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 Martial Art of Aikido, based on several effective anatomical principles, is used to subdue a training partner. One of these methods is Ikkyo (First Teaching). According to Saotome, the original intent of Ikkyo was to "break the elbow joint" of an enemy. Nowadays the intent is to secure or pin a training partner to the mat. This investigation focused on examining Ikkyo with the purpose of describing the nerves, bones, and muscles involved in receiving this technique. Particular focus was placed on the locations and sources of the reported pain.
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PMID:A martial arts exploration of elbow anatomy: Ikkyo (Aikido's first teaching). 180 77

As part of the proposal for drug development using the SMARD/DC-ART definitions, "decreased inflammatory synovitis" needs to be defined. We review the literature with respect to each of the indirect, clinical measures of decreased inflammatory synovitis and recommend a preliminary, testable definition based on a per patient response. It includes minimum disease activity criteria for patients entering studies and improvement in at least 5 of the following 6 criteria: greater than 20% improvement in joint swelling count; greater than 20% improvement in joint tenderness count; greater than 20% improvement in erythrocyte sedimentation rate; greater than 30% improvement in physician/assessor global assessment; greater than 30% improvement in pain. While this definition is sensible within the confines of our knowledge to date, using these criteria prospectively in several clinical trials will allow better definition of the appropriate pooled index to define decreased inflammatory synovitis.
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PMID:DC-ART: decreased inflammatory synovitis. 779 81

Diacerhein is an anthraquinone derivative which is the active ingredient in ART 50. Its unique pharmacological activity involves inhibition of interleukin 1 and cartilage-degrading enzymes. In well-known animal models (carrageenin-induced oedema, adjuvant-induced arthritis, post-contusion or post-patellectomy osteoarthritis), diacerhein demonstrated antiinflammatory effects and protected against the development of osteoarthritis. In humans, approximately 30 studies have documented the efficacy of diacerhein in osteoarthritis. In acute exacerbations of osteoarthritis of the hip, efficacy of ART 50 on pain and on the algorfunctional index was significantly greater than that of a placebo and equivalent to that of tenoxicam on the 60th treatment day. ART 50 was as effective as naproxen after two months of treatment. Gastric tolerance has been excellent with diacerhein. Moderate transient diarrhea has been reported. Because of the promising results obtained with diacerhein in vitro and in animal models, a large human study has been designed to confirm the chondroprotective effect of ART 50.
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PMID:[Diacetylrhein, a new therapeutic approach of osteoarthritis]. 811 57

One of the strongest subduing techniques of the Martial Art Aikido is classified as Nikyo (Second-teaching). This investigation focused on examining this teaching with the intention of describing the anatomical tissues involved in the etiology of pain experienced with the application of this procedure. Particular focus was placed on the examination of a cadaver's arm musculature affected when this maneuver was applied precisely.
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PMID:An anatomical analysis of Aikido's second teaching: an investigation of Nikyo. 836 29

An international working group was formed to select core sets to be used as endpoints in clinical trials in ankylosing spondylitis (AS). The results of the first steps of the selection of these core sets are described. The definition of the settings for which the core set will be intended are defined. The methods used to select the core sets were a combination of literature search, nominal group discussions, and plenary discussions. The following settings were defined: disease controlling antirheumatic therapy (DC-ART), symptom modifying antirheumatic drugs (SMARD)/physical therapy, and clinical record keeping. Over 110 variables used as endpoints in AS were found in the literature. The preliminary core set for DC-ART consists of physical function, pain, spinal mobility, patient global assessment, peripheral joints/entheses, x-ray spine. The selected core set for SMARD/physical therapy includes physical function, pain, spinal mobility, spinal stiffness, and patient global assessment. The core set for clinical record keeping includes all measures of the SMARD/physical therapy core set completed by peripheral joints/entheses, and acute phase reactants. Three preliminary core sets for AS have been defined. Further research will be performed to select specific measures for all domains.
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PMID:Preliminary core sets for endpoints in ankylosing spondylitis. Assessments in Ankylosing Spondylitis Working Group. 937 88

According to the German welfare act of 1998 (Art.5(3)1.), surgical castration of up to 4 wk old pigs does not require anaesthesia. However, the application of a local anaesthesia is discussed in the context of pain related responses to this procedure. In these experiments, effects of different methods of application on the behaviour of piglets during castration are evaluated as a contribution to the welfare assessment of this procedure. A total of 36 piglets between 10 and 14 days of age were castrated with and without a local anaesthesia. Local anaesthesia with Lidocaine 2% was applied in two ways: a) via intratesticular (i.t.) injection and b) intratesticular injection combined with subcutaneous (s.c.) infiltration of the anaesthetic into the tissue around the spermatic cord. The assessment of pain was performed on the basis of vocalisations and resistance movements of the animals during the procedure. Local anaesthesia resulted in a reduction of the relative proportion of resistance movements from the entire period of fixation (castration with i.t. anaesthesia 12.73%, with i.t. and s.c. anaesthesia 14.50% or without a local anaesthesia 18.96%; P < 0.05). In particular, local anaesthesia resulted in a reduction of resistance movements during the cutting of the spermatic cord. The response of piglets to additional skin stimulation of the scrotum was not different between the three treatments.
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PMID:[Behavior of piglets during castration with and without local anesthesia]. 1048 69

