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)

Commercial sources for neuropeptide radioimmunoassays have made this sensitive tool available to clinical investigators for monitoring the potential involvement of neuropeptides in pain modulation. We measured substance P-like immunoreactivity in the plasma, saliva, and pericardial fluid of subjects with and without pain (chronic and acute) to determine if substance P levels are altered. Some recent studies have suggested that substance P in various body fluids may be a correlate of chronic pain. To test this correlation it is important to ensure that the assay is measuring what it was designed to measure. Therefore, the influence of three tachykinins on the analysis of substance P concentrations was assessed with a commercially available radioimmunoassay kit. A small (approximately 2 to 6%), apparently nonspecific elevation in measured substance P was found when alpha-neurokinin, beta-neurokinin, or eledoisin was incubated with substance P and its antibody. Our results also indicate an apparent specific affinity of the substance P antibody for alpha-neurokinin (above 1,000 pg/ml) and beta-neurokinin (above 5,000 pg/ml). Substance P levels in the body fluids we tested ranged from 0.47 to 62.88 pg/mg protein (47.4 to 230.8 pg/ml). Levels of the tested tachykinins have not been determined in body fluids. If alpha-neurokinin or beta-neurokinin is found to be present in high concentrations in these fluids, this commercially available substance P kit may overestimate substance P levels. The concentrations of tachykinins necessary to interfere specifically with the assay are 10- to 100-fold higher than substance P in body fluids.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effects of neurokinin A, neurokinin B, and eledoisin on substance P analysis. 171 34

A case of profound digital vasoconstriction caused by the accidental injection of epinephrine from a commercial bee sting kit is reported. One hour later the patient had a cold, painful, blanched finger. A digital block using a 2-mg dose of phentolamine mixed with 2% lidocaine was performed. Thirty minutes after treatment, the finger was pink and warm. The patient reported a marked decrease in pain. Reexamination 12 hours later showed only mild tenderness at the fingertip. No tissue necrosis occurred. One month after injection, there were no apparent sequelae. Although the use of alpha-adrenergic blocking agents by regional infiltration to treat accidental infusion or extravasation of epinephrine has been suggested, no reports of this technique are found in the emergency medicine literature. The mechanism of digital vasoconstriction and the action of phentolamine are discussed.
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PMID:Epinephrine-induced vasospasm reversed by phentolamine digital block. 229 35

Thirty infants scheduled for a variety of gastrointestinal, genitourinary and thoracic surgical procedures were selected for insertion of lumbar or thoracic epidural catheters via the caudal approach using either an Intracath or a Burron continuous brachial plexus kit. The catheters were inserted with ease by residents in training and no catheter-related complications were encountered. Lidocaine 0.5 per cent with 1:200,000 epinephrine was then injected to assure proper placement of the catheter before narcotics were administered. Postoperative analgesia was adequate in all patients using preservative-free morphine 0.05 mg.kg-1. The mean dosing interval was 15 hr and no episodes of nausea, vomiting, hypotension or histamine release were noted. Urinary retention occurred in two infants and one infant became apnoeic three hours after epidural morphine administration but responded to naloxone and pulmonary ventilation with bag and mask. In conclusion, epidural catheters placed via the caudal approach are a safe and effective means of providing postoperative pain control in infants using preservative-free morphine. However, the use of epidural narcotics in infants less than two years of age is restricted to those who will receive intensive care unit monitoring postoperatively so that if apnoea occurs, rapid intervention can be taken by skilled nursing personnel.
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PMID:Lumbar and thoracic epidural analgesia via the caudal approach for postoperative pain relief in infants and children. 232 73

