bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased sodium channel SNS/PN3 immunoreactivity in a causalgic finger
Authors: Shembalkar Prafulla K. , Till Silke , Boettger Michael K. , Terenghi Giorgio , Tate Simon , Bountra Chas , Anand Praveen
Published: September 2002

The sodium channels SNS/PN3 and NaN/SNS2 are regulated by the neurotrophic factors—nerve growth factor (NGF) and glial‐derived neurotrophic factor (GDNF), and may play an important role in the development of pain after nerve injury or inflammation. These key molecules have been studied in an amputated causalgic finger and control tissues by immunohistochemistry. There was a marked increase in the number and intensity of SNS/PN3‐immunoreactive nerve terminals in the affected finger, while GDNF‐immunoreactivity was not observed, in contrast to controls. No differences were observed for NGF, trk A, NT‐3 or NaN/SNS2‐immunoreactivity. While further studies are required, these findings suggest that accumulation of SNS/PN3 and/or loss of GDNF may contribute to pain in causalgia, and that selective blockers of SNS/PN3 and/or rhGDNF may provide effective novel treatments.
Characterization of secondary hyperalgesia produced by topical capsaicin jelly—a new experimental tool for pain research
Authors: Harding Louise M. , Murphy Anthony , Kinnman Erik , Baranowski Andrew P.
Published: September 2002

Peripheral administration of the nociceptive agent capsaicin is used as an experimental tool to study neurophysiological and pharmacological aspects of the generation and control of pain. When investigating secondary hyperalgesia phenomena, current topical and intradermal capsaicin delivery methods have two key limitations. Intradermal injection can evoke severe chemogenic pain and both delivery methods produce an unstable area of dynamic mechanical allodynia. We present validity studies of a new preparation for capsaicin delivery that overcomes these limitations. The novel capsaicin formulation consists of a water‐based semisolid jelly preparation containing 1% capsaicin which is applied topically under adhesive‐free occlusion to a small area of the skin. We demonstrate that in healthy human subjects this model evokes areas of flare, punctate hyperalgesia and mechanical allodynia which are equivalent to established models and that these areas are stable over time and reproducible on repeat experiments. The jelly formulation evokes only minimal chemogenic pain and, as the preparation remains in situ throughout the study providing constant capsaicin exposure, a stable area of dynamic mechanical allodynia is produced. These validation studies show that this novel capsaicin administration method is a practical, reliable and viable tool for investigating experimental secondary hyperalgesia.
Evaluation of effect of 3D video glasses on perceived pain and unpleasantness induced by restorative dental treatment
Authors: Bentsen BO , Svensson Peter , Wenzel Ann
Published: September 2002

Previous studies on modulation of anxiety, pain and unpleasantness have documented a positive effect of video glasses (I‐Glasses™, Virtual i‐O™, Seattle, USA) on the perceived pain and unpleasantness under different laboratory and clinical conditions. The aim of this study was to evaluate whether distraction induced by video glasses also had an effect on the perceived intensity of pain and unpleasantness during dental treatment. Pain and unpleasantness was evoked by the preparation (drilling) of a minor dental cavity (class I). Twenty‐three patients (17 female and six male, age range 20–49 years) with a need for an occlusal dental restoration in two homologous teeth participated in the study. In this split‐mouth design, the patient received the dental treatment wearing 3D video glasses and without video glasses (control situation) in a randomized order. The tooth cavities were prepared in accordance with conventional techniques after mounting the video glasses. The patient rated the intensity of pain and unpleasantness on 100 mm visual analogue scales (VASs) after preparation of the first cavity; immediately after, the opposite tooth was prepared and again the volunteer rated the intensity of pain and unpleasantness. The cavities were then filled using a routine composite technique. Eventually, the patient indicated whether she would prefer video glasses or not if she were to have another filling and what the expectations of the effect had been. Differences in VAS ratings in the video and control situation were tested by Student's t ‐test. There was no statistically significant effect on the perceived pain (p=0.90) or unpleasantness (p=0.39), but the majority (74%) of the patients would still prefer to wear video glasses if they were to have another dental filling, and 73% had expected a positive effect of the video glasses. These findings suggest that perceived intensity of dental pain is resistant to a simple distraction technique.
A review of statistical methods for analysing pain measurements
Authors: Akhtar‐Danesh Noori
Published: September 2002

In this article the usual methods of analysis of postoperative pain data, measured by a visual analogue scale at several time points, have been studied. These methods are mostly inappropriate or inefficient. Some better methods are discussed and the antedependence test is suggested as a suitable method. With this method, differences between overall profiles and at each time point are detectable and the method can be used efficiently even if some observations are missing.
Phantom limb pain: a report of two cases
Authors: Töpfner Stephanie , Wiech Katja , Kiefer Ralph‐Thomas , Unertl Klaus , Birbaumer Niels
Published: September 2002

