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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intermittent claudication is associated with adaptation in muscle metabolism. This study has evaluated the metabolism of amino acids at rest and during non-steady state exercise in patients with arterial insufficiency of at least six months duration in comparison with matched control individuals. The exchange of amino acids were measured during two periods of acute exercise; one initial exercise period with a standardized work load and exercise time and a second exercise period which continued until further exercise was impossible due to pain in the patients and exhaustion in the controls. The maximum blood flow was reduced by 40% in the patients but the maximum oxygen uptake per unit power developed was almost the same in patients and controls. The patients had significantly lower concentrations of glutamine, lysine and taurine at rest compared with the controls. The exchange of amino acids across the resting leg did not differ between the two groups. Exercise increased the efflux of amino acids in both patients and controls. The efflux of glutamine (896 +/- 205 vs. 48 +/- 359 nmol/100 ml/min/watt) was higher in the patients compared to the controls at the first exercise period with inverse changes in the opposite direction of asparagine (149 +/- 105 vs. 799 +/- 121 and 27 +/- 70 vs. 633 +/- 334 nmol/100 ml/min/watt at the first and second exercise, respectively. Alanine release did not differ between the groups. The complementary patterns of glutamine and asparagine during hypoxic exercise in the patients may reflect the fact that these amino acids share a common carrier system. The similarity in the efflux of non-metabolized amino acids, such as methionine, phenylalanine, tyrosine and 3-methylhistidine, indicated that muscle hypoxia in claudication patients did not promote net degradation of either globular or myofibrillar proteins, although exercise increased the efflux of 3-methylhistidine three- to fourfold in both patients and control individuals (from 1 +/- 0.4 to 4 +/- 1.8 and from 0 +/- 0.7 to 6 +/- 2.5 nmol/100 ml/min/watt, respectively). The exercise-induced alterations in leg exchange of amino acids were restored within 10-20 min following exercise regardless of hypoxia. The results demonstrate that patients with arterial insufficiency have altered intermediary metabolism of amino acids during exercise. However, muscle hypoxia in such patients does not seem to promote a negative protein balance or induce serious alterations in cell membrane integrity.
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PMID:Leg exchange of amino acids during exercise in patients with arterial insufficiency. 340 84

A randomized, single-blind crossover trial tested the effect of 1,000 mg of ibuprofen on jaw muscle pain induced by maximum voluntary teeth clenching (MVC). Subjects exercised MVC until there was onset of pain in the masseter muscles (pain latency in seconds), and until pain and exhaustion of the masseter and anterior temporalis muscles could no longer be endured (pain tolerance in seconds). Pain intensity was quantified by visual analogue scores, and pain sensitivity by the pain sensitivity range and the pain sensitivity ratio. During MVC the mean voltage of the left masseter muscle was recorded by cumulative surface electromyography. Ibuprofen had no significant effect on the pain latency and the pain tolerance. Neither did ibuprofen significantly decrease the pain intensity nor significantly affect the pain sensitivity range and the pain sensitivity ratio. After intake of ibuprofen, the number of electromyograms with a decrease in mean voltage was significantly increased--credibly, an expression of increased central fatigue with voluntary decruitment of motor units, and possibly the result of increased contraction times because of an undisclosed effect of ibuprofen. There was no circumstantial evidence of impaired motor activity that could be attributed to biosynthesis of prostaglandins.
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PMID:Effect of ibuprofen on isometric contractions and associated pain of the human masseter muscle. 347 69

The association of chronic pain, exhaustion, and multiple somatic complaints with apparent physical good health and long survival has a long history. The syndrome was called by many names including neuresthenia, rheumatism, and invalidism. When skeletal pain and stiffness were prominent, many observers recorded the existence of sites of tenderness and sometimes of areas of induration. The work of Lewis and Kellgren provided an experimentally reproducible method of study of the phenomena of referred pain and referred tenderness, which led to hypotheses about the nature of many of these syndromes, which were unfortunately too numerous and often contradictory. More recently, it has been learned that the sites of tenderness are precisely predictable in location and, under some circumstances, experimentally inducible. They are unknown to the patient and, therefore, due to mechanisms other than distortions of interpretation. The association with a variety of forms of sleep disturbance was discovered. These events have permitted the rapid evolution of controlled, numerical studies of these associations, which are reviewed briefly in this article.
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PMID:Tender points: evolution of concepts of the fibrositis/fibromyalgia syndrome. 353 81

