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)

Chronic venous insufficiency is a frequent sequel to lower extremity venous thrombosis. A relatively uncommon, but potentially lethal, cause of the thrombosis is congenital antithrombin III deficiency. Recognition and treatment of this occult deficiency is critical. The following report describes a family treated by the authors for this problem. In one generation of nine siblings, three males had documentation of the disease with functional antithrombin III levels in the range of 50% to 60%. Before evaluation for the deficiency one female sibling died at the age of 20 years as a consequence of a proven pulmonary embolus. Antithrombin III levels in another female sibling, who was free of symptoms, were normal (80% to 120%). Four other siblings who were free of symptoms (one female, three males) refused evaluation. All three men with the deficiency had severe, chronic, bilateral, lower extremity, venous insufficiency manifested by pain, varicosities, edema, pigmentation, and ulceration. Despite chronic warfarin therapy, one experienced recurrent pulmonary embolization with eventual loss of perfusion of the entire right lung. Ascending venography in the symptomatic males with the deficiency revealed evidence of recurrent and diffuse venous thrombosis with partial recanalization. Recurrent lower extremity venous thrombosis consequent to antithrombin III deficiency causes a particularly fulminant postphlebitic syndrome with characteristic venographic findings. Although potentially lethal if unrecognized and treated simply as venous insufficiency, chronic therapy with warfarin offers palliation and prolongs life.
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PMID:Occult antithrombin III deficiency: a potentially lethal complication of the postphlebitic limb. 232 20

A patient is described with an orbital varix arising from the right superior ophthalmic vein, associated with ophthalmoplegia and severe pain, and without proptosis. The varix was detected using computerized tomography and orbital phlebography, and at surgery was verified as a venous aneurysm. During the operation, a pearly phlebolith was found. Histological examination of the varix revealed multiple ectatic venous channels. The etiology of this unusual clinical manifestation and the treatment of the patient are briefly discussed.
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PMID:Orbital varix with a pearly phlebolith. Case report. 236 87

We are presenting the results obtained by endoscopic sclerotherapy with 80% alcohol in fifty-five patients with upper GI bleeding caused by esophageal varices, with or without active bleeding at the moment of the endoscopic study. We obtained control of bleeding in 83.64% with a recurrence of bleeding of 16.36% during the first 15 days. At the same period of time we obtained a 16.36% mortality rate. In the forty six patients that concluded sclerotherapy, decrease in size of the varices occurred in 89.79% and eradication was obtained in 6.11% of the patients. We observed three types of complications: esophageal ulcers in 100% of the cases which healed in a period of three weeks. Retrosternal pain of short duration, in 45.65%, this pain appears when the sclerosant substance is injected. Esophageal stenosis in 5.45% which were treated with dilatations. Our conclusion is that 80% alcohol is an effective and safe sclerosant substance in the management of acute bleeding of esophageal varices and in the prevention of the immediate recurrence, but has the disadvantage of a great number of local complications.
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PMID:[Endoscopic sclerotherapy of esophageal varices with 80% alcohol. Experience with 46 cases]. 253 56

We describe four patients suffering from lower limb compartment syndromes which were caused by constrictive bandages applied after stripping of varices. The dressing was erroneously only partially removed, when the patients started complaining of severe pain and tension in the operated legs. The damages varied from extended irreversible neuromuscular defects to lesser functional handicaps. Three patients had corrective surgery. The clinical follow up over several years showed little improvement, secondary complaints were frequent.
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PMID:Iatrogenic compartment syndrome, A follow-up of four cases caused by elastic bandage. 253 80

Pain in the muscles and the feeling of tension in the lower legs along the varicose veins brings many patients, especially women to an operation, usually after previous attempts of conservative treatment. The aim of the work was to present the choice of analgesia for the operation of the veins of the lower limbs with the control of the post-operative analgesia. The methods included two groups of patients. One group received halothane inhalation anaesthesia in combination with nitrous oxide and oxygen, and the other ketamine hydrochloride anaesthesia applied intravenously. Postoperative pain was graded as strong, medium, mild, and painfree state. The pain intensity was assessed for each patient by the hours, and by multiplying the obtained score by the number of patients, we got the total pain scores. The pain relief 1, 2, 3, and 4 hours after the administration of propoxiphen napsilate with paracetamol was calculated according to the formula: Br = Bo-B1 (2,3,4). As compared to the placebo, we got p.o.05 in favour of the active substance after ketamine hydrochloride anaesthesia. The results have shown that postoperative pain was much lower in the group of patients who had ketamine hydrochloride anaesthesia, what together with increased oxygen saturation during anaesthesia leads to the conclusion that this anaesthesia is appropriate for operations on the veins of the lower limbs because it ensures postoperative analgesia and oxygenation without oxygen inhalation. This is important because in the region attacked by varicosity the tissue metabolism is disturbed, oxygenation decreased and the values of pCO2 increased, frequently followed by skin atrophy, lower limb edema and lymphostasis.
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PMID:[Anesthesia in patients with varicose syndrome]. 261 18

