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The current study investigated the utility of the Back Pain Classification Scale with chronic, intractable low back pain and headache patients. Subjects consisted of 50 chronic low back pain and 50 chronic headache patients referred to a university based Pain Center for evaluation. Data indicated that subjects were a representative sample of severely intractable chronic pain patients typically referred for Pain Center evaluation and treatment. Each was administered the Back Pain Classification Scale as part of a thorough physical and psychological/behavioral evaluation. All subjects were classified by blind review of medical records into one of two categories: (1) presence of psychopathologically based pain complaint with little or no pathophysiological findings and (2) presence of pathophysiologically based pain complaints with little or no psychopathological findings. Subjects were also independently classified from blind review of their scores on the Back Pain Classification Scale into one of these two categories. Findings revealed that the Back Pain Classification Scale accurately predicted the actual classification of 80% of the low back pain patients (i.e., 30% above baseline prediction rate) and only 60% of the chronic headache patients (i.e., only equal to the baseline prediction rate). Furthermore, the scale was found to be most accurate in predicting low back pain patients with primary psychopathologically based pain. It was concluded that the Back Pain Classification Scale was an empirically valid instrument to use with chronic low back pain patients, but not with chronic headache patients. This lack of utility with chronic headache patients was also viewed as support for the construct validity of the scale. Wider use of the scale with chronic low back pain patients was suggested.
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PMID:Cross-validation of the Back Pain Classification Scale with chronic, intractable pain patients. 316 34

The initial findings of this study indicate that menopause is regarded as a natural life-cycle transition in Japan in which the biological marker of cessation of menstruation is not considered to be of great importance. Symptom reporting among all respondents is generally low regardless of menopausal status, and symptoms such as shoulder stiffness and headaches, which are reported frequently, are not linked specifically to menopausal status (even though individual informants may perceive them to be so). Symptoms of hot flashes and sudden perspiration are higher among peri- and post-menopausal women, but their prevalence appears to be much lower than research findings from other areas to date. Reports by Japanese gynecologists emphasize that menopausal women are liable to present with numerous non-specific somatic complaints. This may well be an accurate representation of a clinical population, but the findings of this present study indicate that such a picture is by no means representative of the average middle-aged female population in Japan. While occupational differences do not contribute to variation in reported symptomatology (with the exception of lumbago and shoulder stiffness), there are nevertheless considerable differences in the subjective meaning of menopause, many of which can be accounted for by class and occupational differences. Presentation of these differences awaits a future publication, but there is one topic which is of concern to the majority of the respondents from each of the sub-samples. The present generation of women entering their 50's are the first where the majority must face later middle age in a nuclear family, along with their husbands, although both they and their husbands have been socialized for the more distant male/female relationships of an extended family. Japanese women cannot look forward, as they did in the past, to the power and comforts derived from running an extended family; on the contrary many can expect a late middle age of looking after bed-ridden parents or parents-in-law, and a lonely, isolated and often poverty-stricken old age (Steslicke 1984), since many pension programs are by no means adequate. Some of their fears about aging are expressed in their views on menopause, but these fears do not appear to be manifested at all prominently as either psychological or somatic representations. When asked to compare their lives with that of their own mothers, stories of incredible hardships from pre- and immediately post-war Japan are vividly portrayed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ambiguities of aging: Japanese experience and perceptions of menopause. 348 95

A phase I and pharmacokinetic study of recombinant tumor necrosis factor (rH-TNF Asahi) was carried out in 29 patients, who received a total of 72 courses with doses ranging from 1 to 48 X 10(4) units/m2. Drug was given as 1-h i.v. infusions. Acute toxicities, taking the form of fever, chills, tachycardia, hypertension, peripheral cyanosis, nausea and vomiting, headache, chest tightness, low back pain, diarrhea and shortness of breath were seen, but were not dose-limiting or dose-related. Some early rise in SGOT, without any change in serum bilirubin, was noted at the highest doses. Eosinophilia, monocytosis, mild hypocalcemia and an increase in fibrin degradation products were seen in a few patients. The dose-limiting toxicity was hypotension, which occurred after the end of the drug infusion and was seen in all 5 patients treated at the highest dose. There was no mortality or long-term morbidity. There were no responses. Pharmacokinetic studies indicated a rapid plasma clearance and a short plasma half-life, generally less than 0.5 h.
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PMID:Phase I clinical trial of recombinant human tumor necrosis factor. 366 33

In 1983 26 general practitioners in a Danish provincial town made a week's survey of pain as the main cause of patient-doctor contact during the day time. The population served was 45 000-50 000 persons of all ages. Coexistent pain which was not the cause of actual contact was not recorded. Out of 2 886 contacts of all causes 641 were due to pain (22% or 222/1 000 contacts). Percentages for acute and chronic pain were 61 and 39 respectively. The commonest causes of pain were musculo-skeletal (50%), visceral including cardio-vascular (20%), infectious (15%), and headaches (8%). The overall female: male ratio was 1.5: 1, but with considerable variation within the different pain categories. The ratios for acute and chronic pain were 1.4: 1 and 1.8: 1 respectively. About one hundred contacts were recorded as "problem cases" whose predominant complaints were low back pain, headaches, and visceral pain. Pain--especially chronic pain with a non-malignant cause--is a major problem in general practice. Essentially, pain is a primary health care problem and research in this field should be encouraged.
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PMID:Pain in general practice. Pain as a cause of patient-doctor contact. 372 34

