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)

This review assesses the continuing role of noninvasive vacuum therapy as treatment for erectile dysfunction and discusses the action of negative pressure in producing assisted erection. Through recent research in this area has centered on the development of pharmaceutical therapies, vacuum-therapy programs appear to be a consistent long-term option for patients experiencing either chronic or occasional impotence of any etiology. Very little testing is required before the initiation of vacuum treatment, and the overall; clinical success rate is approximately 90%. Significant success has been reported in more difficult patient populations, including those with veno-occlusive disorders and explanted penile prostheses. Vacuum therapy may also be used in conjunction with other therapies to enhance results. Contraindications to the use of vacuum therapy are few and primarily include patients with unexplained intermittent priapism and bleeding disorders. Side effects such as occasional numbness, pain, penile bruising, or petechiae have a low incidence. A recently reported survey of 5,847 vacuum users showed that 83.5% of patients continue to use the device for intercourse as desired. Patients should receive individual instruction in the use of these devices and should expect a learning or practice period to achieve optimal results. As newer treatments for erectile dysfunction gain increasing attention, it should be kept in mind that nearly every patient showing impotence of any degree or duration as well as patients who have failed other therapeutic choices are candidates for vacuum therapy.
 ...
PMID:External vacuum therapy for erectile dysfunction: use and results. 906 99

We have studied cavernous electrical activity in 42 subjects, healthy volunteer controls and groups of impotent patients using a nonspecific electromyographic device (PICO-MENFIS) and a specific one, the SPACE-recorder 7500 designed to achieve electric recordings from the corpora cavernosa. In all of the patients, we detected under basal conditions a mean amplitude of 583 +/- 323 microV, a mean duration of 4.9 +/- 7 s, a mean polyphasicity of 3.5 +/- 1.4. It should be emphasized that a significant reduction of potential amplitudes was recorded after pharmacological stimulation in both the controls and the impotent patients. The healthy controls showed amplitudes significantly higher than the impotent patients after radical cystectomy (715 +/- 141 microV versus 381 +/- 227 microV, p < 0.01). The patients after a "nerve-sparing" radical cystectomy with a mean amplitude similar to the controls (500-700 microV) reacted well to the intracavernous drugs in a high percentage of cases. In our experience, CC-EMG seems to be a reliable method which can pinpoint directly lesions to the cavernous smooth muscle and penile autonomic nerves. It has also been able to assess the effects of stress, anxiety and pain on the erectile mechanisms.
 ...
PMID:Corpus cavernosum electromyography (CC-EMG): a new technique in the diagnostic work-up of impotence. 908 51

Peyronie's disease is an idiopathic disorder in which an inflammatory fibrosis occurs in the tunica albuginea of the corpora cavernosa which causes the erect penis to become deformed. Peyronie's disease has a prevalence of 1% in men over age 50 years. Paget's disease of bone is a chronic skeletal disease with areas of increased bone turnover leading to pain, deformity, and in some cases arthritis. Because of a high rate of Peyronie's disease in subjects in a Paget's disease industry-sponsored drug trial, we asked whether there was an association between Peyronie's disease and Paget's disease of bone. We evaluated 61 men with Paget's disease attending our clinic for metabolic bone disease in a tertiary referral hospital, reviewed hospital records of all men discharged from our three hospitals with the diagnosis of Peyronie's disease, and mailed a validated questionnaire about shape of the erect penis to 1500 male members of the Paget Foundation. In the clinic population of men with Paget's disease of bone, 51 of 61 (83.6%) reported having normal erections; 10 patients (16.4%) were impotent. Sixteen of the 51 men (31.4%) had developed a bend or deformity in their erect penis which was confirmed by a urologist's examination to be Peyronie's disease. When the men with Paget's disease with and without Peyronie's disease were compared, there was no difference in their ages, years with Paget's disease, or serum alkaline phosphatase level. Upon medical record review, 1 patient of 262 (0.4%) with Peyronie's disease was found to have Paget's disease of bone. The men with Paget's disease returned their questionnaires for a response rate of 44.8% and reported Peyronie's disease with a prevalence of 14.5%. We suggest that Peyronie's disease is associated with Paget's disease of bone. Furthermore, we suggest that Peyronie's disease may be a previously unrecognized complication of Paget's disease of bone.
 ...
PMID:Peyronie's disease is associated with Paget's disease of bone. 916 52

