Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.7.10.1 (ERK)
 95,504 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diclofenac HEP plaster was tested in an open study in the treatment of different traumatic sport and overload injuries, to confirm the results of efficacy and tolerability already shown in other clinical studies. A total of 101 patients were assigned to treatment and were eligible for the evaluation of results at the end of a 14-day treatment period. The average score of spontaneous pain, assessed by means of a verbal scale and a visual analogical scale, showed a clear difference in pain rating between the beginning and end of treatment. In general 60% pain reduction was observed. The difference in analgesic activity was already apparent on the 7th day of treatment (-28%). The reduction of pain was confirmed by changes in another subjective sign related to the injury: provoked pain. This symptom decreased in a manner comparable to spontaneous pain: 61% pain reduction after 2 weeks of treatment. Global assessment of efficacy, performed by the investigator at the end of treatment, showed the clear therapeutic activity of local treatment with diclofenac HEP plaster. Satisfactory results were obtained and only 18% of the patients (most of them with chronic and persistent pain) experienced ineffective pain relief at the end of the 2-week treatment. The beneficial effects of diclofenac HEP plaster on pain are confirmed by the patients' assessment, since almost identical scores were obtained. It is striking that the overall tolerance of diclofenac HEP plaster, applied topically twice a day for 2 weeks, was "good" or "excellent" in the 101 patients treated. Any side effect was reported on the patient's card and all the patients completed the study.
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PMID:A trial with diclofenac HEP plaster as topical treatment in minor sport injuries. 811 1

An increasing percentage of patients with uterine leiomyomas was observed in the Department of Obstetrics, University of Freiburg, on comparing the years 1970-79 (0.25%) and 1980-89 (0.64%). While first trimester bleeding, pain and premature labour, being typical obstetrical complications, were encountered in a comparable frequency, atonic bleeding was observed more often during the nineteen-eighties. Pain and premature labour were often present, if the leiomyomas were large, irrespective of both their number or localization. Atonic bleeding was observed more frequently, if large leiomyomas were present. A correlation between the presence of uterine leiomyomas and placental deficiency, premature birth, and EPH gestosis seems uncertain. The total complication rate among all pregnant patients with uterine leiomyomas was 65% from 1980-89. The Caesarean section rate among patients with uterine leiomyomas increased during the evaluated time span, and reached 51% during the 1980's, as compared to a general frequency of Caesarean sections of 19% during the latter time period; this increase in frequency seems to be rather in keeping with a generally increasing Caesarean section rate as opposed to a changing indication for surgery in patients with myomas. The myomas themselves caused Caesarean sections in 50% of cases, while in the remaining 50% of patients, Caesarean sections were performed for general obstetrical reasons. The probability to be delivered by Caesarean section was especially high amongst patients with multiple myomas or with an isthmic myoma. Our study supports a conservative approach in the case of pregnancy and uterine leiomyomas.
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PMID:[Obstetric complications, incidence and indications of cesarean section in uterus myomatosus]. 837 37

Congenital insensitivity to pain with anhidrosis (CIPA; MIM 256800) is an autosomal-recessive disorder characterized by recurrent episodes of unexplained fever, anhidrosis (absence of sweating) and absence of reaction to noxious stimuli, self-mutilating behaviour and mental retardation. The genetic basis for CIPA is unknown. Nerve growth factor (NGF) induces neurite outgrowth and promotes survival of embryonic sensory and sympathetic neurons. Mice lacking the gene for TrkA, a receptor tyrosine kinase for NGF, share dramatic phenotypic features of CIPA, including loss of responses to painful stimuli, although anhidrosis is not apparent in these animals. We therefore considered the human TRKA homologue as a candidate for the CIPA gene. The mRNA and genomic DNA encoding TRKA were analysed in three unrelated CIPA patients who had consanguineous parents. We detected a deletion-, splice- and missense-mutation in the tyrosine kinase domain in these three patients. Our findings strongly suggest that defects in TRKA cause CIPA and that the NGF-TRKA system has a crucial role in the development and function of the nociceptive reception as well as establishment of thermoregulation via sweating in humans. These results also implicate genes encoding other TRK and neurotrophin family members as candidates for developmental defect(s) of the nervous system.
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PMID:Mutations in the TRKA/NGF receptor gene in patients with congenital insensitivity to pain with anhidrosis. 869 25

