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)

Literature data on the mechanism of Laminaria-induced dilatation of the cervix uteri during abortion in the 2nd and 3rd trimesters are reviewed. Laminaria sticks are made of the stems of the algae Laminaria digitata or Laminaria japonica; the standard stick is 6-7 mm in length and 2-3 mm in diameter. Laminaria acts on the cervix uteri by applying the radial force and by removing water from the cervical stroma. One of the mechanisms of action of Laminaria is associated with the stimulation of synthesis and release of endogenous prostaglandins. The most widely used method of sterilization is gammairradiation of individually packaged Laminaria sticks. The thread attached to the proximal end of the stick simplifies its removal. Dilatation of the cervix uteri during 1st trimester requires insertion of 1-4-6 sticks for 6-12-16 hours. The methods of Laminaria insertion during the 2nd trimester vary depending upon the clinical situation. The major disadvantage of Laminaria is acute or spastic pain during insertion. Complications include migration of the Laminaria stick into the vagina or uterus and the risk of infection. Recently developed synthetic Laminaria have a number of advantages over natural Laminaria (guaranteed sterility, uniform shape, more rapid swelling, relative insensitivity to pressure). The most widely used synthetic Laminaria are manufactured from the polyvinyl alcohol (Lamicel, Merocel) and hydrogel polymer (hypan and Dilapan). Merocel and Lamicel are impregnated with magnesium sulfate providing for additional absorption of the fluid.
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PMID:[Termination of pregnancy in the first and second trimester using natural and synthetic laminaria tents]. 265 10

One hundred-fifty post-operative adult patients with moderate to severe pain were enrolled into this analgesic efficacy study comparing single doses of tonazocine mesylate, a new mixed agonist-antagonist opioid analgesic, with morphine. The patients were randomly assigned to five treatment groups: tonazocine mesylate 2, 4, 8 mg; morphine sulfate 10 mg and a placebo group. The results showed mean total pain relief scores for tonazocine 4 mg were nearly identical with that of morphine sulfate 10 mg while 8 mg of tonazocine were superior to 10 mg of morphine. All the active medication groups were superior to the placebo group (P less than 0.02) for both pain intensity and pain relief. Relative potency determined by the dose response indicates that 3.2 mg of tonazocine is equivalent to 10 mg of morphine. Drowsiness was the main adverse reaction seen in all active treatment groups. Tonazocine mesylate appears to be a potent analgesic with promising clinical usefulness and warrants further study.
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PMID:Tonazocine mesylate in postoperative pain patients: a double-blind placebo controlled analgesic study. 265 77

Topical prostaglandins and intracervical tents at present comprise the most widely used methods for priming of the cervix before surgery. While tents and prostaglandins are comparable in terms of shortening the time interval between labor induction and delivery, tents do not initiate powerful myometrial contractions and thus are not associated with the complication of uterine hypertonus. In early abortion, tents are regarded as superior to prostaglandins, estrogen, and relaxin. In the midtrimester abortion, however, best results are achieved through the combined use of tents and prostaglandins. This approach facilitates a shorter abortion time, a lesser risk of sepsis, and use of a lower dose of prostaglandin. The effect of the particular type of tent selected--Clamicel, Dilapan, or Laminaria--is related to the initial state of the cervix, with the best results achieved in the soft patulous cervix of young pregnant women. Laminaria tents are declining in popularity as a result of their lengthy duration of action, unreliability, pain, or insertion and as the tent expands, and need for several insertions of multiple tents. The synthetic Dilapan tent does not share the disadvantages of inconsistency, long duration of action, and risk of sepsis, but tends to fragment and fracture so that the distal portion remains within the uterus. Lamicel, a polyvinyl alcohol sponge impregnated with magnesium sulfate, has a less impressive speed of action than Dilapan (3 hours and 2 hours, respectively), yet its softness makes it easy to withdraw without fragmentation or fracture. Lamicel has been used successfully in 1st-trimester abortion, before induction of labor or IUD insertion, for hysteroscopy and removal of lost IUDs, and in formal diagnostic curettage.
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PMID:Intracervical tents: usage and mode of action. 266 35

