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

Sleep disturbances are common in cancer patients, but there are few specific data on their prevalence. Among other things, sleep problems may be a symptom of the cancer itself, part of a stress reaction to having cancer, a sequela to some other cancer symptom such as pain, or a side effect of cancer treatment. Insomnia is the more common sleep problem, although hypersomnia also occurs. Most insomnias are related either to pain or to psychophysiologic factors. Treatment should start with identification of a specific cause of sleeplessness; after that, behavioral interventions, medication, or psychotherapy may be helpful. When using medications, keep in mind possible complications, such as daytime sedation, tolerance, and rebound insomnia.
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PMID:Management of sleep problems in cancer patients. 183 74

Both the systemic and local reactions caused by the immunization with the vaccine against diphtheria, tetanus and whooping cough were studied. Side-effects, 48 hours after the vaccination were determined in 730 children between the ages of two months and five years and 11 months. Over 13% of the children were free from side-effects. Eighty-seven percent of the children immunized showed the following side-effects in percentages of frequency: fever, 66.0%; malaise, 37.8%; loss of appetite, 25.0%; sleep disorders, 20.4%; vomiting, 7.9%; and continuous crying, 7.6%. With respect to local disturbances: pain, 41.6%; reddening, 28.0% and subcutaneous nodules, 20.1%. None of the children had convulsions, hypotonic episodes or immediate neurological damage. Two types of DTP vaccines, one from the Connaught (Canadian) Laboratory and another from the National Institute of Hygiene (Venezuelan) were used. No significant differences were found in the appearance of the side-effects between the both, except for localized pain (P less than 0.01) with the national vaccine. The results obtained in relation to age and the number of doses were: there was a significant increase of localized pain as ages increased (P less than 0.01). There were significantly greater number of localized pain and subcutaneous nodules with greater numbers of doses (P less than 0.01).
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PMID:[Side effects of the vaccine against diphtheria, tetanus and whooping cough]. 239 Jan 82

This study examines the nature, pattern, and consequences of pain experienced by cancer patients, both during hospitalization and during the immediate posthospitalization period. Of the 240 hospitalized cancer patients screened, 45% were found to be in pain. Although 59% of these patients had found ways to reduce their pain, nearly one third reported being seriously limited in their daily activities. Sleep disorder and mood disturbance also were related to the experience of pain. Applied pain management strategies were rated by two physicians as inadequate in 54% of cases. The most frequent recommendation for improved pain management was an increase in the dosage or a change in the class of analgesics. The importance of periodic assessment of pain and its consequences, both physical and psychological, is discussed in light of increasing the level of information available to physicians and patients regarding appropriate approaches to pain management.
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PMID:Pain experience and pain management among hospitalized cancer patients. A clinical study. 246 76

1. Assessment of older adults with behavior problems considers factors contributing to the behavior; potential psychosocial interventions; patient characteristics influencing medication action; and medication characteristics influencing therapeutic and adverse effects. 2. Anxiety, agitation, and other behavioral problems in demented patients might arise from their inability to verbally express complaints such as pain and discomfort. 3. Although constant blood levels of medication are most effective for ongoing management of behavior problems, as needed doses can be used to establish the optimal dosing schedule. 4. Medications in low doses can be used to improve the patient's response to psychosocial interventions for behaviors such as anxiety, agitation, depression, and sleep disorders; but they should not be used as the only intervention.
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PMID:Geropharmacology treatment: behavioral problems extend nursing responsibility. 272 43

As an adjunctive treatment, a cognitive-behavioral program for pain management was administered to 25 patients with spondylitis ankylosans organized in self-help groups of the German Rheumatism-League. Another 20 patients with the same disorder served as a waiting-for-treatment control-group. The program consisted of training in progressive muscle relaxation, of cognitive and hypnotic procedures for the control of pain, as well as of information and group discussions, and it was conducted in a group setting with 12 sessions of about 90 min each. A pain diary and questionnaires on trait anxiety, depression, and psychophysiological complaints were used to evaluate the outcome. In a six-month follow-up, significant reductions in pain intensity, in impairments due to pain, in anxiety, and in sleep disorders could be confirmed by analyses of variance. Besides in improvement in pain control, our results indicate a long-term effect on wellbeing as a consequence of our program.
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PMID:[Cognitive behavior therapy in patients with ankylosing spondylitis]. 273 56