We performed a combined manual and computer search of the FMS literature to identify controlled clinical trials in FMS from 1980 to June 1994 inclusive. Our specific objectives were: 1) to determine which outcome measures have been used in clinical trials for FMS, and the methods utilized to measure these outcomes; 2) to identify which outcome measures were most and least sensitive in distinguishing between treatment groups, and 3) to identify weakness in trial design. Our analysis of 24 clinical trials demonstrates the large diversity of outcome measures and measurement instruments that have been used to detect differences between treatment and placebo in the management of FMS. Whereas certain outcomes, such as self-reported pain and sleep quality, were frequently measured, other clinically important outcomes, such as functional and psychological status, were infrequently included in data collection. Finally, we identified several significant potential sources of bias, including potential flaws in subject selection and group allocation, inadequate randomization, incomplete blinding, errors in outcome measurement, and inappropriate analysis of data.
Pain 1996 Feb
PMID:An analytical review of 24 controlled clinical trials for fibromyalgia syndrome (FMS). 874 May 97

Post-traumatic knee injuries often deteriorate if reuptures of anterior cruciate ligaments (ACL) are not treated adequately. Further diagnostic procedures are required if pain-induced muscle contraction impairs clinical examination. The clinical relevance of sonography, however, for the diagnosis of ACL ruptures is controversial. Within 25 months, 74 patients were preoperatively evaluated clinically and by ultrasound. 58 ruptures of the ACL and 21 lesions of the collateral ligaments were confirmed by arthroscopy or arthrotomy. In 16 cases a menisceal tear was found, four patients had a luxation of the patella, and two had PCL ruptures. The sensitivity of the Lachman test was 93%, of the anterior drawer test 68% and of the pivot shift test 48%. Ultrasound diagnosis revealed 88% of all ACL ruptures (91% if patients with bony ruptures of the ACL were excluded). In 75% of ACL ruptures, a popping sensation was reported by the patients. In the case of uncertain diagnosis, examination with ultrasound could be easily performed before further operative diagnostic procedures are scheduled.
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PMID:[Diagnosis of acute rupture of the anterior cruciate ligament. Value of ultrasonic in addition to clinical examination]. 888 Dec 28

Hereditary sensory neuropathy Type II (HSN II) is an autosomal recessive disorder characterized by the loss of peripheral sensory modalities in individuals with otherwise normal development. Patients with HSN II often have chronic ulceration of the fingers and toes, autoamputation of the distal phalanges, and neuropathic joint degeneration associated with loss of pain sensation. Recent descriptions of a similar phenotype in mice carrying a targeted mutation in the low affinity nerve growth factor receptor, p75NGFR, suggested the possibility that mutations in this gene or other members of the nerve growth factor (NGF) family of genes and their receptors might be responsible for this human disorder. In this study candidate genes were evaluated by their inheritance pattern in two sisters affected with HSN II, their unaffected sister and mother in a consanguineous family. The segregation of polymorphic alleles at and around loci for p75NGFR, TRKA, TRKB, BDNF, and familial dysautonomia (another hereditary sensory neuropathy having features in common with HSN II) virtually excluded these genes as the cause of HSN II in this family. Further evaluation of loci for other neurotrophic factors and their receptors, which will be possible when mapping information on their loci becomes available, may permit the identification of the gene responsible for HSN II.
Pain 1996 Sep
PMID:Exclusion of p75NGFR and other candidate genes in a family with hereditary sensory neuropathy type II. 927 17

The NTRK1 gene encodes one of the receptors for the Nerve Growth Factors and it is located at 1q21-22. Rearrangements of NTRK1 are frequently detected in human papillary thyroid carcinoma and lead to the formation of chimeric oncogenes, similarly to what observed for the other neurotrophin receptor RET. In addition, the two receptor genes are target of point mutations associated with different human diseases. RET is affected by germ line and somatic mutations in MEN2A, MEN2B tumor syndromes and in the abnormal developmental Hirschsprung disease, whereas mutations of NTRK1 have been reported very recently in patients with congenital insensitivity to pain with anidrosis (CIPA). With the aim to provide a tool for searching mutations along the whole NTRK1 gene, we have determined its genomic organization. Our results demonstrated that NTRK1 is contained within 25 Kb of DNA and is organized in 17 exons, one of which is alternatively spliced. The sequence of the 5' flanking region indicates a high content in C/G, the absence of TATA box, the presence of several putative binding sites for Sp1, AP1, AP2, AP3, ATF and GCF transcription factors.
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PMID:Genomic organization of the human NTRK1 gene. 895 89

