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)

Reduced plasma fibrinolytic activity may be a risk factor in venous and arterial thrombotic disease. Resting plasma fibrinolytic activity and fibrinolytic potential after ten minutes of venous occlusion were compared in 100 patients with peripheral vascular disease of varying severity and 20 age-sex matched controls. The fibrinolytic assay used was the euglobulin lysis time. Resting plasma fibrinolytic activity was significantly reduced in patients with a recent arterial thrombosis (p = 0.02) and ischaemic rest pain (p = 0.008) compared with controls. Fibrinolytic potential after venous occlusion was significantly reduced also in patients with a recent arterial thrombosis (p = 0.02) and ischaemic rest pain (p = 0.05) compared with controls. There were no significant differences between patients with claudication and controls. A reduced plasma fibrinolytic activity has been confirmed in patients with peripheral vascular disease and fibrinolytic potential may be a superior method of assessment as the euglobulin lysis time after venous occlusion is independent of the fibrinogen concentration. It remains uncertain whether the finding of reduced plasma fibrinolytic activity in patients with peripheral vascular disease is cause or effect and whether the finding has prognostic significance.
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PMID:Resting plasma fibrinolytic activity and fibrinolytic potential in peripheral vascular disease. 337 90

The nerves supplying the spinal dura mater were studied in four human foetuses (16-22 weeks) with the acetylcholinesterase in toto staining method. The ventral spinal dura contains a dense, longitudinally oriented, nerve plexus, which receives its contributions from: (I) the sinuvertebral nerves, (II) the nerve plexus of the posterior longitudinal ligament, (III) the nerve plexus of radicular branches of segmental arteries. Dorsal dural nerves are much smaller in number, do not form an evident plexus and do not reach the medial region of the dorsal dura. The dorsal nerves are derived from the ventral dural plexus at the level of the "intersleeval" parts of the dura mater. The ventral dural nerves may extend up to eight segments, with a great amount of overlap between adjacent nerves. This may provide an anatomical substrate for the understanding of extrasegmentally referred dural pain. The curled bundles of nerve fibres of pathways (I) and (II) provide an adequate adaptation to displacements of the spinal dura mater during flexion and extension. Pathway (III) has not been described before. The described nerve plexuses may be of importance in elucidating the mechanisms of epidural therapies in back pain and peripheral vascular disease.
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PMID:The innervation of the spinal dura mater: anatomy and clinical implications. 340 73

The effects of dipyridamole in association with acetylsalicylic acid were compared with the effects of acetylsalicylic acid alone in patients with peripheral vascular disease. The following parameters were studied in each patient: symptoms-free interval on the treadmill, ankle-arm arterial pressure gradient, oscillographic index, venous occlusion plethysmography and any untoward reactions. Changes were observed in the pain-free interval (p less than 0.005), and in the venous occlusion plethysmography (p less than 0.001) in the patients treated with the two drugs in association.
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PMID:Treatment of claudication with dipyridamole and aspirin. 351 94

Peripheral vascular disease is a chronic progressive disease. Nursing intervention will be aimed at primary prevention through risk factor modification. Quality patient care will be facilitated through the development of an individualized plan of care. An essential element to consider in promoting successful nursing intervention is collaboration of the nurse and patient when developing the plan of care. Overall goals of care for a patient with PVD include promotion of circulation, relief of pain, and prevention of tissue damage or infection.
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PMID:Nursing intervention in patients with peripheral vascular disease. 351 16

The effect of captopril was studied in 40 hypertensive patients (WHO stages I and II) with peripheral vascular disease of the lower limbs (Fontaine stages IIa and IIb). We assessed systolic and diastolic arterial pressure, heart rate in supine and upright position, relative and absolute pain free intervals, and ankle/arm pressure index at rest and after treadmill exercise test. In the first part of the study 20 patients were divided into two groups, one of which was treated with chlorthalidone (25 mg/day) and the other with captopril (50 mg two times a day) for 8 weeks. Statistically significant improvements were only obtained in the captopril-treated group. They concerned the ankle/arm pressure index at rest (P less than 0.05) and after exercise (P less than 0.05) and the absolute pain free interval (P less than 0.05) as well as systolic arterial pressure. Furthermore, 20 more patients were treated with captopril (50 mg two times a day) for 8 weeks, and improvements were found in ankle/arm pressure index at rest (P less than 0.01) and after exercise (P less than 0.001) and in relative and absolute pain free intervals (P less than 0.001) as well as in systolic and diastolic arterial pressure. These results indicate an increase in flow to the limbs of patients with vascular disease treated with captopril, and suggest that captopril is an effective drug without contraindications for the treatment of hypertension associated with claudication.
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PMID:Captopril in the treatment of hypertension associated with claudication. 353 62

Wash-out of 133xenon from a local depot in the subcutaneous adipose tissue in the forefoot was measured continuously during 24 hours on subsequent recordings in 51 feet (normal circulation: 10, intermittent claudication: 22 and ischaemic nocturnal rest pain: 19) with a mean time interval of 26 days (range: 3-90 days). The patients were studied under two different conditions. Firstly, during the day in the erect position, awake (sitting, standing and quiet walking) and secondly, during night hours in the supine position, asleep. The coefficient of variation of nocturnal adipose tissue blood flow was calculated to 10%, and for the ratio of blood flow from day to night to 5%. The method is thus considered apt as a monitor in the treatment of peripheral vascular disease, for example, surgery and medical therapy. As predominant source of error is the formation of oedema.
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PMID:Subcutaneous adipose tissue blood flow in the forefoot during 24 hours. Labeling pattern and reproducibility. 358 86

