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

Nutrients can modify brain biochemistry and behavior. Many studies indicate that one possible mode of action of nutrients is to induce alterations in the bioavailability of neurotransmitter precursors within the brain. However, a series of studies has also indicated that: (a) learning induces a decrease in the level of cholesterol in specific brain regions; (b) an iron-deficient diet induces changes in dopaminergic D receptor activity and in dopamine-associated behaviors (thermoregulation and motor activity) as well as in learning and memory capacities; and (c) dietary manipulation of a specific type of fatty acid resulted in an improved learning capacity, modification of the pain threshold level, and in thermoregulatory response. The most parsimonious explanation for these results seems to be that the treatments (learning, iron-deficient and fatty acid diets) induced changes in the lipid composition of the neuronal membrane. Such changes, in turn, resulted in changes in the membrane functions. Supportive evidence for this hypothesis is presented in this review. The "neuronal membrane functional modification hypothesis" should not be considered as contradictory to the accepted "brain neurotransmitter precursors bioavailability rates model" of nutrient effects, but as a complementary hypothesis.
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PMID:Nutrients, brain biochemistry, and behavior: a possible role for the neuronal membrane. 330 1

Despite the introduction of new intrauterine devices (IUDs), the most important complication involving their use continues to be excessive menstrual bleeding. IUD use in developing countries with women who are already depleted in body iron stores may prove to be deleterious to their health. Mean amounts of menstrual blood loss (MBL) for women not using contraception in the western world is about 32 ml. This mean is increased to 52-72 ml with use of the Lippes loop and other non-medicated devices up to 24 months after insertion. For the Copper-7 and Copper-T-200 devices this mean increase is to 37-40 ml in the first month, decreasing to 30-38 ml at 12 months after IUD insertion. In the users of the Multiload-250 IUD at one month post-insertion the MBL is from 56 to 63 ml and from 36 to 39 ml at 24 months of use. The mean Multiload-375 device users at one month after insertion lose a mean of 45-73 ml at 24 months, 35-50 ml. With the progestogen-releasing IUD mean MBL is 27-36 ml at 1 month and 9-13 ml at 12 months post-insertion. Intermenstrual blood loss is significant only in the first month of use for all IUDs. Discontinuation rates for pain and bleeding with non-medicated IUDs are from 11.0-19.6 per 100 women per year, and for the copper IUDs 4.4 to 6.8 per 100 women in the first year of use. The main problem with prolonged menstrual bleeding is depletion of the body iron stores; this is highly significant with non-medicated devices, less important with copper devices and conversely, iron stores are increased in users of progestogen-releasing devices. This is based on serum ferritin measured up to 24 months after insertion. The ferritin values correlated well with the volumes of MBL. It is suggested, especially for women with low body iron stores, that there is an order of preference for IUDs to be used. This should be: firstly, the progestogen-releasing devices; secondly, the Copper-T and Copper-7 IUDs; thirdly the larger surface copper devices (Cu-T-220C, Multiload 250 and 375, Cu-T-380). Non-medicated devices are not to be recommended for these women.
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PMID:Quantitative studies on menstrual blood loss in IUD users. 331 22

In order to study the role of excessive synovial iron sequestration in the production of anemia in rheumatoid arthritis (RA), the antianemic efficacy and anti-inflammatory effect of desferrioxamine administered in a short-term treatment (14 days), were evaluated in 10 patients suffering from classic or definite RA and hyposideremic anemia. Treatment with desferrioxamine showed an elevated urinary iron excretion, a significant increase of serum iron, UIBC and hemoglobin, and a marked progressive decrease of serum ferritin. A moderate improvement of the pain intensity, morning stiffness and Ritchie's index was also observed. The results obtained suggest that excessive reticuloendothelial iron deposits occur in RA and that the iron uptake can be an important factor in the production of anemia. Desferrioxamine seems to be useful in the treatment of patients suffering from RA and anemia, in order to release iron from synovial tissue, reduce the inflammatory process and improve anemia, changing an anemia which is typically resistant to the martial therapy into an iron-sensitive anemia.
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PMID:Antianemic and potential anti-inflammatory activity of desferrioxamine: possible usefulness in rheumatoid arthritis. 351 95

