Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The best methods of contraception for women with insulin-dependent diabetes mellitus and gestational diabetes are discussed, with results of clinical trials in both types of patients. Women with IDDM require effective contraception since there are serious risks both to the mother and the fetus in case of unplanned pregnancy. For women reliable enough to use them consistently, barrier methods are satisfactory. IUDs are the choice for most diabetic women. In a trial of copper-T 200 IUDs in 103 diabetics compared to 119 normal controls, the effectiveness, expulsion rate, removals for bleeding and pain, and continuation rates were comparable. It was noted that there were no added infections in the diabetic group, who have an increased risk for infection generally. Oral contraceptives may worsen glucose tolerance, due to the effect of the progestogen decreasing diabetes, except in women with history of gestational diabetes. The authors found that a triphasic pill, with lower progestin dose, decreased insulin sensitivity more than did a combined pill, in both normal women and in those with previous gestational diabetes. Since natural estrogens, as used in estrogen replacement therapy in climacteric women, do not affect glucose tolerance as much as synthetic alkylated estrogens (i.e., ethinyl estradiol), the authors tried a combination of 4 mg estradiol, 2 mg estriol and 3 mg norethisterone for contraception in diabetic women. This experimental combination was compared with a low dose ethinyl estradiol-norethisterone monophasic, a progestin only pill, and an ethinyl estradiol-levonorgestrel triphasic. There were no differences among the groups in fasting plasma glucose, 24-hour insulin requirements, HbA1C levels, LDL, or free fatty acids. VLDL and HDL cholesterol and total cholesterol decreased in the natural estrogen group. There was a small, significant increase in LDL, VLDL and total cholesterol in the combined group. The authors also have preliminary results of a trial of a low-dose monophasic with ethinyl estradiol and gestodene, showing no adverse effects on glycemic control in IDDM patients. Thus low dose progestin, triphasic and natural estrogen-progestagen combination oral contraceptives can be recommended as safe to diabetics.
 ...
PMID:Contraception for women with diabetes: an update. 195 24

Life-long sequential changes in glucose tolerance and insulin secretion were investigated in genetically obese Zucker rats (fa/fa) fed a diabetogenic diet rich in lard and sucrose. Comparisons were made with lean littermates (Fa/-) receiving normal chow diet. At 3-month intervals, seven to nine lean and obese rats had two permanent venous catheters implanted, allowing stress- and pain-free sampling of blood before, during, and after substrate administration. Intravenous glucose, iv arginine, and oral glucose tolerance were tested. The obese rats progressively developed hyperglycemia and severe hyperinsulinemia; their basal glycemia reached 8.8 +/- 1.1 vs. 5.8 +/- 0.2 mmol/liter in the lean rats at 46 weeks of age; respective insulinemia was 287.7 +/- 61.9 and 18.1 +/- 2.8 mU/liter (mean +/- SD). In the obese rats a distinct loss in glucose tolerance was seen with progression of age in spite of rising stimulated insulin secretion, which suggests progressive development of insulin resistance without exhaustion of B-cell secretory capacity. Absence of insulin deficiency was also suggested by immunohistochemical staining of pancreatic tissue specimens from obese rats, which showed large populations of insulin-containing cells. Like the obese animals, lean rats exhibited a decrease in insulin sensitivity with age. Relating basal individual glycemia and insulinemia, a rise by 1 mmol/liter in glycemia was associated with a 8.8-fold rise in basal insulinemia in lean rats, but only with a 1.8-fold increase in obese rats. Similar correlations for stimulated glycemia and insulinemia suggest impaired glucose sensitivity of pancreatic B-cells in obese vs. lean rats. In conclusion, hyperglycemia and hyperinsulinemia in insulin-resistant obese Zucker rats on a diabetogenic diet are not characterized by quantitatively deficient B-cell secretory capacity, but, rather, by impaired B-cell sensitivity to glucose with qualitatively intact regulation of glycemia and insulinemia at elevated plasma concentrations.
 ...
PMID:Lifelong sequential changes in glucose tolerance and insulin secretion in genetically obese Zucker rats (fa/fa) fed a diabetogenic diet. 198 47

