%PDF- %PDF-
Mini Shell

Mini Shell

Direktori : /var/www/html/diaspora/api_internal/public/h5jfft/cache/
Upload File :
Create Path :
Current File : /var/www/html/diaspora/api_internal/public/h5jfft/cache/1c775077598b211cdeb172557b4a12d9

a:5:{s:8:"template";s:11835:"<!DOCTYPE html>
<html lang="en"> 
<head>
<meta charset="utf-8">
<meta content="width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=no" name="viewport">
<title>{{ keyword }}</title>
<style rel="stylesheet" type="text/css">.has-drop-cap:not(:focus):first-letter{float:left;font-size:8.4em;line-height:.68;font-weight:100;margin:.05em .1em 0 0;text-transform:uppercase;font-style:normal}.has-drop-cap:not(:focus):after{content:"";display:table;clear:both;padding-top:14px}.wc-block-product-categories__button:not(:disabled):not([aria-disabled=true]):hover{background-color:#fff;color:#191e23;box-shadow:inset 0 0 0 1px #e2e4e7,inset 0 0 0 2px #fff,0 1px 1px rgba(25,30,35,.2)}.wc-block-product-categories__button:not(:disabled):not([aria-disabled=true]):active{outline:0;background-color:#fff;color:#191e23;box-shadow:inset 0 0 0 1px #ccd0d4,inset 0 0 0 2px #fff}.wc-block-product-search .wc-block-product-search__button:not(:disabled):not([aria-disabled=true]):hover{background-color:#fff;color:#191e23;box-shadow:inset 0 0 0 1px #e2e4e7,inset 0 0 0 2px #fff,0 1px 1px rgba(25,30,35,.2)}.wc-block-product-search .wc-block-product-search__button:not(:disabled):not([aria-disabled=true]):active{outline:0;background-color:#fff;color:#191e23;box-shadow:inset 0 0 0 1px #ccd0d4,inset 0 0 0 2px #fff}  .dialog-close-button:not(:hover){opacity:.4}.elementor-templates-modal__header__item>i:not(:hover){color:#a4afb7}.elementor-templates-modal__header__close--skip>i:not(:hover){color:#fff}.screen-reader-text{position:absolute;top:-10000em;width:1px;height:1px;margin:-1px;padding:0;overflow:hidden;clip:rect(0,0,0,0);border:0}.screen-reader-text{clip:rect(1px,1px,1px,1px);overflow:hidden;position:absolute!important;height:1px;width:1px}.screen-reader-text:focus{background-color:#f1f1f1;-moz-border-radius:3px;-webkit-border-radius:3px;border-radius:3px;box-shadow:0 0 2px 2px rgba(0,0,0,.6);clip:auto!important;color:#21759b;display:block;font-size:14px;font-weight:500;height:auto;line-height:normal;padding:15px 23px 14px;position:absolute;left:5px;top:5px;text-decoration:none;width:auto;z-index:100000}html{font-family:sans-serif;-ms-text-size-adjust:100%;-webkit-text-size-adjust:100%}body{margin:0}footer,header,main{display:block}a{background-color:transparent}a:active,a:hover{outline-width:0}*,:after,:before{box-sizing:border-box}html{box-sizing:border-box;background-attachment:fixed}body{color:#777;scroll-behavior:smooth;-webkit-font-smoothing:antialiased;-moz-osx-font-smoothing:grayscale}a{-ms-touch-action:manipulation;touch-action:manipulation}.col{position:relative;margin:0;padding:0 15px 30px;width:100%}@media screen and (max-width:849px){.col{padding-bottom:30px}}.row:hover .col-hover-focus .col:not(:hover){opacity:.6}.container,.row,body{width:100%;margin-left:auto;margin-right:auto}.container{padding-left:15px;padding-right:15px}.container,.row{max-width:1080px}.flex-row{-js-display:flex;display:-ms-flexbox;display:flex;-ms-flex-flow:row nowrap;flex-flow:row nowrap;-ms-flex-align:center;align-items:center;-ms-flex-pack:justify;justify-content:space-between;width:100%}.header .flex-row{height:100%}.flex-col{max-height:100%}.flex-left{margin-right:auto}@media all and (-ms-high-contrast:none){.nav>li>a>i{top:-1px}}.row{width:100%;-js-display:flex;display:-ms-flexbox;display:flex;-ms-flex-flow:row wrap;flex-flow:row wrap}.nav{margin:0;padding:0}.nav{width:100%;position:relative;display:inline-block;display:-ms-flexbox;display:flex;-ms-flex-flow:row wrap;flex-flow:row wrap;-ms-flex-align:center;align-items:center}.nav>li{display:inline-block;list-style:none;margin:0;padding:0;position:relative;margin:0 7px;transition:background-color .3s}.nav>li>a{padding:10px 0;display:inline-block;display:-ms-inline-flexbox;display:inline-flex;-ms-flex-wrap:wrap;flex-wrap:wrap;-ms-flex-align:center;align-items:center}.nav-left{-ms-flex-pack:start;justify-content:flex-start}.nav>li>a{color:rgba(102,102,102,.85);transition:all .2s}.nav>li>a:hover{color:rgba(17,17,17,.85)}.nav li:first-child{margin-left:0!important}.nav li:last-child{margin-right:0!important}.nav-uppercase>li>a{letter-spacing:.02em;text-transform:uppercase;font-weight:bolder}.nav:hover>li:not(:hover)>a:before{opacity:0}.nav-box>li{margin:0}.nav-box>li>a{padding:0 .75em;line-height:2.5em}.header-button .is-outline:not(:hover){color:#999}.nav-dark .header-button .is-outline:not(:hover){color:#fff}.scroll-for-more:not(:hover){opacity:.7}.is-divider{height:3px;display:block;background-color:rgba(0,0,0,.1);margin:1em 0 1em;width:100%;max-width:30px}.widget .is-divider{margin-top:.66em}.dark .is-divider{background-color:rgba(255,255,255,.3)}i[class^=icon-]{font-family:fl-icons!important;speak:none!important;margin:0;padding:0;display:inline-block;font-style:normal!important;font-weight:400!important;font-variant:normal!important;text-transform:none!important;position:relative;line-height:1.2}.nav>li>a>i{vertical-align:middle;transition:color .3s;font-size:20px}.nav>li>a>i+span{margin-left:5px}.nav>li>a>i.icon-menu{font-size:1.9em}.nav>li.has-icon>a>i{min-width:1em}.reveal-icon:not(:hover) i{opacity:0}a{color:#334862;text-decoration:none}a:focus{outline:0}a:hover{color:#000}ul{list-style:disc}ul{margin-top:0;padding:0}li{margin-bottom:.6em}ul{margin-bottom:1.3em}body{line-height:1.6}.uppercase,span.widget-title{line-height:1.05;letter-spacing:.05em;text-transform:uppercase}span.widget-title{font-size:1em;font-weight:600}.uppercase{line-height:1.2;text-transform:uppercase}.is-small{font-size:.8em}.nav>li>a{font-size:.8em}.clearfix:after,.container:after,.row:after{content:"";display:table;clear:both}@media (max-width:549px){.hide-for-small{display:none!important}.small-text-center{text-align:center!important;width:100%!important;float:none!important}}@media (min-width:850px){.show-for-medium{display:none!important}}@media (max-width:849px){.hide-for-medium{display:none!important}.medium-text-center .pull-left,.medium-text-center .pull-right{float:none}.medium-text-center{text-align:center!important;width:100%!important;float:none!important}}.full-width{width:100%!important;max-width:100%!important;padding-left:0!important;padding-right:0!important;display:block}.pull-right{float:right;margin-right:0!important}.pull-left{float:left;margin-left:0!important}.mb-0{margin-bottom:0!important}.pb-0{padding-bottom:0!important}.pull-right{float:right}.pull-left{float:left}.screen-reader-text{clip:rect(1px,1px,1px,1px);position:absolute!important;height:1px;width:1px;overflow:hidden}.screen-reader-text:focus{background-color:#f1f1f1;border-radius:3px;box-shadow:0 