Treatment of fibromyalgia includes various forms of therapy--physical, behavioral, psychological, and pharmacologic. No drug therapy has proved uniformly successful, but some drugs provide temporary relief from pain. After an initial therapy program has been established, patients can assume the major responsibility for management. Research studies aimed at defining the cause of fibromyalgia have linked it to sleep disorders, neurogenic mediators, immune mechanisms, muscle disease, and psychological disturbances.
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PMID:Fibromyalgia. 2. Management guidelines and research findings. 294 33

Diet clearly influences neurotransmission. This can be important in grossly undernourished children. It can also be important in children in whom normal homeostatic mechanisms governing food intake are bypassed. Subtle differences in behavior can occur with physiologic variation in food intake. Components of foods can also be used as drugs. Starvation can impair neuronal maturation and can have lasting effects upon behavior and intellectual performance. The extent of starvation's impact upon the brain depends upon whether undernutrition occurred during a critical phase in brain development. Short-term fasting has small, but significant, effects upon intellectual performance. Even when gross malnutrition is not present, subtle changes in diet may modulate brain function. Tryptophan, tyrosine, and choline in the diet are used as precursors for neuronal synthesis of serotonin, dopamine and norepinephrine, and acetylcholine, respectively. It is likely that the brain's sensitivity to certain components of the diet exists to permit monitoring of food intake by the central nervous system. Tryptophan, tyrosine, and choline may be useful in treatment of humans with sleep disorders, pain depression, mania, hypertension, shock, or dyskinesias. Other components of the diet that may affect behavior include food additives, sugar, and caffeine. Food additives may exacerbate hyperactive symptoms in a small proportion of children with attention deficit disorder. Given that there is little potential for harm and that there is a subpopulation that may respond, a trial of a diet that contains no food additives may be a valid diagnostic approach for children with attention deficit disorder who do not respond to stimulant therapy or for children for whom stimulant therapy is not desired. Refined sugar has been blamed for many behavioral abnormalities. Subtle effects of carbohydrate upon behavior have been reported, but the existing data do not support the hypothesis that sucrose or fructose exert special effects upon neurotransmission. Caffeine is easily detected as a stimulant by humans, but it has little effect upon cognitive function. Administration of large doses of vitamins has no beneficial effect in most humans with schizophrenia, attention deficit disorder, autism, Down's syndrome, or drug addiction. Large doses of niacinamide may even be harmful, as they may cause hepatic damage.
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PMID:Dietary influences on neurotransmission. 302 51

Fibromyalgia in the elderly often occurs in the presence of other musculoskeletal disorders where it is often unsuspected. The clue to the diagnosis of concomitant fibromyalgia lies in the widespread distribution of the pain and in its severity. All patients with this disorder have multiple, symmetrically distributed "tender points," a physical sign which is specific for fibromyalgia. Treatment includes, first, explanation. Aerobic exercise may be helpful in many patients, and administration of tricyclic compounds in very low doses is often effective in treating the associated sleep disorder and in reducing overall disease severity.
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PMID:Fibromyalgia in the elderly: differential diagnosis and treatment. 316 18

Sleep physiology and symptoms of 9 patients with fibrositis syndrome secondary to a febrile illness were compared to 9 patients with fibrositis syndrome who did not attribute their symptoms to a febrile illness and to 10 healthy controls. Both patient groups showed an alpha EEG (7.5 to 11 Hz) nonrapid eye movement sleep anomaly, had similar observed tender points, and self-ratings of musculoskeletal pain. These findings suggest that patients with postfebrile fibrositis have a nonrestorative sleep disorder characteristic of patients with fibrositis syndrome and share similar symptoms with patients who have a "chronic fatigue syndrome."
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PMID:Sleep and symptoms in fibrositis syndrome after a febrile illness. 323 4

Chronic musculoskeletal pain and fatigue of "fibrositis syndrome" are associated with a physiologic arousal disorder within sleep, the alpha (7.5 to 11 Hz) electroencephalographic, non-rapid-eye-movement sleep anomaly. In this nonrestorative sleep disorder, pain and mood symptoms may be mediated by psychologic distress (e.g., following a nonphysically injurious industrial or automobile accident), noxious environmental stimuli (e.g., noise), physiologic disturbance (e.g., sleep-related myoclonus, painful inflamed joints, i.e., rheumatoid arthritis), and altered central nervous system metabolism (e.g., disordered brain serotoninergic functions). Because such heterogeneous agents influence this hitherto poorly understood nonarticular rheumatic syndrome, the descriptive term "rheumatic pain modulation disorder" is suggested.
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PMID:Sleep and musculoskeletal pain. 346 14


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