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

We report the case of a 50 year old patient, hospitalised with a clinical record suggestive of acute pericarditis and disturbance of auricular rhythm of the flutter type. The consciousness of muscular pain, subcutaneous peri-articular nodules developing over periods of 10 to 15 days and the appearance of chondritis of the right auricle on the 2nd day of hospitalisation led to a diagnosis of atrophying polychondritis. A two-dimensional, TM echocardiographic examination confirms the presence of a discrete, pericardial effusion and presents evidence for a concentric hypertrophy and a heterogeneous aspect of the left ventricular myocardium. In atrophying polychondritis, a rare systemic disease the diagnosis for which is essentially clinical, complications readily set in the form of cardiovascular attacks, sometimes lethal (valvulopathies essentially aortic, aneurysm of the ascending aorta, disturbances of rhythm and conduction, myocardial necrosis, etc). A pericardial attack has already been reported for this condition but uniquely according to electrocardiographic criteria, the lack of specificity of which is known. Our case report confirms the possibility of a pericardial reaction and, in addition, permits the observation of a hypertrophy and a heterogeneous aspect of the myocardium which has not yet been reported in the literature.
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PMID:[Cardiac manifestations of atrophying polychondritis. Apropos of a case disclosed by pericardial effusion and auricular flutter]. 408 73

In summation, the neuranatomy and neurophysiology of pain have been presented. Three of the classical theories of pain transmission were also discussed, these being the specificity, pattern, and gate control theories. The gate control theory postulates that stimulation of large diameter sensory nerve fibers blocks pain sensation at the level of the substantia gelatinosa in the dorsal horn of the spinal cord. This theory is used as the basic explanation for the function of the TNS, a device that can control pain by stimulation of the skin through surface electrodes. TNS stimulation appears to be most efficacious when the electrodes are placed either directly over or just proximal to the painful region. Podiatric application appears to lend itself quite naturally to TNS therapy. Several surgical and nonsurgical cases were presented where TNS therapy was employed and in this preliminary study approximately a 63% improvement in pain state was shown. We believe this modality is useful for patients who should limit their intake of analgesic medications, whether they are medically compromised, allergic to various pain medication, or simply are highly intolerant to pain. TNS is also useful in patients who do not respond well to the more traditional and conventional podiatric treatments. Our study illustrates TNS to be efficacious in pain states of a surgical, chronic or acute nature and even pain secondary to systemic disease. It should be noted that TNS is not curative, per se, but is a useful adjunct in the therapeutic regime. This form of therapy, although not without hazard, is relatively safe and easy to use, and although it is not the answer to all pain states, it is highly recommended when applicable.
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PMID:Transcutaneous nerve stimulation: its significance and applications in podiatry. 611 78

The indwelling transcutaneous vascular access device is easily implantable with little more skill or time required than is typically used in placement of standard intravenous needles or catheters. With routine maintenance of the device site, the infection rate in our studies are negligible. Biocompatibilty, assessed by the lack of destruction of blood components and by the paucity of signs of initimal or systemic disease, was good. Over the period of 10 to 21 days, all but one unit maintained adequate flow rates. The device is stable. There was no blood leakage from the area around the limbs in the chronic flow studies or the hemodialysis studies. The one episode of malpositioning occurred after a sudden strong tug on the tubing. A second dacron retaining cuff will be placed on the distal limb. This will be sutured into place and should increase unit stability. There was little evidence of pain or irritation from the device. No thrombotic tendencies were noted at the access site or systemically. The dogs were on Ascriptin and also the model (canine) is not prone to thromboembolic events. Further improvements on the device will include using smoother, more compatible materials: carbon-coated steel, brushed titanium, or covering the steel with PTFE or ceramic rather than the silastic-dacron cuff. Other future changes include the improvement of the device-tubing connection to one in which no blood will be lost when the device is attached to the dialyzer.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Intravenous transcutaneous vascular access device. 653 23

Sarcoidosis is a chronic systemic disease of unknown etiology characterized by non-caseating granulomatous inflammation of various organs. The records of 2319 patients with the diagnosis of sarcoidosis were reviewed to determine the incidence of nasal involvement. Seventeen patients or approximately 1% of the patients with sarcoidosis had histologically proven nasal mucosa involvement. These patients had symptoms of nasal crusting, congestion, epistaxis, pain, or anosmia. The clinical findings in these patients included friable nasal mucosa, nasal polyps, or a characteristic submucosal nodularity. Most patients also had abnormal sinus roentgenograms with either thickening of the sinus mucosa or opacification of the sinuses. Biopsy of the nasal mucosa shows typical non-caseating granulomas, but care must be exercised to exclude other causes of granulomatous inflammation of the nasal mucosa including tuberculosis, fungal infections, and other idiopathic granulomatous diseases such as Wegener's granulomatosis and Churg-Strauss syndrome. The treatment of nasal sarcoidosis has consisted of systemic steroids and in some cases topical beclomethasone dipropionate.
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PMID:Sarcoidosis of the nose and paranasal sinuses. 662 Dec 25

The ability to differentiate the various causes of ocular hyperemia is important in primary care. Symptoms such as pain, photophobia, and significant blurring of vision usually signify a more serious ocular condition or even a serious systemic disease. The majority of cases can be managed by the primary care physician, but the more serious causes of a red eye deserve prompt recognition and referral to an ophthalmologist to ensure appropriate management.
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PMID:The red eye. Why it happens, what to do, when to refer. 668 86