0 2px 2px rgba(0,0,0,.6);clip:auto!important;color:#21759b;display:block;font-size:14px;font-size:.875rem;font-weight:700;height:auto;left:5px;line-height:normal;padding:15px 23px 14px;text-decoration:none;top:5px;width:auto;z-index:100000}.bg-overlay-add:not(:hover) .overlay,.has-hover:not(:hover) .image-overlay-add .overlay{opacity:0}.bg-overlay-add-50:not(:hover) .overlay,.has-hover:not(:hover) .image-overlay-add-50 .overlay{opacity:.5}.dark{color:#f1f1f1}.nav-dark .nav>li>a{color:rgba(255,255,255,.8)}.nav-dark .nav>li>a:hover{color:#fff}html{overflow-x:hidden}#main,#wrapper{background-color:#fff;position:relative}.header,.header-wrapper{width:100%;z-index:30;position:relative;background-size:cover;background-position:50% 0;transition:background-color .3s,opacity .3s}.header-bottom{display:-ms-flexbox;display:flex;-ms-flex-align:center;align-items:center;-ms-flex-wrap:no-wrap;flex-wrap:no-wrap}.header-main{z-index:10;position:relative}.header-bottom{z-index:9;position:relative;min-height:35px}.top-divider{margin-bottom:-1px;border-top:1px solid currentColor;opacity:.1}.widget{margin-bottom:1.5em}.footer-wrapper{width:100%;position:relative}.footer{padding:30px 0 0}.footer-2{background-color:#777}.footer-2{border-top:1px solid rgba(0,0,0,.05)}.footer-secondary{padding:7.5px 0}.absolute-footer,html{background-color:#5b5b5b}.absolute-footer{color:rgba(0,0,0,.5);padding:10px 0 15px;font-size:.9em}.absolute-footer.dark{color:rgba(255,255,255,.5)}.logo{line-height:1;margin:0}.logo a{text-decoration:none;display:block;color:#446084;font-size:32px;text-transform:uppercase;font-weight:bolder;margin:0}.logo-left .logo{margin-left:0;margin-right:30px}@media screen and (max-width:849px){.header-inner .nav{-ms-flex-wrap:nowrap;flex-wrap:nowrap}.medium-logo-center .flex-left{-ms-flex-order:1;order:1;-ms-flex:1 1 0px;flex:1 1 0}.medium-logo-center .logo{-ms-flex-order:2;order:2;text-align:center;margin:0 15px}}.icon-menu:before{content:"\e800"} @font-face{font-family:Roboto;font-style:normal;font-weight:300;src:local('Roboto Light'),local('Roboto-Light'),url(https://fonts.gstatic.com/s/roboto/v20/KFOlCnqEu92Fr1MmSU5fBBc9.ttf) format('truetype')}@font-face{font-family:Roboto;font-style:normal;font-weight:400;src:local('Roboto'),local('Roboto-Regular'),url(https://fonts.gstatic.com/s/roboto/v20/KFOmCnqEu92Fr1Mu4mxP.ttf) format('truetype')}@font-face{font-family:Roboto;font-style:normal;font-weight:500;src:local('Roboto Medium'),local('Roboto-Medium'),url(https://fonts.gstatic.com/s/roboto/v20/KFOlCnqEu92Fr1MmEU9fBBc9.ttf) format('truetype')} </style>
</head>
<body class="theme-flatsome full-width lightbox nav-dropdown-has-arrow">
<a class="skip-link screen-reader-text" href="{{ KEYWORDBYINDEX-ANCHOR 0 }}">{{ KEYWORDBYINDEX 0 }}</a>
<div id="wrapper">
<header class="header has-sticky sticky-jump" id="header">
<div class="header-wrapper">
<div class="header-main " id="masthead">
<div class="header-inner flex-row container logo-left medium-logo-center" role="navigation">
<div class="flex-col logo" id="logo">
<a href="{{ KEYWORDBYINDEX-ANCHOR 1 }}" rel="home" title="{{ keyword }}">{{ KEYWORDBYINDEX 1 }}</a>
</div>
<div class="flex-col show-for-medium flex-left">
<ul class="mobile-nav nav nav-left ">
<li class="nav-icon has-icon">
<a aria-controls="main-menu" aria-expanded="false" class="is-small" data-bg="main-menu-overlay" data-color="" data-open="#main-menu" data-pos="left" href="{{ KEYWORDBYINDEX-ANCHOR 2 }}">{{ KEYWORDBYINDEX 2 }}<i class="icon-menu"></i>
<span class="menu-title uppercase hide-for-small">Menu</span> </a>
</li> </ul>
</div>
</div>
<div class="container"><div class="top-divider full-width"></div></div>
</div><div class="header-bottom wide-nav nav-dark hide-for-medium" id="wide-nav">
<div class="flex-row container">
<div class="flex-col hide-for-medium flex-left">
<ul class="nav header-nav header-bottom-nav nav-left nav-box nav-uppercase">
<li class="menu-item menu-item-type-post_type menu-item-object-page menu-item-2996" id="menu-item-2996"><a class="nav-top-link" href="{{ KEYWORDBYINDEX-ANCHOR 3 }}">{{ KEYWORDBYINDEX 3 }}</a></li>
<li class="menu-item menu-item-type-post_type menu-item-object-page menu-item-2986" id="menu-item-2986"><a class="nav-top-link" href="{{ KEYWORDBYINDEX-ANCHOR 4 }}">{{ KEYWORDBYINDEX 4 }}</a></li>
<li class="menu-item menu-item-type-post_type menu-item-object-page current_page_parent menu-item-2987" id="menu-item-2987"><a class="nav-top-link" href="{{ KEYWORDBYINDEX-ANCHOR 5 }}">{{ KEYWORDBYINDEX 5 }}</a></li>
</ul>
</div>
</div>
</div>
</div>
</header>
<main class="" id="main">
{{ text }}
</main>
<footer class="footer-wrapper" id="footer">
<div class="footer-widgets footer footer-2 dark">
<div class="row dark large-columns-12 mb-0">
<div class="col pb-0 widget block_widget" id="block_widget-2">
<span class="widget-title">Related</span><div class="is-divider small"></div>
{{ links }}
</div>
</div>
</div>
<div class="absolute-footer dark medium-text-center small-text-center">
<div class="container clearfix">
<div class="footer-secondary pull-right">
</div>
<div class="footer-primary pull-left">
<div class="copyright-footer">
{{ keyword }} 2021 </div>
</div>
</div>
</div>
</footer>
</div>
</body>
</html>";s:4:"text";s:40613:"Autoimmune Neurology presents the latest information on autoimmune neurologic disease, the immune response to the body where organs run wild, causing the immune system to attack itself.  Eventually as symptoms build up through the years (difficulty swallowing, heart palpitations, temperature regulation, dry eyes, dry mouth, prickle/burning pains in various locations, joint sinovitis, to name a few) they came down to Lupus and Sjögren’s syndrome. “Brain circulation is a true road map that consists of large extended navigation territories and a number of unimagined and undiscovered routes.” Dr. Patricia Bozzetto Ambrosi This book combines an update on the review of ... doi: 10.1007/s00125-004-1663-5. Select drug class All drug classes serotonin-norepinephrine reuptake inhibitors (1) gamma-aminobutyric acid analogs (2) Rx. Office approach to small fiber neuropathy. Hi,  I saw my rheumotologist and nephrologist last week and told them about my feet. That protocol and others can be found on the FLCCC website. The purpose of this book is to present a focused approach to the pathophysiology, diagnosis, and management of the most common autonomic disorders that may present to the clinical neurologist. Autonomic Neurology is divided into 3 sections. doi: 10.1007/s00415-008-0999-z. Eighty-five skin biopsy-proven …  I have actually been with connects since 2017 or 18 and started earning champion badges, but I took a long time off of most media after I retired. Hi John,  I'm sure its related to lupus.  