The costs for diagnostic workup in the medical emergency room were analyzed for 1000 consecutive patients in the course of a cost analysis program. Next to demographic data, the complaints leading to admission, all diagnostic procedures and tests as well as the final diagnosis were recorded. According to cumulated tariffs of individual services, the total cost for the 1000 patients amounted to Sfr. 303000. Medical, laboratory and technical services each amounted to one third of this sum. The cost of Sfr. 303 per patient compared rather well with those of Sfr. 350 for the average initial consultation at the outpatient clinic. The three symptoms thoracic or abdominal pain and headache covered 50% of the reasons for admission. The five most common diagnoses were: common cold, chest wall tenderness, gastroenteritis, headache and acute upper respiratory tract infection. The most cost-intensive workup was performed for nausea and vomiting and abdominal or thoracic pain. Technical procedures such as chest films and upper panendoscopy were responsible for high costs. Assessment of costs according to symptoms and final diagnosis, respectively, yielded almost identical results. In both cases, minimal and maximal costs varied by a factor of 20 or more.
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PMID:[Costs of diagnosis in emergency room consultations]. 896 20

Inability to work after mandibular third-molar surgery was studied in 201 patients operated on in a specialist clinic. Mean indicated inability to work was 1.07 days; 95% confidence interval, 0.91-1.23 days; range, 0-6 days. Eighty-six (43%) patients did not indicate any reduction in working ability. Duration of operation more than 14 min, heavy smoking (> 19 cigarettes/day), and female sex were associated with prolonged inability to work. Self-administered analgesic consumption and pain scores over the first postoperative week showed positive correlations with inability to work: r = 0.44 and 0.41, respectively. Other indicators of the normal postoperative reaction were to a lesser extent associated with reduced ability to work. Total sick-leave cost in Norway associated with surgical third-molar removals, adjusted for age-related income, employment rate, treatment rate, and provider of treatment, was 46.4 million NOK per year.
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PMID:Inability to work after surgical removal of mandibular third molars. 908 79

We evaluated the utility and safety of arthroscopy for diagnosing and treating symptoms in problematic total knee replacements. From 1988 to 1995, 40 arthroscopies were performed on 38 patients with an average age of 68.4 years. The average onset of symptoms post knee replacement was 33.7 months (range 1 month to 15 years), and the average duration of symptoms prior to arthroscopy was 15.6 months (range 1 month to 5 years). Presenting symptoms included pain in 73%, catching or soft tissue impingement in 35%, and stiffness in 20% of patients. Our protocol involves 24 hours of perioperative, intravenous antibiotics, and two or three routine arthroscopic portals. There were no arthroscopy-related complications or infections. Arthroscopy successfully diagnosed the etiology of the patient's symptoms in all but one case (97.5%). Operative diagnoses included impinging soft tissue under the patella consistent with the "clunk" syndrome (43%), impinging hypertrophic synovitis elsewhere in the knee (15%), impinging PCL stump (10%), prosthesis loosening or wear (10%), and arthrofibrosis (20%). Arthroscopic treatment consisted of removal of impinging tissue or loose body as indicated. Additionally, eight of the patients had a manipulation under anesthesia with an average improvement in flexion of 26.3 degrees postoperatively. At an average follow-up of 19.9 months, 27.5% of knees had developed recurrent symptoms. Two of these patients had repeat arthroscopy for recurrent impinging hypertrophic synovitis. The rates of successfully relieving symptoms without recurrence according to operative diagnosis were 82% for "clunks," 60% for other impinging synovium or soft tissue, and 63% for arthrofibrosis. Three patients underwent total knee revisions. Knees were rated at follow-up using the Knee Society rating system with patients divided according to functional category. The average Knee Society knee scores and function scores respectively were 93 and 92 for group A patients, 91 and 88 for group B patients, and 81 and 76 for group C patients. Arthroscopy successfully identified all cases of soft tissue impingement and prosthetic loosening or wear, and successfully treated 73% of patients without recurrence. There were no arthroscopy associated complications or infections. Thus, arthroscopy is a safe, effective tool for managing certain problematic knee replacements, especially "clunks," and may help to avoid revision or arthrotomy in some cases.
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PMID:The efficacy of arthroscopy following total knee replacement. 912 73


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