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)

For 2 months we observed side-effects and indwelling times when using a subcutaneous catheter (Insuflon, Viggo AB, Sweden) for insulin injections. This method is used by approximately 600 children and adolescents with IDDM in Sweden today. 22 children and adolescents aged 4-19 years with a diabetes duration of 4.0 +/- 3.0 (mean +/- SD) years participated. Their HbA1c was 5.8 +/- 1.0%. All used 4-6 dosages of insulin per day. The catheter was placed subcutaneously in the abdominal wall, and replaced by parents when home tests showed increased blood or urine glucose, when the child experienced pain or when skin changes were observed. The 22 patients used 239 catheters with a mean time between changing catheters of 4.8 +/- 2.2 (range 0.5-17) days (= 1147 catheter days). Noted side effects were (% of catheter days): fixation problems, 5.6%; minor infection/irritation (= redness greater than 1 mm), 5.6%; pain, 2.8%; sore skin from plastic wings, 2.4%; itching/dry skin, 2.0%; eczema from band-aid, 1.7%; blocked catheter/injection needle, 1.6%; leakage of insulin, 1.3%, transient lipohypertrophies, 1.1%; hematoma/blood in catheter, 0.8%, and moist skin, 0.3%. No major infections requiring surgical or antibiotic treatment occurred. In conclusion, the use of indwelling insulin catheters seems to be a safe method to lessen the pain of insulin injections with a low frequency of side effects. The long-term metabolic control was not altered in this group of well-controlled children. We therefore find that we can recommend the use of indwelling catheters to children and adolescents who have difficulties with injections because of needle phobia or pain, particularly when using MIT.
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PMID:Side effects and indwelling times of subcutaneous catheters for insulin injections: a new device for injecting insulin with a minimum of pain in the treatment of insulin-dependent diabetes mellitus. 224 6

The trend toward self-care is increasing among elderly patients. Over-the-counter medications contribute to the well-being of older patients, but adverse effects may occur, including interactions with prescription drugs. Nondrug health care products and agents for external use are also helpful when properly used. Dry skin, dry eyes, arthritis, pain and gastrointestinal complaints are among the major indications for the use of nonprescription medications.
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PMID:Nonprescription drugs and the elderly. 272 42

This work presents a model for the skin which accounts for both the nonlinearities and the asymmetries in its voltage-current characteristic. This model consists of an electrical submodel and a heat transfer submodel. The electrical submodel uses nonlinear devices in which some parameters depend on skin temperature. The heat transfer submodel models the heat exchange between the skin, the surrounding tissues, and the ambient medium and calculates the temperature of the skin to update the necessary parameters of the electrical submodel. The model is based on experiments designed to determine: 1) the dry skin voltage-current characteristic; 2) the changes in the skin breakdown voltage with location; 3) the moist skin voltage-current characteristic; 4) the changes in the voltage-current characteristic of the skin with duration after the onset of stimulation; and 5) the effect of skin temperature on its voltage-current characteristic. During these experiments we used 84-mm2 square Ag-AgCl electrodes to apply sinusoidal voltage of 0.2 and 20 Hz. The simulations were performed using the Advanced Continuous Simulation Language (ACSL), capable of solving differential and integral equations with variable coefficients. The model predicted the skin behavior satisfactorily for a large range of amplitudes and frequencies. We found that the breakdown occurred when the energy delivered to the skin exceeded a threshold. Above this threshold the voltage-current characteristic of the skin became nonlinear and asymmetric and, in a real situation, the subject would experience an uncomfortable sensation which could rapidly develop into pain.
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PMID:A nonlinear electrical-thermal model of the skin. 792 88

