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1
22

Painful diabetic neuropathy

Diabetes is a worldwide epidemic, and associated neuropathy is its most costly and disabling complication. Given the rising prevalence of painful diabetic neuropathy, it is increasingly important that we understand the best ways to diagnose and treat this condition. Diagnostic tests in this field are evolving rapidly. These include the use of skin biopsies to measure small unmyelinated fibers, as well as even newer techniques that can measure both small unmyelinated fibers and large myelinated fibers in the same biopsy. The main treatments for painful diabetic neuropathy remain management of the underlying diabetes and drugs for the relief of pain. However, emerging evidence points to major differences between type 1 and type 2 diabetes, including the ability of glycemic control to prevent neuropathy. Enhanced glucose control is much more effective at preventing neuropathy in patients with type 1 diabetes than in those with type 2 disease. This dichotomy emphasizes the need to study the pathophysiologic differences between the two types of diabetes, because different treatments may be needed for each condition. The impact of the metabolic syndrome on neuropathy in patients with type 2 diabetes may account for the difference between the two types of diabetes and requires further study. Finally, neuropathic pain is under-recognized and undertreated despite an ever evolving list of effective drugs. Evidence exists to support several drugs, but the optimal sequence and combination of these drugs are still to be determined.  
www.bmj.com
over 7 years ago
Preview
1
56

Painful diabetic neuropathy

Diabetes is a worldwide epidemic, and associated neuropathy is its most costly and disabling complication. Given the rising prevalence of painful diabetic neuropathy, it is increasingly important that we understand the best ways to diagnose and treat this condition. Diagnostic tests in this field are evolving rapidly. These include the use of skin biopsies to measure small unmyelinated fibers, as well as even newer techniques that can measure both small unmyelinated fibers and large myelinated fibers in the same biopsy. The main treatments for painful diabetic neuropathy remain management of the underlying diabetes and drugs for the relief of pain. However, emerging evidence points to major differences between type 1 and type 2 diabetes, including the ability of glycemic control to prevent neuropathy. Enhanced glucose control is much more effective at preventing neuropathy in patients with type 1 diabetes than in those with type 2 disease. This dichotomy emphasizes the need to study the pathophysiologic differences between the two types of diabetes, because different treatments may be needed for each condition. The impact of the metabolic syndrome on neuropathy in patients with type 2 diabetes may account for the difference between the two types of diabetes and requires further study. Finally, neuropathic pain is under-recognized and undertreated despite an ever evolving list of effective drugs. Evidence exists to support several drugs, but the optimal sequence and combination of these drugs are still to be determined.  
www.bmj.com
over 7 years ago
Preview
1
17

Painful diabetic neuropathy

Diabetes is a worldwide epidemic, and associated neuropathy is its most costly and disabling complication. Given the rising prevalence of painful diabetic neuropathy, it is increasingly important that we understand the best ways to diagnose and treat this condition. Diagnostic tests in this field are evolving rapidly. These include the use of skin biopsies to measure small unmyelinated fibers, as well as even newer techniques that can measure both small unmyelinated fibers and large myelinated fibers in the same biopsy. The main treatments for painful diabetic neuropathy remain management of the underlying diabetes and drugs for the relief of pain. However, emerging evidence points to major differences between type 1 and type 2 diabetes, including the ability of glycemic control to prevent neuropathy. Enhanced glucose control is much more effective at preventing neuropathy in patients with type 1 diabetes than in those with type 2 disease. This dichotomy emphasizes the need to study the pathophysiologic differences between the two types of diabetes, because different treatments may be needed for each condition. The impact of the metabolic syndrome on neuropathy in patients with type 2 diabetes may account for the difference between the two types of diabetes and requires further study. Finally, neuropathic pain is under-recognized and undertreated despite an ever evolving list of effective drugs. Evidence exists to support several drugs, but the optimal sequence and combination of these drugs are still to be determined.  
www.bmj.com
over 7 years ago
Preview
1
34

Cochlear implants for children and adults with severe to profound deafness | 2-Clinical-need-and-practice | Guidance and guidelines | NICE

2.1 Hearing loss may be caused by interference with the transmission of sound from the outer to the inner ear (conductive hearing loss) or damage within the cochlea, the auditory nerve or auditory centres in the brain (sensorineural hearing loss). In adults the most common cause of sensorineural hearing loss is presbycusis. This is a progressive condition caused by the loss of function of hair cells in the inner ear, leading to deafness. Hearing loss in adults may also be caused by excessive exposure to noise, or by ototoxic drugs, metabolic disorders, infections or genetic factors. Severe to profound hearing loss in children may have a genetic aetiology, or have prenatal, perinatal or postnatal causes. These include conditions such as meningitis and viral infection of the inner ear (for example, rubella or measles), as well as premature birth and congenital infections. Deafness that occurs before the development of language is described as prelingual, whereas deafness that occurs after the development of language is described as postlingual.  
publications.nice.org.uk
over 7 years ago
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2
183

Pharmacokinetics 4 - Metabolism

http://www.handwrittentutorials.com - This tutorial is the fourth in the Pharmacokinetics series. This tutorial discusses how drugs are metabolised by Cytoch...  
YouTube
over 7 years ago
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1
85

110 Hypertension Treatment

http://www.interactive-biology.com - What are the mechanisms that underly the drugs that are used to treat hypertension? Drugs like ACE inhibitors, diuretics...  
YouTube
over 7 years ago
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3
35

Leukemia treatment

There are three main solutions to treat leukemia. Chemotherapy is a collection of drugs which target cells that rapidly multiply (a key characteristic in can...  
YouTube
over 7 years ago
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0
69

HIV: Mechanisms of Action of NRTIs

This animation describes how NRTI drugs work by incorporating themselves into viral DNA as it is being transcribed, and thus, blocking further extension of t...  
YouTube
over 7 years ago
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0
39

HIV: Mechanisms of NRTI Resistance (Primer Nucleoside Unblocking)

This animation describes the second mechanism of resistance of reverse transcriptase enzyme to some of NRTI drugs, called primer nucleoside unblocking. Narra...  
YouTube
over 7 years ago
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0
22

HIV: Mechanisms of NRTI Resistance (Nucleoside Analogue Discrimination)

This animation explains the first mechanism of resistance of reverse transcriptase enzyme to some of NRTI drugs, known as nucleoside analogue discrimination....  
YouTube
over 7 years ago
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2
105

CARDIOVASCULAR DRUGS; ANTI ANGINAL DRUGS by Professor Fink

Check-out professor fink's web-site or additional resources in Biology, Anatomy, Physiology & Pharmacology: www.professorfink.com Down-loadable e-books of th...  
YouTube
over 7 years ago
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4
135

HIV Life Cycle and Drugs [UndergroundMed]

For more videos, check out our website at: http://videos.undergroundmed.net/  
YouTube
over 7 years ago
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2
25

Small Data: The huge cost of developing drugs - BBC News

How the cost of developing new drugs is encouraging big drugs companies to merge with each other.  
BBC News
over 7 years ago
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1
12

Chronotherapy: The science of timing drugs to our Body Clock - BBC News

Doctors are becoming increasingly interested in the science of chronotherapy - aligning medical treatment to our circadian rhythms.  
BBC News
over 7 years ago
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0
2

Turning the tide on conflicts of interest

The US Food and Drug Administration says it may loosen its conflict of interest policies (doi:10.1136/bmj.d5070). A shortage of independent experts means that its current rule—no more than 13% of advisers with industry ties—is delaying the introduction of new drugs, says its commissioner.  
bmj.com
over 7 years ago