recurrent laryngeal nerve (Lrln) and left cricoarytenoideus dorsalis (LCAD) muscle between domestic and feral horse populations. If a difference exists, feral horses may provide a useful control population for research related to recurrent laryngeal neuropathy (RLN) and increase our understanding of potential population pressures influencing the incidence RLN. Objectives: The objective of this study was to compare the Lrln and LCAD of domestic and feral horses using histological and immunohistochemical techniques (IHC). Methods: Sixteen horses, domestic (n = 8) and feral (n = 8), without clinical or ancillary examinations that were processed at an abattoir had the Lrln and LCAD muscle harvested immediately following death. Carcass weights were recorded. Subjective and morphometric histologic assessment were performed on Lrln sections. The LCAD was assessed for myosin heavy chain (fibre type proportion, diameter and grouping using IHC. Results: Fibre‐type grouping consistent with RLN was seen in both groups. Regenerating fibre clusters were more common in domestic compared to feral horses (p = 0.04). No other histologic differences occurred between groups. Muscle fibre typing demonstrated a lower mean percentage of type IIX fibres in the feral group compared to the domestic group (p = 0.03). There was no difference in type I or IIA proportions or mean diameter of any fibre type between the groups. Conclusions: The domestic population showed evidence of nerve regeneration suggesting RLN in this group, yet this was not supported by the higher proportion of type IIX muscle fibres compared to the feral population. Further evaluation to clarify the significance and wider occurrence of the differences is indicated. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Preventing diabetes-related foot ulcers through early detection of peripheral neuropathy
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McMorrow, Rita, Nube, Vanessa L, and Manski-Nankervis, Jo-Anne
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- 2022
5. Nitrous oxide‐induced neurological disorders: an increasing public health concern.
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Redmond, Jessica, Cruse, Belinda, and Kiers, Lynette
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SPINE radiography , *NEUROLOGICAL disorders , *VITAMIN B12 , *POLYPHARMACY , *PUBLIC health , *TERTIARY care , *MAGNETIC resonance imaging , *PREEXISTING medical condition coverage , *MOTOR neuron diseases , *NEUROLOGIC manifestations of general diseases , *NEURAL conduction , *NITROUS oxide , *MENTAL illness , *NEURODEGENERATION - Abstract
Background: Neurological presentations resulting from nitrous oxide (N2O) abuse are increasing in Australia and worldwide. Despite known neuropsychiatric sequelae, N2O canisters remain readily available and its use unregulated. Aims: To examine the demographics, clinical and electrophysiological findings of patients presenting with neurological complications of N2O abuse, and thus inform clinicians and public health decision‐makers of the significant public health concerns of this increasing practice. Methods: Consecutive patients presenting to a tertiary referral metropolitan hospital were included in this series. Patients were identified by a search of discharge summaries of patients admitted with acute or subacute neuropathy or myelopathy and a history of N2O abuse, and from the electrophysiology database. Results: Thirteen patients were identified, most presenting with subacute paraesthesia, sensory ataxia and lower limb weakness. Eleven had low serum vitamin B12. Spinal magnetic resonance imaging was consistent with subacute combined degeneration in eight. Nerve conduction studies revealed a motor or sensorimotor axonal neuropathy (three with motor predominance). There was a bimodal demographic distribution consisting of socially isolated, international university students and local residents with a history of mental illness and polydrug abuse. Conclusions: Recreational N2O use is an emerging health problem in Australia. International university students and patients with pre‐existing mental illness or polydrug use appear to be at increased risk. A severe motor neuropathy may emerge following vitamin B12 replacement. Public health measures are required to limit the availability of N2O and to educate adolescents and young adults about the potential for significant harm. [ABSTRACT FROM AUTHOR]
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- 2022
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6. Establishing risk of vision loss in Leber hereditary optic neuropathy.
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Lopez Sanchez, M. Isabel G., Kearns, Lisa S., Staffieri, Sandra E., Clarke, Linda, McGuinness, Myra B., Meteoukki, Wafaa, Samuel, Sona, Ruddle, Jonathan B., Chen, Celia, Fraser, Clare L., Harrison, John, Hewitt, Alex W., Howell, Neil, and Mackey, David A.
