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

Experience with chymopapain chemonucleolysis in 1,200 cases of lumbar disk disease indicates that it is an effective method of relieving pain resulting from an abnormal intervertebral disk. Complications were few; anaphylaxis occurring immediately after injection was by far the most serious. With the use of a corticosteroid and an antihistamine in preoperative preparation, the incidence of anaphylaxis had dropped, although it still occurs. On long-term follow-up, chemonucleolysis appears to be as good as laminectomy in properly selected cases.
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PMID:Chymopapain chemonucleolysis in lumbar disk disease. 12 15

A 25-year-old white female returned from West Africa with a two-year history of epidosic swelling, pruritus, and pain in a wrist, associated with peripheral eosinophilia. Serologic and immediate skin tests with Dirofilaria immitis antigen were positive, and blood smears transiently showed microfilariae of Acanthocheilonema perstans after the patient had been treated with diethylcarbamazine. Before treatment, both the serum concentration of IgE and the eosinophil content of arylsulfatase, an enzyme that selectively inactivates slow-reacting substance of anaphylaxis, were elevated; the patient's peripheral leukocytes released histamine and eosinophil chemotactic factor of anaphylaxis when challenged with D. immitis antigen. After one course of diethylcarbamazine, the clinical manifestations and abnormal in vitro immunologic results resolved. Host response to A. perstans infection appears to involve both IgE-mediated hypersensitivity and alterations in an eosinophil enzyme.
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PMID:Studies of immediate hypersensitivity in a patient with Acanthocheilonema perstans filarial infection. 107 19

Almost 6,000 healthy adults inoculated with influenza vaccine were asked to record daily for 5 days the presence or absence of defined local and general symptoms; 70 percent completed and returned the record. The overall incidence of subjective reactions derived in this way was high; approximately 50 percent complained of local pain and 40 percent of general symptoms. Only about one-third of vaccinees recorded no symptoms. The incidence of subjective local reactions was about 8 percent higher in women than men. Among 5,600 vaccinees a total of 63 days sickness absence was attributed to reaction in the week of immunization (1.1 days per 100 employees). Almost all the absences were of less than 3 days duration, unsupported by a doctor's certificate. In the week of vaccination sickness absence among vaccinees was not higher than that of non-vaccinees. Although the incidence of subjective reaction was found to be high and vaccination might itself cause some sickness absence, most of the reactions appear to be trivial. Among 700 employees who were interviewed 1 or 2 days after vaccination in 1973, the incidence of what was judged to be significant local pain and erythema was about 5 percent. Nevertheless,the reactions appear to have an important effect on acceptance of influenza vaccination. From the answers given to a questionnaire 30 percent of employees who refused vaccination did so either because they previously had symptoms after vaccination, or because others had told them of their occurrence. In approximately 16,500 injections, only 2 patients had an acute reaction resembling anaphylaxis.
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PMID:Reactions to injected influenza vaccine. 112 81

The percutaneous interventions have gained widespread acceptance for operative treatment of certain lumbar disc herniations. During recent years, percutaneous nucleotomy and laser discolysis replaced more and more the older technique of chemonucleolysis. Reports of anaphylactic shocks and severe neurological complications as well as unsatisfaction with the results of chemonucleolysis were responsible for this change. The basic mechanical concept of reduction of the intradiscal pressure remains the same with the newer methods. At the Inselspital percutaneous nucleotomy replaced chemonucleolysis in 1990. The results of chemonucleolysis were analysed with the aim of quantifying the efficiency of the percutaneous approach among our patient population. A total of 111 patients underwent chemonucleolysis between 1984 and 1989. The indication for the intervention was based on a several month history of lumbosciatica and a correlating radiological finding of disc protrusion or limited herniation. One case of anaphylaxis was the only serious perioperative complication. Upon follow-up examination approximately 2 months later, 54% of the patients were satisfied with the result, 27% reported an unchanged condition, and 19% had more pain than prior to the intervention. These results appear insufficient for an intervention associated with a non-negligible risk. Reduction of the nucleus pulposus appears often not to be an efficient mechanical concept for the treatment of disc protrusions and herniations.
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PMID:[Results of percutaneous chemonucleolysis in lumbar disk hernia]. 128 29

A retrospective survey of 473 cases of snake bite admitted to a Brazilian teaching hospital from 1984 to 1990 revealed 91 cases of bite without envenoming and/or caused by non-venomous snakes. In 17 of these cases the snake was identified, and one patient was bitten by a snake-like reptile (Amphisbaena mertensii). In 43 cases diagnosis was made on clinical grounds (fang marks in the absence of signs of envenoming). The other 30 cases were of patients who complained of being bitten but who did not show any sign of envenoming or fang mark. Most cases occurred in men (66;73%), in the 10-19 years age group (26;29%), in the lower limbs (51/74;69%), between 6 A. M. and 2 P.M. (49;61%) and in the month of April (16;18%). One patient bitten by Philodryas olfersii developed severe local pain, swelling and redness at the site of the bite, with normal clotting time. The patient bitten by Drymarcon corais was misdiagnosed as being bitten by a snake of the genus Bothrops, was given the specific antivenom, and developed anaphylaxis. One patient bitten by Sibynomorphus mikanii presented prolonged clotting time, and was also given antivenom as a case of Bothrops bite. Correct identification of venomous snakes by physicians is necessary to provide correct treatment to victims of snake bite, avoiding unnecessary distress to the patient, and overprescription of antivenom, which may eventually cause severe untoward effects.
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PMID:Non-venomous snake bite and snake bite without envenoming in a Brazilian teaching hospital. Analysis of 91 cases. 134 17

