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

Acute coalescent mastoiditis is an uncommon sequela of acute otitis media. It occurs principally in the well-pneumatized temporal bone. The findings of fever, pain, postauricular swelling, and otorrhea are classic. Cholesteatoma, on the other hand, being associated with chronic infection, usually occurs in the sclerotic temporal bone. The signs and symptoms are isidious in nature and consist of chronic discharge and hearing loss which result from its mass, bone erosion, and secondary infection. Of 17 consecutive cases of acute mastoiditis over a six-year period, four were atypical because they were complications of chronic otitis media and cholesteatoma, yet they had the physical findings of acute mastoiditis-subperiosteal abscess and purulent otorrhea, plus radiographic evidence of mastoid coalescence.
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PMID:Acute mastoiditis and cholesteatoma. 11 28

Experience with renal allograft fracture occurring in 21 of 246 transplants performed over a 29-month period is reviewed. Clinical manifestations included pain and tenderness at the graft site, fever, and falling hematocrit. The fracture occurred without exception in the course of an acute rejection episode. Diagnosis was made from two days to seven weeks following transplantation; in 13 patients (62%) diagnosis was made within two weeks of surgery. Severe damage to the kidney necessitated nephrectomy in all but two transplants. Of those not removed at initial exploration only one regained function to permit a dialysis-free existance for several months. Histologic examination of the fractured kidneys revealed the pathogenesis to be acute rejection in 13 (62%), accelerated acute rejection in four (19%), and a combination of these processes in four (19%). Conclusions from this study are that fractures of renal allografts: (1) are more frequent than commonly realized; (2) are primarily due to the swelling of acute rejection; (3) are often characterized by sudden onset of pain in the region of the graft accompanied by fever and falling hematocrit; (4) should be treated by prompt surgical intervention to control hemorrhage, to perform nephrectomy if indicated, and to evacuate the hematoma in order to reduce the possibility of secondary infection.
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PMID:Renal allograft fracture: clinicopathological study of 21 cases. 34 21

The introduction of the hydrophilic contact lens has been a significant advance in ophthalmology for the correction of ametropia, as well as for the therapy of corneal disease. The number of potential contact lens candidates has been greatly expanded by the introduction of both spin-cast and lathe-cut lenses composed of a variety of individual hydrophilic polymers. Myopia, hyperopia, presbyopia, aphakia and moderate astigmatism can be corrected with a reasonable degree of success with the present lenses. Even in keratoconus hydrophilic lenses offer a nonsurgical alternative, especially when combined with spectacle overcorrection. The introduction of hydrophilic bandages in the treatment of corneal disease has been an important addition to the therapeutic armamentarium of the ophthalmologist. When properly applied, these lenses can provide subjective relief of pain while serving to protect the damaged cornea from the traumatic action of the lids and desiccating effects of the atmosphere. The hydrophilic material is permeable to many topically instilled medications and tends to prolong the contact time of the drugs with the corneal surface. Proper fitting of the bandage lenses can eliminate superficial corneal irregularities and, thus, improve the visual acuity while treatment progresses. Medical indications for the use of this therapy include bullous keratopathy, dry eye syndromes, chemical burns, exposure keratitis, and neurotropic keratitis. A number of recurrent erosions and ulcerations have also responded to this form of therapy. Surgical indications include lacerations, postoperative lamellar and penetrating keratoplasty, and keratectomies. One of the most promising applications concerns their use in the postoperative management of alkaline burns. Best results have been obtained by constant wear of the bandage lens, with topical administration of steroids, antibiotics, and saline solution (hypotonic or hypertonic) as indicated. The possible deleterious effects of standard ocular medication containing preservatives has been overstated. Patients receiving medications without preservatives must be placed on prophylactic antibiotics to avoid secondary infection. In many cases, the therapeutic efficacy is closely related to the diameter and curvature of the bandage lens as well as the inherent physical properties of the polymers. With meticulous fitting and close observation complications have been minimal. In many instances the results have been dramatic, but even if unsuccessful the method provides a safe and relatively simple nonsurgical alternative in the treatment of severe corneal disease. Just as with older modalities, the ultimate success or failure depends upon the intrinsic nature of the disease process as well as reasonable therapeutic application based on a knowledge of the mechanics involved.
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PMID:New aspects of contact lenses in ophthalmology. 95 43