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VISION disorders , *GENETIC counseling , *CHILD death , *NEUROPATHY , *FALSE claims , *RISK perception - Abstract
We conducted an updated epidemiological study of Leber hereditary optic neuropathy (LHON) in Australia by using registry data to establish the risk of vision loss among different LHON mutations, sex, age at onset, and mitochondrial haplogroup. We identified 96 genetically unrelated LHON pedigrees, including 56 unpublished pedigrees, and updated 40 previously known pedigrees, comprising 620 affected individuals and 4,948 asymptomatic carriers. The minimum prevalence of vision loss due to LHON in Australia in 2020 was one in 68,403 individuals. Although our data confirm some well-established features of LHON, the overall risk of vision loss among those with a LHON mutation was lower than reported previously—17.5% for males and 5.4% for females. Our findings confirm that women, older adults, and younger children are also at risk. Furthermore, we observed a higher incidence of vision loss in children of affected mothers as well as in children of unaffected women with at least one affected brother. Finally, we confirmed our previous report showing a generational fall in prevalence of vision loss among Australian men. Higher reported rates of vision loss in males with a LHON mutation are not supported by our work and other epidemiologic studies. Accurate knowledge of risk is essential for genetic counseling of individuals with LHON mutations. This knowledge could also inform the detection and validation of potential biomarkers and has implications for clinical trials of treatments aimed at preventing vision loss in LHON because an overestimated risk may lead to an underpowered study or a false claim of efficacy. [ABSTRACT FROM AUTHOR]
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- 2021
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7. Findings from Western Sydney University Provides New Data on Peripheral Neuropathy (Relationship Between Diabetes-related Large-fiber Neuropathy and Dorsiflexion Range of Motion At the Ankle and First Metatarsophalangeal Joints).
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PERIPHERAL neuropathy ,METATARSOPHALANGEAL joint ,RANGE of motion of joints ,DORSIFLEXION ,NEUROPATHY - Published
- 2024
8. Findings from University of Adelaide Reveals New Findings on Optic Nerve Diseases and Conditions (Optic Nerve Sheath Infiltration In Dysthyroid Optic Neuropathy).
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OPTIC nerve diseases ,OPTIC nerve ,THYROID eye disease ,NEUROPATHY ,MAGNETIC resonance imaging ,INTRACRANIAL hypertension - Abstract
A study conducted by researchers at the University of Adelaide in Australia has found that optic nerve sheath infiltration may be a predictor of dysthyroid optic neuropathy (DON), a condition associated with thyroid eye disease (TED). The study analyzed patients with TED who underwent magnetic resonance imaging (MRI) and found that optic nerve sheath infiltration, fat infiltration, and scleral enhancement were all significantly associated with active clinical disease. However, only optic nerve sheath infiltration was significantly associated with DON. These radiological findings could potentially be used as diagnostic and stratification tools for evaluating TED patients. [Extracted from the article]
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- 2024
9. Patterns of orofacial pain practice amongst oral medicine specialists in Australia.
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Tiwari, Lalima and Balasubramaniam, Ramesh
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OROFACIAL pain , *ORAL medicine , *DESCRIPTIVE statistics , *NEUROPATHY , *TEMPOROMANDIBULAR disorders , *HEADACHE , *PAIN management , *FACIAL pain , *DENTISTS , *MEDICAL specialties & specialists - Abstract
Background: This study aimed to evaluate and describe the current patterns of practice pertaining to orofacial pain amongst oral medicine specialists in Australia and provide insight into the access of care available to orofacial pain patients in Australia.Methods: A survey involving questions relevant to orofacial pain, patient and practitioner demographics was designed and disseminated via an online polling platform to all Australian Health Practitioner Regulation Agency registered oral medicine specialists. Results were collated online, and simple descriptive statistics were utilised for data analysis.Results: Twenty-six oral medicine specialists were included in this study, with a survey response rate of 81.2%. All specialists considered orofacial pain practice as part of the oral medicine specialty. 96.2% assessed and managed orofacial pain patients as part of their oral medicine practice. The greatest proportion (30.8%) of oral medicine specialists were practicing in Western Australia, a state which represents 10.3% of the Australian population. All respondents reportedly diagnose temporomandibular disorders, followed by orofacial neuropathy (96.2%) and headache or neurovascular disorders (80.8%). 92.3% of specialists managed orofacial neuropathy followed by temporomandibular disorders (84.6%) and headache or neurovascular disorders (50%).Conclusion: This is the first study to report on patterns of orofacial pain practice amongst oral medicine specialists in Australia. Findings demonstrate that oral medicine specialists in Australia are actively engaged in the assessment and management of the orofacial pain patient. There, however, appears to be disproportionate access to care by oral medicine specialists for patients with orofacial pain across Australia. [ABSTRACT FROM AUTHOR]- Published
- 2020
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10. Unravelling the efficacy of antidepressants as analgesics
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Janakiraman, Raguraman, Hamilton, Laura, and Wan, Aston
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- 2016
11. Reliability of the English version of the painDETECT questionnaire.
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Tampin, B., Bohne, T., Callan, M., Kvia, M., Melsom Myhre, A., Neoh, E.C., Bharat, C., and Slater, H.
