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)

In the "24-hour Cross Country Ski Race of Pinzolo" skiers attempt to cover as long as possible distances within 24 hours. Cardiac and metabolic changes of 6 volunteer cross country skiers, aging 29 to 39 years, participating to the individual competition, were analysed. All skiers had negative clinical examination and resting standard 12-lead ECG, except for one who had a midsystolic click on auscultation suggesting the presence of mitral valve prolapse. They were submitted to 48-hour Holter monitoring (HM) going from 3:00 p.m. of the day before the race up to one hour after the end of competition. The period of HM going from 3 p.m. of the day before to 1.00 p.m. of the day of race (one hour before the start) was utilized as control as concerns arrhythmias, ST-T wave and QT interval changes observed during the period of competition. In all 6 skiers, standard 12-lead ECG was again recorded on completion of race. The following serum indexes were obtained in basal conditions and within one hour after the end of race: electrolytes (Na+, K+), Myoglobina (MG) and the enzymes GOT, GPT, LDH, CK and CK-MB. Complete urine analysis was also obtained before and immediately after the race. The distance covered by the skiers ranged from 189 to 260 Km, except for the skier with systolic click who covered 95.7 Km within 12 hour and then retired from the race for acute pain of knee.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cardiac and metabolic investigations during 24 hour endurance skiing (Pinzolo, Italy)]. 405 86

This article reports a rare case of the use of low-dose ketamine infusion as an adjuvant to opioids to treat pain in sickle cell disease. A 31-year-old African-American male with history of sickle cell disease presented to the emergency department with complaints of chest tightness, multiple joint pain, and headache for 1 week. His vital signs and physical examination were unremarkable. His admission lab included hemoglobin of 8.4 g/dl, reticulocyte count of 16.3%, bilirubin of 1.7 mg/dl, and LDH of 1,267 U/l. Chest X-ray showed middle and lower lobe opacity and interstitial thickening. He was treated for acute pain crisis and community-acquired pneumonia with intravenous fluids, supplemental oxygen, and intravenous levofloxacin. He was placed on fentanyl patient-controlled analgesia (PCA), oxycodone, ketorolac, and methadone with co-analgesic gabapentin and venlafaxine. Over the course of his hospitalization, his chest pain resolved, but the joint pains continued. He was then transferred to the ICU and was discharged a day later after 7 days of ketamine infusion. Ketamine is a noncompetitive antagonist at the N-methyl-D-aspartate (NMDA) receptor. This property has been shown to modulate opioid tolerance and opioid-induced hyperalgesia. There have been a very few published reports on the use of low-dose ketamine in sickle cell pain management. A PubMed search revealed four published articles (Table 1). Fourteen out of the 17 cases (82.35%) who received ketamine infusion showed improvement in self-reported pain intensity and significant reduction in opioid dosage. Only one patient (5.9%) developed serious side effect leading to discontinuation of the drug. A low-dose ketamine can be an option for pain control in sickle cell disease. Randomized trial is required to establish this benefit of ketamine over currently available therapies.
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PMID:Ketamine infusion for sickle cell pain crisis refractory to opioids: a case report and review of literature. 2423 6