The ART technique consists of hand excavating carious tissue and placing a highly viscous glass ionomer cement as a restoration material and as a sealant. Although the results of several studies are promising, the retention rates of these restorations for primary teeth are not impressive. Materials and methods that yield greater success rates are needed to improve long-term caries management outcomes. In principle, ART should yield outcomes similar to those associated with preservative dentistry, including the potential for minimal surgical intervention, conservation of sound tooth structure, avoidance of pain and need for local anesthetic injections, reduced risk for subsequent endodontics and tooth extraction, and increased survival time of the affected teeth. The ideal direct-filling ART material would be biocompatible and tooth colored; "forgiving" in its handling properties; insensitive to moisture or desiccation; hardenable without special equipment; able to form stable bonds to enamel and dentin; able to seal marginal gaps against bacteria; capable of releasing fluoride or remineralization and antibacterial agents when demineralization is most likely; and resistant to chemical attack. The highly viscous glass ionomer materials currently used for ART meet several of this criteria, though they may be deficient in their ability to seal marginal gaps against bacteria and in their sensitivity to desiccation. Furthermore, although they release fluoride over the lifetime of the restoration, this fluoride release alone may not prevent caries progression in all cases. It is necessary for cases of high caries risk to use chlorhexidine in conjunction with fluoride to achieve caries arrest and remineralization of adjacent areas of the affected teeth. Thus, while the ART technique offers some benefits in restoring function and reducing the rate of caries progression, it is unlikely that current materials will be able to arrest caries progression completely in high-risk persons.
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PMID:Does ART have a place in preservative dentistry? 1060 79

This contribution deals with the issue of the professional autonomy of the medical doctor. Worldwide, the physician's autonomy is guaranteed and limited, first of all, by Codes of Medical Ethics. In Italy, the latest version of the national Code of Medical Ethics (Code 1998) was published in 1998 by the Federation of provincial Medical Associations (FnomCeO). The Code 1998 acknowledges the physician's autonomy regarding the scheduling, the choice and application of diagnostic and therapeutic means, within the principles of professional responsibility. This responsibility has to make reference to the following fundamental ethical principles: (1) the protection of human life; (2) the protection of the physical and psychological health of the human being; (3) the relief from pain: (4) the respect for the freedom and the dignity of the human person, without discrimination; (5) an up-to-date scientific qualification (Art. 5). The authors underline that autonomy is an anthropological--and consequently ethical-- characteristic of the human person. Different positions on autonomy in bioethics (individualistic, evolutionistic, utilitarian and personalistic models) are explained. The relation between the professional autonomy of the physician and the autonomy of the patient and of colleagues is discussed. In fact, the medical doctor is obliged: (1) to respect the fundamental rights of the person, first of all his/her life; (2) to ensure the continuity of the care, even if he can only relieve the patient's suffering; (3) to maintain, except under certain circumstances, professional secrecy and confidentiality regarding patients and their medical records. Moreover, the physician cannot deny the patient correct and appropriate information. He/she should not perform any diagnostic or therapeutic activity without the informed consent of the patient and the medical doctor must give up medical treatment in case of documented refusal of the individual. Furthermore, the medical doctor has the right to raise conscientious objections if he/she is requested to perform medical actions that are contrary to his/her conscience or medical opinion, unless this attitude would seriously and immediately harm the patient. Regarding the relationships with colleagues, the physician is obliged to solidarity, mutual respect, and care of sick colleagues. Finally, the authors discuss the Italian legislation affecting the physician's professional autonomy: (1) the SSN health care Acts; (2) the so-called Charter for Public Health Care Services; (3) the Acts on privacy; (4) Good Clinical Practice.
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PMID:The professional autonomy of the medical doctor in Italy. 1114 44

