Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0006826 (cancer)
 1,092,456 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Despite advances in nuclear medicine, bone scintigraphy remains an important imaging technique. It is sensitive in detecting stress fractures and bone metastases and can assess suspected injury that is difficult to see on plain films (e.g., rib fracture). Scintigraphy is useful in evaluating new symptoms, response to therapy, and prognosis in patients with known malignant tumor. In patients with low back pain, the technique can determine the age of fractures to help identify osteoporosis and can uncover other causes of the pain (e.g., spondylolysis, arthritis). When Paget's disease is suggested by unexplained bone pain or an elevated serum alkaline phosphatase level, bone scintigraphy is a useful screening test. Combined with other appropriate nuclear medicine studies, it helps in early identification and localization of osteomyelitis. Scintigraphic scans can provide a general indicator of malignant versus benign disease (according to the amount of lesion activity seen) and may produce characteristic findings in certain primary tumors (e.g., osteoid osteoma) that are difficult to evaluate with other methods.
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PMID:When to use bone scintigraphy. It can reveal things other studies cannot. 982 85

Low back pain in the elderly has a much wider range of possible causes than in younger patients. In addition to nonspecific mechanical causes, malignancy presenting as back pain occurs more often in older patients. Other systemic and visceral causes of back pain such as polymyalgia rheumatica, aortic aneurysm, Paget disease, Parkinson disease, and osteoporosis with compression fracture occur almost exclusively in persons over age 50. Keys to diagnosis and management of low back pain in older patients are presented.
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PMID:Evaluating back pain in older patients. 998 54

Two separate trials compared controlled-release (CR) oral oxycodone (administered every 12 hours) with immediate-release (IR) oxycodone (4 times a day) to determine whether patients with chronic pain could be titrated to stable pain control as readily with the CR as with the IR formulation. In one study, 48 patients with cancer pain were randomized to open-label titration with either CR or IR oxycodone (maximum dose, 400 mg/day) for a period of up to 21 days. In a study of similar design, 57 patients with low back pain were titrated with either CR or IR oxycodone (maximum dose, 80 mg/day) for a period of up to 10 days. The majority of patients in both studies were converted to oxycodone from other opioid analgesics. Results of both studies showed no difference between CR and IR oxycodone with respect to both the percentage of patients achieving stable pain control, the time to achieve stable pain control, and the degree of pain control achieved. Among cancer patients, 85% achieved stable analgesia, 92% with the CR formulation and 79% with the IR formulation. Among noncancer patients, 91% achieved stable pain control, 87% with the CR formulation and 96% with the IR formulation. The most commonly reported adverse effects in both studies were similar for the two formulations and were those anticipated with opioids: nausea, vomiting, constipation, somnolence, dizziness, and pruritus. Nausea and vomiting were the most frequently cited reasons for treatment discontinuations. These studies suggest that dose titration can be accomplished as readily with oral CR oxycodone as with IR oxycodone in patients with chronic, moderate to severe pain.
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PMID:Can a controlled-release oral dose form of oxycodone be used as readily as an immediate-release form for the purpose of titrating to stable pain control? 1053 67

Sudden low back pain is common in elderly women. It causes physical and mental stress, and results in deterioration of functional movement and in activities of daily living. Awareness of possible sacral insufficiency fracture is important; they may be demonstrated by imaging modalities, mainly radionuclide bone scan. Prognosis is good and accurate diagnosis serves to exclude malignancy and relieve fear of chronic pain and disability. We describe 4 women, aged 84, 82, 71 and 77 who illustrating the clinical and imaging findings of this disorder.
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PMID:[Sacral insufficiency fractures and low back pain in elderly women]. 1095 30

Low back pain radiating to a limb is usually caused by lumbar disc herniation. Tumors of the spinal cord or near the sciatic or femoral plexus can cause neural compression and clinical signs similar to those of disc herniation. Such tumors are usually misdiagnosed as discal herniation and appropriate treatment is delayed. We present 4 men who had tumors causing low back pain radiating to the leg: a 70-year-old with metastatic squamous cell carcinoma of the lung, a 20-year-old with aneurysmal bone cyst of the vertebral column, a 52-year-old with retroperitoneal sarcoma and a 32-year-old who also had retroperitoneal sarcoma. Diagnosis and treatment were delayed because the clinical symptoms were ascribed to lumbar disc herniation. The latter 2 patients had CT-scans showing lumbar disc herniation, but similar findings are common among asymptomatic individuals. The differential diagnosis of low back pain radiating to the leg should include tumor when there is a history of cancer, pain not relieved by conservative treatment nor by lying down, pain is increased at night, pain accompanied by weight loss, and when physical examination demonstrates injury to more than 1 nerve root. In these circumstances work-up should include EMG, radioisotope scan and CT of the pelvis.
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PMID:[Spinal and extra-spinal tumors mimicking discal herniation]. 1095 87

