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

The need for a standardized and valid means of assessing diabetic neuropathy has been increasingly recognized. To identify potential components of such an assessment, interobserver variation (neurologist and internist) of a standard neurologic examination and the comparability of this examination with vibratory and thermal sensitivity testing was studied. The study population comprised the first 100 participants in a neuropathy substudy of 25- to 34-yr-old subjects with insulin-dependent diabetes mellitus taking part in a cohort follow-up study. Symptoms of dysesthesias, paresthesias, and burning, aching, or stabbing pain revealed good interobserver agreement. Signs of neuropathy, more prevalent in the great toe than index finger, showed poor interobserver agreement for vibration, but fair interobserver agreement for touch and pinprick. Mean quantitative sensory thresholds differed significantly by clinical category of abnormal vibratory and pinprick sensations. Threshold testing showed twice the prevalence of abnormality compared with clinical examination. It is concluded that components of the clinical examination can be identified that, along with quantitative sensory-threshold testing, may provide a satisfactory core assessment for use both in epidemiologic studies and incorporation into more in-depth protocols required for clinical research and practice. The clinical relevance of the greater prevalence of abnormalities on threshold testing will be established by long-term follow-up.
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PMID:Measuring diabetic neuropathy. Assessment and comparison of clinical examination and quantitative sensory testing. 270 14

The emotional-pain stress (EPS) in C57BL mice with Lewis carcinoma was studied for its influence on serotoninergic, noradrenergic, dopaminergic, glutamatergic, aspartatergic, glycinergic, taurinergic, GABA-ergic and cholinergic mediator mechanisms of the hypothalamus, the level of corticotropin, free and bound 11-corticosteroids, insulin, thyroxin and testosterone in blood plasma as well as on the content of catecholamines, their precursors and catabolites in urine. EPS contributed to a long-term activation of stress-realizing systems resulting in generalization of decompensation in them. The stimulating effect of EPS on the incidence and growth of metastases is established depending on the terms of its application.
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PMID:[The effect of emotional-pain stress syndrome on the biochemical characteristics of the stress-realizing system and metastasis of Lewis lung carcinoma in mice]. 279 54

We have evaluated the pharmacokinetics, reliability and patient tolerability of a newly developed injection pen for cartridged growth hormone (GH). The cartridge contains 25 IU GH in 2 ml solvents. The pen, which is basically a needle, syringe and vial in one piece, is operated by a turning movement and allows doses from 0.25-4 IU. Nine GH deficient patients were hospitalized twice for overnight bloodsampling following subcutaneous injections (at 8 p.m.) of GH: i.e. when using traditional syringe and vial and after 6 weeks of use of the pen. Serum GH antibodies were measured immediately prior to, and 3 and 6 months following pen treatment. GH containers were collected regularly from the patients for chemical analysis. A questionnaire was completed during and at the end of the study. The absorption rate and bioavailability of GH tended to be higher with syringe and vial (2 P = 0.07) but there were no differences in the profiles of IGF-I, insulin, glucagon or pertinent metabolic parameters following the 2 injection modes. No GH antibodies occurred during 6 months of pen treatment. The content of polymeric GH was lower in the cartridges (2 P less than 0.001). Seven of the patients reported less injection pain when using the injection pen, which they all strongly preferred and wished to continue using. We conclude that the GH injection pen is a reliable tool which seems to be more convenient for the patients.
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PMID:Growth hormone administration by means of an injection pen. 281 89

Hyperactivity of nociceptive C-fibers has been recently described in diabetic BB/Wistar rats. This study assesses the association of hyperalgesia, using an analgesy-meter, with elevated glycosylated haemoglobin levels in three animal models of diabetic and nutritional neuropathies: Psammomys obesus (sand rat), streptozotocin-treated and galactose-fed rats. Pain threshold measurements (paw pressure test) and motor nerve conduction velocities were recorded in controls (n = 75), hyperinsulinaemic (n = 16), insulin-deficient (n = 46) und galactosaemic (n = 12) animals. The reproducibility of the paw pressure test, evaluated by a correlation coefficient, was statistically significant (p less than 0.001). When compared with their controls (396 +/- 18 g), the average pain threshold in young diabetic sand rats (309 +/- 17 g) was found to be markedly reduced and to correlate inversely (p less than 0.001) with their respective HbA1c levels (mean 4.9 versus 7.4%). Acute, subacute and chronic streptozotocin-diabetic rats displayed a reduction of pain threshold (p less than 0.001) associated with slowed motor nerve conduction velocities (p less than 0.001). Similarly, galactose-feeding over 4 weeks resulted in an elevation of glycosylated haemoglobin levels with significant (p less than 0.001) reductions of pain threshold and motor nerve conduction velocity. It is concluded that hyperalgesia is a constant feature of sensory dysfunction in spontaneous and experimental models of diabetic neuropathy.
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PMID:Hyperalgesia in spontaneous and experimental animal models of diabetic neuropathy. 282 Aug 21

