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

Herpes zoster is a self-limited disorder which in most cases resolves without complications. The specific defect in host immunity that permits activation of latent V-Z virus and the occurrence of herpes zoster in both healthy and debilitated individuals has not yet been identified. In some patients, particularly the aged, complications occur during the acute phase of the disease or there are sequelae that may incapacitate the patient later. The most important of these is postherpetic neuralgia. In the elderly the chance of developing neuralgia following herpes zoster is about 50%. Involvement of the eye may produce minimal scarring or permanent blindness. There is an increasing incidence and severity of herpes zoster in association with malignant disease and in particular with Hodgkin's disease. Treatment of herpes zoster in the elderly should be determined by presenting symptoms. Topical medication such as the basic shake lotion is helpful. Personal experience and published reports suggest that early systemic administration of corticosteroids to healthy patients with severe herpes zoster pain with lessen the occurrence of postherpetic neuralgia. Administration of herpes zoster immune globulin is only effective in reducing the morbidity or preventing varicella in high risk individuals. ZIG does not affect the clinical course of herpes zoster.
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PMID:Herpes zoster in the elderly. 6 46

Giant cell arteritis, which is probably due to disturbed immune mechanisms, has a spectrum of clinical symptoms in elderly people. In nearly all cases such general signs as loss of appetite, loss of weight and fever are present. The sedimentation rate is almost without exception about 100 mm in the first hour. The two most frequent and typical clinical syndromes are polymyalgia rheumatica and cranial arteritis. The polymyalgia rheumatica is characterized by periarticular pain which is mostly symmetrical and accentuated in the shoulder girdle. Increasingly severe temporal headache and ocular distrubances are found with cranial arteritis in more than 50% of cases. A combination of both diseases is frequent. Other arterial branches are rarely involved. The course of the disease is over a period of 1 1/2 to 2 years. Treatment with corticosteroids is indicated mainly because of the severe ocular complications with blindness. It should begin immediately, be intensive and last over a long period. Regular followup is necessary over several years in order to avoid relapses.
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PMID:Giant cell arteritis (cranial arteritis, polymyalgia rheumatica). 8 Dec 71

A presumed painful chronic anterior lower leg syndrome was diagnosed in 51 patients (73 legs), 30 women and 21 men, aged 11 to 70 years, over a 2-year period. The duration of the syndrome varied from 1 month to 10 years. The patients' main complaint was pain when walking located in the medial ventral muscle compartment of the lower leg. In addition 10 of the patients (15 legs) had leg pain at rest as well and 12 (15 legs) had paresis of the extensor muscles. Thirty-four paired intracompartmental pressure recordings with the wick technique in 6 patients suggest that the more severe the syndrome the lower the pressure in the tibialis anterior muscle. Blind diathermic fasciotomy in 25 patients (36 legs) with a typical history relieved the pain and paresis completely or partly in 33 (92 per cent) out of 36 legs. No postoperative complications worth mentioning were observed. It is concluded that: 1) a chronic painful anterior lower leg syndrome should be suspected in patients with pain on walking and at rest located in the ventral part of the lower leg; 2) intracompartmental pressure measurements seem to be of little preoperative diagnostic value in non-selected patients; 3) blind diathermic fasciotomy of the anterior, medial compartment of the lower leg, including the extensor retinaculum, gives relief from pain and paresis in most patients with a typical history.
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PMID:The painful chronic anterior lower leg syndrome. A prospective clinical and experimental study. 52 25

A history of blindness in one eye since childhood, the fundus appearance of the other eye, and the family history of elevated plasma levels of carcinoembryonic (CEA) antigen and colorectal carcinoma led us to diagnose bilateral spontaneously regressed retinoblastoma. Massive gliosis of the retina was found in the eye enucleated because of blindness and pain. The diagnosis of regressed retinoblastoma should be considered where the pathologic diagnosis of an enucleated eye is massive gliosis of the retina, but where no known cause is present.
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PMID:Presumed spontaneously regressed retinoblastoma. 67 67

