Clinical observations revealed that many of the symptoms of diabetic neuropathy are similar to those of chronic

The effects of MF exposure on DNA in situ in a cell type-specific manner, we carried out further experiments using a very similar experimental setup and mode of evaluation as described previously. The following questions were addressed: Does MF exposure with much lower flux density than 1.5 mT also result in significant effects on DNA? If this is the case, are all cells or only specific cell types affected ? How do cells that are highly involved in iron storage react to MF exposure? Experiments were carried out on mice with MF flux density of 0.1 mT at 50 Hz as this value represents the current exposure limit for the general population in most European countries. In order to study dose-dependent effects, we also exposed mice to 1.0 mT at 50 Hz. Alongside the brain and kidney, we also analyzed liver cells strongly involved in iron storage. There are over 250 million people in the world with type 1 and 2 diabetes mellitus. Neuropathy is one of the most common complications of diabetes mellitus and leads to increasingly high morbidity and mortality, resulting in a huge economic burden for diabetes care. Diabetic neuropathy is a heterogeneous condition containing symmetrical neuropathies and focal neuropathies, presenting diverse clinical manifestations. Of all the neuropathies in diabetes, chronic diabetic peripheral neuropathy is the commonest. Of all the symptoms in DPN, pain is the most distressing and is the main factor that prompts the patients to seek medical advice. One-third of diabetic patients have symptoms of neuropathic pain according to a recent community-based study and up to 15–20% of patients with DPN may experience painful symptoms. Therefore, a high proportion of patients are suffering from neuropathic pain as well as the relative depression, anxiety and sleep deprivation. The management of neuropathic pain in diabetes still remains challenging mainly due to its various clinical features, wide spectrum severity and different Y-27632 dihydrochloride inquirer distribution involved. Descriptions of pain can be burning, prickling, lancinating, shooting, cramping, aching, and also contact hypersensitivity and “dead feeling” in their legs. The severity may range from mild symptoms in one toe or two to continuous painful symptoms involving both legs and may even extend to the upper limbs. The extent involved may be focal or diffuse. One additional factor that contributes to the treatment dilemma of neuropathic pain is the varied response to the currently different treatments. The diverse manifestations of neuropathic pain in diabetes and various responses to current interventions imply that a number of mechanisms could contribute. Therefore, the management of painful DPN may not be one single intervention and a series of factors should be taken into consideration, one of which, as Vinik, A. and his colleagues put it in one guideline, may be the distribution of pain. According to our clinical experience with management of painful diabetic neuropathy, features and severity of pain may change during the course of diabetic neuropathy while the distribution of pain is relatively invariable, which may be of some value for patient selection for surgical decompression. Thus we carry out this retrospective study to investigate the effects of surgical decompression on the outcome of painful diabetic patients and discuss the role which pain distribution plays in the management of painful diabetic neuropathy as well as the underlying mechanism involved. Aside from traditional management including glucose control, lifestyle modification and pharmacological treatment, surgical decompression is recommended for pain relief in the recent reports based on the “double crush” hypothesis.

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