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 retrospective study was carried out in 100 adult patients with advanced malignant disease. They were given subcutaneous continuous infusions of medication for symptom relief. The drugs were administered through a butterfly needle inserted subcutaneously in the anterior chest wall using a battery-operated infusion pump. The indications for using this technique were inability to swallow due to deteriorating general condition, oesophageal obstruction, intestinal obstruction, severe nausea and vomiting, terminal dyspnoea and poor pain control with oral opiates. All patients received morphine; other drugs administered through the syringe driver included hyoscine, metoclopramide, cyclizine, dexamethasone and midazolam. Ninety-four patients continued subcutaneous infusion until death. The mean duration of treatment was 9.1 days. The treatment was well tolerated by the patients and controlled their symptoms satisfactorily in the great majority. The use of continuous subcutaneous infusion via a syringe driver gives good symptom control. In the last days of life when the patients have difficulty tolerating oral medication, continuous subcutaneous infusion is a superior alternative to frequent intermittent parenteral injections.
 ...
PMID:Administration of drugs by infusion pumps in palliative medicine. 752 12

Cancers of the head of the pancreas are only resectable in 10 to 25% of cases. The majority of patients are therefore candidates for a palliative treatment jaundice, pain or upper gastro-intestinal obstruction. Palliative surgical bypasses offer a durable efficiency for patients with a relatively short-term life expectancy. Endoscopic placement of biliary stents for jaundice is an alternative but leads to frequent complications and does not act on other clinical symptoms. Controlled trials did not show any statistical difference between surgical or endoscopic treatments. We only recommend endoscopic procedures for patients unfit for surgery with poor general status or distant metastases.
 ...
PMID:[Palliative treatment of cancers of the head of the pancreas. Surgery versus endoscopy]. 754 Aug 17

Conservative management of bowel obstruction in advanced cancer patients has been recognized as efficacious in controlling distressing symptoms such as nausea, vomiting and pain. A retrospective analysis of prevalence, treatment and outcome was performed. A group of 25 patients with signs of bowel obstruction were studied from 1001 consecutive patients receiving palliative care at home. A score for total distress was calculated to assess the gastrointestinal symptoms at diagnosis, after 1 week of treatment and 1 day before death. The mean survival was 19 days. Six patients were admitted to hospital, 3 of whom underwent surgery and died in the immediate postoperative period. The patients diagnosed in hospital and discharged received a nasogastric tube (7 cases) and a central venous line. The nasogastric tube was removed after gastrointestinal secretions had been controlled by a combination of drugs, and parenteral nutrition or hydration, mainly started in hospital, was discontinued only a few days before death (13 cases, mean duration 19 days). The distress symptom score was statistically reduced after 1 week of treatment and on the day before death when compared to the referral time. The most frequent combination of drugs was octreotide, haloperidol and low doses of morphine. A subcutaneous route was preferred for administering the drugs. Utilization of a wide range of drugs permits good symptom control for bowel obstruction in patients followed at home.
 ...
PMID:Bowel obstruction in home-care cancer patients: 4 years experience. 754 74

Diarrhea is a distressing symptom that limits the quality of life in terminally ill patients. In these patients, many factors can affect intestinal secretion, absorption, and motility, including drugs, infective agents, antibiotics, chemotherapy, radiotherapy, surgery, malnutrition, neuroendocrine tumors, and mechanical bowel obstruction. Diarrhea can result in water and electrolyte losses. This review discusses the pathophysiology, assessment, and treatment of diarrhea in advanced cancer patients.
J Pain Symptom Manage 1995 May
PMID:Diarrhea in terminally ill patients: pathophysiology and treatment. 760 80

There are many differences between acute appendicitis in the older child and the infants. An understanding of the under three years of age child's response to intra-abdominal infection in contrast to that of the older child and an appreciation for the supportive treatment of the child are vitally important in further lowering the morbidity of young children with acute appendicitis. The purpose of the present study was to investigate the factors contributing to the high perforation rate seen in this age group. A retrospective analysis was done in 88 patients under the age of three who underwent appendectomy. These patients ranged from 4 and 35 months in age. There were 51 (77.4%) male patients. The main complaints were fever, pain and vomiting. Duration of symptoms was more than 24 hours in 80%. Abdominal radiographs showed signs of small bowel obstruction. Peritonitis was found in the majority of the cases (90%). overall morbidity was 31.8% and mortality 1.1%. These data suggest that duration of symptoms is directly proportional to complications rate.
 ...
PMID:[Appendicitis in children under 3]. 771 61

