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)

We collected data on 320 patients complaining to their general practitioner of a new episode of chest pain, discomfort or oppression. Relationships were examined between initial signs and symptoms and a follow-up diagnosis after a period of 2 weeks to 2 months. The data were analysed with CART, a statistical decision theory software package. In our first run, the number of misclassifications by CART was 56%. After regrouping of the data and diagnostic categories, there were 37% misclassifications. The most discriminating variable turned out to be pain on palpation. When comparing each of five diagnostic groups to all others, we found a positive predictive value of 27% for gastrointestinal diseases, 72% for cardiovascular disorders, 69% for respiratory diseases, 58% for psychopathology and 73% for chest wall pathology. The CART methodology needs further investigation and testing before any clinical application will be possible in general practice.
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PMID:Evaluating patients with chest pain using classification and regression trees. 150 1

Presence of a chronic disease influences patients' lives and reinforces demands to accept and then cope with the illness. In the case of inflammatory bowel disease, quality of life greatly differs through phases of remissions and relapses. Could the quality of life questionnaire tell the difference? In this study we are disclosing possibilities of assessing patients' perspectives by analysing analogue scale statements regarding concerns and worries related to ulcerative colitis. Some two hundred Swedish patients, 3/4 in remission and 1/4 in relapse, filled out a booklet containing 36 statements. To characterise the disease activity, we have used multivariate discrimination. To structure and describe in details paths distinguishing the remission from relapse, we have used an artificial intelligence procedure. Applications of the CART (Classification And Regression Trees) algorithm resulted in a set of classifiers which are, based on the similar subsets of significant variables, i.e. statements. Best reached classification accuracy did not exceed 80% in any case. Other classifiers namely, K-nearest-neighbour (KNN), Learning Vector Quantization (LVQ) and Back Propagation Neural Network (BPNN) confirmed that outcome. An expectation that the disease activity should clearly speak throughout the questionnaire held for a certain number of the observations such as pain and suffering, loss of bowel control, dying early, feeling alone, ability to have children, being treated as different and concerns regarding the medication. To highlight the difference of incorrect 20%, K-means clustering was performed. The results settled a basis for a hypothesis that the studied quality of life instrument captures more than the disease activity.
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PMID:Machine learning for the quality of life in inflammatory bowel disease. 1017 49

The clinical status of ankylosing spondylitis (AS) can be defined by several domains (e.g., pain, function, metrology, laboratory) and subcomponents within each domain (e.g., pain using visual analog scale, Schober's within metrology). Our aim was (1) To define groups of highly correlated variables in order to determine the most relevant; and (2) to evaluate the capacity of different clinical and biological variables that best discriminate between placebo and active nonsteroidal drugs in AS. Patients with active AS (n=423) were followed prospectively over 6 weeks while receiving placebo (n=121) or active nonsteroidal antiinflammatory drugs (n=352). Eighteen variables were studied, including global assessment, pain, stiffness, functional indices, metrology, disease activity index, and laboratory markers. Statistics included (1) Evaluation of the relevance of the different domains by multivariate analysis (CART tree-structure classification; variable clustering); and (2) evaluation of the discriminant capacity by univariate analysis [i.e., differences in the standardized response mean (SRM) (mean change/SD) between placebo and active drug. A value > or =0.60 was considered relevant]. Four clusters were identified (patient's subjective perception, inflammatory symptoms, metrology, laboratory data) with multiple correlation R2 revealing the most relevant variables to be the Bath Ankylosing Spondylitis Functional Index (BASFI; 0.75), night pain (0.62), Schober's test (0.58), and platelet count (0.55), respectively, within each cluster. In terms of discriminant power (SRM) the patient perceived global status (0.84), lumbar pain (0.73), night pain (0.71), physician global assessment (0.66), and BASFI (0.65) were most relevant in the univariate analysis. Among the 4 most relevant domains are subjective perception, inflammatory symptoms, metrology, and laboratory. Multivariate analysis of the data reveals that the spinal pain and the patient global assessment are the variables that best discriminate between placebo and active nonsteroidal drug in short term studies.
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PMID:Outcome variables in ankylosing spondylitis: evaluation of their relevance and discriminant capacity. 1022 31

