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

Neurological signs such as lower spinal cord lesions and/or femoral neuritis may be the presenting symptoms of a dissecting abdominal aortic aneurysm (AAA). We describe a patient in whom a severe sciatic pain was the presenting symptom of a non-dissecting AAA. The resection of the vascular mass resulted in dramatic relief of sciatic pain, thus indicating that the neurological impairment was caused by the non-dissecting aneurysm.
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PMID:Sciatic pain: a diagnostic pitfall. 355 73

Paralytic brachial neuritis or Parsonage-Turner syndrome principally involves the shoulder girdle, rarely muscles moving the hand and fingers. Three cases are reported. After an acute episode with severe pain in the arm and fore-arm there appeared, a palsy of flexor pollicis longus and flexor indicis profundus, due to an isolated lesion of the anterior interosseous nerve. Two cases spontaneously recovered their full function, the third incompletely. Delay in recovery may be long; more than two years. Mechanical nerve entrapement should not be confused with this syndrome.
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PMID:Paralytic brachial neuritis or Parsonage-Turner syndrome anterior interosseous nerve involvement. Report of three cases. 359 21

Thirty patients between 60 and 86 years of age (average 73.6 years) [8, 9, 11] with high risk of having the disease for an extraordinarily long time or of developing neuritis were treated for 5 days with 4-5 mg acyclovir per kilogram body weight. They were not immunocompromised and received the drug intravenously at 8-h intervals. Of this group, 20 patients received daily 40-80 mg methylprednisolone simultaneously. All patients were hospitalized because of extensive, hemorrhagic lesions, which in 8 cases were necrotizing. The primary site of the disease was the head in 13 patients (43.3%), the neck or trunk in 15 (50%) and the extremities in 2 (6.7%). In addition, 8 (26.7%) showed generalized lesions. The duration of the disease could be reduced by one-third by acyclovir treatment, as compared with reference groups, and the methylprednisolone group had even better results. Individual pain was more promptly resolved by the combined treatment than by acyclovir alone. No persistent neuritis was observed in the methylprednisolone-acyclovir group, but occurred in two out of ten patients who had received acyclovir alone. No side effects were reported. The antiviral effect of acyclovir obviously reduces the risk of possible generalization during corticosteroid treatment to negligible amounts. Because of the possible selection of resistant strains, acyclovir should usually only be given to high-risk zoster patients beyond the age of 60. Administration must be initiated in the early phase of the disease, since no effect can be expected after viral shedding has been terminated.
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PMID:[Acyclovir-corticosteroid therapy in herpes zoster]. 370 Jan 3

Twenty-eight patients with advanced upper-abdominal malignancy were treated at the University of Utah on a pilot protocol involving regional hyperthermia (HT) produced by the BSD-1000 HT system and the annular phased array applicator (AA), usually driven at 60 MHz. Eighty-two percent of the patients had widespread metastatic disease, and the mean tumor burden was 2,900 cc. Seventy-nine percent of the patients received concurrent radiotherapy. Acute toxicity consisted primarily of pain within the AA aperture (43%), systemic stress (43%), and nausea or vomiting (29%). Systemic stress was the most frequent power-limiting factor (46%). There were two treatment-related complications: sciatic neuritis from intramuscular injection (one) and pleural effusion from thermometry probe placement (one). Detailed thermal mapping and thermal dosimetry were performed on 26 patients. The mean thermal dosimetry parameters were quite low. Concurrent radiation doses were also quite low (mean, 1,500 rad) to avoid toxicity of sensitive organ systems within the abdomen. The objective response rate was only 18%, all partial, but 43% of the patients achieved effective symptomatic palliation. The five objective responders did survive significantly (P = .02) longer than the 23 nonresponders.
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PMID:Abdominal regional hyperthermia with an annular phased array. 370 92

Eight patients (nine cases) with pisotriquetral arthritis were treated by pisiform excision after they had failed to respond to splints, antiinflammatory agents, and local steroid injection. Associated with pisotriquetral arthritis were cases of ulnar neuritis, rheumatoid arthritis, pisotriquetral joint loose bodies, and an anomalous muscle. In seven of eight patients, pisiform excision with release of Guyon's canal afforded prompt relief of pain. A palmar approach was necessary for simultaneous ulnar tunnel release and pisiform excisions. One patient with rheumatoid arthritis required a further operative procedure (Darrach) before pain was eliminated. Pisotriquetral arthritis, diagnosed by clinical and radiographic criteria, may be associated with other disorders, in particular ulnar neuritis. Immobilization, antiinflammatories, and local steroid injections may be of temporary assistance. Pisiform excision produces satisfactory relief of pain.
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PMID:Excision of pisiform in pisotriquetral arthritis. 375 53

