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)

Inability to accurately diagnose infection in granulocytopenic patients is a major cause for morbidity and mortality, and prompted this study of 344 infections (pharyngitis, skin infection, pneumonia, anorectal infection, and urinary tract infection) in a select group of cancer patients. Strikingly similar alterations in clinical presentation were found for all infections that developed in profoundly granulocytopenic patients. Physical findings of exudate, fluctuation, ulceration or fissure, local heat, swelling, and regional adenopathy were all less prevalent in the granulocytopenic patient, while fever was much more common. Only erythema and local pain or tenderness were present in practically all patients regardless of site of infection or level of granulocyte count. A better understanding of how granulocytopenia affects the presentation of infection should lead to earlier and more accurate diagnosis and potentially to more successful therapy.
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PMID:Clinical presentation of infection in granulocytopenic patients. 105 68

Intensive leukapheresis has been used as the initial treatment of chronic granulocytic leukemia (CGL) in six patients. The number of leukaphereses ranged from 3 in 7 days to 13 in 39 days (mean, 8 in 22 days). The procedures were well tolerated, and in all patients there was improvement in hematologic values, in most cases with considerable reduction in the peripheral leukocytosis and thrombocytosis and in the proportion of immature granulocytic cells in the circulation. Splenomegaly decreased considerably in the four patients who had more than four leukaphereses. Symptoms of sweating, malaise, and pain due to splenomegaly were rapidly relieved. Problems due to hyperuricemia did not occur, but four patients required blood transfusions for correction of anemia. This method of initial treatment of CGL appears to give more rapid relief of symptoms than does conventional chemotherapy; it incurs no risk of hyperuricemia and lessens that associated with thrombocytosis. In addition, large quantities of granulocyte-rich plasma are made available for the treatment of infections in neutropenic patients. Intensive leukapheresis deserves more widespread evaluation as the initial treatment of CGL.
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PMID:Intensive leukapheresis as initial therapy for chronic granulocytic leukemia. 106 Apr 70

The results of surgery in 14 immunosuppressed patients with 17 anorectal abscesses are presented. Abscess incision was followed by almost immediate relief of pain. Healing was obtained in 15 cases, but two patients died of causes unrelated to surgery. Symptoms, therapeutic possibilities and prognosis are discussed. The authors conclude that surgery should be performed in all cases to prevent development of septicemia. Fluctuation should not be awaited, but surgery should be minimized if granulocyte and platelet counts are low. Each patient must be managed individually, according to the nature of malignant disease, general state of health and degree of immunosuppression. Antibiotic cover is important, and primary closure of the abscess cavity should never be attempted.
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PMID:Anorectal abscesses in immunosuppressed patients. 134 42

Defects in neutrophil adhesion and migration may contribute to the susceptibility to infection seen in sickle cell anaemia (SCA). These dynamic defects may be influenced by abnormalities in blood rheology found in this disorder. A whole blood model was used to study neutrophil adhesion in SCA patients: neutrophil adhesion to protein coated glass was quantitated by measuring the rate of disappearance of neutrophils from heparinized whole blood circulating through a perfusion chamber. Twenty-three adult patients (Hb SS) were studied in asymptomatic steady state, of whom nine were also studied during pain crisis, both before and 4-7 d after conventional therapy. Red cell and granulocyte filterability and whole blood and plasma viscosity were also measured. The half-time for disappearance from the perfusion system (t1/2) of neutrophils from patients in the steady-state was 93.5 +/- 8.4 min, compared to 49.1 +/- 2.8 min in normal age-matched controls (P = 0.001). In crisis t1/2 was further prolonged to 170.0 +/- 16.1 min (P = 0.01 v. steady state). After therapy, t1/2 decreased to 57.0 +/- 4.5 min (P = 0.001 v. pre-therapy state and P = 0.009 v. steady state) and was comparable to Hb AA controls. These findings reveal a neutrophil adhesion defect in SCA which worsens in crisis but is corrected following supportive therapy. Red cell filterability (expressed as average resistance to flow and pore-clogging particles) and white cell filterability (expressed as pore-clogging particles) were also abnormal in SCA and were found to correlate with neutrophil adhesion. Plasma viscosity also correlated with adhesion t1/2. The defect appears to be related to abnormal blood flow properties in SCA but the rheological factors cannot fully explain either the steady-state defect or the marked changes in neutrophil adhesion during crisis.
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PMID:Abnormal neutrophil adhesion in sickle cell anaemia and crisis: relationship to blood rheology. 187 28

1,2-Dimethyl-3-hydroxypyrid-4-one (L1) has been given daily for 1-15 months to 13 transfusion dependent iron loaded patients. No significant change occurred in liver, renal or cardiac function, ECG and radionucleotide angiocardiogram, in audiometry tests and in visual function and electrical retinography. No skin rashes, gastrointestinal symptoms and no neurological changes that could be detected clinically were observed. Two of the patients died of their underlying diseases. One patient had severe cardiac abnormalities before receiving L1 and died of congestive heart failure with infections 5 weeks after stopping a 2-month course of L1. The other, a patient with myelodysplasia suffered recurring infections due to progression of the disease. Joint and muscle pains occurred in five patients. In two these disappeared despite continuing the drug; another patient developed swollen ankle joints which gradually resolved on stopping L1 therapy; a patient with underlying osteoarthritis complained of mild pain and stiffness in her knees which remained intermittent both on and off the drug while in the fifth patient peripheral small joint swelling and pain present before starting L1 improved with L1 therapy. One patient, with Blackfan Diamond anaemia, developed a Lw red cell antibody 6 months after commencing L1. This disappeared on stopping the drug and did not reappear. She then developed severe agranulocytosis and thrombocytopenia 6 weeks after recommencing L1 after 3 months discontinuation of the drug. No other patient showed a change in granulocyte or platelet count.
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PMID:Long-term trial with the oral iron chelator 1,2-dimethyl-3-hydroxypyrid-4-one (L1). II. Clinical observations. 209 34

