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

The wild ancestors of chickens, along with those of most other farm animals, were preadapted to domestication because their lack of specialized requirements allowed them to adapt to a wide variety of environments provided by humans. Currently most commercial chickens kept for table-egg production are incubated, reared, and maintained as productive adults in high-density, artificial environments. Nevertheless, there are limits to adaptability as indicated by behavioral, physiological, immunological, and individual productivity indicators when environmental conditions become extreme. However, with the exception of obvious injury, no single criterion is likely to be adequate. Multiple indicators are required to obtain reliable evaluation of whether husbandry practices and environmental conditions reduce hens' welfare significantly. Concern for the well-being of hens has led to the phasing out of cages in two European countries. Although cages are known to be associated with some problems of well-being, it is known also that they have some welfare advantages for hens over alternative systems of production and they have definite economic advantages for producers. Therefore, it is doubtful whether the use of cages should be denied without exploring further the possibilities of cage modification or genetic selection aimed at improving the well-being of hens in such environments. Ethical perspectives relative to animals have been evolving since the time of Aristotle more than 300 yr B.C. Recent developments include divergence of welfare concerns between utilitarian and animal rights based philosophies. The utilitarians generally agree that animals may be used for human benefit if unnecessary pain and suffering are avoided and humane care and management criteria are met. Fundamentally, rights-oriented groups reject such exploitation. The general public exhibits a continuum of attitudes towards animals. However, there are indications that they are moving towards a protectionist attitude toward farm animals. Many requirements for good husbandry are known. However, uncertainty prevails in some areas, particularly with the necessity of routine procedures such as beak trimming and the amount of space needed, optimal group size, and whether nests, roosts, litter, and other quality of environment features are necessities or luxuries in terms of hens' welfare. Floor and feeder space and group size seem to be of paramount importance, and space that is adequate for well-being seems to be greater than that which yields the greatest net income. Genetic solutions to several behavior-related problems that compromise hens' well-being seem to be feasible and worthy of greater emphasis by commercial poultry breeders.
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PMID:Review: welfare perspectives on hens kept for egg production. 793 80

The aim of this study was to investigate the effects of recombinant human erythropoietin (rh-EPO) in patients with cancer-related anaemia. Thirty-six ambulatory patients who had malignant neoplasms and haemoglobin (Hb) values of < 11 g/dl (Pretoria is 1,310 m above sea level) entered the study. Patients with renal insufficiency or anaemia caused by bleeding or haemolysis, and patients with iron deficiency or megaloblastic anaemia, were not entered in the study. 22 IU/kg rh-EPO was given subcutaneously 3 times/week. The dose was escalated if Hb values did not rise after 4 weeks. All 36 patients were evaluable for toxicity. Side effects ascribed to rh-EPO were pain or discomfort at the site of injection (12 patients), heart palpitations (3 patients), skin rash (2 patients) and hypertension, deep vein thrombosis, and myalgia in 1 patient each. Thirty of the 36 patients who entered the study were evaluable for response. There were 16 females and 14 males among the evaluable patients. Median age was 64.5 years. Response, defined as an increase of Hb of at least 2 g/dl or to 12.5 g/dl, for at least 1 month, was documented in 12 patients. This was accompanied by an improvement in performance status and occurred within 1 month in 5 of the 12 patients who responded. rh-EPO has a limited but measurable therapeutic value for patients with cancer-associated anaemia.
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PMID:Recombinant human erythropoietin in the treatment of cancer-related anaemia. 797 Apr 93

Important alterations in respiratory function have been observed after open cholecystectomy. These include a decrease in the abdominal tidal volume, forced vital capacity, and forced expiratory volume at 1 s. Laparoscopic cholecystectomy is a new procedure allowing removal of the gallbladder without a subcostal or midline incision. The result is less postoperative pain and earlier ambulation. This study sought to determine whether changes in rib cage and abdominal wall motion are different after laparoscopic than open cholecystectomy. Twelve otherwise healthy patients underwent respiratory inductive plethysmography prior to and one day after laparoscopic cholecystectomy. Frequency of resting breathing increased 29 percent after laparoscopic cholecystectomy (p = 0.03), while abdominal motion decreased 32 percent (p = 0.03). During coached abdominal breathing, rib cage tidal volume increased 70 percent (p = 0.005) and abdominal tidal volume decreased 29 percent (p = 0.01). These alterations in respiratory pattern after laparoscopic cholecystectomy were smaller in magnitude than those reported following the open procedure.
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PMID:Dynamic respiratory patterns after laparoscopic cholecystectomy. 813 60

