Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recurrent oropharyngeal candidiasis is common in patients with acquired immunodeficiency syndrome and the acquired immunodeficiency syndrome-related complex. It causes local pain and discomfort, loss of taste, and aversion to food and may lead to secondary complications. We examined, in a double-blind study, whether recurrent thrush could be prevented by prophylaxis. Twenty-five patients with one to four previous thrush episodes who had no thrush at the outset of the study were randomized to receive 100 mg of fluconazole or placebo daily for 12 weeks. If thrush occurred, prophylaxis was stopped and patients were treated conventionally, after which prophylaxis was resumed. After the randomized study, some patients were given continuous fluconazole (open phase). In the randomized study, thrush occurred in eight of 13 placebo-treated patients and none of 12 fluconazole-treated patients. Possible side effects were not different between the groups. Dermatophytosis and onychomycosis and cryptococcuria also improved in the fluconazole-treated patients, and fungal colonization was significantly decreased. One episode of thrush occurred in the open phase in an intermittently compliant patient (group total, 71.5 patient-months of fluconazole treatment); in contrast, the 25 patients also had had two episodes of Candida esophagitis, three of cryptococcosis, and 13 of dermatophytosis before entry. Subsequent to entry in the randomized trial, in 92.3 patient-months without fluconazole, there were 35 episodes of thrush, one of esophagitis, one of cryptococcemia, and one of dermatophytosis, and preexisting dermatophytosis and onychomycosis were unchanged or worsened. Individual patients observed with and without fluconazole treatment also showed its efficacy. In conclusion, thrush can be prevented in patients with acquired immunodeficiency syndrome and the acquired immunodeficiency syndrome-related complex with negligible toxic effects. Larger trials to confirm prevention of all mycoses with prophylaxis should be considered.
 ...
PMID:Thrush can be prevented in patients with acquired immunodeficiency syndrome and the acquired immunodeficiency syndrome-related complex. Randomized, double-blind, placebo-controlled study of 100-mg oral fluconazole daily. 174 4

Myopathy may be associated with the syndrome of seroconversion in individuals infected by the human immunodeficiency virus (HIV) or may represent the initial symptom of AIDS. In 1990, 39-year old white, single homosexual who was admitted 1 month prior had experienced an episode of edema and pain in the left thigh that faded with the use of nonhormonal antiinflammatory drugs. 15 days later both forearms became enlarged accompanied by pain and erythema. Erythromycin and cefalexine were used without success. Intermittent fever started to appear before admission accompanied by dyspnea when straining. Examination showed tachypnea, oral candidiasis, and enlargement of both upper arms with pain and local erythema without articular involvement. Neurological examination revealed hypotonia and generalized hyperreflexia with intact muscle strength. Serology was positive for HIV, rheumatic activity tests were negative, and muscle biopsy indicated multifocal myonecrosis. Creatinine phosphokinase was 1019 IU (decrease to 44 IU after treatment), aldolase was 19 IU (decrease to 5.6 IU), and glutamic-pyruvic transminase was 50 IU (decrease to 22 IU). Radiography of the thorax indicated interstitial infiltration. Fiberoptic bronchoscopy indicated Pneumocystis carinii pneumonia. Sulfamethoxazole and trimetropim treatment cured the dyspnea and hypoxemia, but the enlargement of both arms progressed. Capillaroscopy indicated vasculitis that was treated without success with indomethacin (150 mg/day), for 7 days; prednisone (40-80 mg/day) for 10 days; and dexamethasone (280 mg/day) for 2 days. 6 days after methotrexate (50 mg/dose/week) treatment the fever disappeared and the enlargement in the extremities receded, but a lower dose of 7.5 mg caused the return of fever and edema in the right thigh. The myopathy remained asymptomatic for 5 months with a weekly dose of 15 mg of methotrexate.
 ...
PMID:[AIDS and myopathy: report of a case and review of the literature]. 180 40

