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)

The aim of this study was to evaluate the efficacy and safety of gemcitabine, a pyrimidine antimetabolite, in the treatment of advanced transitional cell carcinoma of the urinary tract. 35 patients with unresectable or metastatic transitional cell carcinoma of the urinary tract previously treated with a platinum-based regimen were studied. Gemcitabine was administered at a dosage of 1200 mg/m2 as a 30-min intravenous infusion on days 1, 8 and 15, repeated every 28 days. 31 patients were evaluable for efficacy. 4 patients achieved a complete response (12.9%), 3 a partial response (9.6%) and 13 (42%) were stable for at least 4 weeks (overall response 22.5%; 95% confidence interval 8-37%). The median response duration was 11.8 months (range 3.6-17.7 + months) and median survival for all patients entered was 5 months (range 2-21 + months). 2 patients with complete response are still alive with no evidence of disease after 14 and 21 months. Gemcitabine also provided subjective symptomatic relief from pain, cystitis, dysuria, haematuria and peripheral oedema. Patients experienced little WHO grade 3-4 toxicity, with anaemia in 8 patients (23%), thrombocytopenia in 5 (14.2%), leucopenia in 4 (11.4%) and neutropenia in 7 (20%). WHO grade 3-4 hepatic toxicity occurred in 4 patients (11.4%) and transient elevations of transaminase was noted in 3 (8.6%). No patient had WHO grade 3-4 elevation of serum creatinine level. There was no WHO grade 4 symptomatic toxicity and no alopecia was noted. Transient influenza symptoms with gemcitabine occurred in 18 patients (51.4%) with 13 patients (37.1%) experiencing fever (2.9% WHO grade 3). In conclusion, gemcitabine is an new active agent for the treatment of transitional cell carcinoma of the urinary bladder with a mild toxicity profile; it warrants further investigation in combination with cisplatin in chemotherapy naive patients.
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PMID:A phase II study of gemcitabine in patients with transitional cell carcinoma of the urinary tract previously treated with platinum. Italian Co-operative Group on Bladder Cancer. 984 81

Osteoporosis is a disease of low bone mass that may not manifest until a patient has a fracture. Hip fracture is the most devastating, but vertebral fracture is the most common, occurring in 25% of women over 50 years of age and 40% of those age 80-85 years. Although 60% of vertebral fractures are clinically silent, they are easily diagnosed radiographically. They are associated with height loss, deformity, impaired mobility, and pain. Patients should be evaluated for the cause of both the fracture and osteoporosis. Therapy includes education about the disease, an exercise program, and advice about tailoring routine activities. Pharmacotherapy includes annual influenza vaccines, and daily calcium (1200-1500 mg elemental calcium/day) and vitamin D (400-800 IU/day) supplements. New antiresorptive agents alendronate, hormone replacement therapy, and salmon calcitonin should be offered to all patients as they reduce fracture rates.
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PMID:Management of patients with vertebral compression fractures. 991 58

The program of the National Epidemiological Surveillance of Infectious Diseases under the auspices of the Ministry of Health and Welfare started in 1981 apprehended in 1995 emergence of adenovirus type 7 in Japan. We analyzed the reported data of type 7 comparing with those of type 3, both belonging to the same subgenus B, and the following results were obtained: After 1981, the main serotypes in the reports of adenovirus isolation/detection were types 3, 2, and 1 in this order. The reports of isolation of adenovirus type 7 used to be extremely few, however, suddenly increased in 1995. In 1997, reports of isolation of adenovirus type 3 decreased and those of type 7 acquired the third place after those of types 2 and 3. Type 7 infection occur almost every month, but most frequently during May-September. The ages of cases from which type 7 was isolated were 0-4 years accounting for 55%, 5-9 years 35%, teens 6.3% and adults 4.0%, being similar proportions to those yielding type 3. Clinical diagnoses of cases yielding adenovirus type 7 were pharyngo-conjunctival fever (PCF) and influenza-like illness, these two accounting for half. The symptoms were severe, being characterized by higher maximum body temperature during the feverish period and severe pneumonia. Encephalitis and arthro-muscular pain were seen in only type 7-infected cases, although such cases were few.
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PMID:Trend of adenovirus type 7 infection, an emerging disease in Japan. A report of the National Epidemiological Surveillance of Infectious Agents in Japan. 1021 31