Literature data on the mechanism of Laminaria-induced dilatation of he cervix uteri are reviewed. Laminaria sticks are made of the stems of the algae laminaria digitate or Laminaria japonica; the standard stick is 6-7 mm in length and 2-3 mm in diameter. Laminaria acts on the cervix uteri by applying the radial force and by removing water from the cervical stroma. One of the mechanisms of action of Laminaria is associated with the stimulation of synthesis and release of endogenous prostaglandins. The most widely used method of sterilization is gamma-irradiation of individually packaged Laminaria sticks. The thread attached to the proximal end of the stick simplifies its removal. Dilatation of the cervix uteri during 1st trimester requires insertion of 1-4-6 sticks for 6-12-16 hours. The methods of Laminaria insertion during the 2nd trimester vary depending upon the clinical situation. THe major disadvantage of Laminaria is acute or spastic pain during insertion. Complications include migration of the Laminaria stick into the vagina or uterus and the risk of infection. Recently developed synthetic Laminaria have a number of advantages over natural Laminaria (guaranteed sterility, uniform shape, more rapid swelling, relative insensitivity to pressure). The most widely used synthetic Laminaria are manufactured from the polyvinyl alcohol (Lamicel, Merocel) and hydrogel polymer (hypan and Dilapan). Merocel and Lamicel are impregnated with magnesium sulfate providing for additional absorption of the fluid.
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PMID:[Laminaria in obstetrical and gynecological practice]. 269 44

Thirty-seven men with symptomatic bone metastases from prostate cancer that had progressed following earlier treatment with estrogens and/or orchidectomy were treated with low-dose prednisone (7.5 to 10 mg daily). The rationale for this treatment was that some patients might still have hormone-sensitive disease that was stimulated by weak androgens of adrenal origin, and that these androgens could be suppressed by prednisone through its negative feedback on secretion of adrenocorticotrophic hormone (ACTH). Response to treatment was assessed by requirement for analgesics, by the McGill-Melzack pain questionnaire, and by a series of 17 linear analog self-assessment (LASA) scales relating to pain and to various aspects of quality of life. Fourteen patients (38%) had improvement in indices used to assess pain at 1 month after starting prednisone, and seven patients (19%) maintained this improvement for 3 to 30 months (median, 4 months). Reduction in pain was associated with improvement in other dimensions of quality of life, and in the scale for overall well-being. Prednisone treatment led to a decrease in the concentration of serum testosterone in seven of nine patients where it was not initially suppressed below 2 nmol/L, and caused a decrease in serum levels of androstenedione and dehydroepiandrosterone sulfate in more than 50% of patients. Symptomatic response was associated with a decrease in serum concentration of adrenal androgens. We conclude that (1) low-dose prednisone may cause useful relief of pain in some patients with advanced prostatic cancer; (2) relief of pain was associated with suppression of adrenal androgens; and (3) measures of pain and quality of life can be used to assess possible benefits of systemic therapy in patients with metastatic prostate cancer.
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PMID:Treatment of metastatic prostatic cancer with low-dose prednisone: evaluation of pain and quality of life as pragmatic indices of response. 270 88

Sympathetic excitement is not rarely accompanied by sweating over the palm or sole, and this sudatory reaction is often depressed by atropine. But, there was no simple way for quantitative expression of sympathetic activity. As an objective indicator of sympathetic activity, sympathetic skin response (SSR) was studied in 17 volunteers and 5 patients in the pain clinic. SSR was evoked by square wave electric stimulation through a pair of surface electrodes placed on the unilateral forearm. SSR recorded with a surface electrode was much larger than that was taken with a needle electrode inserted deep under the skin, and was markedly reduced by an intravenous administration of atropine sulfate 0.5mg for about 10 min. These findings support the hypothesis that the SSR is developed by an action potential of eccrine glands of a cholinergic nature. Unilateral stellate ganglion block abolished SSR in the ipsilateral palm indicating that the efferent impulse of palmal SSR is transmitted via cervical sympathetic ganglion. Inhalation of 0.1MAC halothane or enflurane in air reduced the height of SSR within 10 minutes. They obtunded SSR dose-dependently, and almost completely abolished at a concentration of 0.3 MAC. SSR may be useful to evaluate sympathetic activity under various conditions, such as under the effect of sedatives, analgesics and general anesthetics, and to evaluate the effects of a nerve block or other drugs which were used to obtund the nociceptive afferent stimuli to the sympathetic center of the brain.
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PMID:[Sympathetic skin response as an objective indicator of sympathetic activity]. 270 6

