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 present study was an attempt to assess the cause of persistent pain in lower limbs among children from Kashmir. The study was conducted on one hundred children attending Paediatric out-patient department of Sher-i-Kashmir Institute of Medical Sciences, Srinagar. All the children were in the age group of 5 to 14 years. They showed markedly raised levels of serum alkaline phosphatase, whereas serum phosphorus, serum calcium levels and antistreptolycin O-titres were normal in 93% cases. None of them had any rheumatic or rheumatoid pathology. Among 15 suspected clinical rickets only three were established radiologically. Dietary and socio-economic history revealed deficient vitamin D intake and less exposure to sun. It was hypothesized that sub-clinical vitamin D deficiency could be a major cause of persistent pain in lower limbs and raised serum alkaline phosphatase could be the earliest marker of vitamin D deficiency. It was confirmed by injecting single dose of vitamin D (3 lac I. U.) which relieved bone pain and lowered the levels of serum alkaline phosphatase to normal within 14 weeks of initiation of therapy.
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PMID:Persistent limb pain and raised serum alkaline phosphatase the earliest markers of subclinical hypovitaminosis D in Kashmir. 262 Sep 72

Because of changes that occur with aging, older people with any other risk factors for vitamin D deficiency are likely to have inadequate stores of this vitamin. The consequences of vitamin D deficiency are likely to be losses in bone, strength, and function and the development of pain. Many questions remain regarding screening, prevention, and treatment of vitamin D deficiency. Supplementation may be unnecessary in most healthy, ambulatory seniors. Excessive supplementation in this group may lead to vitamin D toxicity. There does seem to be a role for supplementation in homebound older people who will not get adequate vitamin D from sunlight exposure. This population is at particular risk of developing vitamin D deficiency. Issues such as inadequate diet, physiologic changes with aging, polypharmacy, and diseases that interfere with vitamin D metabolism contribute to this risk. In such circumstances, a recommendation of 800 IU per day is reasonable. An alternative to daily dosing is a single oral dose of 100,000 IU of vitamin D (ergocalciferol or cholecalciferol) every 3 to 6 months. A simple maneuver is for geriatricians, who see many chronically ill patients with low vitamin D stores (who are likely to be seen in the office every 3 to 6 months), to administer vitamin D during the office visits. These dosing schedules have not been associated with toxicity and can be considered safe in homebound (sunlight-deprived) older adults.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Vitamin D deficiency in older people. 860 Feb 10

Osteoporosis of pregnancy is an infrequent condition of unclear pathogenesis. We report four new cases. Mean age of patients was 28 years; diffuse bone loss was seen on pre-pregnancy roentgenograms in two patients. Two patients were primiparas. In all four cases, acute spinal pain led to the discovery of vertebral crush fractures and diffuse osteopenia predominating in the spine and pelvis. Urinary calcium was low in one case. Our cases and a review of the literature demonstrate that diffuse osteopenia exists prior to the pregnancy and becomes symptomatic during childbearing as a result of additional mechanical stresses with or without concomitant vitamin D deficiency and/or heparin therapy.
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PMID:[Osteoporosis during pregnancy. 4 cases]. 801 35

Osteomalacia is a generalized bone disorder characterized by impairment of mineralization, leading to accumulation of unmineralized matrix or osteoid in the skeleton. The classical clinical features of osteomalacia include musculoskeletal pain, skeletal deformity, muscle weakness and symptomatic hypocalcaemia. In childhood the features of osteomalacia are accompanied by rickets, with widening of the epiphyses and impaired skeletal growth. The major cause of osteomalacia is vitamin D deficiency, which is most often due to reduced cutaneous production of vitamin D in housebound elderly people, immigrants to Northern countries and women who adopt strict dress codes which prohibit exposure of uncovered skin. Vitamin D deficiency osteomalacia may also occur with malabsorption, liver disease and anticonvulsant therapy. Less commonly, osteomalacia may result from abnormal vitamin D metabolism, resistance to the action of vitamin D, hypophosphataemia or toxic effects on osteoblast function.
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PMID:Osteomalacia. 922 90

This study was performed to determine the prevalence of hypovitaminosis D (HD) and hypovitaminosis D associated with secondary hyperparathyroidism (HD-SHPT) among Indo-Asians attending rheumatology clinics in Wolverhampton. A cross-sectional survey of 98 clinic attenders and 36 normal controls subjects was undertaken. The groups were matched for age, gender, and body mass index. There was a high prevalence of vegetarianism, and milk consumption was low in both groups. Clinical scores for musculoskeletal pain, gait, and muscle strength were all significantly worse in clinic attenders (p < 0.001). Comparing clinic attenders with controls, 25-OH-vitamin D levels were 6.6 +/- 3.9 vs. 8.2 +/- 4.8 microg/L (p < 0.01) and the prevalence of HD (<8 microg/L) was 78% vs. 58% (p < 0.05), but neither parathyroid hormone levels (53 +/- 60 vs. 50 +/- 18 ng/L, n.s.) nor HD-SHPT prevalence (22% vs. 33%, n.s.) were significantly different. Routine biochemical tests were not discriminant, but none of the controls and 10 of 98 (10%) clinic attenders had elevated alkaline phosphatase levels: 6 with HD and 3 with HD-SHPT. Vitamin D deficiency has an extremely high prevalence among Indo-Asians in the U.K., particularly in those attending rheumatology clinics. Detection of HD and HD-SHPT is only possible using measurements of 25-OH-vitamin D and PTH.
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PMID:Prevalence of hypovitaminosis D in Indo-Asian patients attending a rheumatology clinic. 1057 83