This study compared two recombinant human (rh) hematopoietic growth factors in healthy volunteers for stem cell stimulation. Granulocyte colony-stimulating factor (G-CSF, n=9) or granulocyte-macrophage colony-stimulating factor (GM-CSF, n=8) was given subcutaneously for 5 days (5 microg/kg/day). Controls (n=5) received no growth factor. Laboratory parameters and side effects were monitored for 8 days. Within 24 h, both cytokines led to a rapid increase of leukocytes, the majority of which were granulocytes. Compared with the controls (n=5), the increase on day 5 in the G-CSF/GM-CSF groups was 37-/10-fold (CD34+ cells), 5.2-/2.4-fold (leukocytes), 7.2-/3.0-fold (granulocytes), 7.4-/4.4-fold (monocytes), 1.7-/1.1-fold (lymphocytes), 9.8-/2.7-fold (basophils), 2.3-/9.6-fold (eosinophils), and 1.9-/1.6-fold (reticulocytes). The mobilization of myeloblasts, promyelocytes, myelocytes, and metamyelocytes coincided with the pronounced increase of CD34 + PBPC observed on day 4. Serum levels of uric acid (UA) and lactic dehydrogenase (LDH) increased under G-CSF, and platelets decreased after G-CSF discontinuation. Rash at the injection site occurred in 50% of the GM-CSF-treated volunteers. Seven volunteers in the GM-CSF group and six in the G-CSF cohort complained of flu-like symptoms, including musculoskeletal pain. We conclude that, in terms of tolerance and mobilization of CD34+ cells and leukocytes, G-CSF is superior to GM-CSF, but higher levels of UA and LDH and late decrease in platelets make monitoring of these parameters necessary.
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PMID:G-CSF versus GM-CSF for stimulation of peripheral blood progenitor cells (PBPC) and leukocytes in healthy volunteers: comparison of efficacy and tolerability. 1021 53

Calcitriol, also known as 1,25-dihydroxy-vitamin D3, is a steroid hormone that has been shown to have effects on cytokine production and lymphocyte proliferation. Coadministration of calcitriol with trivalent influenza vaccine in mice enhanced both mucosal and systemic antibody responses. We studied the effects of calcitriol coadministered with a commercially available influenza vaccine in 175 human volunteers in this double-blind, placebo controlled clinical trial. Subjects that received calcitriol experienced more pain at the injection site compared with placebo recipients. No significant differences in hemagglutination inhibition titers against H1N1, H3N2, or influenza B antigens were detected at 1 or 3 months postvaccination. We conclude that coadministration of 1.0 microg of calcitriol at a site adjacent to influenza vaccination does not enhance humoral immunity in human volunteers.
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PMID:Calcitriol (1,25-dihydroxy-vitamin D3) coadministered with influenza vaccine does not enhance humoral immunity in human volunteers. 1021 85

To determine the public's perception as to the general definition of an emergency medical condition (EMC), and to compare opinions between the general public and healthcare workers (HCW) on which specific medical conditions require emergency department (ED) care, a survey of people at 12 supermarkets and shopping malls in Northern California was conducted over a 6-month period in 1997. Individuals over age 18 were asked in person to complete a survey sheet. It asked participants to choose one of four definitions of "emergency medical condition." In addition, people were asked to determine which of 30 chief complaints they thought needed care in the ED. Demographic information was also collected. A second set of surveys asking the same questions was conducted among nonemergency healthcare providers at hospitals. Healthcare worker was defined as an MD, RN, LVN, or PA. A total of 1,018 members of the public and 126 healthcare workers completed the survey. EMC definitions selected by the public were: 1) an abbreviated federal EMTALA definition: a condition that may result in death, permanent disability, or severe pain (48.7%); 2) the federal definition plus other conditions preventing work (3.0%); 3) the federal definition plus any other conditions outside business hours (16.5%); and 4) any condition at any time as determined by the patient (31.6%). HCWs selected the following: definition 1 (71%); definitions 2 and 3 (0%); and definition 4 (27%). Definitions 1 and 3 were statistically different when comparisons were made between the public and HCWs. On the question of which of the 30 chief complaints needed care in an ED, agreement was seen between the public and HCWs for severe abdominal pain (94% vs. 99%, respectively) and severe chest pain (96% vs. 99%, respectively). However, the two disagreed on the need for ED care for severe headache (58% vs. 91%, respectively); mild chest pain (51% vs. 79%, respectively); and difficulty breathing (77% vs. 98%, respectively). No significant difference in opinions on the need for ED care was seen for some minor conditions: mild headache, sore throat, cough, flu symptoms, minor foot problems. No significant differences in answers occurred when age groups, occupations, or locations were compared. In conclusion, the public has split views concerning the general definition of an emergency medical condition. Approximately half uses a conservative federal definition, and half uses patient self-determined need as the definition. Data on which specific conditions need ED care provide additional insight on agreement between the public and HCWs on most problems. Both groups agree that many perceived minor medical complaints do not require ED care.
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PMID:How do prudent laypeople define an emergency medical condition? 1033 30