The role of opioid receptors in diabetes and hyperglycemia-induced analgesia was studied in male Sprague-Dawley rats. Animals maintained under controlled environmental conditions were used in all studies. Pain latency was determined by the hot plate test (55 degrees C) and analgesy-meter force method. The results of these studies indicate that streptozotocin-induced diabetic animals have a significantly higher pain threshold (P less than 0.01) than the control groups. The pain threshold was found to be diurnally controlled with a peak at the beginning of the light phase (1000 hours) and a trough at the end of the dark phase (0800 hours). Diabetes-induced analgesia was found to be reversed by both acute or chronic insulin administration. In another study, glucose-induced hyperglycemic rats were found to have a significantly higher pain threshold (P less than 0.01) than control animals, with a peak occurring at the beginning of the dark phase (2000 hours), and a trough at the beginning of the light phase (0800 hours). The administration of the opioid antagonist naloxone (2 mg/kg) reversed the hyperglycemia and diabetic-induced analgesia. The results of these studies might indicate that analgesia found in diabetic or hyperglycemic animals may be related to the endogenous opioid system.
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PMID:The role of opioid receptors in diabetes and hyperglycemia-induced changes in pain threshold in the rat. 282 14

Motor and sensory nerve conduction velocities (MNCV, SNCV), beat-to-beat variation (BBV) at rest, speed of pupillary dilation (SPD), and pupillary latency time (PLT) were measured in 32 patients aged 12-36 years after 19 +/- 2 (mean +/- SEM) days and again after 3, 12, and 24 months of insulin treatment. Moreover, BBV under deep respiration was determined after 12 and 24 months, and thermal discrimination thresholds (TDT) as well as pain and vibration perception thresholds (PPT; VPT) were evaluated after 24 months. Mean HbA1 levels during months 3-24 within the normal range (7.2 +/- 0.2%; mean +/- SEM) were observed in 20 patients (group 1), while in 12 patients (group 2) mean HbA1 of months 3-24 was elevated (10.1 +/- 0.4%). There were no significant differences between both groups with regard to the nerve function tests at baseline and after 3 months. After 12 months mean median MNCV and median, ulnar, and sural SNCV were significantly lower in group 2 than in group 1 (p less than 0.05). After 24 months mean median MNCV, peroneal MNCV, median SNCV, and sural SNCV as well as both BBV tests and PLT were significantly impaired in group 2 as compared to group 1 (p less than 0.05). In addition, mean malleolar VPT and PPT to heat and cold stimuli on the thenar and the foot were significantly elevated in group 2 as compared to group 1 (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The natural course of peripheral and autonomic neural function during the first two years after diagnosis of type 1 diabetes. 285 50

A case of primary adenocarcinoma of the urinary bladder occurring in a patient with type 1 multiple endocrine adenomatosis (MEA) is presented. The patient was a 36-year-old female who had a past history of type 1 multiple endocrine adenomatosis, namely, adenomatosis of the parathyroid gland, insulin and gastrin-producing adenomatosis of the pancreas, and prolactin-producing pituitary adenoma. She was admitted in January 1981 with the complaints of gross hematuria, pollakisuria and micturition pain lasting for about one year and a half. Cystoscopic examination revealed four solid tumors in the posterior and left lateral walls of the bladder with diffuse mucosal hyperemia. Biopsy of the tumors disclosed that they were adenocarcinoma. Clinical examinations revealed that there was no extravesical primary malignant neoplasm in this case. Radical cystectomy with urinary diversion by ileal conduit was performed on January 22, 1981. Histological examination revealed that the tumor was adenocarcinoma originating from the vesical mucosa. Follow-up for over three years since the time of surgery has not shown any sign of tumor recurrence or occurrence of extravesical malignant neoplasm. In addition, 28 cases of primary adenocarcinoma of urinary bladder in Japan reported during the last 25 years are reviewed and analyzed.
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PMID:[A case of primary adenocarcinoma of the urinary bladder occurring in a patient with type 1 multiple endocrine adenomatosis (MEA)]. 286 84

