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)

A total of 100 heterosexual adults of either sex with frequent episodes of recurrent genital herpes were allocated to treatment with either Genivir (DIP-253) 1% cream or placebo cream. All patients had genital herpes previously verified by a positive viral culture. The study was carried out as a double-blind parallel group trial. Fifty patients were allocated to each of the two treatment groups. The treatment was initiated within 24 hours after the first sign of a recurrence, and at the pretreatment examination all patients had developed typical lesions with blisters and/or sores. At baseline a sample for herpes virus culture and typing was obtained. The creams were applied four times daily for five days. Follow-up examinations were carried out on days 1, 2, 4 and if needed on days 7, 10 and 14. The major factor used for assessment of efficacy was the time to complete healing of all lesions. Duration of pruritus and pain were also recorded. In the group of patients treated with Genivir cream the time to complete healing was 3.3 days and in the placebo group 6.1 days. The difference was statistically significant (P less than 0.001). The mean duration of pain was 1.3 days in the Genivir group and 2.5 days in the placebo group: this difference also reached significance (P less than 0.01). The duration of pruritus was about the same in both groups. The active agent in Genivir, DIP-253, is a heterocyclic aromatic complex with confirmed anti-herpetic activity and with evidence of a local immunomodulatory effect. It was concluded that the efficacy of topical application of DIP-253 may be due to combined antiviral and immunomodulatory activities.
Int J STD AIDS 1990 Jan
PMID:Genivir (DIP-253) 1% cream versus placebo cream in the treatment of recurrent genital herpes: a double-blind study. 209 94

Risk factors for postcoital bleeding were examined in 475 women who were enrolled in a study of heterosexual transmission of human immunodeficiency virus (HIV). In bivariate analyses, history of sexually transmitted diseases (STDs; P = .03), HIV infection (P = .008), and dyspareunia or pain during intercourse (P = .0001) were significant risk factors. In multivariate analysis, the two latter factors remained significant (for HIV, odds ratio [OR] = 2.1, P = .02, 95% confidence interval [CI] = 1.1-4.0; for dyspareunia, OR = 3.5, P < .001, 95% CI = 1.8-6.6), as did the interaction term of STD history and heavy smoking (OR = 2.4, P = .02, 95% CI = 1.2-5.0). Pain during intercourse was the strongest predictor of postcoital bleeding but may be part of the same phenomenon. Similarly, because this study relied on cross-sectional data, the direction of the causal pathway linking HIV to postcoital bleeding cannot be established. However, these data suggest that smoking, a modifiable risk factor, may increase risk of postcoital bleeding and contribute to susceptibility for HIV and other STDs.
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PMID:Risk factors for postcoital bleeding among women with or at risk for infection with human immunodeficiency virus. 864 35

This is a retrospective review of 279 pelvic ultrasound examinations requested over 19 months by a department of GU medicine. An abnormal ultrasound was rarely seen in women with pain but no pelvic mass (16%). If a mass was found on bimanual palpation, the yield of abnormal ultrasound was much higher (52%). Pelvic ultrasound was also useful in refuting a diagnosis of ectopic pregnancy by demonstrating an intrauterine gestational sac.
Int J STD AIDS
PMID:The use of pelvic ultrasound in female patients attending a GUM clinic. 839 96

