Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-six patients with recalcitrant rheumatoid arthritis entered a trial encompassing a 2-week inpatient period plus a 16-week, randomized double blind, parallel study comparing placebo, 5 mg/m2 and 10 mg/m2 oral weekly methotrexate (MTX). An additional 6 patients, given 20 mg/m2 MTX, contributed to the toxicity, but not the efficacy analysis. All patients had "failed" either gold or D-penicillamine. A linear dose response relationship (placebo vs 5 mg/m2 vs 10 mg/m2) was found for 5 of 11 outcome variables: patient pain and patient global scale, physician global scale, joint tenderness count and activity of daily living scale (p less than 0.05 for each). Gastrointestinal toxicity (p = 0.002), dyspepsia (p less than 0.03) and stomatitis (p less than 0.09) occurred more commonly with MTX, and a general trend, although not significant, was found toward a dose toxicity relationship.
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PMID:Increasing methotrexate effect with increasing dose in the treatment of resistant rheumatoid arthritis. 272 50

The etiology of gastric pain is an unsolved riddle, despite nearly a century of research. While much research and many pharmacologic treatment methods have been aimed at controlling acid secretion, the role of acid in reports of pain is unclear. In this study, 30 patients (10 with endoscopically verified duodenal ulcers, 10 with verified nonulcer dyspepsia, and 10 healthy volunteers) participated in a double-blind crossover study of the effects of ranitidine on pain reports after an injection of pentagastrin. The results showed that whereas pentagastrin caused a significant increase in gastric secretion, only the patients with nonulcer dyspepsia reported any appreciable pain before or after the injection. In addition, they chose more adjectives to describe their pain and reported more symptoms, especially directly after the injection. There were no significant differences between the drug and placebo conditions nor between the ulcer and healthy subjects. The role of acid in reported pain remains unclear.
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PMID:Blocked and nonblocked acid secretion and reported pain in ulcer, nonulcer dyspepsia, and normal subjects. 236 9

We conducted a survey on functional gut disorders and health care seeking behavior in a large non-patient population of an Italian region (Umbria). 533 subjects were interviewed by means of a specific questionnaire. 44 (8.5%) reported symptoms compatible with the irritable bowel syndrome, 30 (5.8%) had non-colonic pain, 48 (9.2%) chronic constipation, and 20 (3.8%) dyspepsia. It is concluded that in our region there is a relatively high percentage of subjects that do not commonly seek health care, although affected by functional gut disorders.
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PMID:Functional gut disorders and health care seeking behavior in an Italian non-patient population. 276 61

A group of outpatients with chronic non-organic upper abdominal pain was followed up 5-7 years after the index investigation, to evaluate the predictive value of several variables on the basis of a questionnaire and a laboratory pain study. Fifty-four per cent had symptoms of irritable bowel syndrome. A low pain tolerance measured with an ischemic pain technique significantly predicted a poor course of the disease (P = 0.03). So did a high score indicating psychic vulnerability (P = 0.02) and two social factors: poor school and vocational education (P less than 0.01). Without significant predictive value were level of abdominal pain rated on a visual analogue scale, length of dyspepsia history, bowel habits, relation of pain to meals and to life events, heartburn, headache, back pain, dysmenorrhea, paresthesias in fingers or feet, present occupation, sex, marital status, days absent from work because of the disease, and consumption of tranquilizers, cigarettes, and alcohol. The findings indicate that psychologic factors and a low pain tolerance may be elements in this poorly understood syndrome. This is supported by earlier findings of a decreased pain tolerance and an elevated psychologic score in this group compared with controls.
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PMID:Predictors for the course of chronic non-organic upper abdominal pain. 278 Dec 39

Cholelithiasis and cholecystitis, with their complications, remain major health problems in the United States. At this time, cholecystectomy is the treatment of choice for all patients with symptomatic gallstones and those with acute cholecystitis, except those who are too ill to undergo surgery. Present therapeutic options may be summarized as follows: Asymptomatic patients and those with flatulence and dyspepsia who have gallstones should be observed. Those who have symptoms of biliary pain, gallstone-induced pancreatitis, or common duct stones should have corrective surgery. Those who refuse surgery or who aren't surgical candidates might be treated with dissolution therapy. Dissolution of gallstones with chemical agents and extracorporeal shock-wave lithotripsy show some promise. We need a better understanding of the etiology and formation of gallstones to address the disease from a preventive standpoint and reduce the incidence of cholelithiasis and cholecystitis, and their complications.
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PMID:Cholecystitis and cholelithiasis. 304 94