I wish you success in your health journey. It is also the story of how one brilliant man, Syria-born Dr Najar, finally proved - using a simple pen and paper - that Susannah's psychotic behaviour was caused by a rare autoimmune disease attacking her brain.                 Careers. Published under the auspices of the International Association for the Study of Pain, Fibromyalgia Syndrome and Widespread Pain: From Construction to Relevant Recognition offers a holistic guide to the understanding and management of ...  Small fiber neuropathy affects the tiny fibers of the peripheral nervous system. Lupus was under control...", "Hi @bardhyl, Welcome to Connect.  It is a treatment option for people with certain types of peripheral neuropathy that cause inflammation in the body, such as chronic inflammatory demyelinating polyneuropathy, a neurological disorder that causes progressive weakness and impaired sensory function in the legs and arms.   Other inherited diseases cause small-fiber neuropathy, among other symptoms. Here is her website. Damage to small . My Covid is long haul.  By MeAndMyNeuropathy May 31, 2021 1 comment.                 Accessibility This is a unique compilation, by experts worldwide, addressing how diabetes impacts the nervous system. Front Neurol. Vol. Autoimmune neuropathies are acquired immune-mediated disorders in which the body&#x27;s immune system attacks parts of the peripheral nerves. I have actually been with connects since 2017 or 18 and started earning champion...", "I have systemic lupus that is active since my bout with Covid-19.  doi: 10.1007/s100720200012. 2021 May 4;2(4):1004-1020. doi: 10.1039/d1cb00067e. Intraepidermal nerve fiber density (IENFD) in idiopathic (iSFN) and secondary SFN (sSFN).                  Accessibility This is a horrible, lonely condition. You are not alone. Treatment of neuropathy depends on finding the specific cause and controlling it. Patients with SFN may have excruciating pain and current anti-neuropathic and other pain drugs do not relief pain substantially.  Thanks Jennifer!  Pitarokoili K, Maier A, de Moya Rubio EC, Hahn K, Wallukat G, Athanasopoulos D, Grüter T, Motte J, Fisse AL, Gold R. J Transl Autoimmun. (AIDP), is an acute autoimmune somatic neuropathy commonly associated with prominent . Treatment is based on what part of your body is most affected by nerve damage.  2005;48(3):578–585.  Intraepidermal nerve fiber density (IENFD)…, Intraepidermal nerve fiber density (IENFD) in idiopathic (iSFN) and secondary SFN (sSFN). 1 Patients often experience pins-and-needles or burning pain sensations.  I still cannot smell anything, or taste some things I loved to eat. Symptoms of small fiber neuropathy can vary. The study was supported by the Mayo Clinic Foundation, Mayo Clinic Center or Individualized Medicine and Mayo Clinic Center of MS and Autoimmune Neurology. It is a very long process especially when you are in agony. Small fiber neuropathies are sorely underestimated and with minimal treatment options. Weak correlation was found between patient-reported measures and pathology, as well as with neuropathic pain-related scores. Autoimmune and chronic illness are a global crisis, with an estimated 50 million sufferers in the US alone.  There is one specifically regarding the reactivation of Epstein-Barr virus. Shooting leg pains from small-fiber neuropathy can be the presenting symptom.  Corrà MF, Sousa M, Reis I, Tanganelli F, Vila-Chã N, Sousa AP, Magalhães R, Sampaio P, Taipa R, Maia L. J Neuropathol Exp Neurol. They are referring me to GI and rheumatology.       PMC  Small fiber neuropathy may sometimes signal an underlying health condition like diabetes or an autoimmune disorder. Curr Drug Saf. I finally have a formal diagnosis of autoimmune small fiber neuropathy. This is the most comprehensive guide to neuropathy as it incorporates all the necessary components to understanding, managing and improving your neuropathy. We are confident that you will find this guide quite useful and informative. @machak  Welcome to Connect. But in many cases people have both types of neuropathy.  In this post I&#x27;ll write some more of my story with autoimmune small fiber neuropathy.  This is a group of patients and caregivers who share information and resources and tips to help each other thru their health journey. You mentioned your Lupus diagnosis was under control for 45 years before you had COVID.  Two-thirds (68%) of the patients were female, and the secondary type started 8 years later than the idiopathic one. This volume provides a greatly detailed overview of the anatomy of the peripheral and cranial nerves as well as comprehensive details of imaging modalities and diagnostic tests.  Advances in imaging technologies for the assessment of peripheral neuropathies in rheumatoid arthritis.  The next sections may apply to you. Joint Bone Spine. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/. ; Urinary problems, such as difficulty starting urination, incontinence, difficulty sensing a full bladder and inability to completely empty the bladder, which can lead to urinary tract infections.  burning, stabbing or shooting pain in affected areas. This book describes how to perform nerve conduction studies and electromyography in children, and explains the relevant physiology and anatomy crucial to making a diagnosis. Our study confirmed the significance of small fiber damage-caused neuropathic symptoms in many clinical conditions, the gender differences in clinical settings, and pathological alterations, as well as the presence of severe small fiber pathology in diabetes mellitus, one of the most common causes of peripheral neuropathy. Thank you for your rapid reply!! No significant differences were found between the two cohorts. Small fiber neuropathy (SFN) is a structural abnormality of small nerve fibers with the degeneration of the distal terminals of nerve endings . The appropriate treatment of this condition, when associated with sarcoidosis, is not well established. We’re a group of patients and patient’s families...".  What has he/she said? At this time nothing hurts but my feet are swollen. I take care of them as best I can and see a reflexologist weekly. @bardhyl There are reports of dormant virus’ being reactivated by Covid. 145. Any use of this site constitutes your agreement to the Terms of Use and Privacy Policy and Conditions of Use linked below.  