BACKGROUND notalgia paresthetica is a subdiagnosed sensory neuropathy presenting as a
condition of intense itching and hyperchromic macule on the back that
interferes with daily habits. OBJECTIVES To determine the efficacy of treatment of notalgia paresthetica using oral
gabapentin, assessing the degree of improvement in itching and influence on
quality of life. Moreover, to evaluate the signs and symptoms associated
with notalgia paresthetica. METHODS We conducted an experimental, non-randomized, parallel, non-blinded study
including 20 patients with clinical and histopathological diagnosis of
notalgia paresthetica. After application of the visual analogue scale of
pain adapted for pruritus and of the questionnaire of dermatology life
quality index (DLQI), ten patients with visual analogue scale > 5 were
given treatment with gabapentin at the dose of 300 mg/day for four weeks.
The other ten were treated with topical capsaicin 0.025% daily for four
weeks. After the treatment period, patients answered again the scale of
itching. RESULTS The use of gabapentin was responsible for a significant improvement in
pruritus (p=0.0020). Besides itching and hyperchromic stain on the back,
patients reported paresthesia and back pain. It was observed that the main
factor in the worsening of the rash is heat. CONCLUSION Gabapentin is a good option for the treatment of severe itching caused by
nostalgia paresthetica.
SUMMARY: Bone metabolism is influenced by different factors and muscle activity acts as a stimulator of bone plasticity. Conditions such as nerve injuries can compromise bone physiology due to muscle inactivity. Preview studies have shown that nerve damage reduces P substance and calcitonin gene-related peptides, also known as neuropeptides that may have a key role on bone healing. Therefore, this study evaluated the osseointegration of hydroxyapatite implants in tibial defects of rats submitted to unilateral sciatic nerve section. Twelve Wistar rats were divided into two groups (G1 and G2). In G1, the sciatic nerve was left intact and in G2 the left sciatic nerve was completely sectioned. An experimental tibial bone defect was then created in both groups and filled with hydroxyapatite granules. The animals were sacrificed 2 months after implantation and samples were submitted to macroscopic inspection and histological analysis. Good radiopacity of the hydroxyapatite granules and radiographic definition of the bone defect were noted. Histologic analysis revealed formation of new bone adjacent to the hydroxyapatite granules in G1 and, to a lesser extent, in G2 in which the proliferation of connective tissue predominated at the implant site. The formation of new bone stimulated by hydroxyapatite in bone defects can be expected even in animals with limb paralysis due to nerve injury; however, bone formation occurs at a slower speed in these animals and the volume of newly formed bone is lower.
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