Candida albicans infection of the nipples and breast ducts is a cause of sore nipples and "shooting" breast pain during lactation. A questionnaire which sought to identify predisposing factors was given to 51 women with candidiasis of the lactating breast, 18 women with other breastfeeding difficulties, and 29 women breastfeeding without any difficulties. Nipple damage in early lactation, mastitis, recent use of antibiotics postpartum, long-term use prior to pregnancy, and history of vaginal thrush were positively associated with candidiasis of the lactating breast. Thrush, especially oral thrush, was more common in babies of mothers in the candida group. However, some mothers with symptomatic candida infection reported none of these predisposing factors.
 ...
PMID:Candida and the lactating breast: predisposing factors. 863 99

16 HIV seropositive patients among the 180 treated at the Hospital Muniz and the Hospital Posadas in Buenos Aires between December 1988 and December 1989 were referred to the Hospital Posadas Endoscopy Service for esophageal studies. The 16 patients were prospectively studies by means of fiberoscopy, radiology, biopsies, virology, mycology, and brush cytology. Early treatment is of utmost importance because opportunistic infections may aggravate the general condition, increase immune system effects, and probably permit greater replication of HIV, in addition to producing symptoms. 14 patients were male and 2 female. Ages ranged from 18 to 41 and averaged 32 years. 10 were male homo- or bisexuals and the other 6 were intravenous drug users. 14 of the patients consulted because of specifically esophageal symptoms. 12 reported dysphagia, 8 odynophagia, and 6 retrosternal pain. 9 patients presented various symptoms. 15 of the 16 symptomatic patients had some pathology related to HIV. The remaining case presented a small submucus tumor and gastroesophageal reflux. The symptoms had appeared between 10 days and 1 year prior to study. Symptoms did not provide accurate diagnostic clues. 11 cases of esophageal candidiasis were diagnosed endoscopically by isolated or confluent white plaques. 3 patients classified as grade 1 or 2 on the basis of the intensity and density of plaques had mild symptoms, and 8 classified as grade 3 or 4 had more severe symptoms. 7 of the 11 patients also had oral candidiasis. 4 of 6 patients presenting ulcerative pathology were diagnosed virologically with herpes simplex virus type 2. Herpetic ulcers were single or multiple and were deep with slightly raised edges. No ulcers attributable to cytomegalovirus were diagnosed. 4 of the 11 patients with candidiasis also had ulcers, in 2 cases herpetic. The studies indicated a change in the stage of HIV infection following Centers for Disease Control criteria in 10 cases. AIDS was diagnosed in 7 cases based on esophageal findings. Endoscopic study and the samples obtained guided treatment in the 16 patients. In 1 case a repeat endoscopy led to a change in treatment. It is recommended that endoscopy be performed in all patients with esophageal symptoms. Radiology was relatively ineffective, with 50% of diagnoses in error. Histopathology required multiple biopsies and was less sensitive than endoscopy and cytology. Cytology was highly specific and sensitive.
 ...
PMID:[Esophageal pathology in patients with the AIDS virus. Etiology and diagnosis]. 182 Jun 92

Oral candidiasis is a common complication of HIV-infected-individuals. The purpose of this study was to evaluate clinical and laboratory findings to assess the impact and efficacy of antifungal treatment. This preliminary report describes findings in 50 HIV-positive, candida culture-positive subjects (49 males, 1 female; mean age: 39 years). The group had been known HIV-positive for a mean of 28 months, and 19 met the CDC/WHO definition for AIDS (63%, KS, 21% PCP). Thirty-four of the fifty patients had oral signs of candidiasis, with almost half having both atrophic (red) and pseudomembranous (white) components. In quantitating the cultures, the higher colony forming unit counts in general were correlated with clinical signs and pain. The other most common oral manifestations were periodontal disease, hairy leukoplakia and xerostomia. The most common candida species was albicans (84%). Response to initial antifungal therapy was satisfactory clinically, but erratic regarding CFU quantitation, species changes, and bacterial emergence. In summary, oral candidiasis is a complex infection with uncertainties as to the significance of quantitation and achieving control.
 ...
PMID:Findings in 50 AIDS virus-infected patients with positive oral Candida cultures. 207 28

