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

Paget's disease is a bone disorder characterized by high rates of bone remodelling. We have evaluated the efficacy of the new drug, ipriflavone, which has a double effect on the inhibition of bone reabsorption and on the activation of bone neodeposition. We studied 20 patients with active Paget's disease: 10 have been treated with 600 mg/die and 10 with 1200 mg/die of ipriflavone, for six months. In pharmacological wash-out, we have measured alkaline phosphatase, plasmatic BGP, the urinary hydroxyproline/creatinine ratio and the urinary calcium (Nordin Test). These valuations have been repeated after three and six months from the beginning of the administration of the drug. We have verified a propitious and speedy effect on pain, independent of dosage, and efficacy of treatment in function of bone turn-over parameter changes, by using no parametric statistical tests. In all subjects favourable effects have been found after three months treatment with 1200 mg/die. These have shown a greater efficacy than the lower dosage. After six months treatment we have not found significant differences as regards the efficacy of both dosages. These results may suggest to start therapy with higher initial doses and to carry-on with lower supporting doses. It's necessary to investigate further confirmation regarding the consolidation and perseverance of obtained favourable results, even after interruption of the treatment.
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PMID:[Paget's disease: the prospects with ipriflavone]. 149 10

Venous stasis is a situation encountered commonly in varicose disorders. The potential implications of this decrease in oxygen levels in terms of the status of the cells of the vein were assessed. When endothelial cells are subjected to hypoxia, there is stimulation of the cells which shows itself as increased synthesis of prostaglandins and of PAF (Platelet Activating Factor). The synthesis of these typical mediators of inflammation results from activation by the calcium of phospholipase A2 which releases the arachidonic acid of phospholipids and this increase in intracellular calcium results itself from a fall in efficacy of calcium pumps due to the fall in ATP caused by hypoxia. Thus the fall in oxygen leads to the production of mediators of inflammation which activate leucocytes and result in local micro-inflammation which can be very rapidly eliminated if the circulation is restored but which can also cause irreversible damage to the vein by changes in venous tissue due to activated leucocytes which release proteases and free radicals after having penetrated the intima of the vein. These processes offer an explanation for the histological changes seen in varicose veins and the onset of localised pain during the development of such disease.
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PMID:[The relation between venous stasis and the occurrence of pain]. 149 30

We report a patient with idiopathic hypoparathyroidism associated with unilateral calcification of the basal ganglia and contralateral choreic movements. A 66-year-old woman was admitted to our hospital because of involuntary movements of the left limbs. Two years before the present admission, she had operations for bilateral cataracts. Eight months before admission, she had an onset of severe carpal spasms and pain in both arms and legs. These symptoms improved after one month's rest in a hospital. About a month before admission, she noted progressive difficulty in using her left hand, followed by difficulty in walking due to the abnormal involuntary movement of the left lower limb. Two weeks before admission her carpal spasms appeared again, bilaterally. On admission, she was alert. The general physical examination was normal. Neurological examination revealed choreic movements in the left hand, arm, leg and neck, and grimacing of the left face. She also complained of the spasms and pain in her hands, dysarthria and shortness of the breath. Chvostek and Trousseau signs were positive. Laboratory examination revealed marked decrease in serum calcium level (2.57 mEq/ml) and increase in inorganic phosphorus level (6.40 mEq/ml). Serum level of parathyroid hormone was less than 10 pg/ml. Ellthworth-Howard test was positive, in that the infusion of parathyroid hormone (100 u) elicited a marked increment of the urinary excretions of phosphorus and cAMP. X-ray examination of the spine revealed ossification of the posterior longitudinal ligament in the cervical region. CT-scans of the brain revealed calcification in the region of right globus pallidus and putamen.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Unilateral choreic movements in idiopathic hypoparathyroidism]. 152 May 67

Unstable angina pectoris is a clinically heterogeneous process with patient symptoms varying between reduced threshold for exertional angina and the occurrence of multiple episodes of rest pain. The major factors in the pathogenesis of unstable angina appear to be intracoronary platelet aggregation and thrombus formation secondary to fissuring or rupture of atheromatous plaques, with associated coronary vasoconstriction due to release of constrictor materials from aggregating platelets and deficiency of endothelium-related vasodilator activity. The latter factor is of particular interest in view of the similar biochemical mechanisms of action of nitroglycerin (NTG) and endothelium-derived relaxing factor (EDRF). The efficacy of NTG in limiting platelet aggregation is also of particular interest in this condition. Medical therapy in patients with unstable angina usually requires use of multiple agents. In the short term, there is a strong case for the use of intravenous heparin both to relieve pain and to reduce the risk of acute myocardial infarction. Aspirin is perhaps less effective in the short term, but very useful in long-term treatment of such patients. Despite their widespread clinical use, beta-adrenoceptor antagonists are probably only marginally beneficial, whereas dihydropyridine calcium antagonists such as nifedipine are potentially harmful as monotherapy and of questionable use in combination with other drugs. Other agents that are effective in relieving ischemic symptoms are the nondihydropyridine calcium antagonists verapamil and diltiazem and the oxygen-sparing agent perhexiline maleate. Despite a paucity of controlled trial data, nitrates are used in the vast majority of patients with unstable angina.
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PMID:Role of nitrates in unstable angina pectoris. 152 28

