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)

Previous experiments have shown that noxious stimulation increases expression of the c-fos proto-oncogene in subpopulations of spinal cord neurons. c-fos expression was assessed by immunostaining for Fos, the nuclear phosphoprotein product of the c-fos gene. In this study, we examined the effect of systemic morphine on Fos-like immunoreactivity (FLI) evoked in the formalin test, a widely used model of persistent pain. Awake rats received a subcutaneous 150 microliters injection of 5% formalin into the plantar aspect of the right hindpaw. The pattern of nuclear FLI was consistent with the known nociceptive primary afferent input from the hindpaw. Dense labeling was recorded in the superficial dorsal horn (laminae I and IIo) and in the neck of the dorsal horn (laminae V and VI), areas that contain large populations of nociceptive neurons. Sparse labeling was noted in lamina IIi and in the nucleus proprius (laminae III and IV), generally considered to be nonnociceptive areas of the cord. Fos immunoreactivity was also evoked in the ventromedial gray, including laminae VII, VIII, and X. There was no labeling in lamina IX of the ventral horn. Since FLI was time dependent and distributed over several spinal segments, we focused our analysis where maximal staining was found (L3-L5) and at the earliest time point of the peak Fos immunoreactivity (2 hr). Twenty minutes prior to the formalin injection, the rats received morphine (1.0, 2.5, 5.0, or 10 mg/kg, s.c.) or saline vehicle. Two hours later, the rats were killed, their spinal cords removed, and 50 microns transverse sections of the lumbar enlargement were immunostained with a rabbit polyclonal antiserum directed against Fos. Prior treatment with morphine sulfate profoundly suppressed formalin-evoked FLI in a dose-dependent and naloxone-reversible manner. The dose-response relationship of morphine-induced suppression of FLI varied in different laminae. To quantify the effect of morphine on FLI, labeled neurons in sections taken from the L4/5 level of each rat were plotted with a camera lucida and counted. Staining in the neck of the dorsal horn (laminae V and VI) and in more ventral laminae VII, VIII, and X, was profoundly suppressed by doses of morphine which also suppress formalin-evoked behavior. Although the labeling was also significantly reduced in laminae I and II, at the highest doses of morphine there was substantial residual labeling in the superficial dorsal horn. These data indicate that analgesia from systemic opiates involves differential regulation of nociceptive processing in subpopulations of spinal nociceptive neurons.
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PMID:Systemic morphine suppresses noxious stimulus-evoked Fos protein-like immunoreactivity in the rat spinal cord. 168 35

New routes of opioid administration that have become available in recent years can be managed by the primary care physician or the oncologist in an attempt to improve pain control and the quality of life. Although oral morphine sulfate is the standard treatment for cancer patients with chronic pain, these novel methods of delivering morphine have enabled some patients whose pain is refractory to traditional methods of drug administration to obtain satisfactory control of their symptoms. The authors review some of these innovative methods.
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PMID:Alternate delivery methods for morphine sulfate in cancer pain. 168 22

Although pain is one of the most feared consequences of cancer, pain management is rarely discussed in the literature on head and neck cancer. The pain experienced by patients with head and neck malignancies, of a biologic origin, is compounded by the emotional distress caused by alterations in function and cosmesis. Control of pain is possible, but an effective program must include more than pain medication. A current treatment program is presented, based on scientific study and clinical experience. The most helpful pain medication is immediate-release, liquid morphine sulfate (20 mg/mL) administered every 4 hours. A nonsteroidal anti-inflammatory drug may also be used and it may decrease the amount of morphine necessary. Stool softeners must be provided, and anti-nausea medication is often given. Steroid drugs are regularly used to increase appetite, decrease edema, and enhance the patient's sense of well-being. Factors related to the selection and dosage of medications are discussed.
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PMID:Pain management in advanced carcinoma of the head and neck. 171 82

