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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Information that has become available since 1974 on the management of pelvic infections unrelated to abortions, the puerperium, or pelvic surgery, with an emphasis on those associated with Neisseria gonorrhoeae are summaried. Attention is directed to both diagnosis (clinical, bacteriologic) and therapy (hospitalized patients, outpatients, indications for hospitalization, and IUDs). Most investigators classify acute pelvic inflammatory disease (PID) as gonococcal or nongonococcal on the basis of the presence or absence of N. gonorrhoeae in cervical specimens. As compared with patients who have nongonococcal pelvic inflammatory disease, patients who have gonococcal disease are often younger, more likely to have elevated temperatures, and more often experience pain in the first 10 days of the menstrual cycle. It is not possible to differentiate gonogoccal from nongonococcal pelvic inflammatory disease without the aid of laboratory tests. N. gonorrhoeae can be isolated from the cervix in 20-80% of acute PID. Much of the variation can be explained by differences in the prevalences of gonorrhea in different populations. In populations with high prevalence of gonorrhea, most cases of acute PID are associated with gonorrheal infection. Where gonorrhea is less common, N. gonorrhoeae is isolated from the cervix in fewer than half of cases of acute PID. Neisseria gonorrhoeae can be demonstrated in the fallopian tube or peritoneal cavity of 8-70% of patients with PID whose cervical cultures yield N. gonorrhoeae. When N. gonorrhoeae is isolated from the lower genital tract of a patient who has acute pelvic inflammatory disease, causal significance is appropriately ascribed to that organism. The use of gram staining of cervical specimens to diagnose uncomplicated gonorrhea in women has been discouraged due to low sensitivity and specificity compared with cultures on selective medium. Comparative evaluation of studies of therapy of acute pelvic inflammatory disease is hampered by differences in criteria for diagnosis of cases, in indications for hospitalization and surgical treatment, in durations of therapy and follow-up, and in criteria for cure. The information available is insufficient to justify recommending a change in the 1974 schedules for therapy of hospitalized patients. Results of 2 studies of treatment of outpatients with PID are summarized in a table. Cunningham et al. reported satisfactory bacteriologic and clinical cure rates for gonococcal PID after use of the currently recommended treatment schedules. McCormack et al. obtained satisfactory results with a 5-day course of spectinomycin HCI administered to a small number of patients. Sweet recommended that hospitalization be considered for all patients with acute PID, as is the practice of many facilities in Sweden. It is now clearly documented that users of IUDs have a 3-9 fold greater risk of developing PID as compared with nonusers. All patients treated for acute PID should be followed closely to monitor their responses to therapy. Controlled therapeutic trials of acute PID should ensure similarity of case definition and identification of "cure."
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PMID:Management of gonococcal pelvic inflammatory disease. 11 99

In many cases of chronic intractable pain without any discernible causes, when both Western medical treatment and acupuncture treatment failed to eliminate the pain, this pain is often due to the unrecognized presence of viral or bacterial infection. Even effective anti-viral or bacterial agents often fail to eliminate or inhibit the infection, as these drugs may also fail to reach the most painful area where often unrecognizable circulatory disturbances co-exist. Using the Bi-Digital O-Ring Test Molecular Identification Method, we were able to localize substance P and thromboxane B2 (a good indicator of the presence and degree of circulatory disturbances) in the painful area along with virus or bacteria. Based on the Bi-Digital O-Ring Test localization method for specific substances or microbes, the author has successfully treated cases of chronic intractable pain by the combination of anti-viral or bacterial agents with either manual acupuncture, electro-acupuncture or transcutaneous electrical stimulation through a pair of surface electrodes. Among a variety of infections, the most common cause of severe intractable pain was herpes simplex virus, and the most common bacterial cause of intractable pain of moderate degree was campylobacter. In addition, chlamydia was a very common cause of mild intractable pain. When peripheral nerve fibers are hypersensitive from nerve injury due to viral infection, in addition to the drug therapy for infection, use of Vitamin B1 25 mg., 2 times a day for an average adult often accelerates recovery time. As an anti-viral agent for the herpes virus family, the author found that EPA (Omega 3 fish oil, Eicosa Pentaenoic Acid, C20:5 omega 3), at doses between 180 mg. and 350 mg (depending upon body weight) 4 times a day for 2 to 6 weeks, without prescribing the common anti-viral agent Acyclovir, often eliminated the symptoms due to viral infection including all well-known types of the herpes virus, such as herpes simplex virus, Epstein-Barr virus, and cytomegalovirus. Epstein-Barr virus and cytomegalovirus are usually not associated with intractable severe pain, but they are often associated with a recurrent burning or itching sensation and they can cause intractable frequent muscle twitching. Viruses belonging to the herpes family almost always exist between the midline of one side of the spinal cord and the midline of the front of the body where these nerves from the spinal cord end and the same virus is localized only on one side of the body at the same spinal level.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Treatment of acute or chronic severe, intractable pain and other intractable medical problems associated with unrecognized viral or bacterial infection: Part I. 197 80

