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)

Thirty patients with ischaemic peripheral vascular disease and intermittent claudication were randomly allocated to receive either placebo or taprostene, a chemically stable prostacyclin analogue, intravenously at a rate of 25 ng/kg/min for 6 hours daily on 5 consecutive days. Taprostene produced a significant (p less than 0.05) increase in absolute walking time compared to placebo on one day after infusion and at 1, 4 and 8 weeks (14% vs 2.8%) later. Taprostene also produced a significant (p less than 0.05) increase in the pain-free walking time compared to placebo in the follow-up period (8 weeks after infusion: 23% vs 3.8%). During the infusion period systolic and diastolic blood pressure decreased (p less than 0.05) and heart rate was accelerated (p less than 0.05) in the taprostene treated group whereas no change was monitored in the placebo group. The ankle/brachial Doppler index was unaffected by taprostene. The platelet half-life was significantly (p less than 0.05) prolonged following taprostene-infusion (72.6 +/- 9.35 vs 77.9 +/- 7.44 hours). However, no change on platelet half-life was found in the placebo group (p less than 0.05). Various measures of platelet function parameters followed in vitro (ADP-induced aggregation, platelet sensitivity to PGI2, PGE1, PGD1 and taprostene, concentrations of platelet factor 4 and beta-thromboglobulin) showed no change with taprostene. Measures of circulating platelet aggregates and endothelial cells count showed no changes during the 2 months follow-up period too. It is assumed that taprostene may be of clinical benefit in patients with ischaemic peripheral vascular disease. However, future investigations have to be carried out to assess the optimal dose regime.
 ...
PMID:Effects of taprostene, a chemically stable prostacyclin analogue, in patients with ischaemic peripheral vascular disease: a placebo controlled double-blind trial. 251 30

Preoperative arteriographic findings in immediate postoperative results as well as follow-up studies of treatment with argon and YAG lasers have been evaluated in 148 lesion found in 137 patients. Preoperative arteriography revealed a solitary lesion in 42 of 148 legs (28%) examined, and a combined lesion was found in the remaining 106 legs (72%). Incapacitating intermittent claudication, rest pain, tissue loss, or a combination of these was an indication for laser arterial reconstruction. None of the argon laser-treated lesions was treated with balloon dilatation, but since March 1988 all appropriate YAG laser-treated lesions were immediately followed by laser-assisted balloon angioplasty. The lesions in 64 of 89 legs (72%) treated by argon and 42 of 59 (71%) treated by YAG were successfully recanalized. However, successful angioplasty was performed in 44 of 89 (49%) and 34 of 59 (58%) lesions, respectively. The recanalization depended on the type of lesion (tight stenosis vs occlusion) and the length of lesion (localized vs total-length occlusion). However, the success rate of recanalization was almost the same as the success rate when both laser systems were used. Argon laser treatment proved successful in 19 of 20 (95%) segmental occlusions in popliteal arteries, whereas YAG laser treatment proved successful in four of five (80%) short segmental (less than 15 cm) occlusions of superficial femoral arteries and in 16 of 23 (70%) long segmental (greater than or equal to 15 cm) occlusions of superficial femoral arteries. In 26 of 36 (72%) total-length occlusions of superficial femoral and popliteal arteries, recanalization was not possible (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Laser arterial disobstructive procedures in 148 lower extremities. 252 17

The efficacy of laser recanalization (LR), laser assisted balloon angioplasty (LABA) and laser angioplasty (LA) was evaluated. These procedures were performed a total of 55 times upon 49 patients who had occlusive arterial disease of a lower extremity with a history of incapacitating, intermittent claudication, rest pain or loss of tissue, or all three. Patients with lesions through which a guide wire could be passed were eliminated from this study. Two lesions in the common iliac artery, 44 in the superficial femoral artery, seven in the popliteal artery and two in the infrapopliteal artery were studied. Thirty-nine of 55 lesions (71 per cent), including 12 of 12 stenoses and 27 of 43 occlusions (63 per cent), were successfully recanalized. None of the seven total length occlusions were successfully recanalized (p less than 0.001); perforation occurred in four. Bypass procedures were required in six of 13 and two of 25 lesions treated by LR and LABA, respectively (p less than 0.05). All patients with lesions successfully recanalized using LR, LABA and LA were observed for a period of 15 days to six months, with an 82 per cent patency rate (32 of 39). Total length occlusions are not a good indication for treatment with currently available laser techniques. The addition of balloon dilation in LR decreased the requirement for bypass procedures in a significant number of patients.
 ...
PMID:Laser recanalization, laser assisted balloon angioplasty and laser angioplasty. 252 14