153Sm-EDTMP (ethylenediaminetetramethylene phosphonate), prepared from a kit, was administered to 28 patients in a clinical trial of therapy for painful skeletal metastases unresponsive to all conventional treatment. The 103 keV gamma emission of 153Sm was utilized for prospective individual estimation of beta radiation absorbed dose to red marrow to minimize myelotoxicity and provide optimum internal radiotherapy to skeletal metastases in each patient. Pain relief occurred within 14 days of administration of 153Sm-EDTMP in 15 of 19 patients (79%) who could be evaluated at 6 weeks, when clinical response was maximal. Duration of response ranged from 4 to 35 weeks. Recurrence of pain responded to retreatment with 153Sm-EDTMP in five of eight cases. No dose-response relationship was apparent for pain relief but reversible myelotoxicity was frequently observed at radiation absorbed doses to bone marrow greater than or equal to 270 cGy. Dosimetry calculation was based on pharmacokinetic studies of a tracer administration of 153Sm-EDTMP in each patient. Assumptions inherent in this prospective method of predicting dose to bone marrow were validated experimentally. Biodistribution studies in rats demonstrated rapid skeletal uptake and long term retention of 153Sm-EDTMP in bone over 5 days. Urinary clearance accounted for 40% of injected dose, and less than 1.0% of administered activity was retained in non osseous tissue. Microdensitometry of autoradiographs of sheep vertebra and femur confirmed surface uptake of 153Sm-EDTMP in cortical bone and demonstrated relatively high trabecular bone activity which is the major component of radiation absorbed dose to bone marrow. Haematological studies in rabbits showed 153Sm-EDTMP-induced myelotoxicity to be transient and no histopathological abnormalities were demonstrable with doses ten times greater than those administered to patients.
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PMID:Samarium-153 EDTMP therapy of disseminated skeletal metastasis. 248 38

The value of several serological tests was assessed by studying sera from 30 women with clinical findings of perihepatitis and a high chlamydial antibody titre in the indirect immunofluorescence antibody test (IFAT). The other tests included the complement fixation test and enzyme immunoassays in which the antigen comprised either partially purified particles (EIA kit) or purified major outer membrane protein (MOMP EIA) of Chlamydia trachomatis L2 or lipopolysaccharide isolated from an Re mutant of Salmonella (Re LPS EIA). High IgG titres were noted in most (88-96%) of the patients by MOMP EIA and EIA kit, and in fewer patients (50%) by Re LPS EIA or complement fixation test. Seroconversion was found in 11-44% of the patients for IgG and in 28-36% for IgM; high IgG titre was thus the best diagnostic indicator for each test. The enzyme immunoassay tests have the advantage of being automated either with partially purified corpuscular or purified MOMP antigen and would allow a sensitive easy screening for chlamydial aetiology of women with pain of the right upper quadrant.
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PMID:Comparative sensitivity of different serological tests for detecting chlamydial antibodies in perihepatitis. 389 92

Delay in diagnosis of ectopic pregnancy is responsible for the high maternal mortality associated with this condition. This study examines clinical and laboratory data collected prospectively from October 1979 to evaluate factors which led to a delay in diagnosis of ectopic pregnancy. 76 patients admitted for laparoscopy with a provisional diagnosis of ectopic pregnancy at the King Edward Memorial Hospital comprised the study group. B-HCG values were made using a standard commercial kit used for radio immunoassay. Ectopic pregnancy was confirmed in only 30 of 76 patients by laparoscopy. 23 of 30 patients (77%) were sent home after presenting with symptoms related to ectopic pregnancy. All patients with ectopic pregnancy had elevated plasma B-HCG values. The finding of a B-HCG value of 2.5 i.u./L could have allowed 36 of the patients to avoid diagnostic laparoscopy. However, the procedure may still be necessary if the pain becomes chronic or significant abdominal signs develop. B-HCG values between 2.5 and 10 i.u./l should be repeated. Ultrasound may be used in the presence of elevated values but caution must be exercised if ultrasound defines an intrauterine 'sac' in the absence of embryonic echoes. A rapid (1-2 hours) B-HCG assay will minimize the number of incorrect diagnosis made on patients with ectopic pregnancy.
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PMID:Problems in the diagnosis of ectopic pregnancy. 645 80

Using a diagnostic kit N.E.N. (USA) the authors investigated beta-endorphin-like immunoreactivity in the plasma of young, healthy subjects. It was found that the level of beta-endorphin determined in this way in 10 subjects ranged from 15 to 120 pgml-1 and showed relatively constant values in two determinations carried out at an interval of one hour. Psychological tests showed that subjects with low beta-endorphin level had a low neuroticism index and extra-version, while in the subjects with high beta-endorphin level the neuroticism index was high and introversion features were more prevalent. After application of a painful stimulus (ischaemic test) the level of beta-endorphin changed in most subjects increasing or decreasing. The comparison of the differences in the levels of beta-endorphin immediately before and after the test for pain tolerance suggests that the higher was this difference the lower was pain tolerance and conversely.
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PMID:[Plasma beta-endorphins under the effect of pain stimulus. Preliminary report]. 741 89

