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

US-guided puncture is the simplest and most popular method in the RFA treatment for HCC. However, depending on the location of tumors, it is often difficult to detect them by US. We report here the utility of CT-guided RFA for the treatment of HCC. We performed CT-guided RFA for 27 nodules in 21 patients with HCC from July 1999 to June, 2001. We used the LeVeen Needle Electrode made by Boston Company and the Cool-tip type electrode made by Radionics Company. We judged the effects of the treatment by dynamic CT within 7 days after RFA. We were able to accomplish the treatment for all patients with the exception of one case who developed severe pain during RFA. We experienced transient increases of AST/ALT in a few cases, subcutaneous emphysema in one case, pleural effusion and ascites in two cases, but conservative treatments were effective for all cases. US-guided puncture was especially useful for the treatment of the tumors localized below the diaphragm that were hardly detectable by US.
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PMID:[Usefulness of CT-guided RFA for hepatocellular carcinoma]. 1170 86

Spontaneous medialstinal emphysema (pneumomediastinum) and pneumopericardium may be defined as the presence of free air or gas in the mediastinal structures and in the pericardial sac without an apparent precipitating cause. It most frequently occurs in young healthy adults without serious underlying pulmonary disease. Although pneumomediastinum and pneumopericardium is often asymptomatic, it may cause pain in the neck and chest, dysphonia and shortness of breath. Treatment is supportive unless the patient has a history of trauma from foreign body aspiration. The course of spontaneous pneumomediastinum and pneumopericardium is usually benign and self-limited. A case of spontaneous pneumomediastinum, pneumopericardium and subcutaneous emphysema in a 20-year-old male is reported in this paper.
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PMID:A case of spontaneous pneumomediastinum and pneumopericardium in a young adult. 1176 80

Subcutaneous emphysema is an uncommon phenomenon in dentistry, usually occurring with the use of air-driven, high-speed handpieces during dental and oral surgery, operative, endodontic, or periodontal treatment. Air is forced into a surgical wound or subepithelial laceration in the oral cavity, dissecting through the different layers of tissue fasciae, and usually creating a unilateral enlargement of the facial and/or submandibular regions. This occurs with or without crepitus, pain, and airway obstruction. Treatment usually consists of antibiotic and mild analgesic therapy, close observation, and reassurance by the attending dentist. Symptoms generally subside in 3 to 10 days; however, consultation with a physician is necessary to rule out further complications.
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PMID:Subcutaneous emphysema after restorative dental treatment. 1191 Oct 57

The incidence of tuberculosis (Tbc) infection is high in some parts of the world and tuberculous cold abscess of the chest wall (CACW) often fails to respond to medical treatment. Medical records of 178 patients who underwent surgical treatment of chest wall abscesses from July 1970 to Sept. 2000 were reviewed and 89 patients who were pathologically confirmed as Tbc cold abscess cases were included in this study. Their ages ranged from 9 to 71 years (mean 33.3 years) and the male to female ratio was 1.2:1 (49 male, 40 female). The symptoms were palpable chest wall mass, pain and pus discharge, and three patients had multiple lesions. Twenty-five patients (28%) underwent excision of chest wall abscesses and 64 patients (72%) underwent chest wall and rib resection. Tbc medication was given preoperatively in 39 patients for an average of 6.3 months and all patients were given Tbc medication postoperatively for an average of 12 months. Postoperative complications were bleeding, pus discharge, empyema, pleural effusion, wound dehiscence, subcutaneous emphysema and activation of pulmonary Tbc. The disease recurred in 7 patients (7.8%) and these 7 patients all underwent a second operation. We recommend preoperative Tbc medication and complete resection of chest wall abscesses including any suspicious ribs. Postoperative Tbc medication for a minimum of 12 months is essential to decrease the risk of a relapse.
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PMID:Surgical treatment of tuberculous cold abscess of the chest wall. 1208 37

Minimally invasive surgical procedures aim to minimize the trauma of the interventional process but still achieve a satisfactory therapeutic result. Tissue trauma is significantly less than that with conventional open procedures, offering the advantages of reduced post-operative pain, shorter hospital stay, more rapid return to normal activities and significant cost savings. Laparoscopic cholecystectomy is now a routinely performed procedure and has replaced conventional open cholecystectomy as the procedure of choice for symptomatic cholelithiasis. Public expectation and developments in instrumentation have fuelled this change. The physiological effects of intraperitoneal carbon dioxide insufflation combined with variations in patient positioning can have a major impact on cardiorespiratory function, particularly in elderly patients with co-morbidities. Intra-operative complications may include traumatic injuries associated with blind trocar insertion, gas embolism, pneumothorax and surgical emphysema associated with extraperitoneal insufflation. Appropriate monitoring and a high index of suspicion can result in early diagnosis of, and treatment of, complications. Laparoscopic cholecystectomy has proven to be a major advance in the treatment of patients with symptomatic gallbladder disease.
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PMID:Anaesthetic considerations for laparoscopic cholecystectomy. 1249 40