The efficacy of pre‐emptive analgesia for phantom limb pain is still unclear. It is generally accepted that pre hyphen;amputation pain increases the incidence of phantom and stump pain, even if pre‐emptive analgesia is performed before and during surgery and in the postoperative period. Two cases of traumatic upper limb amputations are described here with no pre‐existing pain. Both received similar antinociceptive treatment by continuous block of the brachial plexus through infusion of ropivacaine 0.375% at 5 ml/h for 10 days. Treatment of case 1 was initiated immediately after surgery; however, this amputee developed intensive phantom limb pain which persisted at 6 months. Early use of the prosthesis after surgery was not possible for this patient. The intensity of phantom limb pain in case 2 decreased significantly after 6 months, even though brachial plexus blockade was not started until 5 weeks post‐trauma. This patient used a functional prosthesis intensively beginning early after amputation. Serial magnetoencephalographic recordings were performed in both patients. Only case 2 showed significant changes of cortical reorganization. In case 1 markedly less cortical plasticity was found. A combination of relevant risk factors such as a painful neuroma, behavioural and cognitive coping strategies and the early functional use of prostheses are discussed as important mechanisms contributing to the development of phantom pain and cortical reorganization.
Venlafaxine in neuropathic pain following treatment of breast cancer
Authors: Tasmuth Tiina , Härtel Brita , Kalso Eija
Published: September 2002

Amitriptyline effectively relieves neuropathic pain following treatment of breast cancer. However, adverse effects are a major problem. Venlafaxine has no anticholinergic effects and could have a better compliance. The aim of the study was to evaluate the effectiveness of venlafaxine in neuropathic pain. The study was a randomized, double‐blind, crossover comparison of venlafaxine and inactive placebo. The study lasted 10 weeks. The number of tablets (18.75 mg) taken daily was increased by one at a 1 week interval. Pain intensity and pain relief were registered daily by a diary and by a questionnaire and a computer program (Painscreen™) on each visit. Adverse effects were evaluated with the diaries and a 10‐item list on each visit. Also, anxiety and depression were measured on each visit. Venous blood samples were collected before the treatment and at 4 weeks for the determination of the serum levels of venlafaxine and its three metabolites. Thirteen patients were analysed. The average daily pain intensity as reported in the diary (primary outcome) was not significantly reduced by venlafaxine compared with placebo. However, the average pain relief (diary) and the maximum pain intensity (retrospective assessment by the computer program) were significantly lower with venlafaxine compared with placebo. Anxiety and depression were not affected. Adverse effects did not show significant differences between treatments. The two poor responders had low venlafaxine concentrations whereas the two slow hydroxylizers had high venlafaxine concentrations and excellent pain relief. Thus, higher doses could be used in order to improve pain relief. © 2002 European Federation of Chapters of the International Association for the Study of Pain
Subcutaneous formalin and intraplantar carrageenan increase nitric oxide release as measured by in vivo voltammetry in the spinal cord
Authors: Rivot J.‐P. , Montagne‐Clavel J. , Besson J.‐M.
Published: September 2002

The paper describes in vivo voltammetric detection of nitric oxide with carbon fibre microelectrodes at the lumbar spinal dorsal horn level of decerebrated‐spinalized rats during peripheral noxious inflammatory processes. At the lumbar (L3‐L4) dorsal horn level, a nitric oxide dependent peak of oxidation current (650 mV), remaining stable for up to 4 h ((92 ± 5)% of control) could be detected indicating that significant amounts of nitric oxide are produced continuously. Following subcutaneous injection in the hindpaw of 50 μl of 0.5% formalin the oxidation current rapidly increased ((115 ± 5)% of control at 25 min) and reached (120 ± 6)% of control 1 h later. Subsequently the voltammograms stabilized for up to 90 min and decreased ((107 ± 4)% at 124 min). After an injection in the hindpaw of 150 μl of 4% carrageenan, the voltammograms remained at control level for 1 h and then the oxidation current increased continuously for up to 4 h ((145 ± 16)% of control at 240 min); such an increase was reversed by ketamine. In these two models of inflammation, the delay in onset and the duration of the increases in NO release within the dorsal horn relate, to some extent, to the time course of the peripheral inflammatory processes, since they are shorter after formalin than after carrageenan. The results provide a direct in vivo demonstration that the intercellular messenger nitric oxide participates in the transmission of noxious afferent messages within the dorsal horn of the spinal cord following peripheral inflammation. © 2002 European Federation of Chapters of the International Association for the Study of Pain
Trends in the pharmacology of opioids: implications for the pharmacotherapy of pain
Authors: Mather Laurence E.
Published: September 2002

Some 25 years ago, it was popular to write a figurative equation for drug treatment:Patient + drug→effect. Clearly, this was too simplistic for the reliable pharmacotherapy of pain. The ‘patient’ with pain is a complex individual and the ‘drug’ is not the same in effect to every patient, regardless of being an opioid analgesic. Besides, the ‘effect’ needs specification: it really means an acceptable balance between therapeutic and side‐effect—to that patient. These days, neural plasticity and neuromodulation associated with nociception are well‐known. Psychological involvement in the physical domain of nociception is similarly well‐known. Given these complexities, it is surprising that the pharmacological control of pain through the application of relatively simple analgesics can be so effective. Opioid analgesics have been administered by every possible route. Because the degree of invasion of the patient differs between routes, the balance between simplicity, aesthetic appeal, and efficacy of the various routes needs to be considered. The effectiveness of opioid analgesics depends in large measure on the application of the right agent, in the right dose, by the right route, at the right time for that patient. To assist in this task, researchers have produced patient‐controlled analgesia and ‘pharmacologically engineered’ analgetic molecules to achieve receptor selectivity and pharmacokinetic predictability. Also, much relevant data concerning the time courses of analgetic drug (± metabolite) concentrations in the body and in the ways in which these properties are modified by different normal and pathophysiological variations have been gathered, and the philosophy of ‘opioid rotation’ has arisen to maintain therapeutic benefits when tolerance or metabolite‐induced side‐effects prevail. This essay discusses some of the trends in opioid pharmacotherapy over the past 25 years.
Use of morphine and adjuvant drugs according to the condition
Authors: Matoba Motohiro
Published: September 2002