Controlled release morphine sulfate (MS Contin) is a relatively new oral preparation for the relief of chronic severe (cancer) pain. We describe a patient with severe neuralgia who experienced respiratory depression after ingestion of one single dose of morphine sulfate (20 mg). Administration of nalorphine chloride resulted in instant normalisation of respiratory function. This case illustrates respiratory depression as an adverse effect of MS Contin.
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PMID:[Respiratory depression following controlled-release morphine sulfate tablets]. 271 Feb 34

We are reporting a temporary, totally reversed motor and sensory paralysis subsequent to the intrathecal administration of 1.6 mg of morphine sulfate. This may represent an event which is not based on medication-induced myelopathy but on cardiovascular changes occurring as a result of pain relief.
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PMID:Temporary motor and sensory paralysis associated with intrathecal administration of morphine. 271 86

Twenty-three adult patients with chronic pain due to cancer completed a double-blind, randomized, two-phase crossover trial comparing plasma morphine concentrations and analgesic efficacy of oral morphine sulfate solution (MSS) and controlled-release morphine sulfate tablets (MS Contin [MSC], Purdue Frederick, Inc., Toronto, Ontario, Canada). MS Contin was given every 12 hours to all patients except those whose daily morphine dose could not be equally divided into two 12-hour doses with the tablet strengths available. MSS was given every 4 hours. Patients received both of the test drugs for at least 5 days, and, on the final day of each phase, peripheral venous blood samples for morphine analysis were obtained. Eighteen patients received MSC every 12 hours, and five received it every 8 hours. The same total daily morphine dose was given in both phases. In the 18 patients who received MSC every 12 hours, the daily morphine dose was 183.9 +/- 140.0 mg (mean +/- SD). In this group, the mean area under the curve (AUC) with MSC was 443.6 +/- 348.4 ng/ml/hour, compared with 406.8 +/- 259.7 ng/ml/hour for MSS (P greater than 0.20). Mean maximum morphine concentrations (Cmax) for MSC and MSS were 67.9 +/- 42.1 and 58.8 +/- 30.3 ng/ml, respectively (P greater than 0.05). Mean minimum morphine concentrations (Cmin) were 17.0 +/- 17.7 and 18.3 +/- 15.0, respectively (P greater than 0.30). There was a significant difference (P less than 0.001) between the two drugs in time required to reach maximum morphine concentration (Tmax). Mean Tmax after MSC occurred at 3.6 +/- 2.3 hours. After MSS, it occurred at 1.3 +/- 0.4 hours. In the five patients who received MSC every 8 hours, the findings paralleled those in the principal group, with no significant differences between MSC and MSS in Cmax or Cmin and a highly significant difference between the two in Tmax. However, in this small group of patients, the AUC with MSC was significantly (P = 0.04) greater than that with MSS. All patients had very good pain control throughout the study and both formulations were well tolerated. There were no significant differences between MSC and MSS in pain scores or side effects. Under the conditions of this study there was no clinically significant difference in bioavailability between MSC and oral MSS. When given on a 12-hourly basis in individually titrated doses, the MSC provided therapeutic plasma morphine concentrations throughout the dosing interval.
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PMID:Pharmacokinetics and clinical efficacy of oral morphine solution and controlled-release morphine tablets in cancer patients. 272 May 76

Immediate-release oral morphine, given every four hours in individually titrated doses, is effective in the control of severe cancer pain. To evaluate the analgesic efficacy of a controlled-release morphine sulfate preparation, MS Contin tablets (MSC, Purdue Frederick, Toronto, Ontario, Canada), after a single dose and under steady-state conditions, the authors compared MSC administered every 12 hours with morphine oral solution (MOS) administered every 4 hours in 17 adult cancer patients with chronic severe pain. In the single-dose evaluation, in which the patients were randomly assigned to receive MSC or MOS, there were no significant differences in analgesic efficacy or requirement for supplemental morphine between the two treatments. With both preparations, pain severity ratings increased toward the end of the 12-hour, single-dose observation period and were higher than the pain scores reported after dose titration. In the steady-state evaluation, which was a randomized crossover comparison, both preparations provided effective pain control with minimal side effects. There was no significant difference between MSC and MOS in overall pain scores or in pain scores analyzed by time of day and day of therapy. In conclusion, that an individualized twice-daily regimen of MSC is as effective as 4-hourly MOS for the control of chronic severe cancer pain. The twice-daily regimen has several advantages: it allows an uninterrupted night's sleep, it is substantially more convenient, and it can be expected to reduce both medication errors and noncompliance.
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PMID:Analgesic response to single and multiple doses of controlled-release morphine tablets and morphine oral solution in cancer patients. 272 May 78


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