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)

We describe six patients with painful polyneuropathy associated with hyperlipidemia. Each had mild, slowly progressive neuropathy characterized by pain in feet, without proximal extension or involvement of hands. Weakness and autonomic symptoms and signs were absent. Three patients had normal tendon reflexes; three others had decreased ankle reflexes. Serum cholesterol levels were moderately increased; serum triglyceride levels were exceedingly high. In one patient, symptoms resolved with correction of hypertriglyceridemia. No other cause of peripheral neuropathy was found. Marked increases in serum triglycerides may cause painful small-fiber neuropathy.
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PMID:Neuropathy associated with hyperlipidemia. 750 Nov 85

During normal pregnancy, serum transaminase levels remain within normal limits. An elevated level observed in a pregnant woman always signals a disease process, most often of hepatic origin, but in certain cases, of muscular origin. During the last three months of pregnancy and in the immediate post partum period a large number of liver diseases can cause elevated transaminase levels, depending upon the clinical presentation. In everyday practice, a complete liver battery together with specialized consultation is required for all pregnant women with raised transaminase levels. Toxaemia gravis may be evident in patients with severely raised blood pressure, especially if seizures occur. Epigastric or subcostal pain should suggest hepatic involvement. Hypertension may however be absent and epigastric or left shoulder pain may be the only clinical signs. Acute liver steatosis is 20 to 50 times more rare than toxaemia and may cause nausea and vomiting. Certain non-specific signs such as asthenia, anorexia, polyalgia, abdominal pain, diarrhoea and fever, together with pruritus should suggest acute hepatitis. A 25-fold increase in transaminase level is commonly encountered. The risk of fulminating hepatitis is less than 1/1000 but should always be entertained. All drugs should be stopped and careful research for recent xenobiotic contamination (drugs, infusions, alphamethyldopa, etc.) should be undertaken. Viral hepatitis requires serovaccination of the newborn at birth. Herpetic hepatitis is rare but requires rapid diagnosis (liver biopsy) and treatment with acyclovir in addition to cesarean section and treatment of the newborn at birth. Rare cases of hepatitis E may occur after a stay in North Africa, the Middle-East, Southeast Asia or Mexico. Chronic cases with or without temporary pruritus suggest infectious hepatitis B or C although, in chronic hepatitis C, serum transaminase levels often return to normal during pregnancy. Rare cases of asymptomatic elevations of serum transaminase levels can reveal subclinical chronic hepatitis.
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PMID:[Significance of elevated transaminase levels at the end of pregnancy]. 802 21

The purpose of this study was to evaluate the immunity of Israeli adults against the diphtheria toxin and to assess the immune response to a 2 Lf booster vaccination of diphtheria. The antibody levels against the toxin were measured in 200 volunteers aged 18-21. Later, a booster vaccination at a dosage of 2 Lf (flocculation units) was given and the immune response measured. We found that prior to the booster vaccination 174 (87%) of the study group had an antibody level > or = 0.1 IU/ml, 16 (8%) had an antibody level of > or = 0.06 IU/ml and < or = 0.09 IU/ml, and 10 (5%) had an antibody level of < or = 0.05 IU/ml. At the 10th day after the booster vaccination 185 (99%) acquired antibody level > or = 0.1 IU/ml, and at the 28th day all the vaccinees had antibody level above 0.1 IU/ml. When comparing the anamnestic and the delayed reaction to the booster vaccination, no significant difference was found between the group that prior to the vaccination had antibody level < or = 0.05 IU/ml and the group with antibody level > or = 0.06 IU/ml and < or = 0.09 IU/ml. Side effects were mainly local: 76 (38%) of the vaccinees had moderate local pain at the site of the injection and 40 (20%) had severe local pain. Abduction limitation of the injected arm was reported by 17 (8%) of the subjects. Weakness was reported by 67 (33%), headache by 18 (9%) and fever by 2 (1%) subjects. We conclude that antibody levels > or = 0.1 IU/ml are protective and booster vaccination at a dosage of 2 Lf raises the antibody levels to protective levels in all the vaccines.
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PMID:The immune response to booster vaccination against diphtheria toxin at age 18-21 years. 804 40

Long-term treatment with pivampicillin and pivmecillinam for 6-24 months in five adults and one child reduced the total serum carnitine concentrations to 3.7-14.0 mumol/l (reference value 25-66 mumol/l). The muscle carnitine was reduced to 0.3-0.7 mumol/g wet weight (reference value 3-5 mumol/g) in two cases. All patients had asthenia and muscle symptoms with weakness and pain. One showed signs of carnitine depletion in the liver, with increased secretion of dicarboxylic acids (C6, C8, C10) in urine and limited ketone body formation during prolonged fasting (32 hours). The serum carnitine increased slowly after cessation of therapy and reached normal concentrations after 6-12 months. All symptoms caused by carnitine depletion disappeared after the serum carnitine reached 20 mumol/l. This was achieved on a normal diet without carnitine supplement.
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PMID:[Slow replenishment of carnitine level after long-term treatment with pivampicillin/pivmecillinam]. 807 64

