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)

By means of a recently developed technique, red-cell deformability was measured in 44 patients with peripheral vascular disease and in 44 age and sex matched normal control subjects. 28 patients had intermittent claudication and 16 rest pain or gangrene. The ability of the red cells to deform was significantly reduced in patients and significantly less in patients with rest pain or gangrene than in those who only had intermittent claudication. A reduction in red-cell deformability by retarding blood-flow through the microcirculation may be an important factor in states of peripheral vascular insufficiency.
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PMID:Impaired red cell deformability in peripheral vascular disease. 7 40

The teaching of a patient with peripheral vascular disease offers many challenges to the nurse. Although content should be understood and utilized by the patient and significant others, of primary importance is the belief that the learner is the curriculum and that his perception of self and his problems is the focus of teaching. The learning needs generally should be considered as the needs of an adult individual, who has many past experiences and an interest in the present and future. This patient may experience pain from his disease and may require the assistance and support of others. If the purpose of treatment is to improve circulation and prevent trauma and infection, then patient instruction must be recognized as a vital tool in therapy. But the nurse cognizant of the progressiveness of peripheral vascular disease must capitalized on the teachable moments--when the patient is ready and the learning is needed.
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PMID:Teaching patients with peripheral vascular disease. 19 96

A study was undertaken to determine the effect of the development or disease on patients' smoking habits. Interviews with 841 subjects (591 smokers) were conducted following a standard protocol. Of the 841 subjects, 96 (61 smokers) had hydroceles or hernias and were considered a control group; the remainder had neoplastic diseases, respiratory disorders, diabetes, cardiovascular diseases, psychiatric illnesses, peripheral vascular diseases, and gastrointestinal and liver disorders. Patients with cardiovascular, pulmonary, and neoplastic diseases, diabetes, gastrointestinal diseases, and cirrhosis of the liver significantly reduced or stopped smoking because of medical advice (19%), socioeconomic factors (8%), or aggravation of disease (24%). The advent of disease was associated with an increase in smoking in several patients (including 2 with bronchial asthma and 12 with peripheral vascular disease) because of the apparent belief that smoking is beneficial in overcoming the disease or in controlling pain. Additional long-term studies are needed to explore the relationship between disease and smoking habits.
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PMID:Effects of the advent of disease on smoking habit. 60 78

Surgical lumbar sympathectomy is often performed as a last resort in treating peripheral vascular occlusive disease. However, the variable success rate and the morbidity of this procedure prompted us to examine phenol sympathectomy and to elucidate the factors which can be used to predict success with the procedure. During the past three years, 127 phenol sympathectomies have been performed for peripheral vascular disease using a standard technique. The technique has proved simple and harmless. The results of a prospective study of 52 patients indicate that it is possible to predict the chance of success after this procedure by using a combination of clinical criteria and systolic pressure measurements at the ankle. A good response is anticipated in patients with rest pain or night pain if the systolic pressure at the ankle is greater than 35 millimeters of mercury. Patients with gangrene of the digits responded if the pressure at the ankle was greater than 60 millimeters of mercury.
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PMID:Phenol sympathectomy for vascular occlusive disease. 64 32

Intermittent claudication from peripheral vascular disease is sometimes difficult to distinguish from similar claudication due to degenerative disease of the lumbar spine. In the present study 26 patients with vascular disease were compared with 23 patients with lumbar degenerative disease. Assessment was by clinical and radiological examination. In the vascular group characteristic distinguishing features were: abnormal foot pulses, arterial bruits, relief of symptoms by standing, a constant claudicating distance and stocking sensory loss. In the lumbar group typical findings were: discomfort on lifting, bending, coughing or sneezing, pain on standing, history of back injury, variable claudicating distance and segmental sensory loss.
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PMID:Neurogenic and vascular claudication. 73 Dec 61

In approaching a patient suspected of peripheral vascular disease the following signs and symptoms are of key importance (16): 1) Pain in the extremity which is induced by exercise and relieved by rest; pain which is influenced by posture is localized to one digit, is unilateral or is paroxysmal. 2) Impaired pulsations of peripheral arteries. 3) Abnormal color of the skin, particularly when affected by raising or lowering the part. 4) Gangrene, ulceration, impaired nail and hair growth, excessive calluses, or paronychial infections. 5) Unusual warmth or coldness. 7) Swelling, atrophy, or difference in length of extremity. 8) Ausculatory evidence of arteriovenous fistula. 9) Cyanosis or unusual pallor of digits when immersed in cold water. 10) Peripheral neuritis.
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PMID:Occlusive arterial disease in the lower leg and foot. 103 Jul 26

