Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In approaching a patient suspected of peripheral vascular disease the following signs and symptoms are of key importance (16): 1) Pain in the extremity which is induced by exercise and relieved by rest; pain which is influenced by posture is localized to one digit, is unilateral or is paroxysmal. 2) Impaired pulsations of peripheral arteries. 3) Abnormal color of the skin, particularly when affected by raising or lowering the part. 4) Gangrene, ulceration, impaired nail and hair growth, excessive calluses, or paronychial infections. 5) Unusual warmth or coldness. 7) Swelling, atrophy, or difference in length of extremity. 8) Ausculatory evidence of arteriovenous fistula. 9) Cyanosis or unusual pallor of digits when immersed in cold water. 10) Peripheral neuritis.
 ...
PMID:Occlusive arterial disease in the lower leg and foot. 103 Jul 26

In 79 patients in whom distal small vessel bypass with autogenous vein was used for revascularization because of gangrene, gangrenous ulceration or rest pain, 14 had femoroperoneal bypasses. Femorotibial or femoroperoneal bypasses were performed in those patients in whom no popliteal runoff was present on pre-operative arteriogram. Femoroperoneal bypass was performed in preference to primary amputation in each case. Nine of 14 (64.3%) of femoroperoneal bypasses were functional whereas 57 of 79 (72.2%) of total distal bypasses to small vessels were functional. Salvage of severely ischemic lower extremities was achieved in 5 of 14 (35.7%) patients after femoroperoneal bypass and in 46 of 65 (70.8%) patients after bypass to anterior tibial or posterior tibial arteries. Graft patency without limb salvage occurred in 4 of 9 (44.4%) patients with patent femoroperoneal bypasses and in only 2 of 48 (4.2%) of patients with femorotibial bypass. Although limb salvage rate is considerably less with femoroperoneal than femorotibial or femoropopliteal bypass, attempted limb revascularization by peroneal bypasses is preferable to primary amputation in patients with rest pain, gangrenous ulceration or gangrene.
 ...
PMID:Femoroperoneal bypass: evaluation of potential for revascularization of the severely ischemic lower extremity. 111 50

Thirty-one aneurysms of the popliteal artery in 23 patients have been studied. Twenty-nine aneurysms were secondary to atherosclerosis, while one was secondary to trauma and one was associated with a coagulopathy. The lesions were bilateral in eight patients and were associated with extra-popliteal aneurysms in ten patients; the abdominal aorta was the most frequent extrapopliteal site. All except two of the 23 patients were over 50 years of age, and many exhibited atherosclerosis and related symptoms in other vessels. Ischemic rest pain was the most common presenting symptom in patients with popliteal aneurysm, but three of the patients were asymptomatic. The most common physical sign was a palpable popliteal mass in 25 patients, with impending gangrene distal to the aneurysm in four. Thrombosis occurred in 11 of the aneurysms, embolism in three, and rupture in two. Amputation was eventually necessary in five patients with thrombosis and in one patient with embolism. Of 16 patients presenting with a complication of popliteal aneurysm, six patients eventually required amputation. All popliteal aneurysms should be treated surgically and arterial continuity restored unless contraindicated by the over-all condition of the patient. The saphenous vein represents the optimal replacement material available at this time, but fabric grafts can be used successfully.
 ...
PMID:Aneurysms of the popliteal artery. 111 29

Frequently surgical amputation of a lower extremity is required when gangrene develops as a result of peripheral vascular disease. This is particularly true in geriatric patients. A below-knee amputation, with refinements in the surgical procedure, and immediate rigid-cast prosthetic fitting are strongly advocated by our group. The progress of two patients treated in this manner is described. Preservation of the knee joint improves the amputee's prognosis for ambulation with a below-knee prosthesis. The rigid-cast dressing on the below-knee amputation reduces edema and postoperative pain, is of psychologic value to the patient, and permits him to stand at from one to two days postoperatively.
 ...
PMID:Prosthetic fitting immediately after below-knee amputation. 113 52

A 23-year-old man presented witha firm plague-like penile mass with pain and deviationon erection, suggesting Peyronie's disease. Biopsy was erroneously interpreted asconformatory. Irradiation was the one mode of therapy which gave temporary subjective relief. Extension of the mass and focal gangrene led to rebiopsy 6 years later. Epithelioid sarcoma was present microscopically, and was also found on re-examination of theoriginal biopsy. Partial penectomy was performed, but pulmonary metastasis had alreadyoccurred. He was treated with chemotherapy and radiotherapy and is now alive with disease 2 years later. The diagnosis of possible penile sarcoma, although rare, must be considered in patients with symptons suggesting Peyronie's disease, especially if the lesion continues to enlarge.
 ...
PMID:Epitheloid sarcoma masquerading as Peyronie's disease. 114 1