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NEUROPATHY , *INTRACLASS correlation , *FOLLOW-up studies (Medicine) , *NEURALGIA , *MEDICAL screening , *QUALITY assurance , *TRANSLATIONS , *PAIN measurement , *CROSS-sectional method , *STANDARDS , *DIAGNOSIS ,RESEARCH evaluation - Abstract
Background:The painDETECT questionnaire (PD-Q) has been used widely for the identification of neuropathic pain (NeP); however, the reliability of the English version of the PD-Q has never been investigated. Objective:This study aimed to determine the reliability of the PD-Q pre- (T0) and immediately post- (T1) clinical consultation and at one-week follow-up (T2). Methods:We recruited 157 patients attending a Neurosurgery Spinal Clinic and Pain Management Department. Minor changes to PD-Q instructions were made to facilitate patient understanding; however, no changes to individual items or scoring were made. Intraclass correlation coefficients (ICCs) were used to assess the reliability of PD-Q total scores between T0–T1 and T0–T2; weighted kappa (κ) was used to assess the agreement of PD-Q classifications (unlikely NeP, ambiguous, likely NeP) between all time-points. To ensure stability of clinical pain, patients scoring ≤2 or ≥6 on the Patient Global Impression Scale (PGIC) at T2 were excluded from the T0–T2 analysis. Results:Accounting for missing data and exclusions (change in PGIC score), data for 136 individuals (mean [SD] age: 56.8 [15.2]; 54% male) was available, of whomn = 129 were included in the T0–T1 andn = 69 in the T0–T2 comparisons. There was almost perfect agreement between the PD-Q total scores at T0–T1 time-points (ICC 0.911; 95% CI: 0.882–0.941) and substantial agreement at T0–T2 (ICC 0.792; 95% CI: 0.703–0.880). PD-Q classifications demonstrated substantial agreement for T0–T1 (weightedκ: 0.771; 95% CI: 0.683–0.858) and for T0–T2 (weightedκ: 0.691; 95% CI: 0.553–0.830). Missing data was accounted in 13% of our cohort and over 42% of our patients drew multiple pain areas on the PD-Q body chart. Conclusion:The English version of the PD-Q is reliable as a screening tool for NeP. The validity of the questionnaire is still in question and has to be investigated in future studies. [ABSTRACT FROM PUBLISHER]
- Published
- 2017
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12. Using PCR-Based Sequencing to Diagnose Haycocknema perplexum Infection in Human Myositis Case, Australia.
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Koehler, Anson V., Leung, Peter, McEwan, Belinda, and Gasser, Robin B.
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MYOSITIS , *NEUROPATHY , *BIOPSY , *NEMATODES , *POLYMERASE chain reaction , *SERODIAGNOSIS - Abstract
We report a case of myositis in a male patient in Australia who had progressive weakness and wasting in his left lower limb. Although clinical, pathologic, and laboratory assessments were inconclusive, a new, nested PCR-coupled sequencing method enabled the unequivocal diagnosis of myositis caused by the enigmatic nematode Haycocknema perplexum. [ABSTRACT FROM AUTHOR]
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- 2018
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13. Studies from University of Sydney Have Provided New Data on Hyperalgesia (Learning Pain In Context: Response-conditioned Placebo Analgesia and Nocebo Hyperalgesia In Male Rats With Chronic Neuropathic Pain).
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NEURALGIA ,NOCEBOS ,HYPERALGESIA ,CHRONIC pain ,NEUROLOGICAL disorders ,SCIATIC nerve injuries ,VASCULAR dementia ,CONTEXTUAL learning - Abstract
For more information on this research see: Learning Pain In Context: Response-conditioned Placebo Analgesia and Nocebo Hyperalgesia In Male Rats With Chronic Neuropathic Pain. Keywords: Camperdown; Australia; Australia and New Zealand; Health and Medicine; Hyperalgesia; Nervous System Diseases and Conditions; Neurologic Manifestations; Neuropathic Pain; Neuropathy; Pain; Sensation Disorders; Somatosensory Disorders EN Camperdown Australia Australia and New Zealand Health and Medicine Hyperalgesia Nervous System Diseases and Conditions Neurologic Manifestations Neuropathic Pain Neuropathy Pain Sensation Disorders Somatosensory Disorders 699 699 1 05/02/23 20230505 NES 230505 2023 MAY 1 (NewsRx) -- By a News Reporter-Staff News Editor at Pain & Central Nervous System Week -- Research findings on Nervous System Diseases and Conditions - Hyperalgesia are discussed in a new report. [Extracted from the article]
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- 2023
14. X-linked Charcot-Marie-Tooth disease type 6 ( CMTX6) patients with a p. R158H mutation in the pyruvate dehydrogenase kinase isoenzyme 3 gene.