Muscle therapy, a form of manual therapy, was applied to control pain persisting for more than 1 week following posterolateral thoracotomy, and its efficacy for the alleviation of pain was investigated. Eight patients who underwent posterolateral thoracotomy and lung resection for cancer (n=7) or emphysema (n=1) received manual therapy to incised muscles and the muscles inserting into the ribs in the affected area for an average of 17 days postoperatively. Pressure-friction and stretching techniques were used. Treatment was continued until the intensity of the pressure-friction technique reached a level at which the patient complained of pain and a decrease in muscle tone was detected. Treatment was performed once a week for 3 weeks. Pain severity was measured using a visual analog scale (VAS) (0-10). Before the first treatment, the VAS was set at 10, and changes of the score were observed before and after the treatment as well as over time. After three sessions, all patients showed a decrease in pain from 10 to an average of 1.9 (range 1.3-2.6).
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PMID:The effect of postoperative ataralgesia by manual therapy after pulmonary resection. 1263 36

The goal of lung volume reduction surgery (LVRS) is to safely palliate dyspnea in patients suffering from emphysema. Successful LVRS demands attention to the details of patient selection, preoperative preparation, intraoperative anesthetic and surgical technique and multidisciplinary postoperative care. Expertise in and effective communication between pulmonary medicine, thoracic surgery, thoracic anesthesia, pain management services, critical care medicine, respiratory therapy and rehabilitation medicine are vital components to any LVRS program. In experienced centers, bilateral approaches yield nearly twice the physiologic benefit to unilateral LVRS without adversely affecting operative morbidity or mortality. Current practice favors stapled resection over laser ablation to achieve volume reduction. Controversy persists regarding open versus video-assisted operations. The cost-effective need for and choice of materials to buttress staple-lines to reduce the incidence of postoperative air leak have yet to be defined. Ongoing multi-center, randomized, controlled trials should define the utility and durability of LVRS for appropriately selected patients and resolve some of the residual technical controversies. Therapeutic innovations may further reduce the invasiveness of lung volume reduction strategies and allow a more tailored approach to palliate patients with moderate to severe emphysema.
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PMID:Technical issues and controversies in lung volume reduction surgery. 1265 44

Spontaneous cervical emphysema and pneumomediastinum, occurring in the absence of previous disorders or provocating factors, is very rare. The predominant symptoms are retroesternal pain, dyspnea, dysphagia and neck pain. The diagnosis is established radiologically. The evolution is generally good and conservative therapy leads to recovery in most patients. We present an unusual case of pneumomediastinum, cervical and retropharyngeal emphysema that spread to cavum; the suspected symptom was voice alteration as reported by the parents.
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PMID:[Spontaneous cervical emphysema and pneumomediastinum with voice disorders]. 1280 92

Dysphagia of greater than 48 h duration is an indication for indirect laryngoscopy and when odynophagia and otalgia occur simultaneously, the possibility of subluxation of the arytenoids demands an urgent ENT assessment. The potential seriousness of laryngeal lesions following intubation obliges us to use the smallest compatible endotracheal tube. The occurrence of pain cervical surgical emphysema and fever suggests a pharyngeal lesion necessitating the suspension of oral feeding and the initiation of antibiotic therapy with anaerobic activity, while awaiting possible surgical intervention. There is no argument to use a tooth-guard for each intubation, but tooth fragility must be researched. The incidence of nasal fossa trauma is reduced with the use of nasal packs impregnated with local anaesthetic containing a vasoconstrictor. This allows the introduction of a small flexible lubricated tube. Laryngeal mask-induced sore throat is more common than the more serious injuries. The classical technique of introducing a laryngeal mask of appropriate size (4 for women, 5 for men) in which the cuff is inflated to a leak pressure of 20 cm H(2)O reduces this frequency. The facial mask may cause injuries especially with prolonged use. The incidence of pulmonary aspiration, linked to the action of drugs, raised intra-abdominal pressure; an emergent situation or difficult intubation is decreased with the performance of the Sellick maneuver at intubation, rapid induction and the neutralization of gastric acidity. A meticulous technique of insertion of the, individualized anaesthesia, particular vigilance at the time of decurarisation and position changes and a calm awakening assure its optimal use, unless the Proseal laryngeal mask modifies this point of view.
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PMID:[Lesions to lips, oral and nasal cavities, pharynx, larynx, trachea and esophagus due to endotracheal intubation and its alternatives]. 1294 64

Sinusitis is one of the most common health care complaints in the United States. Approximately one in eight people in the US will have sinusitis at one time in their lives. Until recently, sinusitis has been an undertreated disease. The drastic negative effect of sinusitis on patients' quality of life has been generally underappreciated and unrecognized. Recent studies show that patients score the effects of chronic sinus disease in areas such as bodily pain and social functioning as more debilitating than diseases such as angina, congestive heart failure, emphysema, chronic bronchitis, and lower back pain, to name a few. In the past, many patients were told they would just have to "live with" their sinus problem. However, there have been enormous advances in the past 15 years in the ability to diagnose and treat these problems. This is largely because of technological advances in nasal endoscopy and X-ray imaging. Also, the development of newer, more powerful medications and significant advances in surgical treatment have played a major role in improved patient care. In this article, we provide an overview of sinusitis. We describe the modern definition of sinusitis and the normal physiology of the sinuses. We discuss the causes of sinusitis with attention to the role of allergies, acid reflux, and other related disorders. Finally, we review the current approach to the diagnosis of sinusitis.
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PMID:Sinusitis. 1451 84


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