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

Acute febrile neutrophilic dermatosis (Sweet's syndrome) is a rare inflammatory disease of unknown cause characterized by painful, erythematous plaques and a dermal infiltrate of mature neutrophils. Associated systemic disease is a common finding in patients with Sweet's syndrome, and in fact determines the prognosis; therefore, the diagnosis of Sweet's syndrome warrants a thorough medical evaluation. We found only 17 reported cases of Sweet's syndrome in children. Two cases of Sweet's syndrome in children are presented; these cases are typical, except for the tibial pain in the first patient and the marked leukocytosis in the second patient. Both patients responded promptly to systemic corticosteroid therapy, although both had relapse.
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PMID:Sweet's syndrome in children. 811 82

Foot disorders can be a major source of pain, discomfort, and disability for older adults. Neuropathy, impaired leukocyte function, vascular insufficiency, and trauma predispose older diabetics to limb-threatening complications. Therefore, examine the diabetic patient's foot during each visit. Painful foot disorders and lower extremity joint impairment represent major causes of treatable gait disturbance. Treatment of hyperkeratotic lesions (corns, calluses) consists of aseptic debridement and weight dispersion. Interspace maceration, fungal infections, and ulceration must also be managed with care. It is important to distinguish mycotic nail infections from nail dystrophies secondary to systemic disease, vascular insufficiency, and trauma.
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PMID:In-office management of common geriatric foot problems. 817 40

Two otherwise healthy immunocompetent men, ages 62 and 66 years, experienced years of radicular pain without zoster rash. An extensive search for systemic disease and malignancy was negative. Varicella-zoster virus DNA, but not herpes simplex virus DNA, was found in the cerebrospinal fluid of the first patient 5 months after the onset of pain, and in the second patient 8 months after the onset of pain. Prolonged radicular pain without zoster rash combined with the presence of varicella-zoster virus in the cerebrospinal fluid indicates that both men had zoster sine herpete, and strongly supports this syndrome as a clinical variant.
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PMID:Zoster sine herpete, a clinical variant. 817 98

Prostaglandin E1 (PGE1) is a naturally occurring substance that is present in a variety of mammalian tissues, including the semen of fertile men. Its use in the diagnosis and treatment of erectile dysfunction has been extensively studied. In doses of 10-20 micrograms, PGE1 produces full erections in 70-80% of patients with erectile dysfunction. In diagnostic use PGE1 is employed as a simple office test and in conjunction with various hemodynamic tests. Self-injection of PGE1, either with the patient or his partner administering the injection, is a minimally invasive and effective treatment for erectile dysfunction in patients with organic or psychogenic erectile dysfunction. Its use is contraindicated in patients with sickle cell anemia, severe coagulopathy, schizophrenia or severe psychiatric disorder, poor manual dexterity, severe venous incompetence, or severe systemic disease. As calculated from data in the published literature, the most frequent side effects are pain at the injection site or during erection (occurring in 16.8% of patients), hematoma/ecchymosis (1.5% of patients), and prolonged erection/priapism (1.3% of patients). The potential for prolonged erection/priapism, the most serious side effect, can be minimized by careful titration of the dose and through patient education. Systemic side effects occur rarely during PGE1 use. During extended use, patients should be monitored for potential long-term side effects, such as fibrosis and angulation.
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PMID:Intracavernous prostaglandin E1 in erectile dysfunction. 818 62

We studied the painful symptoms associated with human immunodeficiency virus (HIV) infection and its treatment in a group of men enrolled in a prospective longitudinal study of HIV effects on the nervous system. The most common painful illnesses reported were HIV-related headaches, herpes simplex, painful peripheral neuropathy, back pain, herpes zoster, 3'-azido-3'-deoxythymidine (AZT)-induced headaches, throat pain, and arthralgia. Painful illnesses were reported at all stages of systemic disease but were more common in the later stages of disease and in subjects who progressed to a more advanced stage during the study period. There was an association between the frequency of multiple pains, increased disability on the Karnofsky scale, and higher depression scores, as measured by the Brief Symptom Inventory (BSI). We conclude that painful symptoms are important even in relatively healthy and independent HIV-infected men.
Pain 1993 Jul
PMID:Painful symptoms reported by ambulatory HIV-infected men in a longitudinal study. 837 98

Some special points must be taken into consideration when diagnosing complaints of the shoulder joint in older patients by means of sonography. Such patients not only have a higher incidence of systemic disease, but also--as we know from autopsies--a large percentage of rotator cuff tears. These changes--with the exception of small partial tears--can be recognized sonographically with a high degree of certainty. Prospective sonographic studies have provided us with information that the incidence of rotator cuff tears rises from 25% in patients in their fifties to 50% in patients in their seventies. These studies enabled us to explain the hitherto unknown clinical relevance of these changes. In general, the patients complained of little pain, but when large tears were present, there was usually a clear loss of function, which however was astonishingly well tolerated. These findings would call for caution in indicating complicated reconstructive surgery.
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PMID:[Ultrasonographic appearance of the rotator cuff in elderly subjects]. 841 87