The most frequently used postoperative analgesia techniques are intramuscular injection (IM) and patient controlled analgesia (PCA). Recently, the use of epidural catheter injection (EPI) has been done with success. This study was done to prospectively compare these three techniques for postoperative analgesia after extensive operations upon the colon and rectum. Patients were randomized to one of three analgesia groups--IM, intramuscular morphine sulfate; PCA, patient controlled morphine sulfate, and EPI, epidural morphine sulfate. Data collected included age, time to first bowel movement, amount of narcotic, number achieving 75 per cent of preoperative forced vital capacity, postoperative pruritus, headache, nausea and vomiting, respiratory depression, atelectasis or pneumonitis. A visual analog pain scale was used to evaluate postoperative pain severity (0, no; 1, partial; 2, marked, and 3, total relief). Sixty-eight patients were eligible for study (IM, 19; PCA, 22; EPI, 23, and excluded, four). The EPI group required significantly less daily narcotic compared with either the IM or PCA groups (17.0 +/- 6.12 milligrams; 67.8 +/- 26.8 milligrams; 40.5 +/- 20.6 milligrams, respectively, less than 0.05 ANOVA) and total narcotic (81.3 +/- 31.3 milligrams; 355.4 +/- 147.7 milligrams; 215.3 +/- 105.4 milligrams, respectively, p less than 0.05 ANOVA). EPI achieves excellent pain control in more patients with a significantly lower dose of narcotics and significantly fewer pulmonary complications. Therefore, epidural analgesia is the optimal method of postoperative analgesia after extensive abdominal operations.
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PMID:Epidural analgesia. 173 72

A prospective randomized controlled study was designed to evaluate differences in efficacy and complication rate between the two most commonly used sclerosing agents, sodium tetradecyl sulfate (STD) and polidocanol. Of 52 patients with esophageal variceal bleeding, 26 were randomized to receive sclerotherapy with 1.5% STD and 26 to receive 1% polidocanol at weekly intervals. Eradication of varices was achieved in 88% patients each of the STD and polidocanol group. There was no significant difference between patients injected with STD and polidocanol with regard to re-bleeding (27% vs. 15%) and mortality (11.5% in both). The use of STD, in contrast to polidocanol, was associated with a higher incidence of complications in terms of severe retrosternal pain (27% vs. 4%), deep ulceration (53% vs. 23%), dysphagia (88% vs. 46%), and stricture formation (27% vs. 8%). It was concluded that these two agents were similar in efficacy. However, polidocanol was superior due to a lower incidence of complications.
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PMID:Prospective randomized comparison of sodium tetradecyl sulfate and polidocanol as variceal sclerosing agents. 173 94

A wide variety of compounds in foods and beverages produce astringent sensations when introduced into the oral cavity. There is controversy, however, whether "astringency," with its associated puckering and drying sensations, is a fundamental taste quality or is a tactile sensation. To address this issue, electrophysiological recordings were made from the gerbil chorda tympani nerve and the rat lingual nerve. The chorda tympani nerve transmits taste information from the anterior 2/3 of the tongue, whereas the lingual nerve transmits tactile, thermal and pain sensations from the anterior 2/3 of the tongue. The astringent compounds tested were: tannic acid, tartaric acid, gallic acid, aluminum ammonium sulfate and aluminum potassium sulfate. Tannic acid, tartaric acid, and gallic acids were tested at concentrations up to 120 mM over a pH range from approximately 2 to 6. The aluminum salts were tested at concentrations up to 160 mM only at low pH's. All compounds rapidly (and at lower concentrations, reversibly) stimulate the chorda tympani nerve in a concentration-dependent manner at all pH's tested. The rapidity and reversibility of the chorda tympani responses suggest that astringent-tasting compounds interact directly with taste cells rather than indirectly by precipitating salivary proteins. At pH 6, tannic acid, tartaric acid, and gallic acid all elicit robust chorda tympani responses, implying that the ionized forms of these compounds produce taste sensations. None of these compounds stimulate lingual nerves over the same concentration and pH ranges used in the chorda tympani experiments.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chorda tympani and lingual nerve responses to astringent compounds in rodents. 174 51