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Kennerson, Marina L., Kim, Eun J., Siddell, Anna, Kidambi, Aditi, Kim, Sung M., Hong, Young B., Hwang, Sun H., Chung, Ki W., and Choi, Byung‐Ok
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CHARCOT-Marie-Tooth disease , *DEAMINATION , *DEMYELINATION , *ELECTROPHYSIOLOGY , *ISOENZYMES , *LEG , *MAGNETIC resonance imaging , *X-linked genetic disorders , *GENETIC mutation , *NEURORADIOLOGY , *PHOSPHOTRANSFERASES , *PHENOTYPES , *DISEASE relapse , *GENETIC testing , *SEQUENCE analysis , *GENOTYPES , *GENETICS - Abstract
Charcot-Marie-Tooth disease ( CMT) is the most common inherited peripheral neuropathy. Mutations in the pyruvate dehydrogenase kinase isoenzyme 3 ( PDK3) gene have been found to cause X-linked dominant CMT type 6 ( CMTX6). This study identified the p. R158H PDK3 mutation after screening 67 probable X-linked CMT families. The mutation fully segregated with the phenotype, and genotyping the family indicated the mutation arose on a different haplotype compared with the original Australian CMTX6 family. Results of bisulphite sequencing suggest that methylated deamination of a CpG dinucleotide may cause the recurrent p. R158H mutation. The frequency of the p. R158H PDK3 mutation in Koreans is very rare. Magnetic resonance imaging revealed fatty infiltration involving distal muscles in the lower extremities. In addition, fatty infiltrations were predominantly observed in the soleus muscles, with a lesser extent in tibialis anterior muscles. This differs from demyelinating CMT1A patients and is similar to axonal CMT2A patients. The clinical, neuroimaging, and electrophysiological findings from a second CMTX6 family with the p. R158H PDK3 mutation were similar to the axonal neuropathy reported in the Australian family. [ABSTRACT FROM AUTHOR]
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- 2016
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15. Report Summarizes Personalized Medicine Study Findings from University of Sydney (The Impact of Obesity On Neuropathy Outcomes for Paclitaxel- and Oxaliplatin-treated Cancer Survivors).
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INDIVIDUALIZED medicine ,CANCER survivors ,NUTRITION disorders ,NEUROPATHY ,MEDICAL research - Abstract
Keywords: Camperdown; Australia; Australia and New Zealand; Alkylating Agents; Antineoplastics; Bariatrics; Cancer; Cycloparaffins; Diet and Nutrition; Diterpenes; Drugs and Therapies; Health and Medicine; Hydrocarbons; Mitotic Inhibitors; Neuropathy; Nutrition Disorders; Nutritional and Metabolic Diseases and Conditions; Obesity; Obesity and Diabetes; Oncology; Organic Chemicals; Overnutrition; Oxaliplatin Therapy; Paclitaxel Therapy; Personalized Medicine; Personalized Therapy; Pharmaceuticals; Taxoids; Terpenes EN Camperdown Australia Australia and New Zealand Alkylating Agents Antineoplastics Bariatrics Cancer Cycloparaffins Diet and Nutrition Diterpenes Drugs and Therapies Health and Medicine Hydrocarbons Mitotic Inhibitors Neuropathy Nutrition Disorders Nutritional and Metabolic Diseases and Conditions Obesity Obesity and Diabetes Oncology Organic Chemicals Overnutrition Oxaliplatin Therapy Paclitaxel Therapy Personalized Medicine Personalized Therapy Pharmaceuticals Taxoids Terpenes 767 767 1 03/24/23 20230228 NES 230228 2023 FEB 28 (NewsRx) -- By a News Reporter-Staff News Editor at Cancer Weekly -- Investigators publish new report on Drugs and Therapies - Personalized Medicine. Three hundred seventy-nine cancer survivors were assessed 5 (IQR 3-5) months post oxaliplatin or paclitaxel treatment via comprehensive patient-reported, clinical, and functional CIPN measures. [Extracted from the article]
- Published
- 2023
16. Monash University Reports Findings in Pain (Feasibility of virtual reality-delivered pain psychology therapy for cancer-related neuropathic pain: a pilot randomised controlled trial).
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CANCER pain ,PAIN management ,NEURALGIA ,VIRTUAL reality therapy ,PSYCHOTHERAPY - Abstract
However, no virtual reality pain therapy software existed that met the needs of cancer patients with neuropathic pain." Of 87 eligible cancer patients with neuropathic pain, 39 were recruited (47%), allocated to either the intervention (20 patients, virtual reality pain therapy software programme) or control (19 patients, viewing virtual reality videos). [Extracted from the article]
- Published
- 2023
17. Granuloma formation and suspected neuropathic pain in a domestic pigeon ( Columba livia) secondary to an oil-based, inactivated Newcastle disease vaccine administered for protection against pigeon paramyxovirus-1.
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Cowan, ML, Monks, DJ, and Raidal, SR
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GRANULOMA , *NEUROPATHY , *PIGEONS , *VACCINATION , *PARAMYXOVIRUSES , *PAIN management , *DISEASES - Abstract
Case report A domestic pigeon developed a sterile granuloma following vaccination with an oil-adjuvant, inactivated La Sota strain of Newcastle disease. The aim of vaccination was to provide protection against pigeon paramyxovirus-1 ( PPMV-1), a disease previously considered exotic to Australia. Granuloma formation is considered a rare complication of vaccination against PPMV-1 in pigeons. Clinical signs consistent with neuropathic pain became apparent during the extensive management of the granuloma, which included surgical removal of foreign material, control of the pain and inflammation and protection against antimicrobial contamination. Conclusion PPMV-1 is now considered endemic in Australia and protecting pigeons with vaccination is important. Until a product is registered for use, vaccination remains off-label and the risk of adverse reaction, including sterile granuloma, must be considered. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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18. Accredited pharmacist special interest group: Thalidomide-induced peripheral neuropathy
