Nicholas G N Shenker

Learn More
OBJECTIVES Contralateral responses to unilateral stimuli have been well described in animal models. These range from central sensitization to peripheral inflammatory responses. Our aim was to test for contralateral responses following unilateral intradermal capsaicin injection in man. METHODS Three groups were investigated. A healthy volunteer group (1)(More)
Symmetry is a remarkably constant clinical feature of chronic inflammatory disease. Rheumatoid arthritis is almost by definition symmetrical [1]. Osteoarthritis, psoriasis and some of its associated arthritides are also symmetrical [2–4]. Pulmonary fibrosis, glomerulonephri-tis and sympathetic ophthalmia are also symmetrical inflammatory conditions. Whilst(More)
This paper examines rheumatology pain and how it may relate to amputee phantom limb pain (PLP), specifically as experienced in rheumatoid arthritis, fibromyalgia and complex regional pain syndrome (CRPS). Clinical findings, which suggest cortical sensory reorganization, are discussed and illustrated for each condition. It is proposed that this sensory(More)
OBJECTIVES A role for vitamin D in the pathogenesis of autoimmune and inflammatory diseases is emerging. We undertook an audit of 25-hydroxyvitamin D (25OHD) investigation and treatment in rheumatology outpatients. METHODS Serum 25OHD requests were matched to electronic medical records from rheumatology and metabolic bone clinics (April 2006-March 2007).(More)
Acupuncture refers to the insertion of fine needles into the body at specific points for a therapeutic effect. The term comes from the Latin words 'acus' (needle) and 'punctura' (to puncture). The technique has been practiced in the Far East for at least 3000 yrs but it is only in the last 30 yrs that interest has developed in the West underpinned by(More)
Attention and pain are linked inexorably. The manipulation of attention, via either distraction or focused attention, has been used as a therapeutic initiative for generations. Imaging evidence and clinical observations demonstrate that attention can be altered with associated changes at the cortical level and this may have positive or negative effects on(More)
OBJECTIVES To assess microvascular endothelial function in patients with complex regional pain syndrome type I (CRPS) compared with healthy controls, as measured by iontophoresis of vasoactive chemicals and laser Doppler imaging. METHODS Microvascular blood flow was stimulated locally in affected and contralateral limbs of patients with CRPS (n = 17) and(More)
BACKGROUND Rheumatoid arthritis is a systemic inflammatory condition associated with increased cardiovascular risk that may be due to underlying endothelial dysfunction and subsequent aortic stiffening. We hypothesized that supplementation with tetrahydrobiopterin (BH4) would recouple endothelial nitric oxide synthase and thus improve endothelial function(More)
is the perception of pain in response to stimuli that are not normally painful. The management of patients with chronic pain and allodynia is suboptimal, partly because of social stigmatisation. Patients are made to feel that they are malingering or looking for secondary gain. Unfortunately, the legal profession often propagates this myth and the(More)