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)

Twenty-one femoro-crural bypass procedures with a distal arteriovenous fistula (dAVF) were constructed in 20 patients with severe leg ischemia (Fontaine stage III, IV). They were followed-up for 3 to 22 months, with a mean of 8 months. The 15 patients with patent grafts and fistulas no longer had pain at rest; ischemic necroses healed. Telethermography showed a considerable augmentation of the distal limb perfusion. The mean increase of the transcutaneous oxygen pressure was 30 mmHg. One early postoperative amputation was necessary due to graft infection. Another patient lost her leg because of bypass occlusion 9 months after arterial reconstruction. Four patients with late graft occlusion kept their regained mobility and alleviation. Our data confirm experimental results suggesting that femoro-crural bypass with a dAVF improves distal leg perfusion by reversal venous blood flow and stimulation of a collateral network. Femoro-crural bypass with a dAVF may be of benefit in selected cases when only one crural artery is patent and pedal arch vessels are absent.
Thorac Cardiovasc Surg 1985 Dec
PMID:Crural arterial reconstruction with an adjunct arteriovenous fistula for limb salvage. 241 79

We measured the plasma concentrations of mexiletine in patients admitted to a hospital coronary care unit after the intramuscular injection (IMI) of 200, 300, 400, and 500 mg mexiletine. Mexiletine was rapidly absorbed and concentrations greater than 0.75 microgram/ml were achieved in some patients within 5 min of the injection. The maximum mean plasma concentration increased with 200, 300, and 400 mg but was lower after 500 mg than after 400 mg. After 400 mg mexiletine, plasma concentrations greater than 0.75 microgram/ml were achieved in at least seven of nine patients from 15 min to 2 h after administration. There were no local reactions to 200, 300, or 400 mg mexiletine, but local pain and tenderness occurred in three of nine patients after 500 mg. It was decided that 400 mg mexiletine would probably be the desired dose for intramuscular administration. In 14 patients given mexiletine 400 mg by IMI followed at 2 and 12 h by 360 mg by mouth the plasma concentration was in the therapeutic range (0.75-2.0 micrograms/ml) from 15 min to 24 h in at least 64% of patients. In 12 healthy volunteers the IMI of 400 mg mexiletine increased total creatinine kinase (CK), aspartate amino-transferase, and lactate dehydrogenase enzymes but CK-MB, LDi, and LDii concentration or LDi/LDii ratio were not outside the normal range. These studies indicate that mexiletine can be safely given to patients by IMI and that therapeutic plasma concentrations are achieved.
J Cardiovasc Pharmacol
PMID:Plasma concentrations and acceptability of mexiletine given by intramuscular injection in patients admitted to a coronary care unit. 241 87

To assess the safety of the slow calcium-channel blocker nifedipine in patients with acutely evolving myocardial infarction, hemodynamic effects of the drug were studied in 12 patients and infarct size was determined by enzymatic method in 14 patients presenting within 12 h of onset of pain. Nifedipine (3 doses of 20 mg given sublingually at 8-h intervals) produced a significant increase in heart rate and cardiac output accompanied by a fall in systemic arterial pressure and vascular resistance. These effects were sustained for a 24-h period of study. Despite an increase in heart rate and cardiac output, there was no worsening of symptoms or electrocardiographic evidence of myocardial ischemia. Assessment of infarct size did not reveal any differences between the control group and the patients who received nifedipine. We conclude that nifedipine may be safely given to patients with acute myocardial infarction. The drug may be usefully employed in patients with acute myocardial infarction accompanied by angina or hypertension.
J Cardiovasc Pharmacol
PMID:Hemodynamic effects of nifedipine in acute myocardial infarction with observations on infarct size. 242 63

Recent studies indicate a reduced sensitivity to pain in genetically and experimentally hypertensive rats. A similar finding is also reported for human established hypertension. However, to our knowledge, no data have been reported in borderline hypertension. The aim of this study was to assess in subjects with borderline hypertension the sensory and pain thresholds by a noninvasive pulp-stimulation test performed with a commercial pulp tester that delivered stepwise increased electrical stimuli to four healthy teeth. The data reported are the means of measurements. In order to assess the possible importance of differences in the selection of the controls, two distinct groups of normotensives were chosen, one of volunteers and the other of outpatients. Significantly higher values for the pain and sensory thresholds were observed in borderline hypertensives compared with pooled normotensives. No significant effect on pain perception could be observed for sex, whereas a significant tendency toward higher threshold levels was found for younger subjects. In two normotensive groups, the sensory and pain thresholds were significantly higher in volunteers than in patients. These results suggest that changes in pain perception are present not only in established hypertension but also in borderline hypertension and, moreover, that differences in the selection of normotensive controls can have important influences on the results.
J Cardiovasc Pharmacol 1986
PMID:Comparison of pain perception in normotensives and borderline hypertensives by means of a tooth pulp-stimulation test. 242 71

The effectiveness of a 72 h. intra-arterial prostacyclin infusion has been compared to that of naftidrofuryl oxalate (Praxilene) in a double blind study of 29 patients with ischaemic rest pain in 30 legs. Long-term relief of symptoms was achieved in 14 legs (47%) and major limb amputation avoided in 18 (60%). No significant difference was demonstrated between the results of prostacyclin infusion and those of Praxilene.
J Cardiovasc Surg (Torino)
PMID:Intra-arterial prostacyclin compared to Praxilene in the management of severe lower limb ischaemia: a double blind trial. 243 38