The distribution between carnitine and the acyl derivatives of carnitine reflects changes in the metabolic state of a variety of tissues. Patients with peripheral vascular disease (PVD) develop skeletal muscle ischemia with exertion. This impairment in oxidative metabolism during exercise may result in the generation of acylcarnitines. To test this hypothesis, 11 patients with PVD and 7 age-matched control subjects were evaluated with graded treadmill exercise. Subjects with PVD walked to maximal claudication pain at a peak O2 consumption (VO2) of 19.9 +/- 1.3 ml X kg-1 X min-1 (mean +/- SE). Control subjects were taken to a near-maximal work load at a VO2 of 31.3 +/- 1.0 ml X kg-1 X min-1. In patients with PVD, the plasma concentration of total acid-soluble, long-chain acylcarnitine and total carnitine was increased at peak exercise compared with resting values. Four minutes postexercise, the plasma short-chain acylcarnitine concentration was also increased. In control subjects taken to the higher work load, only the long-chain acylcarnitine concentration was increased at peak exercise. In patients with PVD, plasma short-chain acylcarnitine concentration at rest was negatively correlated with subsequent maximal walking time (r = -0.51, P less than 0.05). In conclusion, acylcarnitines increased in patients with PVD who walked to maximal claudication pain, whereas control subjects did not show equivalent changes even when taken to a higher work load. The relationship between short-chain acylcarnitine concentration at rest and subsequent exercise performance suggests that repeated episodes of ischemia may cause chronic accumulation of short-chain acylcarnitine in plasma in proportion to the severity of disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Carnitine metabolism during exercise in patients with peripheral vascular disease. 361 Sep 32

In a series of 38 consecutive patients with advanced peripheral vascular disease (i.e. rest pain) reconstructive vascular surgery was performed with the distal anastomosis below the knee. Ankle/arm pressure index (AAI) was 0.28 (0.11-0.47) preoperatively; accumulated graft patency rate was 0.47 (SD = 0.08) after one year, after three years 0.22 (SD = 0.08). At follow-up (June 83) 34 patients were still alive, 11 patients with patent grafts and an AAI of 0.87 (0.74-1.01). During the study 19 patients required amputation. Seven patients had an occluded graft, but had avoided amputation. Although the prognosis in regard to graft patency is poor, we still suggest that distal vascular surgery should be considered prior to primary amputation.
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PMID:Reconstructive vascular surgery below the knee. 370 22

A method for measuring blood flow below the knee during reactive hyperaemia induced by 3 min of arterial occlusion has been developed. Subjects are positioned with lower limbs within the field of view of a gamma camera and pneumatic cuffs are placed below the knees to isolate the blood and induce a hyperaemic response. The remaining blood pool is labelled with 99Tcm-labelled red cells. Blood flows have been derived from the initial gradients of time-activity curves and from equilibrium blood sampling. The technique has been validated using a tissue-equivalent leg phantom and peristaltic pump. The method has been applied to a small group of patients with peripheral vascular disease and to normal controls. The mean value (+/- SD) of limb perfusion for normal controls was found to be 16.4 +/- 3.0 ml/100 ml/min and for patients with intermittent claudication was 5.1 +/- 2.6 ml/100 ml/min. Flow measurements are found to correlate with clinical findings and with symptoms. Reproducibility (established by repeated measurements) is high. The method is well tolerated even by patients suffering from rest pain.
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PMID:The measurement of limb blood flow using technetium-labelled red blood cells. 370 52

The effect of continuous i.v. infusion of pentoxifylline, administering 1,200 mg/24 hours through 15 days, was studied in 22 patients (19 m, 3 f) with arteriographically confirmed extensive occlusion in the femoro-popliteal segment, associated with marked intermittent claudication and rest pain of varying severity. The following parameters were used for the verification of the therapeutic response: Flow resistance factor (RF), pressure indices at rest (RPI) and after exercise (PPI) and recovery time (RT) assessed by means of ultrasonic Doppler technique; muscle and skin blood flow at rest and after exercise using 99m Technetium Clearance Technique (TC); toe skin temperature (TST) by electric thermometer; painfree walking distance (WD) assessed on treadmill (horizontal, 4 km/h); rest pain (RP) was assessed by a 4-step-relief-scale. There was an overall good response to treatment, the studied parameters showing the following changes: RF improved in 12/17 patients (= 70%); RT decreased in 14/22 patients (= 63%) RPI and PPI showed no change; TC (muscle) increased after exercise in 17/22 patients (= 77%); TC (skin) increased after exercise in 20/22 patients (= 90%); WD increased on average by 80% (from 115 m to 206 m); TS increased in 16 limbs; RP showed an overall relief. The results of this study indicate that the continuous infusion of pentoxifylline is safe and effective in improving the condition of patients with severe peripheral vascular disease.
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PMID:Continuous infusion treatment with pentoxifylline in patients with severe peripheral vascular occlusive disease. 374 May 45


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