Now showing items 1-20 of 8384

    • Impact of gender-affirming hormone therapy on the development of COVID-19 infections and associated complications: A systematic review

      Temple University. Hospital (2022-11-20)
      BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can produce a wide range of clinical manifestations from asymptomatic to life-threatening. Various researchers have worked to elucidate the pathogenic mechanisms underlying these variable presentations. Differences in individual responses to systemic inflammation and coagulopathy appear to be modulated by several factors, including sex steroid hormones. Transgender men or non-binary individuals who undergo gender-affirming hormone therapy (GAHT) are a unique population of interest for exploring the androgen-mediated coronavirus disease 2019 (COVID-19) hypothesis. As the search for reliable and effective COVID-19 treatments continues, understanding the risks and benefits of GAHT may mitigate COVID-19 related morbidity and mortality in this patient population. AIM: To investigate the potential role of GAHT in the development of COVID-19 infections and complications. METHODS: This systematic review implemented an algorithmic approach using PRISMA guidelines. PubMed, Scopus, Google Scholar top 100 results, and archives of Plastic and Reconstructive Surgery was on January 12, 2022 using the key words “gender” AND “hormone” AND “therapy” AND “COVID-19” as well as associated terms. Non-English articles, articles published prior to 2019 (prior to COVID-19), and manuscripts in the form of reviews, commentaries, or letters were excluded. References of the selected publications were screened as well. RESULTS: The database search resulted in the final inclusion of 14 studies related to GAHT COVID-19. Of the included studies, only two studies directly involved and reported on COVID-19 in transgender patients. Several clinical trials looked at the relationship between testosterone, estrogen, and progesterone in COVID-19 infected cis-gender men and women. It has been proposed that androgens may facilitate initial COVID-19 infection, however, once this occurs, testosterone may have a protective effect. Multiple clinical studies have shown that low baseline testosterone levels in men with COVID-19 are associated with worsening outcomes. The role of female sex hormones, including estrogen and progesterone have also been proposed as potential protective factors in COVID-19 infection. This was exemplified in multiple studies investigating different outcomes in pre- and post-menopausal women as well as those taking hormone replacement therapy. Two studies related specifically to transgender patients and GAHT found that estrogen and progesterone could help protect men against COVID-19, and that testosterone hormone therapy may increase the risk of contracting COVID-19. CONCLUSION: Few studies were found related to the role of GAHT in COVID-19 infections. Additional research is necessary to enhance our understanding of this relationship and provide better care for transgender patients.
    • In-hospital mortality of COVID-19 patients hospitalized with ST-segment elevation myocardial infarction: A meta-analysis

      Temple University. Hospital (2022-11-19)
      Introduction: Coronavirus Disease 2019 (COVID-19) has been associated with an increased risk of adverse cardiovascular events including arteriovenous thrombosis, myocarditis and acute myocardial injury. Relevant literature to date has reported widely varying estimates of mortality, ranging from approximately 2 to 11 times higher odds of mortality in COVID-19-positive STEMI (ST-segment elevation myocardial infarction) patients. Hence, we conducted this meta-analysis to resolve these inconsistencies and assess the impact of COVID-19 infection on mortality and other clinical outcomes in patients presenting with STEMI. Methods: This meta-analysis was registered in PROSPERO (CRD42021297458) and performed according to the Cochrane Handbook for Systematic Reviews of Interventions. PubMed and Embase were searched from inception to November 2021 (updated on April 2022) using a search strategy consisting of terms relating to COVID-19, STEMI, and mortality. Results: We identified 435 studies through our initial search. After screening according to our eligibility criteria, a total of 11 studies were included. Compared with the non-COVID-19 STEMI patients, the in-hospital mortality rate was higher in COVID-19-positive STEMI patients. Similarly, the risk of cardiogenic shock was higher in the COVID-19-positive patients. Length of hospital stay was longer in STEMI patients with COVID-19. Conclusions: Our study highlights the necessity for early evaluation of COVID-19 status in all STEMI patients followed by risk stratification, prompt reperfusion and more aggressive management of COVID-19-positive patients. Further research is needed to elucidate the mechanisms behind poorer prognosis in such patients.
    • Application of Deep Learning on Single-cell RNA Sequencing Data Analysis: A Review