Both hands of 39 patients who had symptoms of pain and/or numbness in one or both hands were tested by two hand therapists using the full kit of Semmes-Weinstein monofilaments (SWMFs). The SWMF thresholds were obtained for the thumb, the index finger, and the long and small fingers. These thresholds were classified as normal or abnormal based on four decision rules and two criterion measures. Decision rules were based on whether SWMF 2.83 or 3.22 would be the best limit of normality, and whether the small finger should be used for within-subject comparisons. The criterion measures were the highest threshold of all three radial digits and the highest threshold of the long finger alone. Intertherapist agreement on normality was fair to moderate (kappa = 0.22-0.51), varying according to decision rules and criterion measures. Reliability was higher when the additional comparison with the small finger was omitted. High accuracy in identifying cases of carpal tunnel syndrome (CTS) was possible, but accuracy varied moderately between testers and greatly according to decision rules and criterion measurements. The best overall accuracy (81%-82% sensitivity and 57%-86% specificity) was achieved when SWMF 2.83 was used as the upper limit of normality and the small finger was used for within-subject comparison, and when data from the long finger alone were used for decision making.
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PMID:Decision making in detecting abnormal Semmes-Weinstein monofilament thresholds in carpal tunnel syndrome. 795 7

Since their aparition in 1980, percutaneus endoscopic gastrostomy (PEG), represented a dramatic impact in the enteral nutrition thecnics and their indication have expanded. The PEG have many advantages over the surgical gastrostomy. In this paper, we present our experience with the use of PEG in patients with head and neck cancer using a new home made gastrostome. Included were 61 patients 37 males (64.8%), 21 females (36.2%) with ages betwen 11 and 72 years. In 3 patients the PEG was not intended because tight esophageal stenoses. The PEG was completed in 56 cases (91.8%). In 5 patients (8.6%) there were minor complications (4 infections and 1 patient with pain). We have only one case of major complication which consisted in migration of gastrotome to the abdominal wall (Buried Bumper Syndrome). The gastrostome was patent between 15 and 312 days with a median of 125 days. The gastrostomies was made with siliconed 22Fr Foley catheter, crazy glue, and plastic tops. The Foley catheter is acid resistant and not deteriorate like other materials like latex. There was not adverse reaction at the ostomy site. The cost of the kit is about 11 US$ and the commercial kit is 125 US$, on the other hand the internal diameter is 15% wider than the commercial one.
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PMID:[Percutaneous endoscopic gastrostomy in patients with head and neck neoplasms. Evaluation of a new gastrostomy]. 876 57

This chapter summarized the information available on the pharmacological kits onboard spacecraft and on the use of drugs in space, while the next chapter is dedicated to the impacts of weightlessness on drug pharmacokinetics. The need of a selected group of drugs for the use of astronauts during short-term and long-term spaceflights has been discussed. Recommendations are made for a Space Pharmacopoeia as well as for the areas of research needed to adapt medication to the weightlessness of the space environment. Although the usefulness of these drugs has been clearly demonstrated, their use also raises several problems. Physiological changes due to weightlessness may induce changes in pharmacokinetic behavior of drugs and influence their dosage regimen. Inflight data obtained by salivary drug monitoring have shown changes in the distribution of scopolamine and a significant change in the disposition of the common pain-relief agent acetaminophen taken inflight, in both drug concentration and time course. The authors of this study emphasize, however, that their data are preliminary and as yet incomplete. Further simulation studies and, if possible, inflight experiments are required. In vitro studies of the antibacterial activity of antibiotics under space conditions have shown an increased resistance of Escherichia Coli to colistin and kanamycin, and a lowered resistance of Staphylococcus Aureus to oxacillin, chloramphenicol, and erythromycin. The possible consequences of these findings for the treatment of infections contracted by astronauts are yet to be elucidated. There is still a lack of pharmacological countermeasures, particularly for preventing the progressive bone demineralization occurring in weightlessness. The treatment of space motion sickness with drugs carries with it the problem of undesirable side-effects on psychomotor performance. In order to arrive at the most appropriate medical kit for a particular mission, the best trade-off of risk versus benefit for the individual and the mission must always be attempted for any pharmacological agent.
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PMID:Pharmacology in space: pharmacotherapy. 904 35


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