Adjuvant drugs are used to enhance effects of analgesics and morphine‐resistant pain such as neuropathic pain. If morphine provides inadequate pain relief and evokes drowsiness, morphine is usually ineffective. The key is the patient's reaction to morphine. When a patient's pain includes neuropathic pain, a combination of morphine and non‐steroidal anti‐inflammatory drugs is partially effective, but morphine‐resistant pain remains. Increasing morphine dosage causes drowsiness without pain improvement. Appropriate adjuvant drugs are necessary in these conditions.
Mechanism of opioid dependence and interaction between opioid receptors
Authors: Suzuki Tsutomu , Kishimoto Yayoi , Ozaki Satoru , Narita Minoru
Published: September 2002

Clinical studies have demonstrated that when opiates are used to control cancer pain, psychological dependence and analgesic tolerance are not a major concern. The present study was, therefore, designed to investigate the modulation of rewarding effects of opiates under inflammatory chronic pain. Formalin or carrageenan was injected into the plantar surface of the rat paw. Formalin and carrageenan reduced the paw pressure threshold. The hyperalgesia lasted for 9–13 days. The rewarding effect of morphine was evaluated by conditioned place preference paradigm. Morphine produced a significant place preference. This effect was significantly attenuated in inflamed groups compared with the respective non‐inflamed groups. Furthermore, the morphine‐induced place preference in the inflamed group gradually recovered to the respective control level as the inflammation healed. We also found that κ‐receptor agonists markedly inhibited the rewarding effect of μ‐receptor agonists. Therefore, to elucidate the mechanism of this attenuation, the effects of pretreatment with κ‐ and δ‐receptor antagonists, nor‐binaltorphimine (nor‐BNI) and naltrindole (NTI), on the development of the morphine‐induced place preference under inflammation were examined. Nor‐BNI, but not NTI, eliminated the suppression of the morphine‐induced place preference in inflamed groups. The morphine‐induced increase in dopamine (DA) turnover in the limbic forebrain was suppressed under inflammation, and the suppression was abolished by the pretreatment with nor‐BNI. These results suggest that endogenous κ‐opioid systems may be activated by chronic inflammatory nociception, and then the activation of κ‐opioid system may inhibit DA release in nucleus accumbens, resulting in the suppression of the development of rewarding effects produced by morphine.
Current status of pain management in China: an overview
Authors: Huang Yuguang
Published: September 2002

China is a large country with a huge population.

It is estimated that 1.8 million patients suffer initially from cancer and 1.4 million patients die from it each year in Mainland China. Cancer ranks as the primary reason for death among the common diseases in cities and the second in rural areas.

The management of pain is still a critical issue in the care of patients both with cancer and non‐cancer pain. A national survey suggested that the fear of addicting patients was still a major barrier for medical professionals in prescribing opioid analgesics. The major reasons for poor management or negative factors of pain relief came from patients' own reasons including their over‐concern about addiction to opioid analgesics, their reluctance to report pain and their resistance to use opioid analgesics. Oral long‐acting opioids are the most commonly used drugs for third ladder pain management. With policy support from the government, the consumption of morphine for medical purposes has increased significantly for the first time in recent Chinese history as this new cancer pain relief policy has been developed in the country. As a result, the three‐step analgesic ladder of the World Health Organization (WHO) has been gradually accepted by medical personnel and patients.

Although pain management has been improved since the WHO's strategy of the three‐step approach was implemented in China, variations still exist in different regions of the Mainland. Currently the three main aspects of work on pain measurement are going to be undertaken including (1) continuous support from government policy; (2) consistent education and training; and (3) better availability of drugs for medical use throughout the whole country.
Morphine responsiveness in a group of well‐defined multiple sclerosis patients: A study with i.v. morphine
Authors: Kaiman Sigga , Österberg Anders , Sörensen Jan , Boivie Jörgen , Bertler Åke
Published: September 2002

Pain in multiple sclerosis (MS) is more common than has previously been believed. About 28% of all MS patients suffer from central pain (CP), a pain that is difficult to treat. In the present study we have investigated the responsiveness of this pain to morphine. Fourteen opioid‐free patients (eight woman and six men) with constant, non‐fluctuating, long‐lasting CP caused by MS were investigated. Placebo (normal saline), morphine and naloxone were given intravenously in a standardized manner. The study design was non‐randomized, single blind and placebo controlled. Ten patients experienced less than 50% pain reduction by placebo and less than 50% pain reduction by morphine. Four patients were opioid responders, i.e. had minimal or no effect on pain by placebo, >50% pain reduction after morphine and >25% pain increase after naloxone, given intravenously following morphine. However, this response was obtained after high doses of morphine (43 mg, 47 mg, 50 mg and 25 mg; mean 41 mg). Thus, compared with nociceptive pain, only a minority of the patients with CP due to MS responded to morphine and only at high doses. The present results are in accord with experimental studies indicating that neuropathic pain is poorly responsive but not totally unresponsive to opioids. The results do not support the routine use of strong opioids in MS patients with CP. © 2002 European Federation of Chapters of the International Association for the Study of Pain
Prevalence of pain in the Spanish population telephone survey in 5000 homes
Authors: Català E. , Reig E. , Artés M. , Aliaga L. , López J. S. , Segú J. L.
Published: September 2002