The Duke Health Profile is a 17-item generic questionnaire instrument designed to measure adult self-reported functional health status quantitatively during a one-week time window. It is appropriate for both patient and non-patient adult populations. It can be self-administered by the individual respondent or administered by another person. The administration time is less than five minutes. It is crucial that each question is answered. There are 11 scales. Six scales (i.e., physical health, mental health, social health, general health, perceived health, self-esteem) measure function, with high scores indicating better health. Five scales (i.e., anxiety, depression, anxiety-depression, pain disability) measure dysfunction, with high scores indicating greater dysfunction. Most extensive use has been in family practice patients with the broadest spectrum of diagnoses, but it has also been used in patient populations with specific diagnoses such as insulin-dependent diabetes mellitus, endstage renal disease, ischemic disease, and impotence. Both internal consistency (Cronbach's alpha) and temporal stability (test-retest) testing have supported reliability of the DUKE. Validity has been supported for the DUKE scales by: (a) comparison of the DUKE scores with scores of other health measures for the same patients, (b) comparison of DUKE scores between patient groups having different clinical diagnostic profiles and severity of illness, (c) prediction of health-related outcomes by DUKE scores. Convergent and discriminant validity have been shown when comparing with other instruments.
 ...
PMID:[The Duke Health Profile (DUKE)]. 921 65

In the present study we describe the case of a 11 years old child, female, who was accidentally fulgurated by the left arm and after has presented an episode of pallor, shaking, confusion, throbbing and tingle of the arms. For this reason she was admitted in our Department of Pediatrics, University of Rome "La Sapienza". The child presented also a moderate pain at the left wrist. For this reason was performed a wrist X Ray which showed an incomplete fracture of the distal extremity of the radial diaphysis, with a small ulnar infraction of the same side. Life parameters and the ECG were normal so as the blood exams, in particular the CPK and the LDH (in fact, they can be indication of muscular necrosis). In summary the Authors with this study would like to remark the necessity of to suspect a fracture in the place of admittance of the electric current, even if not immediately appear clean signs of oedema, pain and functional impotence.
 ...
PMID:[Colles' fracture in a girl after fulguration]. 928 Sep 15

A comparative study in 103 unselected patients with erectile dysfunction between MUSE up to 1000 micrograms and intracavernous Alprostadil (Prostavasin) up to 20 micrograms provided total response-rates of 43% (MUSE) vs 70% (Prostavasin). Complete rigid erections were reached in 10% (MUSE) vs 48% (Prostavasin). The average end-diastolic flow values in the deep penile arteries ranged between 9.2-9.4 cm/s after MUSE and 4.5-4.8 cm/s after i.c. Alprostadil confirming the investigator's assessment, that in the vast majority of patients MUSE were not able to induce a complete cavernous smooth muscle relaxation. In terms of side effects the reported penile pain/ burning-rate after MUSE was 31.4% compared to 10.6% after i.c. Alprostadil. In addition after MUSE clinically relevant systemic side-effects like dizziness, sweating and hypotension occurred in 5.8% with syncope in 1%. No circulatory side-effects were encountered after i.c. Alprostadil. Urethral bleeding after MUSE-application was observed in 4.8%. Due to the superior efficacy and lower side-effects self-injection therapy with Alprostadil remains the 'Gold Standard' in the management of male impotence. MUSE should be reserved for a subset of patients suffering from erectile dysfunction.
 ...
PMID:Transurethral alprostadil with MUSE (medicated urethral system for erection) vs intracavernous alprostadil--a comparative study in 103 patients with erectile dysfunction. 954 92

The aim of this study was to assess the reliability of cortical evoked potentials after electrical stimulation of the anal canal. Cortical evoked potentials were recorded on 243 patients presenting with perineal pain (28 patients), impotence (55 patients), anal incontinence (52 patients), urinary continence (30 patients), constipation (49 patients), and on 29 neurological patients, by stimulating the external anal sphincter and penis (or clitoris). The inter- and intra-observer reproducibility was studied by coding recordings interpreted by three different observers on two separate occasions. The influence of recording characteristics and clinical data were assessed. To study operator dependence, five operators investigated the patients. Only one of them was well trained in this technique. The interpretation of the coded curves by the observers was poorly reproducible in about 15% of cases, depending on time between the two readings and the quality of recordings. The interpretation of cerebral responses after anal stimulation were observer-dependent and influenced by the knowledge of clinical data. This was also observed with cortical evoked potentials after electrical stimulation of the penis or clitoris, but to a lesser extent. The cerebral evoked potentials method was also operator-dependent, mainly after anal stimulation. When a study of cortical evoked potentials by perineal stimulation is needed in clinical practice, it seems logical to prefer cortical evoked potentials by penile or clitoral stimulation as they seem easier to obtain than those evoked by anal stimulation if the investigators are not well trained for the performance of electrophysiological studies as the former are much less operator- and observer-dependent.
 ...
PMID:Assessment of the reliability of cerebral potentials evoked by electrical stimulation of the anal canal. 945 26

