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

A 52-year-old unmarried bag craftsman was admitted to East Tokyo Metropolitan Hospital because of a large scrotal hematoma. He had accidentally hit his right testis against the edge of a desk early the previous morning. He had resected his right testis with scissors to release from severe pain 30 min after the accident. He had sutured the scrotal incision with two stitches of string by himself. At the emergency operation 36 h after the self-mutilation, we removed a hematoma weighing 283 g and ligated the cut end of the right spermatic cord after adequate debridement. He was diagnosed by a psychiatrist as having slightly low intelligence without psychotic disorder or drug abuse.
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PMID:Autohemicastration in a man without schizophrenia. 1132 30

The extent of drug abuse in mass sport is only poorly documented. Studies about drug abuse investigated only the prohibited substances according to the Olympic movement antidoping code. So for instance about the use of anabolic androgenic steroids (AAS) by school children or young students. But only few investigations point to the drug abuse in mass sport regarding the easily accessible over-the-counter drugs of the class of nonsteroidal anti-inflammatory drugs (NSAID). These drugs permit an athlete to compete at his normal level of performance despite injuries or pain. However, the masking of pain may exacerbate the injury. Precautions should be taken to prevent the unwarranted or unmonitored use of anti-inflammatory agents during treatment of sport injuries. The abuse may be extensive since most people consider over-the-counter drugs, such as aspirin and ibuprofen, harmless. Studies in Switzerland among endurance athletes in mass sport examining the use of medications before an event showed a prevalence between 5 and 10% of NSAID. Even if this seems a small number, further investigations should focus on the use of medications among different age groups and preventive information to abstain from the use of certain medication for competitors in mass sport should be worked out.
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PMID:[Misuse of drugs in recreational sports]. 1134 54

Marijuana has been used for recreational, ceremonial, and medicinal purposes for thousands of years. Because marijuana is classified as an illegal drug and, little research has been done on its potential medical benefits. In May 1999, it became legal for the National Institute on Drug Abuse (NIDA), the only legal source for marijuana, to sell marijuana to privately funded researchers. This move may make research on marijuana more feasible. Many people believe marijuana is effective in treating pain, AIDS wasting syndrome (AWS), and nausea and vomiting, among other ailments. However, even doctors who recommend marijuana use do not advise smoking it. Other ways of taking marijuana, as well as possible side effects of marijuana use, are discussed.
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PMID:Marijuana mania. 1136 48

Chronic pain is a widespread, difficult problem facing clinicians. This study assessed the current medical management of a general population of patients with chronic pain in 12 family medicine practices located throughout the state of Wisconsin. Medical record audits were conducted on a sample of 209 adults. Sixty-seven percent were female with an average age of 53 years. The most common pain diagnoses included lumbar/low back (44%), joint disease/arthritis (33%), and headache/migraine (28%) pain. The most frequently prescribed opioids were oxycodone/acetaminophen (31%), morphine ERT (19%), Tylenol #3 (15%), and hydrocodone/acetaminophen (14%). Depression/affective disorders were reported in 36% of the patient charts, anxiety/panic disorders (15%), drug abuse (6%), and alcohol abuse (3%). Written drug contracts were utilized by 42% (n = 31) of the practitioners, pain scales 25% (n = 29), and urine toxicology screens 8% (n = 6). This study suggests that primary care practitioners have unique opportunities to identify and successfully treat patients with chronic pain.
J Pain Symptom Manage 2001 Sep
PMID:Opioids and the treatment of chronic pain in a primary care sample. 1153 92

This article is a transcription of an electronic symposium held on November 28, 2000 in which active researchers were invited by the Brazilian Society of Neuroscience and Behavior (SBNeC) to discuss the advances of the last decade in the peptide field with particular focus on central actions of prolactin and cholecystokinin. The comments in this symposium reflect the diversity of prolactin and cholecystokinin research and demonstrate how the field has matured. Since both peptides play a role in reproductive behaviors, particularly mother-infant interactions, this was the starting point of the discussion. Recent findings on the role of the receptor subtypes as well as interaction with other peptides in this context were also discussed. Another issue discussed was the possible role of these peptides in dopamine-mediated rewarding systems. Both prolactin and cholecystokinin are involved in mechanisms controlling food intake and somatic pain thresholds. The role of peripheral inputs through vagal afferents modulating behavior was stressed. The advent of knockout animals as potential generators of new knowledge in this field was also addressed. Finally, interactions with other neuropeptides and investigation of the role of these peptides in other fields such as immunology were mentioned. Knowledge about the central functions of prolactin and cholecystokinin has shown important advances. The role of these peptides in neurological and psychiatric syndromes such as anorexia, drug abuse and physiological disturbances that lead to a compromised maternal behavior seems relevant.
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PMID:The brain decade in debate: VIII. Peptide hormones and behavior: cholecystokinin and prolactin. 1166 45

Recent drug discovery programs aimed at identifying selective metabotropic mGlu receptor ligands by high-throughput functional screening efforts have revealed subtype-selective allosteric modulators of mGlu1 and mGlu5 receptors that are structurally unrelated to glutamate. In contrast to competitive ligands, which bind to the glutamate binding site located in the large N-terminal extracellular domain, these modulators act as non-competitive antagonists, inverse agonists or positive modulators by binding to specific residues in the seven-transmembrane domain. More recent studies to assess the potential of these compounds in in vivo models of nervous system disorders have implicated the mGlu5 receptor subtype as a potentially important therapeutic target for inflammatory pain, anxiety, Parkinson's disease and drug abuse, and mGlu1 and mGlu5 receptors as potential targets for anticonvulsant and neuroprotective therapies. Very recent findings indicate an important regulatory role for intracellular proteins interacting with metabotropic glutamate receptors, which might constitute novel drug targets for modulating metabotropic glutamate receptor activity.
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PMID:Allosteric modulators of group I metabotropic glutamate receptors: novel subtype-selective ligands and therapeutic perspectives. 1178 7

