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 results obtained with a new hormone therapy using medroxyprogesterone acetate (MAP) in previously untested single and total doses in the treatment of advanced breast cancer are reported. Fifty-two postmenopausal patients were treated with an average total dose of 40 g of MAP for a period of 30 days. Nineteen of 44 patients (43%) had complete or partial remission, while the disease remained unchanged in nine of 44 patients (20%). Disease progression occurred in 12 of 44 patients (27%). Partial or complete remission occurred in 12 of 18 (67%) and four of six (67%) of the patients with dominant osseous and soft tissue metastases respectively. Three of ten (16%) of those with visceral metastases had remission. The average duration of remission was 7 months. Average survival times were 15.5 months for patients with remission, 8 months for those with no change, and 2.5 months for those with disease progression. From a subjective standpoint, pain was reduced significantly or disappeared in 34 of 36 patients (94%); this was also the case with respect to dyspnea (13 of 16 patients [81%]), anorexia (24 of 29 [83%]), asthenia (28 of 35 [80%]), and walking impairment (15 of 24 [63%]). When relapse occurred, patients previously treated with massive doses of MAP received further treatment with higher doses of MAP; four of 22 (18%) of the patients attained partial remission once again. Positive effects were also seen in subjective performance status, body weight, and EKG. We also describe the new clinical and toxicologic features of this treatment.
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PMID:A possible new approach to the treatment of metastatic breast cancer: massive doses of medroxyprogesterone acetate. 35 Mar 87

(MPA) Medroxyprogesterone acetate when employed at high doses (5001000 mg/day intramuscularly) can produce objective remission with improved survival in about 30% of postmenopausal women with advanced breast cancer resistant to cytotoxic drugs and endocrine therapies. When administered to women not previously treated with chemotherapy, the objective remission response rate reached 40%. From available evidence, high dose MPA can be considered a useful agent in the treatment of advanced breast cancer in postmenopausal women with soft tissue, pulmonary, pleural, or osseous involvement even when patients have become refractory to prior hormone and cytotoxic therapies. Early results suggest that the response rate can be increased in patients with estrogen-and/or progesterone-positive receptors. It is noteworthy that in a study conducted on postmenopausal women resistant to cytotoxic and/or hormonal drugs, the median duration of survival was 13.5 months, while CRs and PRs did not reach the median at 24 months after beginning MPA treatment. High dose MPA is essentially devoid of major side effects. Relief of pain, increase in appetite, and body weight, and sense of wellbeing are characteristic features of the improved quality of life under MPA treatment. However, a gluteal abscess (from 2-20% dose-related) is the most frequent side effect. A promising area for future studies is combined therapy using hormonal and cytotoxic agents or alternating sequential combinations. Well-designed studies are needed to develop means for increasing the complete response rate and therefore survival. Recent studies of combined chemotherapy and hormonal (MPA) therapy have yielded objective tumor regressions of 53-80% with an increased rate of complete remissions and duration of response. (Author's modified)
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PMID:High-dose medroxyprogesterone acetate (MPA) treatment in advanced breast cancer. A review. 39 Jul 98

A study was conducted at the Family Planning Centre of the Hospital Jose Joaquin Aguirre, Chile, involving 146 patients who had a Progestasert TM IUD inserted and 149 patients who had a Copper 7 IUD, Gravigard TM, inserted to determine the occurrence of dysmenorrhea. All patients completed questionnaires concerning habitual pelvic or genital pain prior to IUD insertion as well as at 1, 3, 6, and 12 months after insertion. Results indicated a reduction in menstrual cramps over 12 months of use. The Progestasert TM group showed a slightly higher reduction of menstrual cramps than Copper 7 users; however, the reductions are not significant. There were no significant differences between premenstrual and intermenstrual cramps. With the use of a questionnaire and the subjective condition of pain, it is difficult to ascertain whether the IUD produced any change in menstrual cramps or whether the reduction of pain originated in the patients; therefore, the technique of questioning the occurrence of pain may not be reliable enough.
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PMID:A comparative study of the effect of the Progestasert TM and Gravigard IUDs on dysmenorrhoea. 52 41

