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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four cognitive measures--MHLC, PLC, CSQ and PRSS/PRCS--were directly compared in 120 U.K. patients with chronic low back pain. 80% of the individual items in the PLC and 86% in the CSQ had satisfactory test-retest reliability, as had most of the scales of the CSQ and the PLC PC scale. The items and the scales of the MHLC and the PRSS/PRCS had lower reliability. The factor structures of the PLC and the PRSS/PRCS bore close similarity to the original descriptions. The CSQ structure was similar to the original but further investigation of its psychometric properties is required. The structure of the MHLC was not replicated. Considerable communality was found between the cognitive measures. The strongest relationship found in this study was between the CSQ and PRSS catastrophising scales and depressive symptoms. There was also a relationship among cognitive measures and both disability and work loss which persisted even after controlling for severity of pain and depressive symptoms. The present results suggest that the concept of catastrophising has greatest potential for understanding current low back symptoms and that the CSQ may be the most useful measure of this. Other work, however, suggests that the PLC may also be of value in following change and predicting response to treatment.
Pain 1991 Sep
PMID:A comparison of cognitive measures in low back pain: statistical structure and clinical validity at initial assessment. 183 66

One hundred eighteen patients with stage D (D1 or D2) prostate cancer with a mean age of 69 years were treated with monthly goserelin (Zoladex; ICI 118, 630; ICI Americas Inc, Wilmington, DE, property of Imperial Chemical Industries PLC) injections and the data were analyzed for predictive parameters for best response and time to treatment failure (National Prostatic Cancer Project [NPCP] and Eastern Cooperative Oncology Group [ECOG] criteria). For best response in a univariate analysis, the performance status (PS 0-1 v 2-3) (P = .01), hematocrit (P = .04), and pain (P = .04) were significant. For time to treatment failure by univariate analysis, ECOG performance status (0-1 v 2-3) was most predictive (P less than .0001), followed by pain at entry (P = .0002), initial testosterone (T) level (greater than 250 ng/dL) (P = .0005), age less than 69 years (P = .02), alkaline phosphatase (less than 115 IU/L) (P = .03), hemoglobin (less than 14 g/dL) (P = .03), whereas normal acid phosphatase (less than 3 IU/mL) (P = .29) was not predictive. In multivariate analysis for time to treatment failure, only the ECOG performance status was of significance (P = .01). Estimated median time to treatment failure for PS of 0-1 was 88 weeks and for PS of 2-3 was 31 weeks.
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PMID:Predictive initial parameters for response of stage D prostate cancer to treatment with the luteinizing hormone-releasing hormone agonist goserelin. 213 2

This randomised, double-blind, placebo-controlled, parallel-group trial was carried out to assess the efficacy and tolerability of a new, locally acting, transcutaneous flurbiprofen preparation (flurbiprofen LATTM, Boots Company PLC) in the treatment of scapulohumeral periarthritis. The new preparation consists of a nonwoven polyester patch supporting a mentholated formulation containing flurbiprofen 40 mg. Eighty patients suffering from the acute, painful phase of scapulohumeral periarthritis entered the trial, three of which failed to provide follow-up data. Each patient applied one patch every 12 hours for the 14 day trial period. Efficacy was assessed in terms of reduction of pain, improvement in shoulder movement and overall clinical assessment of the severity of the condition after treatment. Statistically significant improvements from baseline were observed in both treatment groups, with a constant overall trend in favour of flurbiprofen. The differences between the two treatment groups, however, did not reach statistical significance.
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PMID:Evaluation of the efficacy and tolerability of a new locally acting preparation of flurbiprofen in scapulohumeral periarthritis. 760 Nov 77

In conclusion, PCL injuries occur more commonly than previously noted. The PCL-deficient knee is a serious pathology; it is one of functional disability, not functional instability as seen with an ACL disruption. This functional disability is secondary to pain and inflammation from articular cartilage degeneration. The degeneration process occurs over a period of time normally greater than 5 years; eventually knee function is seriously limited. The rehabilitation of the PCL reconstructive or nonoperative patient is greatly dependent on dynamic quadriceps stability. The biomechanics of the PCL and PLC during various exercises are not well understood; however, research is being performed to advance the clinical management following these injuries. The clinician must realize that tremendous tibiofemoral shear forces are created during various knee exercises, in both the closed and open chain. In particular, various knee exercises, in both the closed and open chain. In particular, there are tremendous stresses applied to the PCL during OKC-resisted knee flexion. The clinician must also realize the role of the hamstrings during most closed chain exercises; therefore the author recommends an early program emphasizing isolated open chain quadriceps strengthening progressing to closed chain drills once adequate quadriceps strength has been established. The numerous clinical challenges for the rehabilitation team to hurdle when treating a PCL-injured knee patient have been discussed in this article. The PCL rehabilitation program can no longer be thought of an an ACL rehabilitation program "turned around." The anatomy, biomechanics, and natural history of the PCL-deficient knee differs dramatically from the ACL-deficient knee, and the treatment approach should reflect these considerations.
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PMID:Rehabilitation of isolated and combined posterior cruciate ligament injuries. 795 89