We report two patients with mononeuritis multiplex, both of whom had focal inflammation of the perineurium and endoneurium on sural nerve biopsy without necrosis of blood vessel walls, histologic evidence of lymphoid malignancy, or mycobacterial infection. The predominant early sensory symptoms were asymmetric pain and paresthesias; subsequently, muscle weakness developed. Electrophysiologic studies showed an asymmetric sensorimotor axon loss radiculoneuropathy with denervation of limb and paraspinal muscles. Spinal fluid protein was elevated in one patient. There was no cause or underlying systemic disease. Marked improvement occurred with steroid therapy.
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PMID:Nonvasculitic, steroid-responsive mononeuritis multiplex. 829 80

Posterior scleritis is an uncommon condition that usually occurs in adults and the diagnosis is often missed. It is even more rare in children. We report five cases of the disease in children. The patients presented with severe pain in an inflamed eye and usually had orbital signs with lid swelling and limitation of extraocular movements; four of the five had optic disc swelling and two had exudative retinal detachments. The diagnosis was confirmed on B-scan ultrasonography and CT scanning and no child had clinical or laboratory evidence of associated systemic disease. The disease took a protracted course and all the children required long-term systemic immunosuppression (15-27 months), which was well tolerated. All children retained good vision and were either off treatment or on a small dose of immunosuppression at last follow-up. This condition, although rare, should be recognised in children as part of the differential diagnosis of acute orbital inflammation.
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PMID:Severe idiopathic posterior scleritis in children. 854 74

The authors report two cases of cholesterol embolism and review the literature on this subject. Cholesterol crystal emboli are very serious complication of atheroma, generally situated in the aorta and usually in patients in their sixties. The frequency of cholesterol embolism is 20% in autopsy studies in this population. The embolic process accounts for the polymorphic clinical feature. Clinical signs are always delayed in relation to triggering factors. The symptoms can sometimes simulate a systemic disease. Cutaneous signs are present in 40 to 75% of cases. Acute renal failure is present in 30% of cases. Other signs may also be observed: alteration of the general state, fever, neurological disorders, pain of the lower limbs, myalgia, gastrointestinal haemorrhage or perforation, ischaemic colitis, pancreatitis, mesenteric or coronary angina. A triggering factor is revealed in 80% of cases: aortic surgery, retrograde aortic catheterization, fibrinolysis or oral anticoagulant treatment. The prognosis is poor due to the clinical context, the patient's age and the absence of any specific treatment. The short-term mortality is 60 to 80% according to various series. The best treatment is prevention: carefully assess the indication for an endovascular procedure in an atheromatous patient; if necessary, perform transoesophageal ultrasonography to evaluate the risk; whenever possible change the incision in vascular investigations or operative procedures in high-risk patients.
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PMID:[Systemic cholesterol embolism]. 866 92

Patients with locally recurrent and metastatic breast carcinoma require effective palliation of pain and complicating cutaneous, soft tissue, and lymph node metastases. Since October 1989, 48 consecutive patients with recurrent breast carcinoma after mastectomy and no further surgical option were entered in a phase I-II study comparing two radiochemotherapy (RCT) regimens. Treatment-related toxicity was analyzed in 48 patients together with short- and long-term efficacy in 44 patients who had a minimum follow-up of at least 1 year. Since October 1989, group A (28 patients) received 60 Gy "split-course" radiotherapy (RT) over 10 weeks with two breaks of 2 weeks each after the second and fourth week of RT. Simultaneous 5-fluorouracil, methotrexate, and cyclophosphamide (CMF) was given during RT. From October 1991 to April 1993, group B (20 patients) received 54-60 Gy "conventional" RT over 6 weeks. Simultaneous 5-fluorouracil/mitomycin C was applied in the first and fifth week. Overall response [complete response (CR) + partial response (PR)] was 82% in group A (CR, 21%). Five of 28 patients developed grade 3-4 toxicity (EORTC/RTOG/WHO). Overall response rate in group B was 87% (CR, 19%). In this group, 6 of 20 patients experienced grade 3-4 toxicities. In both groups, the rate of local response was remarkably lower in patients with distant metastases and a short relapse interval < 2 years. Although both regimens achieved a similar local response rate, group B patients experienced a higher toxicity rate than did group A patients, but the treatment duration was considerably shorter. The local tumor response was greatly influenced by the extent of systemic disease.
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PMID:Simultaneous radiochemotherapy for recurrent and metastatic breast carcinoma: evaluation of two treatment concepts. 867 15


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