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

A case of recurrent pleural pain without pneumothorax, thought to be due to pulmonary endometriosis, is presented. The pain was associated with the menstrual periods, remitted when the patient was sterilised, recurred when she was given oestrogens, and finally disappeared when the oestrogen was stopped. The presentation of pulmonary endometriosis, with pleural pain but no pneumothorax, should be added to those previously described in the literature.
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PMID:Catamenial pleural pain. 260 87

A case of mediastinitis and left pyopneumothorax complicating a laryngeal phlegmon caused by Candida albicans is described. A 64-year-old woman was admitted complaining of pharyngeal pain, hoarseness, dysphagia, and pain behind the left angle of the mandible. In that hospital, she was diagnosed as having a laryngeal phlegmon. She was known to be diabetic and hypertensive since 54 years of age. After admission, she became dyspneic, and chest X-rays revealed left atelectasis, left pleural effusion and left pneumothorax. After a drain was inserted into the left thoracic cavity, she was transferred to our hospital. Chest X-rays showed widening of the mediastinum, an enlarged cardiac shadow, mediastinal emphysema, left pneumothorax and bilateral pleural effusion. A thoracic CT also showed extensive mediastinal emphysema. On March 19, 1988 we incised the abscess behind the left angle of the mandible and inserted drains into both the mediastinum and left thoracic cavity under general anesthesia. Candidiasis was diagnosed based on culture of pus obtained from the abscess behind the left angle of the mandible. She was treated with antibiotics intravenously and through both drainage tubes for about 1 month. She was cured and discharged after 5 months of hospitalization.
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PMID:[Mediastinitis and left pyopneumothorax complicating a laryngeal phlegmon]. 262 14

Chest wall injuries range from relatively trivial to fatal flail chest or huge defects. Significant chest wall injury is present in about one third of patients admitted after severe trauma. In management, the principal areas to be considered are pain control, open wounds, pneumothorax, flail chest, and pulmonary contusion.
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PMID:Chest wall injuries. 264 84

Since the first paravertebral blockade was carried out by Sellheim in 1905, this method has proved effective for the isolated blockade of spinal nerves. The efficacy of preoperative intercostal blockade (ICB) in combination with neuroleptanalgesia (NLA) or Pentothal-pentazocine-N2O anesthesia (Pe-Pz) was studied (unilateral analgesia for cholecystectomy). Group 1: NLA; group 2: NLA with ICB; group 3: Pe-Pz; group 4: Pe-Pz with ICB. The analgesic requirement differed significantly between groups 1 (0.33 mg fentanyl) and 2 (0.15 mg fentanyl) and groups 3 (63.5 mg pentazocine) and 4 (31.5 mg pentazocine). There were also significant differences in circulatory responses. The maximum deviation from the initial value at the beginning of the operation in group 1 compared to group 2 was pulse rate + 28.7% vs + 2.4%, mean arterial pressure (Part) + 24.6% vs + 3.1%, and systolic pressure (Psyst) + 33% vs +/- 0%; group 3 compared to group 4: pulse rate + 16.4% vs + 3.2%, Part + 24.5% vs 0.0%, and Psyst + 26.5% vs + 196. The times of action of ICB extended from 7.54 h to 11.33 h for partial analgeisa, time to the first dose of analgesic from 12.3 h to 16.9 h (etidocaine 0.5% and 1% respectively without and with epinephrine). The mean blood levels after 100 mg bupivacaine-CO2 rose to 1.16 micrograms/ml after 5 min and reached a maximum after 15 min (1.29 micrograms/ml) as compared to 0.98 micrograms/ml after addition of ornithine-vasopressin. These values are very much higher than those after the use of bupivacaine-HCl solution. Etidocaine and bupivacaine-HCl have comparable durations of analgesia. Toxicologically, both substances can be applied safely with consideration of all pharmacological data for ICB. Of a total of 3,485 intercostal blockades, 2,775 were applied perioperatively (pre- and postoperatively); 265 were carried out for trauma patients (rib fractures) and 445 for therapeutic indications (herpes zoster neuralgia, tumor pain, costovertebral pain). In 8 blocks 10% ammonium sulfate, in 4 blocks absolute alcohol, and in 19 blocks 5% phenol were used for neurolysis. In 2 cases a marginal pneumothorax was seen, which was resorbed spontaneously (0.06%). Altogether 16,270 single intercostal nerves were blocked. Single-session intercostal blockade can be combined as unilateral analgesia with general anesthesia. This combination is characterized by stable circulatory conditions with avoidance of hypertensive reactions. The long-lasting analgesia allows early mobilization and physiotherapy both postoperatively and posttraumatically in patients with unilateral thoracic and abdominal pain.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The single intercostal block--surgical and therapeutic indications]. 264 21