The melanocortin (MC) system is involved in several biological functions. Its possible role in nociception has recently attracted attention in the field. Published data suggest that melanocortin antagonists are analgesic and agonists are hyperalgesic. Gene expression information about the MC system components (receptor, agonist and antagonist) in pain relevant areas is at present limited. To deepen our knowledge, we studied the expression of MC system components in nai;ve, sham and neuropathic rat spinal cord and dorsal root ganglia (DRG) by PCR and quantitative real-time PCR. MC4 receptor, proopiomelanocortin (POMC) and agouti-related protein (AgRP) transcripts were detected in both spinal cord and DRG, whereas MC3 receptor was detected only in the spinal cord. To study the relationship between the MC system and chronic pain, we used the chronic constriction injury model and gene expression analysis was performed in rats showing both tactile allodynia and thermal hyperalgesia. MC4 and POMC transcript were upregulated in the spinal cord of neuropathic rats, whereas MC3 and AgRP expression were unaffected. Thus, this study demonstrates for the first time the presence of AgRP in the spinal cord and DRG, suggesting that it could play a role in the regulation of MC system activity. In addition, the upregulation of POMC and MC4, in parallel with the presence of tactile allodynia and thermal hyperalgesia, further supports the idea of MC system involvement in nociception.
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PMID:Gene expression profiling of melanocortin system in neuropathic rats supports a role in nociception. 1455 60

HIV caregivers face many challenges following initiation of ART. The development of jaundice is uncommon but worrisome. In this case, two distinct and contrasting episodes of jaundice were observed. In the first instance, isolated elevation of the indirect bilirubin without elevation of the alkaline phosphatase was noted. The normal PT and serum aminotransferase levels indicate the absence of intrinsic liver dysfunction. Elevations in the indirect bilirubin may result from either impaired uptake/conjugation or excess production. The latter, usually from acquired hemolysis, may be a complication of an occult NHL. A work-up for this AIDS-related malignancy was not initiated since the caregivers recognized jaundice as a complication of IDV, which inhibits UDP-glucuronyl transferase and produces a Gilbert's-like syndrome. Physicians can expect to encounter this syndrome even more frequently with ATV. Experienced patients given RTV-boosted ATV have experienced elevations of unconjugated hyper-bilirubinemia in up to 45 percent of cases in clinical trials. However, such elevations do not reflect liver dysfunction and symptomatic jaundice requiring dosage reduction that occurred infrequently (7 to 8 percent of study patients). Counseling patients about this syndrome may promote adherence and prevent self-directed interruptions of ATV that compromise efficacy. The second case of jaundice provides a more formidable diagnostic challenge. The triad of LFT abnormalities (mild elevation of aminotransferases, normal PT, and marked cholestatic jaundice) implies an acute process that is mildly toxic to hepatocytes without affecting their synthetic function. The subacute nature of the patient's cholestatic jaundice suggests either intrahepatic infiltrative disease of the liver or extrahepatic obstruction of the biliary tree, most likely due to the patient's relatively modest level of pain and lack of fever. Despite LFT abnormalities occurring 17 months after a switch in his ART, cumulative drug-related toxicities must still be considered. Ritonavir can produce significant elevations in the AST/ALT, especially with pre-existing chronic liver disease as with hepatitis C virus coinfection. The NRTIs can produce hepatic steatosis, a result of mitochondrial toxicity and impaired fatty acid oxidation. However, jaundice and cholestasis are not typical of the latter syndrome. With a negative contrast CT that excludes parenchymal liver disease, investigation of the biliary tree to assess the presence of AIDS-related cholangitis was the next step. Performing a sphincterotomy or stent placement, and obtaining brushings or biopsy specimens to determine the extent of extrahepatic obstruction may help define a pathogen and be life-saving. The negative results of the ERCP justify the final diagnostic step, a liver biopsy to evaluate microscopic infiltrative disease that might not have been detected on contrast abdominal CT. Examples might include granulomatous disease (MAC), fungal etiologies (histoplasmosis), carcinomatosis (lymphoma, hepatoma, cholangiocarcinoma), and microvascular disease (bacillary angiomatosis). The failure to observe granulomatous inflammation in the liver does not exclude MAC infection, as MAC may involve other peri-aortic or mesenteric lymph nodes. This form of IRIS is unlikely given the abdominal CT findings, lack of systemic complaints, and extended persistence of liver aminotransferases. The nonspecific results of the liver biopsy are a common outcome in advanced AIDS patients with elevated alkaline phosphatase levels. Despite not having identified a pathogen, the biopsy establishes chronic liver disease and prompts re-evaluation and change of treatment to NFV. The subsequent normalization of the patient's aminotransferase levels suggests a prior adverse effect of LPV/r in the setting of unexplained, chronic liver disease. Most importantly, this case highlights the importance of HIV caregivers to review ART for safety when noting chronic liver dysfunction. Patients need to be counseled to minimize acetaminophen use, to consume alcohol in moderation, and to avoid behavior with risk for hepatitis C. Finally, all HIV patients should receive appropriate vaccination against hepatitis A and B if serology shows lack of protective immunity.
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PMID:Clinical vignette in antiretroviral therapy: jaundice. 1498 14


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