Orbital infections and inflammations present to the clinician with similar findings: periorbital edema, erythema, proptosis, and pain. History and clinical examination determine the work-up required to better define the disease process. Orbital infections continue to be associated primarily with diseases of the paranasal sinuses. Haemophilus influenza type B is no longer a significant pathogen, because of an effective vaccine. Fungal infections extending to the orbit are becoming more frequent due to the prevalence of immunocompromised patients. Orbital inflammations continue to be poorly understood, and an adequate classification scheme does not exist. Corticosteroids continue to be the preferred initial treatment, with the roles of radiation and nonsteroidal antiinflammatory medications to be determined. Specific causes of orbital inflammation such as Wegener granulomatosis must be considered to prevent potentially life-threatening complications.
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PMID:Orbital infections and inflammations. 1038 81

Interferons are a class of glycoproteins whose properties include antiviral, immunomodulatory and antiproliferative effects. Immunotherapy with interferons is used in a variety of diseases, such as haemato-oncological disorders, solid tumours, viral hepatitis and multiple sclerosis. Due to their involvement in the regulation of a large number of physiological functions, many different side effects can occur. Flu-like syndromes, gastrointestinal complaints, fatigue, pain, increased susceptibility to infections, thyroid dysfunction and psychiatric side effects occur frequently with alfa-interferon. Side effects frequently necessitate interruption and dose reduction. Severe or even life-threatening side effects are not frequent but do occur. Patient education is an important promotor of patient compliance, as are proper detection and symptomatic treatment of the side effects.
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PMID:[Side effects of interferon alfa]. 1044 61

Two patients with rhabdomyolysis-induced acute renal failure due to influenza A virus infection are presented. Both had influenza symptoms, with high fever and severe muscular pain leading to walking problems. In addition, they were dehydrated due to vomiting and diarrhoea. Both had evidence of an ongoing influenza infection according to serological tests. Muscle injury due to the viral infection gave rise to rhabdomyolysis with efflux of myoglobin from the muscles, causing renal failure. In conclusion, influenza A virus infection can cause rhabdomyolysis accompanied by reversible acute renal failure.
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PMID:Rhabdomyolysis and acute renal failure associated with influenza virus type A. 1051 90

Increasingly, it is recognised by health planners and social scientists that self medication with drugs bought over the counter in private pharmacies is extremely widespread. Some anthropologists see this trend as an aspect of the 'commodification of health'. In this study, group interviews with health service users and providers in Gaza revealed many health service users reporting an inadequate supply of drugs resulting in the purchasing of drugs in private pharmacies. As a result, a survey of the pattern of utilization of three private pharmacies in three contrasting urban areas within the Gaza Strip was undertaken. Using a questionnaire, data were collected from all customers buying drugs. The results show that variations in the patterns of health seeking behaviour were associated with socioeconomic status. Adult males were the most frequent customers of all three pharmacies. They were buying medicines for members of their nuclear family more often than for themselves. Overall, pain and influenza were the most commonly reported conditions. The drugs purchased most frequently for women were for reproductive health problems, particularly infertility. Customers of the pharmacy in the relatively prosperous area more commonly purchased drugs which were prescribed by a private doctor.
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PMID:Purchasing a quick fix from private pharmacies in the Gaza Strip. 1051 31


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