It is a traditional practice of the Alpine region of Trentino and Alto Adige to use phytothermotherapeutic treatment with fermenting grass ("hay baths") for chronic degenerative arthropathies. A marked lack of clinical validation is however to be found in current literature as to its efficacy and tolerability. To verify these two aspects 27 patients (mean age 59 +/- 8.7 years, range 43-82) with osteoarthritis (15 of them with a generalized form) were evaluated before and after a ten-day treatment with immersion of the whole body in a bed made with fermenting grass according to the traditional method. The following clinical features were considered: pain in affected joints evaluated by visual analog scale, presence of global subjective improvement (or lack of it) immediately and 6 months after treatment, degree of global functional impairment, stiffness duration, handgrip strength. The mean score at the affected joints (on the visual analog pain scale) was 2.51 +/- 0.71 before and 1.83 +/- 0.89 after treatment (p < 0.001), with improvement in 68% of patients. Morning stiffness was reduced from 38.9 +/- 30.5 to 17.5 +/- 17.2 minutes (p < 0.05), with improvement in 57% of patients. Grip strength measure went from 136 +/- 59.7 to 147 +/- 51 mmHg (p < 0.01), with improvement in 77% of patients. Forty-eight percent of the patients were reassigned to better class of functional capacity (p < 0.001). Patient general assessment signaled improvement in 72% of cases immediately after treatment, and in 80% after six months. Tolerability was high in 23 out of 25 patients, nobody was taken off treatment because of side effects, in two cases a one day interval due to asthenia was introduced. In conclusion, improvement rates were found higher when compared with controlled trials on efficacy of nonsteroidal antiinflammatory drugs. Noteworthy is also the persistence of improvement 6 months after treatment compared to the above mentioned drugs and usual physiokinesitherapeutic treatments.
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PMID:[Critical evaluation of phytothermotherapy ("hay baths") in degenerative arthropathies]. 816 50

Three patients with diabetic radiculopathy (DR) are presented. The clinical aspects of DR, its management, and differential diagnosis are reviewed. Diabetic radiculopathy commonly presents with severe unilateral pain of sudden onset that is usually located in the lower extremity, frequently in the proximal segments. Occasionally, bilateral asymmetric pain may be observed. The pain is severe and may require narcotic medications. Sphincteric involvement is rare. Weakness of hip or thigh muscles, decreased sensation and hypo- or areflexia are commonly observed. The clinical picture can resemble that of high lumbar disc herniation. Electrodiagnostic and radiological studies may help differentiate between the two conditions.
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PMID:Diabetic lumbar radiculopathy: sciatica without disc herniation. 830 43

The optimal surgical approach for thoracic disk herniation is controversial, and long-term follow-up is poorly documented. We retrospectively reviewed the records of 31 patients who underwent surgery for herniated thoracic disks at our institution during a 17-year period (1975-1992). Two patients had multiple disk herniations; 16 of 33 herniated disks occurred at or below the T10-11 level. There were three surgical approaches to diskectomy: laminectomy in four patients, transpedicular surgery in 12, and costotransversectomy in 15. Weakness resolved postsurgery in nine of 18 patients. One patient transiently deteriorated neurologically after a laminectomy, three had wound infections, and two required second operations for their herniated disks. Postsurgery half the patients with symptoms continued to have pain or weakness.
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PMID:Herniated thoracic disks: treatment and outcome. 834 71

We report on a tourist returning from Thailand, who presented with classical dengue fever. While in Thailand a 36-year-old Swiss female laboratory assistant suddenly developed fever, devastating headache, retro-ocular pain, myalgia and arthralgia, photophobia, nausea and diarrhea. In addition she suffered from epistaxis, urogenital and skin bleeding, and a morbilliform exanthema. After her return to Switzerland we noted lymphadenopathy and splenomegaly, enanthema and laboratory findings of mild hepatitis, thrombocytopenia and leukopenia. The diagnosis of dengue virus infection was verified serologically. Apart from a long lasting convalescent asthenia we observed restitutio ad integrum within days under symptomatic therapy. Epidemiological clinical and diagnostic aspects of dengue virus infection are discussed.
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PMID:[Imported dengue fever following a stay in the tropics]. 842 57

To test the anti-tumour activity of rhizoxin in recurrent and/or metastatic squamous cell head and neck cancer, we performed a phase II study. Eligibility required histologically proven squamous cell head and neck cancer. Patients could only have received one prior chemotherapy. Patients were entered if WHO PS was < or = 2 and organ functions were normal. Treatment consisted of rhizoxin 1.5-2.0 mg m-2 i.v. bolus injection once every 3 weeks. Thirty-two patients entered the study. All were eligible, 31 were evaluable for toxicity and 25 for response. Toxicity mainly consisted of pain at the tumour site and leucocytopenia. Mild asthenia and stomatitis were also observed. Two objective partial responses, lasting 7.5 and 3.5 months, were seen. Rhizoxin at this dose and schedule has minor activity in recurrent and/or metastatic squamous cell head and neck cancer.
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PMID:Phase II study of rhizoxin in squamous cell head and neck cancer. The EORTC Early Clinical Trials Group. 856 50

30 patients with malignant pleuritis were randomised to be treated, either with intrapleural instillation of mepacrine chloride or with mitoxantrone. The patients were evaluated with chest X-ray and a symptom questionnaire during a follow-up period of 12 weeks. Mitoxantrone levels in the pleural space and plasma were measured at different time points in some of the patients. High concentrations of mitoxantrone were found in the pleural fluid while the plasma concentrations were low, giving a plasma/intracavity ratio generally of less than 1:60. The chest X-rays showed excellent results for both treatment modalities. However, the patients treated with mepacrine chloride experienced greater discomfort with fever and pain, and those treated with mitoxantrone reported significantly less dyspnoea and less asthenia after 4 weeks. We conclude that both treatments are equally effective in preventing the recurrence of malignant effusion. However, mitoxantrone seems to have further advantages when it comes to improving the quality of life.
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PMID:Effects of intrapleural mitoxantrone and mepacrine on malignant pleural effusion--a randomised study. 865 43


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