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Background To determine the role of mechanical allodynia (MA) in predicting good surgical outcome for painful diabetic peripheral neuropathy (DPN). Materials and Methods Data of 192 patients with painful DPN were collected in this study, with 148 surgical patients and 44 patients in the control group. Both groups were further divided into subgroups based on the presence ofMA on admission. Clinical evaluations including the visual analog scale (VAS), the Hospital Anxiety and Depression Scale (HADS), nerve conduction velocity (NCV), and high-resolution ultrasonography (cross-sectional area, CSA) were performed preoperatively and postoperatively. Results The levels of VAS and HADS and the results of NCV and CSA were improved in the surgical group (p < 0.05). In the surgical subgroups, pain reduction, psychiatric amelioration, improvement in NCVs, and the restoration of the CSA were observed in patients with signs of MA (p < 0.05), whereas only pain reduction, psychiatric amelioration, and restoration of the CSA were noted in patients without signs of MA (p > 0.05). Furthermore, better pain reduction was achieved in patients with MA when compared with those without MA (p < 0.05). Conclusions MA is proved to be a reliable predictor of good surgical outcome for painful DPN. [ABSTRACT FROM AUTHOR]

Background and Study Aims Electromyographic (EMG) recordings of the fibularis longus (FL) and tibialis anterior (TA) muscles were performed intraoperatively during common fibular nerve (CFN) nerve decompression (ND) in patients with symptomatic diabetic sensorimotor peripheral neuropathy (DSPN) and clinical nerve compression. Materials and Methods Forty-six legs in 40 patients underwent surgical ND by external neurolysis; FL and TA muscles were monitored intraoperatively. Evoked EMGs were recorded just prior to and within 1 minute after ND. Results Thirty-eight legs (82.6%) demonstrated EMG improvement 1 minute after ND. Sixty muscles (31 FL, 29 TA) were monitored, with 44 (73.3%) improving in EMG amplitude. Mean change in EMG amplitude represented a 73.6% improvement (p < 0.0001). Changes in EMG amplitudes correlated with visual analog scale pain improvement (p = 0.03). Conclusion This is the first report of acute changes in objective EMG responses during ND of CFN in DSPN patients and demonstrates that patients with symptomatic DSPN and clinical nerve entrapment have latent but functional axons that surgical ND can improve immediately. [ABSTRACT FROM AUTHOR]

Studies of phagocytosis promoting capacity and immunoglobulin levels were conducted in a group of 25 long-term heroin addicts. Sera were collected from addicts at Lexington, Ky.; Synanon House, San Francisco; and Albuquerque, N. M. Striking increments in heat-stable opsonins for Escherichia coli and Serratia marcescens were found in many addicts' sera as compared with normal control sera. Marked elevations of gamma M (up to 660 mg/100 ml) were found in many sera. accompanied by 19S antibacterial opsonins as demonstrated by separations in sucrose density gradients. Antigamma-globulin factors were present in 36% of the addicts studied. There was no impairment in ingestion or killing of test bacteria by polymorphonuclear leukocytes obtained from subjects on substitution narcotic therapy. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Mechanisms and Management of Diabetic Painful Distal Symmetrical Polyneuropathy" by S. Tesfaye and colleagues in the 2013 issue.

The author comments on the article "Can Ultrasound of the Tibial Nerve Detect Diabetic Peripheral Neuropathy? A Cross-Sectional Study" by S. Riazi and colleagues published in a 2012 issue. He questions the role of nerve decompression (ND) in the treatment of diabetes sensorimotor polyneuropathy (DSP). He says objective outcome measures such as balance and ulcer appearance have been used in studies highlighting the therapeutic benefit of ND.

Background:  To determine the role of mechanical allodynia (MA) in predicting good surgical outcome for painful diabetic peripheral neuropathy (DPN)., Materials and Methods:  Data of 192 patients with painful DPN were collected in this study, with 148 surgical patients and 44 patients in the control group. Both groups were further divided into subgroups based on the presence of MA on admission. Clinical evaluations including the visual analog scale (VAS), the Hospital Anxiety and Depression Scale (HADS), nerve conduction velocity (NCV), and high-resolution ultrasonography (cross-sectional area, CSA) were performed preoperatively and postoperatively., Results:  The levels of VAS and HADS and the results of NCV and CSA were improved in the surgical group ( p  < 0.05). In the surgical subgroups, pain reduction, psychiatric amelioration, improvement in NCVs, and the restoration of the CSA were observed in patients with signs of MA ( p  < 0.05), whereas only pain reduction, psychiatric amelioration, and restoration of the CSA were noted in patients without signs of MA ( p  > 0.05). Furthermore, better pain reduction was achieved in patients with MA when compared with those without MA ( p  < 0.05)., Conclusions:  MA is proved to be a reliable predictor of good surgical outcome for painful DPN., Competing Interests: None., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)