This study was designed to investigate the effects of naloxone on athletic performance in humans. Two groups of elite middle-distance runners performed a maximal or a submaximal exercise protocol following the double-blind intravenous injection of either naloxone (0.15 mg X kg body wt-1) or saline. The maximal test (group M) was comprised of a short-duration treadmill run to maximal intensity; the submaximal test (group S), a prolonged submaximal treadmill run to exhaustion. O2 uptake, heart rate, ventilation, and perceived exertion were determined during each test. Perception of pain was assessed after exercise by use of a modified McGill pain questionnaire. No significant differences between placebo and naloxone treatments were found in any of the measured variables at the usually accepted 5% (P = 0.05) confidence level; however, evidence suggesting differences (i.e., P = 0.1 to 0.05) in these important respects was observed. In group M, maximal exercise performance measured by maximal O2 consumption was not different between placebo and naloxone; results suggest that VE was increased (P = 0.08) following naloxone, but only at the final work stage. In group S, exercise performance time was reduced following naloxone (P = 0.09), whereas the affective component of pain was increased (P = 0.06); no differences in the measured physiological variables were observed. These results suggest the following: 1) the opiate receptor-endorphin system may alter the perception of pain associated with prolonged high-intensity submaximal exercise with a resultant significant effect on performance; and 2) it may play a role in the control of ventilation during maximal exercise.
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PMID:Effects of naloxone on exercise performance. 609 11

Forty-five patients with intermittent claudication were first treated with placebo tablets for 3 months and then randomly allocated to double-blind therapy with either suloctidil or placebo for 6 months. Walking distance improved significantly in both groups during the 3 months of placebo treatment. During the 6 months of double-blind treatment with a further significant improvement occurred only in the placebo group when all patients were analyzed. However, when patients who stopped for reasons unrelated to claudication such as angina and exhaustion during repeated walking tests were eliminated, only suloctidil-treated patients improved significantly. The evolution of leg flow and distal pressure was similar in the two treatment groups whether all legs or only legs with abnormal flow and pressure values were considered. By contrast, when the analysis was limited to legs with claudication pain, a significant improvement occurred only in the suloctidil-treated group. These findings suggest that suloctidil may improve the claudication symptoms of patients with chronic arterial obstructive disease and in particular the perfusion of legs experiencing claudication pain. However, the clinical significance of this improvement appears limited.
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PMID:Controlled trial of suloctidil in intermittent claudication. 616 99

The exercise tests performed by 197 patients aged 65 years or more (mean age 68.8) have been reviewed, including 43 healthy subjects, 20 with high blood pressure, 10 with mitral valve disease and 125 with demonstrated coronary artery disease. All tests were done on an electrical cycloergometer, with load increases of 30 W every 3 min. Eighty-four (42.6%) achieved at least 85% of their maximal predicted heart rate. The reasons for non-achievement of this heart rate were limitation by symptoms (30.2%), betablocker therapy (25.8), exhaustion (20.2%), pain in lower extremities (14%) and non-adaptation to cycloergometer (10%). The maximum load achieved and the duration of exercise were significantly lower in mitral and coronary patients. Functional aerobic capacity was decreased in coronary and mitral patients. The VO2 max was directly determined in 45 patients. Mean values (ml kg-1 min-1) were 33.3 +/- 3.5 in normals, 15.4 +/- 6.2 in coronary and 15.8 +/- 4.1 in mitral patients. The incidence of arrhythmias during exercise was higher in hypertensive (55%) than in mitral (40%), normal (33.3%) and coronary patients (32.8%). In 5 patients the test had to be interrupted because of ventricular tachycardia. The yield of ST depression (greater than 0.1 mV) or elevation (greater than 0.2 mV) in the diagnosis of coronary artery disease was 0.62 sensitivity and 0.93 specificity. We conclude that stress test is a useful tool in cardiovascular diagnosis among older patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnostic value of stress testing in the elderly. 652 42

