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

We utilized physician-coded diagnoses and chart reviews to estimate the incidence of interstitial cystitis (IC) in women. A computer search of the Kaiser Permanente database was performed to identify newly coded diagnoses of IC (ICD-9 code 595.1) between May 2002 and May 2005. Chart reviews were performed and patient demographics, diagnosing physicians, and symptom characteristics were recorded. The IC incidence rate was 15 per 100,000 women per year. The mean age of the patients was 51 years (range 31-81 years). The most common presenting symptoms were frequency (70%), dysuria (52%), urgency (50%), suprapubic pain (50%), nocturia (35%), and dyspareunia (13%). Cases diagnosed by primary care physicians had a shorter median symptom duration (9 months) compared with those diagnosed by urologists (1 year) and gynecologists (3 years). IC is an uncommon diagnosis in the community setting, with an incidence rate of 15 per 100,000 women per year.
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PMID:Incidence and clinical characteristics of interstitial cystitis in the community. 1826 25

Chronic low back pain as a leading symptom of a somatoform pain disorder is a remnant diagnostic category for many physicians, general practitioners and orthopaedic surgeons. Patients with somatoform pain disorder (ICD-10: F45.4) are often not diagnosed until after several years and multiple diagnostic procedures, in some cases after iatrogenic impairment. A more precise knowledge of the disorder can prevent chronification. This article outlines the clinical features, diagnostic procedure and differential diagnosis in somatoform pain patients and presents current psychotherapeutic approaches.
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PMID:[Chronic low back pain as a somatoform pain disorder]. 1835 30

A comparative analysis was carried out of depressive and anxiety disorders in accordance to ICD-10 criteria in the group of patients with pain variant of somatization disorder (SD), vegetative dysfunction (VD) with monolocal pathological body sensations (PBS) and VD with be- and polylocal PBS (analogous of somatoform vegetative dysfunction without of an accent on disturbances of physiological functioning of any organs or system). Results of this analysis compared with frequency of depressive and anxiety symptomatic in the group of patients with depressive episode (DE). As a result of discriminative analysis 20 depressive and anxiety symptoms were established with possibility of determination of mutual distant/near of 4 clinical groups in feature's space. The SD and VD with monolocal PBS groups take place extreme position in the continuum of 4 clinical groups, DE and VD with be- and polylocal PBS - middle position. Pain variant of SD with primary light (rare middle) severe of depressive episode, as a rule, anxiety modality of low mood can be qualified as masked (somatization) depression. VD patients with be- and polylocal PBS were attributed to atypical monopolar depression; depressive episode without pathological body sensations (to the exclusion of possible vitalization of verbalization/no verbalization melancholy affect) occupied middle position in the continuum of monopolar depression as an affective psychosis.
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PMID:[Integrative estimation of depression, anxiety and somatoform disorders]. 1837 93

In a retrospective, controlled clinical study the life events of 35 patients suffering from chronic low back pain (LBP) and a matched sample of 23 patients with neurotic depression (ICD 300.4) were investigated. The pain patients formed two groups: 19 patients with definite organic diagnosis (IASP code 530.96) and 16 without (adequate) organic lesion (IASP code 510.99). Somatic diseases (other than LBP), injuries and operations, as well as psychic trauma (feelings of shame, narcissistic traumatisations and object losses) were defined and counted as documented in the patient's histories. Their distribution over the period between the 10th year before onset of LBP resp. depression and the 10th year after onset was calculated. As a result all patients have to cope with a maximum of stressful life events in the initial year of their disease. Those patients, who fell ill younger than 30 years old, are confronted with an increased number of stressful life events even during several years before the onset. In all groups significant more stress is experienced after illness onset compared with the time before onset. LBP patients without organic findings experience more narcissistic traumatisations than the other two groups in the initial year and later on. In contrast depressive patients suffer from more other diseases, injuries and have undergone more operations than pain patients throughout the whole time investigated. Object losses occur equally often in all groups, apart from the initial year, when depressive patients have to cope with even more losses than the others. These results are discussed considering the development of chronic pain syndromes, the influence of age and their consequences for models of illness. There is convincing evidence, that physical injury is neither a necessary nor a sufficient condition for the development of chronic pain and that chronic pain is in essence an emotional disease based on unresolved unconscious conflicts requiring psychotherapy.
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PMID:[Chronic low back pain and life events.]. 1841 17

