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)

463 patients (109 nulliparae, 354 uni- and multiparae) were fitted with a new intrauterine device (IUD), Sof-T, and observed during 6,624 cycles. Two independent centres participated in the study. The T of Sof-T is made of flexible polyethylene, the two occlusion bodies, of medically approved silastic. If the Sof-T is correctly placed, they lie in the uterine horns. A copper wire of a total surface of 360 mm2 is winded around the vertical branch. The echogenicity of the occlusion bodies facilitates their visualization by ultrasound, thus improving the safety of the new Sof-T. The softness and the adaptability of these occlusion bodies to the cavity of the uterus decreased trauma, and thus hemorrhage and pain, compared to 16 other studies on IUDs. The small number of salpingitis recorded in our study of the Sof-T may be attributed to the fact that the pathogens transported and transmitted by sperm could probably not penetrate into the uterine tubes because they were stopped by the occlusion bodies.
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PMID:[Pearl index of the new Sof-T spiral in relation to ultrasound follow-up]. 185 99

Postirradiation and Paget's osteosarcomas are high-grade malignancies. The five-year survival was only 10% in recent experience at the author's institution. Progressive pain is an important clinical feature in both conditions. Careful roentgenographic studies demonstrate cortical destruction and a soft-tissue mass in virtually all patients. Metastasis was present in 25% of both groups of patients at presentation. In contrast to previous series, more than 80% of the patients with postirradiation osteosarcoma had had irradiation for malignant entities and more than 70% had been treated with modern radiotherapy regimens (cobalt-60 or linear accelerator). Twice as many patients with postirradiation osteosarcoma were evaluated and treated in the 1980s than in the previous decade. The initial indication for irradiation often was carcinoma of the breast, uterus, or cervix, or lymphoma. Two-thirds of the patients had progressive disease that was not controllable within six months after diagnosis. Early detection may be the only effective means of improving survival with postirradiation or Paget's osteosarcoma. These patients require lifelong follow-up evaluations.
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PMID:Survival and management considerations in postirradiation osteosarcoma and Paget's osteosarcoma. 188 30

Myometrial activity, levels of PGF2 alpha and E2 in uterine flushings were measured in rabbits before and after insertion of four types of IUDs. The results showed that IUDs could increase the uterine contraction during the early stages of insertion. Thereafter, the uterine activity tended to be stable. The sequences of uterine contractility generally were: Cu-IUD greater than SS-IUD greater than LNG-Cu-IUD greater than LNG-IUD. The measurement of prostaglandins, determined by RIA, indicated that the concentrations of PGF2 alpha and E2 in Cu-IUD and SS-IUD groups were higher than those of controls for the early phase of insertion, which was not found after four months of use. Our results suggested that hyperactivity of the uterus in the early stage after insertion of IUDs might be relevant to side-effects like expulsion and pain. Copper released by Cu-IUD stimulates the uterine activity partially through increasing PGF2 alpha and E2 contents. In rabbits wearing LNG-IUD or LNG-Cu-IUD, both PGF2 alpha and E2 levels were low. The relatively low uterine mechanical and electrical activities were also observed in these two groups. Based on these data, it is concluded that development of LNG-Cu-IUD is feasible for reducing expulsion of IUDs.
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PMID:Dynamic changes of myometrial activity, levels of PGF2 alpha and E2 in rabbits after insertion of four types of IUDs. 190 75

By careful observation of the physical findings in the patient complaining of one of the disorders of genital prolapse, it should be possible to discern the origin of the symptoms and therefore to devise an appropriate treatment that would remedy by reconstruction all of the signs of anatomic weakness. The goals of reconstructive surgery are three: to relieve the symptoms, to restore the anatomy to normal, and to restore the function to normal. When any element of weakness in the pelvic floor is found to be sufficient to produce symptoms that warrant repair, it is the responsibility of the surgeon to identify all the sites of weakness, so that all may be repaired at the same time, sparing the patient the expense, pain, and inconvenience of future readmission for further surgery. These weaknesses all relate to deficiencies of the six major organ systems that are involved in the support of the female pelvis, which may be damaged singly or in any combination. There are various types of cystocele, each of which must be carefully excised if an appropriate surgical treatment is to be given. This may involve correction of cystocele, enterocele, rectocele, prolapse of the uterus, and posthysterectomy prolapse of the vaginal vault. With enterocele, it is possible to correlate the four common types of enterocele with their location, which in turn correlates directly with their treatment. The prevention of complications is emphasized along with the treatment of certain mechanical complications easily recognized at the time of surgery.
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PMID:Surgery for pelvic floor disorders. 192 55

