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)

Topical cyclosporine may be effective in the treatment of various oral mucosal disorders. In three open trials and in one double-blind study, a topical formulation of this drug produced significant improvement in oral lichen planus. Cyclosporine blood levels were generally low in these studies and no abnormalities of laboratory values resulted during use. Of six patients with oral bullous diseases treated with topical cyclosporine, four showed a decrease in erythema, partial healing of ulcerations, and a reduction in pain. Three patients relapsed shortly after cyclosporine was discontinued. Four of eight patients with persistent aphthous stomatitis remained virtually free of ulcers during 8 weeks of topical cyclosporine therapy. These results indicate that topical cyclosporine is beneficial as a therapy for oral lichen planus and possibly other mucosal diseases.
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PMID:Topical cyclosporine for oral mucosal disorders. 227 33

Double-blind clinical trials were performed with a placebo to determine the optimum dose of YN-72 in patients with herpes zoster. YN-72 at 10, 50, and 100 mg was administered orally three times daily for 7 days. A total of 226 patients entered the present trial. Six of the 226 patients were excluded from statistical analysis of data. Furthermore, seven patients were excluded from the analysis for efficacy and usefulness, and included in the analysis for safety. The numbers of patients included in the analyses for efficacy and usefulness were 50 in the placebo group, 54 in the YN-72 30-mg/day group, 56 in the 150-mg/day group, and 53 in the 300-mg/day group. The numbers of patients included in analysis for safety were 53 in the placebo group, 58 in the YN-72 30-mg/day group, 56 in the 150-mg/day group and 53 in the 300-mg/day group. The effectiveness rate at the end of administration was 42.0% in the placebo group, 79.6% in the YN-72 30-mg/day group, 80.4% in the 150-mg/day group, and 61.5% in the 300-mg/day group. The rates in the YN-72 groups were significantly higher than in the placebo group. Evaluation at the end of the trials revealed that administration of YN-72 was effective. Among skin symptoms, administration of YN-72 accelerated the disappearance of erythema and vesicles and the formation of crust. Administration of YN-72 tended to accelerate the reduction and disappearance of pain. Reduction and disappearance in the YN-72 150-mg/day group occurred significantly earlier than in the placebo group (log-rank test).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A double-blind clinical study in patients with herpes zoster to establish YN-72 (Brovavir) dose. 228 97

Four commercial gel preparations of topical anti-inflammatory agents have been assessed in six animal models commonly used to determine the biological activity of non-steroidal anti-inflammatory agents for systemic administration. Only UV-induced erythema of the skin, adjuvant induced arthritis and the measurement of vascular permeability proved suitable for differentiation of the potency of the four topical agents. Carrageenin-induced paw oedema, the cotton pellet test and the assessment of the pain threshold according to Randall and Selitto were of little value. The effects of the gel preparation of diclofenac (CAS 15307-86-5) diethylammonium (Voltaren Emulgel) were comparable to two preparations containing 1% and 5% active ingredient, respectively. Gel 4 showed low overall activity. The experiments demonstrated that some of the models used for the assessment of anti-inflammatory agent for systemic administration proved suitable for the testing of topical preparations and that percutaneous absorption was insufficient to elicit anti-inflammatory effect in the animals at sites remote from the site of application.
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PMID:Assessment of topical non-steroidal anti-inflammatory drugs in animal models. 229 49

Inflammation occurring in a defunctionalized portion of bowel, following either ileostomy or colostomy, has long been recognized by endoscopists. However, little has been written about this entity, particularly the histopathologic changes. Glotzer et al in 1981 described 10 cases, and coined the term "diversion colitis". We studied 21 patients without previous history of inflammatory bowel disease who, for reasons including perforated diverticulitis, carcinoma, or trauma, had loop colostomies or Hartmann's procedure performed. Many of these patients became symptomatic with complaints related to the defunctionalized bowel, including rectal discomfort, pain, discharge, and bleeding. Nineteen patients had endoscopic examinations, which revealed a variety of findings including mucous plugs, friability, petechia, erythema, ulcers, exudate, and nodules or polyps. All except one case had tissue from the excluded portions of bowel available for pathologic examination. Most displayed nonspecific changes with mild-to-moderate lymphoplasmacytic infiltrates in the lamina propria, mild architectural alterations of the crypts, and slight decrease in crypt numbers. Ulceration, cryptitis, and crypt abscesses simulating ulcerative colitis were uncommon findings and were observed almost exclusively in more severe cases. Granulomas were observed in two cases, raising the possibility of Crohn's disease.
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PMID:Diversion colitis: a clinicopathologic study of 21 cases. 231 85

Forty-three boys who presented with acute scrotal pain were studied retrospectively. Of these, 40 had torsion of scrotal contents. Torsion of testicular appendages, a self limiting condition, tended to present later than testicular torsion (P = 0.002). The testis was saved in all 11 cases of testicular torsion explored within 12h of the onset of pain but orchidectomy was required in four who presented later. In 11 cases, a torted testicular appendage diagnosed as a tender nodule was found on examining the upper pole of the testis. The remaining 14 cases of torted appendage were diagnosed at operation because testicular torsion could not be excluded due to scrotal swelling. Most (12) of this operated group were not seen until 3 days after the onset of pain. This study suggested that urgent operation was unnecessary in those in whom a tender nodule was found (pathognomonic of a torted appendage) and in those presenting after more than 24h of pain with scrotal erythema and oedema. The likely diagnosis in the latter case is a torted appendage and in cases of torsion of the testis there is no prospect of salvage at this stage. These guidelines were applied to a group of 20 boys studied prospectively. In eight, all with less than 24h of pain, immediate exploration was undertaken and testicular torsion was confirmed in six. The remaining 12 fulfilled the criteria for conservative management and were observed. All had normal testes at late review. Careful clinical assessment in boys with scrotal pain indicates which cases may be treated by non-operative management without fear of losing a salvageable testis.
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PMID:Indications for conservative management of acute scrotal pain in children. 232 97