Pain has become the most common accompanying symptom in patients seeking medical advice, and it is one of the main issues in public health. In Spain, there are no reliable data about the impact of pain in general population. The aim of the study was to estimate the prevalence of acute and chronic pain in the Spanish general population. An epidemiological observational population‐based cross‐sectional study was carried out by means of a telephone survey. Multistep stratified quota‐adjusted sampling was performed with people aged 18–95 years. A computer‐assisted questionnaire was administered, covering physical pain symptoms, site, frequency, perceived cause, therapeutic measures and interference with daily life activities. There were 11980 useful contacts, with 5000 effective interviews (42% of useful sample). Of the interviewees, 29.6% (95% confidence interval, 28.3–30.8%) reported having had pain the day before (women, 37.6%; men, 20.9%) and 43.2% the week before. Most common pain sites were lower extremities (22.7%) and back (cervical and lumbar levels) (21.5%), followed by head (20.5%). Frequency of pain increased with age, reaching 42.6% for people older than 65 years. Among people complaining of pain during the last day or week, duration of symptoms was higher than 3 months in 54% (chronic pain), representing 23.4% of the Spanish general population; most common causes of chronic pain were arthritis, rheumatism and migraine. Regarding treatment, 61.7% of people complaining of pain said they were taking drugs. Source of drug treatment advice was a physician or a nurse in 66.4% of cases and self‐prescription in 29%. It is concluded that pain, particularly chronic pain, has a high prevalence in the Spanish general population and a significant impact on occupational and social relationships. ©2002 European Federation of Chapters of the International Association for the Study of Pain
Anticonvulsants in neuropathic pain: rationale and clinical evidence
Authors: Jensen Troels S.
Published: September 2002

Neuropathic pain, whether of peripheral or central origin, is characterized by a neuronal hyperexcitability in damaged areas of the nervous system. In peripheral neuropathic pain, damaged nerve endings exhibit abnormal spontaneous and increased evoked activity, partly due to an increased and novel expression of sodium channels. In central pain, although not explored in detail, the spontaneous pain and evoked allodynia are also best explained by a neuronal hyperexcitability. The peripheral hyperexcitability is due to a series of molecular changes at the level of the peripheral nociceptor, in dorsal root ganglia, in the dorsal horn of the spinal cord, and in the brain. These changes include abnormal expression of sodium channels, increased activity at glutamate receptor sites, changes in γ‐aminobutyric acid (GABA‐ergic) inhibition, and an alteration of calcium influx into cells. The neuronal hyperexcitability and corresponding molecular changes in neuropathic pain have many features in common with the cellular changes in certain forms of epilepsy. This has led to the use of anticonvulsant drugs for the treatment of neuropathic pain.

Carbamazepine and phenytoin were the first anticonvulsants to be used in controlled clinical trials. Studies have shown these agents to relieve painful diabetic neuropathy and paroxysmal attacks in trigeminal neuralgia.

Subsequent studies have shown the anticonvulsant gabapentin to be effective in painful diabetic neuropathy, mixed neuropathies, and postherpetic neuralgia. Lamotrigine, a new anticonvulsant, is effective in trigeminal neuralgia, painful peripheral neuropathy, and post‐stroke pain. Other anticonvulsants, both new and old, are currently undergoing controlled clinical testing. The most common adverse effects of anticonvulsants are sedation and cerebellar symptoms (nystagmus, tremor and incoordination). Less common side‐effects include haematological changes and cardiac arrhythmia with phenytoin and carbamazepine. The introduction of a mechanism‐based classification of neuropathic pain, together with new anticonvulsants with a more specific pharmacological action, may lead to more rational treatment for the individual patient with neuropathic pain. © 2002 European Federation of Chapters of the International Association for the Study of Pain
Pain‐related fear in acute low back pain: the first two weeks of a new episode
Authors: Sieben Judith M. , Vlaeyen Johan W. S. , Tuerlinckx Sandrine , Portegijs Piet J. M.
Published: September 2002

The overall aim of this study was to explore the natural course of pain‐related fear during the early stage of a new low back pain episode, using a prospective case series design. Specific research questions addressed the existence of typical patterns in individual time series of pain‐related fear and sequential relationships between the occurrence of pain‐related fear, pain and pain catastrophizing. Forty‐four general practice patients who consulted their physician with a new episode of non‐specific low back pain were recruited. They completed diaries on pain‐related fear, pain and pain catastrophizing for 14 days following the consultation. Follow‐up questionnaires on disability were completed at 3 months and 12 months. Time series analyses produced subgroups of patients with descending, stable and rising levels of pain‐related fear over the 2‐week period. These groups differed on baseline characteristics and outcome at follow‐up. A time‐shift between the occurrence of pain‐events and pain‐related fear or pain catastrophizing could not be demonstrated.

