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Query: UMLS:C0000737 (
abdominal pain
)
31,184
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
5346 cases of laparoscopic sterilization, using both electrocautery and Silastic-ring method, were studied from 1972-1978. Of the 4500 electrocautery method patients there were 13 cases of electrical burns, 3 of which required bowel resection. Of the 846 Silastic-ring method patients there were 14 cases of inadvertent ejection of a ring into the peritoneal cavity. In addition, 235 Silastic ring patients had postoperative
abdominal pain
severe enough to require analgesia stronger than aspirin and codeine compared to 399 of the electrocautery patients. 15 women in the electrocautery group experienced pelvic infections; there were no infections in the Silastic-ring group. Mesosalphinx bleeding occurred in both groups and most frequently with coincident suction D and C. There were cardiac complications curing the sterilizations; 6 bradycardia cases, 10 arrhythmia cases secondary to over-distention of the abdomen with
carbon dioxide
. Technical failure was related to previous abdominal surgery due to the presence of adhesions. 37.4% of 366 patients noted increased flow and/or duration of menses and 15% complained of menstral cramping. The majority of women reported unchanged or improved sexual relations; improved sexual relations were more significant among Silastic-ring patients.
...
PMID:Complications of laparoscopic sterilization. Comparison of 2 methods. 15 22
Carbon monoxide
(CO) poisoning is the commonest single cause of fatal poisoning in the U.K. (Broome & Pearson, 1988). The clinical features are numerous and include headache, fatigue, dizziness, confusion, memory loss, paraesthesia, chest pain,
abdominal pain
, nausea, and diarrhoea as well as coma, convulsions and death. Without adequate treatment many patients develop neuropsychiatric sequelae including headaches, irritability, memory loss, confusion and personality changes. The diagnosis of CO poisoning is often suggested only by circumstances surrounding the victim, and remains a challenge to the A&E department. Hyperbaric oxygen therapy (HBO) is internationally accepted as the most powerful form of treatment in severe cases (Drug & Therapeutics Bulletin, 1988; Lowe-Ponsford & Henry, 1989). However, in the U.K. treatment with HBO is often not considered due to lack of hyperbaric facilities (Meredith & Vale, 1988; Anand et al., 1988), and due to inadequate awareness on the part of hospital staff. We report a case of a patient deeply unconscious as a result of CO poisoning, in which serial treatments with HBO over a period of 14 days, produced dramatic results.
...
PMID:Management of the moribund carbon monoxide victim. 811 Mar 42
The French incidence study has registered all new cases of Type 1 diabetic children under 20 years of age, from a population of 2.32 million, in an exhaustive and prospective manner. Three hundred and forty cases were identified between 1 January 1988 and 31 December 1989, yielding a mean annual incidence rate 7.3 per 10(5). The lowest rate was observed in the youngest age group (0-4 yr: 4.1 per 10(5)) and the highest around pubertal development (10-14 yr: 11.5 per 10(5)). Details of the previous personal and family history, and the clinical and biological pictures of the disease at diagnosis were recorded. Almost 8 per cent of the children had a first-degree relative with Type 1 diabetes. Polyuria, weight loss, fatigue and
abdominal pain
were the most frequently reported symptoms, which were of median duration 4.4 months. Mean weight loss before diagnosis was 9.4 +/- 6.8 (+/- SD)% of body weight and was not significantly related to age. Ketonuria was detected in 83.8 per cent and acidosis (total
CO2
less than or equal to 18 mmol l-1, if measured) in 48 per cent of the cases. Ketonuria and acidosis were significantly more frequent in the younger age group than in the rest of the group (p less than 0.001).
...
PMID:Clinical and laboratory features of type 1 diabetic children at the time of diagnosis. 157 13
There is conflicting evidence regarding the benefit of using
carbon dioxide
in a double contrast barium enema. In a double blind prospective study, 200 patients undergoing out-patient double contrast barium enemas (DCBE) were randomly allocated to receive either air or
carbon dioxide
(
CO2
) insufflation. After 24 h they were requested to complete and return a questionnaire regarding
abdominal pain
and distension experienced following the examination. The use of
CO2
reduced the incidence of severe post-DCBE pain from 27% to 7%. There was a higher incidence of severe pain in younger patients, regardless of which gas was used. The incidence of severe pain following DCBE was unrelated to the presence or absence of
abdominal pain
as part of the patient's symptomatology. In the light of these findings we advocate the routine use of
CO2
in DCBE.
