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)

In a Swedish-Norwegian multicentre study patients with endoscopically verified duodenal ulcers (greater than 5 mm) were randomized to 2 or 4 weeks of treatment with either 20 mg omeprazole once daily or 300 mg ranitidine once daily. The aim was to evaluate 2 and 4 weeks' treatment with regard to symptomatic improvement during treatment, relapse after treatment, and safety of the two drugs. Endoscopy was not performed to check healing at the end of treatment. Instead the patients were instructed to contact the investigator in the event of recurrence of symptoms for renewed endoscopy. Follow-up was ended 10 weeks after stopping active treatment. Altogether 450 patients were evaluated at 17 centres. The symptomatic improvement during treatment was good in all groups, with significantly better reductions of daytime pain and heartburn in omeprazole-treated patients. Symptomatic relapse was commonest in the 2-week ranitidine group (57%), significantly more than in the 2-week omeprazole group (31%) (p less than 0.003). In the 4-week groups relapse rates were 34% (ranitidine) and 39% (omeprazole) (NS). It is suggested that in the short-term treatment of acute duodenal ulcer 20 mg omeprazole once daily is most rationally used in a 2- to 4-week regimen, whereas 300 mg ranitidine once daily should not be used for less than 4 weeks.
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PMID:Two and four weeks' treatment for duodenal ulcer. Symptom relief and clinical remission comparing omeprazole and ranitidine. Scandinavian Clinics for United Research. 201

Two groups, each composed of 20 elderly patients suffering from osteoarthritis characterised by intense pain, were treated for 4 weeks with the oral formulation of two modern oxicam derivatives (tenoxicam capsules and beta-cyclodextrin-piroxicam tablets respectively). The analysis of the results showed that both drugs have an excellent antalgic effect. After the first dose the action of beta-cyclodextrin-piroxican was quicker and more marked, with statistically significant differences between treatments for the first 4 hours. At the end of the study period the two drugs proved to be equally effective, with a more pronounced symptomatic effect of beta-cyclodextrin-piroxican. No side effects serious enough to warrant suspension of treatment were observed: the only side effects reported were gastric adverse events (pyrosis, gastralgia) in both groups, having an incidence of 50% (tenoxicam) and 15% (beta-cyclodextrin-piroxicam) respectively.
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PMID:[Osteoarthritic disease: therapy with oxicam derivatives]. 210 68

Due to insufficient casual therapy of oral symptoms of dyniae and pyrosis, we applied infrared soft laser in treatment of patients with those oral symptoms. The laser had a wavelength of 904 nm and a radiation strength of 20 W. The tests were performed on 40 persons with stomatopyrosis and stomatodiniae symptoms, under application of laser through 5 days consecutively with radiation of mucosa lasting 3 minutes on 1 cm2. The testing group was represented by persons exclusively under the laser therapy and the control group was represented by 30 persons, who were under a medicamentose therapy with vasodilatator applied with iontophoresis. By persons with stomatopyrosis and stomatodiniae symptoms analgetic effect was attained through the therapy with the laser already after the first application, and the pain and aches intensity was relieved every day during the therapy, by stomatodinae to complete healing. The obtained differences in the intensity of symptoms before and after the therapy were statistically important. The thermoestesiometric determination of laser efficiency by vasodilatation showed differences which were not important, although the temperature during the therapy has slightly increased for 0.1 degrees C. The soft laser can be used as an effective remedy in the treatment of oral symptoms of stomatopyrosis and stomatodinae.
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PMID:[Use of soft laser in the treatment of oral symptoms]. 213 57

The three main symptoms of esophageal disease or disorder are dysphagia, chest pain, and heartburn. Dysphagia in achalasia is mainly due to a non-relaxing lower esophageal sphincter (LES). The mechanism of dysphagia in diffuse esophageal spasm and related motor disorders is related to a combination of several factors including incomplete LES relaxation, failed or weak peristalsis (pressure less than 30 mmHg in the distal esophagus, and orad positive pressure gradient). Meal manometry and balloon distention may prove to be useful provocation tests. Chest pain of esophageal origin may be due to gastroesophageal reflux and esophageal motility disorders; it may also be a manifestation of an irritable esophagus, in which the esophagus is hypersensitive to various stimuli (chemical, mechanical, ischemic). Esophageal provocation tests may suggest the esophageal origin of the pain but do not give information on the nature of the esophageal disorder. Twenty-four-hour pH and pressure measurements may, however, yield this information. Heartburn and acid regurgitations are the most typical symptoms of gastroesophageal reflux. Transient relaxations of the LES are considered to be an important contributory mechanism of reflux. Absent basal LES pressure is another mechanism, which accounts for about one-fourth of the reflux episodes in patients with severe reflux esophagitis. During long-lasting inappropriate relaxations, swallows often produce deglutitive contraction waves that die out in the upper esophagus, suggesting that reflux often occurs during periods of inhibition of both LES tone and peristaltic esophageal activity.
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PMID:Recent studies of the pathophysiology and diagnosis of esophageal symptoms. 223 80