In a Nordic multi-centre trial, 583 previously untreated multiple myeloma patients were randomized to receive melphalan-prednisone or melphalan-prednisone+ interferon alpha-2b at a dose of 5 million units subcutaneously, 3 d/week. A quality-of-life study was integrated into the trial, using the EORTC QLQ C-30 questionnaire supplemented with 11 questions concerning interferon toxicity. The questionnaire was completed prior to treatment and after 1, 6, 12, 24, 36 and 48 months. 90% of the patients participated in the quality-of-life study, and 83% completed all questionnaires submitted to them. During the first year of treatment the patients on interferon reported significantly more fever, chills, dry skin, fatigue, pain, nausea/vomiting and appetite loss than the control patients. There was a moderate reduction of the global quality-of-life score and slight, non-significant, reductions of physical, emotional, cognitive, social and role functioning scores. After the first year there were no statistically significant differences in any toxicity, symptom or quality-of-life score, except for an increased frequency of dizziness in the interferon group. As only 60% of the patients remained on interferon after 24 months, our data probably underestimate the potential toxicity of the drug. Although there was no significant survival benefit for the interferon patients, a 5-6 months prolongation of the response and plateau phase duration was observed. However, by intention-to-treat analysis, there was no late quality-of-life benefit for the interferon patients to compensate for the early impairment. Thus, the clinical significance of the plateau-phase prolongation is uncertain.
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PMID:Effect of interferon on the health-related quality of life of multiple myeloma patients: results of a Nordic randomized trial comparing melphalan-prednisone to melphalan-prednisone + alpha-interferon. The Nordic Myeloma Study Group. 875 93

The aims of this study were: 1) to describe the demography, symptomology, investigations conducted, non-pharmacological interventions and outcome of patients admitted to an inpatient hospice and 2) to identify the nursing and medical needs of terminally ill patients. Case-notes of the first 300 patients admitted to Dover Park Hospice were studied retrospectively. There were 159 men and 141 women making up 325 admissions. The racial distribution was: Chinese 95.0%, Malays 3.0%, Indians 1.3% and Others 0.6%. Two-thirds of the men (64.2%) had spouses while 44.7% of the women were widowed. The mean age was 64.7 years. The 3 most common cancers were lung (21.7%), colorectal (14.6%) and hepatobiliary (12.5%). A proportion of patients (39.5%) were not known to have any metastases. Most patients were referred from hospitals and the home-care based Hospice Care Association. The commonest reason for admission was for "terminal care" (57.2%). At admission, only 38% of the patients were aware of their diagnoses and prognosis while 30% did not know either. The average length of stay was 25 days with 7.7% of patients having more than one admission. The most common symptoms were pain, anorexia, breathlessness, insomnia, constipation and dry skin. Non-pharmacological interventions ranged from manual evacuation of the rectum to transfers to tertiary hospitals for surgery and other more invasive interventions. Many patients also attended day-care activities (23.1%). Outcome of the 325 admissions were as follows: went home 20%, died in the hospice 73.2%, went home to die 4.9% and others 1.8%.
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PMID:A descriptive study of the demography, symptomology, management and outcome of the first 300 patients admitted to an independent hospice in Singapore. 1010 58

Signs of exsiccation are to be found in almost every fourth acutely ill patient admitted to the geriatric department. The major clinical signs are those associated with reduced general condition, together with somnolence, possibly agitation, oliguria, dry skin, orthostatic hypotension, and a tendency to be bedridden. In such cases, subcutaneous infusion is a simple-to-apply and for the patient stress-free, largely pain-free possibility for fluid replacement. Properly applied and with account being taken of the contraindications--in particular emergency situations, decompensated cardiac insufficiency and severe coagulation disturbances--the risks of s.c. infusion are negligible.
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PMID:[Dehydration in geriatric patients. Fluid substitution--also subcutaneous!]. 1110 4

The effect of interferon on the health-related quality of life in multiple myeloma was assessed in two trials carried out by the Nordic Myeloma Study (Group (NMSG). In both trials, the EORTC QLQ-C30 questionnaire, supplemented with 11 items relating to interferon toxicity, was used. The first was a randomized controlled trial (NMSG 4/90) evaluating the addition of interferon alpha-2b to melphalan and prednisone during induction, maintenance and relapse. During the first 12 months, patients on interferon reported more chills, fever, fatigue, pain, nausea/vomiting, appetite loss and dry skin than the control patients, and a slight reduction of global health and quality of life. From 12 months onward there were no significant differences in any score between the two groups. In a later trial (NMSG 5/94) evaluating the effect of high-dose chemotherapy with stem cell support in patients under 60 years of age with newly diagnosed myeloma, interferon was used as maintenance. During the maintenance phase, symptom and toxicity scores were not significantly different from those in control patients under 60 years of age in the previous trial. Thus, interferon appeared to be well tolerated after high-dose chemotherapy with stem cell support.
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PMID:Health-related quality of life and patients' perceptions in interferon-treated multiple myeloma patients. Nordic Myeloma Study Group. 1114 38

