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)

After a 1-month placebo run-in phase, 27 patients with proven peripheral arterial obstructive disease participated in a double blind placebo controlled study and were divided in 3 groups, receiving either placebo, ridogrel 300 mg b.i.d. (a combined thromboxane synthase and receptor blocking agent) or a combination of ridogrel 300 mg b.i.d. and ketanserin 20 mg t.i.d. (a 5-HT2 serotonergic receptor antagonist) for a period of 1 month. In both active treatment groups, serum levels of thromboxane B2 decreased significantly to 3% of baseline. The levels of 6-keto-prostaglandin F1 alpha and prostaglandin F2 alpha increased two- to three-fold and levels of prostaglandin E2 6 times. Platelet aggregation induced by collagen and by U 46619, a thromboxane A2 mimetic, were significantly inhibited by both treatment regimen. Template bleeding times were significantly prolonged but plasma fibrinogen levels and the activated partial thromboplastin time were not affected with the active treatments. No such changes were seen with placebo. An inhibition of the serotonin-induced platelet aggregation was only seen in the ketanserin-treated group. In a 3-month open follow-up period during combined treatment with ridogrel and ketanserin in 22 patients, the effects on platelet function and prostanoids were maintained. The total duration of the walking distance on a treadmill improved significantly from 323 +/- 53 seconds to 399 +/- 48 seconds and the onset of claudication pain improved significantly from 121 +/- 29 seconds to 212 +/- 44 seconds, whereas the maximal drop of the post-exercise ankle/arm pressure gradient markedly and significantly improved from a control value of 0.38 +/- 0.05 to 0.51 +/- 0.05. These findings suggest that a combination of ridogrel and ketanserin may be of therapeutic value in the treatment of intermittent claudication.
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PMID:The effect of a combined administration of ridogrel and ketanserin in patients with intermittent claudication. 837 14

This study was carried out, using the double-blind method vs placebo, on 36 patients suffering from stage II peripheral vascular disease (PVD) according to Leriche, to check the clinical and hemorrheologic effects of the administration of a new low molecular weight heparin (LMWH). After a one-month washout period, the patients were randomly assigned either to the group treated with the LMWH (15,000 aXaU/day sc) or to the group treated with indistinguishable placebo. At the start of the study and after three and six months of treatment, clinical, instrumental, and laboratory tests were performed to assess local and systemic efficacy and tolerance. The LMWH under study caused a statistically significant increase in claudication time, with a parallel increase in the absolute claudication distance and in the interval free of pain. The drug also led to a significant increase in activated partial thromboplastin time, the values of which, however, remained within the normal limits, and to a marked reduction in blood viscosity. No significant variation was observed in the tolerability parameters in the two treatment groups, and no local or systemic adverse reactions occurred.
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PMID:Clinical assessment of low molecular weight heparin effects in peripheral vascular disease. 838 99

We report a successful treatment of extracorporeal shock wave lithotripsy (ESWL) on a renal stone in a patient with severe hemophilia B. The patient was 44 years old man who had suffered left flank colicky pain with gross hematuria. A radiographic study showed a left renal stone, 22 x 14 mm in size. Before treatment, the intravenous administration of 1,000 U of the missing factor IX was tried, which induced the recovery of the prothrombin and partial thromboplastin times to the normal levels. One thousand units of factor IX were infused 30 minute before ESWL and 2,363 shock waves (Dornier MPL-9000) were administered at 17 kV under intravenous anesthesia by pentazocine. After the treatment, ultrasound and CT did not detect any perirenal hematoma. Antihemophilic therapy was continued with 1,000 U of factor IX per 12 hours for 2 days, 1,000 U per 24 hours for the succeeding 8 days and 500 U per 24 hours for the last 7 days. Gross hematuria disappeared on the 3rd day. We could successfully treat a renal stone in a patient with hemophilia.
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PMID:[Extracorporeal shock wave lithotripsy in a patient with hemophilia B]. 851 46