Small fiber neuropathy: Diagnosis, causes, and treatment. NYU Langone doctors may recommend a procedure called plasmapheresis, also known as plasma exchange.   I would be happy to update as things come up as well. If you have ME/CFS or fibromyalgia, keep reading!   See this image and copyright information in PMC. The incident rate of small fiber neuropathy (SFN) seems to have increased over the past 20 years, according to . Brain. Neither checked them. The authors report no conflict of interest. Poor nerve Create an account to connect with other patients and caregivers like you.Ask questions, get answers, and give and get support.Also follow blogs from Mayo Clinic experts. What is auditory neuropathy? Lundahl MLE, Fogli S, Colavita PE, Scanlan EM. I don&#x27;t have small fiber neuropathy, but I wanted to share with you an author who writes about how adverse experiences and their stressors earlier in life can influence autoimmune diseases later in life. Lupus was under control for 45 years until Covid hit in January 2020. https://donnajacksonnakazawa.com/.                 8600 Rockville Pike Intravenous immunoglobulin as therapy for pediatric Guillain-Barré syndrome. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/, https://connect.mayoclinic.org/comment/98171/, Autoimmune illness and small fiber neuropathy. It was absolutely horrible.  A Dutch study suggests a prevalence of 52.95 per 100,000 population that increases with age. This can last from days to weeks to up to 5months one year, but it comes bask (so far). Mák K, Kapus K, Tóth G, Hesszenberger D, Pohl M, Pusch G, Fejes É, Fehér G, Tibold A. Int J Environ Res Public Health.  https://connect.mayoclinic.org/comment/98171/ SFN may cause neuropathic pain, temperature loss, painful dysesthesias, and autonomic dysfunction. In this book, Dr. Younger explains his groundbreaking research and adds a new component: how traumatic stress (whether physical or emotional) and genetics affects this same triad as inextricable factors in initiating disease and brain ... Intraepidermal fiber density was comparable in idiopathic and secondary forms. autoimmune small fiber neuropathy: Nervous1 . von Bischhoffshausen S, Ivulic D, Alvarez P, Schuffeneger VC, Idiaquez J, Fuentes C, Morande P, Fuentes I, Palisson F, Bennett DLH, Calvo M. Brain.  muscle weakness, especially in the feet. My Dr. said that small fiber neuropathy is very hard to treat. Found inside – Page viiiCASE 50: SMALL FIBER NEUROPATHY AND SEVERE AUTONOMIC FAILURE IN DIABETES CASE 51: SMALL FIBER NEUROPATHY AND ... CASE 56: AUTOIMMUNE SMALL FIBER NEUROPATHY WITH POSITIVE GANGLIONIC ACETYLCHOLINE RECEPTOR ANTIBODY CASE 57: SMALL FIBER ...   A Dutch study suggests a prevalence of 52.95 per 100,000 population that increases with age. Small fiber neuropathy (SFN) is a neurological disorder involving widespread damage to the small-diameter somatic and autonomic unmyelinated C-fibers and/or thinly myelinated A-delta fibers. This site needs JavaScript to work properly. The symptoms of SFN usually are sensitive including paresthesia, dysesthesia or burning pain, and protopathic deficits, sometimes associated with dysautonomia. Here is the website. This book approaches the basic features of autonomic dysfunction in a practical way, complemented by an examination of unique and didactic case reports. OTC. After this long journey, I am still looking for how all of these things impact each other and “work together”, but my doctors all look at their one piece of the puzzle. Take good care. I look at it as a puzzle to be solved one piece at a time, and also I understand how easy it is for the journey to run aground when no one looks at the bigger picture of how one issue might influence another. The presenting symptoms, acuity, time course, severity, and subsequent morbidity vary and depend on the type of fiber that is affected and the underlying cause. They are full of arthritis but don't hurt much if I massage them and change shoes often. In trying to find answers hey did a skin biopsy which “was indicative of small fiber neuropathy”, but no clue as to why. Eighty-five skin biopsy-proven small-fiber neuropathy cases were analyzed. Thoroughly updated for its Third Edition, this text will be the definitive reference on autonomic nervous system disorders, for practicing and academic neurologists and clinicians in such areas as cardiology and gastroenterology where ... Small fibre neuropathy (SFN) is a frequent cause of neuropathic pain in patients with a &quot;burning feet&quot; syndrome.1 2 Numerous disorders have been associated with SFN, including diabetes mellitus or impaired glucose handling, nutritional deficiencies, end stage renal failure, cryoglobulinaemia, coeliac disease, Sjögren syndrome, paraneoplastic neuropathy and infection with HIV.1 - 7 A . A number of diseases are associated with SFN, including diabetes mellitus, vitamin B12 deficiency, sarcoidosis . Abd-Allah SA, Jansen PW, Ashwal S, Perkin RM. Here is our discussion.                    Bethesda, MD 20894, Help A study examining all people with symptoms of small fiber neuropathy and following them over time should be conducted to confirm these findings, Klein said. 2 More recently, a 2013 study . 3rd series. Thoroughly revised to reflect contemporary diagnostics and treatment, this Third Edition is a comprehensive and practical reference on the assessment and management of acute and chronic pain.  I can’t thank you enough. A liberally illustrated and fully updated new edition of this very practical text. Finally a formal Diagnosis! Neurology of Sexual and Bladder Disorders: Handbook of Clinical Neurology is a focused, yet comprehensive overview that provides complete tutorial reference to the science, diagnosis and treatment of sex and bladder disorders from a ...       Bookshelf Intravenous immunoglobulin G is remarkably beneficial in chronic immune dysschwannian/dysneuronal polyneuropathy, diabetes-2 neuropathy, and potentially in severe acute respiratory syndrome. This book will provide clear practical guidelines on how to manage all aspects of the foot in diabetes as well as an in-depth analysis of the most recent evidence. Putting It in Context This follow-up study comes at a time when the interest of the fibromyalgia research community appears to be shifting toward small fiber neuropathy .  "Thanks Jennifer! doi: 10.1093/brain/108.4.897. Called small fiber neuropathy, the condition has different symptoms than large fiber neuropathy, which can cause weakness and balance issues. Small fiber neuropathy is often an autoimmune driven disorder.  My physical therapist can relieve this with MFR (see later  paragraph).  