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Rest pain

It is a NSAID with pronounced antirheumatic, antiinflammatory, analgesic and antipyretic properties. Inhibition of prostaglandin biosynthesis is fundamental mechanism of action. In rheumatic diseases, it leads to marked relief from pain at rest, pain on movement, morning stiffness and swelling of the joints, as well as by an improvement in function. [Pg.90]

Most clinical experience with iloprost has been gained in patients with critical leg ischemia. An intermittent intravenous infusion of up to 2 nanograms/kg/minute for 2-4 weeks reduced rest pain and improved ulcer healing in roughly half of the patients with critical leg ischemia, including diabetics. Compared with placebo, the improvement obtained with iloprost was significant in most but not all individual clinical trials. In addition, a meta-analy-sis showed a 15% reduction in major amputation rate compared with placebo (2). [Pg.121]

New onset angina pectoris or accelerated angina pectoris but no rest pain. [Pg.465]

Many double-bhnd, controlled trials have been conducted with co-dergocrine in senile dementia, and almost all have reported improvements in scores on at least one psychomotor test scale. However, despite this evidence of short-term efficacy, many skeptical clinicians stiU consider it to be no better than placebo, and find support from a double-blind, placebo-controlled trial in which a group treated with the recommended dosage of 1 mg tds for 24 weeks did not perform better after treatment than did the placebo-treated group (5). The clinical value of co-dergocrine in patients with claudication and rest pain is poorly documented. [Pg.1230]

A 44-year-old woman developed claudication and rest pain after gross overuse of ergotamine 100 mg suppositories (up to 6 times a day) for chronic headaches over a period of several years (14). Angiography showed occlusion of both femoral arteries. Intraarterial prostaglandin E (presumably Ei) followed by chemical sympathectomy normalized the circulation in both the legs. [Pg.1231]

Keelan ET, Nunez BD, Grill DE, et al. Comparison of immediate and long-term outcome of coronary angioplasty performed for unstable angina and rest pain in men and women. Mayo Clin Proc 1997 72 5-12. [Pg.288]

Isner 1998 Buerger s disease Critical ischemia, resistant to maximal medical therapy, not surgical candidates Naked plasmid VEGF 165 Intramuscular injection Phase 1 4 months Improvements in wound healing, rest pain, ankle brachial indices, new vessels on MRl and angiogram... [Pg.319]

Symes/Vale 1999 Myocardial ischemia Symptomatic CAD, not amenable to revascularization Naked plasmid VEGF 165 Intramyocardial injection at thoracotomy Phase 1 1 yr Improved SPECT, no rest pain... [Pg.321]

Many patients with advanced peripheral arterial disease are more limited by the consequences of peripheral ischemia than by myocardial ischemia. In the cerebral circulation, arterial disease may be manifest as stroke or transient ischemic attacks. The painful symptoms of peripheral arterial disease in the lower extremities (claudication) typically are provoked by exertion, with increases in skeletal muscle O2 demand exceeding blood flow impaired by proximal stenoses. When flow to the extremities becomes critically limiting, peripheral ulcers and rest pain from tissue ischemia can become debilitating. [Pg.156]

Berry el al. (1955) 41 Grade 1 patients with intermittent claudication only and an average follow-up of four years, only 30 were still alive, i.e., 73% survival at four years 24 Grade 2 patients in which there was mild rest pain in addition to the intermittent claudication with an average follow-up of 51 months—the survival in this group was only 66 %. [Pg.585]

When limb ischemia becomes more severe, rest pain appears usually in the toes or the foot and can become nocturnal. The patient with rest pain at night finds some relief by sitting up on the side of the bed with... [Pg.10]

There are three levels of occlusive disease in the lower limb arteries aortoiliac, femoropopliteal, and infrapopliteal disease. Disease confined to one level may be asymptomatic or it can present with intermittent claudication. The presence of two or three levels of disease are symptomatic, and patients usually present with severe claudication or rest pain. Three levels of disease are often seen in patients with skin damage and critical limb ischemia. Without an intervention most limbs with critical ischemia will be amputated within 1 year. In patients with diabetes mellitus the disease is usually confined in the infrapopliteal vessels. Such patients may develop critical limb ischemia with one level of disease because this is the most distal of the three. Usually, multiple stenoses and/or occlusions are found in at least two of the run-off arteries. Although it is known that atherosclerosis develops most often in bifurcations, in the lower extremities the most frequently involved site is the superficial femoral artery. Other common sites are the aortoiliac, iliac, femoral popliteal, and tibioperoneal trunk bifurcations. [Pg.24]

Johnason J, Ringquist I. Factors of prognastic importance for subsequent rest pain in patients with intermittent claudication. Act Med Scand 1985 218 27-33. [Pg.50]

Interventions for limb salvage are required if a patient develops rest pain, nonhealing ulcers, or gangrene of the toes or foot. After appropriate treatment, rest pain disappears, ulcers heal with standard attention, and gangrenous tissue can be amputated with prompt healing. This allows substitution of a minor toe or forefoot amputation for an otherwise inevitable below- or above-knee amputation. All effort is made to preserve as much extremity as possible so that the potential for rehabilitation is optimal. [Pg.271]

Unfortunately, there have been no randomized controlled studies to date that evaluate the efficacy of sympathectomy in treating advanced arterial occlusive disease. There have been several uncontrolled studies (51,54-57) that demonstrate relief of rest pain and healing of ischemic ulcers in 28 to 73 % of patients and acute limb salvage rates of 60 to 94%. The wide range of these results and lack of a randomized and controlled setting brings into question the effect of placebo as well concomitant medical therapies and conditions. [Pg.278]

In treating limb-threatening ischemia, sympathectomy has a limited role because arterial construction is more reliable and yields a far greater chance of limb salvage. Patients who are candidates for sympathectomy are truly nonreconstructible and have at least some inflow (as manifested by an ankle-brachial index greater than 0.30), no evidence of neuropathy, and limited tissue loss. Response to preoperative chemical sympathetic blockade may predict success for operative sympathectomy. In carefully selected patients, sympathectomy may provide the small increase in limb perfusion needed to tip the scales in the direction of ulcer healing and resolution of rest pain. [Pg.278]

PGE therapy in peripheral vascular disease. Carlson and Eriksson [292] reported in 1973 that femoral arterial infusions of very low doses of PGEi in patients with severe ischaemic peripheral vascular disease was effective in alleviating rest pain and gangrene. More recently Carlson and Olsson have shown that low intravenous doses are also effective [293] and also femoral arterial infusions in patients with verified arterial obstructions produce a dose-related increase in blood flow through the calf of the infused leg [294]. These results suggest that PGEi infusion will soon be available for the non-surgical treatment of such diseases. [Pg.411]

RED FLAG If a patient develops chest pain, take immedi-ate measures to decrease cardiac workload and increase oxygen supply to the myocardiam. These measures include rest, pain relief, and supplemental oxygen. [Pg.240]


See other pages where Rest pain is mentioned: [Pg.402]    [Pg.430]    [Pg.454]    [Pg.457]    [Pg.267]    [Pg.267]    [Pg.269]    [Pg.454]    [Pg.23]    [Pg.23]    [Pg.114]    [Pg.117]    [Pg.133]    [Pg.134]    [Pg.135]    [Pg.137]    [Pg.411]    [Pg.27]    [Pg.120]    [Pg.10]    [Pg.11]    [Pg.29]    [Pg.232]    [Pg.279]    [Pg.176]    [Pg.180]    [Pg.180]    [Pg.44]   


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