Ten cases of various kinds of dermatoses underwent cephradine by injection. Two cases injected cephradine intramuscularly resulted in severe pain. Three of 4 cases with pyogenic skin infection revealed excellent results. Three cases were prevented from secondary infection. Adverse effects such as vertigo were avoided by lowering the speed of intravenous injection. No abnormal findings of serum GOT and GPT levels after the completion of the treatment was noted in 7 of 8 cases, but one case which was administrated large dosis of corticosteroid concomitantly revealed elevated level in this finding.
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PMID:[Administration of cephradine to dermatoses by injection (author's transl)]. 100 78

Thirteen cases of anorectal Herpesivirus hominis infection in male homosexuals are described. Symptoms included pruitus ani in 11 cases, while 7 noticed intense and pain. Change of bowel habits and anal discharge were not presenting symptoms in the majority. None had generalized complications. Inguinal lymphadenopathy, a vesicular eruption, and superficial ulceration around the anal margin were commonly found. Some developed vesicular spread to the natal cleft. Treatment with cotrimoxazole to prevent masking of possible coexistent syphilis, though satisfactory in preventing secondary infection seemed to have little effect on early resolution of the lesions. Relapse occurred in over one third of the patients. Infection with Herpesvirus hominis seems an uncommon but increasingly recognized hazard for the passive homosexual and should be included in the differential diagnosis of lesions presenting at the anus.
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PMID:Anorectal Herpesvirus hominis infection in men. 101 Jul 70

Pain may be absent from the various manifestations making up a post-phlebitis syndrome but when it is present it varies considerably from one patient to another. Thus the very common feeling of heaviness, generally not painful, may be perceived as being painful by certain patients either because of the particular severity of the feeling or because of a low pain threshold in certain cases. Since no method for the objective measurement of pain exists, the assessment of this symptom and of its severity remains highly subjective, most often based upon statements by the patients. However, in practice a distinction can be drawn between the following: Pain related to venous stasis: a simple feeling of heaviness most often but which, in certain patients, may take on a painful connotation. Among such "stasis" pains, particular mention must be made of venous intermittent claudication, a progressive feeling of calf tension during walking which becomes increasingly painful and finally forces the sufferer to stop. This symptom is generally linked to the obstruction of a large collecting vein. Pain accompanying a leg ulcer usually results from secondary infection. Mention may be made of the role of inflammatory lesions developing around the trophic problem and which may encompass nerves, in particular the internal saphenous nerve. Although classical, causalgia type pain is certainly rarer. Demyelinisation of peripheral nerves has been suggested as being at its origin. Once again, the role of inflammatory processes linked to secondary infection appears to be notable. The treatment of pain in a post-phlebitis patient must take the greatest possible account of the pathophysiology of the post-phlebitis syndrome responsible: disinfection of a leg ulcer, treatment of venous stasis by elastic support, or by surgery or sclerosing injections. Sympathectomy has been suggested in causalgia type pain. In fact, this operation has scarcely any indications in post-phlebitis syndrome.
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PMID:[Painful manifestations of the sequelae of phlebitis]. 149 32

In the Omdurman Hospital for Tropical Diseases, Sudan, from 6 October to 1 December 1986, 736 patients with cutaneous leishmaniasis (CL) were studied. The duration of the lesions varied from a few days to 4 months, usually (56%) 1-3 months. Multiple lesions ranging from one to 50 (mean = 4) were present in 80% of cases. Ulcerative lesions were found in 44%, nodulo-ulcerative in 31%, nodular in 31% and others, including infiltrated, fungating and warty lesions, in 5% of patients. The lower limbs were involved in 66%, upper limbs in 50%, face in 6%, back in 4%, chest in 2%, abdomen in 1% and buttocks in 0.1%. Lesions were also found on the ear, scalp, genitalia and mucocutaneous junctions. Lymphatic involvement was present in 11% of the patients, secondary infection in 18%, fever in 17%, pain in 38% and itching in 61%; 3% of the patients were diabetics. Features of diffuse cutaneous leishmaniasis were noted in one patient and three cases presented with an 'id' reaction. A slit-skin smear was positive in 88% of the cases. Using thin-layer starch gel electrophoresis, 23 stocks from man and one from Arvicanthis niloticus were identified by the characterization of 12 enzymes as Leishmania major zymodeme LON-1. Various therapeutic regimens are discussed. Only patients with severe lesions (approximately 15%) were given 3 to 4 weeks' treatment with intravenous Pentostam, to which all except 2 responded satisfactorily with minimal side effects.
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PMID:Studies on the leishmaniases in the Sudan. 2. Clinical and parasitological studies on cutaneous leishmaniasis. 166 50