General pharmacological effects of recombinant human basic fibroblast growth factor (bFGF) were investigated. 1. Central nervous system: Basic FGF produced almost no effect on the general symptoms and behaviors of mice. Basic FGF did not influence the spontaneous motor activity, hexobarbital-induced anesthesia, electroshock seizure threshold, pentylenetetrazole-induced seizure in mice and normal body temperature and spinal reflex in rats up to a dose of 1 mg/kg (s.c., i.v.). As regards pain sensation, it inhibited the acetic acid-induced writhing at 1 mg/kg (s.c.). No abnormal waves were observed in spontaneous EEG of the rabbit up to 1 mg/kg (i.v.) of bFGF, but at 0.1 mg/kg it had a slight effect on the ratio of EEG levels and at 1 mg/kg induced an increase in rest period, disappearance in the period of fast wave sleep and a decrease in the period of deep sleep. 2. Somatic nervous system: Basic FGF did not influence the corneal reflex, twitch response of the skin and diaphragm-phrenic nerve preparations. 3. Autonomic nervous system and smooth muscle: Basic FGF showed little effects on the spontaneous movement of the isolated ileum, contraction induced by various agonists in isolated ileum, resting tension and noradrenaline(NA)-induced contraction of the aorta, resting tension and histamine-induced contraction of isolated trachea, spontaneous movement and 5-HT-induced contraction of isolated strips of stomach fundus, NA-induced contraction of isolated vas deferens of the rat up to the concentration of 10(-4) g/ml. Basic FGF augmented the tone of the isolated non-pregnant uterus at the concentrations of 10(-5) g/ml and above and inhibited or tended to inhibit the contractile tension of non-pregnant or pregnant uterus at 10(-4) g/ml, but it did not influence the spontaneous movement of the uterus, either the non-pregnant or pregnant, under in situ conditions even at a dose of 1 mg/kg (i.v.). Basic FGF did not influence the pupil size. 4. Respiratory and circulatory systems: Basic FGF had no effect on the isolated heart. The influence was not exerted on the heart rate for the isolated atria but slight inhibition of contractile force was observed at 10(-4) g/ml. In anesthetized dogs a decrease in blood pressure, a slight increase in heart rate and respiratory rate and a decrease in femoral blood flow were observed at 0.01 and 0.1 mg/kg (i.v.) of bFGF Similarly, a slight increase in heart rate and a slight decrease of blood pressure were observed at 1 mg/kg (s.c.) in conscious rats. 5. Digestive system: Administration of bFGF at 1 mg/kg did not result in changes in the transport capacity within the gastrointestinal tract (s.c., i.v.) and the secretion of the gastric juice (s.c.). 6. Urine output and electrolyte metabolism: Basic FGF produced a decrease in urinary Na+ excretion at 1 mg/kg (s.c.), and showed a tendency to increase in urinary volume at 0.01 and 0.1 mg/kg (i.v.). At 1 mg/kg (i.v.) urinary excretion of Na+ and Cl- was decreased significantly. It had no effect on the ability of rats to excrete PSP (phenol red) up to 1 mg/kg (s.c.). 7. Blood system: Basic FGF did not influence the coagulation time of the whole blood, prothrombin time and activated partial thromboplastin time of rats up to 1 mg/kg (s.c., i.v.). It did not influence the aggregation of rabbit platelets induced by collagen and ADP up to 10(-4) g/ml. Basic FGF at concentration of 10(-4) g/ml exhibited no hemolytic action. 8. Local action: Plantar subcutaneous injection of bFGF at above 0.005 mg/site induced edema by itself on and after the next day, and also reinforced carrageenin-induced edema from 1 day after injection. The results show that bFGF did not produce any acute effects on the somatic nervous system, autonomic nervous system, smooth muscle and blood system. In contrast, bFGF produced slight effects on the circulatory system, central nervous system and kidney function when injected systemically. Subcutaneous administration may produce edema at the s
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PMID:General pharmacology of recombinant human basic fibroblast growth factor. 884 46