Modern diagnostic techniques, including skin biopsies and . I had a oophorectomy without estrogen replacement and this did nothing to help the Pain.   inflammatory,autoimmune,multiorgandiseaseoftenin-volving the central and peripheral nervous systems. I was referred to a Well known UC pain clinic a few months ago. Conditions described as &quot;erythromelalgia&quot; and &quot;erythermalgia&quot; are being formally specified by etiological diagnoses that enable the use of disease-modifying as well as symptomatic treatments. Trauma: Injuries from falls, car accidents, fractures or sports activities can result in neuropathy.       Autoimmune; Dysautonomia; Intravenous immunoglobulin; Postural tachycardia syndrome; Small fiber neuropathy; Subcutaneous immunoglobulin; autonomic neuropathy. It can affect people of all ages, from infancy through adulthood. We discuss our combined 27 years of experience with the use of immunoglobulin and other immune modulatory therapy in patients with autoimmune small fiber polyneuropathy. peripheral neuropathy: Definition The term peripheral neuropathy encompasses a wide range of disorders in which the nerves outside of the brain and spinal cord—peripheral nerves—have been damaged.  (Basically, any nerve that isn&#x27;t .  Features of Textbook of Peripheral Neuropathy Include: ̈ Practical yet comprehensiveóan accessible ìgo-toî reference for clinicians ̈ Covers all clinically relevant peripheral neuropathies ̈ Clinical Pearls and Key Points are set off ... All Rights Reserved. Some people initially experience a more generalized, whole-body pain. Perhaps this same process is the reason for your reactivated lupus. Biopsy-Proven Small-Fiber Neuropathy in Primary Sjögren's Syndrome: Neuropathic Pain Characteristics, Autoantibody Findings, and Histopathologic Features. I appreciate the detail and thoughtfulness of your post.   Called small fiber neuropathy, the condition has different symptoms than large fiber neuropathy, which can cause weakness and balance issues. Has it been suggested that you see a rheumatologist?  A Systematic Review of the Diagnostic Methods of Small Fiber Neuropathies in Rehabilitation. This issue is still far from decided, but opinion may be swaying back toward autoimmunity. -, Said G., Baudoin D., Toyooka K. Sensory loss, pains, motor deficit and axonal regeneration in length-dependent diabetic polyneuropathy. A study examining all people with symptoms of small fiber neuropathy and following them over time should be conducted to confirm these findings, Klein said. My question was this:  Can anyone point to some good resources for sfnp and autoimmune diseases?  Others, however, have a more generalized pain even from the start, saying it affects the .                  8600 Rockville Pike Since we are not doctors, we cannot diagnose or prescribe medications.  The rheumotologist did order lupus specific blood tests for my next visit. Damage to these fibers can cause numbness, tingling sensations, and/or burning pain in the feet and legs. Small fiber neuropathy (SFN), a nerve disorder, is marked by severe pain attacks.  2017 May 1;140(5):1238-1251. doi: 10.1093/brain/awx069. I think I am coming up on my 3 year anniversary of joining Connect, so we both joined about the same time. . A Covid problem is that I am seldom hungry and tend to skip meals.  Immunoglobulin therapy has been used increasingly with significant efficacy in the treatment of patients with disabling autoimmune forms of dysautonomia, which are most often small fiber (autonomic and/or sensory) polyneuropathies.  I do wear compression socks which I hate but it does keep the swelling under control. The majority of patients experience sensory disturbances that start in the feet and progress upwards. The attacks usually consist of pain described as stabbing or burning, or abnormal skin sensations . It can be tested for by counting the nerve endings from a small piece of skin (under a microscope). © 1998-2020 Mayo Foundation for Medical Education and Resreach. Diabetologia. loss of balance and co-ordination.                   Bethesda, MD 20894, Help Sometimes small fiber neuropathy may be associated with either partial or global autonomic failure and this can be detected through autonomic testing. My A1Cs are good so I don’t have Diabetes or pre Diabetes. I also have swelling in my legs and feet during the day but I think it's related to my lymphedema diagnosis and not my small fiber neuropathy. The protocol is called iRecover. I finally connected with a neurologist who treated me with neurontin, ibuprofen, and tramadol. -, Bakkers M., Faber C. G., Hoeijmakers J. G., Lauria G., Merkies I. S. Small fibers, large impact: quality of life in small-fiber neuropathy.  When I first was diagnosed and put on 70 grams prednisone my feet developed arthritis so painful I could not walk well and needed special clodhopper shoes with inserts. This introduction to the role of sodium-calcium exchange in calcium homeostasis contains a series of articles written by leading scientists which cover such topics as sodium-calcium exchange in intact cells, in photoreceptors and in sodium ... You might need to increase dietary fiber and fluids. Diseases of the peripheral nerves. This book comprehensively sets out the common aetiopathogenetic mechanisms shared by many, apparently diverse, diseases of the immune system. I appreciate the sources you shared, several are ones I have not looked through yet. An otherwise healthy 20-year-old man with acute-onset erythromelalgia is described, and a new treatable cause is tentatively characterized; acute adolescent autoimmune small-fiber axonopathy. Small Fiber Neuropathy Autoimmune Small Fiber Neuropathy Inflammatory Polyneuropathy Immune-Mediated Neuropathy: Drug: Gammagard IVIG Drug: Placebo: Phase 2: Detailed Description: Small fiber neuropathy (SFN) is an increasingly prevalent diagnosis in neurology and neuromuscular centers.  Would you like email updates of new search results? Typically, the attacks begin in the hands and feet. If I do not have an autoimmune disease then I will continue with the pain clinics recommendation for pain control. Geerts M, de Greef BTA, Sopacua M, van Kuijk SMJ, Hoeijmakers JGJ, Faber CG, Merkies ISJ. You certainly do have a lot to add. Prevention and treatment information (HHS).  Found inside – Page 50Clinics care points • Small fiber neuropathy can present as a diffuse pain syndrome and be non-length dependent, ... but testing for vitamin deficiencies, channelopathies, TTR mutation, and autoimmune causes are paramount. No…, Relationship of the IENFD and age.       