Distal transcutaneous oxygen pressure measurement (TcPo2) is a noninvasive method of evaluating tissular hypoxemia in peripheral arterial disease. The poststress area of hypoxemia is a usefull technique for globally quantifying different parameters represented by TcPo2 curves during exercise. Although its use is increasingly widespread, the reproducibility of this method is poorly documented. TcPo2 was monitored three times at twenty-four hour intervals in 5 patients with stage II obliterative arterial disease during a treadmill walking test. In order to get uniform measurement conditions, each patient remained lying and then stood until TcPo2 became stable. The stress duration was calculated so that the pain step could not be reached. TcPo2 curves were digitized and a specific image analyzer was used to make replicate measurements. The area under the curve was computed, the horizontal axis determining the mean TcPo2 value at rest, the vertical axis representing the end of the exercise period. The corresponding areas under the curves ranged from 34 to 2212 mm2 (573.60; SD 826). Significant correlation coefficients were obtained among replicate measurements (first-second day, first-third day). However, owing to the wide range of area values, the authors decided to compute and use the coefficient of variation (STD/mean), since it was more representative of reproducibility. The mean of its value for 5 patients was 21%. Observation of the examination conditions resulted in several findings, especially the ability of certain patients to adapt their efforts to the exercise. These results indicate that TcPo2 poststress area measurements are reproducible, but the conditions of the exercise have to be rigorously defined and may still be improved.
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PMID:TcPo2 measurement reproducibility during stress in stage II obliterative arterial disease. 861 4

A retrospective study was performed to assess the efficacy and low mucosal toxicity of intracavitary contact X-ray therapy (ICRT), a proposed treatment of small/medium sized lesions of oral HIV-associated Kaposi's sarcoma (HIV-KS). Twenty-six patients with histologically confirmed oral HIV-KS underwent ICRT in the period 1986-1995. No patient received antiblastic or interferon therapy during the radiotherapy or follow-up periods. ICRT was performed according to the usual technical modalities of contact X-ray therapy, but the end of the source of ionizing radiations was introduced into the oral cavity. The total doses administered ranged from 10 to 50 Gy per field, in one or two weekly fractions of 5 Gy each. The follow-up ranged from 1 to 44 months (mean 7.5 months). Complete remission was obtained in 20 cases (76.92%), partial remission in 6 (23.08%) and relapse in one case (3.84%). Pain was relieved in all cases. Mucosal reaction was mild and did not result in any interruption of treatment. Our data suggest that ICRT is an effective and well tolerated treatment. It can be used in the management of oral HIV-KS instead of external radiotherapy, provided that the size and the location of the lesions and the conformation of the palate are suitable to this technique.
Int J STD AIDS 1997 Sep
PMID:Intracavitary contact X-ray therapy of oral HIV-associated Kaposi's sarcoma. 929 48

A detailed assessment was completed on 150 consecutive new female patients attending a walk-in genitourinary medicine clinic, in order to elicit the features of vulval pain. Twenty patients (13.3%) experienced vulval pain, and of these, 15 (75%) had an infective cause demonstrated. Candidiasis was demonstrated in more than half (55%) of them and one-fifth had genital herpes. Of the 5 patients in whom no infection was present, 2 were diagnosed with the vulvar vestibulitis syndrome (VVS) following their referral to the dedicated vulval clinic.
Int J STD AIDS 1998 Feb
PMID:Prevalence, causes and outcome of vulval pain in a genitourinary medicine clinic population. 950 73

The objectives of this study were to describe the clinical and radiological features at presentation, and the natural history of HIV-related bronchopulmonary Kaposi's sarcoma. A retrospective review of medical records and chest radiographs was performed in 106 HIV-infected homosexual men with bronchopulmonary Kaposi's sarcoma diagnosed at bronchoscopy between September 1988 and November 1994. The majority of patients had evidence of advanced HIV disease at diagnosis (median CD4 cell count was 15 x 10(6)/l, range 0-288), and 93% had had a diagnosis of cutaneous Kaposi's sarcoma for a median duration of 11 months prior to diagnosis of their bronchopulmonary disease. The most frequent symptoms at presentation were cough (92%), dyspnoea (69%), pleuritic pain (20%), haemoptysis (13%) and wheezing (10%). The most common radiological finding in 73% of our series was of poorly defined and confluent opacities, with predominant middle and lower zone involvement. Median survival was 4 months (range 0-37 months) from diagnosis and 9 months (range 1-25) from the onset of symptoms. Treatment with either chemotherapy or radiotherapy was associated with a significantly reduced risk of death (hazards ratio (HR)=0.48, 95% CI=0.26-0.87). Factors associated with a poor survival, after adjustment for treatment effect were older age (HR=1.79, 95% CI=1.22-2.84) for each 10-year increase in age; a history of pleuritic pain (HR=2.97, 95% CI=1.39-6.32); presence of pleural effusion on X-ray (HR=2.01, 95% CI=1.13-3.59) and a prior diagnosis of cutaneous Kaposi's sarcoma (HR=1.8, 95% CI=1.00, 3.24). Bronchopulmonary Kaposi's sarcoma occurs mainly in patients with advanced HIV disease and a prior history of cutaneous disease. Survival is poor, and adverse prognostic factors include older age at diagnosis and the presence of pleural disease.
Int J STD AIDS 1998 Sep
PMID:Bronchopulmonary Kaposi's sarcoma in 106 HIV-1 infected patients. 976 35

