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

A brief historical introduction traces the evolution of the concept of hypochondriasis. It is suggested that the term should now be used only as a descriptive adjective when there is a morbid preoccupation with health or body. Social and cultural factors are outlined, as well as problems of measurement. The psychopathology, as formulated by Freud and others, is also described. Clinical aspects are discussed under the headings of general symptoms, pain, smell, bodily appearance, sexual, gastro-intestinal, cardio-respiratory, eyes, and ears, nose and throat. Psychiatric syndromes mentioned are: hypochondria as a possible primary state, personality disorders, phobic-anxiety state, neurashthenia, obsessional neurosis, hysteria, depression, paranoid psychosis and organic. In general, hypochondriacal symptoms seem to make the prognosis rather worse. Treatment is to be aimed at the primary condition, which is most commonly depression, anxiety state or conversion reaction.
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PMID:Hypochondriacal states. 77 13

Arterial plasma noradrenaline and adrenaline concentrations before, during and after an attack of pain, induced first by constant supine exercise and then by multistep atrial pacing, were determined in four patients with coronary occlusion disease and stable angina pectoris. An identical protocol was applied to a patient with atypical precordial pain (anxiety state) and normal coronary arteriograms. When compared, the results led to the following conclusions: 1) during supine exercise arterial plasma catecholamine concentrations, particularly noradrenaline, progressively increase, reaching highest values in temporal coincidence with the onset or the peak of pain, 2) during multistep atrial pacing-induced angina no significant changes of arterial plasma catecholamine concentrations are seen. These data, obtained from the same patients, further emphasize that the application of atrial pacing to the study of pathophysiology of angina pectoris and for evaluating antianginal drugs, especially if interfering with adrenosympathetic system activity, must be considered with caution.
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PMID:[Exercise test and atrial pacing in angina pectoris: behaviour of adrenosympathetic system (author's transl)]. 118 66

This study evaluates, 1) the pain induced by extracorporeal shock wave lithotripsy for renal stones using a piezo-electric shock wave lithotriptor (EDAP LT 01) and 2) the predictive factors for severe pain leading to an indication for analgesia. The relationship between extracorporeal shock wave lithotripsy intensity and pain intensity is evaluated by a numerical scale at the beginning of the session (T0), after 15 min (T15) and after 30 min (T30). At the end of the session, patients are categorized by one of us using a three-point scale which integrates the pain and the maximum tolerable intensity. These two types of evaluation are well correlated. Successive levels of stimulation are well discriminated by patients. Habituation is observed during the session for patients with low-level pain. In 28% of the patients, the intensity of pain required analgesia. Pain cannot be predicted by age, anxiety state, side of the stones and size, diameter of the contact between patient and convergence dome. In contrast, three parameters are correlated with the pain level: The L1 distance of renal parenchyma and the L2 distance skin-stone crossed by the piezoelectric waves, the size of the stone. The superior caliceal, middle caliceal and pelvic stones are significantly the most painful. These predictive variables can be easily measured before extracorporeal shock wave lithotripsy.
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PMID:[Pain and extracorporeal lithotripsy for calculi of the upper urinary tract]. 186 65

Relationships between anxiety and pain perception were investigated by comparing pre- and post-pain reactions of highly anxious detoxified substance abusers categorized on the basis of anxiety level changes over treatment. Sensory decision theory methodology was applied to measure discriminative and decisional aspects of pain response. Men exhibiting significant pre-post-anxiety state decreases showed greater discriminability index increases and greater response bias index decreases at post-test, compared to their counterparts exhibiting minimal changes in severe anxiety levels across treatment. Findings have relevance for understanding pain perception and interventions in clinical samples.
Pain 1989 Jul
PMID:Anxiety and pain response changes across treatment: sensory decision analysis. 278 61

Most drugs are ineffective for the long-term treatment of irritable bowel syndrome (IBS). The beneficial effects of medical treatment of IBS are poor and last for only a relative short time. Over a period of 6 months, we investigated the effectiveness of cimetropium bromide, a new antimuscarinic compound, in patients with IBS. Forty-eight patients were treated at random and in double-blind fashion with cimetropium bromide (50 mg, tid) or placebo for 6 months. Personal diary cards and monthly check-ups guaranteed the monitoring of symptoms (mainly pain). In addition, personality patterns (MHQ-CBA tests) were obtained for the patients before and after therapy, both to detect possible psychoneurotic traits and to observe the changes in these traits in relation to the changes in pain symptoms. Three patients on placebo and one on cimetropium dropped out. At the end of therapy, pain scores had decreased an average of 16% in the placebo group and 87% in the cimetropium group (p less than 0.01). Twenty patients (87%) on cimetropium versus five patients (24%) on placebo considered themselves to be globally improved (p less than 0.01). The MHQ test showed significant improvement in the anxiety score in the cimetropium group only. The CBA test confirmed a significant decrease in anxiety state (STAI-X-1) after cimetropium treatment. Eleven patients (48%) on cimetropium reported side effects (mainly dry mouth and sleepiness), but none withdrew from the study. The results of this trial indicate that long-term treatment of IBS with cimetropium bromide significantly improves symptoms and associated psychological disorders.
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PMID:Oral cimetropium bromide, a new antimuscarinic drug, for long-term treatment of irritable bowel syndrome. 305 43