Between March 3, 1987 and Sept. 8, 1989, intra-arterial calcium infusions were used to treat 28 patients (38 extremities) suffering hydrofluoric acid (HF) exposures that failed to respond to topical treatments. Although 18 of the injuries occurred at work, only 1 patient was using HF in a concentration greater than 12%. Many of these products were available over the counter. Most patients did not wear protective equipment and had no concept of the danger of injury from the product. Onset of symptoms (pain, erythema and edema) was delayed from 1 to 6 h after exposure. Arterial catheters were placed and the patient was begun on a protocol using 10 ml of 10% calcium chloride diluted with 40 ml normal saline and infused over a 4-h period. Each patient was allowed a 4-8 h rest period before assessing the need for additional infusions. Blood calcium, magnesium, phosphorus, PT, and PTT were monitored. Infusions were repeated until there was no tenderness. Using tenderness as an end-point increased the number of infusions compared to previous reports. The mean number of infusions was 4.1 (range, 1-10). Success (complete healing) was 100%. There was a significant rise in serum calcium, but not to dangerous levels (range 9.3-12.8). There was also a significant fall in magnesium, which reached levels requiring magnesium intravenously. There were no significant changes in phosphorus, PT, and PTT.
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PMID:Intra-arterial calcium infusion for hydrofluoric acid burns. 156 23

Calcium pyrophosphate dihydrate (Ca2P2O7.2H2O) crystal-associated arthropathy (pseudogout) was diagnosed in a dog. Clinical signs included non-weightbearing lameness, signs of pain on joint manipulation, and high rectal temperature. Arthrocentesis of carpal joints revealed extra- and intracellular crystals containing calcium. The suspected cause was polyarthritis secondary to chronic Ehrlichia infection. Results of joint tap performed after resolution of the clinical signs were negative for calcium pyrophosphate dihydrate crystals.
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PMID:Calcium crystal-associated arthropathy (pseudogout) in a dog. 157 46

In-111 labeled leukocyte scintigraphy was performed on a 90-year-old woman who had a fever and left lower extremity pain for 3 days. Leukocyte images demonstrated abnormal activity in the left knee and ankle. Aspiration of the left knee joint yielded cloudy yellow fluid with a leukocyte count of 30,000 per mm3 (75% polymorphonuclear leukocytes, 1% lymphocytes, and 24% monocytes). Cultures of the aspirate were reported as no growth. Microscopic examination of the aspirate revealed the presence of rod-shaped crystals of calcium pyrophosphate dihydrate, confirming the diagnosis of calcium pyrophosphate deposition disease, also known as pseudogout. The acute arthritis of pseudogout stimulates an intense leukocyte response; therefore, labeled leukocyte images performed on patients suspected of having this condition must be interpreted cautiously because scintigraphically it may not be possible to distinguish pseudogout from septic arthritis.
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PMID:In-111 labeled leukocyte imaging in a case of pseudogout. 158 41

We report a case in which acute digital hydrofluoric acid burns were treated with regional intravenous perfusion of calcium gluconate to relieve pain and protect from further tissue damage. This is the first documented instance of this technique being used. The conventional treatments for digital hydrofluoric acid burns all have their shortcomings; intravenous regional perfusion of calcium gluconate may be an effective method of treatment for digital hydrofluoric acid burns.
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PMID:Intravenous regional calcium gluconate perfusion for hydrofluoric acid burns. 158 69

The results of arthroscopic treatment of chronic resistant calcific tendinitis of the shoulder in twenty-three patients were evaluated. Each patient had greater than 1 year of unsuccessful nonoperative management prior to arthroscopic surgery. The average age was 49 years (range 33-60) and average follow up was 26 months (range 12-47). Subacromial bursectomy was performed in all patients. Based on follow-up radiographs, thirteen patients had partial calcium removal while nine had complete removal of calcium. Results were graded as good in eleven patients (50%) with full motion and complete pain relief, satisfactory in nine (41%) patients with full motion and occasional episodes of pain, and unsatisfactory in two (9%) patients with persistent pain. Arthroscopic calcium removal and subacromial bursectomy are reasonable alternatives in the treatment of chronic calcific tendinitis resistant to conservative treatment.
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PMID:Arthroscopic treatment of calcific tendinitis of the shoulder. 163 30

Increasing pain in the region of the lumbar vertebrae occurred in a 23-year-old woman known for the past 6 1/2 years to have Crohn's disease affecting the ileocolon. Radiology revealed marked osteopenia with collapse and deformation of the vertebral bodies. The only pointer to a bone disease was a markedly lowered serum level of 25-OH-vitamin D (less than 10 ng/ml). Biopsy from the ileal crest revealed pure osteoporosis without osteomalacia. Decisive pathogenetic factors were, in the main, glucocorticoid medication, malnutrition and the long duration of Crohn's disease. During treatment with monofluorophosphate, 152 g daily, in fixed combination with 600 mg calcium as well as calcitonin (initially 100 I.U. daily subcutaneously for two weeks, then 100 I.U. every other day s.c.) and vitamin D (3 x 1,000 I.U. daily by mouth) she became free of symptoms, and she has remained so for 9 months.
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PMID:[Severe osteoporosis in a young female patient with Crohn's disease]. 164 71


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