A prospective and randomized trial that compares Jelonet (Smith & Nephew PLC, London, England) with a new hydrocolloid dressing, Dermasorb (Convatec Ltd., Clwyd, United Kingdom), is presented. The dressings were applied on contiguous donor sites in 21 patients that required skin grafting for burn wounds. Pain experienced with the dressing in situ was assessed on days 2, 4, 7, and on two subsequent occasions. During dressing changes, pain experienced was again assessed, bacteriologic swabs were taken, and the percentage of epithelialization was recorded. Questionnaires completed by investigators and patients were used to assess the perceived performances of both dressings. The results showed that Dermasorb is a less painful dressing than Jelonet, in which wounds heal faster. Dermasorb was preferred by both investigators and patients. No clinical or laboratory evidence of any differences of colonization or infection were found. All results were statistically significant. We would strongly recommend the use of Dermasorb as a split-thickness skin graft donor site dressing for a patient with burns.
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PMID:Dermasorb versus Jelonet in patients with burns skin graft donor sites. 873 72

ATP receptors in the central nervous system (CNS) are divided into 2 major classes, ionotropic (P2Xn) and G protein-coupled (P2Yn) ATP receptors. P2Xn receptors, a member of the 2-transmembrane family, contain non-selective cation channels that may play a role in rapid synaptic transmission. Seven subtypes of P2Xn were reported so far. Although all of these subtypes are distributed in the CNS, P2X4 and P2X6 are most abundantly and widely distributed. P2X3 is distributed only in trigeminal ganglia neurons as well as in small-diameter DRG neurons, suggesting their relation to pain. P2Yn receptors, a member of the 7-transmembrane superfamily, are coupled with Gq/11 to activate PLC beta. These receptors are thought to play an important role in the modulation of synaptic efficacy. Seven subtypes of P2Yn were reported so far. P2Y1, P2Y2, P2Y3 and P2Y4 are distributed in the CNS. Neither selective agonists nor antagonists to P2Xn and P2Yn are known.
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PMID:[ATP receptors in the central nervous system]. 939 22

The present study investigates patients' expectations toward radiotherapy and their associations to quality of life and physician judgements. Fifty-five patients with tumors of different sites (30 with previous tumor-related surgery, 25 without surgery) admitted to the department of radiotherapy filled out a standardized questionnaire (EORTC QLQ-C30, PLC by Siegrist et al., therapy-related expectations and success) before and after inpatient radiotherapy. The corresponding physician ratings were collected. Fifty-eight percent of the patients expected the therapeutic goal "healing", whereas from the physician's standpoint this was realistic in only 7% of cases. The specific radiotherapy-related expectations "tumor control" and "pain relief" reached almost the same levels in patients and physician (71% vs 71% and 40% vs 44%). Patients with healing expectancy reported higher quality of life at the beginning of the therapy (53.4% vs 39.9%); patients expecting pain relief reported lower quality of life (37.1% vs 54.5%). Surgical patients who had been operated on within the past year (n = 18) showed a particularly high healing expectancy (83%), whereas patients whose operation dated back more than 1 year focused on pain relief as therapeutic goal (83%). The surgeon, as the primary contact person for patients, can influence patients' therapy-related expectations. In explaining the overall therapeutic strategy, surgeons should also mention the scope and limits of adjuvant therapies.
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PMID:[Radiotherapy in surgical and nonsurgical patients. Therapy expectations, quality of life and physician assessment]. 957 35