The histochemical analysis of cholecystokinin (CCK) systems in sensory systems has revealed involvement of CCK-ergic mechanisms both at the spinal level and in the viscero-sensory vagal pathway, with distinct differences between these two systems as well as between species. Thus, the CCK1 receptor is particularly abundant in rat nodose ganglion neurons which express the food intake-suppressing cocaine- and amphetamine-regulated transcript (CART) peptide(s), representing a likely link between gastrointestinal CCK and central feeding-regulatory centers. In contrast, rat dorsal root ganglions have lower numbers of CCK1 receptor mRNA-positive neurons, and CART is only expressed sparingly in this system. The CCK2 receptor is normally almost absent from both systems but is strongly upregulated after peripheral nerve injury, suggesting a role in regenerative and trophic phenomena as well as, at the spinal level, in nerve injury-induced pain. In man and monkey the CCK1 receptor seems important in the dorsal horn under normal conditions, indicating distinct species differences.
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PMID:CCK-ergic mechanisms in sensory systems. 1171 83

We investigated the effects of rat cocaine- and amphetamine-regulated transcript CART (55-102) after i.c.v. administration in mouse models of acute and persistent pain. CART was not active in the tail-flick or PPQ tests. It increased the latency to paw licking in the hot-plate test but only at doses that impaired motor function. CART produces antinociception in the formalin test in both phases. Our results suggest that CART is involved in supraspinal pain transmission.
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PMID:Antinociceptive effects of supraspinal rat cart (55-102) peptide in mice. 1291 86

The Female Sexual Function Index (FSFI) is a brief multidimensional scale for assessing sexual function in women. The scale has received initial psychometric evaluation, including studies of reliability, convergent validity, and discriminant validity (Meston, 2003; Rosen et al., 2000). The present study was designed to crossvalidate the FSFI in several samples of women with mixed sexual dysfunctions (N = 568) and to develop diagnostic cut-off scores for potential classification of women's sexual dysfunction. Some of these samples were drawn from our previous validation studies (N = 414), and some were added for purposes of the present study (N = 154). The combined data set consisted of multiple samples of women with sexual dysfunction diagnoses (N = 307), including female sexual arousal disorder (FSAD), hypoactive sexual desire disorder (HSDD), female sexual orgasm disorder (FSOD), dyspareunia/vaginismus (pain), and multiple sexual dysfunctions, in addition to a large sample of nondysfunctional controls (n = 261). We conducted analyses on the individual and combined samples, including replicating the original factor structure using principal components analysis with varimax rotation. We assessed Cronbach's alpha (internal reliability) and interdomain correlations and tested discriminant validity by means of a MANOVA (multivariate analysis of variance; dysfunction diagnosis x FSFI domain), with Bonferroni-corrected post hoc comparisons. We developed diagnostic cut off scores by means of standard receiver operating characteristics-curves and the CART (Classification and Regression Trees) procedure. Principal components analysis replicated the original five-factor structure, including desire/arousal, lubrication, orgasm, pain, and satisfaction. We found the internal reliability for the total FSFI and six domain scores to be good to excellent, with Cronbach alpha's >0.9 for the combined sample and above 0.8 for the sexually dysfunctional and nondysfunctional samples, independently. Discriminant validity testing confirmed the ability of both total and domain scores to differentiate between functional and nondysfunctional women. On the basis of sensitivity and specificity analyses and the CART procedure, we found an FSFI total score of 26.55 to be the optimal cut score for differentiating women with and without sexual dysfunction. On the basis of this cut-off we found 70.7% of women with sexual dysfunction and 88.1% of the sexually functional women in the cross-validation sample to be correctly classified. Addition of the lubrication score in the model resulted in slightly improved specificity (from .707 to .772) at a slight cost of sensitivity (from .881 to .854) for identifying women without sexual dysfunction. We discuss the results in terms of potential strengths and weaknesses of the FSFI, as well in terms of further clinical and research implications.
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PMID:The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. 1584 2

