Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Low-dose ibuprofen is as effective as aspirin and paracetamol for the indications normally treated with over-the-counter (OTC) medications and is associated with the lowest risk of gastrointestinal toxicity of any non-steroidal anti-inflammatory drug. By contrast, even low-dose aspirin is associated with an appreciable risk of gastrointestinal toxicity. Paracetamol is well tolerated and effective in treating mild to moderate pain but there is growing concern about a possible risk of gastrointestinal toxicity and a possible link with asthma in children. The PAIN (Paracetamol, Aspirin, Ibuprofen New tolerability) study was a blinded randomised comparison of the tolerability of OTC analgesics in the treatment of common types of acute pain encountered in the community. A total of 8,677 adults were randomised to treatment with ibuprofen 1200 mg/day, paracetamol 3 g/day or aspirin 3 g/day for 1-7 days. The most common indications for treatment were musculoskeletal conditions (31-33%), colds or flu (19-20%), backache (15-17%), sore throat (11-12%) and headache (10-11%). Significant adverse events were more common with aspirin (10.1%) than ibuprofen (7.0%) (P<0.001) or paracetamol (7.8%). Significant gastrointestinal events were less frequent with ibuprofen (4.0%) than with aspirin (7.1%, P<0.001) or paracetamol (5.3%) (P=0.025). For every 100 patients treated, five more will experience significant adverse events if they are taking aspirin rather than ibuprofen, and four more than if they were taking paracetamol.
 ...
PMID:Forty years of ibuprofen use. 1272 44

Disregarding pain resulting from vitamin deficiency, an analgesic effect seems to be exerted only by vitamin B1 (thiamine), vitamin B6 (pyridoxines), and vitamin B12 (cobalamine), particularly when the three are given in combination. The analgesic effect is attributed to an increased availability and/or effectiveness of noradrenaline and 5-hydroxytryptamine acting as inhibitory transmitters in the nociceptive system. In animal experiments, high doses of these vitamins administered alone or in combination inhibited nociceptive behavior and depressed the nociceptive activity evoked in single neurons of the dorsal horn of the spinal cord and in the thalamus. Moreover, they were found to enhance the antinociceptive effect of non-opioid analgesic agents on withdrawal reflexes. Clinical data fail in most cases to meet current standards of evaluation (randomization, double-blindness). Still, it appears that high doses of the vitamins B1, B6, and B12 administered separately or in combination can alleviate acute pain and potentiate the analgesia caused by non-opioid analgesics such as the NSAIDs and metamizol (dipyrone). Therapeutic effects are observed in neuropathic pain and pain of musculoskeletal origin. Vitamin B6 is effective in the carpal tunnel syndrome which, however, is attributed at least in some cases to vitamin B6 deficiency. It is also worth noting that the B vitamins are shown to enhance the beneficial effect of diclofenac in acute low-back pain so that either the duration of treatment or the daily dose of diclofenac may be reduced. The use of high doses of vitamin B6 may be limited by a neurotoxic effect. The effectiveness of B vitamins in depressing chronic pain has not been established. It would be interesting to know if the B vitamins are of use as adjuvants in the treatment of tumor pain.
 ...
PMID:[Analgesic and analgesia-potentiating action of B vitamins]. 1279 82

Employers are beginning to realize that they face a nearly invisible but significant drain on productivity: presenteeism, the problem of workers' being on the job but, because of illness or other medical conditions, not fully functioning. By some estimates, the phenomenon costs U.S. companies over 150 billion dollars a year--much more than absenteeism does. Yet it's harder to identify. You know when someone doesn't show up for work, but you often can't tell when, or how much, poor health hurts on-the-job performance. Many of the health problems that result in presenteeism are relatively benign. Research in this emerging area of study focuses on such chronic or episodic ailments as seasonal allergies, asthma, headaches, depression, back pain, arthritis, and gastrointestinal disorders. The fact is, when people don't feel good, they simply don't perform at their best. Employees who suffer from depression may be fatigued and irritable--and, therefore, less able to work effectively with others. Those with migraine headaches who experience blurred vision and sensitivity to light, not to mention acute pain, probably have a hard time staring at a computer screen all day. A number of companies are making a serious effort to determine the prevalence of illnesses and other medical conditions that undermine job performance, calculate the related drop in productivity, and find cost-effective ways to combat that loss. Indeed, researchers have discovered that presenteeism-related declines in productivity sometimes can be more than offset by relatively small investments in screening, treatment, and education. So organizations may find that it pays to make targeted investments in employees' health care--by covering the cost of allergy medication, for instance, or therapy for depression.
 ...
PMID:Presenteeism: at work--but out of it. 1555 75