Improved control of postoperative pain is now known to reduce the incidence of morbidity. Although spinally administered narcotics have found a clear role in chest and abdominal surgery, their role in lumbar spinal surgery is debated. We conducted a prospective, double-blind, randomized, placebo-controlled trial of intrathecally administered morphine sulfate after lumbar spinal surgery in 56 patients. Patients received 0, 0.125, 0.25, or 0.5 mg of intrathecally administered morphine during extradural lumbar spinal operations, and the effects on postoperative analog pain scores, narcotic consumption, complications, and length of hospitalization were assessed. As compared with systemic narcotic administration, intrathecally administered morphine provided superior analgesia in a dose-dependent fashion without an increase in narcotic side effects. Consumption of parenteral narcotics on the first postoperative day and over the total hospitalization period decreased in correlation with increasing doses of intrathecally administered morphine. Mean length of hospitalization was significantly decreased, as compared with the control group, in patients receiving 0.25 or 0.5 mg of intrathecally administered morphine. When proper precautions are observed, intrathecally administered morphine can improve the postoperative care of patients undergoing lumbar spinal surgery.
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PMID:Use of intrathecally administered morphine in the treatment of postoperative pain after lumbar spinal surgery: a prospective, double-blind, placebo-controlled study. 180 99

Patients with intractable pain due to cancer present a unique challenge to both medical and nursing personnel. This case study illustrates a unique home hospice managed pain control regime that has been implemented for a terminal cancer patient with intractable pain. A ventricular catheter attached to a reservoir was stereotaxically implanted for the administration of preservative-free morphine sulfate. The presentation will include the history of intraspinal morphine, the surgical placement of the ventricular access devise, and the procedure for intraventricular morphine administration. Also, the preoperative nursing assessment and patient family education will be discussed. Education of hospice nurses in the technique of injection, postoperative pain assessment, monitoring of side effects and discharge planning will conclude the presentation.
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PMID:Stereotaxic placement of a ventricular catheter and reservoir for the administration of morphine sulfate. 188 69

To assess the relative efficacy and incidence of side effects of a single injection versus a continuous infusion of epidural morphine sulfate (MS) in the postcesarean population, the authors report a prospective, randomized, double-blind study. Thirty-one patients received either a 5-mg MS bolus and subsequent saline infusion (n = 13) or a 2.6-mg MS bolus and subsequent MS infusion at 0.1 mg/hour (n = 18), such that after 24 hours both groups had received a total MS dose of 5 mg. No statistically significant differences were found between the two groups in overall satisfaction with analgesia, verbal pain scores, level of activity, need for supplemental opioids, or incidence of sedation during the 24-hour study period. The authors conclude that in this population, continuous epidural morphine infusion offers no obvious advantage over single morphine bolus therapy. However, the theoretical merits of continuous opioid infusion therapy are discussed.
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PMID:A comparison of postcesarean epidural morphine analgesia by single injection and by continuous infusion. 158 Dec 49

To evaluate the efficacy and tolerance of galactosaminoglycuronoglycan sulfate (Matrix vials) in the therapy of tibiofibular arthritis of the knee, forty patients suffering from this illness at radiological stages 1 and 2 undergoing concomitant therapy with NSAIDS, were randomized into two groups of twenty. The treatment group received the drug under study and the control group received placebo. Treatment was carried out in double blind. The therapy protocol comprised 25 intramuscular injections (one injection twice a week). This cycle was repeated for 6 months, for a total of 50 injections. The patients were visited on days 0, 90, 180, 240, 330 and 360. At each visit the following symptoms were evaluated: spontaneous pain, pain on loading, on passive movement and on pressure; changes in NSAIDS posology were also recorded; lastly any possible side effects were noted. Analysis of results has shown a statistically significant higher therapeutic effect on treatment with Matrix for all the symptoms taken into consideration. No important side effects were noted, either local or systemic; in two cases only in the group treated with Matrix and in the same number in the control group slight dyspeptic symptoms were found to occur, but without requiring suspension or reduction in posology. Two patients in the Matrix group and one in the control group left the study for non-compliance with the type of administration. The good clinical results obtained, together with the excellent tolerance shown by the drug, suggest that Matrix may be the drug of choice in the "basic" therapy of osteoarthritis, with its efficacy being demonstrated in an increasing number of clinical studies.
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PMID:Galactosaminoglycuronoglycan sulfate (matrix) in therapy of tibiofibular osteoarthritis of the knee. 191 37


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