In 30 patients undergoing cholecystectomy, a randomized double-blind saline-controlled study was performed using interpleural 0.5% bupivacaine with or without epinephrine (5 micrograms.ml-1) in combination with 0.8% halothane inspired concentration in oxygen. The aim of the study was to investigate whether interpleural 0.5% bupivacaine could decrease the intraoperative opioid requirements and attenuate the metabolic endocrine response to surgical stress. Patients were randomly allocated to one of three groups: Group 1: 0.5% bupivacaine; Group 2: 0.5% bupivacaine with epinephrine (5 micrograms.ml-1); and Group 3: saline. The interpleural catheter was inserted after induction of anesthesia in the spontaneously breathing patient. The study drug was injected 30 min prior to surgery. Peak plasma bupivacaine concentrations in the respective groups were 1.30 +/- 0.78 and 1.16 +/- 0.48 micrograms.ml-1. In all patients concentrations were below suggested convulsive level. Two patients in Group 1 and two in Group 2 required intraoperative fentanyl (0.1 mg each). In contrast, eight patients in the saline group received an average of 0.21 mg (range 0.1 +/- 0.4 mg) fentanyl (P less than 0.05). Postoperatively, a second dose of the study drug was given. Subsequently, pain was assessed using a visual analog score and a verbal rating scale. Pain scores decreased significantly 30 min after the interpleural injection in both bupivacaine groups and remained unchanged in the saline group (P less than 0.05). Pain management by means of interpleural bupivacaine was successful in 17 of the 20 patients. In the saline group seven out of ten patients needed additional analgesics (P less than 0.05). Cortisol levels increased in response to surgery in all groups: maximum levels in Groups 1, 2 and 3 were: 1.09 +/- 0.29, 1.11 +/- 0.20 and 1.19 +/- 0.16 mumol.l-1, respectively. Plasma glucose concentrations increased significantly in all groups: maximum levels in Groups 1, 2 and 3 were: 7.6 +/- 1.3, 7.3 +/- 1.7 and 8.3 +/- 1.7 mmol.l-1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Effects of interpleurally administered bupivacaine 0.5% on opioid analgesic requirements and endocrine response during and after cholecystectomy: a randomized double-blind controlled study. 202 59

Morphine alters affective states in humans and produces reinforcement in humans and animal subjects. Therefore, the present study was designed to determine whether morphine affected the functional activity in brain structures involved in emotion and motivation. Since opioid-induced analgesia largely reflects an influence on the emotional component of pain, the effect of pain on activity in these structures was also studied. Local rates of glucose utilization were measured by the 2-deoxy-D[1-14C]glucose method in the brains of rats, that received morphine or saline, with or without a painful stimulus. Many rostral, and particularly diencephalic, nuclei showed decreased glucose utilization in morphine-treated rats, although caudal regions were mostly unaffected. There were dose-dependent decreases in glucose utilization with doses between 1 and 10 mg/kg morphine. However, nociceptive stimulation, with either formalin or tail-immersion, produced no significant effect on cerebral glucose utilization. The 2-deoxy-D-[1-14C]-glucose technique, as used here, may lack adequate sensitivity to delineate areas of the brain mediating nociception in rats.
 ...
PMID:Morphine decreases cerebral glucose utilization in limbic and forebrain regions while pain has no effect. 203 Aug 20

Plasma growth hormone (GH), insulin, prolactin and blood glucose levels were measured to evaluate postoperative pain relief either with epidural morphine or systemic analgesics in 16 patients who underwent gastrectomy. Continuous epidural morphine with a pump (CADD-PCA, Model 5200P, Pharmacia) was given to eight (epidural morphine group) patients. A bolus of epidural morphine was administered through an indwelling thoracic (Th8.9) catheter at 3 hrs prior to the expected end of surgery, which was followed with continuous epidural infusion of morphine at a rate of 0.167-0.042 mg.hr-1 with the pump during and after anesthesia and surgery with gradually decreasing dose until the third postoperative day. The remaining eight patients (systemic analgesics group) repeatedly received intravenous or intramuscular pentazocine and buprenorphine when needed. Plasma GH levels increased significantly only on the first postoperative day in both groups. Plasma insulin levels increased significantly on the first postoperative day in both groups. Blood glucose levels increased significantly at the end of surgery and during the following three postoperative days in both groups. There are no statistical differences in plasma GH, insulin and blood glucose levels between the two groups. Plasma prolactin concentrations increased significantly at the end of surgery and they were significantly higher in the systemic analgesic group than in the epidural morphine group. They, however, returned to the previous day's levels on the first postoperative day in both groups. Our study suggests that continuous epidural infusion of morphine has no suppressing effect on postoperative changes in plasma GH, insulin, prolactin and blood glucose levels as compared with systemic analgesic regimen.
 ...
PMID:[Effect of continuous epidural infusion of morphine on postoperative glucose metabolism]. 209 89

Previous studies have suggested that acute hyperglycaemia may affect pain thresholds in non-diabetic subjects. We investigated the effects of acute fluctuations in blood glucose on the perception of pain in diabetic patients with and without painful diabetic neuropathy. Rapid swings in blood glucose concentration produced by IV glucose injection did not alter heat pain thresholds in diabetic patients without symptomatic neuropathy. Also, marked changes in neuropathic pain were not accompanied by significant alterations in blood glucose concentration in diabetic patients with painful neuropathy. Therefore, the alleged effects of acute hyperglycaemia on pain perception described in non-diabetic subjects are not reproduced in diabetic patients.
 ...
PMID:Short term fluctuations in blood glucose concentrations do not alter pain perception in diabetic-patients with and without painful peripheral neuropathy. 213 61