A progesterone intrauterine device (IUD), Progestasert, was prescribed for 25 patients unable to use an ordinary non-hormonal IUD. Both the amount of menstrual bleeding and the discomfort was observed to decrease more often than increase during the period of use of the progesterone IUD. Hemoglobin, hematocrit and the serum iron levels either remained static or increased. Continuation rate was 76 per cent after one year. The authors consider Progestasert a suitable alternative to the ordinary non-hormonal IUD in women with dysmenorrhea or menorrhagia and those in whom a previous IUD had been associated with pain or increased menstruation.
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PMID:Intrauterine progesterone contraceptive system as an alternative in cases where conventional IUD's are unsuitable. 57 35

Depo-Provera injections appear to be a safe and effective alternative for women who cannot tolerate the estrogenic side effects associated with oral contraceptives or the pain and bleeding associated with IUDs. However, women considering the method should be fully aware of the possible risks: (a) inability to withdraw the drug promptly in the event of a serious reaction, (b) disruption of menstrual patterns, and (c) delayed return of fertility after discontinuing therapy. Some women may consider the required trip to the doctor every 3 months an additional disadvantage. For women in developing countries where anemia and nutritional problems are prevalent, Depo-Provera has additional advantages in relation to IUDs and OCs: it causes less bleeding than IUDs or OCs and, unlike oral contraceptives, it does not suppress vitamin levels (4-8). Since it requires a trip to the doctor every 3 months, it also provides a better opportunity for medical supervision and care. For postpartum women who which to breastfeed their babies, Depo-Provera has the additional advantage of causing no adverse effect on lactation (1, 2, 13, 14, 16, 18, 19, 25, 32, 36).
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PMID:Experience with medroxyprogesterone acetate (Depo-Provera) as an injectable contraceptive. 60 84

Women with complaints of moderate or severe dysmenorrhea received intrauterine progesterone contraceptive system (16 patients) or placebo systems releasing no hormone (8 patients). Tampons were collected during the period prior to insertion and from 11 and 6 women, respectively, in the two groups at the second and fourth postinsertion periods. Prostaglandins in menstrual blood were extracted, and the amount and concentration of PGF2alpha analyzed for each patient. The menstrual blood loss (MBL) was determined by the method of Hallberg and Nilsson. The total PGF2alpha content was significantly lower in the group using progesterone systems than in the placebo group at collections 2 and 4 and was well below the preinsertion level; in placebo users the content tended to be slightly higher than it had been before insertion. The MBL increased approximately 60% above preinsertion levels in five of the six women using placebo units and decreased approximately 40% in 10 of 11 women with progesterone systems. Of the eight women in the progesterone group who had reported severe dysmenorrhea prior to insertion, seven reported an improvement; three of six in the placebo group reported a lower degree of improvement. These findings suggest that the decreased biosynthesis of PGF2alpha is a concomitant of intrauterine progesterone administration and may be a basis for the ability of the Progestasert system to diminish menstrual pain.
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PMID:The effect of exogenous intrauterine progesterone on the amount and prostaglandin F2alpha content of menstrual blood in dysmenorrheic women. 72 96

This study 1) compared the efficacy and continuation rates for the Progestasert (UPS) and Nova-T (Y-shaped, copper-medicated, 200 sq. mm., with flexible arms) and 2) determined the serum immunoglobulin response to women wearing 1 of these 2 differently medicated IUDs. Overall continuation rates for the 2 types of IUDs over a 1-year observation period (UPS must be changed yearly) were similar. Expulsion rate for Nova-T (9.2%), however, was considerably higher (P=.001) than for the UPS (1.2%). Pregnancy rate for the UPS by the Pearl index was 4.8 and was insignificantly higher than that for Nova-T (Pearl index=2.8). 2 UPS pregnancies were ectopic. Removals for bleeding/pain (i.e., medical removals) were more frequent (P=.082) for UPS (15.4%) than for Nova-T (6.1%). No significant changes in reactive immunoglobins (Igs), i.e., IgA, IgG, or IgM, were observed in either IUD group. Results suggested that neither IUD was preferable to already existing medicated IUDs.
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PMID:Experience with two different medicated intrauterine devices: a comparative study of the Progestasert and Nova-T. 76 75

