Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Endorphin levels in human cerebrospinal fluid (CSF) have been determined by using the electrically stimulated mouse vas deferens bioassay. Endorphins were extracted by adsorption to a synthetic resin of Amberlite XAD-2 eluted with methanol, and dried under a nitrogen atmosphere. Three different groups of patients have been studied: a) control subjects without a history of pain (n = 25), b) patients with acute postoperative pain after high abdominal and thoracic surgery (n = 8) and c) patients with chronic pain due to discal hernia (n = 14). The endorphin levels (expressed as equivalents of Met-E) obtained from the control group were 4.36 +/- 0.7 pmol/ml. In the postoperative group an endorphin decrease of 0.42 +/- 0.07 pmol/ml, was found while in the chronic pain group the levels obtained were 1.39 +/- 0.2 pml/ml. Thus a significantly low level of CSF endorphins was observed in both the postoperative and the chronic pain group as compared with the controls (p less than 0.01). These results suggest a correlation between pain levels and endorphin concentration in CSF. However in the acute postoperative pain group other factors such as depletion of endorphins by drugs used for anesthesia or due to surgical stress cannot be excluded.
 ...
PMID:[Measurement of endorphins in human cerebrospinal fluid. Comparative study of various groups of patients]. 715 54

In laparoscopic hernia repairs, the staples used to affix prosthetic mesh have resulted in entrapment neuropathies. This paper describes the diagnosis and treatment of nine cases of entrapment neuropathy. Injuries to all the branches of the lumbar plexus, with the exception of the obdurator nerve, have been treated. Generally, the entrapments are self-limiting, but chronic disability requiring surgical intervention can occur. Staple removal and neurolysis controlled the severe, chronic pain of one femoral nerve entrapment. A thorough understanding of the anatomy of these nerves can prevent stapling in the areas of danger and thus greatly reduce the incidence of this complication.
 ...
PMID:Entrapment neuropathy in laparoscopic herniorrhaphy. 799 73

Seventy-nine patients (106 repairs) with inguinal hernias underwent laparoscopic transabdominal preperitoneal hernia repair. The patients included 73 males and 6 females, ranging in age from 19 to 86 years. Twenty-five percent had undergone previous abdominal surgery, and 19% had recurrent hernias. Preoperative diagnosis was 40 right inguinal hernias (RIH), 33 left inguinal hernias (LIH), and 6 bilateral hernias. Intraoperatively, 30 RIH, 22 LIH (1 patient also had a left incisional hernia), 26 bilateral hernias, and 2 femoral hernias were diagnosed and repaired. Twenty patients (25%) had contralateral hernias diagnosed intraoperatively. Average operating time for unilateral repairs was 76 minutes and for bilateral repairs was 110 minutes. Forty-three percent of patients underwent day-care surgery, and 35% were discharged on the first postoperative day. Postoperative complications included 6 cases of transient neuralgias (7%), 3 cord/scrotal hematomas (4%), 1 trocar site hematoma (1%), and 1 case of chronic pain (1%). Follow-up ranged from 1 to 12 months with no recurrences. This study demonstrates the importance of laparoscopy in identifying undiagnosed contralateral hernias, that bilateral hernias can be repaired with no additional morbidity, and that there are high rates of success and safety in laparoscopic hernia repairs in a community hospital.
 ...
PMID:Laparoscopic hernia repair. 794 98

The management of chronic pain in sportsmen and women requires consideration of a wide differential diagnosis. A syndrome caused by a distension of the posterior inguinal wall is described, effectively an early direct inguinal hernia. The diagnosis can be made from certain aspects of the history and examination, which are described. The results of surgical repair to the posterior inguinal wall are excellent. The procedure was carried out on 14 sportsmen and one woman. There is an 87% return to full sporting activity, with a follow-up of 18 months to 5 years. The remaining 13% were improved by the repair. Many of the athletes had received other treatments without success. The sports hernia should be high on the list of differential diagnoses in chronic groin pain.
 ...
PMID:The sports hernia: a cause of chronic groin pain. 845 16