A clinical Phase I study of recombinant human interferon alpha A (Ro 22-8181) was performed in patients with malignant tumors; twenty of them received an American product and seven others a domestic product. Both products were administered in single intramuscularly injected doses of 18, 36, 50, 75 and 100 X 10(6)U. Main side effects included fever and influenza-like symptoms (headache, chill/shivering, general fatigue, lumbago), and digestive symptoms (anorexia, nausea/vomiting). Numbness of fingers or limbs and somnolence were also observed in higher dose groups, but these symptoms all disappeared on the day of administration or by the 3rd day after administration. Abnormal laboratory findings included leukopenia, granulocytopenia, lymphocytopenia, thrombocytopenia and increased GOT/GPT/LDH, but these returned to normal by the 10th day after administration. The peak blood concentration was correlated with the dose, falling to the base line 72 hr after administration. The American product and the domestic product were nearly comparable in the type and incidence of their side effects, and also produced generally comparable blood concentrations. Furthermore, increased anti-IFN-alpha antibody titer was not observed in any of the patients; and the Prick Test proved negative in all of them. No significant changes were observed in any immunological parameters, either.
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PMID:[Phase I study of recombinant human interferon alpha A (Ro 22-8181) in patients with malignant tumors]. 400 81

The patients of a local outpatient department in a half--million population town have been examined. The rate of organic angiogenic encephalopathies, vasomotor headaches and epilepsy has been three times greater in those performing light work than in the hard-working group. No dependency between the hard work and rate of ischias and lumbago has been found. Operations of productive machines, similarly as the working place microclimatic conditions do not pose a risk of nervous system diseases, except ischias and lumbago which occur more frequently in an occupational group working at low temperature and considerable humidity or at an open air. Likewise, the body position at work significantly affects the rate of ischias and lumbago. Our findings prove that hard work does not pose an additional risk of nervous system diseases. Another conclusion of those investigations is that advantageous microclimate and body position at the working place, possibly accompanied by corrective physical training, are significant in the prevention of ischias and lumbago.
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PMID:[Nervous system diseases in large-city population. II. Effect of occupational factors]. 621 87

The side effects in myelography are well known and frequently observed. The most common are headache, nausea, and vomiting. In this study, a rather new compound, Thiorphan, was examined, which displays an antinociceptive activity by inhibiting enkephalinase activity. Forty-two patients received intravenous infusions of Thiorphan before myelography. Another 42 patients were in a control group, and Thiorphan was not administered. In the treated group, postmyelographic headache was found in 24% (versus 52% in the control group). Nausea and vomiting were never seen. Low back pain or sciatica was diminished in 33% of cases. Enkephalin levels in cerebrospinal fluid were measured by a radioreceptor-assay method in both groups without any correlation.
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PMID:Double-blind study of effects of enkephalinase inhibitor on adverse reactions to myelography. 622 5

A surface EMG diagnostic protocol was developed to assess the neuromuscular/postural contributions to pain states. The EMG activity of the right and left aspects of 11 muscle groups were monitored while the patient was in the sitting and standing positions. The diagnostic protocol was evaluated by comparing the patterns of EMG activity in four diagnostic groups: headache only, neck/shoulder/upper back pain only, low back pain only, and mixed pain states. The results suggest that (1) bilateral levels of EMG activity in the frontalis and masseter groups are of primary importance for the headache patients, (2) the discrepancy between the right and left EMG activity in the lumbar and cervical paraspinal muscle groups are of primary importance for low back pain patients, (3) position (sit/stand) may provide important diagnostic information, and (4) the data appear to support the notion of a postural disturbance as a contributing factor in low back pain.
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PMID:EMG scanning in the diagnosis of chronic pain. 622 39

Intraspinal tumors with subarachnoid hemorrhage are exceptional. They are most often localized at the cauda equina. Ependymoma is the most common tumor. Low back pain followed by headache (Fincher syndrome) should suggest hemorrhage originating from a low lesion.
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PMID:[Spinal meningeal hemorrhage of tumor origin]. 629 89

Sixteen patients poisoned by ingestion of a rice oil contaminated with polychlorobiphenyls (PCBs) in Taiwan voluntarily joined a trial of fasting cure for either seven or ten days approximately 26 or 35 months after being poisoned. During fasting, mixed juice made of fresh vegetables and fruits and milk or "tohnyu," that is, boiled soybean juice, were given on a fixed schedule. All these patients showed improvements of their symptoms and signs caused by the poisoning. Some of them enjoyed a dramatic relief of their sufferings such as severe headache, lumbago, arthralgia, pain at the sole, cough, sputa, and/or acneiform eruptions. The eruptions forming abscesses or cysts were, however, hard to cure. Thus, the fasting cure was demonstrated to be effective in the treatment of the patients. PCB concentrations in blood were rather elevated during and after the fasting.
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PMID:A trial of fasting cure for PCB-poisoned patients in Taiwan. 642 46


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