These daily or near-daily headaches result from the chronic overuse of all immediate relief antimigraine drugs: ergotamine, analgesics, and/or more recently triptans. Like for much chronic daily headaches, the International Headache Society diagnostic criteria for drug abuse headaches are difficult to apply. Generally, patients confuse primary headaches (usually migraines) with interparoxysmal tension-type headaches called "rebound headaches". Psychosocial factors may play a role. Insidiously, a compulsive automedication results, often in anticipation of headache. This headache syndrome resists symptomatic and prophylactic treatment. These headaches are frequent, very disabling and socioeconomically costly. They are still largely underdiagnosed. Drug-induced headaches may be restricted to those patients who are already headache sufferers. The pathogenesis is not clearly understood: it may involve a deficience of inhibitory pain modulation, a hyperactivation of nociceptive facilitatory systems, and the peripheral and central effects of the incriminating drugs. The withdrawal of all offending analgesic drugs and a multimodality approach are indispensable, but the therapeutic protocoles are actually very heterogeneous and poorly estimated. Non-drug means could be very helpful. Effective education of headache sufferers and regular follow-up are essential to avoid relapses. Prognosis factors have been evoked, but may not be significant for the long term outcome. The rate successfull of is actually estimated at 60 p. cent at five years. The benefits of an adequate management encourage early recognation of drug-induced headaches. This article has in view to take stock of the literature at the end of 1999, and to help physicians become mora aware of this problem and develp a more preventive attitude.
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PMID:[Headaches caused by abuse of symptomatic anti-migraine and analgesic treatment]. 1188 15

A 39 year old male comes to the emergency room because of rapidly increasing pain in his left leg one hour after the injection of Flunitrazepam into a groin vessel. There is a history of drug abuse for more than 15 years. The left leg is cool and shows intense patchy cyanosis. The same skin discoloration is seen at the left lower abdomen and parts of the thigh. The leg is paretic but foot-pulses are detectable. Color-coded duplex-sonography of the left leg shows normal shaped arteries with regular flow. Regarding the veins there are post-thrombotic changes but no signs of actual thrombosis. The ECG shows sinus rythme. No source of emboli can be found by echocardiography. The laboratory tests reveal normal results except of anemia (Hb 9.6 g/dl, normocytic, normochromic). As an accidental intraarterial injection with a toxic/allergic insult to the vessel-walls has to be supposed the patient is treated besides of analgesics with systemic anticoagulation, high doses of cortisone and calcium channel-blockers. With this therapeutic regimen the leg and the left lower abdomen improve gradually except for some toes which remain cyanotic. During the first days the patient develops signs of moderate rhabdomyolysis with swelling of the leg and an increase of creatininase concentration in blood. After 12 days the left leg has normalised but the toes show further demarcation. They have to be amputated six weeks later. The accidental injection of drugs into the femoral artery may result in the clinical picture of acute limb ischemia without occlusion of the big vessels of the leg. This obviously occurs most often with benzodiazepines, especially when crushed tablets soluted in water are injected. Color-coded duplex sonography is able to show open vessels within minutes and prevents ineffective surgical interventions.
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PMID:[Acute ischemia of the leg in a drug addict]. 1195

Necrotizing fasciitis is a rapidly progressive infection of the fascia and subcutaneous tissues accompanied by a high mortality rate approaching 80% to 100%. Factors that predispose patients to this life-threatening complication include obesity, malnutrition, malignancy, chronic alcoholism, drug abuse, peripheral vascular disease, diabetes mellitus, and immunosuppressive therapy. The pathomechanisms for the development of this rare disease still remain unclear. We report a case of necrotizing fasciitis with Clostridium perfringens after laparoscopic cholecystectomy. The patient left the hospital 5 months after admission. Early recognition based on clinical signs (pain, asymmetric abdominal thickening, crepitus) and computed tomography scanning (gas dissection along fascial planes), in conjunction with prompt, aggressive surgical therapy and debridement of all devitalized tissue, high-dose antibiotic therapy, and therapy at the intensive care unit, appears to afford patients the best chance of survival.
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PMID:Necrotizing fasciitis with Clostridium perfringens after laparoscopic cholecystectomy. 1197 28

International requirements for central nervous system (CNS) safety pharmacology are reviewed. Procedures for initial CNS safety screening (core battery studies) can be conducted from the beginning of the drug discovery process, but at latest before first studies in man. They should include assessment of general behaviour, locomotor activity and motor coordination, but can also include studies of pain sensitivity, convulsive threshold and interaction with hypnotics. Follow-up studies, to be conducted later in the drug development process but before product approval, cover assessment of higher cognitive function, electroencephalogram (EEG) and drug dependence/abuse liability. Procedures for assessing cognitive function can include, in order of complexity, passive avoidance, Morris and radial mazes and operant behaviour tasks (delayed alternation, repeated acquisition). EEG can include the quantified EEG (QEEG) and studies of the sleep/wakefulness cycle. Drug dependence/abuse procedures can include precipitated and nonprecipitated withdrawal (drug dependence), and place preference, drug discrimination and self-administration (drug abuse). In contrast to core battery CNS procedures, conducted exclusively in rodents, follow-up studies can include higher species, in particular primates.
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PMID:New perspectives in CNS safety pharmacology. 1216 67


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