Ultrasound (US) therapy is used to reduce pain and inflammation and to accelerate healing after soft tissue injury. However, there is little objective evidence of its effectiveness and the mechanisms which may cause these effects are unknown. In a placebo-controlled double-blind clinical trial we examined the contribution of placebo and massage effects in ultrasound therapy following bilateral surgical extraction of lower third molars. Four to 6 h after surgery the patients (25 per group) received either no therapy, US (0.1 W/cm2), 'mock' US with massage, 'mock' US without massage, or 'self-massage' with a dummy applicator. Facial swelling, trismus, serum C-reactive protein, serum cortisol, pain and anxiety were measured 24 h postoperatively. The results showed that the beneficial analgesic and anti-inflammatory effects of US therapy were placebo-mediated, with maximum effect in the placebo ('mock' US) group without circular massaging with the applicator). Self-massage by the patient produced no significant effect. This placebo action was independent of changes in serum cortisol or patient anxiety state. US therapy can significantly reduce postoperative morbidity, but by placebo-mediated mechanisms which are unrelated to the US itself.
Pain 1988 Jun
PMID:Reduction of postoperative pain and swelling by ultrasound treatment: a placebo effect. 341 38

Women predominate at all ages among patients diagnosed as having primary fibromyalgia. Of 100 patients reviewed, the average age at onset of fibromyalgia was 46. Of 65 patients in whom menopause occurred before diagnosis of fibromyalgia, the average age at menopause was 42, and most of these women had menopause related to surgery and insufficient estrogen therapy. Estrogen deficit is, thus, a prominent promoting factor in the majority of fibromyalgia patients and is likely to have an effect on sleep, mood, and anxiety state. These emotional responses may subsequently be somatized as pain. Therefore, estrogen therapy should be added to the treatment armamentarium for fibromyalgia in selected patients.
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PMID:Fibromyalgia and menopause. Examination of the relationship. 346 50

The relationship of anxiety to depression in a number of the depressive and neurotic syndromes (agitated depressive syndrome, affective hypochondriacal syndrome, depressed obsessive-compulsive syndrome, phobic and obsessive-compulsive syndrome, anxiety state, depressive neurotic syndrome) is far from clear. Are anxiety and depression entirely separate disorders which may co-exist in the same patient? Does anxiety give rise to the depression? Does depression give rise to the anxiety? Are anxiety and depression manifestations of a single underlying disorders, dysphoria? Therapeutic responsivity to specific drugs suggest: relief of anxiety may reveal an underlying depression; anxiety syndromes which fail to respond to anxiolytics may respond to antidepressants; short-term relief of depression may occur at times with anxiolytics. Proposed mechanisms of action of depression and anxiety also involve overlap of the elements and systems involved. The basic sensations of pain, anticipation, depression and euphoria alone or in combination are sufficient to account for the dysphoric feelings and emotions when these sensations are associated with specific mental content. These may be related in turn to biogenic amines, beta-endorphins, diazepam receptors and possibly cocaine receptors.
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PMID:Anxiety and/or the depressive syndromes. 693 14

Thirty-nine patients with acute low back pain were treated with amitriptyline (150 mg/d) or acetaminophen (2,000 mg/d) in a controlled double-blind design for 5 weeks. Both groups revealed mild depression, normal coping, and increased anxiety at the beginning, with significant improvement in anxiety state and pain at the end of treatment. A repeated measures analysis of variance demonstrated that amitriptyline was more effective than acetaminophen in reducing pain intensity from the second week of treatment. Age and depression were the only significant pretreatment predictors of posttreatment pain. The study evaluates the significance of these findings.
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PMID:The efficacy of amitriptyline and acetaminophen in the management of acute low back pain. 860 Apr 97

In order to understand the effects of relaxation training on surgical stress response, a study was conducted among patients with abdominal surgery. Fifty-one patients were randomly divided into two groups. Experimental group (n = 25): patients received preoperative instruction and relaxation training, control group (n = 26): patients received only preoperative instruction. Anxiety state (state anxiety and physical symptoms of anxiety), blood pressure, heart rate, serum cortisone and postoperative pain of two groups were assessed and compared respectively on the third preoperative day, operation day, the first and the fourth postoperative day. Results showed that (1) there were significant differences between two groups (P < 0.05) in state anxiety scores on each day, physical symptoms on the first and fourth day after operation and severity of pain on the first postoperative day. (2) responses of systolic pressure, diastolic pressure and heart rate decreased in the experimental group. (3) Serum cortisone level decreased significantly in the experimental group on the first postoperative day (P < 0.05). This study shows that relaxation training has positive effects on surgical stress responses, especially in reducing the psychological anxiety response. Relaxation training can be served as an easy and effective method in nursing practice.
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PMID:[Relaxation training on stress response to abdominal surgery]. 929 85


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