In summary, these results fit in with previous findings in chronic patients. A relevant subgroup of patients who might benefit from early intervention could be identified. These findings support the need for further research into fear mechanisms in acute low back pain. © 2002 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Science Ltd. All rights reserved.
Immune-Mediated Haemolytic Anaemia in Two Sibling Cats Associated with Multicentric Lymphoblastic Infiltration
Authors: Gunn-Moore D A , Day M J , Graham M E A , Cue S M , Harbour D A
Published: September 2002

Immune-mediated haemolytic anaemia associated with multicentric lymphoblastic infiltration is reported in two sibling cats. Both cats presented at under 16 months of age with clinical signs of acute anaemia. In each case there was autoagglutination, a positive Coombs’ test and the anaemia was regenerative. At presentation, both cats were negative for FeLV antigen. In each case, the disease proved fatal within 2 months of the initial diagnosis. In both cases, T-lymphoblastic infiltration of bone marrow, liver and spleen was found at post-mortem examination.
A Case of Feline Primary Hypoadrenocorticism
Authors: Tasker S , MacKay A D , Sparkes A H
Published: September 2002

A 2-year-old entire female British Shorthair cat was referred to the University of Bristol for investigation of lethargy, weakness, constipation and hypothermia. Clinical examination revealed a profoundly weak, hypovolaemic and hypothermic cat. Serum biochemistry revealed hyponatraemia, hyperkalaemia and hyperphosphataemia and the urine was isosthenuric. Lack of response to exogenous adrenocorticotrophic hormone confirmed a diagnosis of hypoadrenocorticism. Treatment consisted initially of intravenous fluid therapy and subsequently a combination of fludrocortisone and prednisolone per os. At follow-up, 20 months after the initial diagnosis the cat remained stable and free of clinical signs.
Feline Distal Aortic Thromboembolism: A Review of 44 Cases (1990–1998)
Authors: Schoeman J P
Published: September 2002

The clinical case records of 44 cats with distal aortic thromboembolism were reviewed. These detailed 49 separate episodes of thromboembolism. Of the 44 cats, 33 (75%) were neutered males, and 43 (98%) were domestic shorthairs. The mean age was 8.7 years (age range 2–16 years). Evidence of pre-existing heart disease had been noted in 23% of cases. Heart failure was a concurrent diagnosis in 51% of episodes and 36% of these cases survived their thromboembolic episodes. Overall, cats survived 39% of the episodes. Cats died during 28% of the episodes, while 33% of the episodes resulted in the cats being euthanased. The median survival time was 6 months. Seventeen per cent of cats on prophylactic aspirin therapy experienced an episode of re-embolisation. Forty-three per cent of episodes occurred in the spring.
Food Intake and Blood Glucose in Normal and Diabetic Cats Fed Ad Libitum
Authors: Martin G J W , Rand J S
Published: September 2002

Ten diabetic cats were studied at intervals for up to 12 months with twice-daily insulin injections. Ten clinically healthy cats were also studied. Diets fed were based on the individual cat's performance, using mainly commercial dry or canned cat foods and fresh meat. In most cases more than one food was offered. Food was given fresh twice daily, and the cats allowed to eat ad libitum.

The food intake and blood glucose were measured every 2 h in diabetic cats after insulin injection and in diabetic and normal cats without insulin injections. Food was quantified by the energy consumed (kJ ME), crude protein (g), crude fat (g), and carbohydrate (g). The blood glucose in 10 diabetic cats was measured for 2 h following a 20-min meal.

Both diabetic cats and normal cats showed similar patterns of eating, with a higher food intake in the 2 h after fresh food was placed. Both groups of cats ate multiple small meals spread through the day and night. There was little or no correlation between the blood glucose and the amount of food consumed over the previous 2-h period, in insulin- or non-insulin-treated diabetic cats, or in normal cats. An overnight fast did not significantly alter morning blood glucose in diabetic cats. No demonstrable appetite stimulation occurred following an occurrence of low blood glucose; however, recorded incidences were few. No post-prandial hyperglycaemia was seen in the 10 diabetic cats during a 2-h period following the ingestion of typical cat foods.
The Effect of Interday Variation and a Short-Term Stressor on Insulin Sensitivity in Clinically Normal Cats
Authors: Feldhahn J R , Rand J S , Kinnaird E
Published: September 2002