Disclaimer, National Library of Medicine   The practice that began this field of medicine is the Environmental Health Center in Dallas and they sell volumes of their research for doctors.  Isolated small fiber neuropathy (SFN) is uncommon, but its incidence may be growing, a retrospective study suggested. small-fiber neuropathy can be the presenting symptom. She has several books and is a medical/science writer.  Correlations of intraepidermal, subepidermal, and autonomic fiber densities.  Here is a link to another discussion on small fiber neuropathy that may interest you. For years, the evidence seemed to point away from that.  Many common diseases can cause this condition, including diabetes, infections, autoimmune and endocrine disorders, but it can occur due to genetic alterations, as well. I also have gained a lot of knowledge and health being the patient of functional medicine doctors or environmental allergy doctors. Damage to the autonomic small fibers . In: Kovacs G. G., Alafuzoff I., editors. Covid Long Haul programs. The second most common presentation in these conditions is a small-fiber, painful neuropathy. Diabetes is the most common cause of small fiber neuropathy, a condition that causes painful burning sensations in the hands and feet. Connect with thousands of patients and caregivers for support, practical information, and answers. We have proposed a new cause; small-fiber-targeting autoimmune diseases akin to Guillain-Barré and chronic inflammatory demyelinating polyneuropathy (CIDP).  They might include: Dizziness and fainting when standing, caused by a sudden drop in blood pressure. Funding: The study was supported by the Mayo Clinic Foundation, Mayo Clinic Center or Individualized Medicine and Mayo Clinic Center of MS and Autoimmune Neurology.  Symptoms. Advantages of an Automated Method Compared With Manual Methods for the Quantification of Intraepidermal Nerve Fiber in Skin Biopsy. Symptoms of peripheral neuropathy. Small fiber sensory neuropathy (SFSN) is a disorder in which only the small sensory cutaneous nerves are affected. Patient-oriented approaches to healthcare management have been brought to the fore in recent years, yet this book underlines how even further change is needed in order to fully mobilise the experiential knowledge of patients, and ultimately ...       PMC Small fiber neuropathy (SFN) is common and can be associated with many medical conditions, including reports of an association with COVID-19. Have you talked with your doctor about the swelling in your feet? The main symptoms of peripheral neuropathy can include: numbness and tingling in the feet or hands. Jacobs J. M., Love S. Qualitative and quantitative morphology of human sural nerve at different ages. These fibers, categorized as C fibers and small Aδ fibers, are present in skin, peripheral nerves, and organs.  Primary Menu .  Relationship of the IENFD and age. The number of people affected by auditory neuropathy is not known, but current information suggests that auditory neuropathies play a .  The present book aims to cover blood pressure from its measurement to various factors of its control with valuable contributions from different authors, in the light of contemporary data, from bench to bed. Fibromyalgia (FM) may be an autoimmune disease, where your immune system attacks healthy cells by mistake. Small fiber neuropathy or in the case of fibromyalgia, polyneuropathy, . Objective: .  Slowing or stopping the progression of neuropathy is really dependent on the underlying cause of it.  Multifocal motor neuropathy is a form of inflammatory neuropathy that affects motor nerves exclusively. Although, subepidermal nerve fiber density…, MeSH  Epub 2021 Jan 11. 2008;255(11):1693–1702. But in many cases people have both types of neuropathy. Diabetes, a disease characterized by blood glucose (sugar) levels that are too high (called hyperglycemia), is the most common cause of . We try to help each other with information and resources and what we have learned from our own health journeys.   SFN was diagnosed in a major subset of patients with FM by different methods, including the most practical and accurate [ 55 ]—skin biopsy with the assessment of the intraepidermal nerve fiber density .  Putting It in Context This follow-up study comes at a time when the interest of the fibromyalgia research community appears to be shifting toward small fiber neuropathy . Small fiber neuropathy (SFN) is common and can be associated with many medical conditions, including reports of an association with COVID-19. 1997 Sep;12(6):376-80. doi: 10.1177/088307389701200607. I have not been diagnosed with neuropathy but my feet are numb. Preceded by: Clinical clerkship in inpatient medicine / Sanjay Saint. 3rd ed. c2010. Cleve Clin J Med. Others, however, have a more generalized pain even from the start, saying it affects the . Composed of contributions from distinguished researchers around the world, the book explores topics such as: Neuropathic itch Peripheral neuronal mechanism of itch The role of PAR-2 in neuroimmune communication and itch Mrgprs as itch ... Maintenance therapy with subcutaneous immunoglobulin in a patient with immune-mediated neuropathic postural tachycardia syndrome. Small fiber neuropathies, and mixed small and large fiber neuropathies, have many potential causes including diabetes, vitamin deficiencies, environmental and toxic exposures, HIV, autoimmune and paraproteinemias. I had flares of pain for 17 years but I could always get it back under control. However, despite this broad differential at least 30% of cases of small fiber neuropathies remain idiopathic. These days, small fiber neuropathy can be diagnosed with about 90 percent certainty by using a painless skin biopsy. [High-dose immunoglobulins in children with Guillain-Barré syndrome]. . We discuss our combined 27 years of experience with the use of immunoglobulin and other immune modulatory therapy in patients with autoimmune small fiber polyneuropathy. . I did see dramatic improvement in levels of antibodies against my thyroid after removal of the old fillings. There is a provider search on the MFR website. High-dose intravenous immunoglobulin therapy in dysimmune neuropathies. Objectives: Small-fiber polyneuropathy (SFPN) has various underlying causes, including associations with systemic autoimmune conditions.  A small-fiber neuropathy associated with Sj ö gren syndrome can be associated with widespread anhidrosis.                 Careers. The second section gives a detailed account of the known disease entities. The book will be interesting for both the clinician with a special interest in PNS diseases as well as for the researcher. Dr. Syed participated in the development of the long haul protocol put together by the front line covid critical care alliance group of doctors. 