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)

The opioid peptide, beta-endorphin, originates from proopiomelanocortin (POMC) under the influence of corticotropin releasing hormone (CHR). It increases the threshold of pain and has a certain influence on the formation of hypophyseal hormones, especially in stress. It is found that beta-endorphin stimulates the secretion of prolactin, a growth hormone, and vasopressin; it inhibates formation of follicle-stimulating and luteinizating hormones, oxytocin and dopamine, and gonadotropin, a releasing hormone. The process of acetylization decreases its activity. The results of experimental trials revealed that acetylisation in the foetal period was absent. The aim of the study was to define beta-endorphin concentration during normal vaginal labor and Cesarean section. Samples of peripheral blood of patients with spontaneous vaginal labor (n = 15) and of those in whom labor was operatively terminated (Cesarean section) (n = 10), were analysed. Values of this opiate were determined in the umbilical cord of newborn infants, in the amniotic fluid and placental compartment. The obtained results were statistically analysed. In intrapartum beta-endorphins were significantly increased reaching the highest level during expulsion (326 pg/ml); in the placental compartment these values were higher (in retroplacental blood 514 pg/ml) reaching the highest value of 917 pg/ml, p less than 0.01 in the placenta. In Cesarean section beta-endorphin values in the peripheral blood showed no significant differences during spontaneous vaginal labor. However, increased values of this natural opiate were observed six hours after surgery. Beta-endorphin concentrations in the placental compartment and the placenta during normal vaginal labor were significantly higher in comparison with labor by Cesarean section (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The opioid peptide, beta-endorphin, in spontaneous vaginal delivery and cesarean section]. 180 97

Until recently the general regimen for treatment of growth hormone deficient (GHD) children consisted of 2 to 3 intramuscular (i.m.) injections per week using conventional syringes and vials. However, studies within the last 5-10 year have shown that by dividing the same total weekly dosage into daily subcutaneous (s.c.) injections it is possible to achieve a significantly increased growth rate. To make it more feasible for the patients and the parents to cope with this increased number of injections, an injection pen system (Nordiject) for administration of B-hGH has been developed. The Nordiject pen has been investigated both with respect to patient acceptance and bioavailability of the B-hGH (Norditropin) injected with the device. Twenty-seven children with growth retardation were included in a study. The patients had no problems with the handling of the pen and approximately 2/3 of them experienced less injection pain with the pen compared to the syringe. Those patients who had previously been using conventional syringes strongly preferred the pen, and all wished to continue using the device. Fourteen adult GHD patients were included in a randomized cross-over study for investigation of bioavailability. Two separate s.c. injections of 4 IU of B-hGH (Norditropin) each were administered in random order by means of either syringe (4IU/ml) or injection pen (Nordiject) (12 IU/ml). On the basis of this study it was concluded that the bioavailability of B-hGH, measured as AUC, Cmax, and tmax, is equal following injection with the pen to that of injection by syringe.
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PMID:Growth hormone therapy with a new delivery system. 182 74

Childhood disability and chronic disease are common, and their prevalence is increasing as children survive with conditions that were previously fatal. It is important that physicians in training learn about disability and handicap, and the functioning of multidisciplinary teams to manage these problems. Chronic ill-health is often very expensive to manage, and some serious and creative thinking about the best way to fund such health care is urgently needed. Pediatric rheumatologists are involved with the care of many children with chronic and recurrent musculoskeletal pain; however, they have not perhaps focused enough research effort on the investigation of pain and its management. Whether reflex neurovascular dystrophy, fibromyalgia, and chronic fatigue syndrome are part of a disease continuum is unclear, but it seems probable that psychosocial problems are often important contributing factors in all three conditions. Immunoglobulin subclass deficiencies are being increasingly delineated, occurring in chronic fatigue syndrome as well as many other disease states. Their clinical relevance still remains, for the most part, uncertain. Short stature occurs in many chronic illnesses, and the role of growth hormone treatment in these conditions is beginning to be investigated.
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PMID:Pain syndromes, disability, and chronic disease in childhood. 183 44