The most common complication of chronic pancreatitis is pain, which in many cases seems related to pancreatic ductal obstruction with ductal hypertension. Longitudinal pancreaticojejunostomy is indicated in patients with a dilated (larger than 7 mm) duct and pain that requires narcotic analgesics for relief. Chronic pseudocysts may be corrected surgically without the usual 6-week wait, and asymptomatic pseudocysts less than 4 cm in diameter may not require surgery at all. The relative efficacy and risks of percutaneous drainage of pseudocysts versus the standard surgical approaches need to be studied. Pancreatic fistulas may be external or internal, where pancreatic ascites or hydrothorax can be the clinical manifestation. The pharmacologic suppression of pancreatic secretion (e.g., with somatostatin) may be useful in their management, but surgery may be required. Pancreatic resection or internal drainage is usually effective. Persistent jaundice should be relieved surgically by choledochoduodenostomy to avoid the development of secondary biliary cirrhosis. Obstruction at various levels of the gastrointestinal tract (duodenum, small bowel, colon) may require bypass (gastrojejunostomy) or resection. Hemorrhage from major arteries is an infrequent but often lethal complication of chronic pancreatitis, especially associated with pseudocysts. Angiography is invaluable for diagnosis and occasionally for treatment (embolization). Surgery is preferred in good-risk patients, with suture ligation (resection) of the bleeding source. Chronic pancreatitis is the most common cause of splenic vein thrombosis. The resultant hemorrhage from gastric varices is managed effectively by splenectomy.
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PMID:Complications of chronic pancreatitis. 265 60

A study showing the improved results of operations on varices performed under local anaesthetic was based on 100 complete files of operations on varicose veins including crossectomy, long invaginated stripping and superficial phlebectomies (type Muller) carried out in one operation under general anaesthetic, and 100 identical files of operations performed under local anaesthetic. The fact that the result is more comfortable under local anaesthetic is especially to lengths of hospitalization, which mean that day surgery is preferable in 80% of cases, and also to the length of time off work which, statistically, can be reduced by local anaesthetic. Finally, the study of anatomic sequelae (varicosities and post-operative neurological disorders) shows particularly that the development of varicosities during the operative period probably depends on oestroprogestative impregnation, and shows much more clearly that local anaesthetic facilitates the avoidance of lesion to the short saphenal nerve during the stripping, because of the pain signal triggered.
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PMID:[Comparative results of stripping under general anesthesia and under locoregional anesthesia (200 cases)]. 275 73

In particular chronic venous diseases are of considerable sociomedical and socioeconomic significance, and often start early in the age of professional activity. In Germany the number of early retirement is about 2.500 per year. Nevertheless they lack the well-deserved acceptance in the medicopolitical and sociomedical sector, what in addition makes the care for persons suffering from venous diseases at their place of work more difficult, as well as the problematic assessment of chronic venous diseases anyhow and the suitable rehabilitation. Even if there is no occupational disease which manifests itself in the venous system in a particular way, the venous diseases would have essential importance for the occupational medicine. Thus standing pursuit of profession means an essential strain of the peripheral venous system, at least in men it is a risk factor for the appearance of varices, and in women it increasingly leads to pain in the legs. Apart from traumatic lesions in the venous system the "thrombose par effort" may be caused in an almost typical way by hard professional work. The interactions, too, between the therapy of venous diseases and pursuit of profession are manifold, for example a compression treatment at sitting activity. The works medical officer, after all, and if need be, even the expert's opinion has particular chances concerning venous diseases: information and vocational guidance; non-invasive, functional orientated diagnostics; primary and secondary prevention; equipment of working place and process and support of treatment and rehabilitation with simple but effective measures. The therapeutic possibilities in venous diseases are differentiated and practicable.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Social medicine significance, costs, course, therapy and prognosis of venous diseases]. 278 58

To our knowledge, this is the first reported case of intravascular papillary endothelial hyperplasia occurring in the synovium. The patient, a 16-year-old boy, presented with pain and hemarthrosis of the knee in the absence of known trauma. The lesion arose within a subsynovial varix and episodically bled with the intra-articular hemorrhage and reactive synovial changes producing the patient's symptomatology. The clinical, pathologic, and ultrastructural features of the lesion are summarized from a review of the literature, and the differential diagnosis of hemarthrosis with a hemosiderotic synovitis is discussed.
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PMID:Intravascular papillary endothelial hyperplasia involving the synovium. 283 63

Any thrombotic affection can involve the deep veins as well as the superficial veins of the calf. It is considered that venous thrombosis may be a result of low concentrations of the activator of plasminogen levels in the vein wall, which produces a mediocre fibrinolytic response. The concentrations of the activator of plasminogen in these veins are little knows. Immediately after amputation, for pain in the decubitus position, samples of the soleus vein (N = 9) and long saphenous vein (LSV; N = 9) were removed and frozen in liquid nitrogen. In 6 limbs operated for varicose veins, samples of the vein in the calf (VC; N = 6) were removed and frozen. As a control, we examined samples of normal veins removed from the groin of patients undergoing hernia repairs. The quantitative determination of the activator of plasminogen was achieved thanks to a homogenate technique, and the results were expressed in taps by the minute by a tissue microgram. The median activity and the range of results were: LSV 1675 (777-8119); soleus vein 6795 (2232-21 570); CV 2356 (676-4099); inguinal veins 11 221 (6717-13 410). The low concentration of activator of plasminogen in the calf veins may contribute to a mediocre fibrinolytic response in these veins. This is not likely to be the case in the soleus veins. The results may indicate a different thrombotic mechanism in the two types of veins.
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PMID:[Quantitative determination of tissue-type plasminogen activator in varicose soleus veins]. 312 2


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