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)

Of 112 000 patients undergoing surgery between 1952 and 1973, 67 had a primary tumor of the small intestine. 22 patients had a benign tumor, 8 a carcinoid, 21 carcinoma and 15 sarcoma. Benign tumors were more frequent in the duodenum and ileum, carcinoids in the terminal ileum and carcinomas in the duodenum and jejunum. Sarcomas were found equally in all parts of the small intestine. The most common symptom for all types of the tumor was variable pain in the abdomen. Loss of weight occurred only in patients with carcinomas and sarcomas; heavy intestinal blood loss was most common in patients with benign tumors. Benign tumors often show invagination, while sarcomas cause occlusive ileus or perforation. All duodenal tumors show heavy intestinal bleeding but hematemesis is rare. Emergency surgery was necessary in 42% of patients with benign tumors or sarcoma and in 30% of patients with carcinoma. Five-year survival in patients with benign tumors is excellent (100%). Compared to this, five-year survival in patients with carcinoma, sarcoma or carcinoids is only 15%.
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PMID:[Complications in primary tumors of the small intestine]. 16 32

In a preliminary open study of salsalate (3 g daily for 4 weeks) in 61 patients with rheumatoid arthritis or osteoarthrosis, it was found that although the drug produced satisfactory analgesia in 64% of patients, the incidence of side-effects was high (57% of patients): most were symptoms of salicylism and probably related to the high plasma salicylate levels achieved. In a second open study, 20 patients with osteoarthrosis were treated for 4 weeks with 250 mg diflunisal twice daily and then crossed over to salsalate (3 g daily) for a further 2 weeks. The results of subjective assessments of pain relief showed that both drugs produced satisfactory analgesia, and neither was associated with a significant level of gastro-intestinal bleeding. During the diflunisal treatment period there were no reports of salicylism, and plasma salicylate levels were very much lower than those measured after salsalate. The pain relieving effects of both drugs, assessed from patient preference for one or the other treatment, were unrelated to the plasma salicylate levels and it is suggested that plasma levels may have more relationship to the incidence of side-effects than with therapeutic effects.
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PMID:Relationship of plasma salicylate levels to pain relief with two different salicylates. 35 53

Twenty-eight medical specialists (internists, rheumatologists) selected 102 primarily arthritic patients for a two-week efficacy and safety field study of salicylsalicylic acid. Data were gathered on pain, morning stiffness, range of motion, serum salicylate concentration, erythrocyte sedimentation rate (ESR) and gastro-intestinal bleeding before and after a 15-day drug trial. Results showed a 67% favourable clinical response in the physician's global evaluation and a 60% improvement in pain; the drug itself was well tolerated by 96% of patients. Response correlations with morning stiffness and range of motion were equivocal. Of fifty-four patients examined before and after treatment for intestinal bleeding, only two (3.7%) had detectable faecal blood loss. Good clinical response had a statistically significant association with serum drug concentrations of 13.6 to 13.8 mg%; unsatisfactory response was noted in those patients with mean serum salicylate levels of 8.6 mg%. ESR decreased or was unchanged in thirty-five patients with satisfactory clinical response and in fourteen patients with unsatisfactory response.
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PMID:Salicylsalicylic acid revisited: a multicentre study. 42 67

Eight cases are reported of extensive retroperitoneal haemorrhage in patients receiving anticoagulant therapy who subsequently died and underwent postmortem examination. No patient had an obvious source of bleeding, and in 5 cases no other cause for death was apparent. Three patients had had vascular surgical procedures: the other 5 were given anticoagulants for suspected venous thrombo-embolism. Six cases presented as unexpected circulatory collapse with rapid demise. Four patients had in addition gastro-intestinal bleeding of varying degree, with no obvious source. This acute massive type of retroperitoneal bleeding contrasts with the commoner presentations of pain, swelling, bruising and compression neuropathy: a high index of suspicion and urgent treatment are required if mortality is to be reduced.
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PMID:Fatal retroperitoneal haemorrhage complicating anticoagulant therapy. 43 66

A false aneurysm in the suture line of a vascular prosthesis is reported in 4 patients. The complications encountered in these patients are discussed. In patients with an aortic bifurcation prosthesis and with unexplained pain, fever or intestinal bleeding further analysis is indicated to exclude a false aneurysm.
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PMID:[False aneurysm in prosthesis of the abdominal aorta]. 271 90

The incidence of peptic ulceration and gastrointestinal blood loss in patients treated with benoxaprofen is low. Haemophiliac patients frequently suffer recurrent bleeding into their joints with resulting severe arthritis. Their choice of drugs for pain relief and with anti-inflammatory action is limited because of the risk of gastro-intestinal bleeding. Accordingly, four patients with haemophilia had 20 ml of their blood labelled with Chromium51 and 10 ml were reinjected. They were given placebo tablets orally for one week, with a carmine marker at tne end of the placebo period, followed by 300 mg of benoxaprofen daily for a further two weeks. Gastrointestinal blood loss was estimated by daily faecal collections measured for radiochromium. No significant gastrointestinal blood loss was noted in either the placebo or benoxaprofen periods of the trial. This drug can reasonably be regarded as safe to use in haemophiliac patient with arthritis.
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PMID:Gastric microbleeding studies in patients with haemophilia taking benoxaprofen. 697 79