Twenty-seven children, aged 5-20 years, with growth retardation were enrolled in an open study to evaluate the acceptability of a new injection pen (Nordiject 24, Novo Nordisk A/S) for administration of recombinant human growth hormone (r-hGH). Prior to this study, 17 of the patients had been receiving treatment with r-hGH administered via syringes and vials; their experiences with this conventional technique have been used for comparison with Nordiject. The injection pen is provided with a replaceable 27-gauge needle and a cartridge containing 24 IU of reconstituted r-hGH (12 IU/mL). A benzyl alcohol 0.9% solution is used as the solvent for the reconstitution. The pen can be regulated for doses from 0.5 to 8 IU per injection; regulation is accomplished by a turning movement. The patients had no problems with the dissolving procedure or handling the pen. Nearly two-thirds of the patients experienced less injection pain with the pen as compared with the syringe. Special attention was paid to local tolerability, which was reported to be good. The thigh was the preferred injection site. The residual contents from 68 cartridges returned by the patients were analyzed for microbial contamination. Contamination was detected in only one cartridge, which could not be confirmed in a repeated test. Because of the simplification of the injection procedure afforded by the injection pen, 20 of 27 patients were able to perform the injections themselves and hence assume a more active role in their treatment. The patients who previously had been using conventional syringes strongly preferred the pen, and all patients wished to continue using the device.
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PMID:Patient acceptance of Nordiject: a new drug delivery system for growth hormone. 187 65

Plasma growth hormone (GH), insulin, prolactin and blood glucose levels were measured to evaluate postoperative pain relief either with epidural morphine or systemic analgesics in 16 patients who underwent gastrectomy. Continuous epidural morphine with a pump (CADD-PCA, Model 5200P, Pharmacia) was given to eight (epidural morphine group) patients. A bolus of epidural morphine was administered through an indwelling thoracic (Th8.9) catheter at 3 hrs prior to the expected end of surgery, which was followed with continuous epidural infusion of morphine at a rate of 0.167-0.042 mg.hr-1 with the pump during and after anesthesia and surgery with gradually decreasing dose until the third postoperative day. The remaining eight patients (systemic analgesics group) repeatedly received intravenous or intramuscular pentazocine and buprenorphine when needed. Plasma GH levels increased significantly only on the first postoperative day in both groups. Plasma insulin levels increased significantly on the first postoperative day in both groups. Blood glucose levels increased significantly at the end of surgery and during the following three postoperative days in both groups. There are no statistical differences in plasma GH, insulin and blood glucose levels between the two groups. Plasma prolactin concentrations increased significantly at the end of surgery and they were significantly higher in the systemic analgesic group than in the epidural morphine group. They, however, returned to the previous day's levels on the first postoperative day in both groups. Our study suggests that continuous epidural infusion of morphine has no suppressing effect on postoperative changes in plasma GH, insulin, prolactin and blood glucose levels as compared with systemic analgesic regimen.
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PMID:[Effect of continuous epidural infusion of morphine on postoperative glucose metabolism]. 209 89

Plasma noradrenaline (NA), adrenaline (A), dopamine (DA), platelet serotonin (pS), free serotonin (fS), cortisol (CRT), growth hormone (GH), peripheral blood lymphocytes (lymph), lymphocyte subpopulations (LSS) and CD4/CD8 ratio were serially assessed in 50 non-medicated, advanced cancer patients (spontaneous evolution) and in age- and sex-paired controls. Clonidine tests and psychiatric evaluations were also serially performed. Patients showing long symptomless periods had all normal values except for raised pS, whereas those who remained free of symptoms for only a short time had raised NA, A and CRT, plus lowered pS values. Further increases in NA, A and CRT, plus additional increases in DA and fS, occurred during exacerbation periods, during which times reductions in lymph, LSS and NK also were observed. Patients in terminal stages showed maximal decreases of all neurotransmitters and immunological parameters; only DA and fS remained raised. Psychiatric interviews performed simultaneously with the clonidine tests revealed a low incidence of moderate depression during symptomless periods and no depression during exacerbation periods. Several significant positive and negative correlations between neurotransmitters and immunological parameters were found during exacerbation periods. Pain, although not intense, and other symptoms required occasional administration of low doses of non-opiate analgesics.
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PMID:Psychoneuroendocrinological and immunological parameters in cancer patients: involvement of stress and depression. 210 65