4-Hydroxyandrostenedione (4-OHA), a new specific aromatase inhibitor, was used to treat 57 postmenopausal women with advanced breast cancer at a dose of 250 mg by i.m. injection every 2 weeks; 55 women were assessable for response. In all, 18 patients (33%) had objective evidence of a response to treatment, with a median duration of 12 months; the disease stabilised in 8 (14%) patients. Serum oestradiol levels, which were measured weekly in nine of the patients, were found to be suppressed to a mean of between 36% and 51% of pretreatment levels during the first 6 weeks of treatment. Three patients were withdrawn from treatment because of toxicity (pain at injection site, sterile abscess and rash). One patient had an isolated episode of anaphylaxis after 6 months of treatment. In comparison with our previous reports of 4-OHA treatment, a dose of 250 mg given i.m. fortnightly appears to be the optimal dose regimen. The efficacy of the drug seems to be similar to that of tamoxifen and aminoglutethimide.
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PMID:Treatment of advanced breast cancer in postmenopausal women with 4-hydroxyandrostenedione. 232 91

Oxphaman and particularly oxphalin, among other phenolic azomethines, have been proven as strong inhibitors of lipoxygenases (LOX) from reticulocytes, soybean, thrombocytes as well as of quasi-LOX (hemoglobin) with IC50 values which correspond with those of known LOX inhibitors. The 5-LOX is likewise strongly, the cyclooxygenase of sheep seminal vesicles only weakly inhibited. Nevertheless, antiinflammatory effectivity was found in some carrageenin-induced inflammatory models of the rat as well as in the arachidonic acid- and croton oil-induced ear oedema of the mouse. Adjuvant arthritis, experimental pain, skin permeability and allergy models (anaphylactic paw oedema, cutaneous anaphylaxis, asthma, picryl chloride ear oedema) were not, only weakly or irregularly influenced. In the guinea pig ileum a certain antihistaminic, anticholinergic and leukotriene antagonistic activity was found. An inflammation-induced vasodepression (anaphylactic shock, dextran paw oedema. UV irradiation) was dose-dependently prevented or even reversed, obviously on the basis of oxygen radical scavenging.
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PMID:[The pharmacology of the lipoxygenase inhibitors oxphaman (1-(2,5-dihydroxybenzylidene)aminoadamantane) and oxphalin (1-(3,4-dihydroxybenzylidene)-2,4,6-trimethylaniline]. 251 86

A prospective comparative study was carried out between two anesthetic techniques for chemonucleolysis. Patients were divided into 2 groups of 50 patients each. Group A were submitted to general anesthesia and group B to epidural anesthesia with 0.5% bupivacaine, 2% mepivacaine and buprenorphine. Group B was divided into 2 subgroups: in B1, buprenorphine was administered with the local anesthetics, while in B2 buprenorphine was administered postoperatively when pain appeared. Postoperative pain and side effects like anaphylaxis were evaluated. No anaphylactic reactions occurred. Severe lumbar pain appeared in 22% of patients in group A in spite of systematic analgesics, while group B lumbalgia was not severe in any case. Patients in subgroup B1 did not have pain during the 24 first hours and 47.8% of patients in subgroup B2 needed in most of the cases only a dose of buprenorphine. We conclude that epidural anesthesia is a good technique in chemonucleolysis and that the association bupivacaine, mepivacaine and buprenorphine provides a good postoperative pain relief.
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PMID:[Chemonucleolysis. Peridural anesthesia versus general anesthesia]. 278 Oct 93

This article concerns itself with three common reactions (local, toxic and anaphylactic) resulting from insect or arthropod bites and stings. A local reaction consists of sharp, localized pain followed by a reddening at the site, which usually resolves itself in 24 hours. A toxic reaction may include gastrointestinal symptoms, fever, headache, dizziness or convulsions, often following an episode of multiple stings. An anaphylactic reaction may be mild (hives, itching) or severe (systemic reactions including airway and cardiovascular symptoms). Even though most bites and stings are not serious, nurse practitioners should be aware of potential death resulting from insect sting allergy. They should teach hypersensitive patients, or patients with a history of a systemic reaction to any agent, about prophylactic measures. Tables showing the characteristics of insects that cause cutaneous lesions in humans, and measures necessary to decrease the risk of being stung, can be used as learning tools to prevent insect sting allergy. Because of the rapid onset of anaphylaxis, life-saving measures include awareness in persons who are hypersensitive, emergency preparedness and preventing bites and stings from occurring.
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PMID:Insect bites and stings: managing allergic reactions. 286 63

The leukotrienes (LTs) are a novel group of biologically active mediators derived from arachidonic acid via lipoxygenase enzymes. LTB4 is a potent chemotactic agent for polymorphonuclear leukocytes and in vivo may mediate inflammatory reactions by inducing leukocyte recruitment by mediating indirectly vascular permeability charges and by modulating pain responses. LTC4 and LTD4 collectively account for the biological activity known as slow-reacting substance of anaphylaxis and are potent smooth muscle contracting agents. They may mediate inflammatory reactions by producing changes in blood flow and increases in vascular permeability. Evidence for LT involvement in a number of pathological conditions including diseases such as asthma, psoriasis, ulcerative colitis, and gout is now accumulating.
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PMID:Leukotrienes: their formation and role as inflammatory mediators. 298 30


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