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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Many variables affect the outcome of keratomycosis and systemic fungal infections in animals. These include pathogenicity of the fungal organism(toxins, trophisms, and evasion of host response); previous treatment with topical or systemic corticosteroids, which can have a dramatic negative impact on host defense mechanisms: concurrent systemic illness or immunocompromise: severity/extent of infection; and degree of pain (ie,increased reflex tearing dilutes topical medication) [14]. Experimental work suggests that antibiotics may occasionally exacerbate fungal infections [142],and some researchers advocate that concurrent antibiotic therapy is contraindicated in horses with yeast infections and septate fungal infections unless bacterial infection is also suspected [14]. Nevertheless, given that normal conjunctival flora often include bacteria and fungi and because care of keratomycoses often includes mixed bacterial and fungal infections, the possible dynamics (natural influences and local competition) between ocular surface microorganisms merit further investigation. There are many unanswered questions regarding the accuracy of in vitro susceptibilities and corneal concentration capabilities for antifungal topical medications [14]. Inherent host resistance or other immune interactions between the patient and fungus are perhaps the most important determinants of the outcome but are currently difficult to measure or assess except by subjective clinical observation [14].
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PMID:Antifungals and their use in veterinary ophthalmology. 1511 Sep 78

A local inflammatory and potentially painful response, of which the ultimate cause is unknown, has been described in nervous tissues in contact with degenerated disc material in patients with low back and leg pain. With the rationale that a possible cause of such inflammation could be bacterial infection, we utilized PCR (polymerase chain reaction) amplification of the 16S rRNA (ribosomal RNA) gene followed by gene sequencing, to investigate whether bacterial DNA might be detected in the degenerative discs of 10 patients operated for disc herniation or post-discectomy syndrome. One patient with disc hernia harbored DNA homologous to Bacillus cereus, and in one patient suffering from post-discectomy syndrome, Citrobacter braaki/freundii DNA was detected. The finding demonstrates that 16S rRNA PCR can be a useful tool in search of bacterial DNA in degenerated discs, which in turn may be indicative of low-grade infection, manifesting itself only as pain rather than as clinical infection.
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PMID:Detection of bacterial DNA in painful degenerated spinal discs in patients without signs of clinical infection. 1513 61

A 78-year-old man who was being followed-up for a liver cyst was admitted to Asakayama General Hospital because of the sudden onset of severe right hypochondralgia and fever, with a preceding dull pain in the right upper quadrant of the abdomen of four 'days' duration. Computed tomography revealed remarkable enlargement of the liver cyst. We diagnosed intracystic hemorrhage and spontaneous rupture of the liver cyst. As we diagnosed bacterial infection in the ruptured cyst, transhepatic cystic drainage was performed. After improving the clinical status of the patient, we injected ethanol into the cyst, inducing a significant decrease in its size. There has been a few previous reports of intracystic hemorrhage and spontaneous rupture of a liver cyst complicated by infection. Transhepatic cyst drainage combined with antibiotic therapy and intracystic ethanol injection may be a useful and minimally invasive method for liver cysts with these complications, especially in compromised patients.
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PMID:Intracystic hemorrhage with spontaneous rupture of liver cyst complicated by infection: a case report. 1517 32

The idea that opioids modulate the immune system is not new. By the late 19th century, Cantacuzene, used morphine to suppress cellular immunity and lower the resistance of guinea pigs to bacterial infection. While exogenous opioids mediate immunosuppression, endogenous opiates exert opposite actions. Acute and chronic opioid administration is known to have inhibitory effects on humoral and cellular immune responses including antibody production, natural killer cell activity, cytokine expression, and phagocytic activity. Opiates behave like cytokines, modulating the immune response by interaction with their receptors in the central nervous system and in the periphery. Potential mechanisms by which central opiates modulate peripheral immune functions may involve both the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. The presence of opioid receptors outside the central nervous system is increasingly recognized. Those receptors have been identified not only in peripheral nerves but also in immune inflammatory cells. The immunosuppression mediated by opiates may explain the increased incidence of infection in heroin addicts. Opiates may also promote immunodeficiency virus infection by decreasing the secretion of alpha and beta chemokines (important inhibitory cytokines for the expression of HIV) and at the same time increasing the expression of chemoreceptors CCR5 and CCR3, coreceptors for the virus. The fact that peripheral immunosupression is mediated at least in part by opioid receptors located in the central nervous system and that intrathecally administered opioids do not exert the same immunosuppressive effects may have important clinical implications for those patients receiving long-term opioid therapy for malignant and nonmalignant pain.
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PMID:Opioid therapy and immunosuppression: a review. 1535 31

