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)

Blood-letting to a haematocrit of 0.40 to 0.42 was performed over a period of six weeks on 30 randomized patients with peripheral vascular disease (intermittent claudication), stage IIb (after Fontaine), in addition to standardized gymnastics and physical exercise (walking). Subsequently, 15 randomly selected patients received after each blood-letting middle-molecular hydroxyethyl starch solution, another 15 randomized patients received isotonic sodium chloride solution, both groups under a double-blind protocol, gymnastics and walking exercise being continued. At the beginning of the study both groups were comparable with respect to clinical and vascular parameters and results of laboratory tests. Those of the former group had a significantly greater increase in pain-free walking distance than the latter. Blood pressure levels remained unchanged in the former, but significantly rose in the latter. Peak flow during reactive hyperaemia increased significantly in both legs in the first group, remaining unchanged in the second. An increase in spontaneous platelet aggregation occurred only in the second group; alpha 2-macroglobulin concentration rose only in patients of the first group, while fibrinogen decreased significantly in both.
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PMID:[Isovolemic hemodilution in stage-IIb peripheral arterial occlusive diseases. Prospective randomized double-blind comparison of middle-molecule hydroxyethyl starch and electrolyte solution]. 242 1

Epidural spinal electrical stimulation (ESES) has been valuable in the control of pain arising from peripheral vascular disease. Thirty-two of 34 patients experience some relief of pain and 12 of 24 patients showed healing of ischemic ulcers. This technique may prove to be useful in preventing or delaying amputation of ischemic limbs. A prospective randomized study has been undertaken to assess whether this form of electrical stimulation can save limbs.
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PMID:Epidural spinal electrical stimulation in peripheral vascular disease. 243 78

In a randomized patient-blind study iloprost or hydroxy-ethyl starch 200/0.5 were given i.v. 5 h daily for 2 weeks to 24 patients suffering from severe intermittent claudication due to peripheral vascular disease. An increase in pain-free walking distance of more than 50% occurred in 6 of 11 patients after the iloprost infusions and in 7 of 12 patients after HES treatment. No significant effects on haemodynamic or clinical chemistry tests were observed.
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PMID:Clinical effects of intravenous iloprost in patients with intermittent claudication. 244 77

Spinal cord stimulation (SCS) by epidural electrodes is being used more often in the treatment of patients with severe intractable ischemic pain. The promising clinical results and the objective increase in lower extremity blood flow (plethysmography, thelethermography, etc.), suggests that spinal cord stimulation may have an important role in the management of advanced arterial disease when other forms of treatment have failed. The selection criteria for implantation of SCS are very important. Our indications in patients with peripheral vascular disease are: 1. Peripheral vascular disease with severe, intractable symptoms that are untreatable by medical or surgical therapy. 2. Inflammatory or diabetic arterial disease resistant to medical treatment and/or sympathectomy. 3. Persistent and severe ischemic pain and/or ulcers in patients with patent grafts. 4. Patients for lumbar sympathectomy who have a high myocardial risk. Contraindications to implantation of SCS are claudication intermittent, large necrotic lesions (gangrene) and patients who have undergone prolonged narcotic therapy.
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PMID:Our experience with spinal cord stimulation (SCS) in peripheral vascular disease. 247 52

Between 1982 and 1987, 45 patients suffering from painful symptomatology caused by peripheral vascular disease, not curable by medical or surgical therapy, were implanted with epidural neurological stimulators. Measurements used in evaluating the effectiveness of the method were pain control, walking distance, and development of trophic problems. With most patients, we noted a satisfactory and long-lasting degree of pain control. Walking distance increased to a surprising degree. Trophic lesions smaller than 3 sq cm healed, while lesions of greater size required amputation of the limb. Transcutaneous oxygen tension (TcpO2) was used to study the effects of SCS on peripheral circulation in implanted patients. In addition, TcpO2 was calculated in 15 patients before and during the percutaneous test to predict the effectiveness of SCS. Regression of painful symptomatology was achieved only in patients whose TcpO2 improved during the course of the testing. Therefore, this method provides an objective measure for the implantation of neurostimulator.
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PMID:Spinal cord stimulation (SCS) in peripheral ischemic pain. 247 53

