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 authors treated 18 patients with Paget's disease of bone (12 men and 6 women, age 65 +/- 5 years) with pamidronate (bisphosphonate of the second generation). Three patients from this group were treated previously without success with calcitonin or bisphosphonate of the first generation (etidronate) 50% of the patients suffered from the polyostotic form of the disease. In one patient a rare combination of primary hyperparathyroidism with Paget's bone disease was found and in another patient later an osteosarcoma developed in the affected bone. To all patients sodium pamidronate was administered (Aredia, Ciba-Geigy) 30 mg per day by i.v. infusion for 2 hours during three days. Four patients developed fever, two patients phlebitis at the site of injection. These side-effects are described by the manufacturer. Two patients developed transient regional alopecia, not described so far. Subjective pain relief of the affected skeleton occurred in one patient after one month of treatment, after three months in 78%. Laboratory manifestations of activity of the disease (serum activity of alkaline phosphatase, tartrate resistant acid phosphatase and hydroxyprolinuria) declined gradually from the 1st to the 6th month after onset of treatment. There was a less marked decline of the osteocalcin serum concentration. The concentration of calcium, phosphorus and vitamin D metabolites did not change markedly. Twelve months after treatment 14.7% of the patients were inactive according to laboratory tests, 73% however experienced another rise of parameters of osteoresorption and osteoformation. Pamidronate treatment in patients with Paget's disease of bone is effective and safe.
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PMID:[Paget's disease of bone and treatment with pamidronate]. 837 65

The pathomorphological study was carried out on a total of 360 broiler chicken which had been random-sampled on days 22 and 35 of the mast period, respectively, from those flocks that were to be compared. Furthermore, 161 animals with evidence of movement disturbance that were slaughtered in the last two mast weeks, were also evaluated. With regard to incidence, severity of movement disturbance and the spectrum of pathomorphological changes of the skeleton there were no differences between the different groups. When histological and morphometrical methods were applied, no differences in the skeleton structure were noted between flocks with conventional housing and flocks with reduced population density. Equally, no differences were ascertained with regard to dry substance and ash content of the bones including the minerals calcium and phosphorus. Furthermore, there were no group differences in serum calcium, phosphorus and alkaline phosphatase. In numerous chicken from all groups a plantar pododermatitis with differing incidence and strongly varying intensity was observed. The lesions were characterized by a papillomatous proliferation of the basal epithelial layers. There was widespread inflammation with loss of the epithelial layer and deep necroses of the sole. A latent infection with papilloma viruses is discussed. About 90% of the random-sampled chicken of all groups showed bending of the vertebral column by 20 degrees at the height of the 6th thoracic vertebra. In numerous chicken the 6th thoracic vertebra was dislocated and slightly rotated which caused encroachment of the vertebral canal. Whether this alteration may be responsible for the frequently observed movement disturbance of broilers in the last third of the mast period can not be decided on the basis of the pathomorphological study. In any case it must be assumed that both the pododermatitis and the bending and encroachment of the vertebral column cause pain. Thus, both lesions should be evaluated from the viewpoint of animal protection.
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PMID:[Results of pathological-anatomical studies of limbs and spinal column]. 872 27

Pruritus is a significant symptom among patients receiving hemodialysis. However, its underlying mechanisms remain obscure. Substance P, a neuropeptide, has been implicated in the mediation of pain and some itch sensations. Local application of capsaicin depletes the peripheral neurons of substance P and may block the conduction of pain or pruritus. This study aims to assess the efficacy and safety of capsaicin 0.025% cream in the treatment of hemodialysis-related pruritus and to further explore the underlying pathomechanism. Nineteen hemodialysis patients with idiopathic, moderate (n = 5) to severe (n = 14) pruritus were examined in a double-blind, placebo-controlled, crossover study and 17 of them completed the study. Topical agent of capsaicin or placebo base cream was applied to localized areas of pruritus 4 times a day. The severity of pruritus and treatment-related side effects (cutaneous burning/stinging sensations, dryness, or erythema) were evaluated weekly. The results showed (1) that 14 of 17 patients reported marked relief and 5 of these 14 patients had complete remission of pruritus during capsaicin treatment (Wilcoxon signed-ranks test, 2p < 0.001); (2) capsaicin was significantly more effective than placebo (Mann-Whitney rank sum test, 2p < 0.001) and a prolonged antipruritic effect was observed 8 weeks posttreatment; (3) no serious side effects were noted during the study and (4) there were no significant changes in serum concentrations of albumin, calcium, phosphorus, alkaline phosphatase, or intact parathyroid hormone during the treatment with either capsaicin or placebo. In summary, the present study indicates indirectly that idiopathic pruritus in some patients on maintenance hemodialysis may be transmitted by substance P from the peripheral sensory neurons to the central nervous system. Topical capsaicin with the unique pharmacological effect is demonstrated to markedly improve the pruritus of these patients.
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PMID:Hemodialysis-related pruritus: a double-blind, placebo-controlled, crossover study of capsaicin 0.025% cream. 873 Apr 31