Our aim was to determine country-specific attitudes and perceptions of patients with genital warts and to understand the psychosexual impact of the disease and its treatment. We used a standardized discussion guide to interview patients with genital warts in Canada, France, Germany, the UK, and the USA about their perceptions and concerns regarding the diagnosis, treatment, and psychosexual impact of the disease. Interviews were conducted in person and lasted approximately 30 min. The study group included 80 men and 86 women with genital warts. Forty-seven per cent were currently undergoing treatment. Overall, 49% of the men had first consulted a general or family practitioner, and 52% of the women had first consulted a gynaecologist. Although all the patients eventually consulted a physician about their warts, one-third delayed seeing a doctor because they thought the condition would resolve on its own or that the problem was not serious. Most patients reported that treatment was associated with pain, discomfort, and embarrassment. Sixty per cent of patients experienced a recurrence after initial clearance with treatment. More than 80% stated that they had had little or no involvement in the selection of treatment. Globally, 52% of men and 61% of women were 'quite concerned' or 'very concerned' about having genital warts, although there were significant variations by country. Approximately two-thirds of patients had made lifestyle changes regarding sexual relationships. In addition, two-thirds believed that there were risks associated with having genital warts; the most common risk identified was a link to cancer (cervical and unspecified). A high level of anxiety is associated with the diagnosis and treatment of genital warts. Patients with genital warts require understanding and an acknowledgement of their concerns. A better understanding of the psychosexual aspect of the disease by health-care providers is pivotal to effective disease management and patient counselling.
Int J STD AIDS 1998 Oct
PMID:An international survey of patients with genital warts: perceptions regarding treatment and impact on lifestyle. 981 6

With the use of more intensive antiretroviral therapies (highly-active antiretroviral therapy, HAART) particularly in first world countries, reductions in the mortality and morbidity of HIV infection are being seen. However, though the prevalence of symptoms may change, symptom control does continue to be a problem for many people with HIV, particularly as their disease progresses. This is the second of 2 CME articles about palliative care and HIV infection. The first gave a background to palliative care, and covered symptom control of pain. This article gives suggestions for the treatment of common gastrointestinal symptoms in HIV infection; nausea and vomiting, cachexia and anorexia and chronic diarrhoea.
Int J STD AIDS 1999 Aug
PMID:Palliative care and AIDS: 2--Gastrointestinal symptoms. 1047 Oct 98

27 year old Melinda presents to you with increasingly severe dysmenorrhoea. She has been using condoms for contraception and is no longer able to control the pain with the anti inflammatory tablets you suggested at the last consultation 6 months ago. She also complains of the recent development of deep dyspareunia. She has been in her current relationship for the last 5 years. Examination illicits similar pain and tenderness to that which she feels during intercourse. A Pap smear and STD screen are normal. You refer her to a gynaecologist who undertakes a laparoscopy on Melinda. What is seen? Ovarian adhesions secondary to endometriosis (Figure 1). Classic endometriosis (Figure 2).
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PMID:Endometriosis. 1056 95


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