The data available indicate that ROM, strengthening and aerobic conditioning exercises are safe for patients with OA, RA or AS, despite earlier concerns that exercise might exacerbate joint symptoms or accelerate disease. Less clear are the therapeutic benefits of exercise. In patients with OA, stretching, strengthening, and aerobic conditioning programmes can improve the deficits observed in these patients. The improvements observed generally have been small, and the evidence that these individual improvements result in improved overall function is minimal. None the less, it is likely that exercise will reduce pain, improve endurance for physical activities and improve cardiovascular fitness. Study of the long-term effects of exercise in the geriatric population, for sustaining independent living and functioning, is critically important for future health care and social expenditures. In RA, strengthening and aerobic conditioning exercise programmes can increase muscle strength and cardiovascular fitness and probably improve physical function as well. Improvements demonstrated in patients with RA seem more convincing than those in patients with OA and AS; this probably represents their poorer physical status prior to exercising. For patients with AS, intensive physiotherapy brings statistically significant short-term improvements in spinal and hip ROM which are only modestly clinically significant. It is possible that spinal mobility exercises decelerate loss of mobility over the long term, but controlled studies are needed to confirm this. Improvement in respiratory function with exercise appears to be related to cardiopulmonary fitness and perhaps to improvements in diaphragmatic respiration rather than to changes in thoracic cage mobility. Given the overall safety and likely benefits of the described forms of exercise, exercise should be included in the overall treatment of patients with OA, RA or AS. Careful patient evaluation and education about exercise should be a part of the exercise programme.
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PMID:Exercise for arthritis. 814 42

Normal skeletal integrity is maintained by physiological bone turnover through a coupled process of bone resorption, mediated by osteoclasts, followed by new bone formation, mediated by osteoblasts. Major features of the pathogenesis of cancer-associated skeletal destruction are enhanced osteoclast-mediated bone resorption and disruption of normal bone formation. In this article, the literature on the pathogenesis and clinical manifestations of metastatic bone disease is discussed. Animal and clinical trials investigating novel bone targeted agents, emphasizing the bisphosphonates, are critically assessed. The most frequent clinical manifestations of bone metastases are pain, fracture, immobility, spinal cord compression, and hypercalcemia. New treatments under study for patients with bone metastases include agents specifically targeted to the skeleton such as bone-seeking radioisotopes and bisphosphonates. Studies in animal models of metastatic bone disease show that these bisphosphonates are able to inhibit tumor-induced osteolysis and are potentially useful in this condition. Bisphosphonates have been investigated in several clinical trials of patients with skeletal metastases from breast cancer, prostate cancer, and multiple myeloma. Overall, the studies investigating bone targeted radioisotopes or bisphosphonates for the treatment of morbidity due to skeletal metastases have been inconclusive. An improved understanding of the pathogenesis of metastatic bone disease and preclinical studies with bisphosphonates suggest that these agents may have a role in the treatment of this disorder. Additional trials of new generation bisphosphonates, employing a rigorously controlled, randomized study design with adequate numbers of subjects, are needed to demonstrate the safety and efficacy of this class of agents in this setting.
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PMID:New bisphosphonates in the treatment of bone metastases. 824 77

Patients with spinal cord injury (SCI) are at greater risk than others for alcohol abuse because they face physical, psychological and vocational difficulties that include sensory impairment, pain, depression and reduced opportunities to participate actively in society. This study assesses the utility of using a brief screening interview questionnaire, the CAGE (cut, annoyed, guilty and eye opener), to further evaluate patients with SCI for alcohol use, including alcoholism using retrospective data. The study explores patterns of alcohol consumption among SCI patients and investigates the relationship between self-reported alcohol use, age, previous history of drug and alcohol abuse and medical complications after discharge. Results suggest that the CAGE is a valid measure to be used with SCI patients. Age did not correlate significantly with patient's CAGE scores. However, SCI subjects with higher mean CAGE scores also had a higher incidence of medical complications. CAGE scores were significantly correlated with previous history of alcohol and drug abuse and with the average weekly number of drinks reportedly consumed before injury.
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PMID:Alcohol use among spinal cord-injured patients. 836 13

