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)

1. CCK-peptides are distributed throughout the whole brain with the exception of the cerebellum. 2. There is strong evidence that they act as neuromodulators on the noradrenergic, opioid and mainly dopaminergic system. 3. CCK reduces food-intake. However, tolerance occurs, when chronically given. Thus, potential benefits in the treatment of obesity seem unlikely. 4. CCK increases threshold and tolerance to electrically and thermally induced cutaneous pain. CCK yields relief of pain in colic and ischaemic pain. 5. To date, results about CCK-content in CSF and post-mortem-brain in various psychiatric and neurological diseases related to the dopaminergic system are equivocal. 6. Treatment studies do not provide evidence for beneficial effects of CCK-peptides in schizophrenia.
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PMID:Cholecystokinin. 307 40

The onset of therapeutic effectiveness of carbamazepine is generally very rapid in the treatment of seizure and paroxysmal pain disorders, shows some lag in the treatment of mania, and exhibits the longest lag in depression. These time course variations may indicate that different mechanisms underlie the efficacy of carbamazepine in the differential neuropsychiatric syndromes. Biochemical and pharmacological data suggest that the anticonvulsant effects of carbamazepine are related to "peripheral-type" benzodiazepine and alpha 2-noradrenergic receptor systems and to its ability to stabilize sodium channels. GABAB (baclofen-like) actions appear to be involved in antinociceptive, but not anticonvulsant, effects. The relatively acute time course of antimanic efficacy may be related to the above-mentioned mechanisms or to other effects related to systems postulated to be altered in the manic syndrome. These effects might include carbamazepine's ability to increase acetylcholine in the striatum, decrease probenecid-induced levels of CSF homovanillic acid (HVA) in man and dopamine turnover in animals, decrease CSF norepinephrine in manic patients, inhibit adenylate cyclase activity (in response to norepinephrine, dopamine, adenosine, or ouabain), decrease GABA turnover, or act as a vasopressin agonist. Efficacy in depression may be related to actions in man that take time or chronic drug administration to develop, such as increases in plasma tryptophan, decreases in CSF somatostatin, decreases in thyroid indices, and increases in urinary free cortisol excretion and, in animals, increases in substance P sensitivity and increases in brain adenosine receptors. The ability of carbamazepine to block the development of lidocaine- and cocaine-induced seizures also requires chronic administration, suggesting that these seizure models may provide a unique perspective for understanding mechanisms of time-dependent effects.
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PMID:Time course of clinical effects of carbamazepine: implications for mechanisms of action. 328 May 60

A phase-I/II trial was initiated to study the effect of rhGM-CSF in patients with myelodysplastic syndromes who were not eligible for other kinds of therapy, rhGM-CSF was given to 9 patients in doses of 15 micrograms/m2-150 micrograms/m2 as an intravenous 8-h infusion for a cycle of 7 days followed by an interval of 14 days and a second 7-day treatment course. A dose-dependent increase in the leukocyte count was observed in 7 out of 9 patients. No change in reticulocyte numbers was seen and only 1 patient experienced an increase in platelet count. Toxicity mainly consisted of mild local phlebitis at the site of infusion and sternal pain after bolus injection.
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PMID:Recombinant human granulocyte-macrophage colony-stimulating factor in patients with myelodysplastic syndromes--a phase-I/II trial. 328 27

We present 3 new cases of cervical epidural abscess (CEA), a rare condition, along with a review of 12 other case reports. The average patient age was 45 years; just over half were male. The abscesses usually involved the mid to lower cervical region and extended an average of three to four segments. Neck stiffness was present in all patients; root pain and paresthesias were present less often. Weakness of one to four extremities developed in all but one patient. Sensory levels were frequently present, sometimes below the site of the lesion. All but two patients were febrile. All but two had elevated CSF protein, and all but two had a pleocytosis; myelography always revealed a complete or partial block. Staphylococcus aureus was the causative organism in 8 of 11 patients. CEA should be considered in a patient with neck stiffness, paresthesias, and/or radicular pain so that CT or myelography followed by surgical decompression and/or antimicrobial drugs can be initiated before prolonged weakness develops. One of our patients developed a syrinx causing a new neurologic deficit 3 years after treatment. Delayed syringomyelia, a rare complication of extramedullary lesions, lends support to vascular occlusion as the major mechanism of damage in epidural abscess.
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PMID:Cervical epidural abscess. 331

Perfusion of the intrathecal space with artificial CSF was achieved in control and arthritic rats under halothane anaesthesia in order to collect the met-enkephalin-like material (MELM) released from the whole spinal cord. On the fourth week following the intradermal injection of Freund's adjuvant to induce arthritis, a marked reduction (-56%) in the spontaneous outflow of MELM was noted in arthritic rats. This effect did not involve changes in the degradation process of MELM, since it persisted when kelatorphan was added to the perfusing fluid in order to inhibit completely the peptidases acting on met-enkephalin. Raising the K+ concentration in the perfusing fluid from 2.4 to 40 mM, as well as moving the hind paws, produced a significant enhancement of MELM release which was (at least) as pronounced in arthritic as in control rats. These results suggest that the basal activity of spinal enkephalinergic neurones, but not that triggered by various stimuli, is reduced in arthritic rats.
Pain 1988 Jan
PMID:Spontaneous and evoked release of met-enkephalin-like material from the spinal cord of arthritic rats in vivo. 334 Apr 18

