We found high SVR12 rates in monoinfected as well as coinfected individuals. No differences were detected between the two subgroups regardless of whether there was accompanying liver cirrhosis or a shortened treatment duration.

The capsaicin 8% cutaneous patch is an emergent new treatment option for patients with peripheral neuropathic pain. In randomized controlled clinical studies relevant pain relief for 12 weeks was achieved in about one third of patients following a single application. The first part of this paper is a review of the pathophysiology, pharmacology, and published clinical trials with the capsaicin 8% cutaneous patch. The second part reports on outcomes of an interdisciplinary expert workshop, where new treatment results of three major German pain centers were presented and reviewed with the objectives of obtaining responder rates for different pain syndromes, assessing maintenance of effect under real-life conditions, and giving recommendations for practical care. The 12 week responder rates with pain relief of ≥ 30% were comparable in patients with mononeuropathies (37.9%) and postherpetic neuralgia (38.8%). Similar responder rates were seen in a subgroup of patients with cervical spine radiculopathy and back pain (46.7%). In HIV-associated neuropathy the responder rates were high (47.8%) but lower in patients with other polyneuropathies (17.6%). Response rates were nearly identical after 1 week (46.6%) and 4 weeks (43.3) and dropped only slightly at 12 weeks (37.4%). In a subgroup of 54 patients who underwent a second treatment, efficacy was maintained. Response rates in patients with or without lidocaine pretreatment were comparable. Treatment with the capsaicin 8% cutaneous patch was generally safe and well tolerated. The workshop panel recommended further investigation of opportunities to improve the application procedure and to perform studies on the skin penetration and distribution of capsaicin. A modified quantitative sensory testing (QST) should be developed for clinical practice in order to better understand the correlation of sensory profiles and response to capsaicin treatment.

Combined surgery and radiology treats the end result of the failure of the sinusoidal smooth muscle to relax. Although some patients, the majority of whom are young (aged < 40 years), will achieve short-term benefit, all individuals need to be fully counselled with regard to the likelihood of long-term benefit before undergoing this invasive method of treatment.

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BackgroundAlthough conventional MRI (cMRI) has been reported to show specific abnormalities in parkinsonism, the diagnosis of the underlying pathology can be challenging. We report the radiological diagnostic accuracy, and the sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of cMRI abnormalities in a pathologically confirmed cohort of Parkinson's disease (PD), progressive supranuclear palsy (PSP), multiple system atrophy (MSA) and corticobasal degeneration (CBD).MethodcMRI of donors to a neurological brain bank was reviewed by two experienced neuroradiologists blinded to clinical details. Images were systematically reviewed for the presence of specific reported abnormalities.Results48 pathologically confirmed cases (23 PSP, 6 PD, 13 MSA and 6 CBD) and nine controls were studied. The final clinical diagnosis was supported in 68% and the radiological diagnosis in 60%. Using cMRI 55% of PSP, 67% of PD, and 77% of MSA were correctly identified. In this study the Hummingbird sign has 68% sensitivity, 100% specificity and PPV for PSP and the Hot Cross Bun has 62% sensitivity, 100% specificity and PPV for MSA.ConclusionThe confirmation that using cMRI key diagnostic features with very high specificity and PPV have low sensitivity endorses the development of newer MR techniques (e.g., high field diffusion tensor imaging) as useful biomarkers early in disease.