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

The aim was to determine if different doctors prescribed differently for older patients with the same diagnoses as patients who were younger. Five ambulatory-care physicians were selected randomly from a staff of 15. Over age 65 male patients (N = 329) were compared with 889 younger patients in regard to symptoms and medications. Patient-rated symptoms differed by age of patients but not by the five physicians. Comparison of 20 types of medications showed seven differed by patient age but none by physician. Analysis of data in an age x physician grouping, however, showed that certain physicians treated older patients differently in regard to use of digitalis, tranquilizers and pain medications. The findings suggest remarkable similarity in symptoms for older patients seen by different physicians. While use of the medications did not differ between physicians for patients as a total group, they did differ when age of the patient was taken into account. The inconsistent use of certain medications for the old without support of symptoms and diagnoses raises questions about how the old are viewed as a group by some physicians.
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PMID:Patient symptoms and physician prescribing patterns in the elderly. 713 27

To determine maintenance of lifestyle changes following completion of an inpatient behavioral pain management program, 40 patients were followed up by questionnaire 6 months to 3 years after program completion, with the majority contacted at least 18 months postdischarge. Thirty-two patients completed some portion of the questionnaire. Responders were similar to nonresponders in age, sex, chronicity of pain on admission, and time since discharge. Responses to specific items indicated that patients had increased activity level and employment and had decreased use of pain-related medications. A global measure of success was based on 3 criteria: (1) reported nonuse of narcotic analgesics, muscle relaxants and tranquilizers; (2) status as employed, in training, or running a household or continuation of 50% to 100% of exercises and reported increased recreational activities; and (3) no reported increase in pain. Of the patients providing adequate data for application of these criteria, 37% met all 3 standards at follow-up. Such a multivariate criterion is recommended for assessment of multidisciplinary pain programs. More frequently practices behaviors (ie, nonuse of medications, exercises) appeared better maintained. Thus, increased behavioral practice, particularly in vocational and recreational activities, is recommended.
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PMID:Pain management: long-term follow-up of an inpatient program. 725 69

The activity of myorelaxant sirdalud (tizanidine) was studied in 36 patients aged 20-79 with pain syndrome (reflex muscular-tonic, myofascial, acute compression radiculopathy). The condition of the patients was evaluated according to the visual analog scale where the scores were assigned to the intensity of muscular spasm, pain at rest, exercise and at altitude tension and functional decline. Pain symptoms diminished as early as the treatment day 3. The same was true for muscular spasms. The highest effect of sirdalud occurred in acute phases of the diseases. Pain relief was so material that 20 patients were able to discontinue analgetics and tranquilizers. For 12 patients the doses of nonsteroid antiinflammatory drugs were noticeably reduced. Side effects of sirdalud were minimal: slight sleepiness and xerostomia.
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PMID:[The efficacy of sirdalud in the drug therapy of pain in the spine]. 786 33

This article examines the use of analgesics and psychopharmacological adjuvants in children experiencing pain. Peripheral analgesics are effective for mild to moderate pain. Narcotics are effective but may produce dependence and tolerance as well as untoward side effects. Major tranquilizers, minor tranquilizers, tricyclic antidepressants, and stimulants have all been used as adjuvants in pain management. Major tranquilizers are now discouraged because of potential serious adverse effects. Benzodiazepines are relatively safe and decrease anxiety accompanying pain. Tricyclics may be used with caution. Stimulants have received little attention but may be useful in treating both pain and depression in the physically ill.
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PMID:Pharmacological management of pain in children. 840 59

We report a 50 year old male patient with an amphetamine psychosis who had anesthesia for a pneumonectomy. The patient had been intoxicated with methylamphetamine since 1976. After drug abuse for 2 years, he suffered from hallucination and delusion. He was diagnosed to have amphetamine psychosis by psychiatrists and treated with major tranquilizers. During the treatment for the psychosis, a squamous cell carcinoma in the lung was found. Pneumonectomy was scheduled. Anesthesia was induced with thiopental 300 mg and maintained with isoflurane, nitrous oxide, oxygen and epidural lidocaine. In the recovery room, he was injected with a major tranquilizer. Epidural buprenorphine was used to lighten the pain stress. Psychotic state did not appear after the surgery. We also discuss amphetamine psychosis in Japan.
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PMID:[Anesthesia for pneumonectomy in a patient with an amphetamine psychosis]. 832 Aug 13

Previous research has concentrated mainly on surgical aspects and postoperative complication rates after day surgery laparoscopic cholecystectomy (LC), and less on patients' experiences and nursing care aspects. A qualitative study was conducted aimed at investigating patients' experiences of LC in day surgery. Ten women and two men were interviewed. The material was coded, categorized and analysed using qualitative analysis. The findings demonstrate that individuals with gallstone disease experience limitations in their daily life and feelings of socially handicapped. Prior to surgery, the patients felt anxious and expressed a wish for tranquilizers, and to meet the surgeon responsible. At discharge after day surgery, amnesia was experienced and the respondents did not remember important information about the operation given by the surgeon. Experience of postoperative pain varied greatly. Several respondents had a relapse of pain on the third day lasting up to 1 week. The need for additional pain medication and a bloated feeling were reported. Some respondents reported nausea and vomiting, and most had questions about wound care. The need for additional telephone follow-up was mentioned, as was the fact that it was difficult to come home to small children. However, the great majority felt that returning home on the same day as the operation, was positive.
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PMID:Patients' experiences of laparoscopic cholecystectomy in day surgery. 1260 58

