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)

23 women with benign breast disease (fibrocystic disease or fibroadenosis) were treated for three months consecutively with a prolactin inhibitor drug, bromocriptine, at the dose of 2.5 mg every eight hours. Serum prolactin levels were normal before treatment; during treatment prolactin concentrations were significantly suppressed all the day long. 21 out of 23 patients receiving bromocriptine showed marked relief to pain and mammary tension after a few days of treatment; adenomatous of cystic nodules became smaller and softer, often with disappearance of the smaller ones. Two patients failed to respond to treatment. In all positive cases the improvement persisted for at least six months after the end of treatment. No important side effects were observed during the therapy. Our results do not allow any conclusion on the real mechanism of action of bromocriptine in benign breast disease, nevertheless they indicate the possible usefulness of this drug in treating patients with benign breast disease.
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PMID:Treatment of benign breast disease with bromocriptine. 48 22

Twenty patients, mostly with severe endometriosis and infertility, were treated with danazol 600 mg daily for six months. Clinical investigation and laboratory tests were done monthly. During treatment most clinical findings and symptoms of endometriosis disappeared within 2 to 3 months, but rectocervical induration and rectocervical pain decreased more slowly. During the 10 months follow-up after discontinuation of danazol, dysmenorrhoea recurred most commonly of all symptoms, but not to the same degree as before treatment and the patients were mainly satisfied. Gonadotrophin and prolactin levels did not alter significantly during treatment. Serum oestradiol and progesterone values were low during the danazol course. Testosterone values increased because of cross-reaction with danazol metabolites in the testosterone assay. Serum transaminase, creatinine, haemoglobin and blood platelet concentrations increased on average, but the changes were reversible. Three conceptions occurred during the period of study.
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PMID:Effects of danazol in the treatment of severe endometriosis. 53 49

Most clinical trials to date have demonstrated the effectiveness of 2-bromo-alpha-ergocryptine in suppressing the onset of puerperal lactation and confirmed the postulative mechanism of action by suppression of serum prolactin concentrations during its administration. The present study involving 112 patients was carried out to demonstrate the dose response and the timing of the administration. The drug was administered in two dose schedules of 1 mg t.i.d. and 2.5 mg b.i.d. commencing immediately after delivery and continued for 14 days. A third group of patients had 2.5 mg administered b.i.d. only after acute engorgement became a problem in the post-partum period. The drug was just as effective in the lower dose schedule and almost complete relief of pain and engorgement spared both the patient and the nursing staff many complaints. A dramatic relief was also obtained within 48 h even after engorgement had occurred and an overall incidence of rebound filling of 19% is similar to that reported by others.
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PMID:Prevention and suppression of post-partum lactation with 2-bromo-alpha-ergocryptine (CB-154). 61 72

Sensitivity to pain and touch was measured in the nipple, areola, and cutaneous breast tissue of prepubertal boys and girls, postpubertal men and nuliparous women before and after delivery. Before puberty there were no differences between the sexes, but after puberty the tactile sensitivity of all areas of the women's breast was significantly greater than the men's. Tactil sensitivity of all areas also varied during the menstrual cycle, with maximal sensitivity at midcycle and at menstruation; the mid-cycle peak was absent when the women were taking oral contraceptives. But the most dramatic changes occured within 24 hours of parturition, when there was a great increase in breast sensitivity. This may be the key event for activating the suckling-induced discharge of oxytocin and prolactin and inhibiting ovulation during lactation.
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PMID:Changes in breast sensitivity at puberty, during the menstrual cycle, and at parturition. 86 31

The mechanism and hormonal regulation of lactation is explained and illustrated with a schematic representation. Circulating estrogen above a critical amount seems to be the inhibitory factor controlling lactation during pregnancy. Once delivery occurs, the level of estrogen falls, that of prolactin rises, and lactation begins. Nonsuckling can be used to inhibit lactation. Estrogens can also be used to inhibit lactation more quickly and with less pain. The reported association between estrogens and puerperal thromboembolism cannot be considered conclusive due to defects in the reporting studies. There is no reason not to use estrogens in lactation inhibition except for women over 35 who experienced a surgical delivery. Alternative therapy is available for these women. The recently-developed drug, brom-ergocryptine, may replace other methods of lactation inhibition.
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PMID:Inhibition of lactation. 117 77