A case of carotid-ophthalmic aneurysm of unusual location in the optic nerve is reported. The development of the disease was sudden: pain in the eye was followed by unilaternal blindness and manifestations of subarachnoid haemorrhage. The optic nerve was dilated balloon-like, cyanotic and vigorously pulsating. It was divided longitudinally and the aneurysmatic sac was exposed from the nerve. A vascular clip was put on its peduncle communicating with the cervico-ophthalmic portion of internal carotid artery. Despite preserved patency of the ophthalmic artery and partial continuity of the optic nerve, the vision of the eye didn't improve.
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PMID:[Aneurysm situated within the optic nerve]. 85 55

Intraneural and perineural spread of squamous carcinoma from the face to the cranial cavity is an important cause of delayed cranial nerve palsies after local excision of a skin tumour. As exemplified in reports of two cases, signs of this type of centripetal spread of squamous cell tumour along the branches and trunk of the supraorbital nerve are (i) severe unremitting orbital and forehead pain with associated hypoaesthesia, (ii) palpable or radiological evidence of thickening of the nerve at the supraorbital notch and (iii) evolution of ophthalmoplegia, blindness, and sensory loss in the first division of the trigeminal nerve. Appearance of severe supraorbital neuralgia months or years after excision of a skin tumour from the forehead should alert the clinician to extension of tumour cells along the supraorbital nerve. This may enable him to institute timely treatment before a complete orbital apex syndrome has developed.
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PMID:Painful ophthalmoplegia following treated squamous carcinoma of the forehead. Orbital apex involvement from centripetal spread via the supraorbital nerve. 95 Sep 37

Blind-ending bifid ureter is one of the rarest congenital abnormalities of the genitourinary system. It can be symptomatic and can give rise to recurrent urinary tract infection and pain on the affected side. If there is any suspicion of this condition on the intravenous pyelogram, a retrograde ureteropyelogram should be done to demonstrate the blind-ending segment. In symptomatic cases, the condition can be treated successfully by exising the segment.
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PMID:Blind-ending bifid ureter. 114 27

An 88 year old man presented with pain in the hands and wrists, associated with electrodiagnostic studies compatible with a carpal tunnel syndrome in the right wrist. Approximately seven months later he developed manifestations of bilateral temporal arteritis resulting in monocular blindness. Electrodiagnostic studies at this time confirmed the presence of a more severe carpal tunnel syndrome, now present bilaterally. We have been unable to find other case reports of carpal tunnel syndrome related to temporal arteritis. This association may be recognized more frequently if electrodiagnostic studies are performed in patients with temporal arteritis associated with pain in the hands and wrists.
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PMID:Carpal tunnel syndrome in temporal arteritis. 118 30

This study describes 44 cases of cranial arteritis (41 of whome had been established by arterial biopsy). Special attention has been payed to the type and the significance of initial symptoms. The majority of the patients were from 65-80 years, the youngest 55 years old. The frequency was slightly higher in the male than in the female. All the patients except for two suffered from pain in the area of the head or the face. Ocular disorders had been found in 62% of the cases, commonly represented by blindness of one eye, decreased vision, papillar edema and eventually by occlusion of the retineal artery. The sedimentation rate of red blood cells showed acceleration between 32 and 130 mm after 1 hour. In the average a laps of time of one month was noted between the appearance of the first subjective symptoms and the moment when diagnosis was made. The administration of 60-80 mg Prednisone daily was followed by a decrease in the clinical signs within a few days to 3 weeks. It is important that therapy be started with a high dosis of Prednisone and that it should be reduced to smaller doses given during several years.
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PMID:[Neurologic aspects of cranial arteritis]. 122 88

During medical training students and residents reconstruct their view of the world. Patients become bodies; both the faults and the virtues of the medical profession become exaggerated. This reconstruction has moral relevance: it is in part a moral blindness. The pain of medical training, together with its narrowness, contributes substantially to these faulty reconstructions. Possible improvements include teaching more social science, selecting chief residents and faculty for their attitudes, helping students acquire communication skills, and helping them deal with their own pain. Most importantly, clearer moral vision requires time and scope for reflection.
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PMID:Learning to see: moral growth during medical training. 140 82


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