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Gailer, Joy
- Published
- 2015
19. The Cost-Effectiveness of Mandatory Folic Acid Fortification in Australia.
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Rabovskaja, Viktoria, Parkinson, Bonny, and Goodall, Stephen
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FOLIC acid , *NEURAL tube defects , *COST effectiveness , *NEUROPATHY , *ALTERNATIVE medicine - Abstract
The Australian government recently introduced mandatory folic acid fortification of bread to reduce the incidence of neural tube defects (NTDs). The economic evaluation of this policy contained a number of limitations. This study aimed to address the limitations and to reconsider the findings. Cost-effectiveness analysis was used to assess the cost and benefits of mandatory versus voluntary folic acid fortification. Outcomes measures were quality-adjusted life-years (QALYs), lifeyears gained (LYG), avoided NTD cases, and additional severe neuropathy cases. Costs considered included industry costs and regulatory costs to the government. It was estimated that mandatory fortification would prevent 31 NTDs, whereas an additional 14 cases of severe neuropathy would be incurred. Overall, 539 LYG and 503 QALYs would be gained per year of mandatory compared with voluntary fortification. Mandatory fortification was cost-effective at A$10,723 per LYG and at A$11,485 per QALY. Probabilistic sensitivity analysis showed that at A$60,000 and A$151,000 per QALY, the probability that mandatory fortification was the most cost-effective strategy was 79% and 85%, respectively. Threshold analysis of loss of consumer choice indicated that with a compensation value above A$1.21 (assuming a willingness to pay (WTP) threshold of A$60,000 per QALY] or A$3.19 (assuming a WTP threshold of A$151,000 per statistical life-year) per capita per year mandatory fortification would not be cost-effective. Mandatory fortification was found to be cost-effective; however, inclusion of the loss of consumer choice can change this result. Even with mandatory fortification, mean folate intake will remain below the recommended NTD preventive level. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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20. N-of-1 Randomized Trials to Assess the Efficacy of Gabapentin for Chronic Neuropathic Pain.
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Yelland, Michael J., Poulos, Christopher J., Pillans, Peter I., Bashford, Guy M., Nikles, Catherine Jane, Sturtevant, Joanna M., Vine, Norma, Del Mar, Christopher B., Schluter, Philip J., Tan, Meng, Chan, Jonathan, Mackenzie, Fraser, and Brown, Robyn
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DRUG efficacy , *PLACEBOS , *NEUROPATHY , *PAIN management , *RANDOMIZED controlled trials , *META-analysis ,ANALGESIC effectiveness - Abstract
Objective. The objective of this study was to compare the efficacy of gabapentin with placebo for neuropathic pain at the individual and population levels. Design. This study used an n-of-1 trial methodology with three double-blind, randomized, crossover comparisons of gabapentin with placebo. Setting. This study was carried out at specialist outpatient clinics at two Australian hospitals. Patients. The patients are adults with chronic neuropathic pain. Interventions. Following a dose-finding period, participants underwent three comparisons of 2-week periods on gabapentin (600–1,800 mg per day) and placebo. The dose-finding period was commenced by 112 patients, of whom 39 had no response so they did not enroll, leaving 73 trial participants. Of these, 48 completed and 7 partially completed their trials, and 18 withdrew. Outcome Measures. The five outcome measures were the visual analog scale (0–10) of pain, sleep interference and functional limitation; frequency of adverse events and medication preference. The aggregate response was determined by weighting the response to each measure equally. Results. Of the 55 participants who completed at least one cycle, the aggregate response to gabapentin was better than placebo in 16 (29%), of whom 15 continued gabapentin posttrial. No difference was shown in 38 (69%), and 1 (2%) showed a better response to placebo. Fifteen of these 39 continued gabapentin posttrial. Meta-analysis of the mean scores showed lower mean (standard deviation) scores for gabapentin by 0.8 (0.2) for pain, 0.6 (0.2) for sleep interference, and 0.6 (0.2) for functional limitation. Conclusions. The response rate and mean reduction in symptoms with gabapentin were small. Gabapentin prescribing posttrial was significantly influenced by the trial results. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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21. The association between foot-care self efficacy beliefs and actual foot-care behaviour in people with peripheral neuropathy: a cross-sectional study.