...
PMID:Use of air in double contrast barium enema--is it still acceptable? 191 96
We have conducted a phase I study with autologous monocytes activated ex vivo and administered intraperitoneally in nine patients with peritoneal carcinomatosis. Blood monocytes were collected by leukapheresis and then purified by counterflow elutriation (up to 10(9) cells, with a purity of greater than 90%). Ex vivo activation was obtained by incubating these cells with 1 micrograms liposomal MTP-PE/10(6) monocytes for 18 hours in hydrophobic culture bags at 37 degrees C in 5%
carbon dioxide
humidified air. The activated monocytes were then infused in the peritoneal cavity once a week for 5 consecutive weeks through an implanted peritoneal infusion system, Port-A-Cath (Pharmacia Deltec, St Paul, MN), on an intrapatient dose-escalating schedule (10(7) to 10(9) monocytes). No severe adverse reactions occurred. Toxicity was mild, the chief acute reactions being fever (27%), chills (13%), and
abdominal pain
(25%). None of the side effects led to dose reduction. No consistent change in hemostatic function, liver function, or renal function was observed. Significant increases in granulocyte counts, neopterine, and acute phase reactants (fibrinogen, C-reactive protein) occurred in the peripheral blood. In vitro monocyte activation was demonstrated by the relapse of procoagulant activity and monokines (interleukin-1 [IL-1], IL-6, and tumor necrosis factor-alpha [TNF alpha]) in the supernatants of cultured monocytes. Evidence for in vivo monocyte activation was provided by the increase of these monokines in the peritoneal fluids. Kinetic studies with indium-111 (111In)-labeled activated autologous monocytes in five patients suggest that these infused monocytes may remain in the peritoneal cavity for up to 7 days. This locoregional immunotherapeutic approach seems to be encouraging in view of adjuvant therapeutic modality in ovarian cancer patients with minimal residual intraabdominal disease following second-look laparotomy.
...
PMID:Phase I study of liposomal MTP-PE-activated autologous monocytes administered intraperitoneally to patients with peritoneal carcinomatosis. 204 66
Since the discovery of Legionella pneumophila in the late 1970s, this organism and other Legionella sp have been an important cause of pneumonia in solid organ transplant recipients. Legionella sp are obligate aerobes that require a source of amino acids, iron, and L-cystine. Growth is enhanced in a 5%
CO2
atmosphere at 37 degrees C in the presence of charcoal. Legionella sp reside in water supplies and hospital outbreaks associated with contaminated water have been described. Transplant recipients are particularly susceptible to Legionella infection. Legionella pneumonia tends to occur within several weeks after transplantation and frequently coincides with episodes of rejection. A prodrome of influenza-like symptoms is followed by a sometimes "explosive" pneumonia with patchy lobular or interstitial infiltrates on chest radiograph. High fever,
abdominal pain
, and mental status changes are sometimes seen. Diagnosis is made by examination of respiratory secretions by the direct fluorescent antibody technique or culture of the organism. Intravenous erythromycin is the treatment of choice. Rifampin is added if there is a lack of response. Both erythromycin and rifampin have important and opposite effects on cyclosporine metabolism, which may result, respectively, in increased cyclosporine toxicity or graft loss. Patients who must continue cyclosporine will, therefore, require frequent monitoring of cyclosporine levels.
...