Bone pain is a common symptom in disseminated malignancy and may be difficult to manage effectively. Radiation is of proven benefit for pain palliation and there is growing interest in the therapeutic potential of bone-seeking radiopharmaceuticals. Clinical data relating to the use of phosphorus-32, strontium-89, samarium-153 EDTMP, rhenium-186 HEDP and tin-117m DTPA are reviewed in the context of the pathophysiology of metastatic bone pain. Possible mechanisms of action of palliative radiotherapy and, in particular, the theoretical role of early response genes are discussed. The application of Monte Carlo simulation to targeted radiotherapy for bone metastases may provide the basis for a clearer understanding of the microdosimetry and radiobiology of bone pain palliation and for reliable prediction of clinical response and toxicity.
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PMID:Cancer therapy using bone-seeking isotopes. 891 78

The case of a 49-year-old woman suffering from generalized skeletal pain and multiple fractures accompanied by severe hypophosphataemia and low urinary phosphorus excretion is reported. She had been taking large amounts of antacids containing aluminum hydroxide for many years. A diagnosis of antacid-induced osteomalacia was made. It was confirmed by biological work-up, radiographs and bone biopsy. A dramatic biological, osteodensitometric, and clinical improvement was achieved by withdrawal of antacids and phosphorus administration. The literature concerning this unusual condition has been reviewed.
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PMID:Antacid-induced osteomalacia. 892 82

An improved method is described for the quantitation of lidocaine and its dominant metabolites in rat plasma, 3-hydroxy-lidocaine glucuronide and 3-hydroxy-MEG-X glucuronide. Frozen plasma samples (100-200 microliters) were thawed and deproteinated by precipitation with acetonitrile, before the conversion of glucuronidates into their respective hydroxylated forms by acid hydrolysis. After extraction with solid-phase C18 cartridge chromatography, the metabolites and parent drug were analyzed by capillary gas chromatography-nitrogen phosphorus detection, without derivativization. A detection limit of 0.005 microgram/ml for lidocaine and nonglucuronidated metabolites and 0.01 microgram/ml for glucuronidated metabolites was achieved. The method offers significant improvements in sensitivity relative to existing techniques, which should be of specific benefit to studies in which sample volume is limited, such as those concerned with the pharmacokinetics of lidocaine metabolism in small-animal pain state models.
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PMID:An improved method for the measurement of lidocaine and its metabolites in rat plasma. 910 47

This article describes a unique case of vascular calcification of the hands complicated by pain and weakness. The case demonstrates the interaction of the skeletal and renal systems and the consequences of an unrecognized imbalance of calcium and phosphorus metabolism. Definitive medical management to keep the calcium-phosphate product below 70 through the judicious use of aluminum phosphate binders and diet should be coordinated to prevent and limit the extent of these calcifications.
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PMID:Vascular calcification as a source of hand pain and weakness in a patient with end-stage renal failure. 919 97

Fanconi syndrome is a complex destruction of proximal renal tubuli which leads to glycosuria, aminoaciduria, phosphaturia and uraemia. These disturbances are accompanied with hypophosphatemia, osteomalacia and frequently hypokalemia. A 32-yrs. old woman diagnosed as suffering for 10 yrs. with Fanconi syndrome was admitted to the clinic with pain and numbness of the right leg which made walking difficult this resulted from progressive bone destruction. Biochemical disturbances and osteomalacia which are typical for Fanconi syndrome was confirmed in 1984. The reason for 3 hospitalizations in 1990-1992 were similar--especially leg pain and symptoms of uraemia. Recent X-rays showed osteomalacia with osteoporosis and progressive bone destruction. After she was put on a uremic diet, given vitamin D, calcium, phosphorus and sodium bicarbonate, there was a significant decrease in leg pain and relatively normal biochemical parameters.
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PMID:[Idiopathic Fanconi syndrome in an adult]. 927 36

Bioanalytical methods for determining the total concentration of the new local anaesthetic drug ropivacaine in blood plasma, urine and tissues are presented. Ropivacaine is a drug mainly used in connection with surgery and for post-operative pain relief. The biological samples were prepared using liquid-liquid extraction and analysed using capillary gas chromatography with nitrogen-phosphorus detection or mass spectrometry. The methods are highly selective and reliable with a between-day precision, given as the relative standard deviation, generally below 6%. More than 20000 samples have been analysed using the methods described.
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PMID:Determination of ropivacaine and [2H3]ropivacaine in biological samples by gas chromatography with nitrogen-phosphorus detection or mass spectrometry. 965 26

The role of phosphorus-32 (32P) was evaluated in patients experiencing pain due to skeletal metastases from prostate cancer and refractory to other modes of treatment. Twenty patients received 185 MBq (5 mCi)32P intravenously; 12 patients received a single dose each, five patients were injected twice and three patients three times at 3-month intervals. A blood count and clinical assessment for bone pain, tender sites, mobility and analgesic intake were performed before and 4, 8 and 12 weeks after the administration of 32P. A bone scan was performed before and 12 weeks after therapy. The results showed a significant decrease in pain at 4 weeks and a palliative response persisted for up to 12 weeks. Analgesic medication intake decreased significantly (F = 13.2213, P < 0.0001) and mobility improved after therapy. Quantitative analysis of the bone scans showed a statistically significant reduction in osteoblastic activity in metastatic lesions after therapy (t = -3.80, P < 0.001). Transient myelosuppression after 4 weeks, which was statistically significant for WBC and platelet counts only (F = 3.0226, P = 0.0358; F = 6.2514, P = 0.0009 respectively), returned within normal limits by 8 weeks. We conclude that 32P is an effective and safe therapy for pain palliation.
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PMID:Effective and economical option for pain palliation in prostate cancer with skeletal metastases: 32P therapy revisited. 1045 77


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