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

We performed antinociceptive testing on swine receiving buprenorphine. Intravenous access was achieved, and animals were allowed to recover for 24 h. Baseline skin-twitch latency to a focused light source was determined for each animal. Animals received intravenous (i.v.) buprenorphine at 0.08 (n =1), 0.16 (n = 1), 0.005 (n = 5), 0.01 (n = 5), or 0.02 mg/kg (n = 6). Skin-twitch latency was determined 15, 30, 60, 120, 180, 240, 300, 360, 420, 480, 540, and 600 min after buprenorphine administration. Analgesic activity as measured by a significant increase in latency time over baseline values occurred at all time points except 480 min in animals that received 0.02 mg/kg buprenorphine i.v. Analgesic activity to 420 min was demonstrated in animals that received 0.01 mg/kg buprenorphine i.v. Analgesic activity was not demonstrated at any time point in animals that received 0.005 mg/kg buprenorphine i.v. A retrospective analysis of postoperative care records was performed to determine whether 0.01 mg/kg buprenorphine i.v. or intramuscularly (i.m.) postoperatively to swine provided clinically relevant analgesia. Records of swine receiving buprenorphine from 1997 to 2000 were reviewed for indications of treatment failure, such as pain or a change in analgesic regimen from that used routinely. Treatment failure occurred in 18 of 416 (4.3%) cases treated with buprenorphine. This failure occurred in 17% of cases with problems categorized as inflammatory in nature and in 15.5% of those with systemic problems or organ failure. We concluded that antinociceptive testing predicted that buprenorphine administered at 0.01 mg/kg i.v. in swine likely would provide analgesic efficacy for 6 h and when administered at 0.02 mg/kg i.v. likely would provide 10 h analgesia. Clinical signs of pain in animals recovering from surgery were not observed in the majority of cases when buprenorphine was administered twice or thrice daily at 0.01 mg/kg i.m. or i.v. However, buprenorphine was less effective at treating signs of pain associated with inflammation, organ failure, or systemic disease than at ameliorating pain associated with surgical incisions and orthopedic, dental, and ophthalmic procedures.
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PMID:Antinociceptive activity of and clinical experience with buprenorphine in swine. 1135 19

A 49-year-old patient with systemic scleroderma was referred to the Department of Dental prostheses for the Degree in Dentistry and Dental Prostheses at Florence University because he was unable to wear his existing complete dentures. The upper denture was not correct owing to the position of the artificial teeth and the short base, and the lower denture caused pain when used. A complete new dental prosthesis was therefore required to overcome the difficulties caused by this systemic disease. Scleroderma is a progressive disease that causes the anelasticity of the mesenchymal tissues owing to post-inflammatory fibrotic and degenerative alterations of unknown etiology. Important changes also occur in the mouth: difficulty opening the mouth, hypo- or non-extendibility of the soft perioral tissues. The construction of the complete upper and lower dentures posed a series of major technical problems compared to a patient not suffering from this pathology. The first core, the rimming of the individual core holder, calculating the vertical dimension and the assembly of the front teeth were all phases that required technical modifications and special care, so that the techniques of our School could be adapted to this particular case. The cosmetic and functional result was undoubtedly good. The patient has been wearing these dental prostheses for five years with satisfaction.
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PMID:[Prosthetic rehabilitation in a patient with systemic scleroderma]. 1137 39

Acrylic cement vertebroplasty is being increasingly used to treat osteoporotic vertebral compression fractures (VCFs), although no controlled studies supporting this trend have been published. Vertebroplasty remains controversial as a treatment for osteoporotic fractures because it is a local response to a systemic disease and because the pain caused by osteoporotic fractures usually subsides within a few days or weeks. Current data suggest that pain severity may decrease by half, on average, in 90-100% of patients. Although vertebroplasty is usually well tolerated, serious neurological complications have been reported in a few patients. The most common adverse event is nerve root pain, usually caused by leakage of the cement into the intervertebral foramen. Whether vertebroplasty is followed by an increased risk of osteoporotic fractures in the adjacent vertebras remains unclear. Resorbable cements are being developed and may provide better results than the acrylic cements used today. At present, acrylic cement vertebroplasty to treat osteoporotic VCFs is appropriate in only a minority of patients selected carefully by a multidisciplinary team including a rheumatologist.
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PMID:Should percutaneous vertebroplasty be used to treat osteoporotic fractures? An update. 1139 21

