Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The root and stem decoctions of Sinomenium acutum Rehd. et Wils. (formerly Sinomenium diversifolius Diels, one type of Fang-chi (Chinese)) have been used as a folk remedy for neuralgia and rheumatoid arthritis in many areas of the Far East. In Japan and China various viny plants have been identified as Fang-chi (Boi in Japanese) since antiquity. This uncertain nomenclature has made it difficult to evaluate the efficacy of the Fang-chi described in the classic literature. Among traditional Fang-chi plants only Sinomeniumacutum has been demonstrated to contain the alkaloid sinomenine, which is now known to be effective in neuralgia and rheumatic diseases. Sinomenine is a unique plant alkaloid, as it potently releases histamine in association with degranulation of tissue mast cells in mammalian tissues. This action occurs preferentially in the skin and joint capsules. The released histamine is responsible for the dominant pharmacological actions of sinomenine, such as vasodilatation, increased vascular permeability, acceleration of the thoracic and peripheral lymph flow, contraction of plain muscles, increased peristalsis of the intestines, and stimulation of gastric acid secretion. At toxic doses of sinomenine, convulsive central excitation was observed in most laboratory animals. Clinical side effects encountered with high doses of injected sinomenine or of decocted Sinomenium acutum were: injection site flare, pruritus in the head and upper part of the body, edema around the lips and eyelids, and temporary cephalalgia. Most of these side effects were reduced by classical antihistamines (H1-receptor antagonists). Daily subcutaneous injections of sinomenine for more than one week produced an analgesic effect in mice. Granulation tissue growth and adjuvant arthritis induced in rats were both inhibited by daily injections of a small dose of sinomenine hydrochloride or histamine dihydrochloride. These inhibitory effects were mediated through histamine H2-receptors probably on fibroblasts (for granulation tissue growth) and on T-cells (for adjuvant arthritis), since these effects were clearly inhibited by the H2-antagonist burimamide but not by the H1-antagonist mepyramine. The anti-rheumatic effect on Sinomenium acutum are probably genuine and can probably be attributed to the histamine-releasing properties of sinomenine.
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PMID:Pharmacology of sinomenine, an anti-rheumatic alkaloid from Sinomenium acutum. 6 10

Topical capsaicin has been introduced in the U.S. and Canada as a cream indicated for temporary relief of neuralgia following episodes of herpes zoster infections and in the treatment of diabetic neuropathy. Although capsaicin is clinically used as an external analgesic for temporary relief of neuralgia, it has also been widely used as a research tool to study peripheral pain. Capsaicin apparently works to release substance P from sensory nerve fibers and after repeated applications, depletes neurons of substance P. Clinical investigations of topical capsaicin include trials in chronic pain syndromes such as postherpetic neuralgia, postmastectomy neuroma, reflex sympathetic dystrophy syndrome, diabetic neuropathy, rheumatoid arthritis, psoriasis, hemodialysis-associated itching, and vulvar vestibulitis. In addition, therapeutic benefits of capsaicin cream on apocrine chromhidrosis have been described. Further clinical studies are warranted in several of these conditions to establish the efficacy of topical capsaicin. Serious or unexpected adverse reactions from clinical use have not been reported to date. Considering the paucity of safe and effective treatments for the conditions mentioned above, capsaicin cream appears to warrant further clinical investigations to establish its efficacy in a variety of chronic pain syndromes.
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PMID:Topical capsaicin in dermatologic and peripheral pain disorders. 165 16

In the last 10 years genital herpes simplex has reached epidemic proportions, affecting 5 million Americans, with 500,000 new cases yearly. The incidence is highest among middle and upper socioeconomic groups and among whites. There are 2 antigenically distinct strains of the herpes simplex virus, and type II is the cause of 85% of the genital infections. The virus has an affinity for tissues derived from the embryonic ectoderm -- skin, mucous membranes, eye, and central nervous system. Transmission is by personal contact with an infected area. The clinical course of the disease involves 4 stages. In the primary stage the typical lesions are vesicles, which rupture, leaving painful shallow ulcerations. The primary stage lasts from 2 to 4 weeks with approximately 10 days of viral shedding. In the latent stage the virus lies dormant in the sacral ganglion and is noninfectious. In the shedding stage the virus replicates and sheds in genital secretions. The recurrent stage is characterized by prodromal itching or tingling sensations prior to the eruption of the vesicles and by neuralgia. Recurrence occurs as often as 4 to 7 times a year and lasts from 7 to 10 days, with viral shedding for 4 or 5 days. Definitive diagnosis can be made from viral tissue culture or the Tzanck and Papanicolaou smears. There is no cure for herpes although acyclovir has been found to shorten the duration of the episodes. Except for pregnancy complications, the most serious complications of recurrent genital herpes are psychological. The disease is socially stigmatizing and inhibits sexual activity. The nurse should provide supportive care, information about the transmission and symptoms of the disease, and counseling as to precautions to take, such as condom and spermicide use, avoidance of oral sex, abstention when lesions are present, and limiting sex to one partner.
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PMID:Herpes: a dilemma for client and clinician. 364 8

