vitamin-k-semiquinone-radical and Pain

The objective of the study was to assess the efficacy of immediate skin-to-skin care (SSC) versus swaddling in pain response to intramuscular injection of vitamin K at 30 min of birth in neonates.. Healthy full-term newborns were enrolled immediately after normal vaginal delivery and randomized in two groups, SSC and swaddling. Neonatal Infant Pain Scale (NIPS) was measured before, immediately after and at 2 min after the injection.. Total 100 newborns were enrolled in the study (50 in each group). The mean (SD) birth weight of newborns in the SSC and swaddling group was 2668 (256) and 2730 (348) g, respectively. NIPS was comparable between the SSC and swaddling at before [1.78 (0.58) vs. 1.96 (0.83), p = 0.21], and immediately after the injection [4.82 (0.72) vs. 5.08 (0.75), p = 0.08]. NIPS at 2 min after the injection was significantly low in the SSC group compared to the swaddling group [1.38 (0.70) vs. 2.88 (1.00), p < 0.001]. At 2 min after injection, the NIPS score was significantly lower than baseline in the SSC group (p = 0.002), while it was significantly higher in the swaddling group (p < 0.001). A significantly higher proportion of newborns had a NIPS score of more than three at 2 min after injection in the swaddling group as compared to the SSC group (22% vs. 2%, p < 0.001).. Immediate SSC was more efficacious as compared to swaddling as a pain control intervention while giving vitamin K injection.. The trial is registered with the Clinical Trial Registry of India with Registration number: CTRI/2020/01/022984.. Skin-to-skin care and swaddling are commonly used non-pharmacological measures to reduce pain perception in neonates for invasive procedures like heel prick, venipuncture and vaccination. We did this randomized control trial to compare the efficacy of immediate skin-to-skin care after birth vs. swaddling for reducing neonatal pain associated with intramuscular injection of vitamin K at 30 min after birth. We observed that the immediate skin-to-skin care, a standard of care, is more efficacious in controlling pain compared to swaddling for giving routine intramuscular vitamin K injection within one hour of birth.

Topics: Female; Humans; Infant, Newborn; Injections, Intramuscular; Pain; Pain Management; Skin Care; Vitamin K

Topical local anesthetic agents such as amethocaine penetrate intact skin and block pain signals originating from the dermis during medical procedures. They have been found to attenuate pain from various procedures, including intramuscular (i.m.) injection of vaccines. Published data on their effectiveness for i.m. injection of vitamin K in neonates were not identified.. The primary objective of this study was to evaluate the analgesic effectiveness and tolerability of topical amethocaine gel 4% in neonates undergoing i.m. injection of vitamin K. The secondary objective was nurses' response to the use of the intervention and possible barriers associated with its incorporation into clinical practice.. In a double-blind, placebo-controlled, randomized trial, full-term neonates in the Labor and Delivery Unit of Mount Sinai Hospital, Toronto, Ontario, Canada, received 1 g of amethocaine gel 4% or placebo 30 minutes prior to i.m. injection of 0.5 mL of vitamin K. Pain responses were assessed using percent facial grimacing score, percent cry duration, and latency to cry from video recordings. Parents and nurses assessed infants' pain response using a visual analog scale (VAS). Local adverse events (ie, erythema, blanching) at the application site were recorded. Nurses were asked to provide written responses regarding their willingness to incorporate local anesthetics in clinical practice and barriers to their use.. From July 2003 to December 2004, 175 families were approached for participation in the study; 52 declined consent and 13 were not randomized. One hundred ten neonates were enrolled and evenly randomized to each group. Baseline characteristics were similar in both groups. During i.m. injection, the mean (SD) percent facial grimacing score was 70% (30%) for the amethocaine group compared with 75% (34%) for the placebo group (P = 0.41). The mean (SD) for percent cry duration was 55% (34%) compared with 62% (38%), respectively (P = 0.34). The mean (SD) latency to cry was significantly longer in the amethocaine group compared with the placebo group (4.7 [4.5] vs 2.7 [2.3] seconds; P = 0.01). Parents' and nurses' VAS ratings for infant pain did not differ between groups. The incidence of adverse events did not differ between groups. Ninety-seven percent of nurses (89/92) said they would use the intervention. Fifty-seven percent of nurses (52/92) identified barriers to incorporation with the primary reason being time constraint (67% [35/52]).. Topical amethocaine gel 4% was ineffective in reducing pain on i.m. injection of vitamin K in these full-term neonates. Treatment was generally well tolerated and nurses concluded that, given the choice, they would use a topical anesthetic.