3 cases of IUD-related abdominopelvic actinomycosis diagnosed after surgery are described. A 44-year old woman was admitted with high fever and diffused, strong abdominal pain. She had had an IUD for 4 years. Hypersensitivity all over the pelvis, an enlarged uterus, and peritoneal irritation were found upon vaginal examination. Opening the peritoneum yielded 1 liter of pus, a 6 cm diameter abscess of the right adnexa, and a myomatous uterus in 12 weeks of gestation. The uterus and the right adnexa were removed. Histology confirmed actinomycosis. Penicillin was given iv for 6 weeks, and after release she took oral penicillin for 4 more months. A 33-year old woman was admitted with high fever and excruciating pain in the lower right abdomen that had lasted on and off for months. She had had an IUD for 3 years. Vaginal examination revealed a hypersensitive uterus. enlarged right adnexa, and a firm mass between the vagina and the rectal shelf. Surgery showed the omentum attached to the sigmoid colon and the right fallopian tube with an abscess of 5 cm with cysts. The growth was resected, and the cysts were opened. She received iv erythromycin for 3 weeks and then orally for 2 months leading to full recovery. A 52-year old woman was hospitalized for hysterectomy. She had had abdominal pain radiating to the back for 1 year. She had had an IUD for 15 years. A myomatous uterus in 15 weeks of gestation was detected. Surgery revealed a 15 cm size myomatous uterus with an abscess of 6 cm around it. The uterus, the left adnexa, and the abscess were resected. Histology indicated actinomycosis. She received iv ampicillin for 1 month, and scar tissue from the abscess was treated with oral penicillin for 1 month. Cervical actinomycosis was found in 1-30% of women wearing IUDs. Diagnosis requires histopathological examination. The symptomless presence of cervical actinomycosis may require the temporary removal of the IUD and antibiotic treatment.
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PMID:[IUD-associated abdominopelvic actinomycosis]. 193 47

A 915 MHz intracavitary applicator was designed to heat tumours in the cervical and upper vaginal regions. The applicator has a 3.5-turn helical coil wound around the distal 19 mm of a dielectric rod 43 mm long and 30 mm in diameter. For treating uterine cancer, a 2450 MHz, 4 mm diameter helical applicator was made by replacing 6 cm of the outer conductor of a coaxial cable with six turns of copper wire soldered to the outer conductor. The heating patterns were determined thermographically in a muscle phantom. The maximum heating rates were 0.42 and 0.83 degrees C/W-min, respectively, for the 915 and 2450 MHz applicators. Intracavitary temperature distributions in the upper vagina, cervix and uterus were measured at the surface of the applicators with thermocouples. The average temperature was 46.0 +/- 2.1 degrees C (S.D.) at mid-tumour and 44.5 +/- 0.8 degrees C at the tumour periphery. The maximum temperature, up to 51.5 degrees C, was measured at the surface of the cervical applicator. The majority of the patients (28/30) tolerated the investigational treatment without burns or pain. Rectal temperatures were also monitored. The location of the hot-spot (40.7 degrees C) in the rectum, 5-7 cm above the anus, corresponded to the tip of the cervical applicator (47.1 degrees C).
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PMID:Design of intracavitary microwave applicators for the treatment of uterine cervix carcinoma. 194 May 5

Nursing management of second trimester abortion by PGE2 suppository after cervical dilatation with laminaria or Lamicel focuses on monitoring and treating side effects, managing pain, and supporting the patient emotionally. Mean abortion time by this method is 15-17 hours, within 24 hours in 80% of women. The side effects expected from PGs are nausea, vomiting, abdominal cramps, and diarrhea. Premedication with transdermal scopolamine, and ancillary methods such as giving ice chips, airing the room, keeping the patient clean are helpful. Acetaminophen is given orally or rectally for fever, headache, or chills. A beta-adrenergic tocolytic drug such as ritodrine HC1 is given if uterine contractions become tetanic, contractions 2-3 per minute or lasting longer than 6-90 seconds, detected by palpation. This drug must be used with caution in patients with asthma. Pain management in midtrimester abortion depends solely on the woman's comfort. Meperidine, morphine, epidural anesthesia with bupivacaine, lidocaine or morphine SO4, or patient-controlled anesthesia may be used. The nurse should monitor side effects such as hypotension, allergic responses, arrhythmias, and inability to void. Midtrimester abortion is often a stress-filled experience, since women may be ambivalent upon learning of fetal abnormalities. The women should be monitored after delivery to ensure that her uterus remains contracted, and assisted if surgical removal of retained products is necessary. Patients teaching for discharge, including medication to prevent lactation, is described. A care plan is suggested for assisting the family with bereavement, based on that used in case of stillbirth or neonatal deaths.
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PMID:Second-trimester termination of pregnancy: nursing care. 156 89

