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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study indicates that external electrical stimulation is a valuable tool for control of acute pain in about 80 percent of patients but, for significant relief of pain, in only about 25 percent of patients with chronic pain. The author recognizes that in order to increase its use, a system for delivery of this therapy under a doctor's prescription, rather than having to teach each individual practitioner the technique for using the device, must be developed. In chronic-pain patients when external electrical stimulation is inadequate, a more aggressive and comprehensive program of operant conditioning, progressive physical exercise, drug withdrawal, autogenic training, and biofeedback is advised.
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PMID:The viability of external electrical stimulation as a therapeutic modality. 108 Nov 83

Dihydroergokryptine has been evaluated in the prophylaxis of headache attacks in patients with migraine without aura. The study was controlled vs dihydroergotamine with a double-blind crossover design. After a 1-month run-in period, 30 patients were randomized into two groups and submitted to 4 months treatment with dihydroergokryptine 10 mg b.i.d. or dihydroergotamine (controlled release) 5 mg b.i.d. The treatment was repeated in crossover after 2 months washout. The clinical patients' evaluation was determined by monthly Pain Total Index recording, headache days/month and analgesic consumption. The patients were considered responsible when Pain Total Index decreased by 50% or more in 1 or more months of each treatment period; otherwise the patients were considered unresponsive. The response rate to dihydroergokryptine was 66% while 48% of cases were responsive to dihydroergotamine. The response rate to both treatments was 41%, while 26% did not respond to either treatment. Seven cases unresponsive to dihydroergotamine responded positively to dihydroergokryptine while two cases only, resistant to dihydroergokryptine, responded positively to dihydroergotamine. Three cases dropped out during treatment with dihydroergotamine due to gastric pain and nausea, while they did not show any side effects during dihydroergokryptine therapy. During treatment with dihydroergokryptine there was one case of skin rash which disappeared after drug withdrawal. In conclusion, dihydroergokryptine appears to be an effective drug for the prophylaxis of migraine attacks.
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PMID:Dihydroergokryptine versus dihydroergotamine in migraine prophylaxis: a double-blind clinical trial. 190 3

In order to examine its clinical efficacy, recombinant human interferon-beta (rIFN-beta) was instilled intravesically into 51 patients with superficial bladder cancer. Ten patients, who received intermittent intravesical instillation at a dose of (3-36) x 10(6) U rIFN-beta on days 1-3 every week, showed no response. Thirty-two patients received intravesical instillation at a dose of (3-36) x 10(6) U every day for 10-20 days. Eight patients showed partial response, indicating an efficacy rate of 25%. Nine patients received divided doses of 18 x 10(6) U twice a day every day for 10-20 days. Six patients showed partial response, indicating an efficacy rate of 67%. This value was significantly higher than that obtained by administering divided doses. The response to intravesical instillation therapy with rIFN-beta varies with treatment protocol. Frequent and longer exposure to rIFN-beta may induce better regression of superficial bladder cancer. Six incidences of side-effects were found in five cases (9.8%): pollakiuria in one, pain on micturition in two, fever in two, and eruption in one case. All of these side-effects were slight and reversible after drug withdrawal. Laboratory tests showed only a few changes with low severity. Thus, rIFN-beta is potentially a new drug for instillation therapy of superficial bladder cancer, in view of the absence of adverse effects.
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PMID:Intravesical treatment of bladder cancer with recombinant human interferon-beta. Intravesical GKT-beta Chemotherapy Research Group. 259 81

One hundred and twenty-four (71%) of 173 patients, admitted consecutively to the Inpatient Service of the University of Washington Multidisciplinary Pain Center, were consuming narcotic/sedative drugs and 49 (29%) were not. We describe the use of a drug withdrawal protocol entailing outpatient drug consumption diaries; a 48 h inpatient drug profile; the use of drug equivalence tables to convert drugs consumed to a methadone/phenobarbital pain cocktail and the subsequent tapering of the active contents of the pain cocktail. Diaries reliably revealed the types of drug consumed but not extent of consumption. Narcotic consumption in particular tends to be underreported. For patients with a history of a drug problem and those who consume narcotics heavily during the first day of profile, a 48 h profile is appropriate. In others a 24 h profile is safe. Objective signs of excessive consumption or a withdrawal syndrome were noted in 2 patients during the profile period and in 4 patients during the taper from pain cocktail. Published tables appear to give a reasonable estimate of drug equivalence. The importance of monitoring patients during the protocol is emphasized.
Pain 1986 Aug
PMID:Medication management in patients with chronic non-malignant pain. A review of the use of a drug withdrawal protocol. 287 6

