Rapid Pain Reduction Research Articles

TOPICAL TREATMENT OF ACUTE SPRAINS

SUMMARY In a randomised, placebo‐controlled, double‐blind study with parallel group comparison, the efficacy and tolerability of topical treatment with a mucopolysaccharide polysulphate/salicylic acid cream was investigated in 156 patients with acute sprains of the knee or ankle joint. There was a more rapid reduction in pain on movement (the main parameter) in the active drug group compared with the placebo group. On day 9 after randomisation the difference was highly significant. There were no adverse events in the active drug group.

Zur Therapie von Herpes-simplex- und Varicella-zoster-Infektionen im HNO-Bereich*,**

The article reports on 41 patients having infections induced by Herpes simplex and Herpes zoster virus. Systemic intravenous administration of acyclovir results in a very rapid reduction of pain and mucosal changes in herpetic stomatitis. In cutaneous lesions of the trigeminal nerve branches induced by Herpes zoster virus there is also a very rapid reduction of pain and efflurescence after 3 days. In 16 patients suffering from Ramsay Hunt syndrome, also known as Herpes zoster oticus, lesions of the facial nerve function were present. 8 Patients demonstrated cochleovestibular signs and symptoms, 2 had flat inner ear hearing loss of 40 dB, 1 reduced unilateral caloric response. Treatment was effected by intravenous administration of acyclovir and simultaneous classical symptomatic therapy consisting of intravenously administered dextrane, cortisone and antiinflammatory drugs. Symptomatic therapy is necessary because acyclovir stops the replication of viruses but does not influence the disturbed nerve function. In 2 cases with a damage of more than 90% of the facial nerve fibres, endaural decompression of the geniculate ganglion was performed. Cochleovestibular deficits improved to normal during one week and all facial lesions within 8 months. Drug-related side effects were seen in one patient who had an exanthema.

Traitement de l’aphtose par la thalidomide et la colchicine

Thalidomide alone (200-300 mg daily) or associated with colchicine (2-3 mg daily) was given orally to 25 patients with aphthosis: 8 patients with recurrent oral aphthae; 4 patients with recurrent mucocutaneous aphthosis, without visceral involvement, and 13 patients with Behçet's disease (Touraine's aphthosis). A major improvement was noted in all groups, with a rapid healing of mucous lesions and a rapid reduction of pain and burning as compared to prior spontaneous regressions. No new outbreaks were noted at a dose of 50-100 mg thalidomide and 1 mg colchicine daily. Under oral administration of the drugs, thrombophlebitis was noted in 1 case (third group) only. In the other patients with Behçet's disease, skin aphthae, ocular symptoms, arthritis, superficial nodular phlebitis quickly disappeared with treatment. The efficiency of the drugs is only temporary, since new lesions usually appeared a few weeks after the end of treatment. Due to the relatively small number of cases studied in each group, no conclusions can be drawn concerning the efficiency of thalidomide alone compared to the association of the two drugs. However, this open trial does support the usefulness of thalidomide, or thalidomide and colchicine, in recurrent mucocutaneous aphthae, aphthosis and Behçet's disease.

CONSERVATIVE TREATMENT AND THERAPEUTIC TEST FOR ENDOMETRIOSIS BY ANDROGENS

F ROM observations beginning in 1942,l we can state that androgen will not cure “external” endometriosis, exerts relatively little regressive effect upon hard infiltrates or fused masses as compared to cystic endometriomas, and, apart from the menopausal period, has but temporary action. Also, it may induce arrhenomimetic symptoms, which are always objectionable, possibly serious and permanent,* but, except from heavy prolonged dosage, are not inevitable and may be mild. Notwithstanding the above, aside from relation to endometriosis, androgen has both negative and positive values. Unlike estrogen, it is neither experimentally3 nor clinically fibromatogenic or carcinomatogenic,3al 4 but rather antigenie in these respects, particularly versus inception of mammary cancer.5 It has positive value in spasmodic dysmenorrhea and mastalgia, less value in premenstrual tension6 and “functional uterine bleeding,‘” although not comparable to estrogen*’ 8 for the latter condition. Androgen also exhibits a “tonic” effect approaching euphoria notably at the menopause, when other favorable action may be prominent.a* lo In relation to endometriosis, androgen has also both negative and positive values. Unlike estrogen, it will not reactivate the disease after the menopause,llT I2 and, according to two of our cases, will not cause regression of cystic ovaries associated with peri-oophoritis and excessive bleeding. Although androgen has been used for acute pelvic inflammatory disease to suppress menstruation, we have not seen regression of inflammatory residues, and therefore suggest the last two negative observations as diagnostic possibilities. The positive values of androgen, particularly in rapid reduction of pain, tenderness, and swelling of grossly cystic ovarian endometriomas, will be described in 19 brief case reports under diagnostic, therapeutic, preoperative, and postoperative headings, not including a larger number of early nodular cul-de-sac endometriosis with minor symptoms. Contrary to original intention, only inconclusive haphazard endometrial biopsies and vaginal smears were obtained and no hormonal assays13v I4 so that nothing new can be presented as to etiology of the disease or biologic action of androgen. However, the rapidity of effect suggests a direct antagonism of androgen versus estrogen, in addition to known reduction of urinary gonado. tropic hormone excretion, as indicated in two previous reports.‘1 I5 We have had no experience with the sterol desoxycorticosterone acetate, and no conclusive effect with progestin, each of which should theoretically

Conservative treatment and therapeutic test for endometriosis by androgens

F ROM observations beginning in 1942,l we can state that androgen will not cure “external” endometriosis, exerts relatively little regressive effect upon hard infiltrates or fused masses as compared to cystic endometriomas, and, apart from the menopausal period, has but temporary action. Also, it may induce arrhenomimetic symptoms, which are always objectionable, possibly serious and permanent,* but, except from heavy prolonged dosage, are not inevitable and may be mild. Notwithstanding the above, aside from relation to endometriosis, androgen has both negative and positive values. Unlike estrogen, it is neither experimentally3 nor clinically fibromatogenic or carcinomatogenic,3al 4 but rather antigenie in these respects, particularly versus inception of mammary cancer.5 It has positive value in spasmodic dysmenorrhea and mastalgia, less value in premenstrual tension6 and “functional uterine bleeding,‘” although not comparable to estrogen*’ 8 for the latter condition. Androgen also exhibits a “tonic” effect approaching euphoria notably at the menopause, when other favorable action may be prominent.a* lo In relation to endometriosis, androgen has also both negative and positive values. Unlike estrogen, it will not reactivate the disease after the menopause,llT I2 and, according to two of our cases, will not cause regression of cystic ovaries associated with peri-oophoritis and excessive bleeding. Although androgen has been used for acute pelvic inflammatory disease to suppress menstruation, we have not seen regression of inflammatory residues, and therefore suggest the last two negative observations as diagnostic possibilities. The positive values of androgen, particularly in rapid reduction of pain, tenderness, and swelling of grossly cystic ovarian endometriomas, will be described in 19 brief case reports under diagnostic, therapeutic, preoperative, and postoperative headings, not including a larger number of early nodular cul-de-sac endometriosis with minor symptoms. Contrary to original intention, only inconclusive haphazard endometrial biopsies and vaginal smears were obtained and no hormonal assays13v I4 so that nothing new can be presented as to etiology of the disease or biologic action of androgen. However, the rapidity of effect suggests a direct antagonism of androgen versus estrogen, in addition to known reduction of urinary gonado. tropic hormone excretion, as indicated in two previous reports.‘1 I5 We have had no experience with the sterol desoxycorticosterone acetate, and no conclusive effect with progestin, each of which should theoretically