The incidence of early failure in 115 vein femoropopliteal grafts has been analyzed for the presence of reliable prognostic indicators of such failures. One hundred twelve patients had preoperative Doppler ultrasound assessment; 98 had intraoperative graft flow measured. Early graft failure was more prevalent in patients with rest pain and gangrene and in patients with poor runoff. Neither of these two findings had predictive value. Ninety-one percent of patients with a pressure index (ankle systolic pressure/brachial systolic pressure) less than 0.20 had early graft thrombosis. This suggests that arterial reconstruction is futile in this group. Measurement of vein graft flows intraoperatively was of value. Grafts with basal flows less than 70 ml/min uniformly thrombosed. There was significant correlation between ankle pressure index and intraoperative vein graft flow (r=.52). Both ankle pressure index and intraoperative vein graft flow provide prognostic indications of graft failure and should be of value in selecting patients for femoropopliteal reconstructions.
 ...
PMID:Prognostic indicators in femoropopliteal reconstructions. 119 Oct 22

Certain patients who would be candidates for aorto-iliac revascularization surgery because of decubitus pain or gangrene, are not suitable for direct surgery because of general contraindications. Axillo-femoral bridging is thus an excellent and less aggressive revascularization procedure for these patients in order to avoid amputation. The authors carried out this type of bridging 261 times in 5 years in cases of high surgical risk.
 ...
PMID:[The place of axillofemoral bridges in the treatment of arteriopathies of the lower extremities]. 123 Aug 6

Sixty-one patients had lumbar sympathectomies performed for end stage occlusive vascular disease manifested by gangrene of less than one-half of the foot, ulcerating ischemic lesions, rest pain or rapidly progressive markedly limiting intermittent claudication. The operative procedure was standardized to permit removal of the lowermost preganglionic fiber at the level of the crus of the diaphragm and the ganglionated chain to the crossing of the iliac vessels. The immediate postoperative mortality was 6.5% from cardiac causes. Over all improvement rate was 60% while early amputation rate was 40% for the entire group. Those patients with rest pain had the poorest prognosis with an amputation rate of 53%. The results are compared to other groups and factors of patient selection, anatomy of the sympathetic chain in relation to operative technique, physiology of decentralization versus devervation are discussed. The procedure is worthwhile in patients who are not candidates for arterial reconstruction who are faced with the prospect of early amputation.
 ...
PMID:Lumbar sympathectomy in end stage arterial occlusive disease. 124 13

During a three-year interval, 12 multisensory peripheral nerve divisions in ten patients were performed for intractable ischemic foot pain. The two major indications, after concluding that revascularization was impossible, were (1) the presence of localized, dry, and contained acral gangrene in patients who were not candidates for a lesser amputation and (2) patient or family refusal of a limb amputation.
 ...
PMID:Peripheral nerve division for relentless ischemic foot pain. 126 4

The profunda femoris artery is the primary source of collateral flow to the lower extremity in the presence of superficial femoral and/or popliteal occlusion. The arteriosclerotic disease involvement of this segment is relatively less frequent and in the majority of the cases localized on the ostium and reaches to the first branch. Profundaplasty to relieve limb-threatening ischemia is infrequently employed as an isolated procedure. However many Authors reported their experience on this treatment, in case of critical limb ischemia in patients without significative lesions of the aortofemoral district. Our late four year experience concerns of 22 patients (18 male, 3 female). All the patients had severe ischemia of the lower limbs, with serious symptoms, such as invalidating claudicatio (13), rest pain (7) and gangrene (2). Twenty-two profundaplasty were performed as the only reconstructive procedure. There was no postoperative mortality. Two patients had above knee amputations (15 days and 14 months after the revascularization). All of the other patients improved and follow-up extended to 48 months shows a limb salvage rate of 90%. In conclusion, on the basis of our experience, we think that the operation is recommended, whenever possible, in patients with critical ischemia when the possibilities of more extensive revascularization procedures are considered to be poor.
 ...
PMID:[Profundaplasty as the only revascularization procedure in ischemia of the leg. Clinical contribution]. 129 22


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