The peripheral control of appetite is effected by two digestive hormones produced by the stomach and intestine. Bombesin, induced by gastric distension, might act as a messenger informing the nervous centres that the subject is satiated. The pharmacological satiating effect of cholecystokinin, probably mediated by the afferent fibres of the vagus nerve, is well established, but its physiological effect has not yet been demonstrated. Centrally, appetite is controlled by neurotransmitters, satiating and orexigenic properties being shared between monoamines, benzodiazepine-receptors and GABA-receptors. Among digestive hormones present in the central nervous system, the most satiating in pharmacological doses seem to be cholecystokinin and calcitonin, but their physiological role remains obscure. Insulin might be the signal informing the hypothalamus on body fat mass. Endorphins exert an orexigenic effect, reversed by naloxone, which is particularly marked in case of stress, in obese subjects and in the presence of highly palatable food. The control of appetite therefore is complex. It cannot be separated from other functions, such as pain and pleasure, which are regulated by intracerebral peptides.
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PMID:[Mechanisms of the control of appetite]. 286 55

Diabetes mellitus is found in up to 5 per cent of the population. There is an excess of blood sugar due to a deficiency or diminished effectiveness of insulin. It is a complex disease which, if not controlled, has many major complications including an increased incidence of heart attacks, strokes and vascular changes in many other organs. The management of young onset diabetic patients is directed towards: controlling the carbohydrate intake, testing the blood sugar by the patient and regular insulin injections. Great care must be taken in treating diabetics in the dental surgery. Except for children, any diabetic can be treated for simple dental procedures by ensuring freedom from pain, by eliminating stress and by ensuring that the patient does not miss a meal. Children, unstable diabetic patients and those with infections or requiring multiple extractions should be treated in hospital under the care of an endocrinologist. In hypertension it is only after a number of years that complications begin to appear. The main ones are those of stroke, retinal haemorrhages, renal failure and heart disease. Dentists should be encouraged to take the blood pressure of all adults who present for treatment. Patients with increased blood pressure yet controlled by drugs may be treated as normal patients. Those that are not well controlled should be referred to their physician. Dental appointments must be free of pain and stress should be avoided. A screening method is presented which assists in the evaluation of medically compromised patients.
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PMID:The medically compromised patient. 294 77

Efficacy and acceptability of the Medi-Jector II, compared with conventional syringes, was evaluated in a cross-over study (two 4-week periods) in 14 adult insulin-dependent diabetic patients. In 6 out of these 14 patients the clinical diagnosis of needle phobia was confirmed by anxiety tests for trait (45.8 +/- 12.8 (SD) versus 34.0 +/- 6.2; p less than 0.05) and state (50.3 +/- 10.9 versus 28.9 +/- 5.2, p less than 0.05). Five patients (one needle-phobic) dropped out, all for Medi-Jector-related problems. No significant differences were found in body weight, insulin dosage, and number of hypoglycaemic reactions. HbA1 after the Medi-Jector period was significantly higher than after the conventional period (9.8 +/- 1.2 (SE) versus 9.1 +/- 1.1 (SE)%; p less than 0.05). The questionnaire, evaluating the Medi-Jector, revealed poor acceptance of the device (7/9 patients' general impression being moderate or bad). The use of the Medi-Jector in comparison with conventional injections caused the patients to complain about: more immediate pain (4/9 patients), delayed pain (often: 4/9, sometimes: 2/9), more insulin leakage (6/9), more bleeding (6/9), and more haematomas (5/9). Except for 'often occurring delayed pain' (4/5 needle-phobics versus 0/4 non-needle-phobics; p less than 0.05), needle-phobic patients scored the questionnaire similarly to the other patients. We conclude that the use of the Medi-Jector II did not cause a major short-term loss of metabolic control, but that the device was not well accepted by our patients, independent of the existence of needle phobia.
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PMID:The Medi-Jector II: efficacy and acceptability in insulin-dependent diabetic patients with and without needle phobia. 296 78


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