Ten children with isolated growth hormone deficiency were treated for 1 year with 0.5 UI/kg week with Somatrem (recombinant human growth hormone), given as intramuscular injections three times weekly. Before treatment the children had a chronological age of 7-12.4 years (mean 10.4 years), with a bone age at least 25% below the chronological age. There was no radiological evidence of an intra or suprasellar mass in any child, and no response to provocative growth hormone tests (with exercise or arginine-insulin injection). Informed written consent for treatment was obtained from the parents of each child. Clinical signs were registered every month; triiodothyronine, thyroxine, thyrotropine, glucose, urea, creatinine, blood cells count, and hemoglobine, glycosylated hemoglobine, glutamic-piruvic and glutamic-oxalacetic transaminases, alkaline phosphatase, anti-human growth hormone and, E. coli antibodies, insulin like growth factor 1, and bone age were assessed every 3 months. The mean height velocity was 0.27 +/- 0.1 cm/month before treatment, and increased throughout treatment to a value of 0.62 +/- 0.16 cm/month after 12 months. Within the first year eight of the 10 children had a height increase of 8.4 +/- 0.98 cm. The other two children showed no significant difference; one of them with a very low socioeconomic status, and the other developed typhoid fever. All of the children showed an advance in bone age, but none reached a bone age appropriate for their chronological age; without modifications in the laboratory parameters. Insulin like growth factor 1 increased in 9 children. Pain at the injection site was the only side effect reported.
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PMID:[Clinical and biochemical evaluation of the administration of growth hormone]. 225 92

Twenty-five patients with delayed or nonunion of fractures of a long bone had adjunctive treatment with levodopa (L-dopa). Presumably, L-dopa stimulates growth hormone, which has been suggested as helpful in bone growth and repair. All patients had previously been immobilized, and 22 had one or more surgical procedures. L-dopa was administered 500 mg initially and over three weeks was gradually increased to 500 mg orally three times a day. Treatment was continued for six months or until the fracture healed. After six months, 21 patients (84%) had no pain with full activity and solid bony union by roentgenograms and were considered healed. This study suggests that L-dopa improves the capacity of nonunited fractures to heal. Proof would require a randomized, double-blind series of patients. L-dopa could prove to be a useful adjunct in the management of delayed or nonunion of long-bone fractures.
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PMID:L-dopa in the treatment of nonunited fractures. 234 62

Thirty-six women in their second or third pregnancies were studied in two groups (control and exercise) to determine whether plasma alpha-endorphin levels could be elevated by exercise conditioning during pregnancy. Aerobic training was performed on a bicycle ergometer. Both groups were monitored throughout pregnancy by frequent gynecologic examinations. During labor, both groups of women had pain perception assessment. Blood was sampled for levels of beta-endorphin, cortisol, human growth hormone, and prolactin. Plasma beta-endorphin was found elevated compared to controls in patients who exercised throughout pregnancy. This difference was maintained throughout labor and pain perception during labor was reduced in the patients who exercised. Cortisol, human growth hormone, and prolactin levels were lowered during labor for the exercise-conditioned patients. Exercise conditioning during pregnancy seems to be beneficial in reducing pain perception during labor (as determined by measurement of visual analog pain scales) and in reducing stress levels during labor.
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PMID:Effects of physical activity on maternal plasma beta-endorphin levels and perception of labor pain. 252 37

Octreotide is a long-acting cyclic octapeptide with pharmacologic actions mimicking those of the natural hormone somatostatin. It can suppress the secretion of serotonin, as well as the gastroenteropancreatic peptides gastrin, vasoactive intestinal peptide (VIP), insulin, glucagon, secretin, motilin, and pancreatic polypeptide. It also suppresses growth hormone and decreases splanchnic blood flow. Octreotide is completely and rapidly absorbed following subcutaneous injection and has an elimination half-life of 1.5 hours. Clinical trials reviewed here show octreotide useful in the treatment of diarrhea associated with VIP secreting tumors, as well as diarrhea and flushing associated with carcinoid syndrome, both conditions for which the drug is approved. Clinical trials involving the use of octreotide in the treatment of acromegaly are also reviewed. Adverse reactions to octreotide are mild to moderate and most commonly involve injection site pain and diarrhea. Drug interactions are apparently related to the drug's pharmacologic effects. Octreotide is given subcutaneously two to three times daily, with daily doses ranging from 50mcg to 1,500mcg per day. Further research appears necessary to clarify dosing issues.
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PMID:Debut of a somatostatin analog: octreotide in review. 255 39


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