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

The rupture of an aneurysm of the sub-renal aorta may give rise to several clinical presentations which it is essential to recognise in order to carry out emergency operation, e.g. attack of pain, retroperitoneal hematoma, hemoperitoneum, rupture into a hollow viscus, infective aneurysm. The special characteristics of the treatment concern resuscitation, site and type of aortic clamping, aorto-caval or aorto-digestive rupture or an infective aneurysm raising special problems. It is the vascular collapse which makes the rupture serious, an aneurysm operated as an emergency without collapse, has a mortality which differs little from a non-ruptured aneurysm, e.g. 3 deaths out of 55 operated cases. On the other hand, out of 44 aneurysms operated in acute collapse, there were 31 deaths. The complications observed are linked to the latter, e.g. cerebro-vascular accidents, acute coronary ischemia, acute ishemia of the limbs, which may also be due to embolism during operation, renal complications due to renal shock. The prevention of these complications has permitted us to reduce mortality by 40 p. 100 the last 5 years.
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PMID:[Ruptured aneurysms of the sub-renal abdominal aorta]. 108 6

Twenty patients with peripheral arterial disease and 10 normal controls were submitted to i.v. injection of aprotinin, polypeptide (mol.wt. 6512) extracted from bovine lung, in order to examine its effects on: (a) lower limbs pain, (b) lower limbs sensibility, (c) calf blood flow. Aprotinin (100,000 Ku i.v. diluted in NaCl 0.9%) was given in a single dose or twice a day for a week; for control the same subject received, before or after aprotinin, an equivalent volume of diluent (0.9% NaCl). The results demonstrate that aprotinin is able to increase the initial pain limit walking tolerance and to decrease the intensity of pain at rest and of myalgic or "trigger" areas. No variation was observed on skin sensibility and on calf blood flow, both basal resting and hyperemic. The favorable effect of examined polypeptide on ischemic pain can be attributed neither to increase of calf blood flow nor to influence on perception of painful stimuli. It seems therefore to suggest that aprotinin acts on biochemical mechanisms that cause the ischemic pain. Presumably it inhibits kininogenases and tissue protein-hydrolyzine enzymes activated in the course of ischemia.
Pain 1975 Dec
PMID:Effect of a proteinase inhibitor on intermittent claudication or on pain at rest in patients with peripheral arterial disease. 108 49

The effects of ischemia, induced by a tourniquet, were investigated on 36 adult Holtzman female rates in terms of damage to the ventral horn cell of the spinal cord and tibial nerve and motor end-plate degeneration and regeneration. Clinically, the rats were tested for sensory and motor loss and recovery and these results were compared with the histological findings. Ischemic periods of 2, 4, 6, and 8 hours were used followed by survival times of 3 weeks to 9 months. Histologically, there was degeneration and regeneration found to varying degrees in the nerve and motor end-plate. There were no changes found in the ventral horn cell. There was a loss of pain sensation in all animals, except the 2 hour group, and a loss of motor function. Motor function, preceded by sensation, returned in all animals. With the absence of ventral horn cell damage it was not surprising to find adequate regeneration histologically and, therefore, a return of both sensory and motor function.
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PMID:Effects of ischemia on the hind limb of the rat. 113 10

The occurrence of episodic painless ST segment elevation at rest was documented by continuous electrocardiographic monitoring in four patients with ischemic heart disease who did not conform to the classic description of Prinzmetal's variant angina. The degree of ST segment elevation in the absence of pain was generally similar to that seen with painful episodes. Clincopathological correlation was available in three of these patients: two were found to have severe coronary artery disease and one had a 70% obstructive lesion in the right coronary artery only. Three patients subsequently developed a myocardial infarction. Our observations suggest that transient painless ST segment elevation at rest is a serious finding reflecting severe ischemia and more likely to be "preinfarctional" than "variant" angina. Long term monitoring is useful in detecting silent severe ischemia that may sometimes occur with potentially lethal arrhythmias as demonstrated in one case.
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PMID:Case studies: Significance of episodic painless ST segment elevation at rest in ischemic heart disease. 115 Nov 96

Calf basal resting and reactive hypercemia blood flow were measured at 4-h intervals during a day in fifteen healthy subjects and in fifteen patients with intermittent claudication by means of a venous occlusion plethysmograph. Mathematical-statistical analysis of the data failed to demonstrate circadian periodicity of calf blood flow in healthy subjects, but proved the existence of a 24-h rhythm of calf basal resting and reactive hyperemia blood flow in patients with intermittent claudication. This different behavior of calf blood flow can be understood if one considers that in healthy subjects the voluntary muscles in the extremities have a blood supply which can be instantaneously adjusted over a large area. In patients with peripheral arterial disease, on the other hand, the vascular responses in voluntary muscles of the limbs to various endogenous or exogenous stimuli are impaired and reduced. The circadian rhythm observed in patients with intermittent claudication has early evening peaks and a nocturnal trough with a nadir occurring after midnight and before 0400. This rhythm displays marked similarities with those of all other circulatory values. As to the mechanism of rhythm, it is hard to decide whether or not it has an independent endogenous origin. It is known that many of the circulatory variables are interrelated and that some are clearly related to other circadian rhythms. Perhaps the rhythmic reduction of limb blood flow which occurs during the night is the mechanism underlying the nocturnal pain of subjects with limb ischemia by peripheral arterial disease.
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PMID:Behavior of calf blood flow in normal subjects and in patients with intermittent claudication during a 24-h time span. 119 4