The indications for and the results of hypophysectomy for advanced cancer of the breast or prostate gland are reviewed. The technic of open microsurgical transsphenoidal hypophysectomy is described. Since the metabolism of some breast cancers is influenced by estrogenic hormones, the major effect of hypophysectomy seems to be the complete suppression of estrogen production by the gonads and adrenal glands by removal of gonadotropin and ACTH, respectively. Other specific substances, such as growth hormone or prolactin, may also be factors. In cases of prostate cancer which relapse after castration, the adrenals seem to elaborate a significant amount of extradgonadal androgen. Hypophysectomy removes the source of ATCH and thus stops androgen production by the adrenal glands. Other hormones may also be important. In premenopausal patients with advancing cancer of the breast, oophorectomy should be the initial procedure. Most patients after a previous favorable response to oophorectomy get a subsequent objective improvement from hypophysectomy. In postmenopausal patients the effects of hormone therapy should 1st be tried. Many patients responding favorably to hormone therapy will also be benefited later by hypophysectomy. Remission rates are higher in older women. However, hypophysectomy should be carried out relatively early to obtain a useful remission. About 25% of those not responding to other methods will obtain a remission following hypophysectomy. Along interval after the mastectomy before metastases occurs is a favorable prognostic sign. While bony metastases respond best, other sites of metastases do not contraindicate the operation. Most patients with prostatic metastases obtain relief after hypophysectomy, even some of those who have not been benefited by other methods. Advanced age alone is not a contraindication. A preoperative evaluation should be done including a series of endocrine studies. Open microsurgical transsphenoidal hypophysectomy is considered the operation of choice. Complete removal of the gland is accomplished with less disturbance to the patient than an intracranial operation. General anesthesia is used. After the operation tests for pituitary reserve are repeated and a maintenance regimen of hydrocortisone prescribed. Thyroid replacement therapy is often needed. Subjective remissions are more common than objective ones, particularly relief of pain. This operation was done on 20 men with metastatic cancer of the prostate and 23 women and 1 man with metastatic cancer of the breast. Of the prostate cases, 3 patients died during the early postoperative period. Of the other 17, there have been 7 deaths from the cancers after 1-7 months. Of the 23 breast cases, severe body pain was the indication for the operation. Relief occurred in 19 (83%). There have been 7 deaths from the cancers. Hypophysectomy does not predispose to or lead to alterations in emotional state or mental function. Others with larger series of cases have reported that those responding favorably have lived an average of 25.8 months while average survival of those not so responding has been only 5.6 months.
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PMID:Hypophysectomy in the treatment of disseminated carcinoma of the breast and prostate gland. 127 14

Plasmatic and cerebrospinal fluid levels of beta-endorphin and plasmatic concentration of ACTH, cortisol, and prolactin were investigated in 10 healthy volunteers free of pain and in a group of 38 patients who presented moderate or intense postoperative pain. The analgesic technique was transcutaneous neural stimulation. In 28 patients the stimulation was delivered at 40-80 Hz (high frequency) whereas in the remaining 10 patients it was administered in a placebo form. Measurements of hormone concentrations were performed using radioimmunoassay techniques. In patients free of pain hormone analysis was done at once, whereas in patients with pain this analysis was performed before and one hour after transcutaneous neural stimulation. We compared data obtained in control subjects with data collected in patients before and one hour after high frequency and placebo transcutaneous neural stimulation. Levels of beta-endorphin were comparable in patients with and without pain. However, ACTH, cortisol, and prolactin were increased in patients with pain. High frequency stimulation induced greater beta-endorphin levels than placebo neural stimulation and slightly lower concentration of prolactin. There were no significant differences in ACTH and cortisol levels.
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PMID:[Effects of transcutaneous nerve stimulation on the plasma and CSF concentrations of beta-endorphin and the plasma concentrations of ACTH, cortisol and prolactin in hysterectomized women with postoperative pain]. 131 65