Frequently surgical amputation of a lower extremity is required when gangrene develops as a result of peripheral vascular disease. This is particularly true in geriatric patients. A below-knee amputation, with refinements in the surgical procedure, and immediate rigid-cast prosthetic fitting are strongly advocated by our group. The progress of two patients treated in this manner is described. Preservation of the knee joint improves the amputee's prognosis for ambulation with a below-knee prosthesis. The rigid-cast dressing on the below-knee amputation reduces edema and postoperative pain, is of psychologic value to the patient, and permits him to stand at from one to two days postoperatively.
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PMID:Prosthetic fitting immediately after below-knee amputation. 113 52

From experience gained in over 4,500 vascular laboratory procedures, segmental Pulse Volume Recorder (PVR) tracings, systolic pressure measurements, and other noninvasive laboratory techniques have been found extremely useful in the management of patients with arteriosclerotic peripheral vascular disease. Both PVR recordings and limb pressures were found to be important and are used in complementary fashion. Although arteriography is essential in defining structural lesions and in establishing graftability, noninvasive vascular studies provide an inexpensive, accurate, reproducible method for assessing functional significance of arterial disease. These studies contribute to the diagnosis, definition of severity, and establishment of an objective baseline prior to medical or surgical therapy. Because they may be used in a repetitive manner, they are extremely useful in establishing success of a given therapy and in the long-term follow-up of patients. Based upon our experience, laboratory criteria have been developed which allow accurate identification of ischemic rest pain, aid in predicting healing of foot lesions or below-knee amputations, and quantitate the functional disability of claudication.
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PMID:Vascular laboratory criteria for the management of peripheral vascular disease of the lower extremities. 124 89

A prospective, randomised, double-blind study was performed to test the contrast quality, tolerance and safety of ioversol 300 mg/ml (Optiray 300, Mallinckrodt Medical, Inc., St-Louis, USA) versus iohexol 300 mg/ml (Omnipaque 300, Schering AG, Berlin). The study was conducted on 80 patients with peripheral vascular disease, who underwent central venous pelvis-leg angiography. The angiograms in the ioversol group were rated "very good" and "good" in 75.6% of the cases versus 51.3% in the iohexol group. Patient tolerance was nearly identical in both groups. On the 4 point rating scale for pain and heat sensations (1 = none; 4 = severe), the average heat scores were 1.28 for ioversol and 1.44 for iohexol. None of the patients complained of pain when receiving the injection. There were clinically significant changes of blood pressure in 3 patients out of each group and tachycardia in 5 patients in the ioversol group and 9 patients in the iohexol group. Seven out of 80 patients reported mild to moderate side-effects. These were related to the contrast medium in the case of 2 patients in both the ioversol and the iohexol group. All reactions resolved spontaneously or could be controlled by treatment.
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PMID:A double-blind comparative study on the contrast quality, tolerance and safety of ioversol 300 versus iohexol 300 in central venous angiography (C.V. DSA). 129 99

Iloprost is an analogue of epoprostenol (prostacyclin; PGI2; a potent but short-lived prostanoid mainly produced in the vascular endothelium) and mimics the pharmacodynamic properties of this compound, namely: inhibition of platelet aggregation, vasodilatation and, as yet ill-defined, cytoprotection. Improved metabolic and, in particular, chemical stability enhance the clinical utility of iloprost. When administered as an intermittent intravenous infusion at less than or equal to 2 ng/kg/min for 2 to 4 weeks, iloprost reduced rest pain and improved ulcer healing in 40 to 60% of patients with critical leg ischaemia, including diabetic patients, and delayed amputation in the majority of responding individuals. Similar benefits have been seen in thromboangiitis obliterans and, in patients with severe Raynaud's phenomenon, shorter courses of therapy reduced the frequency, intensity and duration of ischaemic episodes for at least 6 weeks. The very few comparative trials reported to date (i.e. vs nifedipine in Raynaud's phenomenon; vs low-dose aspirin in thromboangiitis obliterans) have favoured iloprost, but comparisons with more established agents are needed to assess this drug's value in less severe forms of peripheral ischaemia, such as intermittent claudication. At present, iloprost is administered intravenously and this is a limitation to treatment. The potent, rapidly reversible antiplatelet activity of iloprost suits it for use in extracorporeal circulation and for the intraoperative management of heparin-induced platelet activation. Although results in animal models of ischaemic myocardial injury are encouraging, preliminary clinical experience in patients with myocardial ischaemia or infarction has been disappointing. Most patients tolerate iloprost infusion rates of up to 2 ng/kg/min. Headache and flushing are extremely common and are the suggested end-point of dose titration, as higher doses are associated with a significant incidence of gastrointestinal distress and, ultimately, hypotension. Thus, iloprost provides a pharmacotherapeutic option for patients with severe peripheral vascular disease, a condition for which few alternative drug therapies exist. Its potent but short-lived effects make it well-suited to certain therapeutic niches such as the management of intraoperative platelet activation. Prostanoid analogues have far-reaching therapeutic potential and further experience with iloprost will no doubt help to define its clinical applications.
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PMID:Iloprost. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in peripheral vascular disease, myocardial ischaemia and extracorporeal circulation procedures. 137 60


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