In Peyronie's disease an early "peri-vasculitic" phase and a late "sclerogenic" one are described. In the former, conservative management is believed useful; unfortunately it is empirical concerning treatment modalities, drugs and administration routes, due to the poor pathogenetic knowledge of the disease itself. The Authors report on a preliminary experience based on iontophoresis, that is the drugs' ions direct transport from a solution into the tissues by means of a local electric field. 15 patients (47 to 64 years old, mean 55) all with penile recurvatum due to a well (physically and U.S.) documented Peyronie's plaque, and all but one with normal stiffness during erection, were submitted to the following therapeutic schedule: 3 sessions a week for three weeks; in each session (20 minutes) 10 mg verapamil and 4 mg dexamethasone are administered; the iontophoretic equipment delivers a 3 mA current; the active electrode, shaped as a small cup is placed on the penile skin above the plaque; the other electrode is set on one thigh. At a mean 5 months follow up (3-10 months) penile pain during erection disappeared in 66% patients, recurvatum diminished in 53%, and the plaque was reduced in size and/or was softened in 40% of the cases. No patient worsened nor became impotent during the treatment. The contextual improvement of all three above mentioned parameters (pain-recurvatum-physical examination) was observed in 26% of patients (versus 13% in a previous series treated by the Authors by drug peri-plaque injections). Although a longer follow up is necessary before drawing conclusions about the iontophoretic approach to the Peyronie's disease, the Authors wish to stress two main advantages of this therapeutic modality: absence of pain; absence of local trauma, in order to avoid local sclerogenic stimuli, which could perpetuate the hardening process.
 ...
PMID:[Iontophoresis in the conservative treatment of Peyronie's disease: preliminary experience]. 947 19

Herein we describe the use of intracavernous methylene blue (MB), a guanylate cyclase inhibitor, or internal pudendal artery embolization for the treatment of priapism. Eleven patients with priapism were treated from 1993-1996. Etiologies of priapism included PGE1/papaverine (3), trazodone (2), and sickle cell disease (1), in the other five cases the causes the cause was unknown. The average duration of priapism was 27 h for all patients (6-72 h). Five patients who failed intracavernous MB or an alpha-adrenergic agonist, underwent unilateral or bilateral pudendal artery embolization. The average duration of priapism for patients undergoing embolization was 43 h. Sixty-seven percent of the patients treated with MB responded with immediate detumescence. One-hundred percent of patients with priapism secondary to intracavernous injection therapy or trazodone responded. Of the five patients who underwent embolization, 40% achieved immediate pain relief and subsequent detumescence. The three non-responders exhibited a partial detumescence over 47-72 h. After follow-up of one year embolization available for only two patients revealed that one regained potency while the other remained impotent. These results confirmed that MB is effective for pharmacologically-induced priapism. Embolization is a less invasive option for refractory priapism, although results are less than satisfactory in men with priapism of several days duration.
 ...
PMID:Alternative approaches to the management of priapism. 954 85

Intracavernous injection of vasodilators has been the greatest diagnostic and therapeutical breakthrough in erectile dysfunction (E.D.). After 15 years experience, these vasodilators have demonstrated efficacy rates over 85%. This suggests that most cases of E.D. are the result of and inability of the smooth muscle to relax. This paper presents an overview of the diagnostic and therapeutic use of intracavernous vasodilating drugs. It includes an extensive review of the literature and our personal series with regard to efficacy, indications, contraindications and side-effects of these compounds. Alprostadil i.c. injection (PGE1) is an effective (> 70%) and safe treatment, and its use has been accompanied by an increased quality of life of patients, with very few side effects. Currently, PGE1 is a first choice drug in the treatment of impotence. When no response is seen, or pain develops after PGE1 administration, a number of vasoactive compounds associations can be used instead (phentolamine + PGE1, papaverine + phentolamine, and papaverine + phentolamine + PGE1). The phentolamine + VIP association has shown encouraging results. Prior to prescribe IC treatment with vasoactive drugs it is necessary to conduct a basic diagnostic study, and advise the patient. If treatment is finally accepted, the performance of adequate training and detailed medical follow-up is crucial.
 ...
PMID:[Treatment of erectile dysfunction using intracavernous pharmacotherapy]. 965 42


<< Previous 1 2 3 4 5 6 7 8 9 10