In order to reduce the oxygen consumption of the myocardium and preserve the areas around the infarction, still alive but undergoing ischemia, 8 patients with early extension of their infarction were placed under circulatory assistance by intra-aortic counter-pulsation. In 8 patients, the pain disappeared and did not recur, permitting left ventriculography and coronary arteriogrpahy. This examination is often considered high risk, but in no patient in our series, during the acute phase of myocardial infarction, were there any complications. 6 patients underwent operation, and aortic counter-pulsation was used during the post-operative period. In all, eight coronary by-pass operations were carried out and, in one case, part of the ventricular wall was resected. All patients are still alive, none have heart failure or residual angina; the follow-up period is now 2 years for the first case.
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PMID:[Emergency myocardial revascularization with assisted circulation for early extension of infarction]. 122 51

The management of 23 patients with traumatic pseudoaneurysms is presented. A pulsatile mass associated with pain was the usual presentation. Hypertension and hypovolemic shock from rupture are uncommon presentations but potential hazards of this lesion. Twenty-one pseudoaaeurysms were treated surgically. Resection with end-to-end anastomosis (eight patients), with graft replacement (one patient), with lateral repair (seven patients) was done. Hypothermia with circulatory arrest and external Dacron shunt were used to prevent visceral ischemia during high aortic occlusion. There were no mortalities or significant postoperative complications.
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PMID:Traumatic pseudoaneurysms: a review of 32 cases. 124 98

Over the span of two or three days in August, 1972, in two separate communities in eastern Massachusetts two men, one aged 39, the other 66, each without previous overt heart disease, were stung by wasps. Each went into shock rapidly after an interval of over a half-hour developed chest pain and, later, sequential electrocardiographic changes diagnostic of acute myocardial infarction. Each survived; each had normal electrocardiograms before the sting. Though preexistent coronary artery disease can be excluded in neither, the view is favored that acute myocardial infarction in each was caused by deficient coronary perfusion secondary to anaphylactic shock induced by the wasp stings. An intriguing case was just recently reported58 of a 62-year-old man with previous angina who developed pulmonary edema but no chest pain following wasp sting and went on to show rapidly reversed electrocardiographic changes attributable to subendocardial ischemia or infarction. In a sense, this sequence fills the gap as an intermediate phase between the normal and the two individuals described here who developed pain after anaphylactic shock, then proceeded, perhaps through this phase, to develop transmural infarction.
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PMID:Acute myocardial infarction following wasp sting. Report of two cases and critical survey of the literature. 125 36

The clinical and laboratory findings diagnostic of acute myocardial infarction include at least two of the following: (1) a history of pain consistent with myocardial ischemia, (2) electorcardiographic findings consistent with infarction, and (3) a rise in the serum level of specific cardiac enzymes. By the 4th or 5th day of illness, specific criteria can be applied to assign certain patients to a subset with "uncomplicated completed acute myocardial infarction." These criteria include the absence of evidence of (1) continuing cardiac ischemia, (2) left ventricular failure, (3) shock, (4) important cardiac arrhythmias, (5) conduction disturbances, and (6) other serious illnesses in patients with an established acute myocardial infarction. In terms of prognosis and management, patients in this subset should be regarded as substantively different from patients in other subsets. They should respond favorably to short periods of immobilization and hospitalization than those generally used. They may remain at bed rest (modified in regard to sitting and the use of a commode) for 4 days. Subsequently, mobilization with a program of progressive activity over the ensuing 5 to 10 days should reduce the duration of hospitalization to less than the current average of 17.5 to 20.8 days for patients with acute myocardial infarction. Nine to 14 days should suffice in most instances. Current and future trials may indicate that still earlier mobilization and shorter hospitalization periods can be applied to certain patient groups, but the evidence on this point is incomplete. For the individual patient, many factors will determine the optimal duration of bed rest and hospital stay. The patient's physician must consider the therapeutic benefits that may attend earlier mobilization and shorter hospitalization while weighing potential disadvantages. When the responsible physician does not regularly care for the patient, consultation with an experienced cardiologist is desirable. Patients whose condition is classified as "uncomplicated" may manifest deterioration during their illness and require assignment to a subset with a different prognosis and requiring different forms of treatment. For patients with uncomplicated acute myocardial infarction, as well as those in other subsets, absolute rules for therapy are unwise and application of broader principles by the alert physician is more likely to be beneficial.
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PMID:Duration of hospitalization in "uncomplicated completed acute myocardial infarction". An Ad Hoc Committee review. 125 73

A case of giant retinal tear treated by injection with dimethicone 350 (medical fluid silicone) was observed for six years before enucleation. About four months after the injection, signs of anterior segment ischemia were evident. A year after the injection, an injury resulted in displacement of dimethicone 350 into the anterior chamber. Enucleation was done because of pain.
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PMID:Ocular findings six years after intravitreal silicone injection. 126 41


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