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

Between 1954 and 1975, 80 pancreaticojejunostomies were performed on 77 patients for intractable pain of chronic pancreatitis. All patients had a history of chronic alcoholism. Drainage operations done primarily for pseudocysts were excluded. Operative procedures included seven caudal pancreaticojejunostomies, 42 longitudinal pancreaticojejunostomies with splenectomy and implantation of the pancreas into the jejunum, and 31 side-to-side pancreaticojejunostomies. Eighty-one percent of the patients noted substantial improvement or complete resolution of their abdominal pain on follow-up that ranged up to 21 years. The operative mortality was 5%. Thirty-two patients died during the period of the follow-up. Continued alcohol abuse, carcinoma, and cardiovascular disease were the leading causes of mortality. Data from this review confirm the effectiveness of pancreaticojejunostomy in relieving the pain of chronic relapsing pancreatitis.
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PMID:Pancreaticojejunostomy for chronic pancreatitis. Two- to 21-year follow-up. 7 68

Nonalcoholics who, on a problem drinking inventory, responded "yes" to items reflecting a psychological dependence on alcohol, tended after alcohol ingestion to report a decrease in pain experienced in a cold pressor test. Conversely, those whose responses indicated no psychological dependence on alcohol tended to report pain increases after the consumption of alcohol.
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PMID:Pain as a joint function of alcohol intake and customary reasons for drinking. 44 27

Severe, often fatal liver damage results from extreme overdosage with acetaminophen. In usual dosage, it is considered harmless. We describe three cases of toxic hepatitis associated with the chronic ingestion of excessive doses of acetaminophen. Each patient took approximately 5 to 8 g of acetaminophen per day during a period of several weeks. The transient elevations of serum hepatocellular enzyme concentrations and the histologic evidence of a toxic hepatitis suggest the liver damage was related to the use of acetaminophen. Alcohol abuse in one patient and negative nitrogen balance in another may have increased the susceptibility to acetaminophen toxicity. With the increasing popularity of acetaminophen for mild pain relief, hepatotoxicity from acute or chronic ingestion may be more common than previously recognized, especially in those patients with predisposing conditions.
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PMID:Chronic excessive acetaminophen use and liver damage. 90 Jun 73

Thirty-three patients with pancreas divisum studied by endoscopic retrograde cholangiopancreatography (ERCP) are described. Documented pancreatitis was present in fifteen patients, and another eleven had recurrent episodes of pain typical of pancreatitis. The major papilla was cannulated in all patients, but the duct of Wirsung was opacified in only twenty-eight and showed changes of pancreatitis in one. Attempts were made to cannulate the minor papilla in fifteen of the thirty-three patients and were successful in four. The duct of Santorini showed typical changes of pancreatitis in one. One patient had pancreatic cancer, and the duct of Wirsung demonstrated only nonspecific abnormalities. In only two cases was pancreatitis due to alcohol abuse. The high incidence of pancreatitis and pancreatic-like pain in patients with pancreas divisum, may be due to the very small ampulla of the duct of Santorini which in these patients drains the majority of the pancreas, creating a marked relative stenosis of the ampulla. Surgery for relief of pain was required in five patients. The operation of choice, when pancreatitis involves the dorsal pancreas, appears to be distal resection with drainage.
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PMID:Pancreas divisum: its association with pancreatitis. 92 Aug 76

Fractures of the mandible are commonly seen in most urban trauma centers. Over the past decade, the authors have seen a rise in these injuries secondary to an increase in drug and alcohol abuse, violent crime, and high-speed motor vehicle accidents. Several reports have described an association between mandibular fractures and cervical spine injuries and recommend routine cervical spine radiographs in all patients with mandibular injuries. These studies have failed to show a "cause and effect" relationship because of concomitant injuries found in these patients. This study reviews mandibular fractures and cervical spine injury retrospectively and prospectively over a 3-year period. The retrospective study included patients with isolated mandibular fractures who came to Cooper Hospital/University Medical Center Emergency Room in 1987. Thirty patients were identified, 18 of whom had cervical spine x rays. No patients had a significant radiologic or clinical cervical spine injury. The prospective study included all patients with mandibular fractures seen in the emergency room during 1988 and 1989. Seventy-three patients were identified, 44 of whom had mandibular and cervical spine radiographs. None had a significant radiologic or clinical cervical spine injury. The authors conclude that routine cervical spine x rays are costly and unnecessary. Also, any patient with a suspicion of concomitant cervical spine injury (i.e., patients with a loss of consciousness, multi-organ system injury, cervical pain or tenderness, or intoxication from alcohol use) should have cervical spine x rays, including anteroposterior, lateral, and open-mouth odontoid views.
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PMID:Is routine cervical spine radiographic evaluation indicated in patients with mandibular fractures? 159 38