The objectives of this study were to compare the pharmacokinetic properties and the duration of analgesia following intrathecal administration (L5-S1) of 2 mg morphine in 2 forms: (1) an isobaric (NaCl 0.9%) and (2) a hyperbaric solution (7% dextrose). The study was carried out on 5 cancer patients with severe, intractable pain in the lower half of the body. Samples of CSF were collected at the level of the 10th thoracic vertebra at regular intervals for 15 h after administration. Morphine concentrations were determined by HPLC. The pharmacokinetic properties of the solutions (I and II) were quite different. Peak levels (I) were reached in 5-15 min (30 and 60 micrograms/ml); they then fell rapidly during the 1st hour (7 and 11 micrograms/ml) with an elimination half-life of 10 and 15 min, followed by a change in slope (elimination half-life of 108 and 140 min). Peak levels (II) were reached in 4-5 h (0.8-3.3 micrograms/ml); they then fell progressively according to a single exponential function (elimination half-life: 144-246 min). The duration of analgesia for a dose of 2 mg was 30 h for solution 2 and 24 h for solution 1. The hyperbaric solution, which produced the same degree of analgesia as the isobaric solution, limited the cephalad diffusion of morphine and reduced or abolished the central depressant effects of the drug.
Pain 1988 Feb
PMID:CSF morphine levels after lumbar intrathecal administration of isobaric and hyperbaric solutions for cancer pain. 336 53

A 57-year-old male was repeatedly admitted to hospital because of complex neurological symptoms, including radicular pain, disturbance of micturition, seizures, and severely impaired mental state. The diagnosis was encephalomyeloradiculitis possibly of viral origin, and treatment with immunosuppressants was initiated. An alternating course with a tendency towards improvement ensued. Two and a half years after the occurrence of the initial symptoms, identification of specific antibodies in the blood and CSF led to the diagnosis of borreliosis with CNS involvement. High-dose therapy with penicillin rapidly reduced the symptoms, beginning with those of radicular pain and followed by an improvement of the mental state. Attention is directed to the wide spectrum of clinical symptoms of chronic borreliosis with CNS involvement. Previous reports that immunosuppression may result in some improvement but with a tendency towards relapse are confirmed. Our encouraging treatment results support those of other reports that penicillin therapy may lead to improvement even at late chronic stages in patients with severe CNS deficits.
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PMID:Chronic borrelia encephalomyeloradiculitis with severe mental disturbance: immunosuppressive versus antibiotic therapy. 336 60

Magnetic resonance is the best noninvasive modality for imaging the size, shape, position, and presence or absence of compression of the spinal cord. MR is less optimal than CT for the assessment of intrinsic bone abnormalities. Myelography and CT have, as their chief advantage relative to MR, short data acquisition times. Consequently, MRI has the problem of image degradation from patient motion. The advent of gadolinium-DTPA as a paramagnetic contrast agent (following FDA approval) is expected to increase the sensitivity of MR further in defining neoplasms arising from intramedullary, intradural-extramedullary, and extradural locations. In view of the ability of multiplanar MR to demonstrate neoplasms that affect the spinal cord, the use of sedation and pain medication protocols appears justified. Moreover, to eliminate intrinsic artifacts arising from cardiac pulsation, respiration and CSF flow, MR imaging must utilize advanced techniques such as flow compensation and cardiac gating.
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PMID:Imaging of tumors of the spinal canal and cord. 342 Feb 41

In the majority of cases, meningoradiculitis consecutive to tick bite most probably belongs to Lyme disease caused by Borrelia burgdorferi. The disease may be limited to the primary, though inconstant, stage of cutaneous migratory erythema, or it may develop into cardiac and, mostly, neurological disorders. The nervous system involvement, which we observed in 7 patients, mainly consists of peripheral motor neuropathy of moderate severity and sometimes limited to the cranial nerves, associated with very severe radicular pain regularly heralding radicular deficit. Lyme disease predominates in a rural environment, and most patients live near wooded areas where ticks parasitize numerous mammals. The diagnosis, suggested by the socio-environmental context, the clinical features and the results of CSF examination, is confirmed by serology at a 1/256 dilution. Tetracyclines are effective in the initial stage, but intravenous penicillin is necessary in the secondary stage and to reduce the risk of arthritis and also perhaps neuropsychiatric disorders at a late stage.
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PMID:[Tick bite meningoradiculitis and other neurological aspects of Lyme disease]. 342 73

A model for studying the relationship between chronic arachnoiditis and pain sensitivity was developed. Thirty male ICR mice were randomly divided into three groups and the tail-flick test was done using an EMDIE-TF6 apparatus (Emdie Instrument Co., Montpelier, VA). Ten mice were injected intrathecally with 5.0 microL of a kaolin-metrizamide mixture and ten control mice were injected intrathecally with 5.0 microL of an electrolyte solution resembling CSF. A third group, (naive controls) were given no treatment. Six weeks later tail-flick tests were repeated. The kaolin-treated mice had significantly decreased tail-flick latencies (P less than .05) compared with the baseline; the controls had no significant change in tail-flick latency. Histologic examination revealed moderate to severe arachnoiditis in the kaolin-treated animals and no evidence of arachnoid abnormalities in the controls. This study suggests that arachnoiditis may be associated with decreased pain thresholds.
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PMID:Effect of arachnoiditis on pain threshold. 342 73


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