In the process of evaluating the effects of external Qi Gong on inanimate substances by the Bi-Digital O-Ring Test, Qi Gong energy was shown to have a polarity which the author designated for convenience sake (+) or (-), where (+) increases the strength of muscles and (-) weakens them. Depending upon how external Qi Gong is applied and from which part of the body it emanates, the polarity changes. In general, it was found that, when (+) polarity is applied to the painful area or spastic muscles or arteries in vaso-constriction it often reduced or eliminated the pain, spastic muscles or circulatory disturbances. The author succeeded in storing part of the Qi Gong energy in inanimate materials, such as papers, metals (such as a sheet of aluminum foil), glass, stone, band-aids, clothes, drugs, etc. in bi-polar (one end of the same material becomes (+) polarity and the other end of the same material becomes (-) polarity) form in one material or uni-polar, i.e., the entire material either has pure (+) polarity or (-) polarity. Water, EPA, vitamins, antibiotics and other drugs were also converted to (+) polarity. When the material has a bi-polar state, it becomes possible to eliminate one of the polarities by applying certain changing electrical fields. The effect of placing (+) polarity Qi Gong energy stored material was compared with direct application of the Qi Gong on pain, spastic muscle and spastic vertebral arteries. The therapeutic effects of these 2 methods were quite similar for the identical time duration but a more predictable effect was often obtained in the former. As our previous study indicates that acupuncture, electrical stimulation (1-3 pulses/sec.), as well as Qi Gong not only improved the microcirculatory disturbance and relaxed spastic muscles and vaso-constrictive arteries but also reduced or eliminated the pain and also selectively enhanced drug uptake to the area where drugs could not be delivered due to existing circulatory disturbances, by placing (+) Qi Gong stored material, such as a sheet of paper or aluminum foil, band-aid or clothes. Bi- Digital O-Ring Test evaluation indicated that not only did it produce all the beneficial effects of Qi Gong but also enhanced the drug uptake selectively in the area where it is necessary for the drug to be delivered for effective treatment, and reduced lead deposits in tissue.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Storing of qi gong energy in various materials and drugs (qi gongnization): its clinical application for treatment of pain, circulatory disturbance, bacterial or viral infections, heavy metal deposits, and related intractable medical problems by selectively enhancing circulation and drug uptake. 197 4

The author found that the onset of hypertension or hypotension is relatively often associated with infections or development of so-called "sneezing due to allergy to pollen or dust," with or without headache, or due to trauma to the occipital area of the head. Using the "Bi-Digital O-ring Test," it was possible to demonstrate that, among bacterial and viral infections, the most common cause of infection associated with the appearance of hypertension is chlamydia, herpes simplex virus, cytomegalovirus, or Epstein-Barr virus. Particularly chlamydia and/or herpes simplex virus, with or without coexistence of other microbes, is usually present at the heart representation area of the medulla oblongata, especially at the left ventricular representation area, often accompanied by upper respiratory infection, cephalic, cervical or facial pain, with or without coexisting genito-urinary infection. The left ventricular representation area of the medulla oblongata is usually located at the right side. In most hypertensive patients, the left ventricular representation area of the medulla oblongata is enlarged up to 3 or 4 times normal size. Sufficient antibiotic treatment of chlamydia with erythromycin sometimes eliminated severe hypertension which appeared after chlamydia infection. In the presence of viral infections, such as herpes simplex, which is also causing severe pain in the head or neck, oral administration of acyclovir, erythromycin, or EPA (Eicosa Pentaenoic acid)-DHA (docosa hexaenoic acid) Omega 3 fish oil often reduced associated intractable pain and hypertension toward the normal level. Thus, the author is proposing new possible mechanisms as among the causes of so-called essential hypertension as a result of microbial infection or trauma of the cardiovascular representation area, particularly that of the left ventricular representation area at the right side of the medulla oblongata.
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PMID:Microbial infection or trauma at cardiovascular representation area of medulla oblongata as some of the possible causes of hypertension or hypotension. 290 10

