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

The differential diagnosis of trigeminal neuropathy is quite challenging because there is a significant variety of causes for the disorder. We reviewed our cases of trigeminal neuropathy by studying first the initial manifestations in order to evaluate their underlying disorders. Sixty-four patients with trigeminal neuropathy came to our Out-Patients clinic. We have excluded from our analysis any patients with atypical pain, facial migraine, nasal sinusitis, pain from inflammation of dental pulp or facial bones, and pretrigeminal neuralgia. In 53 cases (83%) we identified the causes; 35 of them were cases of symptomatic trigeminal neuritis and 18 were trigeminal neuralgia while, in the remaining 11 cases, no definitive causative disorder was identified. Among the 35 patients with symptomatic neuritis, 10 cases were found to have malignant neoplasms including 5 cases of squamous cell carcinoma, 6 had a virus infection, 5 had traumatic origin, 4 had multiple sclerosis, 2 exhibited Tolosa-Hunt syndrome, 2 had MCTD, and there were single cases of sarcoidosis, serpentine aneurysm, cavernous sinus thrombosis, maxillary cyst and trigeminal neurinoma. The remaining 11 cases of neuritis whose causes were undetermined showed clinical features similar to trigeminal sensory neuropathy, an analogue of Bell's palsy, a benign self-limiting condition. Since the cases shared symptoms of impairment of taste, and, occasionally, of facial palsy, vestibular insufficiency, hearing disturbance, hypoglossal palsy or signs of cerebellar lesion, we strongly suspected a virus origin.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical analysis of trigeminal neuropathy as initial manifestations--an etiological study]. 319 Sep 35

Upper respiratory tract infections, particularly pharyngitis and acute otitis media (AOM) are the commonest diseases in children. Although viruses are the main causative agents, bacteria may play an important role. With regard to antibiotic therapy, clinicians must solve two problems: differentiation between viral and bacterial aetiology and choice of the optimal drug for each bacterial disease. In patients with pharyngitis the identification of group A haemolytic streptococci as the causative agent may be very difficult if only clinical and haematological data are considered. Throat culture is time consuming and difficult to perform in ambulatory practice; the recent techniques for rapid detection of streptococcal antigens are a possible answer to this problem. In bacterial pharyngitis a single injection of benzathine penicillin is considered to be first choice. However local pain and the significant increase of the relative risk of allergic problems in comparison with the decrease of incidence of rheumatic fever may shift therapeutic preference towards macrolides. The recently marketed ones, especially miocamycin, seem to offer easier administration, fewer side-effects and better efficacy. With regard to AOM, the differentiation between bacterial and viral disease is less important because over 70% of cases are of bacterial origin. Besides, an exact aetiological diagnosis is possible only by tympanocentesis, an invasive method. In Italy amoxicillin is still the drug of choice: a twice-daily regimen has been demonstrated to be as effective as the traditional thrice-daily schedule.
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PMID:Upper respiratory tract infections in children: antibiotic treatment. 332 54

Delay in appendectomy occurs from failure to contact a physician, or from a physician's failure to make a proper diagnosis. In our study delay was due to physician error in 32 of 422 children who had appendectomy. Symptoms consistent with appendicitis were documented on the initial visit in each case, but 22 patients had a history of previous similar pain or recent viral illness to confuse the diagnosis. Misdiagnosis was responsible for the delay in 14 cases (gastroenteritis in ten and urinary tract infection in four). Antibiotics given before proper diagnosis in 22 instances increased diagnostic difficulty in 20. Late referral is increasing, perhaps because of a perceived innocuous nature of appendicitis. Complicated appendicitis was found in 26 children (81%), compared with 38% of the total experience. Their hospital stay averaged nine days, as opposed to 6.6 days in the nondelayed group. Failure of resolution of symptoms after therapy begins mandates reassessment to avoid progression of this common surgical disease.
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PMID:Delayed diagnosis in pediatric appendicitis. 333 98

A subacute, oligoarthritic syndrome developed in four patients with human immunodeficiency virus (HIV) infection. Three had true acquired immunodeficiency syndrome (AIDS) and all had lymphocyte abnormalities. The arthritis was characterized by extreme pain and disability in three patients and moderate pain in one. Knees and ankles were affected. Symptoms developed over a one- to six-week interval; response to treatment was rapid, especially to intra-articular corticosteroids. Despite the clinical severity of the arthritis, synovial fluids were non-inflammatory and biopsy specimens revealed only mild chronic synovitis. A definite etiology could not be established. None of the patients had recognized infections predisposing to reactive arthritis, and the three patients who underwent tissue typing were HLA-B27-negative. A viral infection, including HIV, is a possible cause. In distinction to these four patients, arthritides with clearly established etiologies developed during this same time period in four other HIV-infected patients.
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PMID:Acquired immunodeficiency syndrome-associated arthritis. 336 41