We characterized the acute manifestations of gastroesophageal reflux in 46 patients attending an emergency ward. 43 were females and the mean age was 41 +/- 14. The diagnosis of G-E reflux was confirmed in all by the acid reflux test; esophagitis was present in 55% of patients submitted to endoscopy; the Bernstein test was positive in 43%. The population represents 3% of all emergency consults and 8% of gastroenterological consults. Severe epigastric pain, usually burning or constrictive and radiating to the dorsum, left hypochondrium and sternal region was the presenting form in 55% of patients. Pain was refractory to antispasmodic agents but was relieved by antacids. Dyspnea or bronchial obstruction was the main symptom in 16% of cases, heartburn in 13%, hematemesis in 6%. Among these patients a prolonged history of chronic G-E reflux was common. Surgical correction was undertaken in 6%, with some symptoms persisting in 17%.
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PMID:[Prevalence of acute manifestations of pathologic gastroesophageal reflux]. 229 74

In a study of 154 consecutive patients who had a Nissen fundoplication performed by 12 surgeons over a 10-year period, 117 (76%) were available for review of symptoms 5-15 years after the procedure. Heartburn, the most common presenting symptom, was abolished in 85.5% and epigastric pain in 84.6% of patients. Fifteen patients (12.8%) considered the operation a failure because of dysphagia (17%), bloating (17%), pain (13%), heartburn (13%) or diarrhoea (6%). Comparison of possible risk factors between successes and failures showed no difference between these two groups in terms of age, sex, rank of surgeon, smoking, or accompanying crural repair. Prior response to H2-receptor antagonists did not influence outcome. Nissen fundoplication is successful in some 85% of patients over a period of 5-15 years after operation.
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PMID:Long-term results after Nissen fundoplication: a 5-15-year review. 239 29

Ibuprofen, a commonly proscribed nonsteroidal anti-inflammatory drug that is also available in many countries, including the United States, without a prescription, is known to cause hemorrhage and erosion of the gastroduodenal mucosa. This study was conducted to compare the efficacy of 200, 100, and 50 micrograms of misoprostol and placebo administered qid for 6 days, with a final dose on the morning of the 7th day, in the prevention of gastric and duodenal lesions induced by the concurrent administration of 800 mg of ibuprofen qid. A total of 120 healthy subjects with endoscopically normal gastric and duodenal mucosae were enrolled in the study. The endoscopic examination was repeated 2 h after the final dose on day 7, and the mucosae were graded on a 0 to 4+ scale. In the stomach, all three misoprostol groups were significantly more protective than placebo and did not differ significantly from each other. In the duodenum, the endoscopic scores of the 200- and 100-micrograms misoprostol groups, but not the 50-micrograms group differed significantly from placebo. The 200- and 100-microgram groups did not differ significantly from each other, but both differed from the 50-micrograms group for duodenal mucosal injury. Subjective symptoms thought to be primarily attributable to the NSAID (e.g., pain, indigestion/heartburn and nausea) were recorded by each subject in a diary. Subjects in the 200-micrograms misoprostol group attained the greatest degree of mucosal protection and had a significantly higher incidence of indigestion/heartburn and abdominal pain than the placebo group. One can conclude that misoprostol in both antisecretory (200- and 100-micrograms) and non-antisecretory (50-micrograms) doses protects the gastric mucosa from injury from high anti-inflammatory doses of ibuprofen (3200 mg/day). Only the antisecretory doses (100 and 200 micrograms qid) were effective in the duodenum, suggesting that acid suppression is necessary for mucosal protection to occur in the duodenum.
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PMID:A double-blind placebo-controlled comparison of the efficacy and safety of 50, 100, and 200 micrograms of misoprostol QID in the prevention of ibuprofen-induced gastric and duodenal mucosal lesions and symptoms. 249 87

Pain of esophageal origin includes heartburn, odynophagia, and spontaneous chest pain. The etiologic causes of esophageal chest pain are varied and include gastroesophageal reflux, esophagitis from radiation, infection, accidental ingestion, medication, and systemic disorders, and motility disorders. Useful tools in the evaluation of patients with suspected esophageal disease include endoscopy, manometry with provocative agents, and prolonged pH and pressure studies.
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PMID:Chest pain of esophageal origin. 266 69

Thirty-one patients about to undergo surgery for gastroesophageal reflux were randomized into either a Nissen fundoplication group (12) or a modified Toupet semifundoplication group (19). All patients were followed on a long-term basis for 5 years with a standard questionnaire, endoscopy, and manometry. Ninety-five percent of the patients in the modified Toupet group had good or excellent results versus 67% for the Nissen group. However both procedures are effective in curtailing esophagitis with an improvement of the endoscopic grading in the Nissen group by 91% and 89% in the group undergoing the modified Toupet procedure. A significant improvement in symptoms (acid regurgitation, heartburn, retrosternal pain) was noted in both groups, except for dysphagia in the Nissen group. Three patients with a Nissen fundoplication had a slipped Nissen requiring reoperation and two had gas-bloat syndrome. These specific complications of the Nissen procedure were not found in the modified Toupet group.
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PMID:A long-term randomized prospective trial of the Nissen procedure versus a modified Toupet technique. 268 67

In a double-blind study, 59 patients with chronic erosive gastritis received 50 mg of pirenzepine twice daily and 55 patients received 400 mg of cimetidine twice daily for six weeks. In both groups, days of pain, of heartburn, and of nausea per week were significantly reduced during treatment (P less than 0.01). After six weeks, 64% of the pirenzepine group and 62% of the cimetidine group were free of symptoms and endoscopy revealed healing of lesions in 78% and 80%, respectively. Differences between groups were not significant.
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PMID:Treatment of chronic erosive gastritis: a double-blind trial of pirenzepine and cimetidine. 269 20


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