Diabetic Peripheral Neuropathy Pain Treatment

2007-08-17T15:26:00.000-07:00

In the United States the prevalence of overweight and obesity dramatically increasing the incidence of diabetes. According to W.H.O. in the year of 2010 it would be 220 million people with diabetes worldwide. This statistics demonstrate the necessity of physician education not only in the treatment of diabetes but also in the managing of diabetes complications. Nearly a quarter of diabetes patient is already suffering from diabetic peripheral neuropathy and up to 50% of all diabetics develop peripheral neuropathy after 25 years of having this disease. Patients with diabetic peripheral neuropathy often presenting with pain that characterize as burning, aching, tingling, cold, allodynia and/or numbness.

There are numerous therapeutic agents are available but there is no single therapeutic agent available that is without adverse side effect and it is completely effective for the general diabetic population. Tricyclic antidepressants such as amitriptyline, imipramine, desipramine, and nortriptyline are useful in treatment of diabetic neuropathy. Pregabaline, gabapentin, tramadol and many others also are available for the treatment of diabetic peripheral neuropathy. When the right agent is determined, it does not necessarily relieve the pain in 100%. The physician must manage the patient on multiple levels using all available modalities in multi-functional strategy to alleviate initial pain and manage progression to other complications.

Percutaneous minimum invasive pain management technique is part of continuous strategy of permanent pain treatment that is widely use in nova days implanting the leads into epidural space and connecting them to subcutaneously positioned of spinal cord stimulator. Spinal cord stimulation applies electrical current in the form of short bursts or pulses to a specific area of the spinal cord. The pain control is very satisfactory in peripheral diabetic neuropathy patient population. Spinal Cord Stimulation has been used for many patients with failed back surgery syndrome after laminectomy as an alternative to re-operation. It has also been used to treat Complex Regional Pain Syndrome (former Reflex Sympathetic Dystrophy), post herpetic neuralgia, spinal cord injury and many others.

Traditionally, Neurostimulation was reserved as a late modality in the pain treatment continuum. In nova days, Spinal Cord Stimulation treatment implementing in pain treatment in earlier stage can enhance multidisciplinary care by facilitating participation in activities, such as physical therapy, which is essential for rehabilitation.
About the Author

Dr. A. Krakovsky, M.D., PhD., Dr., Sc. is an interventional pain management physician, a professor of medicine and surgery. Dr. Krakovsky leads International Pain Institute in La Jolla, CA providing procedures to elevate pain. To learn call 858-5519500 or visit http://www.internationalpaininstitute.net

NOVA Chemicals, Aux Sable Plan Ethane Plant in Alberta

2007-08-01T15:28:00.000-07:00

NOVA Chemicals Corporation has signed a letter of intent with Aux Sable Canada Ltd to develop an ethane extraction plant in Fort Saskatchewan, Alberta that would process natural gas from the Alliance Pipeline.

Aux Sable and NOVA will work together to develop the project, which is to be owned and operated by Aux Sable and expected to begin operating in mid-2010. Estimates put the cost of the plant at C$100 million.

The extraction plant will have the capacity to process as much as 1.2 billion cfd of natural gas and will produce approximately 40,000 b/d of ethane. The extraction plant will be located on land owned by Aux Sable in Fort Saskatchewan, adjacent to the site of Aux Sable's Heartland Off gas Plant. Ethane will be delivered by pipeline to NOVA's Joffre, Alberta petrochemical complex for use as an ethylene feedstock.

"Maintaining and extending the Alberta Advantage for the production of ethylene is fundamental to the long-term viability of the petrochemical industry in the province," said Jeffrey M. Lipton, president and CEO of NOVA Chemicals. "By increasing the recovery of ethane currently being exported from the province, this project will help position NOVA Chemicals and the rest of the Alberta petrochemical industry for future growth."

Bill McAdam, president and CEO of Aux Sable, said the project is an important step in the company's strategy to be a leader in fee-for-service processing in the Fort Saskatchewan area. "We are excited about the opportunity to grow our Fort Saskatchewan facilities and to play an increasing role in the Government of Alberta's vision of value-added resource processing in the province," he said.

The increased ethane supply created by the plant could help the Alberta Advantage over Gulf Coast producers for the longer term. However, in a Tuesday research report, Merrill Lynch analyst Don Carson pointed out that increased U.S. Gulf Coast ethane supply could ease he Alberta Advantage as new LNG import terminals open with ethane extraction capabilities.

Meanwhile, Tim Sauft, Aux Sable's executive vice president, told The Canadian Press that the ethane royalty changes proposed by the Alberta government did play a role in the development of the project. "We do expect to be applying under the program when it is announced," he said.

Many producers currently find ethane unprofitable to extract within the province with many shipping the liquid on natural gas streams to the United States via the Alliance Pipeline. However, last fall the provincial government announced it would be revising outdated ethane royalty regimes to encourage incremental ethane production in Alberta.

Final details are expected later this year on the changes.

original from here

Undre Nova for...

Diabetic Peripheral Neuropathy Pain Treatment

NOVA Chemicals, Aux Sable Plan Ethane Plant in Alberta