Sixteen healthy male volunteers had 30 mg of cocaine HCI solution or normal saline placebo impregnated in cotton-covered applicators administered intranasally on different days in a double-blind procedure. Ischemic tourniquet pain was significantly less after cocaine than it was in pretreatment control. It was also significantly less than after administration of a placebo. Responses to questionnaires concerning subjective drug effects, mood, and alertness revealed little change in psychological status associated with either cocaine or placebo. Thus, the reported decrease in pain was probably not caused by a change in affect or by altered consciousness. These results indicate that, in addition to its known properties as a local aesthetic, cocaine when applied intranasally exerts an analgesic effect.
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PMID:Effect of intranasal cocaine on experimental pain in man. 719 54

To date in the United States when a patient has presented with a complaint of pain requiring some form of pharmacologic relief, the physician has had the choice of two broad classes of drugs: peripherally acting (i.e., NSAID) or centrally acting (i.e., opioid) analgesics. The antidepressant monoamine reuptake inhibitors, particularly when combined with an opioid analgesic, have also proven efficacious in treating certain types of pain conditions. A new approach, available for almost 20 years in Europe and recently approved for use in the United States, is the centrally acting synthetic analgesic tramadol HCI. Preclinical evidence suggests that tramadol produces its antinociceptive effect in animals and analgesic effect in humans through a complementary dual mechanism of action. One mechanism relates to its weak affinity for mu-opioid receptors (6,000-fold less than morphine, 100-fold less than d-propoxyphene, 10-fold less than codeine, and equivalent to dextromethorphan). A metabolite (O-desmethyltramadol; M1) binds to opioid receptors with a greater affinity than the parent compound and could contribute to this component. However, in most animal tests and human clinical trials, the analgesic effect of tramadol is only partially blocked by the opioid antagonist naloxone, suggesting an important nonopioid mechanism. This nonopioid mechanism possibly relates to an increase in central neuronal synaptic levels of two neurotransmitters, 5-hydroxytryptamine (5-HT; serotonin) and norepinephrine. The opioid and nonopioid mechanisms appear to combine in a supra-additive manner in several tests of antinociception, but only in an additive or even counteracting manner in measures of adverse-effect liability. In sum, the apparent dual mechanism of action of tramadol suggests a possible new approach to pain relief.
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PMID:A novel approach to the pharmacology of analgesics. 876 59

Animals are commonly given opioid analgetics such as buprenorphine for post-operative pain management. In this study, the effect of the analgetic buprenorphine, a partial mu receptor agonist and kappa receptor antagonist, on L-DOPA-induced contralateral rotation was measured in 6-hydroxydopamine (6-OHDA) treated rats. Male Sprague-Dawley rats received dopamine-depleting brain lesions by infusion of 6-OHDA into the medial forebrain bundle. After the procedure, buprenorphine was administered (430 microg/kg, s.c.) to 17 of 54 animals. Three weeks after 6-OHDA treatment, animals were given benserazide HCI (25 mg/kg, i.p.) and L-DOPA (4 mg/kg, i.p.). Contralateral rotations were monitored for 2 h. Animals receiving buprenorphine had significantly higher rates of rotation as compared with non-buprenorphine-treated animals (P = 0.023). The results suggest that buprenorphine sensitizes animals to the effects of L-DOPA.
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PMID:Buprenorphine potentiates L-DOPA-induced contralateral rotation in 6-hydroxydopamine-treated rats. 1053 May 11

We measured matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMP) in temporomandibular joint (TMJ) disorders. All patients were fully investigated, by visual analogue pain scores, plain radiographs and double-contrast arthrotomograms. The patients were grouped according to whether or not they were in pain. There were 35 patients with painful joints; 16 painless crepitating joints and 10 with chronic closed locked joints. A further group of 9 volunteers with no symptoms of TMJ abnormalities were used as controls. We found that synovial fluid concentration of MMP-3 was significantly increased (1117.2 (164.0) ng/ml) (P< 0.05) in the painful group compared with controls (436.2 (94.8) ng/ml) and with the two groups with painless TMJ (475.0 (113. 0) ng/ml/crepitation, and 516.0 (115.1) ng/ml/closed locked joints). MMP-1 and TIMP-1 were not recordable in most joints, and the serum concentrations of MMP-1, MMP-3, and TIMP-1 were similar to those in controls in all groups. There was no correlationship between MMP-3 concentration and joint morphology as shown by plain radiographs and double contrast arthrotomograms. These findings indicate that the synovia of painful joints are inflamed.
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PMID:Matrix metalloproteinase and tissue inhibitor of metalloproteinase in serum and lavage synovial fluid of patients with temporomandibular joint disorders. 1092 68