The usefulness, efficacy, safety, and tissue effects of Nd:YAG laser photocoagulation were investigated prospectively in 100 patients. Sixty-seven elderly patients with colorectal adenoma and 21 patients with rectal stump polyps after colectomy and ileorectal anastomosis in familial polyposis were evaluated. We subdivided our patients into those with extensive, intermediate, and small lesions, and we assessed completeness of tumor ablation, recurrence, and complications in all three groups. In the extensive group only 8 patients achieved complete (i.e., gross endoscopic and histologic) tumor ablation, whereas in 18 patients adenomatous tissue persisted or recurred after a tumor-free interval. In the intermediate group complete tumor ablation was achieved in 10 of 22 patients. Small adenomas were completely ablated in 18 of 19 patients. Five instances of carcinoma were detected in each subgroup of nonresponding extensive (18 patients) and intermediate (12 patients) lesions at follow-up. Prior to laser photocoagulation, symptoms such as watery diarrhea, excessive mucous discharge, hypokalemia, dehydration, and hematochezia and iron-deficiency anemia were present in 16 of 26 patients with extensive adenoma and in 13 of 22 patients with intermediate adenoma. Symptoms subsided during the course of treatment in all but 1 patient, even with the absence of complete ablation. Major complications, consisting of bleeding, symptomatic stenosis, or perforation occurred in 11.6% with extensive adenomas, in 9.1% with intermediate adenomas, and in none with small adenomas. Minor complications such as transient asymptomatic stenosis, minor posttreatment hemorrhage, pain, and "serositis" occurred in 30.9% with extensive lesions, in 27.3% with intermediate lesions, and in 10.6% with small lesions. There was no mortality. Treatment of multiple tiny polyps in 21 patients with familial polyposis was easy and efficient, without retraction and scarring, and without complications. We have concluded that laser photocoagulation is safe and uniformly effective in the ablation of small colorectal adenoma and in recurrent polyps in patients with familial polyposis. In patients with intermediate or large adenomas, symptoms are highly responsive to treatment, but complete tumor ablation--as documented upon repeated endoscopy and multiple biopsies--can only be expected in approximately 40%-50% in long-term follow-up. The high incidence of cancers in these two groups (21%) underscores the need for continued surveillance and frequent biopsy. Major and minor complications will occur in 40% in these sizeable lesions, being of clinical importance in only 10%.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Nd:YAG laser photocoagulation in colorectal adenoma. Evaluation of its safety, usefulness, and efficacy. 369 5

Four cases of giant inflammatory polyps were found in a series of 86 consecutive colectomies for inflammatory bowel disease. Two presented a distinctive clinical syndrome of abdominal pain and chronic iron-deficiency anemia due to blood loss. Secondary ulceration of the heads of the polyps accounted for the bleeding and anemia, and the size of the polyps accounted for the abdominal pain. In both cases unusually long portions of colon were involved by the giant polyps. The third and fourth cases had rare complications--reactivation of an enterocutaneous fistula and perforation of an acquired diverticulum. These cases demonstrate that giant inflammatory polyps may produce symptoms independently of the underlying inflammatory bowel disease. In reported cases of giant inflammatory polyps, approximately two-thirds had Crohn's disease and one-third had ulcerative colitis. The transverse colon was the commonest location, pain was the commonest symptom, and the polyps were localized to a short segment of colon in the majority of cases. More than 50% of cases mimicked neoplasm on barium enema. Giant inflammatory polyps may produce a variety of distinctive signs and symptoms and deserve independent recognition.
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PMID:Giant and symptomatic inflammatory polyps of the colon in idiopathic inflammatory bowel disease. 371 97