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Perrin, Byron M., Swerissen, Hal, and Payne, Craig
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DIABETES , *SELF-efficacy , *NEUROPATHY , *APPLIED psychology , *CARBOHYDRATE intolerance , *CARING , *PREVENTIVE medicine , *ALTERNATIVE medicine - Abstract
Background: People with diabetes and peripheral neuropathy often do not implement the footcare behavioural strategies that are suggested by many health professionals. The concept of selfefficacy has been shown to be an effective predictor of behaviour in many areas of health. This study investigated the relationships between foot-care self-efficacy beliefs, self-reported foot-care behaviour and history of diabetes-related foot pathology in people with diabetes and loss of protective sensation in their feet. Methods: Ninety-six participants were included in this cross-sectional study undertaken in a regional city of Australia. All participants had diabetes and clinically diagnosed loss of protective sensation in their feet. The participants completed a self-report pen-paper questionnaire regarding foot-care self efficacy beliefs (the "Foot Care Confidence Scale") and two aspects of actual footcare behaviour-preventative behaviour and potentially damaging behaviour. Pearson correlation coefficients were then calculated to determine the association between foot-care self-efficacy beliefs and actual reported foot-care behaviour. Multiple analysis of variance was undertaken to compare mean self-efficacy and behaviour subscale scores for those with a history of foot pathology, and those that did not. Results: A small positive correlation (r = 0.2, p = 0.05) was found between self-efficacy beliefs and preventative behaviour. There was no association between self-efficacy beliefs and potentially damaging behaviour. There was no difference in self-efficacy beliefs in people that had a history of foot pathology compared to those that did not. Conclusion: There is little association between foot-care self-efficacy beliefs and actual foot-care behaviour. The usefulness of measuring foot-care self-efficacy beliefs to assess actual self foot-care behaviour using currently available instruments is limited in people with diabetes and loss of protective sensation. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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22. Physician attitudes towards ventilatory support for spinal muscular atrophy type 1 in Australasia.
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Geevasinga, Nimeshan and Ryan, Monique M.
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GENERAL practitioners , *SPINAL muscular atrophy , *EARLY death , *NEONATAL death , *PHYSICIANS' attitudes - Abstract
Background: Without ventilatory support, premature death from respiratory insufficiency is virtually universal in infants with spinal muscular atrophy type 1 (SMA1). With mechanical ventilation, however, long-term survival has been reported from numerous international centres. We aimed to characterize physician attitudes to the various forms of ventilatory support for children with SMA1. Methods: We surveyed neurologists, respiratory physicians, clinical geneticists and intensivists from all major paediatric hospitals in Australia and New Zealand regarding their views on ventilatory management of SMA1. Results: Ninety-two of the 157 (59%) physicians surveyed replied. Respondents included 16 clinical geneticists, 19 intensive care physicians, 28 neurologists and 29 respiratory physicians. Almost half (47%) opposed invasive ventilation of children with SMA1 and respiratory failure precipitated by intercurrent illness. The majority (76%) opposed invasive ventilatory support for chronic respiratory failure in SMA1. In contrast, non-invasive ventilation was felt by 85% to be appropriate for acute respiratory deteriorations, with 49% supporting long-term non-invasive ventilatory support. Most physicians felt that decisions regarding ventilation should be made jointly by parents and doctors, and that hospital Clinical Ethics Committees should be involved in the event of discordant opinion regarding further management. A majority felt that a defined hospital policy would be valuable in guiding management of SMA1. Conclusions: Respiratory support in SMA1 is an important issue with significant ethical, financial and resource management implications. Most physicians in Australian and New Zealand oppose invasive ventilatory support for chronic respiratory failure in SMA1. Non-invasive ventilation is an accepted intervention for acute respiratory decompensation and may have a role in the long-term management of SMA1. Clinical Ethics Committees and institutional policies have a place in guiding physicians and parents in the management of children with SMA1. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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23. Proventricular dilatation disease: an emerging exotic disease of parrots in Australia.
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Doneley, R. J. T., Miller, R. I., and Fanning, T. E.
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PARROTS , *VIRUS diseases , *NEUROPATHY , *SYMPTOMS in animals , *VETERINARY autopsy , *AVICULTURE - Abstract
Proventricular dilatation disease is a viral disease seen as a segmental neuropathy in parrots. It has always been believed to be a disease exotic to Australia, with the only reported case being a legally imported Green Wing Macaw ( Ara chloroptera) in 1993. This paper reports a cluster of cases seen in south-east Queensland in 2005 to 2006. Clinical signs, autopsy findings and histopathological findings are described. No pattern or common source for these cases could be identified. The implications for Australian aviculture and avifauna are discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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24. Foot complications in Type 2 diabetes: an Australian population-based study.
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Tapp, R. J., Shaw, J. E., de Courten, M. P., Dunstan, D. W., Welborn, T. A., and Zimmet, P. Z.
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DIABETIC neuropathies , *VASCULAR diseases , *PEOPLE with diabetes - Abstract
Abstract Aims To determine the prevalence and risk factors for neuropathy and peripheral vascular disease (PVD) in the Australian diabetic population and identify those at high risk of foot ulceration. Methods The Australian Diabetes Obesity and Lifestyle study included 11 247 adults aged ≥ 25 years in 42 randomly selected areas of Australia. Neuropathy and PVD were assessed in participants identified as having diabetes (based on self report and oral glucose tolerance test), impaired fasting glucose, impaired glucose tolerance and in a random sample with normal glucose tolerance (total n = 2436). Results The prevalence of peripheral neuropathy was 13.1% in those with known diabetes (KDM) and 7.1% in those with newly diagnosed (NDM). The prevalence of PVD was 13.9% in KDM and 6.9% in NDM. Of those with diabetes, 19.6% were at risk of foot ulceration. Independent risk factors for peripheral neuropathy were diabetes duration (odds ratio (95% CI) 1.73 (1.33–2.28) per 10 years), height (1.42 (1.08–1.88) per 10 cm), age (2.57 (1.94–3.40) per 10 years) and uric acid (1.59 (1.21–2.09) per 0.1 mmol/l). Risk factors for PVD were diabetes duration (1.64 (1.25–2.16) per 10 years), age (2.45 (1.86–3.22) per 10 years), smoking (2.07 (1.00–4.28)), uric acid (1.03 (1.00–1.06) per 0.1 mmol/l) and urinary albumin/creatinine ratio (1.11 (1.01–1.21) per 1 mg/mmol). Conclusions The prevalence of neuropathy and PVD was lower in this population than has been reported in other populations. This may reflect differences in sampling methods between community and hospital-based populations. Nevertheless, a substantial proportion of the diabetic population had risk factors for foot ulceration. [ABSTRACT FROM AUTHOR]
- Published
- 2003
- Full Text
- View/download PDF
25. Neuromyelitis Optica Spectrum Disorder and Anti-Aquaporin 4 Channel Immunoglobulin in an Australian Pediatric Demyelination Cohort.
