Catechol-O-methyltransferase polymorphism Val158Met is associated with distal neuropathic pain in HIV-associated sensory neuropathy

Background: Many of those aging with HIV suffer from distal neuropathic pain (DNP) due to HIV-associated sensory neuropathy (HIV-SN). Prior studies have linked chronic pain conditions to a variant of the catechol-O-methyltransferase (COMT), Val158Met. This variant confers reduced enzymatic activity and results in higher synaptic dopamine levels. Here we examined the role of Val158Met as a predictor of DNP in HIV-SN. Methods: In 1044 HIV-infected individuals enrolled in CNS HIV Antiretroviral Therapy Effects Research, an observational study across six US institutions, we characterized the relationship between Val158Met and DNP in HIV-SN. Participants underwent neurologic examination and genotyping. Stratification into genetic ancestry groups was employed to eliminate bias due to genetic background. Findings: Of 590 participants with HIV-SN, 38% endorsed DNP, 24% reported nonpainful symptoms of neuropathy (paresthesia and numbness), and 38% were asymptomatic. Compared with asymptomatic HIV-SN, Val158Met was associated with 2.3 higher odds of DNP. There were no increased odds of nonpainful symptoms. The association remained significant after controlling for other risk factors for DNP: lifetime diagnosis of depression, older age, ancestry, cumulative exposure to dideoxynucleoside antiretrovirals, diabetes, and nadir CD4+. Stratified by genetic ancestry, the association between Val158Met and DNP was significant in European and African genetic ancestry. Interpretation: V...
Source: AIDS - Category: Infectious Diseases Tags: CLINICAL SCIENCE Source Type: research

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Ryan R. Kelly1,2†, Lindsay T. McDonald1,2†, Nathaniel R. Jensen1,2, Sara J. Sidles1,2 and Amanda C. LaRue1,2* 1Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States 2Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States The significant biochemical and physiological effects of psychological stress are beginning to be recognized as exacerbating common diseases, including osteoporosis. This review discusses the current evidence for psychological stress-associated mental health disorders as risk factors for os...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
In the course of many nurses'healthcare careers, witnessing the illness, suffering, and death of others is commonplace. From dialysis and med-surg to home health and the ICU, nurses create therapeutic relationships with patients and their families, providing spiritual and emotional comfort, compassion, and expert skilled care based on many decades of nursing science and evidence-based interventions.Aside from witnessing the challenges faced by others, nurses are themselves human beings with their own life experiences, victories, and suffering. How a nurse navigates their own personal suffering plays a role in determining h...
Source: Digital Doorway - Category: Nursing Tags: healthcare nurse nurses nursing Source Type: blogs
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease and demystify some of the potential diseases you need to consider in those who are severely immunosuppressed. While trying to be comprehensive this post can not be exhaustive (as you can imagine any patient with ...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Cases Tropical Medicine AIDS art cryptococcoma cryptococcus HIV HIV1 HIV2 PEP PrEP TB toxoplasma tuberculoma Source Type: blogs
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
In January, 2018, Academic Press published my bookPrecision Medicine and the Reinvention of Human Disease. This book has an excellent " look inside " at itsGoogle book site, which includes the Table of Contents. In addition, I thought it might be helpful to see the topics listed in the Book's index. Note that page numbers followed by f indicate figures, t indicate tables, and ge indicate glossary terms.AAbandonware, 270, 310geAb initio, 34, 48ge, 108geABL (abelson leukemia) gene, 28, 58ge, 95 –97Absidia corymbifera, 218Acanthameoba, 213Acanthosis nigricans, 144geAchondroplasia, 74, 143ge, 354geAcne, 54ge, 1...
Source: Specified Life - Category: Information Technology Tags: index jules berman jules j berman precision medicine Source Type: blogs
The Department of Veterans Affairs (VA) Pharmacy Benefits Management Services and the Institute for Clinical and Economic Review (ICER) recently announced a collaboration in which the VA will use the ICER’s drug assessments as part of its formulary development and price negotiations. This type of relationship might be normal outside of the United States (for example, in the United Kingdom, Germany, and Australia), where input from governmental health technology assessment organizations is used in determining health care coverage decisions. However, in the United States—with our multipayer health care system cov...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Drugs and Medical Innovation Insurance and Coverage Payment Policy Population Health Department of Veterans Affairs drug pricing Institute for Clinical and Economic Review pharmaceuticals quality of care Veterans' He Source Type: blogs
Those diagnosed with diabetes, asthma more likely to attempt suicide than healthy peers
Source: The Doctors Lounge - Psychiatry - Category: Psychiatry Tags: Cardiology, Endocrinology, Family Medicine, Gastroenterology, Gynecology, Internal Medicine, Emergency Medicine, Nephrology, Neurology, Nursing, Oncology, Pharmacy, Psychiatry, Pulmonology, Rheumatology, AIDS, Anesthesiology & Pain, Journal, Source Type: news
By Susan Blumenthal, M.D. and Alexandrea Adams The recent commemoration of National Women’s Health Week provided an important time to mark the progress that has been made in advancing women’s health over the past two decades and to highlight what more needs to be done to achieve women’s health equity in America. Historically, women have experienced discrimination in health care despite making 80 percent of health care decisions for their families, using more medical services than men, and suffering greater disability from chronic disease. Before the mid 1990’s, women were often excluded as subjects ...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
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Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
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Source: The Lancet - Category: Journals (General) Source Type: research
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