Inpatient and community-based care can be complementary in relation to the management of HIV disease. Medical records from 200 inpatients of Chikankata Hospital near Lusaka, Zambia and 200 home based patients were examined and compared for the common symptoms of presentation of HIV disease, associated opportunistic infections, and treatment protocols. Drug costs of both groups were also compared. The most common respiratory symptoms in the 2 groups are cough, chest pains, weight loss, and hemoptysis. Treatment employed for these symptoms were cortimoxazole, penicillin V, erthromycin, and tetracycline. Acetyl saliclic acid and paracetamol were used for pain relief in both groups. Gastointestinal system symptoms for both groups were diarrhea, weight loss, abdominal pain, and vomiting. Cotrimoxazole and metronidazole were used in treating diarrhea. Additional treatment protocol for the 2 patient samples included oral rehydration therapy for dehydration, antacid or bismuth subsalicylate for diarrhea and enteritis, and mycostatin for oral candidiasis. Central nervous system symptomatology included headache, dementia, neckace, and lethargy. Chloramphenicol was employed in treating bacterial meningitis. Diazepam and chlorpromazine were effective for restless patients. Genito-urinary system symptomatology for the 2 groups included dysuria, genital ulcers, hematuria, viral warts, and buboes. Antibodies were used for sexually transmitted diseases and infections. Skin symptomatology included rash and dermatitis, herpes zoster, abscess, kaposi's sarcoma, ulcers, furunculosis, and discharging anal sinus. In treating these symptoms, hospital based care and home based care were similar. Overall, it was found that hospital treatment protocols were detailed, expensive, and time consuming. Furthermore, hospital treatment for HIV positive patients is more expensive than HIV negative patients; hospital costs for 50 HIV negative patients totaled US$415.94 compared to US$1204.98 HIV positive/PTB negative patients and US$1705.62 for HIV positive/PTB positive patients. Drug cost/patient admission is increased by 469% if HIV positive. (author's modified).
 ...
PMID:Clinical care as part of integrated AIDS management in a Zambian rural community. 248 94

Chronic oral candidiasis is generally not considered a premalignant condition. We report on two patients with carcinoma in situ and carcinoma in the soft palate, probably preceded by long lasting chronic Candida infection. The first patient was a 56-year-old woman who suffered from disturbances in the calcium and potassium metabolism and high blood pressure due to a previous goiter operation during which the parathyroids had been removed. She also suffered from bronchitis and had been smoking 12 cigarettes a day for many decades. For several years she had had more or less constant symptoms from airway infections. Increasing symptoms from the throat had developed 2 years before referral and, in this period, she had been in constant antifungal therapy with no effect on the symptoms. Objectively, the entire soft palate, uvula and the palatoglossal arches were fiery red with whitish plaques which were not removable (Fig. 1). A biopsy revealed severe dysplasia and focal carcinoma in situ Subsequently, the lesion in the soft palate was partly removed by laser surgery followed by radiation therapy over a period of 2 month. One year later there was no signs of recurrence (Fig. 4). The second patient, a 53-year-old healthy woman, was referred because of difficulties in eating due to pain in the throat which had existed for 2 years. Without any effect on the symptoms, she had had antifungal therapy for 4 weeks. The patient had been smoking 15 cigarettes a day for many years. Objectively, an area with whitish plaques and nodules on an erythematous background was found (Fig. 5).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Carcinoma in situ and carcinoma in patients with chronic oral candidiasis]. 263 19