Ultrasonic vocalizations may be an expression of the affective pain response in laboratory animals. The present experiment compares the effects of morphine to the delta agonist, DPDPE (D-Pen2,D-Pen5 enkephalin) on a range of reflexive, behavioral and affective responses during an aggressive interaction. In experiment 1, naive female Long-Evans rats received morphine (0, 1, 3, 6, 10 micrograms ICV), or DPDPE (0, 30, 60, 100 micrograms ICV). In experiment 2, female rats were treated with naltrindole (1.0 mg/kg IP) 20 min before DPDPE (0, 60, 100 micrograms ICV). The following endpoints were measured: (1) latency to tail flick in response to heat stimuli; (2) high (33-65 kHz) and low (20-32 kHz) frequency ultrasonic and audible vocalizations; (3) defensive behavior; and (4) motoric activity. Following a brief exposure to attack, rats were threatened by the aggressor but protected from further attack by a large, wire mesh cage, thereby allowing for continued behavioral and vocal measurement without the risk of physical injury; video and audio recordings were made during the attack and then during a portion of the protected encounter (2 min). Morphine suppressed pain reactions varying in complexity from a spinal reflex, to an organized escape reaction, to an affective vocal response. The delta agonist, DPDPE, attenuated high frequency ultrasonic calling and tail flick responding. Defensive behaviors were also modulated by DPDPE at doses that had no effect on walking or rearing, indicating behavioral specificity. By contrast, doses of morphine that decreased defensive upright and escape also decreased motor activity. In female rats, morphine and DPDPE share a common profile of effects on a range of functional end-points, but DPDPE appears to modulate more selectively the reactions related to aversiveness without exerting sedative effects.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Delta opioid receptors: reflexive, defensive and vocal affective responses in female rats. 854 26

The purpose of this retrospective study was to determine the prevalence of alcoholism among terminally ill cancer patients when assessed by multidisciplinary interviews and by the CAGE Questionnaire. We reviewed the charts of 100 consecutive patients assessed by a multidisciplinary team for the presence of alcoholism during 1989, and 100 consecutive patients assessed by the CAGE Questionnaire during 1992. Alcoholism was diagnosed in 28/100 patients during 1989 (28%) and 18/66 patients during 1992 (27%). Thirty-four patients were unable to complete the CAGE Questionnaire in 1992 because of sedation or cognitive impairment; six of these patients (17%) were found to be alcoholics after multidisciplinary assessment. Only 9/28 (32%) and 8/24 (33%) patients diagnosed as alcoholics during 1989 and 1992, respectively, had been previously diagnosed as alcoholics according to the medical charts. The mean equivalent daily dose of morphine during admission and on Day 2 during 1992 were 153 +/- 193 mg and 183 +/- 198 for alcoholic patients, versus 58 +/- 80 and 70 +/- 79 mg for nonalcoholics (P = 0.06 and 0.03, respectively). The maximal dose of opioid and the pain intensity during admission, however, were not significantly different between alcoholics and nonalcoholics. Our results suggest that alcoholism is highly prevalent and underdiagnosed among symptomatic terminally ill cancer patients. The CAGE Questionnaire should be used for screening for alcoholism in this population. When multidimensional assessment and management of pain is applied, the outcome of alcoholic patients appears to be similar to that of nonalcoholics.
J Pain Symptom Manage 1995 Nov
PMID:The frequency of alcoholism among patients with pain due to terminal cancer. 859 20

Outbred albino NMRI male mice encountering a brother in adulthood, after a long period of separation, show an opioid-dependent increase in pain threshold. Unrelated and unfamiliar males show no similar changes in pain sensitivity. This study investigates which kind of stimuli from the partner may be responsible for such a modification at the neural level. The tail-flick test is used as a measure of pain sensitivity. Exposure to the scent of the brother's home cage, as well as exposure to visual, olfactory and auditory stimuli and partial physical contact with the related male, are not sufficient to induce changes in nociception. Physical affiliative contact between males is higher in sib than in nonsib pairs, and a positive correlation exists in sib pairs between huddling behavior and pain sensitivity at the end of a 2-h social session. Siblings injected with naloxone, an opioid receptor blocker, show a decrease in social behaviors involving physical contact. These results suggest that physical affiliative contact between sibling mice may be responsible for the enhancement of nociceptive threshold.
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PMID:Reunion of separated sibling mice: neurobiological and behavioral aspects. 867 11

The treatment of cancer-associated pain in the terminally ill patient requires a vast knowledge of the available treatment modalities, but we also have to be aware of the fact that the continuous education of patients, nurses and doctors about the proper usage of these modalities is of paramount importance. The 3-step ladder proposed by the World Health Organization (WHO) remains the backbone of pain treatment. Adjuvant drugs may add to the analgesic effect, and medications to relief opioid side effects should routinely be prescribed. Local irradiation remains one of the mainstays in painful bone metastasis. Newer systemic modalities to treat skeletal pain such as the bisphosphonates or radionuclides may in the future change some of our current approaches. The treatment of pain in the terminally ill remains a continuous challenge.
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PMID:[Palliative pain therapy in terminally ill tumor patients]. 868 69


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