Vertebral collapse is one of the most common fractures associated with osteoporosis. The subsequent back pain is severe and often requires medications, bed rest and hospitalization to control pain and improve mobilization. The purpose of this systematic review was to assess the effects of calcitonin versus placebo for the treatment of acute pain in patients sustaining stable, recent, osteoporotic vertebral compression fractures. MEDLINE (1966-2003), EMBASE (1980-2003), Cochrane Controlled Trial Registry (2003, volume 3), other databases, and conference proceedings were searched for relevant research. Primary study authors and the pharmaceutical manufacturer were contacted, and bibliographies of relevant papers were hand-searched. Randomized, double-blind, placebo-controlled trials comparing calcitonin versus placebo for the acute pain of recent osteoporotic vertebral compression fractures were included. Two reviewers extracted data, performed numeric calculations and extrapolated graphical data independently. The combined results from five randomized controlled trials, involving 246 patients, determined that calcitonin significantly reduced the severity of pain using a visual analogue scale following diagnosis. Pain at rest was reduced as early as 1 week into treatment (weighted mean difference [WMD] =3.08; 95% confidence interval [CI]: 2.64, 3.52) and this effect continued weekly to 4 weeks (WMD =4.03; 95% CI: 3.70, 4.35). A similar pattern was seen for pain scores associated with sitting, standing, and walking. Side effects were gastrointestinal, minor and often self-limited. Calcitonin appears to be effective in the management of acute pain associated with acute osteoporotic vertebral compression fractures by shortening time to mobilization.
 ...
PMID:Calcitonin for treating acute pain of osteoporotic vertebral compression fractures: a systematic review of randomized, controlled trials. 1561 41

Back pain is divided into two phases; acute pain is due to the increased signal from the nociceptive receptors in the nerve endings and chronic pain is resulting from the reconstruction of the new nervous net work during the healing stage. Use of NSAIDs and opioids is indicated for the acute pain that is not eased by taking a rest. NSAIDs is also profitable to control chronic pain, but NSAIDs has complications of renal and digestive functions. Persons with ages of more than 65 are especially liable to those dysfunctions. Pharmacological intervention on back pain may not only give the therapeutic benefits but also it can provide the clues for the elucidation of the mechanism and the new therapeutic interventions.
 ...
PMID:[Indication and significance of pharmacological intervention for back pain]. 1574 73

In this open prospective trial, 53 patients with acute pain from osteoporotic vertebral fracture related to osteoporosis or malignancy underwent vertebral augmentation with a new bisphenol-a-glycidyl dimethacrylate (bis-GMA) resin (Cortoss, Orthovita, Malvern, Pa, USA). Treatment consisted of up to 8 ml of Cortoss injected into a given vertebra. The procedure encompassed single and multiple injections (including the contralateral hemivertebra, to a maximum of 3 vertebral levels). Follow-up was at 4 and 8 days and at 1, 3, and 6 months. The primary efficacy end point was patient-rated pain using a 100-point visual analog scale (VAS, with 100 as severest pain) on day 4 following treatment; secondary end points were analgesic use and quality-of-life and disability scores from the Oswestry Disability Index (ODI) and a short-form 12-item questionnaire (SF-12). The present report contains interim results collected up to the 1-month post-treatment time point. At baseline, the group's mean VAS score was 69, indicating moderate to severe pain; at day 4, 32 of 53 patients (60.4%) reported a 30% or greater reduction in baseline pain accompanied by a VAS pain score less than 50 (mean 38.1). Pain reduction was maintained at 1 month (mean VAS 31.3). The average ODI score at baseline was 55, suggesting significant disability among participants prior to Cortoss treatment. Following treatment, the ODI scores were significantly reduced from these baseline levels (day 8, 47.4; 1 month, 33.6). Further, SF-12 physical and mental component scores at 1 month after treatment increased from baseline by 26% and 11%, respectively; while analgesic use decreased concomitantly, primarily among patients with underlying osteoporosis. A total of 20 adverse events were deemed to be device-related. The most frequent clinically significant adverse events attributed to Cortoss were leakage of Cortoss from within the vertebral body at placement (12%), back pain (7%), and unspecified pain (7%). These results indicate that vertebral augmentation with Cortoss rapidly reduces pain, decreases disability, and improves physical functioning in patients with painful vertebral compression fractures.
 ...
PMID:Clinical results of an open prospective study of a bis-GMA composite in percutaneous vertebral augmentation. 1593 11