Bacterial pyomyositis has been defined as a subacute, deep bacterial infection of the soft tissues. The entity was originally described only in tropical climates, but it is increasing in incidence in temperate climates, such as in the United States. This is mainly attributed to the presence of immunocompromising states such as HIV/AIDS or liver disease. The etiology of pyomyositis remains a mystery, but its characteristics are well-described. If untreated, the disease process progresses through three distinct stages. The first stage is defined by vague complaints, muscle pain, and a low-grade fever. The second stage presents as worsening pain, swelling, fever, and actual abscess formation in the muscle. If the patient remains untreated, pyomyositis progresses to the third stage, which includes septicemia and possible septic shock. Large muscles around the pelvis are most commonly affected, and Staphylococcus aureus is the bacteria seen in most documented cases. To make a timely diagnosis and prevent serious sequelae, physical examination, laboratory results, imaging studies, and a high clinical suspicion must all be combined. Magnetic resonance imaging is the diagnostic study of choice, but it may be inconclusive early in the disease process. Definitive diagnosis must be made with aspiration or surgical drainage. Once diagnosed, treatment consists of appropriate intravenous antibiotics and possible surgical intervention. A full recovery is expected if appropriate treatment is initiated early in the process.
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PMID:Bacterial Pyomyositis. 1546 91

Foreign-body injury of the juvenile knee is frequently seen in the outpatient department. Arthroscopy is the most important diagnostic and therapeutic procedure along with radiographic examination in a case of typical history and clinical symptoms. In this case, an intra-articular thorn in a juvenile knee was not diagnosed at arthroscopy despite typical injury. Five months later, the boy developed knee pain and joint swelling. Bacterial infection of the knee and rheumatoid causes were excluded by serologic blood analysis several times at the children's hospital. Magnetic resonance imaging of the knee revealed an intra-articular foreign body. At a second arthroscopy, the thorn was removed and a hypertrophic plica with dependent cartilage damage of the medial femoral condyle was resected. At follow-up after 4 weeks, the boy was free of pain and swelling. After the first arthroscopy, persistent knee swelling and pain had to be taken as a hint of an intra-articular irritation. All arthroscopic surgeons should do a complete diagnostic examination of the affected joint in case of a foreign-body injury.
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PMID:Monarthritis of the pediatric knee joint: differential diagnosis after a thorn injury. 1548 50

The anatomical and structural characteristics of the pulp make this structure prone to altering as a result of, for instance, periodontal conditions (proximity), iatrogenic alterations, infections and involvement of vascular and nerve structures (it is surrounded by hard tissues that prevent expansion), to name just a few. Pulpitis is a process that courses with pain of varying intensity that allows us to determine the location of the lesion in clinical terms. Its evolution varies and may even progress to pulpar necrosis that in turn, produces neuritis-like pain. Diagnosis is established by means of clinical symptomatology and supported by X-rays, palpation of tissues at painful sites, application of electrical stimuli, heat, etc. Periodontitis is a bacterial infection originating in the apex. The most important form is the so-called acute apical periodontitis that arises as a result of a prior episode of pulpitis. It is characterized by acute pain located in the tooth, accompanied by the feeling of having a long-tooth. The patient refers being unable to chew on that side; there may be painful mobility of the tooth and an outflow of pus that alleviates symptoms. X-rays do not provide a lot of information, but may attest to a widening of the apical space. This pathology may disseminate to surrounding tissues, leading to conditions of considerable severity.
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PMID:Bacterial infections of pulp and periodontal origin. 1558 Jan 35