Congenital agranulocytosis is a disorder characterized by severe neutropenia and a profound deficiency of identifiable neutrophil progenitors in bone marrow. In an attempt to stimulate neutrophil production and thereby reduce the morbidity and mortality associated with this disease, we administered recombinant human granulocyte colony-stimulating factor (rhG-CSF) in doses of 3 to 60 micrograms per kilogram of body weight per day to five patients with congenital agranulocytosis. In all five patients, an increase in the number of neutrophils was noted eight to nine days after the initiation of the effective dosage (the dose at which the neutrophil count reached 1000 cells per microliter or more and the bone marrow showed granulocyte maturation beyond the myelocyte stage). The absolute neutrophil counts rose from less than 100 to between 1300 and 9500 cells per microliter. Marrow aspirates obtained after 14 days at the effective dosage showed maturation to the mature neutrophil stage. The side effects that were observed were medullary pain, splenomegaly, and an elevation of levels of leukocyte alkaline phosphatase. All five patients have had sustained neutrophil counts of 1000 cells per microliter or more for 9 to 13 months while receiving subcutaneous maintenance therapy. Preexisting chronic infections have resolved clinically, and the number of new infectious episodes and the requirement for intravenous antibiotics have decreased. We conclude that treatment with rhG-CSF can lead to a large increase in the numbers of functional neutrophils in patients with congenital agranulocytosis.
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PMID:Effects of recombinant human granulocyte colony-stimulating factor on neutropenia in patients with congenital agranulocytosis. 247 Oct 75

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

Because they can obstruct blood vessels and release noxious substances, white blood cells may contribute to the development of tissue ischaemia. The flow properties of white cells were tested after myocardial infarction, by measuring the filtration rates of cell suspensions through 8 microns pore filters. Compared with mononuclear cells from age matched controls, mononuclear cells from patients with infarction showed impaired filterability within the first day after the onset of pain; this condition persisted for at least two days and by day 10 it was improved. On day 1, granulocyte filterability and the proportion showing morphological evidence of activation were nearly normal. By day 3 the flow resistance and activation had increased, but the changes seen depended on the age of the patient. The filterability and activation of granulocytes from patients aged less than 60 were significantly increased from day 1, whereas there were no changes in granulocytes from patients aged greater than 60 years. Suspensions of unfractionated white cells showed changes intermediate between the mononuclear cells and granulocytes. A group of five patients who presented with chest pain but who were subsequently found not to have had an infarction showed no evidence of abnormal filterability or activation. The changes in filterability probably reflect white cell activation, which may have an adverse effect on the perfusion of the ischaemic myocardium.
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PMID:Changes in the flow properties of white blood cells after acute myocardial infarction. 259 May 86

L1 is a major granulocyte and monocyte protein. It is released during leukocyte activation, and the plasma level is thought to reflect the inflammatory activity. Fifteen patients with classical or definite rheumatoid arthritis were examined monthly during one year. The laboratory tests included L1, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), orosomucoid, haptoglobin, ceruloplasmin, alpha 1-antitrypsin, immunoglobulins and blood cell counts. The clinical tests included articular index, grip strength, morning stiffness and pain. The L1 protein was found to have highly significant correlations (p less than 0.0001) with orosomucoid (r = 0.86), CRP (r = 0.79), ESR (r = 0.78), haptoglobin (r = 0.75), alpha 1-antitrypsin (r = 0.63) and ceruloplasmin (r = 0.44). Significant correlation was also found between L1 and IgA. None of the laboratory variables showed significant correlation with pain, but when they were correlated with articular index, grip strength and morning stiffness, L1 was found to have the highest average correlation coefficient (p less than 0.0001).
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PMID:A longitudinal study of the leukocyte protein L1 as an indicator of disease activity in patients with rheumatoid arthritis. 260 Sep 39

Leucocytes have been implicated in the development of tissue ischaemia. No studies on leucocyte rheology and activation in the earliest stages of controlled ischaemia in Peripheral Vascular Disease (PVD) exist. Blood samples were taken from 15 PVD patients and 15 matched controls before and after treadmill exercise (5 mins/2 km/hr/12% slope). Leucocytes were separated by density and adherence into their granulocyte, lymphocyte and monocyte sub-populations and their filterability rates through 5 micron diameter pore filters were measured. Leucocyte activation as observed under a light microscopy was monitored. Compared to controls, calf pain in the PVD patients was associated with a significant (p less than 0.001) increase (+22%) in monocyte filterability but not in leucocyte activation.
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PMID:Peripheral vascular disease: role of leucocyte rheology and activation during controlled ischemia. 280 Jun 79


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