Laser-assisted angioplasty has been used on 47 occasions in 45 patients for the management of atherosclerosis of the superficial femoral and proximal popliteal arteries. Twenty-four procedures were performed to treat disabling intermittent claudication and 23 procedures were performed for a "threatened limb" (rest pain, ischaemic ulceration or digital gangrene). Technical success was achieved in 40 (85%) cases; the mean length of occluded segment was 7.7 cm. The presence of heavily calcified occlusions contributed significantly (P less than 0.001) to technical failure. In 28 (70%) of the successfully treated cases, the recanalized arteries were patent at one month and in 21 (53%) cases they have remained patent during the follow-up period. In five of nine cases with a nine-month follow-up, the arteries still were patent. The mean length of the occluded segments that were treated initially was 7.1 cm in those that remained patent compared with 8.2 cm in those that reoccluded. Thirty-six (77%) patients were discharged from hospital on the day after the procedure. Laser-assisted angioplasty is a promising new technique that is applied best to short-segment, non-calcified occlusions and should reduce the requirement for femoropopliteal arterial bypass surgery.
 ...
PMID:Early experiences with laser-assisted thermal angioplasty for peripheral vascular disease. 252 19

To clarify the efficacy of laser-assisted reconstructive vascular surgery (LARVS) for patients with severe symptoms of peripheral arterial occlusive disease, 118 ischemic legs of 104 patients were retrospectively analyzed (argon:89 and YAG:29 lasers). Of those 118 legs, 26 (22%) had tissue loss, 60 (51%) had rest pain, and 32 (27%) had incapacitating intermittent claudication. The LARVS was adequate in 60 of 118 (51%) and inadequate in 58 of 118 (49%). With argon:89 and Nd:YAG:29 lasers, respectively, 41 of 89 (46%) and 19 of 29 (66%) were adequate. In the superficial femoral artery (SFA) and popliteal artery (PA), the LARVS was adequate in 31 of 43 (72%) in segmental occlusion and in one of 31 (3%) in total-length occlusion (p less than 0.001). In segmental occlusion of the SFA, however, argon:89 and Nd:YAG:29 lasers were adequate in four of 12 (33%) and in 10 of 12 (83%), respectively (p less than 0.05). The legs in which laser was used in more than one artery (eight of eight) or in occluded grafts (proximal SFA to distal PA; three of 18) required amputation within 30 days. A follow-up study demonstrated patency in 31 of 34 (91%) 1-24 months later with the argon:89 laser and in 15 of 16 (94%) 1-6 months later with the Nd:YAG:29 laser. This study indicates that LARVS was adequate in segmental occlusions, particularly in SFA and PA lesions; however, total-length occlusions and combination arterial lesions were not appropriate for the currently available laser systems. Laser application should not be performed if a guidewire passes through the lesion, since these lesions may be more appropriately treated with balloon angioplasty.
 ...
PMID:Laser-assisted reconstructive vascular surgery. 253 8

To evaluate efficacy of the YAG laser in severe occlusive arterial lesions of lower extremity, 64 lesions were considered for either laser recanalisation (LR) or laser assisted balloon angioplasty (LABA). Indications for the procedure were incapacitating intermittent claudication (28), rest pain (17) and tissue loss (19). Of those 64, 46 (72%) were recanalised whereas 38 (59%) recanalised to adequate diameter. In stenoses, segmental occlusions and total length occlusions, successful recanalisation resulted in 12/12 (100%), 28/35 (80%) and 6/17 (35%) cases respectively. As compared to stenoses and segmental occlusions, successful recanalisation rate was significantly low in total length occlusions (p less than 0.001). Addition of balloon dilatation to LR decreased the requirement of additional by-pass surgery from 6/16 (60%) to 2/30 (7%) (p less than 0.05). Addition of balloon dilatation to LR had improved the results.
 ...
PMID:YAG laser angioplasty in lower extremity: sole therapy as well as adjunct to balloon dilatation. 253 15