Severe chronic pain after groin hernia repair is uncommon but potentially debilitating. Fifteen patients with this condition were retrospectively reviewed. All patients had severe pain, which prevented their working or normal activity and was refractory to nonoperative treatment. Essentials of therapy included 1) a preoperative attempt to identify the involved nerve and 2) high ligation and division of the involved nerve identified at exploration. Twelve patients obtained excellent results and were able to return to normal activity with no requirement for analgesia. Understanding of the typical nerve anatomy, as well as the individual variation in nerve anatomy, can help prevent this complication and is essential for correction if the complication does develop.
 ...
PMID:Neuralgia after inguinal hernia repair. 871 65

Laparoscopic hernia repair has evolved considerably since its introduction. Different methods have been described, and multiple studies have been performed reporting widely varying outcomes. This study was undertaken to review all the major publications on laparoscopic herniorrhaphy from 1993 to 1996 and evaluate the rates of recurrence and complications involved in the various techniques. In a total of 11,222 laparoscopic hernia repairs, the procedure performed most frequently was the transabdominal preperitoneal patch (TAPP), followed by the total extraperitoneal patch (TEP). There were 300 (2.7%) recurrences. From 9,955 hernia repairs, there were 1,534 (15.4%) complications. Hematoma/seroma (456), neuralgia (199), urinary retention (150), and chronic pain (39) were the most frequently reported complications. Laparoscopic herniorrhaphy is a higher effective method of hernia repair with results comparable with the open technique. TAPP is still the most widely performed technique. TEP is becoming more popular, mainly because of its excellent outcome. The major drawback of TEP is the difficulty of reproducibility by different general surgeons with comparable results. Other techniques such as plug and patch carry a high rate of recurrence and complications and should probably be completely abandoned.
 ...
PMID:Laparoscopic herniorrhaphy: review of complications and recurrence. 953

We here report a patient with chronic pain who was treated with large doses of oral morphine. A 37-year-old female was diagnosed as Lyme disease and lumbar disc hernia. When she received lumbar puncture for myelography, she fainted due to severe pain in the legs. After this incident, her pain increased markedly, and she visited our outpatient clinic in 1996. After confirming the temporary pain relieving effect of caudal block, we prescribed oral morphine tablets 60 mg daily. The dose of morphine necessary to relieve her pain increased gradually to 220 mg. But she did not develop dependence or side effects. However, when the daily dose of 300 mg was administered, she felt dizzy. We therefore performed lumbar sympathetic block with phenol. After the block, her conditions improved markedly at a dosage of 300 mg. In conclusion, our experience in this case has shown the effectiveness of long-term morphine use with non-cancer patients and the efficacy of nerve block to avoid increasing the morphine dosage.
 ...
PMID:[Long-term administration of large doses of oral morphine for chronic pain]. 969 99

Chronic pain on the ventral surface of the scrotum and the proximal ventro-medial surface of the thigh especially in athletes has been diagnosed in various ways; recently, in Europe the concept of "sports hernia" has been advocated. However, since few reports discuss the detailed course of the nerves in association with the pain, we examined the cutaneous branches in the inguinal region in 54 halves of 27 adult male cadavers. From our results, in addition to the cutaneous branches from the ilioinguinal n. (in 49 of 54: 90.7%), cutaneous branches originating from the genital branches of the genitofemoral nerve were found in the inguinal region in 19 of 54 halves (35.2%). In 7 cases (in 7 of 54: 13.0%) the genital branch and the ilioinguinal nerve united in the inguinal canal. In 6 cases the genital branch pierced the inguinal lig. to enter the inguinal canal, and in three cases the genital branch pierced the border between the ligament and the aponeurosis of the obliquus externus m. to be distributed to the inguinal region. Therefore, the courses of the genital branches vary considerably, and may have a very important role in chronic groin pain produced by groin hernia. In addition, entrapment by the ligament may be a reasonable candidate for the cause of chronic groin pain.
 ...
PMID:Anatomic basis of chronic groin pain with special reference to sports hernia. 1037 Sep 86