The Heel Pain-Plantar Fasciitis Guidelines link the International Classification of Functioning, Disability, and Health (ICF) body structures (Ligaments and fascia of ankle and foot, and Neural structures of lower leg) and the ICF body functions (Pain in lower limb, and Radiating pain in a segment or region) with the World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD) health condition (Plantar fascia fibromatosis/Plantar fasciitis). The purpose of these practice guidelines is to describe evidence-based orthopaedic physical therapy clinical practice and provide recommendations for (1) examination and diagnostic classification based on body functions and body structures, activity limitations, and participation restrictions, (2) prognosis, (3) interventions provided by physical therapists, and (4) assessment of outcome for common musculoskeletal disorders.
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PMID:Heel pain--plantar fasciitis: clinical practice guildelines linked to the international classification of function, disability, and health from the orthopaedic section of the American Physical Therapy Association. 1843 70

In 2004 cervicogenic headache was introduced into ICD-10 classification. The reasons of cervicogenic headache are changes within bones, soft tissue and nervous structures of cervical spine section. The pain may spread to the neck, occipital area of skull, area of jaw and eyeballs, and arms. There are many theories trying to explain spreading of the pain outside the area innervated by C1, C2 and C3 cervical roots. Their common denominator is communication between fibres running in those roots and neurons of trigeminal nerve. Many authors describe a possibility of such connection through the jelly-like nucleus of the trigeminal nerve located in the back funiculi of spinal cord. In this mechanism, the pain conducted via occipital nerves may affect activity of neurons of the trigeminal nerve and influence areas innervated by the trigeminal nerve. In general case history and physical examination are sufficient to make a diagnosis. Additional radiological and imaging examinations support this diagnosis. According to some authors, the necessary condition to make a diagnosis of cervicogenic headache is finding the changes of spondylosis nature of the cervical spine section in additional examinations. In doubtful cases, diagnostic blockade of greater occipital nerve, resulting in headache relief, supports finally a diagnosis. Any treatment includes pharmacotherapy, rehabilitation, psychotherapy and surgical methods. The purpose of the study is to view literature on cervicogenic headache which causes many diagnostic problems and hence makes it difficult to choose effective treatment.
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PMID:[Cervicogenic headache]. 1870 41

Currently, little is known about the influence of depressive symptoms and gender-specific aspects in rehabilitation outcome of patients with chronic low back pain. Effects of gender and depressive symptoms on rehabilitation outcome were examined immediately after rehabilitation, as well as three and six months after rehabilitation in 116 patients with chronic low back pain (43 women, 73 men; M=48 yrs.; ICD-10 diagnoses: M45.4/M45.5, M54.4/M54.5). Immediately after rehabilitation, general improvements with medium effect sizes in all rehabilitation measures were found. In contrast, six months after rehabilitation, only pain-related measures showed moderate improvements. Additionally, the mid-term outcomes were influenced by gender and depressive symptoms; women showed more stable rehabilitation outcomes in pain intensity, in the impaired function related to family/leisure, and the coping with pain strategies of "perceived self-competence" and "relaxation". In contrast, especially male patients with severe depressive symptoms revealed regressive rehabilitation outcomes, both in pain-related variables as well as marginally in the coping with pain strategy of "cognitive restructuring". In post-hoc analyses, in the mid-term, they even showed a deterioration of functional capacity and somatisation compared to prior to rehabilitation. Our results suggest that the outcome of orthopaedic rehabilitation may be persistently improved by implementing gender-specific treatments in general and elements of depression treatments for the patients with severe but sub-clinical depressive symptoms.
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PMID:[Influence of depressive symptoms and gender in chronic low back pain rehabilitation outcome: a pilot study]. 1893 61