In a new statistic concerning 245 cases of primary ano-rectal neuralgia, it can be seen that the schematic classical classification derived from Thaysen, Theile, and Bensaude must be maintained (proctalgia fugax: 45 cases; coccygodynia: 44 cases; ano-rectal neuralgia: 95 cases), partially integrating unusual cases of pruritus ani. Among the 4 principle etiologies, while not underestimating the neuropsychical and intestinal factors (constipation, laxatives), the importance of two other factors must be underlined (the urogenital factor, and particularly, the role of menopause, and important pelvic operations (33 cases) often overestimated; rachidian factors: tendomyositis (Garrigues), pseudoradicular factor. The interest of this study is to show that besides these typical cases (81,7%), a number of atypical cases exist, which have often been under-estimated. These cases can be classified in intermediary (4%), associated (10%), alternating (3,3%) cases, in the course of which the different syndromes replace each other or seem superposed. It must be underlined that the notion of these primitive ano-rectal neuralgias must be inserted in the much larger class of perineal urinary, gynecological or bone and ligament neuralgias. The classification remains opened. An etiopathogenical treatment must be installed, that rejects all regional or surgical aggressive acts when not absolutely necessary, and underlines the importance of massage, internal (levator ani), or external (Maigne's technique, attentive and repeated sessions of rachidian massage).U
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PMID:[Primitive ano-rectal neuralgia. Atypical cases (author's transl)]. 628 Mar 9

Based on a study of 400 patients (272 patients with herpes zoster and 128 with postzoster neuralgia), the subcutaneous injection of triamcinolone in saline is concluded to be a safe and effective measure for reducing pain. The acute eruption and symptoms of herpes zoster cleared in an average of less than four days. Postzoster neuralgia developed in only 2.9% of the patients, although nearly 70% of these patients were more than 50 years of age. In cases of postzoster neuralgia, 35% cleared completely; 28.9% improved enough so that they could live with the occasional pain, itching, or numbness, and therapy was not beneficial for an additional 15.6%, and it failed in 18.7% of the cases. The results were satisfactory in 63.9% of the patients, and the side effects were minimal.
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PMID:Treatment of herpes zoster and postzoster neuralgia by subcutaneous injection of triamcinolone. 720 70

The treatment and prevention of the algic symptomatology of Post-Herpetic Neuralgia (PHN) are problems still to be solved. In our opinion the reason of this failure is to be found in an insufficient knowledge of the pathophysiological phenomena which cause the PHN. In fact, many fundamental aspects, such as its "temporal" and symptomatological definition and its pathogenesis are still unsolved. This revision tries to focus the problems and discrepancies hindering an improvement in PHN treatment and prevention. The literature reports three different symptomatological levels after herpes zoster acute phase: patients affected by pain and/or allodynia, patients with "abnormal sensations" (anesthesia, paresthesia, dysesthesia, prickling, itching, burning, etc.,) and patients in "complete recovery". Only two studies have analyzed the final incidence of these symptomatologies. Therefore, it is absolutely unclear whether the patients in "abnormal sensations", that is with a symptomatology which is definitely less weakening than pain, have to be considered in PHN (patients with pain) or in "complete recovery". On the contrary, from a clinical and physiopathological point of view this symptomatological difference may have a great importance: the symptomatological non-distinction could be the cause of the disagreement concerning PHN incidence data; this distinction could differentiate and compare in a reliable way the effects of the various therapies reported in the literature. The lack of a symptomatological classification does not facilitate a verification of the physiopathological hypothesis of PHN onset and maintenance. The differentiation among pain, "abnormal sensations" and "complete recovery" could correlate these three symptomatological conditions to the anatomopathological and viral data which according to literature characterize the evolution of Herpes Zoster acute phase in PHN. This would largely help to improve the therapeutic strategy.
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PMID:[Herpes Zoster and post-herpetic neuralgia: everything to revise?]. 1047 41

We report a case of effective treatment with clonidine ointment for herpetic neuralgia in a child. Clonidine hydrochloride is an alpha 2-agonist. It is generally administered intravenously, intramuscularly, intrathecally and orally. However, there have been only a few reports on transdermal usage. In our department, we have investigated the analgesic effect of topical application of clonidine in adults, and we have obtained sufficient evidence on the effects of clonidine. Therefore, we decided to use clonidine to a child. A 9-year-old child who had undergone BMT and developed herpes zoster was experiencing severe pain, itch, and insomnia. Many drugs were ineffective in relieving the pain, itch, and insomnia. To remove the symptoms, we tried clonidine ointment. Immediate improvement was observed in all the symptoms. Therefore, clonidine ointment was thought to be effective and we decided to prescribe clonidine ointment and amitriptyline hydrochloride. The application of clonidine showed no side effects such as bradycardia and low blood pressure. We conclude that clonidine can be administered to children without causing side effects.
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PMID:[A case of effective treatment with clonidine ointment for herpetic neuralgia after bone marrow transplantation in a child]. 1216 88

