Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We show that in benign aging, normally functioning elders have minor neurobehavioral deficits in activities of daily living, and in their neurologic, motor and sensory status; hearing is peripherally and centrally impaired. Also, depression appears in 25%. Gentle physical exercise improves mobility, prevents falls, diminishes pain, wards off depression, reduces mortality, and increases cerebral blood flow and cognition. Diagnosis of Alzheimer disease consists of (1) proof of dementia, (2) meeting established clinical criteria, and (3) staging of severity. We describe dementia, giving tables to identify it and distinguish it from depression, and cite some reversible dementias. We report the accepted clinical inclusion criteria and exclusion criteria for this disease. We show, also with tables, the staging of severity of both dementia and Alzheimer disease as mild, moderate, or severe.
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PMID:Benign aging or Alzheimer disease? 747 16

The aims of this study were to investigate the impact of medical and non-medical factors on the cardiopulmonary resuscitation (CPR) preferences of patients, to determine which of them are the most important to patients when considering CPR, and to compare the views of older (> or = 70 years) and younger (< 70 years) patients. We interviewed 180 patients, 86 of whom were aged 70 years or older. 'I do not want to be a burden on my family' was the most important factor for older patients, and they were more ready to leave the decision to the doctor than were the younger patients. 'I want to retain my capacity to think clearly' was most important to younger patients. In general, younger patients gave higher ratings in favour of CPR than older patients. Increased age, drug abuse, dementia, pain, poor functional status and a low likelihood of success were associated with a lower preference rating for CPR in both age groups.
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PMID:What factors influence patient preferences regarding cardiopulmonary resuscitation? 747 23

Psychotropic drugs are frequently employed to treat the wide range of neuropsychiatric syndromes that patients infected with the human immunodeficiency virus (HIV) may develop. In order to administer these agents properly, physicians should take certain factors into account: the central nervous systems of these patients are often impaired, the patients tend to suffer from medical illnesses, and they may be taking various other drugs. The possible interactions between substances taken by these patients may sometimes make it necessary to adjust the dosage of psychotropic agents administered. In addition, some of the antimicrobial, antifungal and antiviral agents used in the management of HIV infection may have adverse effects that include neuropsychiatric symptoms. The use of antipsychotic agents in these patients frequently results in the development of extrapyramidal symptoms. Tricyclic antidepressants are not well tolerated by patients with AIDS, due to the anticholinergic effects of these agents. The new antidepressants, which have fewer and milder adverse effects, are safer and have shown their efficacy in the treatment of the depressive episodes often seen in HIV-infected patients. Benzodiazepines must be prescribed with caution in patients with HIV infection and organic brain syndrome, since they can produce amnesia, confusion, lack of inhibition and paradoxical reactions. The indications for the use of psychostimulants in certain clinical situations, such as HIV-associated dementia and depression, is open to debate. Opiates are indicated in pain treatment, and in methadone maintenance programmes. Lithium and carbamazepine are advisable only in very restricted situations.
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PMID:Use of psychotropic drugs in patients with HIV infection. 751 59

As many as 45% to 80% of nursing home residents have pain that contributes materially to functional impairment and decreased quality of life. Substantial barriers, including a high frequency of dementia, multiple pain problems, and increased sensitivity to drug side effects often make pain assessment and management more difficult in the nursing home setting. Logistic problems in carrying out diagnostic procedures and management interventions are also common. Pain can be alleviated in nursing homes through the careful use of analgesic drugs combined with nonpharmacologic strategies, including exercise programs and other physical therapies. Elderly nursing home residents are more sensitive to the side effects associated with many analgesic drugs, but this does not justify the failure to treat pain, especially in those who are terminally ill or near the end of life. Structured programs for routine pain assessment and treatment are needed. Physician involvement in pain assessment and management is necessary if pain control is to be improved for nursing home patients.
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PMID:Pain evaluation and management in the nursing home. 757 24

A total of 273 participants (186 with clinical dementia; 87 "normal" controls; mean age 72 years) in a prospective, longitudinal, dementia research study, underwent lumbar puncture (LP), where possible, on an annual basis. Reporting of symptoms after all LP's (n = 541) was 21.6%, the predominant complaints being mild localised back-pain (12.8%) and headache (10.7%). All symptoms were self-limiting. Analysis of headaches after all first LP's (n = 273) revealed an incidence of 14.2% with marked differences between subjects under 60 years of age (33%) and those over 60 years (10.1%), between subjects with "minimal" cerebral atrophy (19.5%) and those with "significant" atrophy (5.6%) and, to a lesser extent, between subjects with no or mild cognitive impairment (20.6%) and those with significant impairment (9.5%). Age under 60 years and lack of significant cerebral atrophy were shown to be independent predictors of headache. Acceptability of LP was high as demonstrated by agreement to a second procedure by 92.2% of eligible subjects. Our results show that LP can be successfully incorporated into research with the elderly.
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PMID:High acceptability and low morbidity of diagnostic lumbar puncture in elderly subjects of mixed cognitive status. 763 73

