Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0009676 (confusion)
 21,692 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical histories and radiographs of 28 patients with ankylosing spondylitis were reviewed. Symptoms developed before the age of 17 in all cases. Juvenile ankylosing spondylitis affected youths in their early teens, who presented most commonly with appendicular joint complaints rather than low back pain. The disease was progressive, with the characteristic changes of ankylosing spondylitis eventually occurring in the spine and sacroiliac joints, frequently accompanied by widespread and severe changes in the appendolar joints. HLA B 27 antigen was present in 8 of the 9 patients tested. Thorough clinical, radiographic, and laboratory examination should prevent confusion with juvenile rheumatoid arthritis.
 ...
PMID:Juvenile ankylosing spondylitis. 92 8

The purpose of the present study was to determine whether patients with recurrent low back pain display a different pattern of mood fluctuations across days than matched healthy controls and whether these mood states are related to pain occurrence and/or magnitude using a prospective design. The questions addressed are whether mood states prior to a pain episode are associated with the episode or whether mood relates to pain as a secondary reaction. Similarly, the relationship between mood state recorded prior to, during or following pain and magnitude of pain experienced was investigated. Thirty-three ambulatory chronic low back pain patients and an equivalent group of asymptomatic controls matched for age, sex, socioeconomic status, and reported activity level monitored mood state (anxiety, tension, depression, anger, vigor, fatigue, confusion) and pain before breakfast, at 4 p.m. and at bedtime for 14 consecutive days. Groups were successfully matched. Analyses revealed significantly higher levels of tension, anxiety and fatigue and lower levels of vigor in the pain cases. No mood state was predictive of pain onset but fatigue was associated with pain 24 h following pain, indicating fatigue as secondary to pain. While mood state recorded prior to or following pain was unable to predict magnitude of pain, fatigue was associated with the level of pain experienced during the pain episode itself. The findings reveal a pattern of anxiety, tension and fatigue where fatigue is associated with increased pain during the pain episode and is increased 24 h following pain. This fatigue-pain relationship is superimposed upon a continuous elevation of anxiety and tension. These findings suggest the importance of pain management efforts directed at decreasing patients' fatigue levels, and increasing functional endurance while simultaneously reducing anxiety. The results also question the role of negative mood states in the initiation or exacerbation of pain and highlights the influence of physical mood states such as fatigue on pain in low back pain.
 ...
PMID:A prospective analysis of stress and fatigue in recurrent low back pain. 296 55

The safety of AmBisome was evaluated in 187 transplant recipients treated for 197 episodes. Patients included 89 bone marrow transplant recipients, 64 liver transplant recipients, 20 renal transplant recipients and 14 recipients of combined organs. AmBisome was instituted for verified invasive fungal infection in 34 cases, suspected invasive fungal infections in 80 cases and as prophylaxis in 83 cases. AmBisome was given for a median of 11 days (range 1-112 days) with a maximum daily dose of 1.49 +/- 0.70 mg/kg/day (mean +/- SD). The total cumulative dose of AmBisome was 1.11 +/- 1.78 g (mean +/- SD). Side-effects definitely attributed to AmBisome therapy included low potassium (n = 3), low back pain (n = 3), dyspnoea (n = 2), allergic rash (n = 1), nausea and vomiting (n = 1), confusion (n = 1), rise in alkaline phosphatase (n = 1) and cholecystitis (n = 1) with an overall incidence of 13 of 197 (7%). AmBisome was discontinued due to side-effects in 6 (3%) of the cases. During AmBisome treatment the mean cyclosporin dose was 9.6 +/- 28.8 mg/kg/day. Compared to pre- and post-AmBisome therapy there was a significantly increased cyclosporin concentration in blood during AmBisome therapy. Side-effects with possible association to AmBisome therapy included low serum potassium (36%), increase in serum creatinine (31%), rise in alkaline phosphatases (26%) and fever (3%). The overall mean increase in serum creatinine was 20%. Other possible side-effects like headache, abdominal pain, rash, rise in bilirubin, cramps and pancreatitis was seen in single patients.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Safety of liposomal amphotericin B (AmBisome) in 187 transplant recipients treated with cyclosporin. 770 25