Zoster is a localised, generally painful cutaneous eruption that occurs most frequently among older adults and immunocompromised persons. It is caused by reactivation of latent varicella zoster virus (VZV). A common complication of zoster is postzosteric neuralgia (PZN), a chronic, often debilitating pain condition that can last months or even years. The risk for PZN in patients with zoster is 10 % - 20 %. Another complication of zoster is eye involvement, which occurs in 10- 25 % of zoster episodes and can result in prolonged or permanent pain, severe itch, facial scarring, and loss of vision etc. Prompt treatment with the oral antiviral agents acyclovir, valacyclovir, brivudine or famciclovir decreases the severity and duration of zoster-associated pain (ZAP). Additional pain control can be achieved by supplementing antiviral agents with analgesics, tricyclic antidepressants, and other agents, e. g., gabapentin. Efficacy of the therapy depends on its early initiation. Because zoster starts with unspecific symptoms, specific treatment starts late, as a rule 3 - 7 days after the beginning of virus replication, responsible for complications. A licensed zoster vaccine is a preparation of a live, attenuated strain of VZV, the same strain used in the varicella vaccines. However, its minimum potency is at least 14-times higher than the potency of single-antigen varicella vaccine. In a large clinical trial, zoster vaccine was more than 50 % efficacious for preventing zoster. It is also efficacious in reducing the severity and duration of pain and preventing PHN. Therefore zoster vaccination is recommended for elderly persons.
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PMID:[Skin involvement in zoster]. 2049 Sep 89

Neuroepidermal tropism of varicella-zoster virus accounts for cutaneous and nerve lesions following herpes zoster. Skin lesions heal in a few weeks and may or may not leave visible scars. Nerve lesions involve peripheral sensory fibres, sometimes causing permanent damage that results in partial denervation of the affected dermatome. The effects of the nerve injury involve the sensibility function, thus causing neuralgia, itch, allodynia, hypo- or anaesthesia, as well as the immune function that is related to neuropeptide release, thus altering immune control in the affected dermatome. The neuro-immune destabilization in the zoster-infected site paves the way for the onset of many and various immunity-related disorders along the affected dermatome.
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PMID:Beyond zoster: sensory and immune changes in zoster-affected dermatomes: a review*. 2229 36

Pain is a natural protective mechanism and has a warning function signaling imminent or actual tissue damage. Neuropathic pain (NP) results from a dysfunction and derangement in the transmission and signal processing along the nervous system and it is a recognized disease in itself. The prevalence of NP is estimated to be between 6.9% and 10% in the general population. This condition can complicate the recovery from stroke, multiple sclerosis, spinal cord lesions, and several neuropathies promoting persistent disability and poor quality of life. Subjects suffering from NP describe it as burning, itching, lancing, and numbness, but hyperalgesia and allodynia represent the most bothersome symptoms. The management of NP is a clinical challenge and several non-pharmacological and pharmacological interventions have been proposed with variable benefits. Botulinum toxin (BTX) as an adjunct to other interventions can be a useful therapeutic tool for the treatment of disabled people. Although BTX-A is predominantly used to reduce spasticity in a neuro-rehabilitation setting, it has been used in several painful conditions including disorders characterized by NP. The underlying pharmacological mechanisms that operate in reducing pain are still unclear and include blocking nociceptor transduction, the reduction of neurogenic inflammation by inhibiting neural substances and neurotransmitters, and the prevention of peripheral and central sensitization. Some neurological disorders requiring rehabilitative intervention can show neuropathic pain resistant to common analgesic treatment. This paper addresses the effect of BTX-A in treating NP that complicates frequent disorders of the central and peripheral nervous system such as spinal cord injury, post-stroke shoulder pain, and painful diabetic neuropathy, which are commonly managed in a rehabilitation setting. Furthermore, BTX-A has an effect in relief pain that may characterize less common neurological disorders including post-traumatic neuralgia, phantom limb, and complex regional pain syndrome with focal dystonia. The use of BTX-A could represent a novel therapeutic strategy in caring for neuropathic pain whenever common pharmacological tools have been ineffective. However, large and well-designed clinical trials are needed to recommend BTX-A use in the relief of neuropathic pain.
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PMID:Botulinum Toxin Type A for the Treatment of Neuropathic Pain in Neuro-Rehabilitation. 2613 56


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