Groin pain in athletes is a common problem that can result in significant amounts of missed playing time. Many of the problems are related to the musculoskeletal system, but care must be taken not to overlook other more serious and potentially life threatening medical cases of pelvis and groin pain. Stress fractures of the bones of the pelvis occur, particularly after a sudden increase in the intensity of training. Most of these stress fractures will heal with rest, but femoral neck stress fractures can potentially lead to more serious problems, and require closer evaluation and sometimes surgical treatment. Avulsion fractures of the apophyses occur through the relatively weaker growth plate in adolescents. Most of these will heal with a graduated physical therapy programme and do not need surgery. Osteitis pubis is characterised by sclerosis and bony changes about the pubic symphysis. This is a self-limiting disease that can take several months to resolve. Corticosteroid injection can sometimes hasten the rehabilitation process. Sports hernias can cause prolonged groin pain, and provide a difficult diagnostic dilemma. In athletes with prolonged groin pain, with increased pain during valsalva manoeuvres and tenderness along the posterior inguinal wall and external canal, an insidious sports hernia should be considered. In cases of true sports hernia, treatment is by surgical reinforcement of the inguinal wall. Nerve compression can occur to the nerves supplying the groin. In cases that do not respond to desensitisation measures, neurolysis can relieve the pain. Adductor strains are common problems in kicking sports such as soccer. The majority of these are incomplete muscle tendon tears that occur just adjacent to, the musculotendinous junction. Most of these will respond to a graduated stretching and strengthening programme, but these can sometimes take a long time to completely heal. Patience is the key to obtain complete healing, because a return to sports too early can lead to chronic pain, which becomes increasingly difficult to treat. Management of groin injuries can be challenging, and diagnosis can be difficult because of the degree of overlap of symptoms between the different problems. By careful history and clinical examination, with judicious use of special tests and good team work, a correct diagnosis can be obtained.
 ...
PMID:Groin injuries in sport: treatment strategies. 1049 31

A total of 186 consecutive patients underwent open tension-free inguinal hernia repair, either on one or both sides. Overall, 220 hernias were repaired under local anesthesia conditions after intraoperatively classifying the size of the hernia. The follow-up investigation took place as planned in 165 hernias. The mean follow-up time was 15.5 months, with a range from 6.6 to 30. 8 months, and the follow-up rate was 75.0 %. During this first follow-up it was especially interesting to read the patients, self-assessment concerning their physical restrictions during the first month after the operation. Furthermore, we were interested in learning about the objective and subjective operation-linked consequences in the patients, inguinal region. Most patients (89.7 %) were able to do sports and drive their car; 86.1 % were able to manage their usual physical activity 4 weeks after the operation. Focusing on the operation site, patients complained about chronic unpleasant effects, such as mild pain (21.2 %), local hypoesthesia (12.1 %), weather-dependent changes in sensitivity (7.2 %), moderate pain (3.6 %), inguinal syndrome (1.8 %) and hyperesthesia (1.2 %). Persistent swelling in the parainguinal region was found in 1.8 % of the patients and only one recurrence was found (0.6 %). In the analysis we found that mild chronic pain was not related to the time period after the operation and the age or sex of the patient, but there was a correlation with the size of the hernia. Patients with small hernias significantly more often experienced chronic pain than patients with bigger hernias. These results suggest that open tension-free inguinal hernia repair according to Lichtenstein appears to be overtreatment in patients with small inguinal hernias.
 ...
PMID:[Long-term results after tension-free inguinal hernia repair]. 1050 66


1 2 3 4 5 6 7 8 9 10 Next >>