      Brendel, Matthew; Su, Chang; Bai, Zilong; Zhang, Hao; Elemento, Olivier; Wang, Fei; Su|0000-0003-4019-6390 (2023-03-08)
      Single-cell RNA sequencing (scRNA-seq) has become a routinely used technique to quantify the gene expression profile of thousands of single cells simultaneously. Analysis of scRNA-seq data plays an important role in the study of cell states and phenotypes, and has helped elucidate biological processes, such as those occurring during the development of complex organisms, and improved our understanding of disease states, such as cancer, diabetes, and coronavirus disease 2019 (COVID-19). Deep learning, a recent advance of artificial intelligence that has been used to address many problems involving large datasets, has also emerged as a promising tool for scRNA-seq data analysis, as it has a capacity to extract informative and compact features from noisy, heterogeneous, and high-dimensional scRNA-seq data to improve downstream analysis. The present review aims at surveying recently developed deep learning techniques in scRNA-seq data analysis, identifying key steps within the scRNA-seq data analysis pipeline that have been advanced by deep learning, and explaining the benefits of deep learning over more conventional analytic tools. Finally, we summarize the challenges in current deep learning approaches faced within scRNA-seq data and discuss potential directions for improvements in deep learning algorithms for scRNA-seq data analysis.
    • The SARS-CoV-2 spike protein binds and modulates estrogen receptors

      Sbarro Institute for Cancer Research and Molecular Medicine (Temple University) (2022-11-30)
      The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) protein binds angiotensin-converting enzyme 2 as its primary infection mechanism. Interactions between S and endogenous proteins occur after infection but are not well understood. We profiled binding of S against >9000 human proteins and found an interaction between S and human estrogen receptor α (ERα). Using bioinformatics, supercomputing, and experimental assays, we identified a highly conserved and functional nuclear receptor coregulator (NRC) LXD-like motif on the S2 subunit. In cultured cells, S DNA transfection increased ERα cytoplasmic accumulation, and S treatment induced ER-dependent biological effects. Non-invasive imaging in SARS-CoV-2–infected hamsters localized lung pathology with increased ERα lung levels. Postmortem lung experiments from infected hamsters and humans confirmed an increase in cytoplasmic ERα and its colocalization with S in alveolar macrophages. These findings describe the discovery of a S-ERα interaction, imply a role for S as an NRC, and advance knowledge of SARS-CoV-2 biology and coronavirus disease 2019 pathology.
    • Associations between SARS-CoV-2 infections and thrombotic complications necessitating surgical intervention: A systematic review

      Temple University. Hospital (2022-11-20)
      BACKGROUND: Several unique clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19) infection, have been identified and characterized. One such feature, mostly among patients with severe COVID-19 infection, has become known as COVID-19-induced coagulopathy. Surgical patients with a history of or active COVID-19 infection bear a significantly higher risk for postoperative thrombotic complications. These patients may require surgical intervention to treat severe thrombotic complications. Few studies have been carried out to better characterize this association. The purpose of this study was to perform a systematic review and meta-analysis of the literature on COVID-19 infections that led to thrombotic complications necessitating surgical intervention. We hypothesized that patients with recent or active COVID-19 infection would have high rates of thromboembolic complications both arterial and venous in origin. AIM: To perform a systematic review and meta-analysis of the literature on COVID-19 infections that led to thrombotic complications necessitating surgical intervention. METHODS: The current systematic review implemented an algorithmic approach to review all the currently available English medical literature on surgical interventions necessitated by COVID-19 thrombotic complications using the preferred reporting items for systematic reviews and meta-analysis principles. A comprehensive search of the medical literature in the “PubMed”, “Scopus”, “Google Scholar” top 100 results, and archives of Plastic and Reconstructive Surgery was performed using the key words “COVID-19” AND “surgery” AND “thromboembolism” AND “complication”. The search string was generated and the records which were not specific about surgical interventions or thrombotic complications due to COVID-19 infection were excluded. Titles and abstracts were screened by two authors and full-text articles were assessed for eligibility and inclusion. Finally, results were further refined to focus on articles that focused on surgical interventions that were necessitated by COVID-19 thrombotic complications. RESULTS: The database search resulted in the final inclusion of 22 retrospective studies, after application of the inclusion/exclusion criteria. Of the included studies, 17 were single case reports, 3 were case series and 2 were cross sectional cohort studies. All studies were retrospective in nature. Twelve of the reported studies were conducted in the United States of America, with the remaining studies originating from Italy, Turkey, Pakistan, France, Serbia, and Germany. All cases reported in our study were laboratory confirmed SARS-CoV-2 positive. A total of 70 cases involving surgical intervention were isolated from the 22 studies included in this review. CONCLUSION: There is paucity of data describing the relationship between COVID-19 infection and thrombotic complications necessitating the need for surgical intervention. Intestinal ischemia and acute limb ischemia are amongst the most common thrombotic events due to COVID-19 that required operative management. An overall postoperative mortality of 30% was found in those who underwent operative procedures for thrombotic complications, with most deaths occurring in those with bowel ischemia. Physicians should be aware that despite thromboprophylaxis, severe thrombotic complications can still occur in this patient population, however, surgical intervention results in relatively low mortality apart from cases of ischemic bowel resection.
    • Little Brown Bats (Myotis lucifugus) Support the Binding of SARS-CoV-2 Spike and Are Likely Susceptible to SARS-CoV-2 Infection