A series of polymers bearing hydroxamic acid-terminated side chains were prepared for the purpose of developing new iron chelators for treating iron overload in beta-thalassemia (Cooley's anemia) and other iron diseases. The polymers are for the most part amino acid amide derivatives of acrylic and methacrylic acid with the terminal carboxyl group converted to the hydroxamic acid. The polymers are generally water soluble and sequester iron(III) avidly. The polymeric iron chelators were assayed via a mouse screen for activity in removing iron. Iron overloaded mice were administered i.p. the iron chelator over a 7-day period. Urine and feces were collected and the iron content measured by atomic absorption. At the end of the treatment period the mice were sacrificed and the livers and spleens were homogenized and examined for iron content. The results were compared with similar data obtained for the iron chelator drug desferrioxamine as a standard. Four of the polymers prepared exhibited strong activity, as good or better than desferrioxamine in iron removal capability. The four polymers are the polyacroloyl and polymethacryloyl derivatives of beta-alanine with the side chain carboxyls converted to the N'--H or N'--CH3 hydroxamic acids. Of these four the polyacryloyl N'--CH3 derivative exhibited superior behavior, being 3 to 5 times as effective as desferrioxamine at the lower dose level. None of the four polymers produced toxic signs and the administration was accompanied by little or no pain response.
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PMID:Evaluation of polymeric hydroxamic acid iron chelators for treatment of iron overload. 397 22

16 male and 28 female patients experiencing moderately severe pain during episodes of sickle-cell disease at least once in 3 months with little or no fever or exacerbations of jaundice were selected for a cross-over trial of low doses of steriods against saline solution. The patients each completed 4-6 months of treatment. All patients were on regular folates and had high or normal serum-iron values. Weights ranged from 24-134 pounds and ages from 2-35 years. Male patients were randomly assigned to either testosterone in oil (10 mg in 1 ml) or physiological sodium chloride solution (1 ml). Females were randomly assigned to progesterone in oil (10 mg in 1 ml) or physiological saline solution. A score was computed each month reflecting the severity, duration, and frequency of episodes of pain. About 80% of the individuals on steriods had good responses and about the same proportion of the sodium chloride group had very poor responses. 22 of the original 31 patients stopped taking saline injections after the 1st 2 weeks. The packed-cell volumes in the steroid group rose during the period of steroid injections, while there was no appreciable change in the sodium chloride group. There were no sex differences in the pattern of response and no deleterious side effects were noted.
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PMID:Steroid treatment in the prevention of painful episodes in sickle-cell disease. 411 53

Painful lymphadenopathy developed in eight female patients after massive infusions of iron dextran for sideropaenic anaemia. Fever, arthralgias, and malaise were also features of the clinical picture. The histology of one lymph node is described and changes in it are discussed in relation to the pathogenesis of the syndrome reported.
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PMID:Lymph node enlargement after a single massive infusion of iron dextran. 569 50

Rats made nutritionally iron-deficient (ID) have been shown to have a lower brain non-haem. A selective diminution of the binding capacity of the D2-dopaminergic receptors alone was found among nutritionally iron-deficient rats. Peripherally administered beta-endorphin significantly elevated the pain threshold only in the iron-deficient rats. Naloxone blocked the beta-endorphin effect in ID rats. Morphine, as well as haloperidol, elevated the pain threshold in both the iron-deficient and the control rats but significantly more in the former group. No additive effects of combined treatment with beta-endorphin and haloperidol on pain threshold were found. Other neuroleptics also elevated the pain threshold. A possible hypothesis is that dopamine (via beta-endorphin) may play a role in modifying the pain threshold.
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PMID:The increased opiate action of beta-endorphin in iron-deficient rats: the possible involvement of dopamine. 609 14

2 patients afflicted with beta-thalassemia major presented with pain and swelling of the parotid salivary gland. In 1 patient, the symptoms were of long standing and particularly severe, with diminished and highly viscous salivation. In the other patient, the parotid glands had only recently become painful, while salivary output and quality remained normal. The parotid anatomy in both patients, as demonstrated by sialography, and the clearance of opaque material were normal. Tc99 scintigraphy revealed reduced uptake and rapid clearance of the isotope from the parotid serous glands into the oral cavity, in contrast to the increased uptake by the sublingual mucous glands. Iron deposits were demonstrated in the parotid secretory serous cells. It is postulated that the impaired function of the parotid is linked to iron deposits in the serous cells of this gland, as a sequella of beta-thalassemia.
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PMID:Changes in the parotid salivary gland of beta-thalassemia patients due to hemosiderin deposits. 640 23


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