There have been significant advances in our understanding of occupational low back pain over the last decade largely because of a noteworthy improvement in the number and quality of prospective trials. More recent work confirms that genetic factors may drive a large portion of thr risk factors. The importance of physical fitness and spine support muscle fitness is believed to protect against future occurrences. Psychosocial factors can play a role in increasing the risk of future low back pain and acute pain in becoming chronic. Some of the psychological influence may be through a muscular pain component. It is arguable that an emphasis should be placed on resources, education, and support to allow workers to be productive whether suffering from back pain or not.
 ...
PMID:Epidemiology of occupational low back pain. 1696 73

Non-prescription (over-the-counter [OTC]) analgesics are used for the short-term treatment of acute painful conditions of mild to moderate intensity in everyday life. Well documented safety and efficacy, a rapid onset of action and a flexible daily dosing regimen are essential in this context. Film-coated, immediate-release, low-dose diclofenac potassium, developed for OTC use, offers a flexible daily dosing regimen with an initial dose of two tablets (2 x 12.5mg) followed by one or two tablets up to a maximum daily dose of six tablets (75 mg/day). The maximum plasma drug concentration is reached 30 minutes after administration, and the mean terminal half-life is 1-2 hours, allowing a 4- to 6-hour duration of activity, depending on the condition. Thirteen randomised, double-blind trials with both placebo and active controls have demonstrated the efficacy of diclofenac potassium 12.5mg tablets in conditions suitable for treatment with OTC medication, for example, acute lower back pain, headache, acute pain after dental extraction, symptoms of cold and influenza (including fever), and dysmenorrhoea. A single dose of diclofenac potassium 12.5mg is the lowest recommended effective dose. A two-tablet single dose of 25mg is at least as effective as ibuprofen 400mg. A flexible dosing regimen of an initial two tablets followed by one or two tablets up to a total daily dose of 75 mg is as effective as ibuprofen used in comparable fashion up to a total daily dose of 1200 mg. The incidence of adverse events in patients taking single or multiple doses of diclofenac potassium is similar to that of ibuprofen and placebo. In a safety study conducted to compare diclofenac potassium with ibuprofen for up to 3 months in patients with osteoarthritis of the knee, no differences in the pattern of adverse events were noted. There was no evidence of either hepatic injury or cardiovascular safety-related issues at any time during the study. Patients are generally capable of taking diclofenac potassium appropriately. A maximum OTC treatment duration of 5 days for pain and 3 days for fever is recommended.
 ...
PMID:Diclofenac potassium 12.5mg tablets for mild to moderate pain and fever: a review of its pharmacology, clinical efficacy and safety. 1730 13

Six articles are presented which illustrate the activities at the summer workshop "Pain and awareness" held 27-28 May 2005 in Marienfeld by the German Interdisciplinary Collaboration for Pain Therapy (DIVS). One article on pain constructs in the mind explains the advantages of functional imaging methods: these enable characterization of partial aspects of pain processing in the brain and the mechanisms that lead to chronic states of pain syndromes. A further overview explains the influence of different drugs on pain perception and various conscious states. How back pain patients experience their illness was analyzed in a study using an explanatory model interview: somatic aspects were dominant, but in three-fourths of the patients psychological illness attributions also played a role. A summary from the perspective of religious history and theology explores how pain is interpreted and accepted in various religious communities. Another article addresses hypnosis as a complementary technique to anesthesia procedures in surgical medicine, for treating chronic pain and experimental acute pain. The last contribution deals with how people in different cultures experience pain: ethnocentric bias can lead to difficulties in communication and misjudgments when treating foreign-born patients. All in all the workshop highlighted important formative factors in pain processing in a condensed form and offered stimulating perspectives for this area of pain research and future treatment options.
 ...
PMID:[Pain and consciousness. Articles from the summer workshop held by the German Interdisciplinary Collaboration for Pain Therapy (DIVS) in 2005]. 1754 51

Acute pain in peripheral joints is not a common presenting symptom for chiropractors or osteopaths. However, chiropractors or osteopaths may be asked to assess peripheral joints when patients present with other conditions such as back pain. This paper reviews the literature on bacterial arthritis as a specific type of infectious arthritis. Information was obtained from Medline and internet search using the keyword: "bacterial arthritis". The most common presenting symptoms are described, with specific reference for chiropractors and osteopaths in clinical presentation of patients' with this condition.
 ...
PMID:Bacterial arthritis. A review. 1798 91


<< Previous 1 2 3 4 5 6 7 Next >>