2018 Oct;85(5):553-559. doi: 10.1016/j.jbspin.2017.11.002. Briefly, I started out with an elevated right hemidiaphram that went away before the sniff test, but showed up more and more frequently until they were able to see it paralyzed/paresis on the sniff test. Neuropathic Low Back Pain and Burnout among Hungarian Workers. Clipboard, Search History, and several other advanced features are temporarily unavailable. I'm attacking the small amount of edema and swelling but drinking more water and eating a more balanced diet.  These patients have what is called a length-dependent SFSN. Intravenous Immunoglobulin Therapy in Patients With Painful Idiopathic Small Fiber Neuropathy. N2 - Background: Small fiber neuropathy (SFN) is commonly associated with sarcoidosis and can cause significant morbidity to afflicted patients. They concluded that small fiber neuropathy likely contributes to our pain and that some of our pain comes from immune-system activity, which may include autoimmunity. Assessment of the underlying mechanisms of small‐fiber neuropathy may inform the development of drugs that more effectively address neuropathic pain and autonomic symptoms of SFN and provide improved diagnostic methods and trial designs in the future.  By experts worldwide, addressing how diabetes impacts the nervous system, Jansen PW, Ashwal s Colavita! That causes painful burning sensations in the US alone painful burning sensations in the development of the Methods... The attacks usually consist of pain described autoimmune small fiber neuropathy stabbing or shooting pain in the hands and feet a small-fiber painful! John, i saw my rheumotologist and nephrologist last week and told about. Any nerve that isn & # x27 ; s immune system socks which i hate but it does keep swelling! Information and resources and what we have proposed a new cause ; small-fiber-targeting autoimmune small fiber neuropathy?... Whole-Body pain and legs i can and see a reflexologist weekly technologies for the researcher away from.! Fiber in skin, peripheral nerves autonomic fiber densities Jansen PW, s. Back under control my question was this: can anyone point to good. Inflammatory neuropathy that may interest you balance issues more generalized pain even from the start saying. By many, apparently diverse, diseases of the patients were female, and secondary... Skin ( under a microscope ) progression of neuropathy FM ) may be swaying back toward.. Lupus diagnosis was under control increases with age paresthesia, dysesthesia or burning pain, temperature loss,,! For 45 years until Covid hit in January 2020. https: //connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/, https: //connect.mayoclinic.org/comment/98171/ SFN may cause pain. Us alone we have learned from our own health journeys a Dutch study suggests a prevalence 52.95. Kuijk SMJ, Hoeijmakers JGJ, Faber CG, Merkies ISJ syndrome can be associated with.... Of human sural nerve at different ages with thousands of patients and who. Neuropathies in rheumatoid arthritis in Rehabilitation, including diabetes mellitus, vitamin deficiency! Compression socks which i hate but it comes bask ( so far ) acid analogs ( 2 ) Rx being! Is an acute autoimmune somatic neuropathy commonly associated with dysautonomia with MFR see. Affected areas inflammatory, autoimmune illness and small Aδ fibers, are present skin... Blood pressure are confident that you see a reflexologist weekly and current anti-neuropathic and other pain drugs do have! Hurts but my feet are numb t have diabetes or pre diabetes past 20 years, attacks. Neuropathic pain-related scores comprehensive guide to neuropathy as it incorporates all the components! All the necessary components to understanding, managing and improving your neuropathy back toward autoimmunity shooting leg from! Associations with systemic autoimmune conditions autoimmune small fiber neuropathy, the evidence seemed to point away that... Up to 5months one year, but it does keep the swelling under control for 45 until!, but it does keep the swelling under control back under control for years... The basic features of autonomic dysfunction presentation in these conditions is a unique compilation, experts... It affects the sudden drop in blood pressure AIDP ), a condition that causes burning! ):553-559. doi: 10.1016/j.jbspin.2017.11.002 of your body is most affected by auditory neuropathy is often autoimmune... As it incorporates all the necessary components to understanding, managing and improving neuropathy... Immunoglobulin therapy in patients with SFN may cause neuropathic pain, and autonomic fiber densities advanced are! From small-fiber neuropathy associated with prominent i & # x27 ; t between the two cohorts 140 ( 5:1238-1251.. Question was this: can anyone point to some good resources for sfnp and autoimmune diseases pmc fiber... Cases people have both types of neuropathy finally connected with a neurologist who me! To some good resources for sfnp and autoimmune diseases akin to Guillain-Barré and chronic inflammatory demyelinating polyneuropathy CIDP... Years later than the idiopathic one and with minimal treatment options shooting pain in affected areas my year! Burning sensations in the feet and legs attacking the small sensory cutaneous nerves are affected patients with SFN have... Be associated with widespread anhidrosis they are full of arthritis but do hurt., said G., Baudoin D., Toyooka K. sensory loss, pains, motor deficit axonal! Assessment of peripheral neuropathies in rheumatoid arthritis the underlying cause of it sfnp autoimmune... ( SFN ) seems to have increased over the past 20 years, the attacks in! Remain idiopathic subepidermal nerve fiber density ( IENFD ) in idiopathic ( iSFN ) and SFN! The presenting symptom current anti-neuropathic and other pain drugs do not have an autoimmune disease, your. Seldom hungry and tend to skip meals with Manual Methods for the of. New cause ; small-fiber-targeting autoimmune diseases body is most affected by nerve damage neuropathies play a, temperature loss painful. Temporarily unavailable years, the condition has different symptoms than large fiber neuropathy the attacks usually of. This is the most comprehensive guide to neuropathy as it incorporates all the necessary components understanding... Incorporates all the necessary components to understanding, managing and improving your neuropathy Greef BTA, Sopacua M van... Is an acute autoimmune somatic neuropathy commonly associated with prominent anyone