Neuroendocrine activation in acute myocardial infarction (AMI) may have important physiological consequences for myocardial perfusion and function. We measured plasma angiotensin II in 60 patients with AMI within 6 hours of pain and on days 1-3 and day 10. On admission, AII was normal at 9.9 + 1.3 pmol/l (normal range 2-12 pmol/l). At day 3, AII rose markedly to 77.5 + 25.0 in those with heart failure (group 1, n = 13); but AII also rose in uncomplicated patients (group 2, n = 47) to 27.8 + 4.0 (p less than 0.001). At day 10, levels of AII remained high, especially in group 1 (50.5 + 22.2 vs 6.1 + 1.5, p less than 0.005). Thus neuroendocrine activation, present early in AMI, is seen in both uncomplicated infarcts and in those developing heart failure. Angiotensin II mediated vasoconstriction perhaps enhanced by catecholamines could have deleterious effects on myocardial function and perfusion, and indicates the potential for angiotensin-converting enzyme inhibitors in early AMI.
J Cardiovasc Pharmacol 1987
PMID:Neuroendocrine activation in acute myocardial infarction. 244 Nov 95

In a 7-center Scandinavian double-blind placebo-controlled study of 179 patients with intermittent claudication, the effect of the serotonin antagonist ketanserin was evaluated on walking distance, brachial and ankle blood pressure, and symptoms. For all centers together, pain-free walking distance was significantly increased after 6 months with both ketanserin (+65%; 71 patients) and placebo (+42%; 78 patients), with no significant difference. However, there was large variability among centers. Classification of "responders" (doubling of walking distance) and patients who deteriorated (decrease of walking distance or dropout for inefficacy) showed significantly more patients responding and significantly fewer patients deteriorating with ketanserin than with placebo. Systemic blood pressure was significantly decreased by ketanserin in hypertensive, but not normotensive, patients, while ankle pressure was unaffected. The incidence and nature of side effects were equal with ketanserin and placebo, but there were more side effects causing dropout in the ketanserin group. An unexpected and possibly important observation was the occurrence of six serious cardiovascular events (myocardial infarction, cerebrovascular complications, and development of rest pain) in the placebo group but none in ketanserin-treated patients. Moreover, there were four additional similar complications in the placebo run-in period. Ketanserin appears to be beneficial in a subgroup of patients with intermittent claudication. A fortuitous finding of this study is that ketanserin might possess a protective effect against thrombovascular complications in patients with intermittent claudication.
J Cardiovasc Pharmacol 1987 Jun
PMID:Ketanserin in intermittent claudication: effect on walking distance, blood pressure, and cardiovascular complications. 244 41

Percutaneous biliary drainage was performed in 296 patients on 311 occasions using a fine-needle puncture technique. In 59%, the procedure served as postoperative decompression, and in 35% for palliation of obstruction, particularly in malignant disease. Postoperative drainage for the management of postoperative complication accounted for 2.5%. In more than 80% of the patients treated, the underlying disease was malignant obstructive jaundice. In 257 retrospectively evaluated patients the following complications were observed: cholangitis (6.6%), sepsis (3.1%), bile leakage (1.6%) with two deaths (0.7%), and subcapsular hematoma and hematoma in the hepatoduodenal ligament (1.2%). Catheter dislocations accounted for 8.5% and were eliminated by the use of self-retaining catheters. In 51 prospectively studied patients pain was encountered in 55% and cholangitis in 11.8%. The procedure is most valuable for complicated biliary obstruction, palliative drainage, and endobiliary manipulations.
Cardiovasc Intervent Radiol 1988 Apr
PMID:Percutaneous transhepatic biliary drainage: experience with 311 procedures. 245 99

Endothelin-1 (ET-1) induced hyperalgesia in rats, abdominal constrictions in mice, incapacitation in dogs, and, when injected intradermally into humans, caused wheal and flare responses, which were accompanied by itching. The ET-1 induced constrictions in mice were prevented by indomethacin. In contrast, indomethacin had no effect on the hyperalgesic responses in the rat. These results indicate that ET-1 may play a role in modulating pain.
J Cardiovasc Pharmacol 1989
PMID:Endothelin-1 participation in overt and inflammatory pain. 247 19

Three hundred thirty-one patients with mild to moderate essential hypertension, 182 males and 149 females with a mean age of 54 (range, 17-87 years), were studied for 1 year in a clinical trial with ramipril, an angiotensin converting enzyme (ACE) inhibitor. The patients included had completed double-blind trials with ramipril vs. captopril, HCT, atenolol and ramipril plus piretanide. All cases were treated first with 5 mg ramipril and, where appropriate, also with 25 mg HCT. Adjustment of the dose in the range 1.25-20 mg ramipril was left to the investigator. Overall, a consistent reduction in blood pressure was achieved. Only small changes in mean blood pressure were noted during the 12 months (mean diastolic blood pressure 84.3-86.9 mm Hg, mean systolic blood pressure 145.6-148.2 mm Hg). Two hundred sixty-two (82%) of the 331 patients had diastolic values consistently equal to or lower than 95 mm Hg. There was a downward shift in the dosages upon which the investigators finally settled during the 12-month period in the patients receiving ramipril monotherapy. In patients also receiving HCT the initial dose was increased in most cases. Adverse events were observed in 6.7% of patients taking ramipril alone. The most frequent symptoms were dizziness, asthenia, pain in the upper abdomen and headache. Adverse effects occurred more frequently under continuous additional treatment with HCT, the same symptoms being reported. The clinical trial was prematurely terminated in six patients, in only two cases for medical reasons. The analysis of the laboratory findings revealed no general deterioration.(ABSTRACT TRUNCATED AT 250 WORDS)
J Cardiovasc Pharmacol 1989
PMID:An open multicenter study to assess the long-term efficacy, tolerance, and safety of the oral angiotensin converting enzyme inhibitor ramipril in patients with mild to moderate essential hypertension. 247 9


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