Two-hundred and fifty-two patients waiting for a total hip replacement for degenerative hip disease were randomized to two groups of nonsteroidal anti-inflammatory medication using piroxicam, 20 mg per day, and naproxen, 750 mg per day, after exclusion for severe dyspepsia or peptic ulcer, asthma, idiosyncracy, dissent, age below 50 years, Harris hip score above 50, or significant contralateral disease. A significant improvement in the pain and daily activity parameters was obtained in both groups. The effect was better in the piroxicam group one month after the commencement of the treatment, and equal in the groups later during the observation period of 2-5 months. We conclude that continuous medication is beneficial in patients with severe osteoarthritis scheduled for operation. However, the side effects of the medication have to be carefully considered and followed up.
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PMID:Piroxicam and naproxen in patients with osteoarthritis of the hip waiting for total hip replacement. 304 26

Thirty elderly patients (mean age 74) with osteoarthritis effecting various joints were treated with an oral suspension of either tiaprofenic acid (TA) (600 mg per diem b.i.d.) or lysine acetyl salicylate (1800 mg per diem b.i.d.) for 3-6 months in an open randomized experimental study. The parameters of efficacy assessed were pain at rest and under load, stiffness, ability to perform a pre-selected daily exercise and joint movements hampered by the disease. Blood flow, liver and kidney function and side effects were examined on a monthly basis. The tiaprofenic acid proved more effective in reducing pain and aiding functional recovery and was also better tolerated, especially at gastrointestinal level. Nine patients under lysine acetyl salicylate and 2 under tiaprofenic acid were forced to suspend treatment due to pyrosis, epigastralgia ed dyspepsia.
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PMID:[Comparative clinical study of tiaprofenic acid and lysine acetylsalicylate in aged osteoarthrosis patients]. 311 Jun 54

Patients with dyspepsia of unknown origin were randomly allocated to a controlled double-blind study to examine the symptomatic effect of cimetidine and antacid especially on the relief of pain, nausea, and bloating. Two hundred and twenty-two patients with no previous history of peptic ulcer disease and no evidence of other organic causes of dyspepsia were treated for 6 weeks with placebo, cimetidine, or antacid. The results showed that cimetidine was superior to both placebo and antacid in relieving pain and nausea but not bloating. Certain background factors, such as epigastric pain and symptoms relieved by solid food, had a significant positive influence on the outcome of treatment. When the impact of background factors was taken into account, cimetidine was found to be more effective than both placebo and antacid also with regard to the number of patients who improved in general well-being.
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PMID:Treatment with cimetidine, antacid, or placebo in patients with dyspepsia of unknown origin. 327 66

The transferability of a British data base for differential diagnosis of dyspepsia using data obtained by computer interrogation was tested in 467 Swedish patients. The diagnostic value for peptic ulcer disease of symptoms such as frequent night pain relieved by food or antacids, smoking, family history of ulcer, food relief pain, male sex, and episodic pain was shown to be reproducible. However, for a number of symptoms their value for the diagnosis of peptic ulcer disease could not be reproduced in Swedish patients. The combined value of indicants was tested using a computer based algorithm for calculating diagnostic probabilities. The performance of this algorithm was poor when British data were applied to Swedish patients but reclassification of the Swedish patients on their own data base showed promising results. Crean and colleagues in Glasgow have developed a computer system for automated interrogation of patients with dyspepsia. The system utilises a large number of questions to obtain information regarding a maximum of 160 diagnostic indicants. The symptoms elicited from a patient can be compared with those of a large number of previously examined patients and the probabilities of ten different diagnoses can be calculated. The calculation of diagnostic probabilities is based on scores reflecting the diagnostic value of different symptoms in different diseases. After careful translation of questions the system has been transferred for use in Sweden. The present report is based on data from patients seen during the first two years with the system at a Swedish hospital.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Transferability of a computer system for medical history taking and decision support in dyspepsia. A comparison of indicants for peptic ulcer disease. 330 99

The results of cholecystectomy in terms of symptomatic improvement were prospectively evaluated in 124 unselected gall stone patients interviewed before and two years after elective surgery. Indications for cholecystectomy were biliary pain (n = 65), previous complications of gall stone disease (n = 52), and flatulent dyspepsia (n = 7). At two years 93 patients could be re-evaluated, of whom only 49 (53%) were completely symptom free. Postcholecystectomy symptoms occurring in the remaining 44 patients were mainly flatulent dyspepsia (which had relapsed in 22 of 46 patients who suffered it preoperatively), dull abdominal pain or diarrhoea. Incisional hernia was present in five patients and one had recurrence of pain because of retained common bile duct stones. Symptomatic cures after cholecystectomy decreased with the duration of the preoperative history. The results reconfirm that cholecystectomy eradicates specific symptoms and complications of gall stone disease, but they also show that nearly one half of operated patients are dissatisfied with the procedure because of mild but distressing 'postcholecystectomy' symptoms. These are probably caused by previously undiagnosed functional gut disease associated with, but unrelated to, gall stones. A systemic approach to multisymptomatic patients with gall stones is recommended.
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PMID:Postcholecystectomy symptoms. A prospective study of gall stone patients before and two years after surgery. 342 78


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