In earlier studies it has been reported that patients with carcinoid tumours have a relatively good health-related quality of life (HRQoL) and low levels of anxiety and depression. The aims of this study were (a) to investigate the extent to which psychosocial function changes in patients with carcinoid tumours with time from diagnosis and its possible relation to tumour markers, and (b) to compare the HRQoL of patients with carcinoid tumours with that of healthy Swedish adults. Twenty-four patients reported on HRQoL (the EORTC QLQ-C30), anxiety and depression (the Hospital Anxiety and Depression Scale) five times during their first year of treatment. After one year, improvement in nausea/vomiting, flush and anxiety was reported, but there was deterioration of physical function, an increase in muscular pain and problems with dry skin. Levels of tumour markers were not associated with psychosocial function. Patients reported a lower HRQoL compared with healthy Swedish adults. Thus, deterioration of physical function was not accompanied by a deterioration of emotional function, and levels of tumour markers were not related to patients' HRQoL.
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PMID:Health-related quality of life, anxiety and depression in patients with midgut carcinoid tumours. 1185 81

Aquaporins (AQP) are a family of at least ten homologous water transporting proteins in mammals that are expressed in many epithelial, endothelial and other tissues. Abnormalities in humans and mice lacking AQPs provide direct evidence for their physiological importance. Humans lacking AQP1 or AQP2 manifest polyuria with defective urinary concentrating ability and humans with mutations in MIP (AQP0) develop cataracts. Transgenic knockout mice lacking AQP1 or AQP3 are also remarkably polyuric, and knock-in mice expressing a mutant AQP2 have severe nephrogenic diabetes insipidus resulting in impaired neonatal survival. Other interesting phenotypes in AQP knockout mice include reduced pain sensation, reduced intraocular pressure, defective corneal fluid transport and impaired dietary fat processing (AQP1), dry skin (AQP3), protection from brain swelling and impaired hearing/vision (AQP4), and reduced fluid secretion by salivary and airway submucosal glands (AQP5). However, many phenotype studies were negative, such as normal airway/lung and skeletal muscle function despite AQP expression, indicating that tissue-specific aquaporin expression does not indicate physiological significance. The general paradigm from studies on transgenic mouse models of AQP deletion is that AQPs facilitate rapid near-isosmolar transepithelial fluid absorption / secretion, as well as rapid vectorial water movement driven by osmotic gradients. The transgenic mouse studies suggest that aquaporin inhibitors may have clinical indications as diuretics and in the treatment of cerebral edema, elevated intraocular pressure, and other conditions of abnormal fluid homeostasis.
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PMID:Physiological importance of aquaporin water channels. 1217 89

The name of Carpal Tunnel Syndrome (CTS) refers to a complex of symptoms resulting from the pressure exerted on the median nerve in the carpal tunnel area [81]. In most cases, it is not possible to establish CTS causes, and we diagnose idiopathic CTS. CTS is the most frequent pressure neuropathy. Typical clinical symptoms include sensory effects in the forms of pain paresthesia or hypesthesia, limited to the wrist area innervated by the median nerve, presence if Tinel's symptoms, or a positive Phalen's test. In more advance cases, doctors find motor symptoms displayed by difficulties in the performance of precise activities, grasp weakness or thenar muscle atrophy. In some patients, we observe autonomous symptoms, e.g. skin perspiration disorders (dry skin on thumb, index and middle fingers), or vasomotor disorders. The most essential for diagnosis confirmation are electrophysiological examinations, which evaluate the median nerve functions. Sometimes, imaging techniques are useful, e.g. ultrasound, MRI and CTS scanning of the wrist. The most effective form of idiopathic treatment of CTS is surgery.
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PMID:[Carpal tunnel syndrome]. 1523 Jan 55


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