Confusion surrounding low back pain syndrome may partially be resolved in a select small group of patients by instituting a provocative intraarticular injection of a combination of a local anesthetic and a steroid. This approach enables one to determine whether the sacroiliac joint (SIJ) is the site of origin of the low back pain syndrome. We carried out a study of 71 computed tomography (CT)-guided injections in 58 patients with noninflammatory etiology. The injection was confirmatory to the SIJ abnormalities in 64 (90.1%) joints. The effect wore off in 2-14 days in 90% of the patients. We conclude that CT guidance is the best method of precise needle placement, and thus CT-guided anesthetic injection is the most specific confirmatory test for diagnosing the SIJ arthritis. In addition, in noninflammatory conditions, the role of intraarticular injection is primarily for diagnostic purposes and it has little or no therapeutic benefit.
 ...
PMID:CT-guided sacroiliac joint injections. 1094 99

Chronic pain patients have complex problems. Due to this, much research effort has been expended on the classification of pain patients and the classification of pain problems. A mainstay of most pain classification systems is the use of the physical location of the pain. Yet describing the location of the patient's pain is not straightforward. Many patients have pain at multiple sites and thus simple statements such as 'patients with low back pain' have considerable ambiguity. Does the statement refer to patients with pain just in the lower back or those with low back pain who may also have pain elsewhere (e.g. pain down the leg)? If patients do have pain elsewhere, at what other body sites and what are the implications of this? This paper presents data on the body location of pain for a large sample of 5279 patients seen with chronic pain in Scotland and the north of England. It shows that one-third of patients have pain in multiple locations, and that using a single body site to classify patients leads to groups with large overlaps. Thus, 38% of patients reported pain in the 'lower back/spine' and 34% reported pain in the 'buttock, leg, foot' - but there was considerable overlap between these groups. Nineteen percent of patients reported pain in both of these body areas, and one-third of these patients also had pain in at least one further body area. Furthermore, a systematic look at patients with diverse physical pain locations but a single site in common shows large demographic differences. Common pain groupings help to reduce the confusion; 13 pain site descriptions were able to account for 82% of all patients. The remaining 18% of patients had pain in a combination of body sites which they shared with fewer than 1% of other patients. Thus, pain patients are widely heterogeneous and complex. Patients report pain in more complex patterns than can easily be captured by a single body-site code. Further, large demographic differences between patients with different painful sites, even when they have at least one pain site in common, suggests that grouping patients based on a single site descriptor may be inappropriate. These findings have important implications for chronic pain description and classification. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
 ...
PMID:Where does it hurt? Describing the body locations of chronic pain. 1070 Mar 3

A 75-yr-old male simultaneously having lymphoplasmacytic lymphoma (LPL) and diffuse large B-cell lymphoma (DLBCL) is presented. He had manifested with lumbago, high-grade fever, and confusion. Physical examination on admission showed disorientation and severe back pain. There were neither lymphadenopathy nor hepatosplenomegaly. Routine laboratory tests showed moderate pancytopenia, hypercalcemia (serum calcium, 15.9 mg/dL), IgM lambda-type monoclonal gammopathy (IgG, 405 mg/dL; IgA, 42 mg/dL; and IgM, 2023 mg/dL), and lambda-type Bence-Jones protein in the urine (0.8 g/d). Bone marrow biopsy showed the clusters of surface lambda-positive small-sized mature-appearing lymphoplasmacytoid cells. Bone survey and computed tomographic scan showed multiple osteolytic lesions and a tumor involving the third lumbar spine (L3). An open biopsy of the L3 tumor showed diffuse proliferation of CD20- and lambda-positive large cells. We thus diagnosed the patient as simultaneously having LPL and DLBCL. Although the combination chemotherapy was at least partially effective, he died of bacteremia and organ failure after three courses of chemotherapy. To clarify the clonal relatedness between LPL and DLBCL, we analyzed the sequences of the complementarity-determining region 3 in immunoglobulin heavy-chain genes. The data showed that LPL and DLBCL in the present patient originated from two independent clones.
 ...
PMID:Simultaneous development of lymphoplasmacytic lymphoma and diffuse large B-cell lymphoma--analyses of the clonal relatedness by sequencing CDR3 in immunoglobulin heavy chain genes. 1258 Nov 94