Three children with pronounced livedo reticularis present since birth (cutis marmorata-telangiectasia congenita) have been followed to the ages of eight, 17 and 21 years. During childhood they developed frequent recurrent transient stroke-like hemipareses, affecting either side of the body, associated with ipsilateral pain, headache, visual symptoms, dysphasia, fits and confusion. Intellectual failure and, in one, progressive spasticity have followed. Attacks were more frequent in winter. Other problems have included abnormal peripheral vascular responses to temperature change, gastro-intestinal bleeding, glaucoma, local tissue hypertrophy and, in the two older patients, renal involvement with hypertension. Their condition represents a form of congenital vasculopathy. Anticonvulsants, anti-migraine agents, anti-platelet drugs and flunarizine have been ineffective. Nifedipine prevented further attacks in one patient and reduced attacks in another, but has not helped the third child. Adequate clothing and warmth may also be important.
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PMID:Congenital livedo reticularis and recurrent stroke-like episodes. 840 21

The epidemiology and clinical presentation of abdominal tuberculosis were studied retrospectively in 298 adult cases admitted in Safdarjang Hospital, New Delhi over a 3-year period. These constituted 17% of the total number of admissions for tuberculosis. Age at presentation was variable with maximum cases in 21 to 40-year age group (58% of cases) with a mean age of 32.7 years. There was a slight female preponderance (57%). Sixty-three per cent were residing in urban areas. Pain abdomen, ascites and subacute intestinal obstruction were the commonest modes of presentation (34%, 30%, 28% respectively). Other clinical features included fever (21%), altered bowel habits (19%), weight loss (8%) and lump abdomen (6%). Acute intestinal obstruction and lower gastro-intestinal bleeding were uncommon (5% and 4% respectively). Co-existent pulmonary tuberculosis was seen in 16% cases. Histological evidence was available in 41% cases. Majority improved with conservative management with only 21% requiring surgical intervention. Mortality recorded was 11%.
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PMID:Epidemiology and clinical presentation of abdominal tuberculosis--a retrospective study. 901 81

This report describes an association between hepatic encephalopathy and central anticholinergic syndrome (CAS). A 60-year-old anaemic woman was admitted unconscious and with a delayed reaction to pain but with no focal neurological deficits. She had signs of portal hypertension and a history of non-alcoholic liver cirrhosis grade Child B. Suspecting upper gastro-intestinal bleeding, she was intubated for gastro-duodenoscopy and a fibrin-covered ulcer was revealed. Raised intra-abdominal pressure resulting from ascites caused cardiopulmonary failure, which required mechanical ventilation for 24 h, but extubation was possible after drainage of the ascites and blood volume replacement therapy. However, her neurological state remained unchanged despite normal blood ammonia concentration and no sedation. CAS was considered and physostigmine injected with immediate effect. The patient opened her eyes immediately and was fully orientated to personal and medical history. We suggest that hepatic encephalopathy may trigger CAS, although the significance of physostigmine in the treatment of hepatic encephalopathy remains to be addressed by controlled investigations.
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PMID:Hepatic encephalopathy--a physostigmine-reactive central anticholinergic syndrome? 1010 33

Angiosarcoma occurs very rarely in the intestinal tract as either a primary or metastatic malignancy and can present great diagnostic difficulty, especially when it displays epithelioid cytomorphology. Since only isolated case reports have been published, the purpose of this study is to more fully delineate the histopathological and clinical features from a series of 8 angiosarcomas involving the gastrointestinal tract. There were 5 male and 3 female patients whose ages ranged from 25-85 years (median 57). Presenting symptoms included intestinal bleeding, anemia and pain. Five cases involved the small bowel and 3 involved the colon/rectum. Four cases were primary to the intestinal tract, 2 patients initially presented with secondary involvement of the large bowel from occult retroperitoneal primaries, 1 patient presented with disseminated disease including small bowel involvement, and 1 case was metastatic from a breast primary. Seven cases were composed predominantly of sheets of malignant appearing epithelioid cells with subtle areas forming cleft-like spaces suggestive of vascular differentiation. Immunohistochemical studies revealed the lesional cells to be immunoreactive for CD31 (8/8), CD34 (8/8), Factor VIII (8/8), cytokeratins AE1/AE3 (7/8), cytokeratin 7 (2/8), Cam5.2/cytokeratin 8 (5/8), and cytokeratin 19 (5/8). Cytokeratin 20 was negative in all eight cases, which contrasts sharply with the characteristic positivity for cytokeratin 20 in virtually all intestinal carcinomas. One case was weakly and focally positive for EMA and all cases were negative for S-100 protein. Cytokeratin staining was variable and ranged from focal to extensive. Follow-up was available in eight cases and ranged from 1-33 months (median 12.5). Five patients died of disease, between 1 and 33 months (median 6) after diagnosis. One recently diagnosed patient is alive with disease 18 months after diagnosis, and one patient is free of disease 27 months after original diagnosis. Angiosarcomas of the gastrointestinal tract commonly display epithelioid cytomorphology, may be diffusely and strongly positive for cytokeratins and only show subtle signs of vascular differentiation, creating potential diagnostic confusion with primary or metastatic carcinoma. Given the clinically aggressive behavior of angiosarcoma, proper classification and treatment is important. Immunohistochemistry with vascular markers, CK20, and S-100 protein may be helpful in differentiating angiosarcoma from carcinoma and melanoma.
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PMID:Angiosarcoma involving the gastrointestinal tract: a series of primary and metastatic cases. 1510 92


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