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)

The authors present the clinical history of a 61 year old woman who was treated in the Metropolitan Hospital Complex Arnulfo Arias Madrid of the Social Security. The patient had experienced weight loss, chills and pain in the left chest for a period of one month. The chest X-ray showed an irregular oval shaped pulmonary infiltrate, 5 x 5 cm, in the upper one third of the left lung field. Fiberoptic bronchoscopy revealed an endobronchial lesion in the superior division of the left upper lobe bronchus. Transbronchial biopsy and bronchial brushings showed Crytpcoccus neoformans. Clinical evaluations did not reveal involvement of the central nervous system, the immunological system or evidence of neoplastic disease. The patient was treated with Amphotericin B and Ketoconazole resulting in a complete cure. Amphotericin B was used on an ambulatory basis for the first time in their institution and in Panama.
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PMID:[Pulmonary cryptococcosis]. 202 56

The antifungal drug ketoconazole has been shown to block testosterone synthesis. High dose ketoconazole therapy was given to 17 patients with previously untreated stage D2 prostatic cancer. Rapid relief of pain occurred in 15 patients with significant pain. Prostatic acid phosphatase levels normalized or decreased in all patients. Bone scan scores were stable or improved. Two patients remain on therapy for more than 30 months. The remainder have ceased treatment owing to subsequent progressive disease (5 patients), side effects (6) or noncompliance. Eleven patients who had relapse after previous endocrine ablative therapy were treated with ketoconazole. Subjective responses were frequent but long-term objective responses were rare. There was a high incidence of side effects, particularly nausea. Ketoconazole may have limited usefulness as initial therapy in patients with endocrine responsive advanced prostatic cancer. The drug can be palliative in some patients who have failed previous therapeutic modalities. Analogues of the drug should prove to have better efficacy and fewer side effects.
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PMID:Long-term experience with high dose ketoconazole therapy in patients with stage D2 prostatic carcinoma. 243 34

Forty-four patients who had metastatic cancer of the prostate that had not responded to conventional hormonal manipulation were treated with high-dose ketoconazole (600 to 1200 mg/d). All had castrate serum concentrations of testosterone prior to therapy. All patients had been categorized as having progressive cancer on assessment by the criteria of the National Prostatic Cancer Project. After treatment with ketoconazole, 57% were recategorized as having stable disease. The majority showed marked subjective lessening of pain on this therapy. Objective responses were noted but were not consistent. Side-effects were common but tolerable. The mean survival time was 73.3 weeks. Ketoconazole may be a useful palliative adjunct in the treatment of hormone-refractory prostatic cancer.
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PMID:Effects of high-dose ketoconazole on patients who have androgen-independent prostatic cancer. 247 37

Ketoconazole in high doses causes castrate levels of testosterone within twenty-four to forty-eight hours; therefore it is extremely useful in the initial medical treatment of patients with metastatic prostate cancer who need a prompt therapeutic response. Review of 17 patients who presented with severe radicular pain or acute paraparesis/paraplegia showed that there was frequent delay in urologic consultation, pathologic confirmation, and initiation of efficacious therapy. In fact, 5 of 12 patients (42%) who received radiation therapy prior to effective hormonal therapy suffered significant morbidity and mortality. The case is made for the use of ketoconazole for initial empirical therapy for these patients.
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PMID:Ketoconazole in initial management and treatment of metastatic prostate cancer to spine. 317 17

Forty-four patients with metastatic cancer of the prostate that had failed conventional hormonal manipulation were treated with high-dose ketoconazole (600-1,200 mg/day). All patients had castrate serum concentrations of testosterone prior to therapy. All of the patients had been assessed by the criteria of the National Prostatic Cancer Project and been categorized as progressing. Over 50% of the patients were recategorized as having stable disease. The majority of the patients showed marked subjective improvement in pain on this therapy. Objective responses were noted but were not consistently seen. Side effects were common but tolerable. The median time of survival was 73.3 weeks. Ketoconazole may be a useful palliative adjunct in the treatment of hormone refractory prostatic cancer.
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PMID:Effects of high-dose ketoconazole in patients with androgen-independent prostatic cancer. 324 85

Five previously untreated patients with advanced carcinoma of the prostate were treated with the non-estrogenic antifungal agent Ketoconazole in high doses. A rapid fall in serum testosterone, adrenal androgens and serum prostatic acid phosphatases was recorded accompanied by a striking clinical response with reduction of skeletal pain and improvement of performance status. In one patient this was dramatically shown by reduction of a large pelvic tumor and associated edema of the left lower limb. Side-effects such as weakness, fatigue and loss of appetite made four of the patients withdraw from the study. Serum testosterone and serum prostatic acid phosphatase initially suppressed, increased slowly during the treatment period. Consequently, Ketoconazole as sole therapy in the treatment of advanced carcinoma of the prostate was stopped. However, the initial rapid decrease in serum testosterone and the striking positive clinical effect may possibly be utilized combined with orchiectomy or treatment with LHRH agonist analogues.
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PMID:Ketoconazole high dose in the hormonal treatment of advanced carcinoma of the prostate. A pilot study. 344 23

A patient presented with pain in the right lower back, radiating down the right leg. Initial pelvic X-rays did not reveal any lesion. A follow up computerized tomography (CT) scan and technitium scan showed a sharply lytic lesion of the right ilium extending to the right sacroiliac joint. Open biopsy revealed a granulomatous inflammation with many budding yeast from consistent with Blastomyces dermatitidis. Subsequent culture confirmed this identification. There was no other site of fungal infection. Two courses of Amphotericin B (each to 2 g total dose) failed to eradicate this infection. The patient is now responding to Ketoconazole.
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PMID:Case report: blastomycosis causing sciatic neuritis. 608 84

Eighty-five consecutively seen HIV-positive persons with oral candidiasis were evaluated for clinical characteristics, staging of HIV disease, quantitation of candidal colony formation, and response to systemic antifungal treatment with Nizoral (ketoconazole). Fifty-five had CD4 counts less than 200. There was an inconsistent association between clinical signs, patient symptoms, CD4 counts, and candidal colony-forming units. However, there was a trend toward higher colony-forming unit counts (> 500) in patients with lower CD4 cells (< 200). Sixty-five patients had a complete clinical response to the ketoconazole treatment (200 mg daily for 7 days), even though 81% of posttreatment cultures remained positive. Nonsmokers were more likely to respond to antifungal treatment when compared with smokers, and there was a slight tendency for complete responses when colony-forming unit counts were low. The most common lesion presentation was a combination of the white (pseudomembranous) and red (erythematous) forms. Forty-nine percent had complaints of pain. The variable responses indicated the importance of flexible dose-time and drug considerations in antifungal management. Candida albicans was the predominant species.
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PMID:Clinical characteristics and management responses in 85 HIV-infected patients with oral candidiasis. 889 77