The aim of our study was to determine the prevalence of vitamin D deficiency (<20 ng/dl) among patients with fibromyalgia or muscle pain in a musculoskeletal clinic in the United Arab Emirates. Consecutive patients who were diagnosed with fibromyalgia and/or non-specific musculoskeletal pain (ICD-9 729.1) were screened for vitamin D deficiency. Patients were seen at follow-up after treatment with vitamin D was given. Improvement was assessed by a simple questionnaire. Patients (139) with muscle pain were seen in 2007. Average age was 40 +/- year; 95% were female; 69 (49%) were Arab, of whom 92% were veiled; 43 (30%) Indian of whom 11% were veiled; 23 (16%) were Caucasian; and four were East Asian (3%) and all wore western clothes. One hundred three (74%) of these patients had a low vitamin D level. Vitamin D deficiency was most common among Arab patients (86%) and Indo-Pakistani (87%) and least common among the Caucasians (8%) and was equally prevalent among veiled and non-veiled patients. Treatment resulted in clinical improvement in 90% of patients. Non-specific muscle pains among Arab and Indian-Pakistani populations may indicate vitamin D deficiency, and prompt treatment can result in resolution of symptoms.
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PMID:Myalgias or non-specific muscle pain in Arab or Indo-Pakistani patients may indicate vitamin D deficiency. 1927 14

This study assessed the utilization of prescription and over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) as well as the rate of self-medication with diclofenac, ibuprofen, and naproxen in the Braneechevo District of the Republic of Serbia. Estimation of gastrointestinal (GI) disease (morbidity) trends and GI toxicity-associated hospitalization were studied and direct costs due to NSAID-induced GI toxicity are presented. This descriptive, retrospective study addressed drug use and outcomes between 2004 and 2006 documented in the Health Insurance Fund database of the Pozarevac Public Pharmacy in the Pozarevac Public Health Centar of the Braneechevo District, which includes 200,503 inhabitants. Data type/selection were defined daily doses (DDD) per 1000 inhabitants per day for utilization of drugs, number of patients with ICD-9 diagnosis codes for GI disorders; GI hospitalization count (average annually length of stay [in days] and number of GI hospitalizations); direct cost of hospital care. The OTC diclofenac use showed an increasing tendency: 6.2279; 6.5983; 8.2911 DDD units, as well as the utilization of OTC ibuprofen: 2.4389, 2.4899, 2.5776 DDD units, respectively (2004-2006), whereas OTC naproxen had relatively low utilization. In the same period, GI morbidity decreased: 9636, 7982, 7806, respectively, and the number of GI morbidity-associated hospitalizations increased 10.18% in 2005 and 15.06%, in versus 2004. The costs of GI morbidity-associated hospitalizations increased: 12.20% (2005) and 94.51% (2006), compared to 2004 costs with a positive correlation between utility of diclofenac and ibuprofen (self medication) and increased GI hospitalizations in Braneechevo.
J Pain Palliat Care Pharmacother 2009
PMID:Nonsteroidal anti-inflammatory drug usage and gastrointestinal outcomes in the Republic of Serbia. 1929 54

We experienced two cases of complicated pseudoseizure, whose diagnosis and treatment were based on Kretschmer's concept of "primitive hysteria". The first case was a 16-year-old boy who experienced a convulsion before a swimming class which he disliked. He was immediately brought to the emergency department of our hospital. Initially, he was treated as a true epileptic patient, and his convulsion continued for hours. We monitored the patient by video, which aided in making a precise diagnosis. He also showed a pain disorder. The second case was a 16-year-old girl who developed hyperventilation and convulsion during her graduation ceremony. The characteristics of her convulsion were similar to the first case. Four days after her admission to our hospital, we concluded that her symptoms were a part of primitive hysteria. After her discharge, she experienced some intermittent episodes of convulsion. There was also a possibility of sexual abuse from her father. Both patients had a family history of mental retardation and an unstable home life, as well as similar symptoms. Even in a modern general hospital, there is a lack of understanding about pseudoseizure, thus, medication may be unnecessary for undiagnosed patients. DSM-IV-TR as well as ICD-10 criteria do not mention anything about primitive hysteria. However, we recommend revitalization of this concept because it is a useful, appropriate, and necessary description of pseudoseizure with complications.
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PMID:[Two adolescent cases of pseudoseizure with mental retardation]. 1937 70


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