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

Pyogenic arthritis of the sacro-iliac joint is uncommon in children; 6 cases were observed over 4 years. The diagnosis may be difficult and should include specific examination of the sacro-iliac joint. Posterior pain with a febrile illness needs radiological examination and a skeletal scintigraphy, which has always been positive in our experience. All the patients had a very good functional recovery after antibiotherapy and rest (bed or plaster).
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PMID:[Pyogenic sacroiliac arthritis in children. Apropos of 6 cases]. 306 22

Posterior capsulitis, which is characterized by pain and inflammation localized above and behind the condyle of the mandible, usually develops as a result of premature contacts in dental occlusion. The pain at the affected side is related to the severe spasm of M. Pterygoideus Lateralis or the splinting action of the masticatory muscles. This condition can be readily treated by occlusal grinding of these premature contacts after a definite diagnosis. The amount of grinding on the teeth varies according to the localization of premature contacts and the pain at the joint. This study covers 123 patients diagnosed as having posterior capsulitis and the results are presented.
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PMID:Posterior capsulitis of the temporomandibular joint. 308 60

When spasticity becomes severe and harmful, in spite of physical and medical therapy, neurosurgery can give functional improvement. This paper deals with the long term results of Selective Peripheral Neurotomies of the Tibial Nerve and Selective Posterior Rhizotomies in the Dorsal Root Entry Zone, in 123 patients with spastic disorders localized to the limbs. The micro-techniques and intra-operative electro-stimulation for identification of the nervous structures responsible for the spastic components, can give a substantial reduction of the harmful spasticity, without suppressing the useful muscle tone and impairing the residual motor and sensory functions. The results were effective, with a 1 to 13 year follow-up (5 on average), in 89% of 47 Selective Peripheral Neurotomies of the tibial nerve for spastic foot, in 92% of 53 Selective Posterior Rhizotomies for paraplegia and in 87% of 23 Selective Posterior Rhizotomies for hemiplegia. In the most severe situations ("comfort" indications), correction of the abnormal postures and relief of pain facilitated nursing and physiotherapy. Sometimes there was reappearance of some useful voluntary movements. In the less affected patients ("functional" indications), the suppression of the harmful spastic components made the persistant capacities more effective.
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PMID:Microsurgical procedures in the peripheral nerves and the dorsal root entry zone for the treatment of spasticity. 316 6

Fifty-four patients were given intraoperative radiation therapy (IORT) for adenocarcinoma of the pancreas between April, 1980 and August, 1987 at Aichi Cancer Center Hospital. Thirty-five of these patients with well-advanced cancer underwent palliative IORT of their main primary lesions which could not be resected. Twenty (or 57%) of them had liver and/or peritoneal metastases. Electron irradiation at doses of 12 Gy (1 patient), 15 Gy, 20 Gy, 22 Gy, 22.5 Gy, 25 Gy and 30 Gy was given to these patients in single doses. Gastric and/or biliary bypasses were performed in 27 (77%) of them following IORT. Twenty (80%) of the 25 patients in this group who had intractable back pain before this treatment achieved relief of pain within one week postoperatively. The median survival for this group of 35 unresectable cases was 5.3months (range 0.5-28.6 months). The remaining 19 patients underwent pancreatectomy and received adjuvant IORT to the bed of the pancreas. Two of the patients in this group had liver metastases and one patient had peritoneal seeding. All of the visible metastatic lesions were removed by local excision in these three patients. Posterior surgical margins were cancer-positive in 8 patients, suspicious in 6 and negative in 5. IORT doses were 20 Gy (7 patients), 25 Gy and 30 Gy. Median survival for this group of 19 resectable cases was 9.4 months, including 10 patients who remain alive at the time of this report (August 15, 1987). The longest survival has been 6 years 10 months in one patient after absolute non-curative distal pancreatectomy followed by 20 Gy of IORT for cancer of the body of the pancreas with a microscopically proven cancer-positive posterior surgical margin. The other nine are alive at 5 years 10 months, 2 years 4 months, 1 year 5 months, 1 year, and within one year (5 patients), respectively. Survival rates were compared between one group of 41 patients operated on in the 5 years before we began IORT and another group of 70 patients operated on after IORT introduction. The latter group included 16 patients who did not receive IORT for various reasons. The background factors were rather worse in the latter group, but both the survival rates and the staying-home survival rates were significantly better (p less than 0.05). One-year survival rates were 7% in the before-IORT period and 26% in the after-IORT period. One-year staying-home survival rates were 2% and 18%, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Intraoperative radiation therapy (IORT) of adenocarcinoma of the pancreas]. 338 27

The characteristics features of right-sided endocarditis are summarized in this case report of a 30-year-old female admitted with a history of high grade, continuous, fever, breathlessness, and dry cough over a 10-day period. The patient had had an incomplete abortion 15 days earlier for which dilatation and curettage was performed. On examination, the patient was toxic, febrile with a pulse of 118/minute and respiration 36/minute. Her blood pressure was 110/70 mm Hg. There was soft, tender hepatomegaly and soft splenomegely. There also were scattered coarse crepitations over both lungs. The vaginal examination revealed posterior fornicial bogginess and tenderness. Urine and cervical pus swab showed growth of klebsiella. The blood culture was negative. A plan chest X-ray revealed multiple, small, basal, pulmonary infiltrates. Posterior colopuncture revealed a small quantity of clear, yellowish fluid. Abdominopelvic ultrasonography revealed an ill-defined haziness in the parauterine region. The patient was treated with ampicillin, gentamycin, and metronidazole, but she continued to deteriorate. An urgent exploratory laparotomy was performed. The patient died on the 2nd postoperative day. The autopsy findings revealed that the heart was normal in size and shape. The tricuspid valve showed a large vegetation projecting into the ventricle. Microscopic examination revealed polymorphonuclear infiltration with clumps of gram-negative bacillifocal areas of myocarditis also were seen. In lungs the right lower lobe showed a small, hemorrhagic infarct. Both the liver and spleen were congested. Kidneys showed multiple petechiae on the external surface and on the cut section. Endocarditis during pregnancy may be because of perinatal infections, urinary tract infection, or septic thrombophlebitis of pelvi veins. Septic abortion of pelvic infection secondary to IUD also can provide portal of entry for bacteria. The common organisms are streptococcus, staphylococci, and occasionally bacteroides and gram negative bacilli. Clinical suspicion of right-sided endocarditis is justified in any patient with prolonged fever, cough, pleuritic pain, tachycardia, and multiple pulmonary infiltrates. Heart murmurs are usually absent and if present are soft and may be heard at atypical sites.
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PMID:Tricuspid valve endocarditis following septic abortion. 371 Oct 12