To determine whether there is a day-to-day variation in insulin sensitivity in cats, we subjected six clinically normal cats to four insulin-modified frequently sampled intravenous glucose tolerance tests (FSIVGTTs) over 7 days. The insulin-modified FSIVGTTs were analysed by the minimal model method. Minimal model insulin sensitivity (SI) averaged 2.9 ± 0.4 × 10−4 min−1/μU/ml (range 1.9–4.6 × 10−4 min−1/μU/ml), with a mean interday coefficient of variation (CV) of 35.4 ± 6.4% (range 12.8–58.5%). Glucose effectiveness (SG) averaged 0.029 ± 0.002 min−1 (range 0.024–0.037 min−1), and showed less interday variability with a mean CV of 24.7 ± 4.3% (range 7.9–39.3%). Insulin sensitivity was also measured after a short-term stressor (5-min spray bath) of sufficient magnitude to elevate blood glucose levels. The mean insulin sensitivity after the stressor was 3.6 ± 0.8 × 10−4 min−1/μU/ml (range 1.6–7.3 × 10−4 min−1/μU/ml), which was not significantly different to the mean insulin sensitivity before the short-term stressor ( P=0.237). The mean glucose effectiveness after the stressor was 0.046 ± 0.004 min−1 (range 0.032–0.057 min−1), which was significantly different from mean glucose effectiveness before the short-term stressor ( P=0.003). We conclude that insulin sensitivity is highly variable from day to day in normal cats, and that hyperglycaemia in response to short-term stressors is probably due to increased hepatic glucose production, rather than peripheral insulin resistance.
Infection of the Subcutis and Skin of Cats with Rapidly Growing Mycobacteria: A Review of Microbiological and Clinical Findings
Authors: Malik R , Wigney D I , Dawson D , Martin P , Hunt G B , Love D N
Published: September 2002

Mycobacteria were isolated and characterised from 49 cats with extensive infections of the subcutis and skin. Cats were generally between 3 and 10 years of age, and female cats were markedly over-represented. All isolates were rapid-growers and identified as either Mycobacteria smegmatis (40 strains) or M fortuitum (nine strains). On the basis of Etest for minimum inhibitory concentration and/or disc diffusion susceptibility testing, all strains of M smegmatis were susceptible to trimethoprim while all strains of M fortuitum were resistant. M smegmatis strains were typically susceptible to doxycycline, gentamicin and fluoroquinolones but not clarithromycin. All M fortuitum strains were susceptible to fluoroquinolones, and often also susceptible to gentamicin, doxycycline and clarithromycin. Generally, M smegmatis strains were more susceptible to antimicrobial agents than M fortuitum strains. Treatment of mycobacterial panniculitis involves long courses of antimicrobial agents, typically of 3–6 months, chosen on the basis of in vitro susceptibility testing and often combined with extensive surgical debridement and wound reconstruction. These therapies will result in effective cure of the disease. One or a combination of doxycycline, ciprofloxacin/enrofloxacin or clarithromycin are the drugs of choice for long-term oral therapy.
Gastric Helicobacters in Cats
Authors: Lecoindre P , Chevallier M , Peyrol S , Boude M , Ferrero R L , Labigne A
Published: September 2002

The types of helicobacter which are found in the stomachs of carnivorous pets, especially cats, have been traditionally referred to as ‘gastric helicobacter-like organisms’ (GHLOs). These are microaerophilic, Gram-negative, spiral bacteria with multiple terminal flagellae and are endowed with high-level urease activity which allows them to survive in an acidic environment. Certain species have one or more periplasmic fibrils. The two GHLOs most commonly found in cats are Helicobacter felis and a species related to H heilmannii which was recently cultured from dogs. All phenotypic and genotypic (16S RNA gene sequences) evidence suggests that both of these bacteria belong in the genus Helicobacter. Whether or not helicobacters can be transmitted to humans from carnivorous pets is controversial but the recent discovery of H pylori-infected cats may be evidence of an animal reservoir for this pathogen. Although the role of H pylori in inducing antral gastritis and perpetuating pyloric ulcers in humans is well established, whether or not Helicobacter spp are causally involved in any feline gastric inflammatory conditions is unknown.
A Study of Feline Upper Respiratory Tract Disease with Reference to Prevalence and Risk Factors for Infection with Feline Calicivirus and Feline Herpesvirus
Authors: Binns S H , Dawson S , Speakman A J , Cuevas L E , Hart C A , Gaskell C J , Morgan K L , Gaskell R M
Published: September 2002

A cross-sectional survey of a convenience sample of cats was carried out to determine the prevalence of and risk factors for respiratory tract disease, feline calicivirus (FCV) infection and feline herpesvirus (FHV) infection. Seven hundred and forty cats were studied; samples for isolation of FCV and FHV were obtained from 622 (84%). Data on individual cat and household variables were obtained by questionnaire for each cat and analysed using univariable and logistic regression analysis. Thirty-eight percent (282/740) of cats surveyed had respiratory tract disease. Eighteen of 24 predictor variables were found to be significantly ( P<0.05) associated with the presence of respiratory tract disease in a cat on univariable analysis. Following logistic regression, several factors retained significance including isolation of FCV and FHV, younger cats (4–11 months of age) and multiple cat households. A negative association was found with breeding catteries and other types of household in comparison with rescue catteries. Overall, feline calicivirus was isolated from 162/622 (26%) of cats sampled; 33% of the cats with respiratory tract disease were FCV positive compared to 21% of healthy cats. Variables significantly associated with FCV isolation on logistic regression were the presence of respiratory tract disease and contact with dogs with and without respiratory tract disease. Feline herpesvirus was isolated from 30/622 (5%) of all cats sampled; 11% of cats with respiratory tract disease were FHV positive compared to 1% of healthy cats. Variables significantly associated with FHV isolation on univariable analysis included age, gender, and the presence of respiratory tract disease. Vaccination showed a negative association. Logistic regression analysis of the data for FHV was limited by the sample size and the low prevalence of FHV.
Cerebral Cryptococcal Granuloma in a Cat
Authors: Foster S F , Charles J A , Parker G , Krockenberger M , Churcher R M , Malik R
Published: September 2002