Histoplasmosis is a generalized fungal infection that is caused by the organism H capsulatum. In the most common disease-producing mechanism, the organism is inhaled and lodges in the lung, where it initiates an inflammatory focus. The peribronchial lymph nodes are subsequently involved, forming a primary complex that may ultimately calcify and become radiographically evident. From the primary complex, dissemination by the bloodstream may lead to colonization elsewhere. In the less frequent disease-producing complex, the organism is introduced directly into the tissue through a break in its continuity. A primary complex is then formed by involvement of the lymph nodes. Dissemination from such a focus is rare. It is generally believed that oral and pharyngeal lesions of the histoplasmosis represent symptoms of a systemic disease and are not a localized form of the disease. Histoplasmosis can occur at all ages; however, it is more often found in infancy and old age, especially in white males. Any area in the oral cavity may be affected; the most common sites are: larynx, tongue, palate, buccal mucosa. gingiva, and pharynx. The most frequently reported symptoms are pain, hoarseness, loss of weight, ulcer, and sore throat. The appearance of the oral and pharyngeal lesions may vary and may manifest as ulcers, nodules, or verrucous plaques. Deep, indurated ulcers are common, accounting for the predominant clinical impression of squamous carcinoma.
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PMID:Ulcerated lesion of the alveolar ridge. 693 20

Rheumatoid arthritis (RA) is a painful systemic disease and is believed to be exacerbated by stress. Relaxation and biofeedback strategies have demonstrated utility in alleviating both pain and stress-related symptomatology, and therefore were tested for efficacy with this disease in a two-phase study. First, 24 patients were taught a relaxation technique and then trained in either temperature elevation or reduction. Second, a group of 15 patients thus trained was compared with 8 others who received traditional physiotherapy modalities. Psychological tests, functional/physical evaluations, as well as measurements related to pain, sleep, and other activities were carried out. Results of the first study revealed significant and positive changes following treatment that were primarily related to pain, tension, and sleep patterns for both groups, but no differential effects were noted between temperature elevation or reduction conditions. This was attributed to both groups having maintained temperature above baseline during biofeedback training. The results of the second study consistently favored the relaxation and biofeedback over the physiotherapy group on the physical/functional indices. The psychological measures tended to remain constant throughout both studies, leading to the conclusion that the effectiveness of treatment was specific to physical functioning rather than to a psychological enhancement of well-being.
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PMID:Rheumatoid arthritis: a study of relaxation and temperature biofeedback training as an adjunctive therapy. 702 Jul 77

Pruritus is a cutaneous sensation sharing neural receptors and pathways with pain but is characterized by its own precipitants, potentiators, and range of severity. Among patients with generalized pruritus, the prevalence of systemic disease has been reported as 10% to 50%, with renal, hepatic, hematopoietic, or endocrine causes most commonly identified. Malignant neoplasms, neurologic disorders, certain drugs, or advanced age also may be responsible. Although the pathogenesis of pruritus is unknown, clinically AG event potential mediators have been investigated in several settings. Therapy often fails when the underlying disorder cannot be corrected, but por pruritus associated with chronic renal failure or hepatic cholestasis, specific and usually effective treatments exist.
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PMID:Pruritus: pathogenesis, therapy, and significance in systemic disease states. 703 41

Even though mammographic techniques have improved and small tumors of 0.5 cm in diameter can be detected, decreased breast cancer mortality has not yet resulted. Because small tumors may cause systemic spread, in many patients breast cancer at the time of diagnosis is a systemic disease which is incurable. A reduction in breast cancer mortality seems possible by prophylactic bilateral mastectomy in women at extraordinary high risk of breast cancer. These are patients with (a) breast cancer in mother and sister, (b) breast cancer in mother or sister and a combination of various risk factors (early menarche - late menopause, nulliparity, late first pregnancy), (c) noninvasive malignant breast disease (carcinoma in situ), (d) therapy-resistant fibrocystic disease with intolerable pain and/or extreme anxiety (carcinophobia, and (e) benign breast neoplasia with malignant potentials (cellular atypia = precancerosis). Also, in breast cancer patients without regional and systemic spread and who are at high risk for developing cancer in the other breast, prophylactic contralateral mastectomy may be indicated. These are patients with (a) unilateral invasive breast cancer in the premenopause and a family history (mother or sister) of breast cancer, (b) unilateral invasive lobular carcinoma or tubular (ductal) carcinoma, and (c) unilateral invasive breast cancer and precancerous lesions in the other breast.
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PMID:Aspects of breast cancer control: is prophylactic mastectomy a feasible modality? 708 17

A previously undescribed syndrome affecting the fingers of women is presented. The patients experience a sharp pain and then the fingers become blue and numb. The discoloration resolves within 72 hours without the changes normally associated with an ecchymosis. Clinical and haematological examination of six patients failed to show any common factors or associated systemic disease. This syndrome is of no clinical significance to the patient, but it is important for clinicians to be aware of it because the acute phase can cause anxiety, suggesting more serious vascular disease.
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PMID:Acute blue fingers in women. 709 22


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