PMID:Legionella infection in transplant patients. 218 18
Since the first paravertebral blockade was carried out by Sellheim in 1905, this method has proved effective for the isolated blockade of spinal nerves. The efficacy of preoperative intercostal blockade (ICB) in combination with neuroleptanalgesia (NLA) or Pentothal-pentazocine-N2O anesthesia (Pe-Pz) was studied (unilateral analgesia for cholecystectomy). Group 1: NLA; group 2: NLA with ICB; group 3: Pe-Pz; group 4: Pe-Pz with ICB. The analgesic requirement differed significantly between groups 1 (0.33 mg fentanyl) and 2 (0.15 mg fentanyl) and groups 3 (63.5 mg pentazocine) and 4 (31.5 mg pentazocine). There were also significant differences in circulatory responses. The maximum deviation from the initial value at the beginning of the operation in group 1 compared to group 2 was pulse rate + 28.7% vs + 2.4%, mean arterial pressure (Part) + 24.6% vs + 3.1%, and systolic pressure (Psyst) + 33% vs +/- 0%; group 3 compared to group 4: pulse rate + 16.4% vs + 3.2%, Part + 24.5% vs 0.0%, and Psyst + 26.5% vs + 196. The times of action of ICB extended from 7.54 h to 11.33 h for partial analgeisa, time to the first dose of analgesic from 12.3 h to 16.9 h (etidocaine 0.5% and 1% respectively without and with epinephrine). The mean blood levels after 100 mg bupivacaine-
CO2
rose to 1.16 micrograms/ml after 5 min and reached a maximum after 15 min (1.29 micrograms/ml) as compared to 0.98 micrograms/ml after addition of ornithine-vasopressin. These values are very much higher than those after the use of bupivacaine-HCl solution. Etidocaine and bupivacaine-HCl have comparable durations of analgesia. Toxicologically, both substances can be applied safely with consideration of all pharmacological data for ICB. Of a total of 3,485 intercostal blockades, 2,775 were applied perioperatively (pre- and postoperatively); 265 were carried out for trauma patients (rib fractures) and 445 for therapeutic indications (herpes zoster neuralgia, tumor pain, costovertebral pain). In 8 blocks 10% ammonium sulfate, in 4 blocks absolute alcohol, and in 19 blocks 5% phenol were used for neurolysis. In 2 cases a marginal pneumothorax was seen, which was resorbed spontaneously (0.06%). Altogether 16,270 single intercostal nerves were blocked. Single-session intercostal blockade can be combined as unilateral analgesia with general anesthesia. This combination is characterized by stable circulatory conditions with avoidance of hypertensive reactions. The long-lasting analgesia allows early mobilization and physiotherapy both postoperatively and posttraumatically in patients with unilateral thoracic and
abdominal pain
.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:[The single intercostal block--surgical and therapeutic indications]. 264 21
In an attempt to reduce pain after laparoscopy, presumed to be due to persistence of
CO2
in the peritoneal cavity especially under the diaphragm, women were kept 30 degrees head down for 30 min immediately after operation. By random selection 67 treated patients were compared with 64 kept flat, postoperative symptoms being recorded at fixed times for 3 days. Although tilting was found to be of no significant benefit there were two useful findings. In both groups there was a significant fall in the frequency of upper
abdominal pain
during the first postoperative night from about 53% to about 25%, followed by a rise after returning home on the first postoperative day to about 60% and only a slow fall in the next 2 days. The severity of pain followed the same pattern. Patients should be warned to expect increased pain on ambulation after leaving hospital. Also, there was doubling in lower
abdominal pain
during the first 6 h associated with the use of Falope rings for sterilization, compared with either Hulka clip sterilization or only diagnostic laparoscopy.
...
PMID:Pain after laparoscopy related to posture and ring versus clip sterilization. 295 60
A syndrome of headache, fatigue, dizziness, paresthesias, chest pain, palpitations and visual disturbances was associated with chronic occult
carbon monoxide
exposure in 26 patients in a primary care setting. A causal association was supported by finding a source of
carbon monoxide
in a patient's home, workplace or vehicle; results of screening tests that ruled out other illnesses; an abnormally high carboxyhemoglobin level in 11 of 14 patients tested, and abatement or resolution of symptoms when the source of
carbon monoxide
was removed. Exposed household pets provided an important clue to the diagnosis in some cases. Recurrent occult
carbon monoxide
poisoning may be a frequently overlooked cause of persistent or recurrent headache, fatigue, dizziness, paresthesias,
abdominal pain
, diarrhea and unusual spells.
...
PMID:Occult carbon monoxide poisoning. 382 10
A 45-year-old man who was admitted with nausea, vomiting, and
abdominal pain
was found to have severe metabolic alkalosis, with a PaCO2 of 11.4kPa (85.5 mm Hg), PaO2 of 5.8 kPa (43.5 mm Hg), pH of 7.61, and plasma bicarbonate concentration of 82.0 mmol/l. He was treated with oxygen, intravenous physiological saline, and phenytoin and improved within 48 hours. Radiographs showed gastric outlet obstruction secondary to peptic ulcer, which was treated by surgery. Though sever, the rise in
carbon dioxide
concentration in this patient was probably lifesaving. The PaCO2 was therefore allowed to fall gradually as the alkalosis was treated. The return of both PaCO2 and plasma bicarbonate values to normal in parallel suggests that hypoventilation compensated for the metabolic alkalosis and emphasises the importance of conservative treatment in cases of metabolic alkalosis.
...
PMID:Severe metabolic alkalosis: a case report. 679 44
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