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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 the principal symptom in stage II of peripheral arterial occlusive disease. As this is a multilocular manifestation of atherosclerosis, a distinction must be drawn between treatment of the underlying disease with consideration of the individual risk factors and improvement and abolition of the intermittent claudication. Various therapeutic principles exist, and drug therapy is the subject of controversial discussion. On the basis of eight controlled, randomized studies, it was demonstrated that in comparison with placebo a statistically significant increase in the pain-free walking distance can be achieved by oral drug administration within 3-6 months. This drug therapy should be considered for those patients with intermittent claudication who cannot undergo revascularization, angioplasty, or walking training.
J Cardiovasc Pharmacol 1990
PMID:Peripheral arterial occlusive disease: conservative treatment of intermittent claudication. 136 24

A study was carried out in patients with intermittent claudication (Fontaine's stage II). The atheromatous origin of the disease was confirmed and localized by angiography or Doppler. One hundred eight-three patients were selected initially (day -30) with a pain-free walking distance on a treadmill (at a speed of 3 km/h and a slope of 10%) ranging from 150 to 300 m. During the first month (washout period) all patients received two placebo tablets daily. At the end of this run-in period (day -30; day 0) and after checking walking distance stability (allowed variation: 20% between the two measurements), patients were included in the study. According to this criterion, 112 patients were selected and 94 remained during the whole study. The study was designed in double-blind, using two parallel, randomly selected groups. Fifty-two patients received naftidrofuryl (2 x 316.5 mg tablets daily with meals) for 6 months; 42 patients received placebo under the same conditions. During this period, clinical and paraclinical examinations were carried out every quarter (day 90 and day 180). After checking the initial homogeneity of the naftidrofuryl and placebo groups, the comparison between the two groups indicates a significant improvement in the naftidrofuryl group after 3 months and 6 months of treatment, for the pain-free walking distance. For the maximal walking distance, a significant improvement was found at day 180. Nonparametric analysis (chi 2 test) also indicated a significant improvement for the naftidrofuryl group. These results confirm that naftidrofuryl is beneficial in the treatment of patients with chronic arterial disease.
J Cardiovasc Pharmacol 1990
PMID:Treatment of stage II chronic arterial disease of the lower limbs with the serotonergic antagonist naftidrofuryl: results after 6 months of a controlled, multicenter study. 136 25

A meta-analysis was performed on four clinical trials, conducted during 1980-1989 in France (two trials) and in the Federal Republic of Germany (two trials). Altogether, 596 patients with peripheral arterial occlusive disease (Fontaine's classification stage II) entered these four multicenter studies. Four hundred fifty-two patients completed the trials, 241 were treated with 600 mg naftidrofuryl orally per day and 211 were given a placebo. The studies were of a double-blind parallel design and lasted for 3 or 6 months. Inclusion and exclusion criteria were comparable, as were the experimental methods used. Occasionally, differences in study design and methods were observed. Risk factors were recorded in three of the four studies. The outcome criterion of pain-free walking distance was studied for the four trials together and showed a significant improvement in the active drug tested group, following both 3- and 6-month duration of treatment. The type of treatment, the severity of the disease, the existence of blood lipid disorders, and smoking were found to be the predictive factors associated with the evolution of pain-free walking distance during 3 months. The meta-analysis confirms the beneficial effect of naftidrofuryl in treating peripheral arterial occlusive disease.
J Cardiovasc Pharmacol 1990
PMID:The effect of naftidrofuryl on intermittent claudication: a meta-analysis. 136 27

Thirty-two patients (median age: 51 years) underwent aortoiliac endarterectomy between 1982 and 1990, for disabling claudication (27), rest pain (3), and tissue loss (2). There was no post-operative death and morbidity affected 6 patients. Five patients showed insufficient or suboptimal vascularisation of a limb which justified early reoperation in four. Follow-up was obtained in 31 patients with a median time of 36 months (6 months to 8 years). Five patients experienced recurrence of claudication symptoms: two received an aortofemoral bypass at 6 and 36 months. In the other patients, distal arterial occlusive disease accounted for recurrence alone (2 patients) or in association with aortoiliac involvement (1). Technical problems or disputable indications were responsible for postoperative failure in 3 cases or early recurrence of symptoms in 2. Cumulative patency rates of aortoiliac endarterectomy were 94 and 90 per cent at 2 and 5 years, and actuarial rates of clinical improvement were 90 and 82 per cent at 2 and 5 years, respectively. Aortoiliac endarterectomy provides the advantages of avoiding foreign material. The success of this reconstruction depends on strict criteria of selection and surgical expertise. It is indicated for the relatively young patient with nonectasic disease where atherosclerosis has not attacked the external iliac arteries.
Thorac Cardiovasc Surg 1992 Jun
PMID:Aortoiliac endarterectomy: a 9-year experience. 141 83

The development of new instruments that can be applied endoscopically opens up new possibilities for minimally invasive thoracic surgery. The surgical technique is exemplified by a thoracoscopic resection of a pericardial cyst. The benefits for the patient are impressive: minimization of surgical trauma and postoperative pain, a short convalescence, and an optimal cosmetic outcome.
Thorac Cardiovasc Surg 1992 Aug
PMID:Thoracoscopic resection of a pericardial cyst. 141 90

