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)

Ten patients (6 women and 4 men), with a group mean age of 65 years, defined as severe and with a mean follow-up period of 9 years and refractory to conventional treatments, were treated with monoclonal anti-CD4 antibodies in an open study. The monoclonal antibodies, of murine origin, were administered by intravenous route for ten consecutive days at a dose of 10 mg (1 patient), 15 mg (2 patients) or 20 mg (7 patients). Local and systemic tolerability were excellent. Clinical improvement was rapid (pain, morning stiffness, Ritchie index, p = 0.005 between D0 and D15), as was the paraclinical improvement (C-reacting protein, p = 0.008), although without achieving complete remission. The outcome revealed that the effect was more prolonged in patients treated with 20 mg per day than in the others, suggesting a dose-effect relationship. The improvement obtained may persist for more than 9 months in some patients. No significant change in immunological parameters was found at the end of the treatment (lymphocyte populations, immunoglobulins, complement). Only 2 out of 10 patients developed anti-mouse antibodies. As a result of its excellent tolerability and rapid effectiveness, this antibody appears to offer fresh therapeutic prospects in rheumatoid arthritis.
Rev Rhum Mal Osteoartic 1991 Jan
PMID:[Therapeutic use of a monoclonal, anti-CD4 antibody in refractory rheumatoid polyarthritis. Preliminary results]. 187 15

This study analyses the results of 30 surgical repairs of the rotator cuff. The basic problem was degenerative pathology in which medical treatment had been tried previously in all cases. The type of treatment was based upon preoperative evaluation and arthro-CT scan in particular. Results were invariably good, with regression of pain and recovery of activity. Muscle power was significantly correlated with the value of the tendon repaired, this being reflected overall by incomplete recovery.
Rev Rhum Mal Osteoartic 1991 Jun
PMID:[Surgical treatment of ruptures of the rotator cuff]. 189 81

Four new cases of ankylosing spondylitis complicated by a cauda equina syndrome are reported. Similarly to the previous descriptions, the patients present with long-standing and severe spondylitis at the time when neurological symptoms, mainly radicular pain, develop. Computed tomography of the lumbar spine demonstrates in all cases typical laminar erosions and posterior arachnoid diverticula. Up to now, magnetic resonance imaging has rarely been performed in this particular pathology, though it is helpful in determining the anatomical relations and the nature of the lesions. Based on the previous publications, our study aims at describing the clinical and pathogenic aspects of the disease and defining the most useful diagnostic investigations and treatment choices. Therapeutic possibilities are often limited because of a late diagnosis. Better knowledge of this rare complication could lead to earlier recognition and more efficient therapy.
Rev Rhum Mal Osteoartic
PMID:[Ankylosing spondylarthritis and partial cauda equina syndrome. Apropos of 4 cases and review of the literature]. 192 99

On the basis of a prospective study of 104 patients, the authors discuss the diagnostic value of the clinical symptoms revealing the thoracic outlet syndrome (TOS), as well as the specificity of the vascular functional exploration carried out to establish the diagnosis. Non-systematized pain and dysesthesia in the upper limb, with a postural or nocturnal onset, and Raynaud's sign are the most frequently observed signs. The "candlestick" maneuver still is the most reliable clinical triggering maneuver. The clinical features and the vascular functional explorations (capillaroscopy and digital plethysmography) allow demonstrating the existence of a true Raynaud's syndrome secondary to the TOS. The results of the arterial Doppler study distinguish the symptomatic and asymptomatic sides in the same patient, though without any correlation with the symptoms observed. The Doppler examination therefore seems to be reliable to demonstrate an anatomical duct, but remains insufficient to establish a causal relationship with the signal symptoms in most cases.
J Mal Vasc 1991
PMID:[Vascular manifestation of thoracic outlet syndrome. Prospective study of 104 patients]. 194 Jun 45

Arthritis in mucoviscidosis has been described as aseptic arthritis with the picture of oligo or polyarticular intermittent rheumatism, independent of the pulmonary course of the disease, often accompanied by skin signs, sometimes in the form of vasculitis, and without radiological signs. Chronic forms with the presence of rheumatoid factor and/or radiological signs have also been described. The authors found 4 cases of arthritis (incidence 2%) in a retrospective study of 208 patients with mucoviscidosis. These included one case of typical intermittent rheumatism, one of chronic arthritis of the wrist with positive rheumatoid factor, one case associated with purpura, the course of which was linked to pulmonary secondary infections, and one case of polyarthritis with spinal pain which was difficult to classify. Arthritis in mucoviscidosis appears to be a clinically heterogeneous entity, the pathophysiology of which could involve various immune reactions, secondary to a chronic bacterial stimulus of bronchopulmonary origin.
Rev Rhum Mal Osteoartic 1991 Mar
PMID:[Arthritis in mucoviscidosis. 4 new cases and review of the literature]. 205 87

The subject of this prospective study was to appreciate the natural history of 34 herniated lumbar nucleus pulposus after recovery excluding surgical or intra-discal therapy. First CT scan was performed when radicular pain was worst, second CT between 1 and 32 months after recovery (6 to 40 months after the first CT). After the first 18 months, 18 herniations decreased more than 50% (group I) and 7 less than 25% (group II). Most herniations of group II were large or middle sized and two narrowing of discs were observed between the two CT. Group II was made of small sized herniations and 4 discs out of 7 narrowed. Beyond 18 months, herniations decreased more than 75% excepted one being calcified. Decrease of herniations and of intra-discal pressure were observed in the study. Both could allow recovery.
Rev Rhum Mal Osteoartic 1991 May
PMID:[X-ray computed tomographic study of the outcome of lumbar disk hernia after conservative medical treatment (34 cases)]. 178 Jun 81

