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)

Continuous subcutaneous infusions offer a safe, simple, effective alternative to intravenous or intramuscular injections when oral medications cannot be used. They are extremely useful for cancer patients suffering from pain, vomiting, seizures, and other symptoms. Hydromorphone or morphine may be combined with metoclopramide, methotrimeprazine, or haloperidol (in D5W only), in the same pump to control both pain and nausea. Seizures can be controlled by subcutaneous infusion of phenobarbital or midazolam. If proper doses are prescribed and skin irritation is watched for, they can be used safely in the patient's home.
J Pain Symptom Manage 1990 Feb
PMID:Subcutaneous infusions for control of cancer symptoms. 196 87

Pain in osteoarthrosis of the big weight bearing joints is either derived from periarticular ligaments, tendons, fasciae, muscles, bursae--peri-arthropathy as sign of decompensation--or from the reactive synovitis with or without effusion. NSAIDs systemically administered have been so far considered as first choice medication together with physical therapy. New pharmacokinetic data on the topical, percutaneous application of NSAIDs (ibuprofen, diclofenac, indomethacin, some salicylates and to a lesser degree for etofenamate and piroxicam) have demonstrated relevant advantages of the percutaneous route over the systemic one in soft tissue rheumatism. NSAIDs, mentioned above, locally administered as cream, gel or spray, quickly penetrate through the corneal layer of the skin at the site of application, reach high effective concentrations in subcutis, fasciae, tendons, ligaments and muscles, lesser in joint-capsule and -fluid indicating direct penetration. The blood levels of topical NSAIDs are extremely low with no systemic side effects, especially no gastric toxicity; however, local skin irritation is observed (1 to 2%). In contrast to this, systemic (oral) NSAIDs lead primarily via high blood levels to a much lesser concentration--only one tenth--in particular soft tissues with a high incidence of side effects. In conclusion the percutaneous application of certain NSAIDs has become a well established therapeutic regimen in painful osteoarthrosis and in all other inflammatory degenerative and posttraumatic alterations of soft tissue structures.
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PMID:[Percutaneous therapy of painful arthritis]. 201 38

A group of 36 patients were tested for the effects of percutaneous iontophoretic application of Vinblastin inj., a microtubular transport inhibitor (Gideon Richter, Hungary) in the treatment of chronic intractable pain. The group is divided into two subgroups: (1) 16 patients with persistent root pain following one or more operations for lumbar intervertebral disk herniation. (2) 20 patients with persistent pain in the area of the radicular skin zones or in the skin innervation areas of peripheral nerves. Vinblastin was injected in the place of maximal pain, 0.01% concentration in the total amount of 5 mg of active substance. The active electrode was the anode. There were at least 15 procedures per patient. The therapeutic effect was evaluated from the patients' subjective reports on pain relief in per cent, from the intensity of actual pain and from the interference of pain intensity with daily activities. Considering all the criteria, an improvement was achieved in 29 cases, i.e. 81%. The beneficial effect of the therapy was observed from the 8th to 10th application. In the first group of patients, 69% showed a clinically significant relief of the algetic symptoms. In the other group, the therapeutic effect was 90% of cases. A significant difference between both these groups was found to be in the degree of pain relief after the end of therapy. In the first group the average pain relief was 22.2%, in the other one 47.7%. This difference is statistically highly significant. Except for one case, the beneficial effect was always recorded in the place of administration (under the anode). Apart from local skin irritation in 2 patients and spot burns under the electrode in 2, no other side adverse effects were seen in the course of therapy, after its termination or at the checks made after some time interval (maximum 3 years).
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PMID:Vinblastin iontophoresis in treating intractable pain. 214 99

Significant progress has been made in replacing animals in toxicology/safety assessment with in vitro systems, in reducing the number of animals used, and in refining how they are used. Review of annual reports of the numbers of animals used in testing in the United States, the United Kingdom, and Japan shows a continuing reduction in the numbers for all species. Multiple in vitro systems have been developed for screening/testing for eye and skin irritation, skin sensitization, teratology, and other endpoints and a scientific consensus has been formed on requirements and process for validation. However, the use of these test systems in place of existing in vivo tests is minimal. At the same time, innovative designs have been developed (and are in wide use) for in vivo tests which reduce both the numbers and the pain and distress of animals used in testing. Progress and dialogue continue on modification of both U.S. and international requirements and guidelines for testing, and for defining an "approval" process for alternatives and innovations.
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PMID:Recent developments in replacing, reducing, and refining animal use in toxicologic research and testing. 219 47

It was demonstrated that patients with coronary heart disease with coronary angiographically documented stenosing coronary atherosclerosis and frequent episodes of angina pectoris had significantly higher pain threshold in response to electric skin irritation and greater defense unconditioned flexor reflex R-III threshold than healthy subjects and patients with chest pain of extracoronary genesis.
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PMID:[Decreased thresholds of pain sensation and defense flexor reflex in patients with ischemic heart disease]. 277 81