The walking and cycling tolerance of 19 patients with neurogenic claudication and 11 with intermittent claudication was assessed, first in the upright and then in 30 degrees of flexion, repeating the tests on a second day. The flexed posture improved the walking and cycling distance, respectively, in 11 and six patients with neurogenic claudication. In two of the 11 patients, this posture significantly improved by more than 100% of both walking and cycling distances. In addition, one patient had claudication pain when he was walking, but could cycle unlimited distance. Only one of the patients with intermittent claudication could walk or cycle further in the flexed position. Although some patients with neurogenic claudication increase their walking distance by flexing forwards, we conclude that posture-related walking and cycling are insufficiently sensitive tests to distinguish between neurogenic and intermittent claudication.
 ...
PMID:Walking and cycling tests in neurogenic and intermittent claudication. 255 Oct 51

In the presence of peripheral atherosclerotic disease, inappropriate adenosine release during exercise might promote excessive arteriolar dilation leading to steal phenomena and ischemia. In order to test this hypothesis, IV aminophylline (6 mg/kg over fifteen minutes), a dosage known to effectively block adenosine receptors, was acutely administered--in a double-blind, placebo-controlled study design--in 13 patients with intermittent claudication and documented atherosclerotic disease. All patients performed two treadmill exercise tests at the same hour on two consecutive days, five minutes after aminophylline or placebo administration randomly allocated. Pain-free time was 109 +/- 133 (mean +/- SD) seconds after placebo and 173 +/- 165 seconds after aminophylline (p less than .01); maximum time to claudication was 273 +/- 191 seconds after placebo and 397 +/- 318 seconds after aminophylline (p less than .05). The authors conclude that intravenous aminophylline markedly increases the walking capacity in patients with intermittent claudication, possibly by preventing flow maldistribution phenomena through adenosine receptors blockade.
 ...
PMID:Increase of walking capacity after acute aminophylline administration in intermittent claudication. 259 36

The course of 53 patients presenting with 76 legs with ischaemia, defined by blood pressure on the big toe below 30 mmHg, were investigated. The series consists of those patients who after an angiography were considered non-candidates for arterial reconstructive surgery. There were 38 limbs with low pressure and severe ischaemic symptoms, i.e. rest pain and/or gangrene and 38 limbs with low pressures and only intermittent claudication or no leg symptoms at all. There were statistically significant differences in the fate of the limbs in the two groups, the first group suffering a 68 per cent risk of amputations compared to only 16 per cent in the second group. The corresponding risk of death was approximately 60 per cent and 10 per cent. The social fate was poor in the group with rest pain and/or gangrene due to the high number of amputations.
 ...
PMID:The ischaemic leg: a long-term follow-up with special reference to the predictive value of the systolic digital blood pressure. Part I: No arterial reconstruction. 261 99

Ninety-five patients with 122 legs with a systolic blood pressure on the big toe below 30 mmHg were the subject of arterial reconstructive surgery. Investigating the limb survival rate we found the systolic blood pressure on the big toe to be the most important predictor, whereas there was found no predictive value of the ankle pressure/index. Preoperative clinical symptoms, which are closely related to the digital blood pressure, were significant predictors of the limb survival rate: the low-pressure limb with no symptoms or intermittent claudication had a significantly higher survival rate than the limb with rest pain and/or gangrene. Following arterial reconstructive surgery the social fate of patients with threatened legs was fairly good as 83% became fully independent.
 ...
PMID:The ischaemic leg: a long-term follow-up with special reference to the predictive value of the systolic digital blood pressure. Part II: After arterial reconstruction. 261


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