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)

A 9-year-old child was admitted to the hospital with congenital left ureteropelvic junction obstruction with massive left pyelocaliectasis and underwent dismembered pyeloplasty of the left kidney under general anesthesia without complications. Postoperatively, the child was placed on patient-controlled analgesia, with morphine as the drug of choice. The patient was discharged to the ward with adequate pain control and no complaints of nausea or vomiting. Once on the ward, a transdermal scopolamine patch was placed for nausea and vomiting. More than 24 hours after patch placement, the child experienced central anticholinergic syndrome (CAS) with hallucinations and incontinence. The scopolamine patch was promptly removed, and all symptoms of CAS rapidly ceased. A transdermal scopolamine patch should not be used in the pediatric population, and with extreme caution in the elderly. Treatment of CAS includes prompt removal of the patch, cleansing of the area, and possible physostigmine administration.
 ...
PMID:Central anticholinergic syndrome in a pediatric patient following transdermal scopolamine patch placement. 144 54

An eight-year-old girl has had urge incontinence for the last three years and muscle weakness and pain in the lower extremities for one month. Urodynamic study revealed a bladder instability of severe degree. Tethered cord syndrome caused by a tight filum terminale was identified by metrizamide myelography. An untethering of the filum terminale resolved her symptomatology completely. The urologist should be aware of this syndrome in a patient presenting with incontinence that has persisted for a long time or has recurred.
 ...
PMID:Tethered cord syndrome: cause for urge incontinence and pain in lower extremities. 150 50

We reviewed the charts of 206 patients who underwent the Raz bladder neck suspension between January 1984 and June 1990 for stress urinary incontinence. Mean followup was 15 months. Overall, our results demonstrated a successful outcome (cure or rare stress urinary incontinence not requiring protection) in 186 of 206 patients (90.3%). Cox multivariant analysis showed that the only predictor of outcome was the degree of preoperative stress urinary incontinence (mild, moderate or severe, p less than 0.001). When the results were stratified by degree of incontinence preoperatively 20 of 21 patients (95%) with mild, 151 of 162 (93%) with moderate and 15 of 23 (65%) with severe incontinence had a successful outcome. No statistical correlation was found with patient age, number of prior operations, hysterectomy, urgency incontinence or menopause. For the patients who failed, the mean interval to recurrent stress urinary incontinence was 5 months. Significant urgency incontinence was present preoperatively in 58 of the 204 patients (29%), with postoperative resolution in 66%. De novo urgency incontinence occurred in 7.5%. Complications included secondary prolapse (6% of the patients), prolonged retention (2.5%) and suprapubic pain (3%). In summary, the Raz bladder neck suspension for correction of stress urinary incontinence has been successful in more than 90% of this patient population.
 ...
PMID:The Raz bladder neck suspension: results in 206 patients. 151 37

This is a preliminary investigation into a recently defined urological disorder occurring in a subgroup of women with "urethral syndrome" suggestive of pelvic floor muscular (PFM) dysfunction. Symptoms include straining to void, urgency, frequency, hesitation, incontinence and/or retention, and subpubic pain. Finding neither bladder nor urological abnormalities, urologists may consider these women emotionally unstable without organic cause for their symptoms. However, their distress may be a consequence rather than a cause of their voiding problems. Sixteen female urological patients were matched with 16 asymptomatic controls to investigate PFM functioning, psychological status, and symptomatology. Results showed heterogeneity of symptomatology and little elevation of depression or anxiety when comparing patients with controls. Hypotheses of muscular abnormality were confirmed. Patients evidence poor control over testing and relaxing PFM, elevations of PFM activity under various conditions, and chronic pain as a prominent symptom. Treatment approaches specifically designed to address PFM dysfunction are discussed.
 ...
PMID:A psychophysiological evaluation of female urethral syndrome: evidence for a muscular abnormality. 162 41

Four homosexual male patients with giant anal carcinomas, ranging from 10 to 17 cm in diameter, are presented. These patients were not candidates for abdominoperineal resection because of fixation to adjacent structures. Common symptoms included pain, sepsis, anemia, incontinence, and weight loss. Diverting colostomy was performed in all patients. Two of the four patients were treated by wide local excision of the tumors for palliation. Two patients were treated with chemotherapy and radiation therapy. Three of the four patients died within 12 months. The authors conclude that diverting colostomy and wide local excision of giant anal cancers offer effective palliation of local wound problems in selected cases.
 ...
PMID:Giant malignant tumors of the anus. A strategy for management. 168 59

Palliative therapy for rectal carcinoma is only indicated in selected patients who do not tolerate radical surgery or with very advanced disease. In a retrospective series the results of transanal electrocoagulation are analyzed. In addition patients or their relatives were questioned about the treatment related increase in quality of life and the wish of recurrent coagulation if needed. The main indication for transanal electrocoagulation was rectal stenosis, blood loss, discharge of mucosa and tumor as well as pain. Anal incontinence only gets better when it is due to discharge. However, transanal exposition bears the risk of worsening the incontinence. The electrocoagulation is favored by all continent patients before colostomy. The main indication for a colostomy was incontinence and fistula. Palliative irradiation was concentrated in patients with pain. In 59 operations upon 40 patients there was one rebleeding and one death due to sepsis resulting in a mortality of 1.7%. We conclude from our results that transanal electrocoagulation is a safe procedure in patients with rectal carcinoma who do not qualify for radical surgery.
 ...
PMID:[Palliative therapy of rectal cancer by electrocoagulation]. 169 Jan 4