A 1-year prospective study was conducted to identify epidemiological factors associated with caterpillar envenomations. Of 117 envenomations, 112 were included in the study. Identification of the caterpillars involved was accomplished in 68% of the cases. Six caterpillar species were identified, 4 of which [Hemileuca maia (Drury), Automeris io (F), Megalopyge opercularis (JE Smith)/Lagoa crispata (Packard) and Sibine stimulea (Clemens)] were properly implicated in envenomations. Clinical effects most commonly reported were local pain, erythema and swelling in 96%, 89% and 72% of patients, respectively. Atypical responses including muscle spasms, paresthesia and radiating pain to an extremity were noted in 26% of patients. Sixteen percent of patients had a history of allergy, but no patient in this subgroup exhibited a "hive-like" dermatologic or anaphylactic allergic response. No positive correlation could be drawn between allergy history and extent of clinical effect following envenomation. Mild to moderate local response following envenomation was typical. However, 61% of patients evaluated experienced mild to moderate effects at least 24 h post-envenomation.
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PMID:Caterpillar envenomations: a prospective study of 112 cases. 232 53

An analysis was made of 539 cases of venous flare reactions associated with the administration of doxorubicin. These reactions always were nondebilitating and generally were transient with complete resolution occurring within 45 minutes of onset in 462 patients (86%). Local urticaria occurred in 133 patients (25%), and 35 patients (6%) reported either vein pain or a stinging sensation. In 20 cases (4%), erythema in the region immediately surrounding the infusion site accompanied the primary manifestation of erythema along the course of the vein proximal to the infusion site. The incidence of initial flare reactions peaked in the autumn months. These reactions frequently occurred at clinical sites in sporadic clusters. Clinical features are described that differentiate flare reactions from early extravasations of doxorubicin. Procedures for minimizing the possibility of the occurrence or reappearance of flare reactions are suggested.
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PMID:Doxorubicin-associated flare reactions. 234 72

The authors report four large-volume (greater than 20-mL) extravasations in adults and one intermediate-volume (18-mL) extravasation in an infant of iopamidol, a nonionic contrast medium, that occurred during dynamic enhanced computed tomography. The largest volume that extravasated (in two patients) was 150 mL. Although all five patients initially had swelling, erythema, and/or pain after extravasation, all recovered uneventfully. The authors suggest that emergent surgical drainage of all large-volume extravasations, a procedure that was recently recommended, is unnecessary. Large extravascular collections of nonionic contrast media can be well tolerated and are often resorbed without adverse sequelae.
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PMID:Extravasation of nonionic radiologic contrast media: efficacy of conservative treatment. 235 13

An assessment was made of 36 extravasations of Adriamycin (doxorubicin) in which vascular access devices had been used. Of these, 25 (69%) were sufficiently severe to warrant removal of the device. Physical manifestations were frequently of delayed onset. Edema and/or erythema often involved extensive areas around the catheter or access device and in several cases were accompanied by pain, discomfort or paresthesia. In 20 patients (59%), spontaneous resolution without ulceration occurred in spite of occasional extravasation of large amounts of doxorubicin. Most extravasations were caused by a limited number of technical errors and equipment problems. These were equally divided by site into injection port extravasations and catheter-related extravasations (18 patients each). The two most frequent causes were needle and catheter tip dislodgements. Procedures are suggested for minimizing the opportunities for extravasation of doxorubicin administered through vascular access devices.
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PMID:Extravasation of doxorubicin from vascular access devices. 192 17

Ninety-seven patients with breast cancer recurring in a previously irradiated area (mean dose 44 Gy) were reirradiated in combination with hyperthermia and had evaluable tumor responses. In the reirradiation series, radiotherapy was given twice weekly in most patients, with a fraction size varying from 200 to 400 cGy, the total dose varying from 8 to 32 Gy. Hyperthermia was given following the radiotherapy fractions. The combined treatment resulted in 35% complete and 55% partial responses. Duration of response was median 4 months for partial response and 26 months for complete response, respectively. The median survival time for all patients was 12 months. Acute skin reaction was mild, with more than moderate erythema in only 14/97 patients. Thermal burns occurred in 44/97 patients, generally at sites where pain sensation was decreased, and therefore they did not cause much inconvenience. In the 19 patients who survived more than 2 years, no late radiation damage was observed. When patients who received a "high dose" (greater than 29 Gy and hyperthermia) were compared with those who received a "low dose" (less than 29 Gy and hyperthermia), a higher complete response rate was observed in the high dose group (58% vs. 24%), whereas no difference in acute toxicity was found. We conclude that reirradiation with 8 x 4 Gy in combination with hyperthermia twice weekly is a safe, effective and well tolerated method for palliative treatment of patients with breast cancer recurring in previously irradiated areas.
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PMID:Low dose reirradiation in combination with hyperthermia: a palliative treatment for patients with breast cancer recurring in previously irradiated areas. 246 20


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