It is claimed that a significant percentage of chronic pain patients suffer from drug/alcohol abuse/dependency/addiction. To address this question, 24 articles alluding to chronic pain patient drug/alcohol dependence/addiction were reviewed according to the following criteria: method for drug misuse diagnosis, which drug misuse diagnosis used (abuse, dependence, or addiction), and percentage of patients within each diagnostic category of drug misuse. The result of the review indicated that only seven studies utilized acceptable diagnostic criteria and/or definitions for the drug misuse diagnoses and gave percentages of drug misuse. Within these seven studies, the prevalence percentages for the diagnoses for drug abuse, drug dependence, and drug addiction were in the range of 3.2-18.9%. It is concluded that these diagnoses occur in a significant percentage of chronic pain patients. However, there is little evidence in these studies that addictive behaviors are common within the chronic pain population.
Clin J Pain 1992 Jun
PMID:Drug abuse, dependence, and addiction in chronic pain patients. 163 86

Geriatric patients with affective illness often present with unusual or atypical symptom patterns that make diagnosis difficult. Depression may be masked as pseudodementia, somatization, or anxiety/irritability, or it may be an underlying factor in pain syndromes and alcohol abuse. In the elderly, depression may be a primary or secondary symptom of a concomitant medical condition, including thyroid disease and occult neoplasm. Common medications, including some antihypertensive agents, may also have etiologic significance.
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PMID:Geriatric depression: atypical presentations, hidden meanings. 191 4

Truncal subdiaphragmatic vagotomy with pyloroplasty was used in 28 patients with chronic relapsing pancreatitis, 19 of them were inclined to alcohol abuse. In 27 patients followed-up during 3 years, 18 were delivered from pain attacks resulting from chronic pancreatitis, the attacks became rarer and less intense in 4 patients, 3 patients had single attacks of pancreatic colic. In 2 patients the results of treatment were assessed as unsatisfactory due to often admission to the hospital for pain attacks. They were not found to have increased excretory and endocrine insufficiency of the pancreas in this period, but had mental disorders.
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PMID:[Effect of truncal subdiaphragmatic vagotomy on the pain syndrome in patients with chronic recurrent pancreatitis]. 217 81

(1) Subchondral avascular necrosis is an important cause of joint pain and disability and accounts for upwards of 20% of total hip replacements done in our hospital. (2) Early diagnosis may be made with the aid of magnetic resonance imaging and radioactive isotope studies. (3) Although the signs and symptoms are similar to those of osteoarthritis, there are significant differences--namely, (a) a history of sudden onset of pain, present in more than half the patients; (b) a younger age group; (c) a shorter duration of symptoms at time of surgery; (d) clinically the limiting factor is pain rather than actual joint deformity to account for restriction of movement; (e) a high incidence of multiple sites of involvement. (4) The disease is commonly associated with steroid treatment or alcohol abuse. Although many other causes are recognised, they are rare in Western urban practice. (5) Patients with stage I-II subchondral avascular necrosis, especially of the knee, are better treated conservatively. (6) Surgical treatment gives less satisfactory results than the treatment of osteoarthritis by similar modalities.
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PMID:Subchondral avascular necrosis: a common cause of arthritis. 220 Mar 57

Chronic calcific pancreatitis (CCP) is the most clear-cut form of chronic pancreatitis. Till date, the common treatment of CCP has been directed toward discontinuation of alcohol consumption if the disease is associated closely with alcohol abuse, relief of pain, enzyme replacement, and the management of some complications like diabetes mellitus, cyst or abscess of the pancreas, malnutrition etc. In 1979, the research group for chronic pancreatitis in Japan proposed the therapeutic policy for this disease as illustrated in Fig. 1. A plausible new treatment is the dissolution of protein precipitates or calcified stones in pancreatic ducts by oral or intravenous administration of drugs.
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PMID:Dissolution of pancreatic stones. 221 44


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