A 52-year-old man was given a diagnosis of type 2 diabetes mellitus at age 39. At age 46, he stopped taking medication. Two weeks after burning his legs at low temperature, he fell, using his right arm to protect his legs. The next day, he complained of pain and slight swelling from his right shoulder to his anterior chest and came to our hospital. At that time, a plain computed tomography scan suggested gasogenic bacterial infection and we discussed the indications for debridment. Although his widespread inflammation required extensive treatment including thoracostomy, we abandoned surgical treatment and administered several antibiotics in appropriate combination because of his severe condition. After admission, the mass grew rapidly and it was diagnosed as necrotizing fasciitis based on percutaneous needle biopsy and clinical findings. Although both inflammatory reactions and mass size tended to improve, he had repeated recurrence of pain and swelling in his right anterior chest. When he had a second recurrence, he received additional short-term steroid therapy. Afterwards he had no further recurrence. In this case, early clinical diagnosis, using broad-spectrum antibiotics prior to definite diagnosis, and additional short-term steroid therapy at the time of the recurrence were effective.
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PMID:[A case of successful medical treatment for necrotizing fasciitis of the chest wall with diabetic nephropathy]. 1580 Dec 85

Acral mutilation and analgesia (AMA) is reported in 13 French spaniels in Canada. This newly recognized disorder shares striking similarities in clinical features and biopsy findings to the other acral mutilation syndromes or hereditary sensory neuropathies reported in German short-haired pointer dogs, English pointer dogs and English springer spaniels. Clinical signs are first noted between 3.5 and 12 months of age. Affected dogs lick, bite and severely self-mutilate their distal extremities resulting in ulcers with secondary bacterial infection. Auto-amputation of claws, digits and footpads occurs in severe cases. Single or multiple feet can be affected. Affected dogs walked on their severely mutilated feet without evidence of pain, lameness, or ataxia. The majority of the dogs were euthanized within days to months of diagnosis.
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PMID:Acral mutilation and analgesia in 13 French spaniels. 1584 38

Irritable bowel syndrome (IBS) is a debilitating disease, which is characterised by recurrent abdominal cramping and pain, and is associated with either constipation and/or diarrhoea. It is approximately twice as prevalent in women as it is in men and is among the most common gastrointestinal (GI) disorders encountered in primary care. The aetiology of the disease is poorly understood but may include motility dysregulation, visceral sensitivity, inflammation, bacterial infection, dietary antigens, psychological stress, GI surgery or a gut-brain phenomenon. At present, there is no acceptable treatment for IBS, although recent advances indicate that some relief may be achieved by the administration of compounds that act on 5-HT (serotonin) receptors. This suggestion is the result of numerous studies which have shown that 5-HT may exert a number of diverse effects on human GI tissues. In addition, it has emerged that the levels of the 5-HT metabolite (5-HIAA) are raised in the plasma of IBS patients and that administration of 5-HT-like compounds may mimic the symptoms of IBS. It has therefore been proposed that therapy with compounds that act at 5-HT receptors will return the intestine to normal activity and alleviate the pain experienced by these patients. One compound (alosetron, a 5-HT3 receptor antagonist) has already been released onto the market but showed benefit in female patients only and only in those whose primary symptom was diarrhoea. In addition, the compound was recently withdrawn following concerns over its safety. The reasons why alosetron only appears to show efficacy in females, why these treatments are only effective in a subset of the population of IBS patients and why alosetron elicits its particular side effect profile have not been elucidated. One further serotonergic compound, tegaserod (Zelmac, a 5-HT4 receptor agonist), has shown promise for the treatment of patients with constipation-predominant IBS and is currently in pre-registration for this indication. It is clear, however, that further research will have to take place before the utility of serotonergic modulation in the treatment of IBS can be fully validated.
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PMID:Serotonergic modulation and irritable bowel syndrome. 1598 96


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