- Author
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Dahan A, Brilot F, Leventer R, Kornberg AJ, Dale RC, and Yiu EM
- Subjects
- Adolescent, Australia epidemiology, Child, Cohort Studies, Female, Humans, Male, Retrospective Studies, Syndrome, Aquaporin 4 blood, Immunoglobulin G blood, Neuromyelitis Optica blood, Neuromyelitis Optica epidemiology
- Abstract
Neuromyelitis optica spectrum disorder is uncommon in children, and often seronegative for aquaporin-4 immunoglobulin G (AQP4-IgG). We conducted a retrospective study of 67 children presenting to a single Australian center with acquired demyelinating syndromes over a 7-year period. All patients were tested for AQP4-IgG. Five children (7.5%) had neuromyelitis optica spectrum disorder. One child was seropositive for AQP4-IgG (1.5%) and had a relapsing disease course with mild residual deficits. She also had a concomitant motor axonal neuropathy that improved with immunosuppressive therapy. Of the remaining 4 children, 3 had a monophasic course and 1 a relapsing course. Two were tested for anti-myelin oligodendrocyte glycoprotein (anti-MOG) antibody and both were seropositive. This study confirms that neuromyelitis optica spectrum disorder is uncommon in children, and that AQP4-IgG seropositivity is rare. Anti-MOG antibodies should be tested in children with neuromyelitis optica spectrum disorder.
- Published
- 2020
- Full Text
- View/download PDF
26. Factors associated with type of footwear worn inside the house: a cross-sectional study.
- Author
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Barwick, Alex L., van Netten, Jaap J., Hurn, Sheree E., Reed, Lloyd F., and Lazzarini, Peter A.
- Subjects
- *
FOOTWEAR , *SHOE stores , *SAFETY shoes , *FOOT ulcers , *CROSS-sectional method , *RUNNING shoes - Abstract
Background: In specific populations, including those at risk of falls or foot ulcers, indoor footwear is an important aspect of preventative care. This study aims to describe the indoor footwear worn most over the previous year in a sample representative of the Australian inpatient population, and to explore the sociodemographic, medical, foot condition and foot treatment history factors associated with the indoor footwear worn. Methods: This was a secondary analysis of data collected from inpatients admitted to five hospitals across Queensland, Australia. Sociodemographic information, medical history, foot conditions and foot treatment history were collected as explanatory variables. Outcomes included the self-reported type of indoor footwear (from 16 standard footwear types) worn most in the year prior to hospitalisation, and the category in which the self-reported footwear type was defined according to its features: 'protective', 'non-protective' and 'no footwear'. Multivariate analyses determined explanatory variables independently associated with each type and category. Results: Protective footwear was worn by 11% of participants (including 4% walking shoes, 4% running shoes, 2% oxford shoes), and was independently associated with education above year 10 level (OR 1.78, p = 0.028) and having had foot treatment by a specialist physician (5.06, p = 0.003). Most participants (55%) wore non-protective footwear (including 21% slippers, 15% thongs/flip flops, 7% backless slippers), which was associated with older age (1.03, p < 0.001). No footwear was worn by 34% of participants (30% barefoot, 3% socks only). Those of older age (0.97, p < 0.001) and those in the most disadvantaged socioeconomic group (0.55, p = 0.019) were less likely to wear no footwear (socks or barefoot). Conclusions: Only one in nine people in a large representative inpatient population wore a protective indoor footwear most of the time in the previous year. Whilst having education levels above year 10 and having received previous foot treatment by a specialist physician were associated with wearing protective footwear indoors, the presence of a range of other medical and foot conditions were not. These findings provide information to enable clinicians, researchers and policymakers to develop interventions aimed at improving indoor footwear habits that may help prevent significant health burdens such as falls and foot ulcers. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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27. Cognition and Understanding of Neuropathy of Inpatients Admitted to a Specialized Tertiary Diabetic Foot Unit With Diabetes-Related Foot Ulcers.