Topics: Administration, Topical; Anesthetics, Local; Attitude of Health Personnel; Crying; Double-Blind Method; Facial Expression; Gels; Humans; Infant, Newborn; Injections, Intramuscular; Neonatal Nursing; Ontario; Pain; Pain Measurement; Tetracaine; Vitamin K; Vitamins

To investigate associations of dietary vitamin K intake with changes in knee symptoms and structures in patients with knee osteoarthritis (OA).. Participants with symptomatic knee OA were enrolled (n = 259) and followed up for 2 years (n = 212). Baseline dietary vitamin K intake was calculated from a validated food frequency questionnaire. Knee symptoms were assessed by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Knee cartilage defects, bone marrow lesions, and effusion-synovitis volume were measured from magnetic resonance imaging (MRI) scans. Univariable and multivariable linear regressions were used for analyses.. A higher vitamin K intake quartile was significantly associated with a greater decrease in the total WOMAC score and dysfunction score over 24 months. The subgroup analyses showed in patients with severe baseline visual analog scale (VAS) pain that a higher vitamin K intake quartile was associated with more improvement in all WOMAC scores. There were no overall significant associations between vitamin K intake and changes in MRI features. In subgroup analysis, vitamin K intake was negatively associated with changes in tibiofemoral, patellar, and total cartilage defects in participants with a severe baseline radiographic grade and was negatively associated with change in total and patellar cartilage defects in participants with severe baseline VAS pain and in female patients.. The association of higher vitamin K intake with decreased knee symptoms over 24 months in patients with knee OA suggests that clinical trials examining the effect of vitamin K supplementation for knee OA symptoms are warranted. Whether there is an effect on knee structure is unclear.

Topics: Eating; Female; Humans; Knee Joint; Magnetic Resonance Imaging; Osteoarthritis, Knee; Pain; Vitamin K

Pain is one of the common and debilitating health manifestations associated with the majority of diseased conditions, thus making it a serious health concern worldwide. While trying to decipher the cryptic mechanism of pain in hope to provide better gene-based therapeutics, researchers have concluded pain to be of multigenic origin making it hard to cure. Apolipoprotein E is a protein coded by APOE gene containing 4 exons, located on chromosome 19q13.2. It is among the key regulators of various crucial body functions such as lipid transport, apoptosis, vitamin k pathway, and cognition, hence, it is highly suspected to play a pivotal role in the nociception process. However, very few studies have tried and succeeded to find a direct involvement of APOE in pain processing. The current article attempts to throw light on some of the major clinical research findings which strengthen the hypothesis stating that apolipoprotein E has a concealed yet deeply embedded association with the pain regulating pathways, through several underlying physiological, biochemical and neurological processes, that in turn, decide the fate of pain sensation in a complex manner.

Topics: Apolipoproteins E; Apoptosis; Bone and Bones; Chronic Pain; Cognition; Humans; Inflammation; Lipids; Models, Theoretical; Neurons; Nitric Oxide; Nociception; Pain; Pain Management; Stress, Physiological; Synaptic Transmission; Vitamin K

Topics: Anticoagulants; Combined Modality Therapy; Coumarins; Drug Combinations; Factor IX; Factor VII; Factor X; Hemorrhage; Humans; Male; Middle Aged; Pain; Plasma; Poisoning; Prothrombin; Suicide, Attempted; Vitamin K