      Chothe, Shubhada K.; Jakka, Padmaja; Boorla, Veda Sheersh; Ramasamy, Santhamani; Gontu, Abhinay; Nissly, Ruth H.; Brown, Justin; Turner, Gregory; Sewall, Brent J.; Reeder, DeeAnn M.; Field, Kenneth A.; Engiles, Julie B.; Amirthalingam, Saranya; Ravichandran, Abirami; LaBella, Lindsey; Nair, Meera Surendran; Maranas, Costas D.; Kuchipudi, Suresh V.; Sewall|0000-0001-8714-571X (2023-04-30)
      Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), believed to have originated from a bat species, can infect a wide range of non-human hosts. Bats are known to harbor hundreds of coronaviruses capable of spillover into human populations. Recent studies have shown a significant variation in the susceptibility among bat species to SARS-CoV-2 infection. We show that little brown bats (LBB) express angiotensin-converting enzyme 2 receptor and the transmembrane serine protease 2, which are accessible to and support SARS-CoV-2 binding. All-atom molecular dynamics (MD) simulations revealed that LBB ACE2 formed strong electrostatic interactions with the RBD similar to human and cat ACE2 proteins. In summary, LBBs, a widely distributed North American bat species, could be at risk of SARS-CoV-2 infection and potentially serve as a natural reservoir. Finally, our framework, combining in vitro and in silico methods, is a useful tool to assess the SARS-CoV-2 susceptibility of bats and other animal species.
    • Current SARS-CoV-2 Protective Strategies for Healthcare Professionals

      Ting, Miriam; Molinari, John A.; Suzuki, Jon B.; Suzuki|0000-0003-3348-8893 (2023-03-07)
      Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the Coronavirus disease 2019 (COVID-19). COVID-19 was first reported in China in December 2019. SARS-CoV-2 is highly contagious and spread primarily via an airborne route. Hand hygiene, surgical masks, vaccinations and boosters, air filtration, environmental sanitization, instrument sterilization, mouth rinses, and social distancing are essential infection control measures against the transmission of SARS-CoV-2. This paper aims to provide healthcare professionals with evidence-based protective strategies.
    • The Effect of COVID-19 on Maternal Mental Health and Medical Support

      Honors Program (Temple University) (2022-12-23)
      The Coronavirus disease 2019 (COVID-19) is a pandemic that affected the overall mental health of the population. As seen in previous situations, there seemed to be an extreme impact of disasters on the mental health of pregnant women and new mothers; therefore, we investigated the relationship between COVID-19 and maternal mental health. The pregnant subjects were identified during the study period through convenience sampling. The study received Institutional Review Board approval and online surveys were sent to subjects via email. The questions were focused on feelings about being pregnant and the influence of the practices during the pandemic. Fifty-one (51) pregnant patients were identified. Our study found that 92.3% of the participants felt negatively, as the COVID-19 precautions did not permit their significant other to attend their routine prenatal visits with them. 64.7% felt that the visits were less personal, 100% felt that they had to take more precautions. Only 42% of the doctors of the subjects discussed how COVID-19 could affect the pregnancy and the baby. Pregnant subjects all had negative feelings towards the pandemic, routine precautions, and the inability to include significant others in prenatal visits and delivery. The majority did not feel their medical teams discussed how COVID-19 could affect the baby.
    • Identification of Evolutionary Trajectories Shared across Human Betacoronaviruses