In a retrospective analysis of 149 patients with metastatic spinal tumors, the postoperative outcome was compared in patients who had posterior decompressive laminectomies alone (PL) and patients who had supplemental posterior stabilization at the time of laminectomy (PLS). The object of the analysis was to define the indications for stabilization. Posterior stabilization relieved pain, improved sphincter function, and encouraged ambulatory status. The use of adjunctive radiotherapy preceding laminectomy did not significantly improve the patient's postoperative course. Sex, age, initial symptom, length of time from onset of initial neurologic symptom to the time of laminectomy, the presence or duration of pain or sensory loss, the number of vertebrae involved with tumor, and the presence of widespread metastatic disease did not seem to influence the results of the surgical treatment. The presence of significant motor dysfunction, which was rapidly progressive before surgery, or profound sphincteric dysfunction prior to decompressive laminectomy was more frequent in patients who had unsatisfactory results. Decompressive laminectomy with stabilization should be considered in patients: with progressive neurologic symptoms, who are ambulatory, but whose pain increases despite radiotherapy, and who are ambulatory and were receiving radiotherapy for pain relief but who display neurologic dysfunction. For patients with established paraplegia and sphincter dysfunction, decompressive laminectomy and posterior stabilization are adjunctive measures of pain control.
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PMID:Laminectomy for metastatic epidural spinal cord tumors. Posterior stabilization, radiotherapy, and preoperative assessment. 372 Jan 4

Posterior dislocations of the shoulder are rare, comprising only 4% of shoulder dislocations. Several operative procedures have been described in treating recurrent dislocations, and results have been varied. A retrospective review of eight shoulders in eight patients treated by posterior glenoidplasty with capsulorrhaphy and infraspinatus advancement revealed generally good results. Followup ranged from 10 to 114 months, with an average of 36 months. Seven patients were classified as recurrent traumatic dislocators and one as a recurrent atraumatic voluntary dislocator. Results graded as good, fair, and failure were based on pain, range of motion, return to activities, recurrence, and roentgenograms. Six patients had good results with return to full activity, full range of motion, no pain, no recurrence, and no degenerative changes of roentgenograms. One patient, who has not returned to athletic activities and has occasional pain and limited range of motion, was graded as a fair result. The patient classified as an atraumatic voluntary dislocator has occasional feelings of instability and slight pain with strenuous activity, but has not had a recurrence and has no difficulty with activities of daily living. She was also classified as a fair result. There have been no recurrences or degenerative changes on followup radiographs. Computerized tomography performed on two patients documented a definite change in orientation of the glenoid. We feel that glenoidplasty with capsular reefing and infraspinatus advancement, if performed carefully, provides an excellent operative treatment for recurrent posterior dislocations of the shoulder.
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PMID:Operative treatment of posterior shoulder dislocations by posterior glenoidplasty, capsulorrhaphy, and infraspinatus advancement. 375 56

Trigeminal neuralgia nearly always can be relieved initially with drug therapy. Long-term relief, however, is achieved in only 25 percent of patients. When medical therapy fails, surgery may be necessary. Percutaneous rhizotomy is an effective technique for pain relief, with few medical contraindications. Posterior fossa exploration and neurovascular decompression or sensory root sectioning is reserved for those patients who do not improve after rhizotomy and for selected younger patients.
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PMID:Surgical treatment of trigeminal neuralgia. 388 75

The goals of management of spine fractures from C3 to C7 are to provide stability for maximum pain-free function and to prevent further or future injury to the spinal cord and nerve roots. Surgical fusion may be necessary to provide immediate and long-term stability. Posterior instability should be treated by posterior fusion, and anterior instability should be treated with anterior stabilization.
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PMID:Management of spine fractures C3 to C7. 394 82

The indications and techniques for internal fixation of the lumbar spine in degenerative conditions have changed drastically since internal fixation was first applied to the spine almost 100 years ago. Anterior instrumentation and fusion may be used for repair of pseudarthrosis after posterolateral fusion; symptomatic lumbar scoliosis associated with degenerative disc disease; late pain secondary to posttraumatic kyphosis; postlaminectomy instability; and lumbar pain secondary to thoracolumbar kyphosis. Posterior instrumentation and fusion has been performed with Luque instrumentation over 3-4 levels in cases of multilevel instability. Combined anterior and posterior instrumentation and fusion are required for lumbosacral fusion in lumbar scoliosis with degenerative disease, and surgical correction of postsurgical lumbar kyphosis (flat-back syndrome). The techniques are demanding but with attention to detail can be performed with acceptably low-complication rates.
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PMID:Techniques of internal fixation for degenerative conditions of the lumbar spine. 395 84


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