The two basic mechanisms underlying most of the pleuropulmonary complications of severe acute pancreatitis include pulmonary atelectasis and alveolar flooding. Like in any abdominal catastrophe, pleural effusion and limited diaphragmatic excursion due to pain and intestinal atony are the main factors responsible for alveolar collapse and secondary infection. Physical therapy and needle pleural evacuation are the cornerstones of management. Owing to its pathophysiologic mechanisms adult respiratory distress syndrome is peculiar to acute pancreatitis. Alveolar capillary membrane injury is related to pancreatic necrosis, to its regional extent and to the subsequent over-amplification of the inflammatory reaction. Diversion of those potential mediators of the syndrome either surgically or by thoracic duct drainage is essential in order to improve survival in these patients.
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PMID:[Respiratory complications in severe acute pancreatitis]. 179 36

To assess the response and toxicity of liquid nitrogen cryotherapy for cutaneous lesions of Kaposi's sarcoma (KS) associated with AIDS, we evaluated 20 subjects with biopsy-proven KS in a phase II clinical trial. Subjects had two to four cutaneous KS indicator lesions treated with liquid nitrogen cyrotherapy. Treatment was repeated at 3 week intervals, allowing adequate healing time. On average, subjects received three treatments per lesion with a mean follow-up time of 11 weeks (range of 6-25 weeks). One treatment consisted of two freeze-thaw cycles, with thaw times ranging from 11 to 60 s per cycle. A complete response was observed in 80% of treated KS lesions and lasted a minimum of 6 weeks following the completion of therapy. Greater than 50% cosmetic improvement of KS was observed. Histopathology of treated lesions correlated poorly with cosmetic improvement. Response was not predicted by tolerance to zidovudine therapy, CD4+ cell count, presence of B symptoms, or previous chemotherapy. Subjects without prior history of opportunistic infection (OI) were more likely to have a better response than those with a prior history of OI. Subjects tolerated cryotherapy well. Blistering occurred frequently, but local pain was limited and relieved by acetaminophen. Secondary infection did not occur. Based on this study, we recommend cryotherapy to subjects with cutaneous KS lesions. Liquid nitrogen cryotherapy is easily applied as a primary therapy, and may also have a role in the treatment of cutaneous KS lesions that respond slowly or show incomplete cosmetic improvement with systemic therapies.
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PMID:Cryotherapy for cutaneous Kaposi's sarcoma (KS) associated with acquired immune deficiency syndrome (AIDS): a phase II trial. 189 4

A case of primary erythromelalgia which was treated successfully with lumbar sympathetic block and total spinal block (TSB) is reported. The patient was a 21-year-old woman with 18-year history of pain, burning, swelling, redness and warm sensation in both feet and lower part of the legs that caused the patient to soak her feet and legs frequently in ice cold water in order to obtain pain relief. The patient had been treated with a variety of medications including aspirin, indomethacin, methysergide maleate, and carbamazepine with no relief. Recently, the excessive exposure to cold water had caused extensive immersion foot (trench foot) with secondary infection (fusarium infection). Treatment with bilateral lumbar sympathetic block had markedly improved the symptom. Furthermore, treatment with TSB against causalgic state was performed 8 times for 4 months. During this period, the patient experienced the symptom which was much milder than those before treatment with TSB. Lumbar sympathetic block and TSB are useful methods for treatment of primary erythromelalgia.
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PMID:[A case of primary erythromelalgia (erythermalgia) treated with neural blockade]. 266 81


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