This prospective, Human Subjects Committee and Ethics Committee approved investigation was performed to determine if coronary angioplasty (PTCA) might be a reasonable alternative revascularization method for unstable angina patients thought to be at high risk for operative (CABG) mortality. Between March 1990 and October 1991, thirty-four consecutive patients with medically refractory rest angina were deamed to have high risk of surgical mortality and underwent PTCA without surgical backup. Predicted operative mortality was calculated for each patient based upon the VA Surgical Risk Assessment model. Angioplasty of 52 vessels was attempted. Reduction in lumenal narrowing to < 50% and improved angiographic flow was obtained in 47 vessels. There were four complicating infarctions. One death occurred in the lab, and three patients with unsuccessful angioplasty died within 30 days of pump failure. Relief of angina occurred in 30/34. Thirty patients were discharged home. In follow-up from 1 to 12 months, there have been 2 late sudden deaths at 4 months and 9 months, 1 death from lung cancer; 4 patients have stable exertional angina; 2 are awaiting heart transplant but are pain free, and one patient who had PTCA during cardiogenic shock from acute myocardial infarction had elective coronary artery bypass surgery. There have been no late myocardial infarctions. The observed angioplasty 30-day mortality of 11.8% (95% confidence limit 1% to 22.6%) compares favorably with the predicted operative mortality of 23.8% for this group. This prospective but non-randomized series supports the concept that balloon angioplasty may be a reasonable alternative to surgical intervention in some patients with unstable angina and high risk for surgery. A prospective randomized trial is warranted.
Cathet Cardiovasc Diagn 1992 Nov
PMID:Salvage angioplasty: an alternative to high risk surgery for unstable angina? 142 70

The purpose of this study was to examine the effect of a concurrent record of chest pain episodes on later completeness and accuracy of verbal recall. Patients included 23 men and eight women, ages 43 to 76 years from a private cardiology practice who were randomized into experimental (n = 16) and control (n = 15) groups. Following an initial interview, experimental patients were instructed in using a Chest Discomfort Diary in the home setting to record eight categories of information about each episode of chest pain experienced during the next 7 to 10 days. At the end of that time, both groups were interviewed about a specific typical episode of chest pain that had occurred; patients who did not have chest pain during the study period described an episode experienced prior to the initial interview. Experimental patients recalled their chest pain more completely than controls (P = 0.007), whether it had occurred during or prior to the study period. Experimental patients who had pain (n = 11), and thus actually used the diary, accurately recalled the duration, intensity, description, and treatment of the typical episode but were often inaccurate regarding their mood and the total number of episodes they had experienced. The findings suggest that a concurrent diary offers one method of teaching patients how to report their chest pain symptoms and may improve the completeness and accuracy of those reports.
J Cardiovasc Nurs 1992 Oct
PMID:Effect of concurrent chest pain assessment on retrospective reports by cardiac patients. 144 85

Placement of a balloon-expandable metallic stent (Strecker-Stent) for biliary drainage has been attempted in 30 patients. The stent was successfully implanted in 22 patients; in the remaining 8 patients, dilatation of the biliary stricture prior to stent placement was inadequate and delivery of the Strecker-Stent was, therefore, not possible. Insufficient balloon dilatation was related to the rigid nature of the stricture and to pain experienced during dilatation. During 2-9 months follow-up, 3 of 21 patients (14%) presented with reocclusion of the stented bile ducts. In all other patients, biliary drainage remains adequate. No major complications related to stent placement were observed.
Cardiovasc Intervent Radiol
PMID:A new balloon-expandable tantalum stent (Strecker-Stent) for the biliary system: preliminary experience. 147 60

Fifty-six patients with superior sulcus syndrome were evaluated at the First Surgical Department of the University of Padua between 1981 and 1990. Forty-two patients with the characteristic of Pancoast's tumor received preoperative irradiation and then en bloc resection of the tumor, chest wall, and adjacent structures. Seven lobectomies and 35 segmentectomies or wedge resections were performed. There was one early postoperative death. Median survival was 14 months, and actuarial survival was 25% at 5 years. Patients with pain relief had better 5-year survival (36.4%) than patients without pain relief (9%). We have no patients with vertebral invasion who survived more than 1 year. Of the five patients with subclavian artery invasion, only one survived more than 1 year. Of five patients with N2 disease, only one survived more than 1 year. Our results suggest that pain relief after irradiation is a good prognostic factor, whereas N2 involvement and vertebral body and great vessel invasion are ominous factors. Another ominous prognostic factor is the Claude Bernard-Horner syndrome even if it is not a contraindication to resection.
J Thorac Cardiovasc Surg 1992 Sep
PMID:Carcinoma of the superior pulmonary sulcus. Results of irradiation and radical resection. 151 56

This report assesses the validity of subscales from the Quality of Life Index (QLI). Subscale validity is tested across different samples of patients with cancer and other diseases. The results of the factor analyses of different versions of the QLI tested in six studies confirm four important health-related quality of life dimensions. These dimensions are psychological well-being, physical well-being, symptoms/side effects, and nutrition. Psychological well-being is represented by a satisfying life, having a good (general) quality of life, having fun, feeling happy and enjoying life. Physical well-being is defined by tiring easily (fatigue), ability to work/carry out usual tasks, strength, and feeling healthy. The symptoms/side effects dimension is characterized by nausea, vomiting, pain distress, and perhaps, by pain amount and pain frequency. Finally, the nutrition dimension is represented by able to eat/eat sufficiently, eating pleasure/appetite, worry about weight, and possibly also taste changes. Good construct validity can be attributed to these health-related quality of life subscales.
Prog Cardiovasc Nurs
PMID:Validity of health-related quality of life subscales. 151 79


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