Out of 80 kidney graft recipients treated with cyclosporin A and low dose steroids 19 (23.8%) developed herpes virus infection and from these 15 (18.8%) herpetic stomatitis. Evaluation of enhancing factors for herpetic stomatitis suggested a role of cyclosporin A rather than of steroids and a probable relation to preceding CMV infection. Acyclovir treatment was effective on the course of stomatitis and pain in 12 of the 15 patients. No serious side effects were observed. Leukopenia as a possible hazard was discussed.
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PMID:Herpetic stomatitis and acyclovir therapy in cyclosporin A treated renal graft recipients. 391 58

The beneficial effects of gamma-globulin, which were used for agammaglobulinemia and severe infectious disease as an adjuvant or combination therapy in conjunction with antibiotics, are well known. In this study, a new intravenous human gamma-globulin (SM-4300) was administered to 5 patients with bacterial infection and 2 patients with viral infection. In 4 out of 7 patients (57.1%), several symptoms such as high fever, general fatigue and pain were improved clinically. Furthermore, there were no side effects due to SM-4300 either in clinical findings or in laboratory examinations.
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PMID:[Treatment with combination of antibiotics and human gamma-globulin (SM-4300) for severe infection in surgery]. 407 30

Herpes zoster can be a severe, and sometimes fatal, virus infection in its disseminated form in immunocompromised hosts. Previous studies have suggested that delay in appearance of antibody to varicella-zoster virus occurs as one defect in such patients. In this study, pooled gamma-globulin (normal serum globulin [NSG]) and zoster immune globulin ([ZIG] prepared from convalescent zoster patients) were compared for their ability to prevent dissemination of early localized zoster in immunocompromised hosts. Either agent was given intramuscularly in randomized double-blind fashion within nine days of onset of zoster in 97 patients. Despite greater than 100-fold differences in titer of anti-varicella-zoster virus antibody, ZIG did not appear superior to NSG in prophylaxis of dissemination or diminishing postherpetic pain in zoster in immunocompromised hosts. Zoster immune globulins should be reserved for prophylaxis and modification of varicella, where its beneficial effect has been demonstrated.
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PMID:Zoster immune globulin prophylaxis of disseminated zoster in compromised hosts. A randomized trial. 615 60

A patient who had meningoencephalitis and corneal inflammation originating in a herpes virus infection sustained severe pure sensory polyneuropathy with superficial pain sensitivity and proprioceptive sensory deficits. The sensory deficiencies were diagnosed both in clinical and in electromyographic testings. The clinical EMG picture pointed to a pure sensory polyneuroplathy with a viral background according to blood serum and CSF examinations.
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PMID:Pure sensory polyneuropathy of herpes virus origin associated with meningoencephalitis. A case report. 624 4

A retrospective study of 107 cases of serologically proven chikungunya (CHIK) virus infection was undertaken. All respondents had contracted the disease at least 3 years previously; 87,9% had fully recovered, 3,7% experienced only occasional stiffness or mild discomfort, 2,8% had persistent residual joint stiffness but no pain, while 5,6% had persistent joint pain and stiffness and frequent effusions. Synovial fluid from 3 patients was analysed. All the patients with persistent joint pain and stiffness had very high antibody titres against CHIK virus.
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PMID:Chikungunya virus infection. A retrospective study of 107 cases. 629 56

Forty marrow transplant patients were treated with acyclovir for varicella-zoster virus infection. Median duration of virus positivity and of new lesion formation was 2.1 and 2.2 days, and pustulation , crusting, and healing occurred at medians of 3.5, 8, and 28 days, respectively. Acute pain ceased at a median of 7 days, though seven patients had later recurrence of pain and eight had pain that persisted for more than 28 days. Three patients had recurrence of infection within 4 days after the end of treatment and were successfully treated in each case with a second course of acyclovir. Side effects were minimal. These data compare favorably with published data both from the treatment of normal persons with acyclovir and treatment of normal persons with acyclovir and treatment of immunocompromised patients with vidarabine, and they indicate that acyclovir is safe and effective for the treatment of varicella-zoster virus infection in the severely immunocompromised host.
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PMID:Acyclovir treatment of varicella-zoster virus infection in the compromised host. 632 3


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