The cases of a 43 years old-man with gout and a 24 years-old woman with severe back pain who developed dextro-propoxyphene addiction during pain treatment are reported. They had severe edema and fibrosis of skin, subcutaneous tissue and muscle involving the upper and lower limbs. ESR was elevated, CPK and LDH were normal. EMG in proximal muscles showed decreased duration and voltage of potentials, excess of short polyphasics and increased recruitment (BSAP), with positive waves and fibrillations; distal muscles had fasciculations, fibrillations, positive waves, normal voluntary potentials, decreased recruitment. Lymphography indicate delayed progression of contrast media and obstruction in the thighs. Muscle biopsy on fresh-frozen section and histochemistry showed extensive connective tissue proliferation with intense acid and alkaline phosphatase activity in the perimysial and endomysial area, infiltration of lymphocytes near and around small vessels and capillaries. There were perifascicular and type II fiber atrophy. After discharge the patients returned to propoxyphene addiction and the symptoms who subsided during drug withdrawal come back again. New admission, new drug withdrawal and they were discharged free of symptoms and pathologic changes.
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PMID:[Myopathy caused by propoxyphene: report of 2 cases with muscle histochemistry]. 616 47

One may conclude from this series of studies and the data of others reviewed at this symposium that NE systems are involved in fear or anxiety and in mediating the actions of opioids and endorphins. It is rational pharmacotherapy, therefore, to utilize anatomically and neurophysiologically characterized receptors to produce those desired specific effects on NE systems that are expected to reduce anxiety. These same receptor interactions could also be used to antagonize side effects or to reverse withdrawal syndromes via alternative receptor sites. This strategy of using different receptors to produce synergistic or antagonistic effects on a common neuronal pathway has benefited the treatment of pathological anxiety, pain, drug withdrawal symptoms, and other classical psychosomatic conditions. It should be emphasized, of course, that the LC-noradrenergic system has a much broader function than the mediation of fear or anxiety, and that the endorphins, opiates, and clonidine influence many other systems, as do their abstinence syndromes. Anatomical projections of the LC and similar central NE systems also produce the observed effects. Detailed studies are needed to discover precisely how the abnormalities observed in numerous biochemical systems [Eidelberg, 1976] are related to the alterations in NE function we have studied and discussed in this chapter. Finally, careful clinical studies are needed to determine, define, and delimit the potential therapeutic uses of clonidine in the areas suggested by the preliminary studies reviewed here.
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PMID:Clonidine and the primate locus coeruleus: evidence suggesting anxiolytic and anti-withdrawal effects. 627 92

43 patients with osteoarthritis of the knee and/or hip(s) were treated with suprofen 800 mg/day or ibuprofen 1,600 mg/day for 14 days. Both drugs produced an improvement in subjective symptoms by day 7, although the most rapid analgesic effect was obtained with suprofen. Patients receiving suprofen experienced a significantly greater improvement in pain on motion at day 7 than did patients taking ibuprofen. Patients and investigators evaluated both drugs as having good to very good efficacy in the great majority (over 75%) of cases. Both drugs were well tolerated, with only a single drug withdrawal in the ibuprofen group.
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PMID:Comparison of suprofen and ibuprofen in the treatment of pain secondary to osteoarthritis. 636 90

Thirty-seven arthritis patients participating in a drug withdrawal trial, simultaneously completed a 20-point visual analogue scale and 7-point verbal rating scale for pain severity while on active medication and 48 hours following its withdrawal. The relationship between the two scales could be better approximated by a curve than a straight line, and further interpretation suggested that the relationship might be sigmoidal. This indicates that only the middle of the scales are linearly related with a lack of agreement occurring towards the upper and lower ends. Although the visual analogue scale proved superior to the verbal rating scale in its ability to detect changes in pain, until more is known about factors which influence subjective magnitude estimation, this conclusion must remain tentative. The implications of the findings to pain measurement are discussed.
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PMID:Problems associated with pain measurement in arthritis: comparison of the visual analogue and verbal rating scales. 652 75

The Johns Hopkins Pain Research and Treatment Program is based upon individual diagnosis, psychiatric evaluation, and individualized therapy. This is done within the framework of a concurrent program involving neurosurgeons, consulting physicians, psychiatrists, clinical psychologists, social workers and specialized nurses. The basic theme is self-help and self-responsibility. Drug withdrawal is mandatory, and an emphasis is placed upon psychotherapeutic techniques. Pain relieving procedures are available and utilized in a small number of patients.
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PMID:A comprehensive model for the study and therapy of pain: Johns Hopkins Pain Research and Treatment Program. 679 Oct 27

1 In patients with chronic pain, two types of analgesic drug dependence occur, that is, dependence of the barbiturate-type and of the morphine-type. Eighty cases of analgesic drug dependence of the barbiturate-type were examined. All these patients were dependent on drug combinations, not a single patient being on one analgesic alone. 2 Psychotropic agents were found to be the common pharmacological denominator of all abused preparations. These findings confirm the hypothesis that the addition of psychotropic or dependence-producing substances to analgesics is the crucial factor in the complex of mild analgesic drug abuse. 3 One group of patients with chronic pain, who were dependent on analgesic drug mixtures, had both lowered experimental pain thresholds and tolerances. After drug withdrawal, these parameters showed a tendency to increase in some patients.
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PMID:Abuse and paradoxical effects of analgesic drug mixtures. 743 79


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