A 7-year-old cat was presented for seizures. Cerebrospinal fluid cytology and serology were consistent with a diagnosis of toxoplasmosis. The cat was treated with clindamycin but seizures continued and additional neurological signs developed over 6 months. A mass lesion was identified in the left cerebral hemisphere using magnetic resonance imaging (MRI). The lesion enhanced after gadolidium and a tumour was considered likely. Histologically, the lesion proved to be a cryptococcal granuloma and retrospective serology confirmed that the cat had cryptococcosis at its initial presentation. This report provides the first description in the veterinary literature of the MRI appearance of a cerebral cryptococcoma and emphasises the importance of performing cryptococcal antigen determination in cats with signs of intracranial disease.
Aspergillus Species Cystitis in a Cat
Authors: Adamama-Moraitou KK , Paitaki CG , Rallis TS , Tontis D
Published: September 2002

A Persian male cat with a history of lower urinary tract disease was presented because of polydipsia, polyuria, constipation and nasal discharge. Ten weeks before admission, the cat had been treated for lower urinary tract disease by catheterisation and flushing of the bladder. The animal was thin, dehydrated, anaemic and azotaemic. Urine culture revealed Aspergillus species cystitis. Antibodies against Aspergillus nidulans were identified in serum. Fluconazole was administered orally (7.5 mg/kg, q 12 h) for 10 consecutive weeks. The azotaemia was resolved, the kidney concentrating ability was recovered and the cat has remained healthy without similar problems.
Pharmacology of a 40 IU/ml Porcine Lente Insulin Preparation in Diabetic Cats: Findings during the First Week and after 5 or 9 Weeks of Therapy
Authors: Martin GJ , Rand JS
Published: September 2002

The aim of this study was to measure the pharmacokinetics and pharmacodynamics of subcutaneously injected 40 IU/ml porcine lente insulin preparation (Caninsulin, Intervet BV, The Netherlands) in diabetic cats. The pharmacological properties of the insulin in poorly controlled or untreated cats were compared with those after several weeks of treatment, to determine if improved diabetic stability altered the pharmacology of this insulin. In addition, the pharmacological properties of intravenously injected 100 IU/ml regular porcine insulin (Actrapid MC, NovoNordisk, Denmark) were measured.

Serial plasma samples were collected after subcutaneous injection of porcine lente insulin from 25 diabetic cats in the first week of admission to a 12-month diabetic treatment trial. Samples were also collected after 4 or 8 weeks of treatment, in those cats which had not achieved diabetic remission by this time. At this time, serial plasma samples were also collected from these cats after intravenous injection of porcine regular insulin. Plasma samples were assayed for glucose, anti-insulin antibodies were extracted using a PEG technique, and samples were assayed for insulin using an RIA kit with low sensitivity for endogenous feline insulin, but high sensitivity for exogenous porcine insulin in feline plasma.

Caninsulin injected subcutaneously in diabetic cats led to a peak insulin concentration in plasma after 1.7 ± 0.1 h, and a nadir of blood glucose after 4.1 ± 0.3 h. Insulin and glucose concentrations returned to baseline within 12 h. There was no significant change in the onset or duration of Caninsulin action between the first week of treatment and 5 or 9 weeks of treatment. Actrapid MC injected intravenously had a peak insulin at 0.36 ± 0.03 h, and a nadir of blood glucose at 1.9 ± 0.3 h. Insulin and glucose returned to baseline within 6 h. It was concluded that Caninsulin injected subcutaneously has suitable pharmacological properties for the twice-daily treatment of diabetes mellitus in cats. In addition, Actrapid MC insulin injected intravenously has suitable pharmacological properties for injection every 4–6 h in diabetic cats.
Review of Feline Pancreatitis Part One: The Normal Feline Pancreas, the Pathophysiology, Classification, Prevalence and Aetiologies of Pancreatitis
Authors: Mansfield CS , Jones BR
Published: September 2002

The cellular mechanisms involved once pancreatitis has been initiated are reasonably well understood. The events leading up to this process are less well established. Much of our current understanding of pancreatitis in cats has been determined from experiments in cats or extrapolated from other species. The normal anatomy and function of the pancreas and a review of the current state of knowledge about the pathophysiology of pancreatitis is discussed. The current prevalence of feline pancreatitis is unknown, but the disease is being reported with increasing frequency. The aetiology of pancreatitis and the types of pancreatic inflammation present in cats is different from other species, such as the dog, a species where the disease is considered more common. Concurrent diseases are often present that may be more serious than the pancreatic inflammation and the treatment of these diseases is often complicated by pancreatitis.
Anatomy of the Patent Ductus Venosus in the Cat
Authors: White RN , Burton CA
Published: September 2002