Though patients usually die peacefully, problems may arise in the last period of a terminal illness. In the final days new symptoms may arise or there may be exacerbation or recurrence of symptoms previously well controlled. Two hundred consecutive hospice patients were studied. The incidence was noted of pain, dyspnea, moist breathing, nausea and vomiting, confusion, restlessness, jerking and twitching, difficulty in swallowing, incontinence and retention of urine, sweating, moaning and groaning, and loss of consciousness. Each symptom is considered and the results of the management employed are noted. Many of the features appearing in the last days of a terminal illness, especially cancer, can be attributed to organic brain disease consequent to metabolic disorder associated with multi-organ failure. An awareness of the nature of the problems that may arise in the last 48 hours of life makes it possible to keep the patient comfortable to the end.
 ...
PMID:The last 48 hours of life. 170 17

Currently, there is much enthusiasm in the urologic community for the development of alternative treatments to transurethral prostatectomy for management of benign prostatic hyperplasia (BPH). At the Mayo Clinic, the role of a permanently implanted intraurethral stent (UroLume Wallstent) is being examined. It is a biocompatible prosthesis made from a "super" alloy that is woven into a tubular mesh. It is both flexible and self-expanding with no elastic recoil; when fully expanded, it has a large internal diameter of 42 Fr (1.4 cm). Twelve patients (mean age = 67 years; range = 62 to 77 years) with obstructive BPH have been treated with this stent. After 3 months, the decrease in the total symptom score was 65% (mean preoperative score, 13.9 +/- 5.2; mean postoperative score, 4.8 +/- 3.7, P less than 0.001), whereas the increase in peak urinary flow rate was 99% (mean preoperative value, 10.1 +/- 3.3 ml/second; mean postoperative value, 20.1 +/- 6.2 ml/second; P less than 0.001). The postvoid residual urine volume decreased by 76% (mean preoperative value, 133 +/- 68 ml; mean postoperative value, 32 +/- 38 ml, P less than 0.001). There has been no difficulty with infection, encrustation, stent erosion, stent migration, incontinence, or potency. Eight patients (67%), however, did have irritative voiding symptoms after stent placement. These untoward effects subsided markedly during the follow-up period. No patient has required either pain or antispasmodic medications, and as of this time, it has not been necessary to remove any stent because of side effects. These results suggest that the intraurethral stent may be a viable treatment option for patients with BPH.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:A permanent, epithelializing stent for the treatment of benign prostatic hyperplasia. Preliminary results. 172 99

The effect of abdominal rectopexy on bowel function is difficult to assess in retrospective studies because preoperative bowel habit cannot be determined accurately. This study examined bowel symptoms and physiologic tests of anorectal function prospectively in 23 patients before and at three months after rectopexy. Rectopexy eliminated complete prolapse in all and stopped bleeding in 16 of 18 patients. Incontinence improved significantly. Constipation (less than 3 bowel actions per week or straining for more than 25 percent of defecation time) was relieved in 4 of 11 affected patients but developed in 5 of the 12 who were not constipated preoperatively. Since the median bowel frequency was 21 motions per week before surgery and 17 afterward, the main determinant of constipation was straining. Abdominal pain was relieved after rectopexy in 6 of 12 patients but developed in 3 of 13 who were pain-free before surgery. Three patients (13 percent) had a first-degree relative with rectal prolapse. Perineal descent decreased significantly. Maximal anal resting pressure increased significantly, but this did not correlate significantly with improved continence. Twenty-one patients (91 percent) could expel a 50-ml balloon preoperatively; 18 of those 21 could still do so postoperatively. The two patients who could not expel the balloon preoperatively were able to do so postoperative. This study shows that rectal prolapse is associated with profoundly abnormal defecation and abdominal pain. While abdominal rectopexy improved continence, it may improve or worsen other bowel symptoms, including constipation.
 ...
PMID:Abdominal rectopexy for complete prolapse: prospective study evaluating changes in symptoms and anorectal function. 173 83

The spontaneous spinal epidural haematoma (SSEH) is a rarity, but the severe and permanent motor disability underlines its importance. From 1957 seven cases of SSEH have been diagnosed and operated on in the National Institute of Neurosurgery, Budapest. These cases are analysed and discussed. The clinical picture began with local pain of the spine and radicular signs but some hours or days later paraparesis or paraplegia and incontinence developed. In the discussed cases the neurological deficit progressed to complete para- or tetraplegia in 5 cases. Only 2 patients had partial spinal transverse lesions on admission. All patients underwent myelography to detect the spinal space occupying lesion and were operated on soon. Three patients recovered completely, 2 remained partly and 2 totally paralysed. The outcome depended mainly on the timing of neurological deficiency. If the neurological signs existed less than 8 hours the patients recovered completely or fairly well while the prognosis was poor if the transverse lesion persisted longer than 24 hours. The authors stress the importance of correct and fast decisions at the first medical examination for the outcome of this disease, because only immediate transfer to a neurosurgical department gives a chance of good recovery.
 ...
PMID:Spontaneous spinal epidural haematomas. 192 22


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