- Author
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Corbett C, Jolley J, Barson E, Wraight P, Perrin B, and Fisher C
- Subjects
- Australia, Diabetes Complications physiopathology, Diabetes Complications psychology, Female, Hospitalization statistics & numerical data, Humans, Male, Mental Status and Dementia Tests, Middle Aged, Patient Care Management methods, Patient Selection, Surveys and Questionnaires, Attitude to Health, Cognition physiology, Cognitive Dysfunction diagnosis, Cognitive Dysfunction etiology, Cognitive Dysfunction physiopathology, Comprehension, Diabetic Foot diagnosis, Diabetic Foot psychology, Diabetic Foot therapy, Diabetic Neuropathies psychology, Diabetic Neuropathies therapy
- Abstract
This study investigated cognitive functioning and understanding of peripheral neuropathy in a cohort of individuals with diabetes-related foot ulcers requiring hospitalization. The aim was to examine the association between cognition, understanding of peripheral neuropathy, and diabetic health variables. Thirty inpatients referred to the Diabetic Foot Unit Clinical Psychology service, at the Royal Melbourne hospital, were assessed using the Montreal Cognitive Assessment (MoCA) and the Patient Interpretation of Neuropathy (PIN) questionnaire. Relevant demographic and medical information was collected. In this predominantly middle-aged, male cohort, the average MoCA score (22.37, SD = 3.65) fell below the general population age-matched mean, and a quarter of the MoCA patient scores were consistent with those seen in early dementia samples (<20). There appeared to be several misperceptions regarding peripheral neuropathy, less accurate attributions of blame to self or practitioners, and more accurate attributions of control of ulcer management to practitioners. Correlation analysis indicated that individuals with stronger MoCA scores tended to provide more accurate answers on the Acute Foot Ulcer Onset PIN scale. Individuals with diabetes-related foot ulcers requiring hospitalization demonstrate reduced cognitive functioning and this may affect their understanding of peripheral neuropathy, particularly information regarding foot ulcer onset. Routine screening of cognitive functioning in this cohort may be useful so that health education and care management can be adjusted according to individual patients' cognitive capabilities.
- Published
- 2019
- Full Text
- View/download PDF
28. Self-reported physical activity in community-dwelling adults with diabetes and its association with diabetes complications.
- Author
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Johnson NA, Barwick AL, Searle A, Spink MJ, Twigg SM, and Chuter VH
- Subjects
- Aged, Australia epidemiology, Female, Humans, Independent Living, Male, Middle Aged, Risk Factors, Diabetes Complications epidemiology, Diabetes Mellitus, Type 2 epidemiology, Exercise, Self Report statistics & numerical data
- Abstract
Aims: To describe the physical activity levels of an Australian community-based adult population with diabetes, and investigate the interaction between diabetes complications and physical activity., Methods: Anthropometric, demographic, biochemical and self-reported physical activity measures (IPAQ) were performed. Associations and multiple regression analyses were undertaken between physical activity, known risk factors for diabetes complications, and history of cardiovascular disease (CVD), neuropathy and foot ulceration obtained from medical records., Results: 240 participants were recruited (96% type 2 diabetes; age 68.7 ± 10.5 y; 58% men; diabetes duration 14.3 ± 11.4 y). Sixty seven percent of participants reported undertaking moderate or vigorous intensity exercise to recommended levels, and 29% reported no moderate-vigorous exercise. In addition to being associated with known demographic and biochemical risk factors and other complications, diabetes complications were also associated with different physical activity behaviours. Individuals with a history of CVD were more likely to participate in moderate-vigorous exercise and meet exercise guidelines, individuals with neuropathy undertook less walking and moderate intensity exercise, and those with a history of foot ulceration sat more and participated less in vigorous exercise., Conclusions: In Australian adults, the presence of diabetes complications may influence physical activity participation, and associate with characteristic physical activity approaches., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
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29. Botox cured my PELVIC PAIN.
- Author
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Morgan, Jan
- Subjects
DRUG efficacy ,BOTULINUM toxin ,THERAPEUTICS ,NEUROPATHY ,MEDICAL experimentation on humans - Abstract
This article relates the effectiveness of using Botox in treating Australian store assistant Catherine Aurubind's pudendal neuropathy, which causes pain in the pelvic region. Aurubind signed up to be a guinea pig for gynaecologist professor Thierry Vancaillie, going under a full anaesthetic while the doctor took a hundred units of Botox and injected it all around the pelvic floor. In desperation, she continued having treatments with the Botox and, gradually, her condition improved. After about seven weeks she had less pain all round.
- Published
- 2007
30. Leflunomide and peripheral neuropathy.
- Subjects
- *
LEFLUNOMIDE , *RHEUMATOID arthritis treatment , *NEUROPATHY , *ANTIRHEUMATIC agents , *DRUG side effects - Abstract
The article presents information on leflunomide, a disease modifying anti-rheumatic prodrug (DMARD), which has been available in Australia since 2000 for the treatment of active rheumatoid arthritis. 659 reports of neuropathy or peripheral neuropathy have been received by the ADRAC so far in relation to leflunomide. It suggests a causal relationship between leflunomide and peripheral neuropathy.
- Published
- 2006
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