Twenty patients with post-herpetic neuralgia (median duration 28.5 months) were randomly allocated to receive transdermal iontophoresis of either vincristine or saline. Although significant improvement in pain by word score and visual analogue scale (P = 0.05) was reported by 6 out of 10 of the vincristine group, none of the patients considered themselves 'cured.' There was no significant change in the saline group. No adverse haematological or neurological side effects were seen, but skin irritation and painless electrical burns were common in both groups. The dramatic relief of pain in patients with post-herpetic neuralgia of 3 months or less reported elsewhere was not seen in our group who had pain of a longer duration. This present trial does not confirm the value of vincristine iontophoresis in the treatment of post-herpetic neuralgia of over 6 months duration.
Pain 1986 May
PMID:Iontophoresis of vincristine versus saline in post-herpetic neuralgia. A controlled trial. 352 93

A prospective study of the use of transcutaneous neural stimulation (TNS) in 90 arthroscopic knee surgery patients was performed to determine: if TNS is as effective as traditional pain medication in treating postoperative knee pain; and if patients that had received TNS regain preoperative motion and strength quicker than the control population. The patients were divided into three equal groups. Group I consisted of patients with no TNS unit, Group II had a "placebo" unit, and Group III had a "live" unit. Preoperatively, each patient received an isokinetic muscle examination, orientation to the TNS unit, leg circumference measurements, and exercise instruction. An isokinetic muscle examination and leg circumference measurements were repeated at 1, 3, and 7 weeks postoperatively. Additionally, the amount of pain and medication required was analyzed. The results of the study indicated that the use of a TNS unit is an effective adjunct in decreasing postoperative pain in 93% of patients. The amount of pain and total pain medication required was greatest in the control group, less in the placebo, and markedly reduced in the TNS group. A comparison among the three groups revealed that the TNS group regained the following preoperative values 1 month sooner than the other two groups (3 as opposed to seven weeks postoperatively): isokinetic power in flexion and extension (P less than 0.05), range of motion (P less than 0.02), and leg volume (P less than 0.05). There was no correlation between the pain and irregular wave forms on the isokinetic graph. The only complication noted was skin irritation at the electrode sites.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The use of transcutaneous neural stimulation and isokinetic testing in arthroscopic knee surgery. 387 82

Thirty-four patients with decubitus ulcers were studied in a randomized trial to compare topical cadexomer iodine with the standard decubitus ulcer treatments used in the participating hospitals. There was a significant reduction of ulcer area with both treatments within three weeks; however, eight of 16 patients treated with cadexomer iodine had a reduction of ulcer area of more than 50 per cent, compared with one of 18 patients treated with the standard treatment (P less than 0.01). Twenty-seven patients continued the same treatment for five more weeks, during which time six in the cadexomer iodine group healed, compared with one in the standard treatment group (P less than 0.05). Cadexomer iodine was superior to the standard treatment in removing pus and debris from the ulcer surface and in reducing pain at the ulcer site. It was found to be easy both to apply and to remove from the ulcers and did not stain skin or clothing. Transient smarting during the first hour after application was reported by three patients, and one patient complained of skin irritation. The results show that cadexomer iodine applied daily has a debriding effect on decubitus ulcers and accelerates healing.
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PMID:A randomized trial of cadexomer iodine in decubitus ulcers. 668 61

From 1977 through 1980, 251 veterans from the San Francisco Bay Area received permanent lower-extremity prostheses at the two local Veterans Administration hospitals. For a survey, 213 of the 251 were contacted and 179 of them (84%) responded to written or telephone questionnaires concerning their prosthetic problems and complaints and their recommendations regarding prosthetic care. Seventy-four percent of the patients were traumatic amputees and 23 percent were dysvascular amputees. Eighty-six percent of the traumatic amputees said they wore their limbs all day, compared with only 51 percent of the dysvascular group. Seventy-one percent of traumatic and 43 percent of dysvascular amputees engaged in some form of recreational activity. There was a high incidence of complaints of pain in the residual limb: 55 percent among the dysvascular group and 44 percent among the traumatic group. Half of the patients had socket problems. Fifty-four of the 178 patients received a physical examination, a prosthetic evaluation, and a gait analysis. Among this group, 59 percent of the below-knee prostheses and 78 percent of the above-knee prostheses had inadequate socket fitting. Improper shaping of socket margins was the most frequently observed deficiency. Moreover, 41 percent of below-knee and 22 percent of above-knee amputees had mechanical skin irritation or skin breakdown in the examined residual limbs. Faulty suspension and alignment in addition to improper socket fit and construction contributed to this problem. Excessive stiffness of SACH foot heel cushions was the most common prosthetic foot problem and contributed to gait abnormalities.
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PMID:Evaluation of problems and needs of veteran lower-limb amputees in the San Francisco Bay Area during the period 1977-1980. 688 67

A double-blind within-patient crossover trial compared the new nonsteroidal antiinflammatory agent benoxaprofen with ibuprofen in the treatment of osteoarthritis in 31 patients. Both benoxaprofen (600 mg once daily) and ibuprofen (400 mg qid) improved measurements of pain, stiffness, range of movement, mobility, patient preference, and overall assessment. However, the improvement was statistically significant only for pain at rest and range of knee movement for both drugs and for range of hip movement (N = 8) for ibuprofen. There was no statistically significant difference between treatments with the 2 drugs. Six patients taking benoxaprofen reported skin irritation on exposure to sunlight.
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PMID:Benoxaprofen in the treatment of osteoarthritis--a comparison with ibuprofen. 699 68


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