Intestinal endometriosis mimics a wide variety of inflammatory, infectious, or neoplastic digestive diseases. To alert clinicians to its diverse manifestations, we describe nine patients who required laparotomy. The underlying diagnosis was elusive initially. In no case were symptoms clearly cyclic or temporally related to phases of the menstrual cycle. Presenting complaints included acute or subacute lower abdominal pain (three patients), hematochezia (two patients), signs or symptoms of small-bowel obstruction (two patients), peritonitis (one patient), and a partially obstructing sigmoid lesion (one patient). The findings of barium enema were nondiagnostic in the five cases in which it was performed. Surgery was needed in each case; indications included inability to exclude carcinoma (two patients), small-bowel obstruction (two patients), diffuse peritonitis (one patient), persistent colonic obstruction (one patient), pericolonic abscess (one patient), and intractable pain (one patient). Intestinal endometriosis has a diverse clinical spectrum, with nonspecific features in many patients. This disease should be considered during the evaluation of unexplained digestive complaints in women of childbearing years.
 ...
PMID:Intestinal endometriosis masquerading as common digestive disorders. 772 6

The porphyrias are a group of metabolic disorders of heme biosynthesis genetically determined defects. Acute intermittent porphyria is the most common form of porphyria found in the United States. It is caused by a genetic defect in chromosome 11, where one of two genes for porphobilinogen deaminase is defective. Acute intermittent porphyria is characterized by intermittent, acute, occasionally fatal attacks of abdominal, neurologic, psychiatric, and renal symptoms. Attacks are often confused with acute abdomen or bowel obstruction. A variety of drug, hormonal, nutritional, and infectious factors can precipitate clinical symptoms. Managing patients with acute intermittent porphyria involves removing the precipitating factors, increasing carbohydrate intake, controlling pain, and administering medications. A case study is provided.
 ...
PMID:Caring for patients with acute intermittent porphyria. 776 95

Phytobezoar is a rare cause of intestinal obstruction in children. A 7-year-old boy was operated on for intestinal obstruction due to a phytobezoar. An exceptionally large amount of Lupin seeds had been eaten a few hours before the onset of pain. lupin seeds have not been documented as a cause of phytobezoar.
 ...
PMID:[Intestinal obstruction due to lupin phytobezoar in a child]. 781 45

Intussusception is commonly the etiology of intestinal obstruction in infants and children. To investigate demographic data, clinicopathologic features and therapeutic prognosis of patients with intussusception, we reviewed 361 intussusceptions in 333 patients over an 11-year period. Most patients were below two years of age and there was a male preponderance of 1.6:1. There was no seasonal difference between the number of cases. The clinical triad of vomiting, abdominal colicky pain and bloody stools was manifested in only one-third of our patients. Secondary intussusception contributed to 6.6% of cases and Meckel's diverticulum was the most common pathologic cause. Positive findings were recorded in 82% of 67 patients undergoing sonographic examination. Intussusception of the ileo-colic type was most frequently encountered. Most patients (79%) were diagnosed within 48 hours and almost all cases underwent primary barium enema reduction. The success rate was 45%. Laparotomy was performed in 207 patients (57%) refractory to enema reduction or with critical illness, and intestinal resection was required in 28 (14%). Long-standing duration of illness (> 24 hours), positive clinical triad, positive pathologic lead point, and radiologic finding of bowel obstruction were identified as risk factors leading patients to surgical reduction (p < 0.001). Postoperative complications and recurrent intussusception developed in some patients, and the overall mortality was 0.6%. The clinical characteristics of intussusception in children generally remained unchanged as compared to previous reports. Early identification of patients with risk factors for surgical treatment is important to decrease the need for intestinal resection.
 ...
PMID:Intussusception in infants and children: risk factors leading to surgical reduction. 785 36

Traumatic avulsion of the right diaphragm from the lumbocostal arch is a very rare lesion. The authours report the case of a 27-year-old man who had suffered a severe polytrauma with blunt thoracic injury, fracture of the lumbar spine, Malgaigne-type fracture of the pelvis and fracture of the femoral shaft on the right side, 10 years before. At the time of injury the lesion of the diaphragm went unnoticed. The diagnosis was made 10 years later when the patient was referred for chronic right thoracic pain combined with postprandial abdominal distension and crampy pain in the abdomen. The chest radiogram and CT-scan showed displacement of the right kidney and most of the right colon into the thorax due to avulsion of the diaphragm from its dorsal insertion on the lumbocostal arch. Surgical repair was necessary to obtain relief from pain and to prevent intestinal obstruction. Reduction of the hernia, reinsertion of the diaphragm to the lumbocostal arch and reinforcement of the repair with a prolene mesh prosthesis was performed through a right thoracophrenolumbotomy incision.
 ...
PMID:[Symptomatic enterothorax in right-sided dorsal rupture of the diaphragm]. 787 10


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