      Institute for Genomics and Evolutionary Medicine (Temple University) (2023-05-23)
      Comparing the evolution of distantly related viruses can provide insights into common adaptive processes related to shared ecological niches. Phylogenetic approaches, coupled with other molecular evolution tools, can help identify mutations informative on adaptation, although the structural contextualization of these to functional sites of proteins may help gain insight into their biological properties. Two zoonotic betacoronaviruses capable of sustained human-to-human transmission have caused pandemics in recent times (SARS-CoV-1 and SARS-CoV-2), although a third virus (MERS-CoV) is responsible for sporadic outbreaks linked to animal infections. Moreover, two other betacoronaviruses have circulated endemically in humans for decades (HKU1 and OC43). To search for evidence of adaptive convergence between established and emerging betacoronaviruses capable of sustained human-to-human transmission (HKU1, OC43, SARS-CoV-1, and SARS-CoV-2), we developed a methodological pipeline to classify shared nonsynonymous mutations as putatively denoting homoplasy (repeated mutations that do not share direct common ancestry) or stepwise evolution (sequential mutations leading towards a novel genotype). In parallel, we look for evidence of positive selection and draw upon protein structure data to identify potential biological implications. We find 30 candidate mutations, from which 4 (codon sites 18121 [nsp14/residue 28], 21623 [spike/21], 21635 [spike/25], and 23948 [spike/796]; SARS-CoV-2 genome numbering) further display evolution under positive selection and proximity to functional protein regions. Our findings shed light on potential mechanisms underlying betacoronavirus adaptation to the human host and pinpoint common mutational pathways that may occur during establishment of human endemicity.
    • COVID-19: An opportunity to engage African Americans and women in research on cardiovascular disease

      Crabbe, Deborah L.; Richardson, Briana T.; Hausman, Alice; Gardiner, Heather; Crabbe|0000-0003-0061-3985; Gardiner|0000-0003-2017-991X (2023-08-19)
      Introduction: African Americans (AA) have been disproportionately affected with the COVID-19 disease experiencing 30%-60% of the deaths, while only making up 13% of the US population. Early data suggest that pregnant women and those with cardiovascular disease (CVD) may experience worse outcomes with severe coronavirus infection. There is an urgent need to incorporate AA and female perspectives into the design of research on the CVD complications related to COVID-19. Objectives: The goal of this project was to incorporate perspectives of AA and female patients in developing research priorities and AN agenda related to COVID-19. Objectives included: (a) develop a strong, research-ready partnership capable of executing PCOR, (b) creation of a research agenda and a set of priorities on racial/sex-specific CVD disparities in COVID-19 which reflects the perspectives of AA's and women; (c) long-term objective is creation of a set of research questions suitable for clinical research using the AHA Registry. Methods: The project used principles of active and adult learning within the framework of capacity building to build a strong, patient-centered vision of research needs. Different methods of obtaining patient input were used to identify questions suitable for research using the America Heart Association COVID-19 CVD Quality Improvement Registry: focus groups and town halls to identify concerns and interests vis-à-vis CVD and COVID research; narrative medicine methods collected compelling real-life, COVID-19 health stories; a research advisory council reviewed and prioritized research questions. Results: Outcomes include a replicable method of obtaining patient-oriented input into the creation of a research agenda and a set of research priorities for COVID-19. Outputs include the establishment of a research advisory council and stakeholder training using the PCORI funded, PORTAL program resources; a catalogue of patient generated narratives on COVID-19 experiences in the voice of AAs and women, and a set of research questions suitable for research using the AHA Registry. Conclusion: The project created a research ready stakeholder network, ready to develop a research agenda about COVID-19.
    • COVID-19: Variants, Immunity, and Therapeutics for Non-Hospitalized Patients