The objectives of this study were to find out women's health concerns for the community and for themselves as they age and whether the promotion of hormone replacement therapy for prevention is important to them. A postal questionnaire was sent to 1649 women aged 20-69 years. The sample was random but stratified for age and taken from the lists of eight general practices in the town of Stockton-on-Tees in north east England. The questionnaire included questions on priorities for health care, fears for personal health with ageing, knowledge about osteoporosis, cardiovascular disease and hormone replacement therapy. A 74.3% response rate was achieved. Cancer was named as deserving highest priority for health care in Britain today by 40.7% of respondents. The promotion of long term hormone replacement therapy was given a relatively low priority. The health problem women named as the one they most fear will affect them as they age was, for 30.2% of women, cancer; for 18.8% of women, dementia; for 11.6% of women, arthritis; for 8.8% of women, heart disease. The role of oestrogen in preventing osteoporosis was known by 74.9% of respondents and its role in prevention of cardiovascular disease by 6.6%. Lack of exercise as a risk factor for osteoporosis was known by 29.0% and as a risk factor for cardiovascular disease by 84.6%. Arthritis-like pain was thought to be a warning sign of osteoporosis by by 55.8% of respondents. The promotion of hormone replacement therapy for prevention does not appear to be a high priority for women.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Women's health concerns. Is the promotion of hormone replacement therapy for prevention important to women? 766 43

We report a 74-year-old man with a lung cancer, who developed right leg weakness, neurogenic bladder, and multiple cranial nerve palsies. The patient was well until December of 1992, when he was 74-year-old, when he noted transient double vision; in February of 1993, he noted numb sensation and weakness in his right leg. Later in the same month, he developed overflow incontinence of urine and weakness in his right face. He also noted deafness in his left ear (he had a marked loss of hearing in his right ear since childhood because of otitis media). His weakness in his right leg had progressed, and he was admitted to our service on March 19, 1993. On admission, he was afebrile and BP was 130/50 mmHg. General physical examination was unremarkable. On neurologic examination, he was alert and oriented to all spheres; no dementia was noted nor were detected aphasia, apraxia, and agnosia. His optic fundi were unremarkable; ocular movement appeared normal, however, he complained of diplopia in far vision. Sensation of the face was intact. He had right facial palsy of peripheral type; he was unable to close his right eye, and Bell's phenomenon was observed on attempted eye closure. On the left side, he had facial spasm. He had marked bilateral deafness. He had no dysarthria or dysphagia. The remaining of the cranial nerves were intact. Motor wise, he was unable to stand or walk alone; weakness did not appear to account for his difficulty in gait; manual muscle testing revealed 4/5 weakness in his tibialis anterior muscle, 1/5 in the peroneus longus, 0/5 in his extensor hallucis longus and extensor digitorum longus, all on the right side. Brachioradial and quadriceps femoris reflexes were increased to 3/4; plantar response was equivocal on the right side, and flexor on the left. Sensory examination revealed loss of touch and pain sensation in the L5 and S1 distributions in his right leg: vibration and position sensations were also diminished in his right foot. He had overflow urinary incontinence with loss of bladder sensation. Marked nuchal stiffness was noted, however, no Kernig's sign or eye ball tenderness was present. Pertinent laboratory findings were as allows; WBC 8,100/microliters, Ht 42.5%, platelet 326,000/microliters, TP 6.8 g/dl, BUN 16 mg/dl, creatinine 0.54 mg/dl, glucose 95 mg/dl, Na 136 mEq/l, K 4.4 mEq/l, Cl 100 mEq/l; liver profile was normal; CEA 436.6 ng/ml, CA19-93 U/ml; urinalysis was normal.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A 74-year-old man with urinary incontinence, right leg weakness and multiple cranial nerve palsies]. 766 22

In 190 patients, we studied changes in intellectual status during perioperative period using Hasegawa's Dementia Scale (HDS-R), and analyzed preoperative, intraoperative, and postoperative risk factors. HDS-R is one of the most popular scoring tests for evaluating dementia or delirium. Risk factors impairing preoperative score were aging, and preoperative complications including cerebral vascular disease, old myocardial infarction, arrythmia, and diabetes mellitus. Risk factors impairing postoperative score were, in addition to above-mentioned factors, hypoproteinemia and postoperative stressful conditions such as prolonged fever, pain, bed rest, and naso-gastric tube. In the patients who showed postoperative score deterioration, the incidence of old myocardial infarction, hypertension, and postoperative stressful conditions was significantly greater. In the patients who showed postoperative score improvement, local anesthesia including epidural and spinal anesthesia was used more often. In conclusion, aging or preoperative complications such as cerebral vascular disease, old myocardial infarction, arrythmia, and diabetes mellitus are high risks for the development of postoperative dementia and delirium under general surgical procedures and general anesthesia. Intraoperative management with patients awake using local anesthesia and postoperative stress-less conditions are important to avoid postoperative dementia.
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PMID:[Changes in intellectual function during perioperative period evaluated by Hasegawa's Dementia Scale]. 769 25

Adiposis dolorosa is a disease characterized by painful, subcutaneous fatty tumors. This disorder usually occurs in obese, postmenopausal women and is associated with weakness and mental disturbances such as depression, confusion, lethargy, and dementia. The cause is unknown, and there is no specific treatment. Pain may be relieved by steroids, intravenous lidocaine, or analgesics. Surgical treatment consists of excision or liposuction of the painful masses. We present two cases of adiposis dolorosa in men, with a follow-up of more than 10 years.
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PMID:Adiposis dolorosa (Dercum's disease): 10-year follow-up. 788 63

There has been tremendous interest in 5-HT3 receptor antagonists since their discovery and the subsequent identification of 5-HT3 receptors in the CNS. Based on the results of early behavioural tests with these compounds, there has been substantial interest in their potential use for the treatment of various CNS disorders. In this review, Andrew Greenshaw attempts to clarify the status of the therapeutic potential of these drugs, discussing inconsistencies in preclinical findings and identifying areas in need of clarification through future research. 5-HT3 receptor antagonists are claimed to be potentially useful in the treatment of nausea, inflammatory pain (migraine and irritable bowel syndrome), anxiety, depression, schizophrenia, dementia and drug abuse!
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PMID:Behavioural pharmacology of 5-HT3 receptor antagonists: a critical update on therapeutic potential. 810 96


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