Pain threshold was assessed via tail flick latency in alloxan-diabetic, streptozotocin-diabetic, BB/W-diabetic, and control laboratory rats. In addition, tail flick latency was determined under conditions of both euglycemia (60-120 mg/dl) and hyperglycemia (greater than 250 mg/dl). Conditions of hyperglycemia resulted in a significant decrease in tail flick latency in both diabetic and control animals. More interestingly, tail flick latency was returned to control values in diabetic rats following normalization of blood glucose levels. It is concluded that elevated blood glucose levels result in a decrease in pain threshold in both diabetic and control rats. In addition, a permanent state of painful symptoms may be avoided in clinical diabetes by improvement of diabetic control.
 ...
PMID:Glycemic control of pain threshold in diabetic and control rats. 215 59

A 31-year-old male patient with type Ia glycogen storage disease was admitted to our department complaining of general fatigue and right hypochondriac pain. He exhibited massive hepatomegaly with systemic hypoglycemia, lactic acidosis, hyperuricemia, hyperpyruvatemia and hyperlipemia. The failure of blood glucose levels to increase after a glucagon loading test, and a reduced lactate level on glucose tolerance test were also observed. Various imaging techniques suggested hepatic adenoma with hemorrhage in the tumor, which was confirmed histologically. There was a complete absence of glucose 6-phosphatase activity, as determined by an enzyme assay on resected liver specimens, which proved the case to be type Ia glycogen storage disease. We also reviewed all previously reported cases of hepatic tumor and glycogen storage diseases. We conclude that, since hepatic adenoma is not rare in this disease, and is complicated by hemorrhage, rupture and malignancy, careful follow-ups are necessary.
 ...
PMID:A case of type Ia glycogen storage disease complicated by hepatic adenoma. 217 Feb 59

For 2 months we observed side-effects and indwelling times when using a subcutaneous catheter (Insuflon, Viggo AB, Sweden) for insulin injections. This method is used by approximately 600 children and adolescents with IDDM in Sweden today. 22 children and adolescents aged 4-19 years with a diabetes duration of 4.0 +/- 3.0 (mean +/- SD) years participated. Their HbA1c was 5.8 +/- 1.0%. All used 4-6 dosages of insulin per day. The catheter was placed subcutaneously in the abdominal wall, and replaced by parents when home tests showed increased blood or urine glucose, when the child experienced pain or when skin changes were observed. The 22 patients used 239 catheters with a mean time between changing catheters of 4.8 +/- 2.2 (range 0.5-17) days (= 1147 catheter days). Noted side effects were (% of catheter days): fixation problems, 5.6%; minor infection/irritation (= redness greater than 1 mm), 5.6%; pain, 2.8%; sore skin from plastic wings, 2.4%; itching/dry skin, 2.0%; eczema from band-aid, 1.7%; blocked catheter/injection needle, 1.6%; leakage of insulin, 1.3%, transient lipohypertrophies, 1.1%; hematoma/blood in catheter, 0.8%, and moist skin, 0.3%. No major infections requiring surgical or antibiotic treatment occurred. In conclusion, the use of indwelling insulin catheters seems to be a safe method to lessen the pain of insulin injections with a low frequency of side effects. The long-term metabolic control was not altered in this group of well-controlled children. We therefore find that we can recommend the use of indwelling catheters to children and adolescents who have difficulties with injections because of needle phobia or pain, particularly when using MIT.
 ...
PMID:Side effects and indwelling times of subcutaneous catheters for insulin injections: a new device for injecting insulin with a minimum of pain in the treatment of insulin-dependent diabetes mellitus. 224 6

Ten children with isolated growth hormone deficiency were treated for 1 year with 0.5 UI/kg week with Somatrem (recombinant human growth hormone), given as intramuscular injections three times weekly. Before treatment the children had a chronological age of 7-12.4 years (mean 10.4 years), with a bone age at least 25% below the chronological age. There was no radiological evidence of an intra or suprasellar mass in any child, and no response to provocative growth hormone tests (with exercise or arginine-insulin injection). Informed written consent for treatment was obtained from the parents of each child. Clinical signs were registered every month; triiodothyronine, thyroxine, thyrotropine, glucose, urea, creatinine, blood cells count, and hemoglobine, glycosylated hemoglobine, glutamic-piruvic and glutamic-oxalacetic transaminases, alkaline phosphatase, anti-human growth hormone and, E. coli antibodies, insulin like growth factor 1, and bone age were assessed every 3 months. The mean height velocity was 0.27 +/- 0.1 cm/month before treatment, and increased throughout treatment to a value of 0.62 +/- 0.16 cm/month after 12 months. Within the first year eight of the 10 children had a height increase of 8.4 +/- 0.98 cm. The other two children showed no significant difference; one of them with a very low socioeconomic status, and the other developed typhoid fever. All of the children showed an advance in bone age, but none reached a bone age appropriate for their chronological age; without modifications in the laboratory parameters. Insulin like growth factor 1 increased in 9 children. Pain at the injection site was the only side effect reported.
 ...
PMID:[Clinical and biochemical evaluation of the administration of growth hormone]. 225 92


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>