      Lee, Cameron Y. S.; Suzuki, Jon B.; Lee|0000-0002-2184-9885; Suzuki|0000-0003-3348-8893 (2023-07-21)
      The continuing transmission of coronavirus disease 2019 (COVID-19) remains a world-wide 21st-century public health emergency of concern. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused greater than 600 million cases of COVID-19 and over 6 million deaths globally. COVID-19 continues to be a highly transmissible disease despite efforts by public health officials and healthcare providers to manage and control the disease. Variants identified in selected worldwide epicenters add to the complexity of vaccine efficacy, overage, and antibody titer maintenance and bioactivity. The identification of the SARS-CoV-2 variants is described with respect to evading protective efficacy of COVID-19 vaccines and breakthrough infections. Vaccines and other therapeutics have prevented millions of SARS-CoV-2 infections and thousands of deaths in the United States. We explore aspects of the immune response in a condensed discussion to understand B and T cell lymphocyte regulatory mechanisms and antibody effectiveness and senescence. Finally, COVID-19 therapies including Paxlovid, Remdisivir, Molnupiravir and convalescent plasma in non-hospitalized patients are presented with limitations for identification, collection, and distribution to infected patients.
    • A Developmental Systems Guide for Child and Adolescent Behavioral Health Practitioners

      Snyder, Sean E.; Snyder|0000-0002-2958-1991 (Temple University. North Broad Press, 2023)
      A Developmental Systems Guide for Child and Adolescent Behavioral Health Practitioners provides clinicians with actionable evidence-based practices for the assessment, diagnosis, and treatment of child and adolescent mental and behavioral health. This approach combines developmental psychology and ecological systems in recognition of the fact that children’s developmental challenges, tasks, and capacities intersect with the risks and protective factors of their environment. Chapters feature detailed case studies and conclude with conversations with clinicians in which they share targeted recommendations for patient evaluation, treatment approaches, and family engagement and support.
    • Clinical Review of Adhesive Capsulitis of the Ankle: An introductory article and clinical review

      Shamsi, Bilal; Falk, Jennifer-Nicole; Pettineo, Steven J.; Ali, Sayed (2011-10-01)
      Adhesive capsulitis is a well known ailment that most often affects the shoulder, but can occur in the hip, wrist, and the ankle. As it relates to the ankle joint, the condition is commonly referred to as ‘frozen ankle’ and presents as a challenge in both its diagnosis and treatment. Although there is much literature regarding the etiology, pathology, and treatment of ‘frozen shoulder’, there is little with regards to the ankle, with most being case reports. The purpose of this article is to provide a clinical review of the concept of adhesive capsulitis, its impact as it relates to the ankle, diagnostic criteria, and current treatment modalities.
    • A rare cutaneous manifestation of a neurilemmoma of the foot: A case report

      Temple University. Hospital (2021-10-31)
      A neurilemmoma is a benign peripheral nerve tumor that may manifest clinical as paresthesias and numbness/tingling along the potentially affected nerve. Cutaneous manifestations especially without any associated neurologic symptoms are rare and to our knowledge, has not been reported in the literature. This is a case study of a 62-year old female who presented to the office with a relatively benign soft tissue lesion on her right foot. She underwent a local punch biopsy and subsequently the pathology report revealed a tumor consistent with a neurilemmoma. This is a simple case report that demonstrates a relatively benign presentation with an unusual diagnosis.
    • Quantitative Geometry of the Distal First Metatarsal Axis Guide Concept

      Meyr, Andrew J.; Stern, Stephen F. (2009-01-01)
      The axis guide concept was introduced as an intra-operative tool to assist the surgeon in estimating the transverse and sagittal plane motion of the capital fragment during lateral transposition of a distal first metatarsal osteotomy for the surgical correction of the hallux abductovalgus deformity. The intention of this investigation was an attempt to provide a quantitative estimate to the previously qualitative axis guide concept. The Law of Cosines was applied to the morphologic characteristics of a sawbone first metatarsal model. Measurements were calculated based on 1/4, 1/3, and 1/2 lateral transpositions of the capital fragment of the first metatarsal. An average of all measurements resulted in a change of the absolute first metatarsal position of 1mm for every 10˚ change in axis guide orientation in both the transverse and sagittal planes. It is the authors’ hope that this data can be used to further understanding of the perioperative evaluation and surgical correction of the hallux abductovalgus deformity.
    • A pictorial review of reconstructive foot and ankle surgery: elective lesser forefoot procedures