A review of 2,092 patients who had sustained closed thoracic trauma or undergone mechanical ventilation was made in order to clarify the incidence, clinical picture, pathogenesis and prognosis of pneumomediastinum without pneumothorax or lesion of mediastinal organs. Air in the mediastinal space was observed in ten patients (0.5% of cases). Bronchial and esophageal lesions were excluded at bronchoscopy and esophagoscopy. The clinical presentation included subcutaneous emphysema of the neck, without signs of mediastinitis. No patient had pain or dyspnoea. Trauma or barotrauma were assumed to have caused sudden rise in the intrapulmonary pressure, leading to passage of air from the parahilar alveoli into the mediastinum along the peribronchial and perivascular spaces. Management was conservative and the prognosis good, with normalization of the chest radiogram usually within a week.
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PMID:Pneumomediastinum not associated with lesion of mediastinal organs. 274 23

The complications associated with harvesting were retrospectively evaluated in 28 patients in whom a total of 31 rib resections had been performed. There was one pleural tear that was repaired without resultant pneumothorax. There was no incidence of pneumothorax, pulmonary complications, or wound infection or breakdown. Long-term follow-up showed no chronic donor site pain or unsightly scars.
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PMID:Donor site morbidity following harvesting of autogenous rib grafts. 274 89

A pneumothorax occurred in a 29-year-old HIV-positive woman with rapidly progressive dyspnoea at rest and left-thoracic pain, dry cough and fever. Sputum test revealed Pneumocystis carinii pneumonia. Treatment was started with 20 mg/kg trimethoprim and 100 mg/kg sulfamethoxazole, but was poorly tolerated and changed for pentamidine, 4 mg/kg i.v. from the fifth day onwards. A chest drain was inserted, but pleurodesis became necessary after two further lung collapses. After three weeks secondary prophylaxis of the Pn. carinii pneumonia was started with pentamidine inhalations (60 mg every two weeks). The patient gradually improved under this regimen. Pneumothorax is a rare complication of Pn. carinii pneumonia, but should be considered in patients with rapid respiratory deterioration. In addition, Pn. carinii pneumonia should be considered in HIV-positive patients with pneumothorax.
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PMID:[Pneumothorax as a complication of Pneumocystis carinii pneumonia]. 280 85

A 39-year-old woman had a 7-yr history of recurrent right-sided pneumothoraces. These occurred within 1 to 2 days before or after the beginning of the menstrual cycle. The patient recalled often having developed the right-sided pleuritic pain of pneumothorax during or shortly after sexual intercourse. She had no symptoms or signs to suggest endometriosis. A trial of cyclic birth control pills was unsuccessful in preventing recurrent pneumothoraces. Finally, approximately a year ago, laparoscopic tubal ligation was performed. The patient has not had pneumothorax since. We conclude that in our patient, the catamenial pneumothorax was most likely related to transtubal passage of air during sexual intercourse. Passage from the peritoneum to the pleura presumably occurred through a congenital defect or fenestration of the right hemidiaphragm.
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PMID:Postcoital catamenial pneumothorax. Report of a case not associated with endometriosis and successfully treated with tubal ligation. 294 3

The complications of tracheotomy are reviewed and divided into two categories: early and late complications depending on whether the cannula has been removed or remains in situ. In the acute period, severe haemorrhages (0.3 to 2%) and oesophagotracheal fistulae (0.5 to 2%) result from a conflict between cannula and trachea during prolonged intensive care. Cardiac arrhythmia is frequent during aspiration (35%) but rarely lethal. Various technical problems related to the tracheotomy material are common (4 to 6%) and often very serious. Air leakage is represented mainly by severe pneumothorax (1 to 5%) under artificial ventilation. Tracheotomy wound infections (0.5 to 3.5%) may facilitate pulmonary superinfections (15 to 30%) which have a 5 to 8.5% mortality rate. In the acute phase, the overall mortality rate due to the tracheotomy itself is 1.7% (40 deaths in the 2,692 tracheotomies reviewed). The main post-decannulation complication is tracheal stenosis. The incidence of severe stenosis (more than two-thirds of the tracheal diameter) varies from 8 to 12%. Stenosis is difficult to diagnose unless endoscopic examination is routinely performed. The classical treatment is surgical, but laser is helpful in this as in granulomas. In patients with in-dwelling cannula, granulomas may be responsible for pain, obstruction and bleeding which can be avoided by using an adequate equipment. Chronic invasion of the bronchi by Gram-negative organisms is almost constant and results in episodes of superinfection. Finally, patients with a permanent cannula often have psychological and social problems influencing their quality of life.
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PMID:[Complications of tracheotomy]. 329 Oct 71

The incidence of endometriosis is between eight and 15 percent among sexually mature women, with peaks being in the third and fourth decades of age. External thoracic endometriosis is associated with implantation of endometrial tissue into lung, pleura, bronchial system, and diaphragm. Major indicators symptoms of thoracal endometriosis include haemoptysis, thorax pain, recurrent spontaneous pneumothorax, and haemorrhagic pleural effusion, with all these manifestations being temporally coordinated with menstruation. Bronchoscopy and radiography are used for diagnosis, while surgery, hormonal treatment, and radiotherapy are used for therapeutic action. One patient with systemic endometriosis is reported in greater detail in this paper.
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PMID:[Endometriosis externa thoracalis]. 336 48


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