Rizatriptan (MAXALT, a registered trademark of Merck & Co. Inc.) is a selective 5-HT(1B/1D) receptor agonist with rapid oral absorption and early onset of action in the acute treatment of migraine. This randomized, open-label, crossover outpatient study assessed the preference of 481 patients for rizatriptan 10-mg rapidly disintegrating tablets versus sumatriptan (IMIGRAN, a registered trademark of GlaxoWellcome PLC) 50-mg tablets in the treatment of a single migraine attack with each therapy. Almost twice as many patients preferred rizatriptan 10-mg rapidly disintegrating tablet to sumatriptan 50-mg tablet (64.3 vs. 35.7%, p < or = 0.001). Faster relief of headache pain was the most important reason for the preference, cited by 46.9% of patients preferring rizatriptan and 43.4% of patients who preferred sumatriptan. Headache relief at 2 h was 75.9% with rizatriptan and 66.6% with sumatriptan (p < or = 0.001), with rizatriptan being superior to sumatriptan within 30 min of dosing. Fifty-five percent of patients were pain free 2 h after rizatriptan, compared with 42.1% treated with sumatriptan (p < or = 0.001), rizatriptan being superior within 1 h of treatment. Forty-one percent of patients taking rizatriptan were pain free at 2 h and had no recurrence or need for additional medication, compared to 32.3% of patients on sumatriptan. Rizatriptan was also superior to sumatriptan in terms of the proportions of patients with no nausea, phonophobia or photophobia, and patients with normal function 2 h after treatment intake (p < 0.05). More patients were (completely, very or somewhat) satisfied 2 h after treatment with rizatriptan (73.3%) than 2 h after treatment with sumatriptan (59.0%) (p < or = 0.001). Additionally, 2 h after the dose, more patients found rizatriptan to be very convenient, convenient or somewhat convenient (87.2%) than they did sumatriptan (76.3%) (p < or = 0.001). Both active treatments were well tolerated. The most common side effects with rizatriptan and sumatriptan were nausea (6.6 and 6.9% of patients, respectively), dizziness (6.1 and 5.8%) and somnolence (7.4 and 6.7%).
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PMID:Comparison of preference for rizatriptan 10-mg wafer versus sumatriptan 50-mg tablet in migraine. 1138 69

Fluid-ventilated, gas-permeable scleral lenses are a valuable front-line tool in the management of severe ocular surface disease. In addition to enhancing vision, they have the potential to reduce greatly the disabling ocular pain and photophobia associated with SJS, TEN, and ocular cicatricial pemphigoid. They are also useful in healing some PEDs that are refractory to all other treatment strategies and in reducing PED recurrence in stem cell-deficient and neurotrophic corneas. The therapeutic benefits of these lenses are provided by the oxygenated aqueous environment they create over the corneal epithelium. The oxygenated precorneal fluid compartment that is maintained at neutral pressure protects the epithelial surface from the desiccating effects of exposure to air and the friction generated by blinking and avoids the shearing forces generated during the blink-induced movement of soft lenses.
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PMID:The Boston Scleral Lens in the management of severe ocular surface disease. 1268 51

The SkyePharma PLC subsidiary SkyePharma Inc. (formerly DepoTech) is developing a sustained-release formulation of morphine sulphate [DepoMorphine, C 0401, D 0401, SKY 0401] using its DepoFoam proprietary drug delivery technology. It is intended for epidural administration in the treatment of acute postoperative pain. DepoFoam consists of microscopic spherical particles with internal aqueous chambers separated by lipid membranes containing the encapsulated drug. DepoFoam particles are synthetic replicas of natural lipids that are biodegradable and biocompatible. DepoFoam can be administered subcutaneously, intramuscularly and intrathecally. In December 2002, SkyePharma and Endo Pharmaceuticals signed a development and commercialisation agreement providing Endo Pharmaceuticals with exclusive marketing and distribution rights in the US and Canada for Depomorphine and another product, Propofol IDD-D trade mark, with options for other development products. Under the terms of the agreement, SkyePharma will receive an upfront payment and may receive further milestone payments. Skye-Pharma will also receive a share of each product's sales revenue. SkyePharma is responsible for clinical development towards the US FDA approval and for product manufacture and associated costs. Following the approval, SkyePharma will as act as a supplier, while Endo will market each product in the US and Canada. SkyePharma has received 30 million US dollars from Paul Capital Partners, a US private equity group, to develop DepoMorphine. This capital will enable SkyePharma to fund phase III clinical trials without raising extra funds. Paul Capital will have rights to 15% of any revenues from DepoMorphine until 2014, and also receive some royalties on three other SkyePharma products. However, if DepoMorphine fails in clinical trials or is declined for registration, Paul Capital will not be compensated for the investment. SkyePharma expect to conclude a European license by the end of 2003, and are also in discussions with potential Japanese licensees. In July 2003, SkyePharma submitted an NDA to the US FDA for DepoMorphine in the treatment of moderate to severe postoperative pain. The FDA accepted the filing in September, triggering a milestone payment to Skye-Pharma. Positive results from two phase III trials in 750 patients after hip surgery and lower abdominal surgery released in June 2003 report that DepoMorphine is effective in providing sustained dose-related analgesia. DepoMorphine demonstrated sustained dose-related analgesia and achieved its primary endpoint and also statistical significance on several secondary endpoints such as patient perception of pain intensity and adequacy of pain relief. The Financial Times in January 2001 reported that analysts have forecast DepoMorphine to reach peak sales of more than 200 million US dollars. In April 2001, the Wall Street Journal quoted the CEO of SkyePharma predicting that DepoMorphine has the potential to reach combined annual sales, in the US and Europe, of approximately 350 million US dollars.
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PMID:Morphine Liposomal--SkyePharma: C 0401, D 0401, morphine--DepoFoam, SKY 0401. 1458 69


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