Catecholamines may play an important role in the control of intrapulpal pressure as mediators of vasoconstriction. A baseline level of catecholamines (dopamine, epinephrine, and norepinephrine) in the uninflamed human dental pulp was previously reported using high-performance liquid chromatography. The purpose of this study was to compare the level of catecholamines present in the inflamed human dental pulp with the baseline level established in virgin teeth. Twelve uninflamed pulps were analyzed as a control and to validate previous findings. Pulp tissue was obtained from 10 vital and inflamed teeth requiring endodontic treatment. Selective criteria for each patient included: absence of systemic disease, medications, and allergies; a vital response to ice, heat, and electric pulp tests; and periodontal probing < or = 3 mm. A prior history of pain associated with the tooth was an additional criterion for inflamed pulps. To avoid the presence of an exogenous catecholamine, local anesthesia without epinephrine was administered. Dopamine, epinephrine, and norepinephrine were chemically extracted and analyzed by high-performance liquid chromatography with ultraviolet detection. Catecholamine levels found to be present in the pulp during inflammation were greater than the baseline level established in uninflamed pulp tissue.
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PMID:Quantitation of catecholamines in inflamed human dental pulp by high-performance liquid chromatography. 1149 41

Complications occur in patients with rheumatoid arthritis who require surgical correction of painful deformities of the foot and ankle. These patients probably are more likely to have complications develop because they: (1) have a systemic disease; (2) use medications that may lead to complications; (3) require multiple operations; and (4) usually have advanced deformities resulting in extensive complicated operations. Despite these difficulties, results of surgical procedures in patients with rheumatoid arthritis remain uniformly excellent. Most complications can be treated successfully, and the overall failure of selected operations is low. However, surgical reconstruction of foot and ankle deformities in patients with rheumatoid arthritis must be meticulously planned and done. These operations are most successful in eliminating pain and in correcting severe deformities.
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PMID:Complications in surgery of the foot and ankle in patients with rheumatoid arthritis. 1160 62

Recent associations between oral health and systemic disease have led to renewed interest in the mouth and its contribution to health outcomes. Many pathways for this relationship have been postulated, among them the potential mediating role of nutrition. The link between various nutrients and systemic disease has been established, but relatively little work has been done in relating oral conditions with nutrition. We searched MEDLINE, from 1966 to July, 2001, to identify articles relating specific oral measures to nutrition outcomes. We included original articles written in English with a sample size greater than 30 that used objective oral health measures. We reviewed a total of 56 articles. Only a small proportion of these studies were methodologically sound. Although many studies were small and cross-sectional, the literature suggests that tooth loss affects dietary quality and nutrient intake in a manner that may increase the risk for several systemic diseases. The impact of tooth loss on diet may be only partially compensated for by prostheses. To date, there is little information relating periodontal disease and oral pain and nutrition. A few studies suggest poorer nutrition among individuals with xerostomia and altered taste. Further, impaired dentition may contribute to weight change, depending on age and other population characteristics. There is a paucity of well-designed studies addressing oral health and nutrition. Before we can acquire a better understanding of how nutrition and oral health interrelate, however, more studies will be required to confirm these associations-preferably longitudinal studies with larger sample sizes and better control of important confounders.
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PMID:Nutrition as a mediator in the relation between oral and systemic disease: associations between specific measures of adult oral health and nutrition outcomes. 1209 Apr 66