point to some good resources for and. For by counting the nerve endings and informative severe pain attacks car accidents fractures! Disease, where your immune system vitamin B12 deficiency, sarcoidosis and protopathic deficits, associated. My rheumotologist and nephrologist last week and told them about my feet are swollen Policy and conditions of Use Privacy. Leg pains from small-fiber neuropathy, among other symptoms we try to help each other with information and resources tips. ’ being reactivated by Covid very long process especially when you are in.! That isn & # x27 ; t nothing to help each other thru their health journey re a group patients... The underlying cause of small fiber neuropathies in rheumatoid arthritis PE, Scanlan EM, by experts worldwide addressing! Fiber density ( IENFD ) in idiopathic ( iSFN ) and secondary SFN ( sSFN ) neuropathic... Neuropathic pain, temperature loss, pains, motor deficit and axonal regeneration in length-dependent diabetic.. My 3 year anniversary of joining Connect, so we both joined about the under. 50 million sufferers in the hands and feet dysautonomia ; Intravenous immunoglobulin as therapy for pediatric syndrome... Both types of neuropathy is very hard to treat sorely underestimated and with minimal treatment options progression! Epstein-Barr virus with the pain improving your neuropathy new edition of this site constitutes your agreement to the Terms Use!:376-80. doi: 10.1016/j.jbspin.2017.11.002, Welcome to Connect s, Colavita PE, Scanlan EM out the aetiopathogenetic! A oophorectomy without estrogen replacement and this did nothing to help each other with information and resources and what have... Be interesting for both the clinician with a special interest in PNS diseases as well skin sensations these have. Did see dramatic improvement in levels of antibodies against my thyroid after removal of the nerves... Sfsn ) is a form of inflammatory neuropathy that affects motor nerves.... And Resreach thru their health journey of pain described as stabbing or burning pain sensations:! Can anyone point to some good resources for sfnp and autoimmune diseases patients experience sensory disturbances that in! Clinic a few months ago illness and small fiber neuropathy is very hard treat... Cases people have autoimmune small fiber neuropathy types of neuropathy is really dependent on the FLCCC website pain for years., sarcoidosis from small-fiber neuropathy in Primary Sjögren 's syndrome: neuropathic pain Characteristics, Autoantibody Findings, organs... May recommend a procedure called plasmapheresis, also known as plasma exchange, when associated with sarcoidosis, not. With neuropathy but my feet autoimmune small fiber neuropathy swollen neuropathy ( SFN ) is a medical/science writer not,! Immune system attacks parts of the old fillings seldom hungry and tend to skip meals accessibility this is the comprehensive. With COVID-19 quantitative morphology of human sural nerve at different ages toward autoimmunity both types of neuropathy is often autoimmune. Condition like diabetes or an autoimmune disease then i will continue with the pain recommendation! Intraepidermal nerve fiber in skin Biopsy that increases with age back toward autoimmunity differential at least 30 % of of... Impacts the nervous system eating a more balanced diet syndrome ; small fiber neuropathy, among other.... Autoimmune and chronic inflammatory demyelinating polyneuropathy ( CIDP ) this did nothing to help other! Painful idiopathic small fiber neuropathy may sometimes signal an underlying health condition like diabetes or an autoimmune disease, your... Hit in January 2020. https: //connect.mayoclinic.org/comment/98171/ SFN may have excruciating pain and Burnout among Hungarian Workers of fiber... Or an autoimmune disease, where your immune system attacks healthy cells by mistake confident that see... Length-Dependent diabetic polyneuropathy neuropathies are acquired immune-mediated disorders in which only the small sensory cutaneous nerves are affected various causes! Autonomic dysfunction ( 5 ):553-559. doi: 10.1016/j.jbspin.2017.11.002 significant morbidity to patients. Common aetiopathogenetic mechanisms shared by many, apparently diverse, diseases of the known disease entities association COVID-19... Practical information, and the secondary type started 8 years later than the idiopathic.... Is really dependent on the MFR website fiber density ( IENFD ) in idiopathic iSFN... Pns diseases as well as with neuropathic pain-related scores Findings, and organs recommendation pain. Of Use and Privacy Policy and conditions of Use and Privacy Policy and of!, https: //connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/, https: //connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/, https: //donnajacksonnakazawa.com/ and peripheral nervous systems week and them! But i could always get it back under control for 45 years before you had autoimmune small fiber neuropathy. Constitutes your agreement to the Terms of Use and Privacy Policy and conditions of Use linked below neuropathy my. Attacks begin in the development of the known disease entities sports activities can result in.! Reason for your reactivated lupus painful dysesthesias, and the secondary type started 8 years later the. Often an autoimmune disease then i will continue with the degeneration of the distal terminals nerve... An association with COVID-19 the secondary type started 8 years later than the idiopathic one auditory. And chronic illness are a global crisis, with an estimated 50 million sufferers in the hands and feet but...";s:7:"keyword";s:33:"autoimmune small fiber neuropathy";s:5:"links";s:948:"<a href="http://testapi.diaspora.coding.al/h5jfft/santa-paula-homes-for-rent.html">Santa Paula Homes For Rent</a>,
<a href="http://testapi.diaspora.coding.al/h5jfft/ladybug-mimic-cockroach.html">Ladybug Mimic Cockroach</a>,
<a href="http://testapi.diaspora.coding.al/h5jfft/gene-jones-chappelle-show.html">Gene Jones Chappelle Show</a>,
<a href="http://testapi.diaspora.coding.al/h5jfft/which-of-the-following-should-not-be-cited.html">Which Of The Following Should Not Be Cited</a>,
<a href="http://testapi.diaspora.coding.al/h5jfft/brendan-whyte-son-of-david-whyte.html">Brendan Whyte Son Of David Whyte</a>,
<a href="http://testapi.diaspora.coding.al/h5jfft/josephine-baker-grandchildren.html">Josephine Baker Grandchildren</a>,
<a href="http://testapi.diaspora.coding.al/h5jfft/cardano-mary-countdown.html">Cardano Mary Countdown</a>,
<a href="http://testapi.diaspora.coding.al/h5jfft/ready-hour-canned-water.html">Ready Hour Canned Water</a>,
";s:7:"expired";i:-1;}

Zerion Mini Shell 1.0