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Unpleasant Sensation (unpleasant + sensation)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Pathophysiology and therapy of pruritus in allergic and atopic diseases

ALLERGY, Issue 7 2010
J. Buddenkotte
To cite this article: Buddenkotte J, Steinhoff M. Pathophysiology and therapy of pruritus in allergic and atopic diseases. Allergy 2010; 65: 805,821. Abstract Pruritus (itch) is a major characteristic and one of the most debiliating symptoms in allergic and atopic diseases and the diagnostic hallmark of atopic dermatitis. Pruritus is regularly defined as an unpleasant sensation provoking the desire to scratch. Although we achieved rather good knowledge about certain inducers of itch such as neuropeptides, amines, ,-opioids, cytokines and proteases, for example, less is known about the pathophysiological specifities among the different diseases, and the therapeutic consequences which may derive thereoff. This review dissects the role of mediators, receptors and itch inhibitors on peripheral nerve endings, dorsal root ganglia, the spinal cord and the CNS leading to the amplification or , vice versa , suppression of pruritus. As the treatment of pruritus in allergic and atopic skin disease is still not satisfactory, knowing these pathways and mechanisms may lead to novel therapeutic approaches against this frequently encountered skin symptom. [source]

Assessment of postoperative nausea using a visual analogue scale

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2000
J. G. Boogaerts
Background: Assessment of postoperative nausea intensity is difficult because nausea is a subjective and unpleasant sensation. We propose using the Visual Analogue Scale (VAS) device to increase the efficiency and precision in the assessment of nausea. We carried out a pilot study on postoperative patients suffering from nausea to measure the degree of agreement between the VAS scores and those given on a 4-point verbal descriptive scale (VDS). Methods: Postoperative nausea was evaluated by means of a classical VAS (0,10 cm) device and a 4-point VDS (0=no nausea, 1=mild, 2=moderate, 3=severe) in 128 surgical spontaneously complaining patients. Evaluation was repeated 45 min after rescue medication given if nausea was intractable, lasted more than 10 min or at the request of the patient. Ordinal logistic regression was used to measure the association between VAS and VDS and to determine cut-off points on the VAS. Results: The VAS device was easily understood and used by patients. VAS scores decreased significantly from 5.5±2.3 to 1.4±1.8 after rescue medication (P=0.002). Application of ordinal logistic regression to pre- and post-medication data combined yielded an agreement of 86% between VAS and VDS and the cut-off points on the VAS were estimated as follows: 0,1 (no nausea), 1+,4 (mild), 4+,7 (moderate) and 7+,10 (severe). Conclusion: The VAS method proved to be useful for assessing quantitative nausea intensity and for testing the efficacy of rescue medication. It was found that a cut-off value of 4 on the VAS may be considered as a critical threshold triggering anaesthesiologists or nurses to administer rescue medication. [source]

Adjuvant topical therapy with a cannabinoid receptor agonist in facial postherpetic neuralgia

JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 2 2010
Ngoc Quan Phan
Summary Background: Postherpetic neuralgia is a frequent adverse event in herpes zoster patients and difficult to treat. Conventional analgetic therapy often fails to reduce the burning pain transmitted by unmyelinated nerve fibers. These nerves express cannabinoid receptors which exert a role in modulation of nociceptive symptoms. Therefore, topical therapy with cannabinoid receptor agonist seems likely to suppress local burning pain. Patients and methods: In an open-labeled trial, 8 patients with facial postherpetic neuralgia received a cream containing the cannabinoid receptor agonist N-palmitoylethanolamine. The course of symptoms was scored with the visual analog scale. Results: 5 of 8 patients (62.5 %) experienced a mean pain reduction of 87.8 %. Therapy was tolerated by all patients. No unpleasant sensations or adverse events occurred. Conclusions: Topical cannabinoid receptor agonists are an effective and well-tolerated adjuvant therapy option in postherpetic neuralgia. [source]

The neurophysiology of dyspnea

JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 6 2008
Matthew Scott Mellema DVM
Abstract Objective , To review the human and veterinary literature regarding the neurophysiology of dyspnea and to provide evidence for the beneficial effects of several novel therapies aimed at the alleviation of dyspneic sensations. Data Sources , Data sources included scientific reviews, case reports, original research publications, and recent research conference proceedings. Human Data Synthesis , The use of blood oxygenation level-dependent functional magnetic resonance imaging technology has revealed that the brain regions activated by air hunger in humans are also those activated by fear, pain, and thirst perception. In human subjects, it has been found that agents known to enhance the firing of pulmonary slowly adapting receptors (SARs) can alleviate the sensation of dyspnea without altering central respiratory drive. Several small studies have also shown that nebulized opioids can reduce the sensation of dyspnea apparently via activation of peripheral opioid receptors in the lung. Veterinary Data Synthesis , There are several animal models relevant to both small and large animal clinical patient populations. Treatment of rats with a nebulized SAR sensitizing agent (furosemide) enhances SAR firing in response to lung inflation. Behavioral escape responses to airway occlusion are reduced in lightly anesthetized cats when treated with nebulized furosemide. Opioid agonists have been shown to inhibit the release of acetylcholine and other mediators from the airways of dogs and guinea pigs. Studies using a goat model with bilateral destruction of the pre-Bötzinger Complex do not support current paradigms of air hunger origination. Conclusions , Veterinary patients may benefit from an approach to dyspnea that incorporates an understanding of the origins of the unpleasant sensations associated with the condition. Several novel therapies have shown promise in alleviating dyspneic sensations without altering respiratory drive. Further study is needed to determine the safety and efficacy of these therapies in veterinary patients. [source]