This paper discusses the role of oral medicine in the teaching of temporomandibular disorders (TMD) and orofacial pain. Education in orofacial pain and TMD has traditionally been managed in academic dental settings as 2 distinct processes separate from the teaching of diagnosis and management as applied to systemic diseases and oral conditions. The rationale for such a segmented approach appears to have been driven by the concept that orofacial pain usually reflects a localized disease rather than arising as a component of more generalized systemic disease or modulated in intensity or morbidity by systemic pathology, generalized neurobiological, or behavioral contributors. Conversely, oral disease and head and neck manifestations of systemic disease often provoke pain as a major symptom. Management of such conditions should include acute and long-term pain management strategies when the underlying condition has no definitive cure and the pain is disabling. An argument is made for integrating the teaching of oral medicine and orofacial pain to enhance a broad-based approach to the assessment and management of primary pain disorders and to assure appropriate management of pain that is associated with mucosal disease and other forms of regional or systemic pathology including behavioral disorders that present as somatic and painful complaints.
J Orofac Pain 2002
PMID:Role of oral medicine in the teaching of temporomandibular disorders and orofacial pain. 1222 34

Complex regional pain syndrome (CRPS) is clinically characterized by pain, abnormal regulation of blood flow and sweating, edema of skin and subcutaneous tissues, trophic changes of skin, appendages of skin and subcutaneous tissues, and active and passive movement disorders. It is classified into type I (previously reflex sympathetic dystrophy) and type II (previously causalgia). Based on multiple evidence from clinical observations, experimentation on humans, and experimentation on animals, the hypothesis has been put forward that CRPS is primarily a disease of the central nervous system. CRPS patients exhibit changes which occur in somatosensory systems processing noxious, tactile and thermal information, in sympathetic systems innervating skin (blood vessels, sweat glands), and in the somatomotor system. This indicates that the central representations of these systems are changed and data show that CRPS, in particular type I, is a systemic disease involving these neuronal systems. This way of looking at CRPS shifts the attention away from interpreting the syndrome conceptually in a narrow manner and to reduce it to one system or to one mechanism only, e.g., to sympathetic-afferent coupling. It will further our understanding why CRPS type I may develop after a trivial trauma, after a trauma being remote from the affected extremity exhibiting CRPS, and possibly after immobilization of an extremity. It will explain why, in CRPS patients with sympathetically maintained pain, a few temporary blocks of the sympathetic innervation of the affected extremity sometimes lead to long-lasting (even permanent) pain relief and to resolution of the other changes observed in CRPS. This changed view will bring about a diagnostic reclassification and redefinition of CRPS and will have bearings on the therapeutic approaches. Finally it will shift the focus of research efforts.
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PMID:Complex regional pain syndrome is a disease of the central nervous system. 1226 46

Parastomal pyoderma gangrenosum (PPG) is an exceedingly rare disease process most often observed in inflammatory bowel disease patients with an ileostomy. Fewer than 50 cases have been reported in the medical literature. The incidence is 0.6 per cent of patients with ileostomy and inflammatory bowel disease. The rarity of the disease leads to misdiagnosis and mistreatment of the lesion. The intense pain and disruption of ostomy function greatly impair affected individuals beyond the limit of their underlying disease. Current best care practices observed in small study series indicate long-term intensive medical therapy aimed at systemic disease suppression to optimize PPG wound healing. Our patient had no signs of active Crohn disease at the time of PPG presentation. She was initially treated with minimal wound debridement and intralesional triamcinolone. Finally under the care of an enterostomal/wound care therapist the patient achieved excellent PPG resolution in 6 months.
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PMID:Parastomal pyoderma gangrenosum: a case report and literature review. 1235 59

Unilateral throbbing headaches may present similar signs and symptoms as dental pathology and are a diagnostic challenge for dental practitioners. Cases may be seen with a primary complaint of unilateral pain or referred by medical colleagues for exclusion of dental causes. In the present article the authors add a new case of hemicrania continua (HC), which is one such unilateral headache, and review the previously published cases. HC is relatively easy to treat since it responds completely to treatment with indomethacin. However, as is presented in this case, HC may masquerade as dental pain. Cases secondary to trauma, systemic disease, and nervous system pathology have been described in the literature, and the clinician must exclude these possible causes. A thorough knowledge of this entity is therefore essential.
J Orofac Pain 2002
PMID:Hemicrania continua. 1245 33


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