The bioavailability of two different s.c. doses of Desmin (a new low molecular weight dermatan sulfate) was evaluated in 12 healthy volunteers (6 men, 6 women aged 22-45 years) who were injected, on 3 separate days and with a wash-out period of at least 21 days between each administration, with 200 and 300 mg of Desmin by the s.c. route and 200 mg by the i.v. route. Immediately before injection and at various times thereafter (after 15 min and 30 min for i.v. only and after 1, 2, 3, 4, 6, 8, 12, and 24 h for both s.c. and i.v. dosing), blood samples were drawn to investigate bioavailability by measuring several coagulation parameters: activated partial thromboplastin time, thrombin time, inhibition of factor Xa, Heptest, and heparin cofactor II. Furthermore the local tolerance of the s.c. and i.v. injections were investigated. The s.c. administration of the two Desmin doses had a negligible effect on the activated partial thromboplastin time and a very small effect on the thrombin time, measured with human thrombin; in contrast, Heptest, heparin cofactor II, and anti-Xa activities increased, with a good drug bioavailability (more than 100%). The plasma effects of Desmin were dose dependent only when measured by Heptest, which also gave a greater response after the s.c. administrations. There were no symptoms of intolerance or pain at the injection site after single i.v. and s.c. Desmin administration.
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PMID:Bioavailability of Desmin, a low molecular weight dermatan sulfate, after subcutaneous administration to healthy volunteers. 935 83

Hypovolemic shock occasioned for the spontaneous hemorrhage is a complication very rare in the course of the anticoagulant therapy with heparin. We are going to introduce you five cases where a therapy with heparin produced spontaneous hemorrhage and hypovolemic shock. We noticed them in our Intensive Medicine Service in five the last ones years. In all the patients we found helping factors of hemorrhage. In two of the patients the hemorrhage took place in spite of to maintain an activated partial-thromboplastin time (APTT) inside the therapeutic range of anticoagulation; another two presented a APTT excessively elongated; and a patient had it completely normal. In all the cases the hemoglobin and hematocrit values were normals at the beginning; however the pain ws always in all the patients and gave us an idea about the place where the bleeding was. In a patient the computed tomographic (CT) confirmed the diagnosis. In two cases the treatment was surgical. We explain coadyuvanted factors that are required in the hemorrhage genesis in anticoagulated patients with heparin.
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PMID:[Hypovolemic shock due to spontaneous hemorrhage associated with heparin anticoagulant treatment; a report of 5 cases]. 944 85

The aim of the study was to evaluate in a double-blind manner the effect of the long-acting 5-hydroxytryptamine 2 (5-HT2)-receptor blocker Ritanserin on clinical symptoms in patients with fibromyalgia syndrome (FM) and on production of antibodies to serotonin, gangliosides and phospholipids, recently shown to have a high incidence in this disease. Fifty-one female patients with typical FM were included in the 16-week study: 24 received Ritanserin and 27 received a placebo. Antibodies to 5-HT, gangliosides (Gm1) and phospholipids (thromboplastin) were determined by enzyme-linked immunosorbent assay at day 0 and at the end of week 16. The psychological and physical status, including tender points, of the patients was evaluated at day 0 and at the end of weeks 4 and 16. At the end of the study, there was an improvement (p < 0.05) in feeling refreshed in the morning in the Ritanserin-treated group and headache was also significantly improved compared with the placebo group. There was no difference in pain, fatigue, sleep, morning stiffness, anxiety and tender point counts in the Ritanserin and placebo groups. Fifty-one per cent of the 51 patients had at least one of the three antibodies to 5-HT, Gm1 and phospholipids. The incidence and activity of these antibodies were not influenced by Ritanserin or placebo. The observation that Ritanserin has only a small effect on clinical symptoms indicates that disturbances in serotonin metabolism or uptake may be only one factor in the pathogenesis of the disease. The high incidence of a defined autoantibody pattern in FM could again be confirmed in this study. However, it remains speculative whether immunological reactions are, indeed, involved.
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PMID:A randomised double-blind 16-week study of ritanserin in fibromyalgia syndrome: clinical outcome and analysis of autoantibodies to serotonin, gangliosides and phospholipids. 964 2