Twenty-one patients with intermittent claudication underwent a physical exercise program lasting 8 weeks. The patients were classified on the basis of maximal walking tolerance (MWT) and diagnosis at the initial examination. Seven of the patients had a MWT less than 1,000 m and no symptoms of chronic obstructive airways disease (COAD) or angina (group A), seven had a MWT less than 1,000 m plus angina and/or COAD (group B) and seven had an unlimited (greater than 1,250 m) MWT (group C). At the completion of the training program all three groups showed a significant improvement in walking distance to pain and stress test capacity. During the post-training walking tolerance test, the venous lactate concentrations in group A were lower after 2 min and 4 min of exercise, and at exhaustion (P less than 0.05). Group A patients showed a significant correlation between an increase in MWT after training and a decrease in maximum lactate concentration measured during walking. Although the patients in group B had a significant increase in MWT, blood lactate concentrations in this group were not always decreased by physical training. Group C lactate concentrations were lower after 8 min, 15 min, and 30 min of walking (P less than 0.05). It is concluded that a physical training program increases walking tolerance in different categories of claudicants, and possible mechanisms for the improvement are discussed.
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PMID:Intermittent claudication. The effect of physical training on walking tolerance and venous lactate concentration. 654 Jun 70

The development of fatigue and the relationship between psychological and physiological indices of fatigue were studied in a group of 18 male subjects during static contractions. Exercise was performed as a static elbow flexion at 25% MVC. Heart rate (HR), intraarterial blood pressure (BP) and surface EMG [mean amplitude (MA) and central frequency (CF)] were studied during contractions sustained until exhaustion. The amount of effort expended (relative to total exhaustion) and the rating of perceived pain were recorded following contractions interrupted after 20, 30 . . . 80, and 100% of endurance time. HR, BP and EMG amplitude responses were similar to those previously recorded. The decline in CF occurred in two phases, possibly related to a change in motor unit recruitment after the initial 70% of endurance time. The subjects overestimated the amount of effort expended and thus underestimated their endurance capacity. The best correlation between perceived effort and physiological responses was obtained using blood pressure data, whereas changes in EMG data did not parallel the psychological responses. It is concluded that the perception of effort during a static contraction is produced through a complex process, in which several influences of peripheral and central origin are integrated.
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PMID:Physiological and psychological indices of fatigue during static contractions. 668 52

Six male subjects exercised maximal voluntary tooth clenching until fatigue appeared in the masseter muscle and until pains and exhaustion of this muscle could no longer be endured; that is, the fatigue threshold and the pain tolerance of the muscle were determined in seconds. An occlusal splint was inserted and the clenching exercises were repeated. During these exercises, and also during 10s of clenching, the electrical activity in the masseter muscle was recorded by bipolar surface electrodes and linearly integrated. Use of the splint did not result in significant changes in the subjective sensations of onset of fatigue and endurance of pain. As the periods of clenching increased, after insertion of the splint, the electrical activity decreased consistently, and use of the splint caused a significant decrease in the electrical activity of the pain tolerance test. As induced by the splint, there was no orderly pattern in changes of the fatigue thresholds and pain tolerances in relation to changes in the electrical activities of these parameters. The mode of action of the splint, in reducing the muscle activity, might have been that of stretching the elevator jaw muscles beyond their resting length.
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PMID:Effects of an occlusal splint on integrated electromyography of masseter muscle in experimental tooth clenching in man. 693 79

Twelve children, five girls and seven boys with a mean age of 12 years, exercised maximal voluntary tooth clenching until intolerable pains and total subjective exhaustion of at least the right masseter muscle forced the children to stop the isometric muscle exercise; that is, the pain tolerance, or the isometric endurance time, of at least the right masseter muscle was determined in seconds, and it amounted to an average of 100 s. Concomitantly, the electrical activity in the right masseter muscle was recorded by bipolar surface electrodes and integrated, and it showed a significant decrease of 32% during the endurance test, probably as an expression of progressive physiological muscle fatigue. A large ANB angle was associated with relatively little decline of the contractile activity and a trend not to endure pains, possibly because isometric tension was generated predominantly by muscle fibres with a high anaerobic capacity.
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PMID:An electromyographic and cephalometric study on facial pains and facial morphology in children. 694 39


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