A 42-year-old woman was admitted to the National Cancer Center Hospital in Tokyo, Japan, because of lumbago and bilateral leg pain. Clinical examination revealed a retroperitoneal bulky tumor, a breast tumor, and lymphoblasts in bone marrow. She did not have surface lymph node swelling or systemic symptoms such as weight loss and night sweats. Lymphoblasts in bone marrow were positive for CD10 and CD19 but negative for CD20, surface immunoglobulin, and T-cell antigens. Needle biopsy of a retroperitoneal mass revealed diffuse infiltration of lymphoblastic tumor cells. Because the cells were immunoreactive for CD79a, CD10, and terminal deoxynucleotidyl transferase, the patient was diagnosed as having precursor B-lymphoblastic lymphoma (which is rare in adults) with bone marrow involvement. The patient achieved complete remission by an induction therapy for acute lymphoblastic leukemia, underwent allogeneic bone marrow transplantation, and has remained in complete remission for more than 3 years.
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PMID:Successful allogeneic bone marrow transplantation in a case of adult precursor B-lymphoblastic lymphoma. 1119 21

Low back pain may present as acute pain or as an acute exacerbation of a chronic pain problem. Acute low back pain is self-limited, with 90% of affected individuals recovering within 3 weeks to 3 months. Pain duration of more than 4 weeks warrants a more complete work-up, including ruling out malignancy. Pain duration of more than 6 months defines chronic pain, which is frequently associated with affective and behavioral components. When taking the history, determine pain intensity, location, pattern of radiation, onset, and duration. A gentle physical exam may help locate the source of pain through palpation and maneuvers, such as the straight leg raise test. Imaging is recommended for patients with a clinical finding that raises suspicion of spinal malignancy.
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PMID:Primary care work-up of acute and chronic symptoms. 1171 Aug 12

Knowledge about the economic burden of rheumatic diseases has progressed during recent years. In addition to the increasing number of studies published, the Economics Working Group of the Outcome Measures in Rheumatoid Arthritis Clinical Trial (OMERACT) Conference has produced substantial work to improve methodological standards for the economic evaluation of rheumatic diseases. Some of their preliminary results are presented in this review. Recent data have confirmed two main conclusions of previous studies: the total economic burden of rheumatic diseases is often more substantial than other chronic conditions, including cardiovascular diseases and cancer; and the impact of the disability caused by musculoskeletal diseases is significant on both direct (long-term care in osteoporosis for example) and indirect costs (productivity loss in chronic patients). Besides that, cost-effectiveness studies have provided valid information to improve disease management, especially for patients with rheumatoid arthritis or chronic low back pain.
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PMID:Cost of illness studies in rheumatic diseases. 1184 16

We report a case of advanced gastric cancer complicated by disseminated intravascular coagulation successfully treated with chemotherapy consisting of 5-fluorouracil and cisplatin. The patient was a 53-year-old woman who complained of loss of appetite, weight loss, and low back pain. Based on the laboratory data, a diagnosis of disseminated intravascular coagulation was made. Gastroscopy revealed gastric carcinoma (Borrmann type 3) that was continuously bleeding, and chest computed tomography showed a solitary lung metastasis and bilateral pleural effusion. Bone scintigraphy revealed multiple bone metastases. Accordingly, we made a diagnosis of stage IV gastric cancer complicated by disseminated intravascular coagulation. We selected the 5-fluorouracil and cisplatin combination chemotherapy for treatment and obtained the patient's consent. After two cycles of the 5-fluorouracil and cisplatin therapy, the bleeding symptoms improved and the disseminated intravascular coagulation process was successfully controlled. We concluded that disseminated intravascular coagulation caused by gastric cancer may be improved when the primary cancer and its metastases are brought under control by treatment with FP combination chemotherapy.
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PMID:Advanced gastric cancer associated with DIC successfully treated with 5-FU and cisplatin: a case report. 1194 41

Epidural abscess of the spinal column is a rare condition that can be fatal if left untreated. Risk factors for epidural abscess include immunocompromised states such as diabetes mellitus, alcoholism, cancer, and acquired immunodeficiency syndrome, as well as spinal procedures including epidural anesthesia and spinal surgery. The signs and symptoms of epidural abscess are nonspecific and can range from low back pain to sepsis. The treatment of choice in most patients is surgical decompression followed by four to six weeks of antibiotic therapy. Nonsurgical treatment may be appropriate in selected patients. The most common causative organism in spinal epidural abscess is Staphylococcus aureus. Spinal epidural abscess involving actinomycosis is rare.
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PMID:Spinal epidural abscess: a diagnostic challenge. 1199 16


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