Thalassophryne nattereri (niquim) is a venomous fish found on the northern and northeastern coasts of Brazil. Every year, hundreds of humans are affected by the poison, which causes excruciating local pain, edema, and necrosis, and can lead to permanent disabilities. In experimental models, T. nattereri venom induces edema and nociception, which are correlated to human symptoms and dependent on venom kininogenase activity; myotoxicity; impairment of blood flow; platelet lysis and cytotoxicity on endothelial cells. These effects were observed with minute amounts of venom. To characterize the primary structure of T. nattereri venom toxins, a list of transcripts within the venom gland was made using the expressed sequence tag (EST) strategy. Here we report the analysis of 775 ESTs that were obtained from a directional cDNA library of T. nattereri venom gland. Of these ESTs, 527 (68%) were related to sequences previously described. These were categorized into 10 groups according to their biological functions. Sequences involved in gene and protein expression accounted for 14.3% of the ESTs, reflecting the important role of protein synthesis in this gland. Other groups included proteins engaged in the assembly of disulfide bonds (0.5%), chaperones involved in the folding of nascent proteins (1.4%), and sequences related to clusterin (1.5%), as well as transcripts related to calcium binding proteins (1.0%). We detected a large cluster (1.3%) related to cocaine- and amphetamine-regulated transcript (CART), a peptide involved in the regulation of food intake. Surprisingly, several retrotransposon-like sequences (1.0%) were found in the library. It may be that their presence accounts for some of the variation in venom toxins. The toxin category (18.8%) included natterins (18%), which are a new group of kininogenases recently described by our group, and a group of C-type lectins (0.8%). In addition, a considerable number of sequences (32%) was not related to sequences in the databases, which indicates that a great number of new toxins and proteins are still to be discovered from this fish venom gland.
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PMID:Transcriptome analysis of expressed sequence tags from the venom glands of the fish Thalassophryne nattereri. 1648 69

CART peptides are found in brain and spinal cord areas involved in pain transmission. In the present study, we investigated the role of rat CART (55-102) in the modulation of chronic pain using models of chronic neuropathic (nerve injury model) and inflammatory (carrageenan test) pain models in the mouse after intrathecal administration. The results show that CART (55-102) was highly effective in reversing the hyperalgesia and allodynia signs of chronic neuropathic pain in a dose-related manner at doses (0.05-2 microg/mouse) that did not affect motor coordination of the animals. These effects lasted for at least 3 h after injection and were not blocked by naloxone, an opiate antagonist. Although CART (55-102) attenuated carrageenan-induced hyperalgesia, it failed to reduce the inflammation associated with this model. These results suggest the involvement of the CART peptides in the development of hyperalgesia and allodynia associated with neuropathic pain.
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PMID:Intrathecal CART (55-102) attenuates hyperlagesia and allodynia in a mouse model of neuropathic but not inflammatory pain. 1681 1

A new instrument was developed and assessed for internal consistency, validity and test-retest reliability. A total of 151 women undergoing IVF/GIFT in California rated concern levels about anesthesia, surgery, recovery time, side-effects, finances, missing work, pain, insufficient information and delivering a healthy baby. Validity was assessed by comparing CART to the Infertility Reaction Scale and Bipolar Profile of Moods States, and reliability was investigated by calculating correlations between repeat CARTs. Factor analysis identified three domains: procedural concerns; missing work; and achieving a successful delivery. CART is a new, valid and reliable instrument, which measures concerns during IVF/GIFT not previously identified by existing instruments.
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PMID:Validation of a new scale for measuring Concerns of Women Undergoing Assisted Reproductive Technologies (CART). 1728 98

Activation of extracellular signal-regulated kinase (ERK) cascade in the spinal cord dorsal horn may contribute to pain hypersensitivity. Our recent study showed that cocaine- and amphetamine-regulated transcript peptide fragment 55-102 (CARTp) increased the levels of phosphoserine 896 and phosphoserine 897 on the N-methyl-d-aspartate (NMDA) receptor NR1 subunit (pNR1-ser896 and pNR1-ser897) via protein kinase A (PKA) and protein kinase C (PKC) signaling pathways leading to increases in NMDA receptor function in spinal cord dorsal horn neurons. Because NMDA receptor, PKC, and PKA signaling pathways may participate in ERK activation, we examined the effects of CARTp on ERK activation in spinal cord dorsal horn neurons in vitro. Western blot analysis showed a significant increase in the level of phosphorylated (activated) ERK (pERK) in the dorsal part of the spinal cord slices after incubation of the slices with CARTp (300nM). Co-administration of CARTp with an NMDA receptor antagonist, MK801 or AP5, or an ERK inhibitor PD98059 blocked the increase in the level of pERK. Interestingly, the increase in the level of pERK by CARTp was observed in postnatal week 3 (W3) and postnatal week 4 (W4), but not in postnatal week 2 (W2) rats. The age-related responses were also noted by CARTp-induced increases in the levels of pNR1-ser896 and pNR1-ser897. In the in vitro electrophysiological study, CARTp increased the amplitude of NMDA-mediated depolarizations in spinal substantia gelatinosa neurons of W3 and W4 rats, but not W2 rats. The results suggest that CARTp activation of ERK signals via the NMDA receptor in the spinal cord dorsal horn was age-dependent.
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PMID:Cocaine- and amphetamine-regulated transcript (CART) peptide activates ERK pathways via NMDA receptors in rat spinal cord dorsal horn in an age-dependent manner. 2059 30


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