Reports suggest that white blood cells are involved in the development of tissue ischaemia. No studies on leucocyte rheology in the earliest stages of ischaemia exist. In 10 peripheral vascular disease (PVD) patients, 10 stable angina pectoris (SAP) patients and two groups of 10 matched controls leucocytes were separated by density and adherence into their granulocyte, lymphocyte and monocyte subpopulations. Blood samples were taken from the PVD group and respective controls before and after treadmill exercise (5 min 2 km-1 h-1, 12% slope) and from the SAP patients and controls before and after cycle ergometer test (25 W every 3 min). All the subpopulations were filtered through five micron diameter pore filters. Compared to controls, calf pain in the PVD patients was associated with an increase in monocyte filterability (P less than 0.01). ST depression in the SAP patients was linked to impaired granulocyte filterability (P less than 0.04). Therefore leucocyte rheology appears impaired in the earliest stages of ischaemia.
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PMID:Human leucocyte rheology and tissue ischaemia. 250 15

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.
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PMID:Effects of taprostene, a chemically stable prostacyclin analogue, in patients with ischaemic peripheral vascular disease: a placebo controlled double-blind trial. 251 30

In this study we report on the atherectomy technique, acute and long-term data, and histological findings of excised specimens from patients with peripheral vascular disease treated with the Simpson atherectomy catheter. Forty patients with a total of 72 lesions of the iliac (n = 5), superficial femoral (n = 62), and popliteal (n = 5) arteries could be treated; five patients had rest pain and two had gangrene. The primary success rate (of all lesions, including total occlusions and longer stenoses) was over 90%. The percent of stenosis decreased from 87.2 +/- 19.9% to 16.6 +/- 15.5%; the claudication distance improved from 80.5 +/- 65.7 m to 152.8 +/- 80.3 m; the Doppler index (leg/arm) increased from 0.57 +/- 0.17 to 0.81 +/- 0.16. At 6 months the mean walking distance and Doppler index remained stable from post-atherectomy; the mean percent of stenosis had increased to 35.7 +/- 30.9%. The angiographic restenosis rate (defined as stenosis greater than 70%) was 21% with a clear difference found depending on the primary morphology of the lesion: in eccentrics 5%, concentrics 27%, and total occlusions 42%, thereby allowing categorization of the suitability of a primary lesion for atherectomy. Histologically, restenoses showed more cellular proliferation and organized thrombus as compared to their primary stenoses; further investigations (cell culture, immunohistochemistry, and electron microscopy) are underway.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Angiography and functional results and histologic findings following percutaneous atherectomy in patients with arterial occlusive disease]. 253 Jul 9

We studied the quantitative and qualitative behaviour of white blood cells (WBCs) at rest and after standard treadmill exercise in 20 male stage II peripheral vascular disease (PVD) patients, compared to 20 healthy matched controls. The aim of this study was to define the role of WBCs in PVD. The results confirm the WBC count was significantly increased in PVD patients. Surprisingly, however, the only rheological WBC variable which showed a significant variation during the ischaemic pain caused by treadmill exercise was the filterability of mononuclear leukocytes. This would seem to identify disturbances in mononuclear filter-ability, associated with ischaemic pain resulting from claudication, as a functional sign of PVD.
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PMID:[The behavior of leukocyte rheology in induced ischemia in peripheral arterial occlusive disease]. 258 33

The effects of physical exercise on 8 stage II peripheral vascular disease (PVD) patients were observed after a six-month training program. Doppler velocimetry (including the treadmill test), strain gauge plethysmography, and transcutaneous oxygen pressure were used to quantify the results, which were compared with those obtained in a control group of another 8 stage II PVD patients, under placebo therapy for six months. The results show physical exercise increased the walking capacity, both the pain-free walking time and the maximum walking time. No significant difference was observed in the other parameters studied, in either the exercise patients or the control group.
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PMID:Effects of physical training on peripheral vascular disease: a controlled study. 264 71


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