Short term symptomatic treatment concerns, above all, painful, active osteoarthritis. Long term treatment prevents or slows down the destruction of cartilage and is assessed by radiological measurement of the joint space in the hip and knee. This must also be combined with a clinical criterion based on a functional pain index and the quality of the patient's life. Interphalangeal osteoarthritis, excluding root arthrosis of the thumb, is a good model and the preventive effect of treatment can be assessed from the extension of interphalangeal involvement. In the lower limbs, osteoarthritis of the hip in its idiopathic form (with overall superior or supra-external narrowing) and minor dysplasias were selected. Internal femorotibial osteoarthritis is suitable for evaluating a drug's effect in protecting cartilage. Other varieties are reserved for symptomatic treatments.
Rev Rhum Mal Osteoartic 1990 Oct 30
PMID:[Objectives to be assigned to the various proposed treatments (NSAID, analgesics, preventive or curative fundamental treatments). Which type of patients for which type of clinical trials]. 208 Apr 12

The best assessment tests for long term trials on osteoarthritis (OA) of the hip and knee are the following, in order of relevance value (consensus of french experts): 1) the loss of joint space thickness on successive radiographies; 2, 3) the indices of the severity for OA of the hip and knee; the investigator's overall opinion; 4) the patient's overall opinion (visual analogue scale of handicap); 5, 6, 7) the pain level (visual analogue scale); the time for going up and down a standard flight of stairs and the time of pain in this distance; the limitation of two articular movements; 8) the increase of either analgesics or NSAIDs consumption; 9) concerning OA of fingers, the number of joints newly involved on successive radiographies. At present, only the radiological tests 1 and 9 are validated. The clinical tests 2 to 8, valuable for short term trials, have yet to be validated for long term follow-up. Recommended duration of trials is three years. A rigorous organisation is necessary to avoid erroneous inclusions: all data recorded in the pre-inclusion visit have to be checked by the principal investigator. Since we have not yet a validated chondroprotective agent as a reference drug, the trial must be randomised, double blind, placebo controlled, parallel group study.
Rev Rhum Mal Osteoartic 1990 Oct 30
PMID:[How to evaluate the long-term course of osteoarthritis. Tests for trials of fundamental treatments (spine excluded)]. 208 Apr 13

The results of immediate percutaneous transluminal coronary angioplasty (PTCA) (260 +/- 167 minutes after onset of pain and an average of 56 minutes after thrombolysis) and deferred PTCA (average 9.6 days, range 1 to 30 days after infarction) were compared in 118 consecutive patients with acute myocardial infarction. The overall primary success rate of PTCA was 82.2 per cent; it was higher in those patients undergoing deferred angioplasty (96% vs 78%; p less than 0.05). The primary success rate of immediate PTCA was related to the severity of the stenosis before dilatation: 75 per cent success in occluded compared to 84 per cent in suboccluded vessels (over 90% stenosis) and 100 per cent success in vessels with under 90 per cent stenosis. Eighty one per cent of failed angioplasties occurred in patients with occluded arteries, the majority being left anterior descending (LAD) arteries (71.4%). The incidence of restenosis was 13.4 per cent. This complication was diagnosed at coronary arteriography performed 40 days after PTCA in 1 case, 47 days after PTCA in another case and at the 6 month control in 11 cases. Reocclusion was observed in 21 patients (21.7% of immediate successes). The occlusion was diagnosed at the first control after an average of 8 days in 15 cases. The interval between the onset of pain and thrombolysis and dilatation was significantly longer in the group with reocclusion compared with patients without reocclusion (314 minutes vs 193 minutes for thrombolysis, p less than 0.01; and 356 minutes vs 204 minutes fort PTCA, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1990 Feb
PMID:[Immediate or delayed angioplasty during the acute phase of myocardial infarction. Apropos of 118 cases]. 210 49

Two-dimensional echocardiography with intravenous injection of dipyridamole (0.56 mg/kg) was performed in 33 consecutive patients with acute (2 +/- 2 days) postero-inferior myocardial infarction for semiquantitative segmental wall motion analysis. The results were compared with those of coronary angiography which was carried out during the hospital period. After a second evaluation of the recordings the following results were obtained: feasibility: 94 per cent with 85 per cent of segments analysed. Residual ischaemia in the first days of myocardial necrosis was common (70%). The ischaemia was often clinically silent including during the investigation (61%). When pain occurred, it always followed changes in regional wall motion. The dipyridamole test suggested multivessel disease with a sensitivity of 72 per cent and a specificity of 90 per cent, and residual arterial stenosis with a sensitivity of 75 per cent ans specificity of 80 per cent the secondary effects were minor. The main limitation of the test is related to the distinction between pharmacological and physiologic ischaemia. A positive test was associated with lesions justifying myocardial revascularisation (coronary bypass or angioplasty) in 19 out of 23 cases but with a very poor correlation with the topography of the coronary lesions. A negative test indicated arterial occlusion, residual stenosis with extensive myocardial damage or a normal coronary angiogram. Therefore, the dipyridamole echocardiography test may help identify a group of patients with little or no myocardial ischaemia in whom invasive investigations could be deferred; these patients contrast with the group with a positive test indicating residual ischaemia in which the coronary lesions should be documented by coronary angiography.
Arch Mal Coeur Vaiss 1990 Feb
PMID:[Dipyridamole echocardiography test during the acute phase of lower myocardial infarction]. 210 58


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