Linoleic and alpha-linolenic acids, obtained from plant material in the diet are the precursors in tissues of two families with opposing effects which are referred to as "essential fatty acids" (EFA): arachidonic acid (AA) and pentaene (eicosapentaenoic acid: EPA) and hexaene (docosahexaenoic acid: DHA) acids. The role of EFA is crucial, without a source of AA or compounds which can be converted into AA, synthesis of prostaglandins (PGs) by a cyclooxygenase (COX) enzyme would be compromised, and this would seriously affect many normal metabolic processes. COX, also known as prostaglandin endoperoxide synthase (Pghs) or as prostaglandin G/H synthase, is a key membrane bound enzyme responsible for the oxidation of AA to PGs. Two COX isoforms have been identified, COX-1 and COX-2 that form PGH2, a common precursor for the biosynthesis of thromboxane A2 (TxA2), prostacyclin (PGI2) and PGs (PGD2, PGE2, PGF2alpha. COX-1 enzyme is expressed constitutively in most cells and tissues. Its expression remains constant under either physiological or pathological conditions controlling synthesis of those PGs primarily involved in the regulation of homeostatic functions. In contrast, COX-2 is an intermediate response gene that encodes a 71-kDa protein. COX-2 is normally absent from most cells but highly inducible in certain cells in response to inflammatory stimuli resulting in enhanced PG release. PGs formed by COX-2 primarily mediate pain and inflammation but have multiple effects that can favour tumorigenesis. They are more abundant in cancers than in normal tissues from which the cancers arise. COX-2 is a participant in the pathway of colon carcinogenesis, especially when mutation of the APC (Adenomatous Polyposis Coli) tumour suppressor gene is the initiating event. In addition, COX-2 up-regulation and elevated PGE2 levels are involved in breast carcinogenesis. It seems that there is a correlation between COX-2 level of expression and the size of the tumours and their propensity to invade underlying tissue. Inhibition by non-steroidal anti-inflammatory drugs (NSAIDs) of COX enzymes which significantly suppress PGE2 levels, reduced breast cancer incidence and protected against colorectal cancer. Therefore it is suggested that consumption of a diet enriched in n-3 PUFA (specifically EPA and DHA) and inhibition of COX-2 by NSAIDs may confer cardioprotective effects and provide a significant mechanism for the prevention and treatment of human cancers.
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PMID:Polyunsaturated fatty acids (PUFA) and eicosanoids in human health and pathologies. 1219 20

One of the major serotonin (5-HT) receptor subtypes expressed in the rat dorsal root ganglion (DRG) neurons is the 5-HT2A receptor. We have previously shown that 5-HT2A receptors in the peripheral sensory terminals are responsible for 5-HT-induced pain and hyperalgesia. In the present study, we characterized neurons expressing 5-HT2A receptors in the rat DRG neurons by means of in situ hybridization, immunohistochemistry, reverse transcription-polymerase chain reaction (RT-PCR) and behavioral tests. In situ hybridization on consecutive sections revealed that 5-HT2A receptor mRNA is colocalized with calcitonin-gene related peptide (CGRP) mRNA (100/104; 96.2%) but not with c-Ret mRNA (1/115; 0.9%). Signals for 5-HT2A receptor mRNA were found in 9.4 +/- 2.2% of normal DRG (L5) neurons, most of which were small to medium in size. Four days of complete Freund's adjuvant-induced inflammation of the hindpaw doubled the incidence of 5-HT2A receptor mRNA-expressing neurons to 19.3 +/- 2.8%. The level of 5-HT2A receptor mRNA in DRGs of normal and various pathological conditions was then determined by RT-PCR. The level was up-regulated by peripheral inflammation, but not by axotomy or chronic constriction of the peripheral nerve. Systemic administration of 5-HT2A receptor antagonist (Sarpogrelate HCI) produced analgesic effects on thermal hyperalgesia caused by peripheral inflammation, but failed to attenuate thermal hyperalgesia in chronic constriction injury model. These findings suggest that 5-HT2A receptors are mainly expressed in CGRP-synthesizing small DRG neurons and may be involved in the potentiation of inflammatory pain in the periphery.
Pain 2002 Sep
PMID:5-HT2A receptor subtype in the peripheral branch of sensory fibers is involved in the potentiation of inflammatory pain in rats. 1223 91


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