This study used the National Violence Against Women Survey (NVAWS) of women and men to estimate noncohabitating dating violence prevalence by type (physical, forced sex, and stalking), associations between dating violence and other types of interpersonal violence across the lifespan, and association of dating violence with longer-term mental health including substance abuse. Among respondents aged 18 to 65, 8.3% of 6,790 women and 2.4% of 7,122 men experienced physical aggression, forced sex, or stalking victimization by a dating partner. Few (20.6% of women and 9.7% of men) reported more than one type of dating violence. Childhood physical aggression by a parent or guardian was strongly associated with subsequent dating violence risk for men and women. Dating violence (physical aggression specifically) was associated with current depressive symptoms, current therapeutic drug use (antidepressants, tranquilizers, or pain medications), and current recreation drug use for women. Implications for parents, survivors, health care, and service providers are discussed.
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PMID:Physical aggression, forced sex, and stalking victimization by a dating partner: an analysis of the National Violence Against Women Survey. 1510 16

Patients with Duchenne muscular dystrophy (DMD) and severe congestive heart failure (CHF) frequently feel mental anguish due to severe mental and physical restriction. Since therapy is not efficacious enough, their quality of life is often disturbed during the terminal stage. We retrospectively evaluated the treatment and care for 11 cases of DMD with severe CHF in our hospital. All cases had unrest and anxiety, which were successfully treated with benzodiazepines and haloperidol. In many cases, patients' families craved for patients' comfort without mental and physical pain. Nine cases resulted in death and 2 cases survived. We also sent a questionnaire to doctors of muscular dystrophy wards of 27 Japanese national hospital, inquiring about therapy protocol, monitoring system, intravenous nutrition, limitation of feeding/recreation/visitors, management of pain/anxiety/sedation, and cardiopulmonary resuscitation (CPR). Sixty-eight doctors answered the questionnaire. Forty-seven doctors (69%) had the experience to treat DMD patients with severe CHF. The majority of them monitored electrocardiography, SpO2 and blood pressure. About a half adopted intravenous nutrition. If recovery was expected, limitation of feeding/recreation/visitors was based mainly on discussion with the patients and their families. If recovery was impossible, the limitation was decided according to their wishes. Nonsteroidal anti-inflammatory drugs were properly used for pain, and minor and major tranquilizers for sedation. Morphine was also used. Only one doctor adopted positive CPR, while the others answered "do not CPR" or "do CPR according to the wish of patients' families". The burden to patients and their families during treatment is unavoidable but should be reduced as much as possible. Medical staffs should ask themselves about the problems to support the families as well as patients repetitively.
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PMID:[How we have treated and cared patients with Duchenne muscular dystrophy and severe congestive heart failure]. 1602 89

The nonmedical use of scheduled medications commonly prescribed for pain, pain-related symptoms, and psychiatric disorders began rising in the mid-1990s. Physicians are confronted with the dilemma of how to minimize the abuse and diversion potential of these products without compromising access for patients with a legitimate medical need. Using data from the National Survey on Drug Use and Health, we describe the scope of nonmedical use of opioids, stimulants, and tranquilizers; characteristics of nonmedical users; and options available to reduce abuse liability. In 2003, lifetime prevalence estimates of nonmedical use were 31.2 million for opioids, 20.7 million for stimulants, and 20.2 million for tranquilizers. Nonmedical users of psychotherapeutics were more likely to be Caucasian; use alcohol, cocaine, or heroin; and to use needles to inject drugs than those who reported using illicit drugs only. Sources of diversion are enumerated, and options for minimizing the abuse liability associated with these medications are described.
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PMID:Nonmedical use and abuse of scheduled medications prescribed for pain, pain-related symptoms, and psychiatric disorders: patterns, user characteristics, and management options. 1621 51

The authors examined the relationship of noise sensitivity with health status and psychological factors in individuals <70 yr of age in Finland. Subjects (n = 1,355) were selected from a 1988 case-control study, based on the Finnish Twin Cohort, that assessed noise sensitivity, lifetime noise exposure, and hypertension. Other health status and psychological factors were obtained from a questionnaire that had been administered to the same individuals in 1981. Statistical analysis showed that noise sensitivity was associated significantly with hypertension, emphysema, use of psychotropic drugs (i.e., sleeping pills, tranquilizers, and pain relievers), stress, smoking, and hostility, even after adjustment for lifetime noise exposure. These results indicate that noise sensitivity has both psychological and somatogenic components.
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PMID:Somatic and psychological characteristics of noise-sensitive adults in Finland. 1626 17


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