The peripheral cholinergic, central dopamine antagonist drug metoclopramide was assessed as an anesthesia adjunct in a randomized, double-blind trial in 15 women having 2nd trimester abortion by intraamniotic prostaglandin F2a (Pgf2alpha). 7 of the women received 10 mg metoclopramide iv, and 8 received saline, when patient-controlled-analgesia with iv morphine by pump according to a standard protocol was begun. Pain was assessed every 2 hours by a visual analogue scale (0-10), and by number of doses and total amount of morphine used. The metoclopramide group used 54% less morphine (24.1 vs 52.0 mg), used less morphine in 2-hour intervals for the 1st 6 hours, reported less pain on analog scales, and expelled the fetus significantly earlier than did the saline group (7.2 vs 15.3 hours, p0.05). The lower cumulative morphine dose was influenced by the fact that the fetus was aborted earlier in the test group. There were no significant differences in time of placental delivery, or of hospital discharge, dose of antiemetic (droperidol) or of PGE suppositories given to speed the onset of contractions. metoclopramide may act to coordinate the contractions of the uterus and improve expulsive force. It was effective here only for 6 hours, probably related to its half life of 4-5 hours.
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PMID:Metoclopramide: an analgesic adjunct to patient-controlled analgesia. 195 34

General pharmacological properties of carvedilol (BM 14.190) were investigated in comparison with propranolol. 1. Central nervous system: Carvedilol caused reduction of awareness, motor activity and muscle tone, and staggering gait in Irwin's test (mice). It decreased spontaneous motor activity and potentiated hexobarbital anesthesia (mice). It lacked anticonvulsant activity (mice) and did not have any effect on body temperature (rabbits). Various changes were produced in mono- and polysynaptic spinal reflex (cats). In EEG, a slight arousal pattern was observed (cats). These effects of carvedilol were weaker than those observed after propranolol administration in general. Carvedilol, however, caused potentiation of hexobarbital anesthesia at lower doses than propranolol. Carvedilol inhibited acetic acid-induced writhing syndrome, whereas it failed to show analgesic activity in the tail-pinch test (mice). Propranolol inhibited both pain reactions. 2. Respiratory and cardiovascular system (dogs): Carvedilol increased respiratory rate and decreased expiratory velocity. It produced hypotension and bradycardia. Cardiac contractility was reduced and femoral blood flow was transiently increased after carvedilol administration. Propranolol induced weaker hypotension and greater bradycardia in comparison with carvedilol. It decreased femoral blood flow. 3. Autonomic nervous system: Carvedilol had little or no effects on pupil size, whereas propranolol produced mydriasis (rabbits). Carvedilol inhibited pressor response to norepinephrine (rats), and it also reduced the nictitating membrane contraction induced by pre- and postganglionic sympathetic nerve stimulation (cats). Propranolol did not show any inhibitory effect on pressor response to norepinephrine and on the contractile response induced by preganglionic sympathetic nerve stimulation. 4. Smooth muscle: Carvedilol produced inhibitory effects on spontaneous motility, and contractile responses to acetylcholine, histamine, nicotine, serotonin and BaCl2 in isolated ileum (guinea pigs). It also inhibited contractile responses to acetylcholine and histamine in isolated trachea (guinea pigs), and spontaneous motility in isolated uterus (rats). Carvedilol reduced norepinephrine-induced contraction of isolated vas deferens at lower concentration (guinea pigs). 5. Digestive system: Decrease in intestinal motility was observed after intravenous administration of carvedilol and propranolol (rabbits). However, carvedilol failed to influence on gastric motility and tonus, whereas propranolol increased them (rabbits). Carvedilol, like propranolol, induced little or no effects on gastro-intestinal transit (mice) and gastric emptying rate (rats). Both drugs decreased gastric secretion at similar dose (rats). Carvedilol at higher doses produced lesion of gastric mucosa, whereas propranolol did not show these effects (rats). 6. Skeletal muscle: In in vitro experiment, carvedilol, like propranolol, reduced the contractile response of diaphragm to nerve and muscle stimulation (rats)...
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PMID:General pharmacological profiles of the new beta-adrenoceptor antagonist carvedilol. 197 93

Patient preparation and a modified operative technique are described for electrocoagulation ablation of the endometrium using a roller-bar electrode. No preoperative or postoperative endometrial suppression was used. Rather, the endometrial cavity was denuded by suction curettage just before ablation, which was performed in the early proliferative phase of the menstrual cycle. Lidocaine paracervical block containing vasopressin was injected at the start of the procedure to control pain and to minimize bleeding and irrigation fluid absorption. Pulsed irrigation of the uterus was used to improve visibility through uterine debris and the bubbles generated by the electrical current. The first 20 patients who had electrocoagulation ablation of the endometrium with these modifications were compared with the first 18 patients who had laser coagulation ablation using standard technique and preoperative endometrial suppression. Compared with the laser method, the modified coagulation method resulted in a comparable rate of satisfactory bleeding decrease at 6 months (90 versus 94%), but involved a clinically significant reduction in total anesthesia time (66.8 versus 117.3 minutes) and volume of irrigation fluid used (5.7 versus 15.9 L).
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PMID:Modified endometrial ablation: electrocoagulation with vasopressin and suction curettage preparation. 203 Aug 76


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