In conditions where there is moderate or severe pain, such as in low back pain, sciatica and osteoarthritis affecting the hip, the patient often reports the sensation that the two legs are of unequal length. This sensation cannot be explained as a result of fracture or other trauma that might cause a real change in length of the legs. There is confusion as to whether this 'leg length inequality' causes the pain or vice versa. It is argued here that the sensation occurs when there is pressure on the sensory nerves, especially the dorsal spinal roots. This causes pain but, more relevantly, causes an increased discharge in muscle spindle nerves, this in turn signaling an increased length of the associated muscles. This idea is testable using percutaneous electrodes.
 ...
PMID:Leg length inequality in humans: a new neurophysiological approach. 1513 85

Lumbosacral transitional vertebrae (LSTV) are a common finding in the general population. Their clinical significance is controversial with no consensus as to their relationship to low back pain or disc prolapse. However, on magnetic resonance imaging (MRI) they may be difficult to positively identify on sagittal sequences and can lead to confusion with respect to numbering of lumbar discs and vertebrae, with the consequent risk of surgical intervention at an inappropriate level. The imaging findings of LSTV on plain radiography and MRI are reviewed and their clinical significance discussed.
 ...
PMID:Imaging of lumbosacral transitional vertebrae. 1548 46

Recent reports of provocative discography not only instill confusion, but also create numerous questions about its value in evaluating low back pain. It was reported that provocative discography produced pain in patients who were not suffering with low back pain but suffering with somatization disorder and depression. This study was designed to evaluate 50 randomly assigned patients, with 25 patients in Group I without somatization disorder and 25 patients in Group II with diagnosis of somatization disorder. In addition, depression, generalized anxiety disorder and combinations thereof were also evaluated. All patients underwent discography, investigating two to three discs in each patient. All studies included a control level with a disc that did not produce the patient's pain upon injection of contrast medium. Provocation with exact pain reproduction concordant with the symptom complex upon injection of contrast into the disc was considered positive. Any other response, with or without pain, was considered negative. Results showed positive provocative discography in 46% of the patients in the somatization group compared to 54% in the non-somatization group; in 46% of patients with depression compared to 54% of patients without depression; in 15 of 30 patients with generalized anxiety disorder; in 11 of 20 patients without generalized anxiety disorder; and in 42% of patients with combined somatization and depression, with negative discography in 58% of the patients. It is concluded that provocative discography provides similar results in patients with or without somatization, with or without depression, with somatization but with or without depression or with other combinations of the psychological triad of somatization disorder, depression, and generalized anxiety disorder.
 ...
PMID:Provocative discography in low back pain patients with or without somatization disorder: a randomized prospective evaluation. 1690 Feb 51

Stability is one of the most fundamental concepts to characterize and evaluate any system. This term is often ambiguously used in spinal biomechanics. Confusion arises when the static analyses of stability are used to study dynamic systems such as the spine. Therefore, the purpose of this paper is to establish a common ground of understanding, using standard, well-defined terms to frame future discussions regarding spine dynamics, stability, and injury. A qualitative definition of stability, applicable to dynamic systems, is presented. Additional terms, such as robustness (which is often confused with stability) and performance are also defined. The importance of feedback control in maintaining stability is discussed. Finally, these concepts are applied to understand low back pain and risk of injury.
 ...
PMID:Spine stability: the six blind men and the elephant. 1730 12


1 2 Next >>