Untreated coeliac disease may induce malabsorption of many nutrients. It may also induce vitamin K deficiency, which causes prolongation of the prothrombin time. The aim of the present study was to evaluate the prevalence and associations of prolonged prothrombin time in a series of coeliac adults.. We carried out a cross-sectional analysis of data collected on 390 adults with untreated coeliac disease diagnosed from January 1997 to December 2000. Prolonged prothrombin time was defined as INR > or = 1.4.. A prolonged prothrombin time was found in 72 coeliac patients (18.5%). Parenteral vitamin K therapy was required in 5.6% of patients. Patients with prolonged prothrombin time had significant lower values of haemoglobin, iron, proteins, cholesterol and serum aspartate transaminase, and significantly higher prevalence of diarrhoea, weight loss, abdominal pain and low bone mineral density in comparison with patients with normal prothrombin time. However, low bone density was present in 11.6% of patients with normal INR. A prolonged prothrombin time was only found in a few patients with subclinical coeliac disease (0.9%).. Data indicate that the prevalence of prolonged prothrombin time is about 20% in a large series of adult untreated coeliac patients. A prolonged prothrombin time was significantly related to all the markers of severe malabsorption, including low mineral density. Our suggestion is that vitamin K related proteins may also play a role in determining or worsening calcium homeostasis disorders in coeliac disease. The very low prevalence of coagulation disorders in subclinical coeliac disease indicates that there is no need to screen for coeliac disease in patients with isolated coagulation disorders.

Topics: Adult; Aspartate Aminotransferases; Blood Proteins; Bone Density; Celiac Disease; Cholesterol; Cross-Sectional Studies; Diarrhea; Female; Hemoglobins; Humans; Infusions, Parenteral; Iron; Male; Pain; Prothrombin; Prothrombin Time; Retrospective Studies; Vitamin K; Weight Loss

The antinociceptive effect of vitamin K2 (menatetrenone) in diabetic mice was examined using a tail-pressure test. Intraperitoneal injection of menatetrenone (10-100 mg/kg) produced a dose-dependent increase in the nociceptive threshold in diabetic mice. There was no significant difference between non-diabetic and diabetic mice in the menatetrenone-induced changes in the nociceptive threshold. The results suggest the therapeutical usefulness of menatetrenone for treating painful diabetic neuropathy and osteoporosis.

Topics: Analgesics; Animals; Diabetic Neuropathies; Male; Mice; Mice, Inbred ICR; Pain; Pain Measurement; Tail; Vitamin K; Vitamin K 2

Gammacarboxyglutamic acid (gla) is a non essential amino acid synthesized in presence of vitamin K, predominantly found in coagulation and bone proteins. In 14 cases of deep vein thrombosis and in 11 cases of disseminated intravascular coagulation, compared to 19 normal subjects and 9 patients hospitalized for leg pain, free plasma gla levels were found significantly elevated (respectively 372 +/- 244 and 559 +/- 361 versus 146 +/- 34 and 120 +/- 40 pmol/mL). In six paired plasma and serum, gla levels were similar. These results suggest an involvement of blood coagulation in gla generation with need of a catabolism of the activated factors. A significant decrease was noticed during vitamin K antagonist therapy and liver disease, both instances in which the synthesis of gla containing coagulation factors is affected. During hepatocellular carcinoma with elevated desgamma carboxyprothrombin, gla was found normal, denying an global impairement of the vitamin K metabolism.

Topics: 1-Carboxyglutamic Acid; Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers; Carcinoma, Hepatocellular; Chronic Disease; Disseminated Intravascular Coagulation; Female; Hemangioma; Humans; Leg; Liver Diseases; Liver Neoplasms; Male; Middle Aged; Pain; Pulmonary Embolism; Skin Neoplasms; Thrombophlebitis; Vitamin K

Topics: Analgesics; Animals; Dose-Response Relationship, Drug; Female; Ilium; In Vitro Techniques; Male; Mice; Morphine; Muscle Contraction; Naloxone; Pain; Rabbits; Rats; Sensory Thresholds; Vitamin K

Topics: Pain; Vitamin A; Vitamin K; Vitamins

Vitamin U, administered as raw cabbage juice to 100 patients with peptic ulcer, was apparently effective in promoting the rapid healing of uncomplicated peptic ulcers. The evidence of therapeutic benefit was (1) the rapid relief of the symptom, pain, without the use of any set plan of symptomatic treatment, and (2) ulcer crater healing time (determined roentgenographically) considerably shorter than in groups of cases, reported in the literature, in which "standard" types of diet and drug therapy were employed.

Topics: Brassica; Employment; Food; Humans; Neuroaxonal Dystrophies; Pain; Peptic Ulcer; Vitamin A; Vitamin K; Vitamin U; Vitamins; Wound Healing