Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spinal cord stimulation (DCS) has proved effective in different types of Deafferentation Pain. Long-term results are good in 60-85% of cases. DCS improves microcirculation and ischemia in cases of inoperable peripheral vascular diseases. Advantages of this method are: Absence of severe complications and estimation of the effect during the test phase. - Nevertheless, other neurosurgical possibilities (destructive pain surgery, spinal/cerebral application of medicaments) continue to preserve their indications.
 ...
PMID:[The current significance of spinal cord stimulation in the framework of functional neurosurgery]. 221 26

Currently lumbar sympathectomies are infrequently performed because the effectiveness of the procedure is unclear. The previous indication of limb-threatening ischemia has been usurped by distal arterial reconstruction. Some vascular surgeons feel there is no remaining clinical role. This paper suggests four categories of patients, represented by five case reports, where lumbar sympathectomy may prove beneficial: 1) Hypertensive patients with painful leg ulcers; 2) Toe and foot amputations in which arterial reconstruction is not feasible; 3) Posttraumatic causalgia (sympathetic dystrophy); 4) As an adjunct to distal graft bypass.
 ...
PMID:Lumbar sympathectomy: a place in clinical medicine. 261 43

Neurovascular compression syndromes at the thoracic outlet generally present with predominantly arterial, venous, or neurogenic symptoms. The arterial abnormalities produce unique problems in diagnosis and management, and usually affect young, otherwise healthy, active individuals. Between 1984 and 1995 23 patients presented to our facility, with acute symptoms of arterial occlusion or embolization, found to be originating from the axillosubclavian arterial segment. The group comprised 14 females and nine males, ranging from 15 to 74 years, with an average age of 37 years. There were seven competitive athletes, three industrial workers, and 13 home, office, or service workers. The most severe presenting symptoms, occurring alone or in combination, and ranked in order of frequency observed, were: arm 'claudication' (74%), hand ischemia (48%), and digital gangrene (44%). Transaxillary thoracic outlet decompression was undertaken in 22 cases. This was combined with arterial reconstruction in 11 cases and sympathectomy for ischemic causalgia in seven cases. Transaxillary resection of a cervical rib was accomplished in 8 cases. There was one postoperative graft occlusion (PTFE), corrected by thrombectomy, with cumulative secondary patency (to 64 months), and one secondary embolic occlusion. Excepting the two secondary procedures, no patient had recurrent symptoms at a mean follow-up of 61 months. Effective and durable correction of the axillosubclavian arterial compressive abnormalities requires adequate thoracic outlet decompression, and anatomic vascular reconstruction when necessary. Failed prior procedures were a consequence of inaccurate diagnosis, failure to identify and correct the proximal embolizing arterial lesion, or inadequate decompression. Unilateral Raynaud's symptoms require meticulous investigation for arterial compression at the thoracic outlet with careful interpretation of subtle angiographic findings.
 ...
PMID:Diagnosis and management of arterial compression at the thoracic outlet. 923 91

We consider lumbar sympathectomy (LSE) to be the last attempt to improve the condition of the limb. Though being aware of inconsistent opinions on LSE, we are not opponents of this method, particularly if it is carried out in a selected group of patients, that is in case of: 1) treatment of frostbites, 2) treatment of patients at an early stage of advanced ischemia whose main symptom is moderate night pain at rest, 3) desiccation of chronically moist ulcerations between the toes, 4) treatment of patients with reflex symptomatic dystrophy (causalgia), 5) Buerger's disease.
 ...
PMID:[Ischemic disease of the lower extremity and lumbar sympathectomy]. 1091 71

Pelvic cancer causes several types of pain, i.e., visceral, neuropathic, and somatic pain. Somatic pain is due to stimulation of nociceptors in the integument and supporting structures, namely, striated muscles, joints, periosteum, bones, and nerve trunks by direct extension through fascial planes and their lymphatic supply. In 60% of patients with malignant disease of soft tissues, nerve trunk, and sacral invasion from carcinoma of the cervix, uterus, vagina, colon, rectum, and other tissues in women, and from penile, prostate, and colorectal carcinoma and sarcoma in men, they have neuropathic pain. The infiltration of the perineal nerves results in lumbosacral plexopathies and complete destruction of the nerve, including perineural lymphatic invasions producing symptomatic sensory loss, causalgia, and deafferentation. Visceral pain is the result of spasms of smooth muscles of hallow viscus; distortion of capsule of solid organs; inflammation; chemical irritation; traction or twisting of mesentery; and ischemia, or necrosis, and encroachment of pelvis and presacral tumors. Pain of these types is managed by different modalities depending on the age of the patient, the expected life expectancy, availability of invasive and non-invasive pain control modalities, and the resources of the patient, community, and health care agencies. Patients with pelvic cancer can live with less pain due to better pain-control modalities that are available today with the help of dedicated and caring algologists.
 ...
PMID:Pelvic cancer pain. 1113 74

Ischemic-reperfusion (I/R) is common in various pathological conditions like diabetic complication, complex regional pain syndrome type II (CRPS II), necrotizing vascular occlusive disease and trauma. We have developed an animal model of ischemic-reperfusion injury induced nociceptive sensory neuropathy in rats. The model was validated after 2, 4 and 6h of ischemia followed by prolonged reperfusion. The sensory behavioral assessment revealed thermal and mechanical hyperalgesia in paw and in tail which expressed the peripheral and central neuropathic pain respectively. We observed a decrease in the serum IL-10 and nerve conduction velocity and increase in the serum nitrate, malondialdehyde (MDA) and TNF-alpha levels in the 4 and 6h I/R groups in biochemical and electrophysiological evaluations. Histopathological study had revealed the decrease in nerve fiber density in the moderate and severe I/R groups. We selected the moderate (4h) ischemic-reperfusion injury as beneficial model because of the good correlation with clinical status for the development of neuropathy in human associated with severe pain disorders. This model can be used to explore pathophysiological mechanisms implied in the genesis of neuropathic pain and also to evaluate the new analgesic agents, peripheral neuro-vasoactive substances and neuroprotective drugs.
 ...
PMID:Development of animal model for vasculatic neuropathy: Induction by ischemic-reperfusion in the rat femoral artery. 2002 13