The elbow joint is frequently affected by rheumatoid arthritis causing pain and disability which limits the use of the upper limb. Excisional or interpositional arthroplasties of the elbow have failed to provide satisfactory results. The design of a total elbow prosthesis in early 1970's followed the principles and evolution of joint replacement in the lower limb. In this study twenty-two Liverpool elbow prostheses (non-constrained) in nineteen patients were reviewed with an average follow-up of 26.5 months. Postoperatively the arc of flexion-extension improved with no change in pronation-supination range. Pain was significantly improved postoperatively. Rheumatoid patients were very pleased, but patients with secondary osteoarthritis were less satisfied. Two prostheses became loose and three had deep infection and were removed. Five patients had postoperative symptoms of ulnar neuritis and in three the symptoms gradually resolved. Early results of total elbow arthroplasty are promising in carefully selected patients.
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PMID:A review of total elbow arthroplasty and an early assessment of the Liverpool elbow prosthesis. 379 86

A group of 182 patients with subcalcaneal pain related to sports activity was studied to determine injury types and patterns. Running/jogging produced the greatest percentage of subcalcaneal injuries, 76%. A survey was done of the specific types of heel pain, plantar fasciitis and median calcaneal neuritis. A review of each entity was given and surgical approach was detailed. Subcalcaneal surgical decision making is based on six specific tenets: correct diagnosis; approximately 12 months of conservative treatment; EMG for diagnosis and appropriate nerve blocks; thorough knowledge of the anatomy or complete review; patient understanding that surgery may not give a good enough result to allow the return to high performance athletics; and correct and appropriately directed surgery.
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PMID:Surgical decisions in athletes' subcalcaneal pain. 379 74

Transthoracic total fundoplication gastroplasty has been reported as having a low mortality and a 1.1% recurrence rate and to produce excellent results in 93.1% of patients, moderate results in 3.7% and poor results in only 2.8% of patients. In approximately 7.0% intercostal neuritis is a serious residual problem. The transabdominal total fundoplication gastroplasty uses the identical repair technique but avoids the chest-wall pain. Previous esophageal or gastric surgery and major esophageal shortening are contraindications to an abdominal approach. The authors report their results with 50 patients who underwent transabdominal total fundoplication gastroplasty and were followed up for 6 to 20 months. There was no mortality or major morbidity. Clinical follow-up was complete, 94% of patients were assessed by roentgenography and 72% by manometry. None had anatomic recurrence, 46 (92%) were asymptomatic and 4 (8%) had minor residual gastric symptoms of fullness or occasional epigastric pain. All were much improved and none had wound pain. Long-term follow-up of transabdominal total fundoplication gastroplasty is necessary; however, since the technique of repair is identical to the thoracic approach, the results should be similar.
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PMID:Transabdominal total fundoplication gastroplasty to control reflux: a preliminary report. 397 Dec 36

Brachial neuritis is an unusual syndrome of unknown etiology that can be confused with other causes of pain or weakness, or both, of the shoulder and arm. It is important to distinguish this disorder because of its dramatic symptoms and relatively good prognosis. Sharp pain, usually in the elbow or shoulder, marks the onset of brachial neuritis, but is relatively short-lived. Weakness generally occurs as the pain is subsiding and most frequently involves the deltoid, spinati, serratus anterior, biceps, and triceps. Paresthesias, atrophy, and sensory loss are inconstant features. Electromyographic findings of fibrillation potentials and positive waves characteristically are found in a pattern indicating combined nerve-root and peripheral nerve involvement. Electromyography more frequently than clinical examination shows that the lesion is bilateral, and also is of both diagnostic and prognostic value. Other laboratory studies serve only to exclude other causes of shoulder pain. The clinical course is variable, but in 90 per cent of patients complete recovery occurs within three years. Recurrences are uncommon.
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PMID:Brachial neuritis. 401 36

A clinical and electrophysiological followup study was done on 23 patients with ulnar neuritis treated by surgical transposition of the nerve at the elbow. Pain was relieved in all those affected and other sensory symptoms showed some degree of improvement in most. Weakness tended to persist, but recovery of full use of the hand followed operation in 74%. Muscle wasting was the least likely to improve. The chance of recovery after operation was greatly reduced in patients in whom preoperative symptoms had been present for more than one year.
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PMID:Results of anterior transposition of the ulnar nerve for ulnar neuritis. 541 1


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