193 women were fitted with a progesterone-releasing IUD (Progestasert) and followed for a total of 1823 woman-months (minimum 1 year use); 108 were nulliparous and 84 parous. Patients were examined at 1, 6, and 12 months and were interviewed to assess length of cycle, duration of flow, amount of flow, pain associated with menstruation, and intermenstrual bleeding and pain. Endometrial biopsies were performed on 45 patients and serum estrogens and progesterone measurements were made. There were .5 pregnancies/100 woman-years during the first 12 months of use. Overall expulsion rate was 7.4/100 woman-years; 4.8 and 10.7 corresponding to nulliparous and parous, respectively. 77% of expulsions occurred within 1 month of insertion. Intermenstrual bleeding occurred in small amounts and during the first 2 months of use. Menstrual flow and dysmenorrhea were significantly reduced. The overall continuation rate was 76.0 + or -3.2. Normal ovulatory function continued after insertion. Endometrial biopsies demonstrated glandular atrophy and decidual reaction after 12 months use.
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PMID:Effects of the Progestasert on the menstrual pattern, ovarian steroids and endometrium. 92 52

55 patients, aged 18-40, for whom functional dysmenorrhea had been diagnosed, were inserted with the Progestasert, a progesterone-releasing IUD, on the 4th day of cycle. 14 patients had previously been treated with estroprogestinic agents for dysmenorrhea, but had stopped the treatment because of its side effects. All patients were checked 1, 6, and 12 months after insertion. Menstrual and premenstrual pain regressed sensibly after the first month, and almost disappeared after the 6th. A normalization of the menstrual cycle was also noted. No side effects were reported.
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PMID:[Use of Progestasert in the treatment of function dysmenorrhea]. 92 38

Progesterone, like estrogens, is used in the treatment of metastatic breast cancer. The 3 most active derivatives are megestrol, norethisterone acetate, and medroxyprogesterone acetate (MPA). This study evaluates the use of MPA in treating metastatic breast cancer in 40 postmenopausal women (average age, 63 years; average duration of postmenopause, 14 years) who have either not responded to or have relapsed after therapy with estrogens and androgens. 18 patients received a depot preparation of MPA intramuscularly in a loading dose of 3.2 g over a 2-week period and then 400 mg at 2-4 week intervals. 22 patients received the drug orally in a dose of 200 to 300 mg daily. Patients were evaluated after 6 weeks of therapy. Criteria for evaluating response were those used by the Eastern Cooperative Oncology Group. Only 2 of 40 patients exhibited an objective response (disappearance of metastatic lymph node for 9 months in 1 and well-documented clinical improvement and control of brain metastases for 22 months in another). 2 patients had mixed responses of chest wall metastases (regression of some but not all lesions) lasting 3 and 4 months respectively. 5 patients had obvious subjective response (pain relief) but no objective response. Overall response rate was 22%: 4 objective responses (10%) and 5 subjectives responses (12%). Route of administration did not correlate with response. Tumor stimulation and clinical deterioration occurred in 4 patients. It appears that MPA therapy is costly and of minimal usefulness as secondary therapy in metastatic breast cancer. Further studies should focus on megestrol and norethisterone acetate which have been documented to have better response rates.
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PMID:Response to medroxyprogesterone acetate (NSC-26386) as secondary hormone therapy for metastatic breast cancer in postmenopausal women. 126 Jul 80


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