Oral mucosal ulceration complicating bone marrow transplantation interferes with patients' comfort, nutrition and may lead to systemic infection derived from the mouth. The mucosal injury results from epithelial damage due to the cytotoxic effects of chemotherapy and radiation conditioning as well as from superficial oropharyngeal infection. Because chlorhexidine gluconate is a broad spectrum topical antimicrobial which has been demonstrably effective in preventing oral infection and gingivitis, we performed a randomized, placebo controlled, double-blind trial of chlorhexidine as a mouth rinse in BMT recipients to study the severity of oral mucositis and both oral and systemic infectious complications. One hundred patients were randomly assigned to receive either chlorhexidine gluconate 0.12% mouth rinse or placebo three times daily from the initiation (day -8) of chemoradiotherapy conditioning until day +35 post-BMT. Chlorhexidine use resulted in a trend toward improved oral hygiene index (reduced dental plaque) (p = 0.06) but did not modify the oral mucositis. Patients using chlorhexidine developed a maximum ulceration of 18 +/- 22% of their oral mucosa, while placebo patients ulcerated 25 +/- 31% of the mouth. Ulcerative mucositis was significantly worse in adults compared with children, in individuals who received methotrexate for graft-versus-host disease prophylaxis, and was most prominent on non-keratinized epithelium. Overall, there was no clinically demonstrable additional therapeutic advantage to the use of chlorhexidine in either reducing the mucositis, controlling oral pain, facilitating oral nutrition, shortening hospital stay, or reducing oral infection with herpes simplex virus. There was a trend toward diminished oral candidiasis in chlorhexidine users (p = 0.06).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Oropharyngeal mucositis complicating bone marrow transplantation: prognostic factors and the effect of chlorhexidine mouth rinse. 264 92

Three women had a diagnosis of oral lichen planus (OLP), which was made on the basis of clinical and histologic features. All three had persistent burning pain associated with large mucosal lesions. Changes in the color (red, red and white, white), configuration, and severity of the lesions were unpredictable and did not correlate well with topical corticosteroid therapy. Only one patient used tobacco (cigarettes)--this patient had recurrent oral candidiasis and was receiving multiple medications. One of the two nonsmokers was a denture wearer with a single episode of candidiasis. After 63, 32, and 56 (mean 50) months, carcinoma developed in all three. In retrospect, the initial biopsy specimens of two patients exhibited lichenoid dysplasia, whereas that of the third showed only lichenoid mucositis. Although speckled erythroplakia was the earliest clinical sign of a classic, nonregressing premalignant lesion, it already signaled the presence of invasive carcinoma. Some early epithelial dysplasias appear to have a robust inflammatory/immunologic response to the antigenically (but as yet not histologically) altered dysplastic epithelium and a high probability of at least temporary resolution. Mucosal erythema of obscure origin displaying spontaneous, usually temporary, partial to complete regression may be common to both purely inflammatory conditions like lichen planus and early epithelial dysplasia. We contend that some, if not most, cases of apparent malignant transformation of OLP likely represent red and white lesions that were dysplastic from their inception but that mimic OLP both clinically and histologically.
 ...
PMID:Oral lichenoid dysplasia: a clinicopathologic analysis. 275 89

In a closed internal medicine practice for homosexual men in Central Manhattan herpes zoster developed in 112 men between 1980 and mid-1986. In these patients the incidence of acquired immunodeficiency syndrome (AIDS) was high: Kaplan-Meier survival analysis indicated cumulative incidences of AIDS of 22.8% within 2 years after herpes zoster, 45.5% within 4 years, and an estimated 72.8% after 6 years. Severity of zoster (relative risk, RR = 4.6), degree of pain (RR = 3.4), and zoster of the cranial or cervical dermatomes (RR = 2.2) were all associated with a poor outcome. Oral thrush, oral hairy leucoplakia, amoebiasis, and superficial (tinea) fungal infections also indicated an increased risk of AIDS among zoster patients. Oral thrush and oral hairy leucoplakia manifestations were diagnosed an average of 1.2 and 1.1 years, respectively, after the diagnosis of herpes zoster; thus zoster is an early indicator of an impaired immunity. Herpes zoster can be used as a predictor of AIDS and in AIDS risk groups should be regarded as a poor prognostic sign.
 ...
PMID:Risk of AIDS after herpes zoster. 288 39


1 2 3 4 5 6 Next >>