      Temple University. Hospital (2016-11-16)
      This pictorial review focuses on basic procedures performed within the field of podiatric surgery, specifically for elective procedures of the lesser forefoot including the correction of hammertoes and lesser metatarsal deformities. Our goal is to demonstrate objective radiographic parameters that surgeons utilize to initially define the deformity, lead to procedure selection and judge post-operative outcomes. We hope that radiologists will employ this information to improve their assessment of post-operative radiographs following reconstructive foot surgeries. First, relevant radiographic measurements are defined and their role in procedure selection explained. Second, the specific surgical procedures of the digital arthroplasty, digital arthrodesis, lesser metatarsal osteotomy, and correction of metatarsus adductus are described in detail. Finally, specific plain film radiographic findings that judge post-operative outcomes for each procedure are detailed.
    • A pictorial review of reconstructive foot and ankle surgery: hallux abductovalgus

      Temple University. Hospital (2015-06-10)
      This pictorial review focuses on basic procedures performed within the field of podiatric surgery, specifically for the hallux abductovalgus or "bunion" deformity. Our goal is to define objective radiographic parameters that surgeons utilize to initially define deformity, lead to procedure selection and judge post-operative outcomes. We hope that radiologists will employ this information to improve their assessment of post-operative radiographs following reconstructive foot surgeries. First, relevant radiographic measurements are defined and their role in procedure selection explained. Second, the specific surgical procedures of the distal metatarsal, metatarsal shaft, metatarsal base, and phalangeal osteotomies are described in detail. Additional explanations of arthrodesis of the first metatarsal-phalangeal and metatarsal-cuneiform joints are also provided. Finally, specific plain film radiographic findings that judge post-operative outcomes for each procedure are detailed.
    • A pictorial review of reconstructive foot and ankle surgery: evaluation and intervention of the flatfoot deformity

      Temple University. Hospital (2017-06-27)
      This pictorial review focuses on basic procedures performed within the field of podiatric surgery, specifically for elective reconstruction of the midfoot and rearfoot with focus on the flatfoot deformity. Our goal is to demonstrate objective radiographic parameters that surgeons utilize to initially define the deformity, lead to procedure selection, and judge post-operative outcomes. We hope that radiologists will employ this information to improve their assessment of post-operative radiographs following reconstructive foot surgeries. First, relevant radiographic measurements are defined and their role in procedure selection explained. Second, the specific surgical procedures of the Evans calcaneal osteotomy, medial calcaneal slide osteotomy, Cotton osteotomy, subtalar joint arthroeresis, and arthrodeses of the rearfoot are described. Finally, specific plain film radiographic findings that judge post-operative outcomes for each procedure are detailed.
    • The role of tinea pedis and onychomycosis prevention in diabetic education: A literature review

      Love, Ebony; Vlahovic, Tracey; Christie, Lauren (2019-09-30)
      The prevalence of individuals with diabetes has steadily been increasing, creating both a health and economic crisis world-wide. Previous studies have suggested that foot fungal infections, including onychomycosis and tinea pedis, increase the risk of developing a diabetic foot ulcer. Through a thorough PubMed search, this article aims to review relevant literature relating to superficial fungal infections and patients with diabetes.
    • Overview of diabetic neuropathy and review of FDA-approved oral therapies

      Love, Ebony; Garcia, Michelle; Labbad, Ziad (2020-12-31)
      Diabetic neuropathy is the most common complication of uncontrolled and chronic diabetes. Neuropathy is the result when the somatosensory system is compromised leaving patients with irreversible nerve damage. The continuity of this neuropathic pain may lead to disorders such as insomnia, depression, and anxiety. The cause of neuropathic pain cannot be treated, and current treatment management focuses on treating the symptoms. A review of current literature on diabetic neuropathy and of FDA approved oral therapies is performed to provide an extensive overview in order to reduce and prevent the progression of this disease. The epidemiology of diabetic neuropathy can be characterized by its prevalence and risk factors. Symmetric polyneuropathy is the most common type of diabetic neuropathy accounting for about 75% of affected patients and is divided into classes depending on the types of sensory fibers involved. Small fiber neuropathy is associated with burning, prickling pain due to non-painful stimuli or an exaggerated response to painful stimuli. Large fiber affected neuropathy involves numbness, tingling without pain, and loss of protective sensation. Besides lifestyle intervention and glucose control the first line medication for diabetic neuropathy is gabapentin, pregabalin and duloxetine. This literature review guide is dedicated to the millions suffering from diabetic neuropathy. Neuropathic pain is a chronic disorder that can impair a patient’s quality of life. The results of this literature review demonstrate a need for long-term research with advancing technologies on new medications to understand their specific effects and risks to patients.