In the quantitative evaluation of bone osteopenia is defined as a decrease of mineral density by more than 1 SD from the established normal values (age, sex, peak bone mass...). The border of osteopenia and osteoporosis is demarcated by -2.5 SD (T-score) in adults, while in children the most proper is considered to be -2.0 SD (Z-Score). The aim of the study was to determine whether developmental osteopenia is accompanied by biochemical abnormalities and what are clinical symptoms concomitant with this condition. The studies include 28 children aged 5-17 years, in whom no chronic disease, especially of locomotor system, was found. The basis for diagnosis was densitometric examination of bone, with DEXA method (densitometer by Lunar), vertebral column (Spine) in the pediatric program or for adults. The most frequent causes for referring to the examination were pain in the spine, limbs or history of multiple bone fractures. In the performed biochemical examinations hypomagnesemia, decreased concentration of 25OHD and PTH in blood serum, increased activity of bone isoenzyme of alkaline phosphatase as well as increased excretion of hydroxyproline in urine, were found in several children. In about 1/3 of the children low body mass, and in some cases also retardation of the bone age was revealed. The results of our studies allow a conclusion, that in children with certain clinical abnormalities from locomotor system osteopenia may take place. This disturbance is concomitant with various deviations in calcium-phosphate metabolism and requires adequate therapy. It may be supposed, that in the majority of children, osteopenia was caused by low dietary calcium intake, together with reduced physical activity and vitamin D deficiency. The observations and conclusions from the study are of important practical significance, because children with osteopenia are the risk group for the appearance of osteoporosis in their future life.
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PMID:[Developmental osteopenia: decrease of bone mineral density or systemic impairment?]. 1107 Jul 15

The discovery of the antirachitic properties of sunlight and cod liver oil led to the disappearance of rickets as a common disease in western countries. However, this view has had to be readjusted as immigrants to western countries from those countries closer to the equator have been shown to suffer from symptomatic vitamin D deficiency. Immigrants from Africa in particular have several risk factors, such as dark skin, the tendency to stay out of the sun, wearing well-covering clothes, and a diet which is low in dairy products. The vitamin D deficiency is manifested by pain in the legs and muscle weakness. In particular, stair climbing becomes difficult. In a multicultural society such as in the Netherlands, advice regarding vitamin D (for example that provide by the Dutch Health Council) should take into account the above-mentioned risk factors.
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PMID:[Vitamin D deficiency in a multicultural setting]. 1171 87

Vitamin D deficiency is a problem of considerable magnitude that has reemerged as a major public health issue in the United States and several other developed countries. Vitamin D plays a crucial role in calcium homeostasis in the body. Hypovitaminosis D leads to osteomalacia and increased risk of fractures, especially in the elderly. Preliminary research suggests that vitamin D can prevent certain types of cancer and autoimmune diseases. A recent large study has shown the association between severe hypovitaminosis D and persistent, non-specific musculoskeletal pain, further suggesting that patients with no apparent cause of pain should be assessed and possibly treated for vitamin D deficiency.
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PMID:Hypovitaminosis D-induced pain. 1549 69

Vitamin D deficiency among hospitalized patients may be more widespread than realized. Vague musculoskeletal complaints in these chronically ill patients may be attributed to multiple underlying disease processes rather than a deficiency in vitamin D. However, the failure to diagnose an underlying deficiency places the patient at risk for continued pain, weakness, secondary hyperparathyroidism, osteomalacia, and fractures. The causes of hypocalcemia and hypophosphatemia in the chronically ill patient are many, and the patient may respond to simple replacement therapy. Elderly hospitalized patients with ionized hypocalcemia and hypophosphatemia, with or without an elevated parathyroid hormone level, are most likely deficient in vitamin D. Initiating treatment during hospitalization is reasonable once the diagnosis has been confirmed by finding a low 25-hydroxyvitamin D level. Treatment with high doses of vitamin D is safe. Unfortunately, some hospital formularies continue to provide multivitamin supplements that contain less vitamin D than currently is recommended.
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PMID:Undiagnosed vitamin D deficiency in the hospitalized patient. 1568 95

Multiple sclerosis (MS) is a chronic disease and a major cause of disability in young adults. The aims of this study were to assess bone mass in patients with MS in comparison to healthy age- and sex-matched controls, and to evaluate factors influencing bone mineral density (BMD), and the relationship of the pain threshold at peripheral and axial sites with BMD in MS. Thirty-one patients with MS and 30 matched healthy controls participated in the study. The Kurtzke expanded disability status scale (EDSS) and the functional independence measure (FIM) were used to scale disability, mobility, and functional status. Serum 25(OH) vitamin D levels were measured. BMD was measured using dual X-ray absorptiometry (DXA). MS patients had significantly lower BMD at the lumbar spine (L2-L4) and femur trochanter compared to the matched controls. BMD of the lumbar spine was nearly 1 SD lower in MS patients compared with the healthy reference population (Z scores). MS patients had significantly lower vitamin D levels (17.3 ng/ml vs 43.1 ng/ml; P < 0.001) compared to controls, and 19 patients (61%) had a serum level of vitamin D that was less than 20 ng/ml. EDSS scores in the patients were inversely correlated with proximal femur BMD but not with spinal BMD. There was a negative correlation with the cumulative steroid dose and BMD only for femur trochanter BMD. Total myalgia scores for paravertebral muscles correlated significantly with spinal BMD. In conclusion, BMD is significantly lower in MS patients than in healthy controls, vitamin D deficiency is prevalent in MS, and ambulatory status is a determinative factor for osteoporosis in MS. Patients should be encouraged to have adequate sunlight exposure and to increase their mobility. Specific strengthening exercises for hip and back muscles in MS patients would have a substantial impact on bone density, osteoporosis, fracture risk, and mobility.
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PMID:Vitamin D deficiency and reduced bone mineral density in multiple sclerosis: effect of ambulatory status and functional capacity. 1598 Oct 27


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