We designed a prospective, randomized, double-blind study to test the efficacy and safety of ibuprofen compared with acetaminophen with codeine for pediatric posttonsillectomy/adenotonsillectomy patients. Twenty-seven children, aged 6 to 16 years, were enrolled. We collected information on pain control, return to normal sleep pattern, return to normal diet, and duration for which medication was required. Coagulation profiles were measured before surgery and on postoperative day 3. Acetaminophen with codeine was more effective in controlling pain on days 1 and 3 (p = 0.0475 and 0.0328, respectively). However, we detected no difference between the treatment groups (p = 0.2216) with regard to pain control on day 5. The ibuprofen group required medication for a longer period (p = 0.0464). We detected no statistically significant differences between groups with regard to return to normal diet (p = 0.2346) and return to normal sleep pattern (p = 0.9554). The postoperative hemorrhage rate was 0% in the acetaminophen-with-codeine group and 12.5% in the ibuprofen group. The ibuprofen group demonstrated a mean increase in bleeding time of 2.07 minutes on the third postoperative day (p = 0.0379). The mean change in postoperative bleeding time between the two groups was statistically significant (p = 0.0140). We found no statistically significant differences in prothrombin time and partial thromboplastin time between groups. On the basis of the findings of this pilot study, we conclude that acetaminophen with codeine is safer and more efficacious than ibuprofen in the management of posttonsillectomy/adenotonsillectomy pain in children.
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PMID:Ibuprofen for tonsillectomy pain in children: efficacy and complications. 980 75

The safety and tolerability of clopidogrel coadministration to patients with recent acute myocardial infarction (AMI) treated with recombinant tissue plasminogen activator (rt-PA) and heparin were assessed. Patients of either sex who had a recent uncomplicated AMI with ischemic pain lasting at least 20 minutes and ST-segment elevation, and with indication for thrombolysis were included. Treatment was started within 12 hours after the onset of pain. Clopidogrel 75 mg was administered within 3 hours of starting the rt-PA infusion, and was continued at 75 mg once daily over the next 6 days. Heparin was administered as a 5000 IU intravenous bolus followed by a 1000 IU/h infusion for at least 48 hours to maintain an activated partial thromboplastin time at 1.8 to 2.2 times the control value. rt-PA was administered as a 15 mg bolus injection, followed by a 0.75 mg/kg (up to 50 mg) infusion over 30 minutes and a subsequent 0.50 mg/kg (up to 35 mg) infusion over 60 minutes. The patients were hospitalized at least during the 7-day study period, after which they were followed for 10 days. The primary end point of the study was the occurrence of bleeding complications validated by a data monitoring and safety committee as severe (intracerebral or with substantial hemodynamic alteration requiring treatment), moderate (need for transfusion), or minor (other bleeding). Based on the statistical assumption, at alpha = 0.05 of a true probability of severe bleeding < or =0.06, the required minimum number of patients was calculated as 45, 65, or 94 if no, one, or two moderate-to-severe bleeding events occurred, respectively. Efficacy was assessed based on mortality, reinfarction, or need for emergency revascularization procedures. One intracranial hemorrhage occurred among the first 49 patients included, and one after the inclusion of 16 additional patients (total of 65). After further increase in the number of patients to 94, then to 116 in order to secure a number of 94 evaluable patients for safety, there were no additional cases of severe bleeding. Hence, the observed rate of moderate-to-severe bleeding was estimated at 1.7%, with a 95% probability that the underlying rate was below 7.5%. Deaths occurred in 3.6% compared to 6.3% in the GUSTO trial. Recurrent myocardial infarctions occurred in 4.5% and emergency revascularization procedures in 14.5% of the 110 patients deemed evaluable for efficacy, rates which are similar in this study and the GUSTO trial. The results of the study compare favorably with historical data showing a moderate-to-severe bleeding rate of 6% with aspirin given concomitantly with rt-PA and suggest that clopidogrel could be safely given as platelet aggrega
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PMID:Clopidogrel-rt-PA-heparin combination in the treatment of acute myocardial infarction. 1044 Apr 28

A retrospective analysis of 7 patients with streptococcal toxic shock revealed isolated prolongation of the activated partial thromboplastin time, which returned to normal during recovery. Levels of factor XII were reduced in 2 patients who had single factor assays performed, consistent with activation of the kallikrein-kinin system. We speculate that bradykinin release following activation of the kallikrein-kinin system in streptococcal toxic shock may underlie the features of pain, capillary leaking, and severe hypotension characteristic of this syndrome.
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PMID:Kallikrein-kinin system activation in streptococcal toxic shock syndrome. 1088 Mar 16


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