Although the aetiology of cyclical mastalgia is poorly understood, the consistent finding of an increased prolactin stimulation response probably due to oestrogen dominance has led to the use of treatment with prolactin-lowering drugs and antioestrogens. The efficacy and safety in cyclical mastalgia of gestrinone, which has androgenic, anti-oestrogenic, and antiprogestagenic properties, were investigated in a multicentre study. In a double-blind randomisation procedure, 72 patients were allocated placebo and 73 treatment with gestrinone (2.5 mg twice a week) for 3 months. The patients recorded the severity of breast pain on a visual analogue scale before and during treatment and scored other breast symptoms as not present (0), mild (1), moderate (2), or severe (3). The gestrinone group had significantly greater reductions than the placebo group in breast pain score at months 1, 2, and 3 of treatment (mean reduction 59.5 [SD 22.6] to 11.7 [17.0] vs 58.2 [17.6] to 36.7 [23.0] at month 3; p less than 0.0001). All six breast symptoms had lower scores in the gestrinone than in the placebo group by the end of treatment. In a subset of 30 participants (15 from each group), serum concentrations of oestradiol, progesterone, and tri-iodothyronine were significantly lower than baseline after 3 months of gestrinone, but concentrations of luteinising hormone, follicle-stimulating hormone, prolactin, thyroid-stimulating hormone, and thyroxine did not change. 41% of gestrinone-treated and 14% of placebo-treated patients reported at least one side-effect; most of these were androgen-mediated. 11 placebo-treated patients and 4 on gestrinone discontinued treatment. Thus, gestrinone was very effective in the treatment of cyclical mastalgia and was well tolerated.
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PMID:Multicentre study of gestrinone in cyclical breast pain. 134 2

We studied 2 members of a family suffering from paroxysmal attacks elicited by tactile stimuli. The attacks consist of burning pain of the stimulated body part, followed by either complete collapse or tonic posturing. Noxious stimuli provoke episodes regardless of their somatic location, whereas it is only necessary for nonnoxious stimuli to be applied to specific trigger zones, such as the rectum, to provoke attacks. Episodes are most commonly precipitated by bowel movement, leading to extreme fear of defecation and resultant fecal retention. An ictal electroencephalographic video recording revealed only slowing of the background; however, serum prolactin was significantly elevated postictally. The attacks were completely suppressed by carbamazepine and resumed on discontinuing the medication. These attacks may represent a form of reflex epilepsy manifested by autonomic nervous system dysfunction.
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PMID:Familial rectal pain: a type of reflex epilepsy? 836 60

Women tend to suffer more often from migraine than men (19% vs. 9%). Further menstruation is associated with attacks in 60% of women who have migraine. Moreover 14% of women with migraine suffer from attacks only with menses. Migraine may be linked to late luteal phase dysphoric disorder and dysmenorrhea. these conditions occur when the greatest fluctuation of estrogen levels occur. These fluctuations indeed cause prostaglandin levels to rise, prolactin release to intensify, and central nervous system opioid dysregulation to occur. In fact, several studies show that decreasing levels of estrogen activate menstrual migraine. Further estrogens and progesterone trigger synthesis of endometrial prostaglandins. In fact, prostaglandins regulate descending norepinephrine pain control systems in the brain, thus increased levels of prostaglandins decreases the pain threshold. In addition, falling levels of estrogens produce dopamine receptor hypersensitivity. Dopamine antagonists cause increased prolactin release throughout the luteal phase in all women and during the entire menstrual cycle in women with menstrual migraine. Physicians can treat menstrual migraine with various nonsteroidal antiinflammatory drugs, simple or combination analgesics, ergotamine, or hormonal therapy when other treatments fail. They should be aware that diuretics and pyridoxine are ineffective in treating menstrual migraine. Several replacement therapies to treat menopausal women with migraine exist. these include adding androgens, reducing estrogen dosage, converting to continuous dosing, and converting to parenteral dosing. Some data show an increase in or severity of migraine among oral contraceptive (OC) users, but other studies find no difference in headache among OC and placebo users. In fact, OCs may exacerbate, improve, or not change the frequency or severity of headaches.
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PMID:The role of sex hormones in headache. 155 90


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