The biplanar mesenteric vein portovenograms of 10 cats with left divisional intrahepatic portosystemic shunts consistent with a patent ductus venosus (PDV) were reviewed. A corrosion cast of the hepatic portal vasculature was made post mortem from one individual that died post operatively following surgical attenuation of the shunting vessel. On the basis of the combined surgical, post mortem and imaging data, these left divisional shunts were found to have consistent anatomy, each having a straight vessel which drained into a venous ampulla before draining into the caudal vena cava at the level of the diaphragm. The left phrenic vein and left hepatic vein both entered the ampulla independently of the shunting vessel. The anatomical similarity between these findings in the cat and the PDV in the dog suggest that it is appropriate to describe this particular portosystemic shunt as a PDV.
Gastroduodenal Ulceration in Cats: Eight Cases and a Review of the Literature
Authors: Liptak JM , Hunt GB , Barrs VRD , Foster SF , Tisdall PLC , O'Brien CR , Malik R
Published: September 2002

Gastroduodenal ulceration (GU) and blood loss was diagnosed in eight cats and compared with 25 previously reported cases of feline GU. Cats with GU presented in a critical condition. Clinical signs consistent with gastrointestinal bleeding were infrequently identified although anaemia was a common finding. Non-neoplastic causes of feline GU tended to have a shorter clinical course with ulcers confined to the stomach. Conversely, cats with tumour-associated GU usually had a more protracted clinical course, weight loss, and ulcers located in the stomach for gastric tumours and the duodenum for extra-intestinal tumours. In this series, definitive diagnosis was possible for cats with neoplasia (gastric tumours and gastrinoma), however, it was difficult to precisely identify the underlying aetiology in cats with non-neoplastic GU. Prompt stabilisation with a compatible blood transfusion, surgical debridement or resection, antibiotic and antiulcer therapy, and treatment of the underlying disease, if identified, was successful in the majority of cases. The prognosis for cats with appropriately managed GU depended on the underlying aetiology, but even cats with neoplasia could be successfully palliated for prolonged periods.
Long-Term Outcome of Eight Cats with Non-Iymphoproliferative Nasal Tumours Treated by Megavoltage Radiotherapy
Authors: Mellanby RJ , Heritage ME , Dobson JM
Published: September 2002

A retrospective study was undertaken to evaluate the long term survival of eight cats with non-lymphoproliferative nasal tumours treated by megavoltage radiotherapy alone. Adenocarcinoma was the most commonly diagnosed tumour. Megavoltage radiotherapy was given to eight cats in 4–6 fractions of 4–8 Gys over a 16 to 28 day period. Seven cats completed the radiotherapy schedule and only two cases developed mild acute radiotherapy side effects. Median survival time after the completion of the radiotherapy course as calculated by Kaplan-Meier survival analysis was 382 days. The 1 year survival rate was 63%. All cats were euthanased because of either a poor response to radiotherapy or recurrence of the nasal tumour. This study demonstrates that a coarse fractionation regime of megavoltage radiotherapy can provide effective long-term palliative treatment for feline nasal tumours. The coarse fractionation schedule has the advantages of requiring only four to six treatments.
Diabetes Mellitus and Bilateral Cataracts in a Kitten
Authors: Thoresen SI , Bjerkås E , Aleksandersen M , Peiffer RL
Published: September 2002

An 18-week-old male domestic long-hair kitten was presented with a history of polyuria and polydipsia for several weeks. The general condition was unremarkable, but the kitten was considerably smaller than expected for the age and showed cataracts in both eyes. Serum glucose concentrations were persistently elevated and based on clinical findings and an elevated serum fructosamine concentration, a diagnosis of diabetes mellitus was established.

Diabetes mellitus is not commonly diagnosed in young kittens, nor are cataracts recognised as a frequent feature of this disease in cats. The cataracts progressed in spite of the insulin therapy and the kitten was euthanised 10 weeks after referral. Histopathological examination of the pancreas revealed few and small islets of Langerhans compared to the examination of pancreas from a healthy kitten of the same age. Histopathological changes in the eyes included cataracts affecting both cortex and nucleus.
Double blind placebo controlled clinical trial of homoeopathic medicines in HIV infection
Authors: Rastogi DP , Singh VP , Singh Vikram , Dey SK , Rao K
Published: September 2002

A 6 month study comprising of a Double-blind Placebo-controlled trial of homoeopathic medicines in HIV/AIDS under 2 separate schemes (I) Asymptomatic HIV infection and (II) Persistent generalised lymphadenopathy (50 subjects each) was undertaken from June 1995 to February 1997. As soon as a subject had undergone 6 months of study, they were put on an indicated medicine. Unblinding of the schemes was done only when the last subject had undergone 6 months of study. Changes in the CD4+ T cell numbers in each case before, during and after completion of the study, was taken as the main criterion to assess the outcome of the treatment. Preliminary studies in Scheme I after unblinding, show practically no significant difference in changes in number of CD4+ T cells in subjects of both the placebo and the medicine group. Studies in Scheme II after unblinding, show a significant improvement in CD4+ cell numbers (Upward trend) in the subjects of the medicine group compared to the placebo group. Significantly, after 6 months of study, 5 subjects of the placebo group under Scheme II and 4 from Scheme I with an initial downward trend of CD4+ T cell, have shown an increase in CD4+ T cell count after administration of the indicated homoeopathic medicine in a period of 15–30 days. The study confirms a positive role of homoeopathic medicines in improving immune status of HIV/AIDS patients.