Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 52 year old patient was admitted for retrosternal pain not responding to nitroglycerin. Two years before he had suffered myocardial infarction. He had known cholecystolithiasis. Reinfarction was excluded, but the patient developed right upper quadrant abdominal pain with rebound tenderness, fever and leukocytosis. Abdominal sonography supported the diagnosis of acute cholecystitis. Acute illness resolved rapidly without complications under treatment with antibiotics. The patient underwent cholecystectomy during the free interval four weeks after discharge from the hospital. Intraoperative diagnosis was empyema of the gallbladder with cholecystolithiasis.
 ...
PMID:[Acute retrosternal pain]. 264 31

At Baylor University Medical Center in Dallas, we began performing lithotripsy with the Medstone STS lithotripter for gallstones in January 1988 and in the first year treated 81 patients. Fifty-five of these patients were available for 4-month follow-up. We randomized half of the patients to receive ursodeoxycholic acid for 7 days prior to lithotripsy and gave all of the patients ursodeoxycholic acid after lithotripsy. Only 10.4 percent of the patients who contacted us ultimately proved to be candidates for lithotripsy. Gallstone fragmentation occurred in 95 percent of all patients and in 97 percent of those patients with solitary stones under 20 mm in size. The rate of clearance for solitary stones less than 20 mm in size was 50 percent. Unfavorable effects ascribable to lithotripsy were infrequent. All of the patients had pain before treatment, and one-third complained of biliary colic after treatment. Minor skin bruising which resolved in 1 to 5 days was found in 20 percent of the patients. This study lends credence to the findings of previous studies and demonstrates that lithotripsy combined with bile acid therapy is a useful therapy for cholelithiasis.
 ...
PMID:Biliary lithotripsy. 267 41

The efficacy, safety, and side-effects of a piezo-ceramic system for extracorporeal shock-wave lithotripsy of gallbladder stones were assessed in the first 38 patients treated. Gallstone fragmentation was achieved in 34 patients; 25 required more than 1 treatment session (range 1-5). Extracorporeal shock-wave lithotripsy, conducted without sedation, analgesia, or anaesthesia, was well tolerated by all patients; no patient reported pain or discomfort either during or after the procedure. Side-effects were negligible: transient microscopic haematuria in 2 patients, transiently abnormal liver function tests in 1, and short-lived cutaneous petechiae in 4. Initial experience shows that lithotripsy with this system is effective, safe, and well tolerated.
 ...
PMID:Piezo-ceramic lithotripsy of gallbladder stones: initial experience in 38 patients. 289 67

A prospective study on biliary and pancreatic obstruction during gallstone migration was performed in patients without acute pancreatitis. From January to October 1986, 125 patients with upper abdominal pain due to cholelithiasis were admitted to the hospital. Ultrasonography performed in all patients at admission demonstrated a distal bile duct measuring 7 mm or more in 39 patients, who were monitored for diameter changes of the biliary and pancreatic duct every 24 h and their stools screened for gallstones. Patients underwent surgery at least 8 days after admission. Gallstone migration was found preoperatively in 10 patients, of whom 6 had total serum bilirubin values lower than 2 mg/100 ml. Migration time was accurately determined by the sudden decrease in bile duct caliber. Simultaneous dilatation of biliary and pancreatic duct was found in 4 out of 10 patients with migrating gallstones and in 7 out of 23 patients without gallstone migration, though differences proved non-significant. Acute pancreatitis developed in 2 patients with lithiasis of the distal bile duct who ingested a fatty meal against medical advice. Gallstone migration, even of small stones, was preceded by a period of biliary obstruction. Pain and jaundice before migration were not as frequent as expected.
 ...
PMID:Biliary and pancreatic obstruction during gallstone migration. 328 65

Benign papillary disease is an uncommon entity. For the small percentage of the population afflicted, however, it is a very real, incapacitating disease. In an attempt to alleviate the distressing pain associated with papillary disease, we performed a transampullary septectomy on 105 patients, between the years of 1972 to 1985. There were no operative deaths, and only five serious complications. The findings at exploration were almost equally distributed between stenosing papillitis (53), and septitis (45). The papilla was normal in 7. Histologic findings of inflammation were more common in the former, while fibrosis was seen more frequently with the latter. Long term follow-up (1 to 13 years) in 94 patients revealed complete pain relief in 50 per cent and improvement in 75 per cent Gallstones, pancreatitis, and peptic ulcer appeared to play a role in the pathogenesis of this obscure, rare, and disabling disease.
 ...
PMID:Pathogenesis and treatment of inflammatory lesions of the papilla of Vater. 407 40

The present retrospective study was undertaken to investigate the value of diagnostic procedures--clinical and biochemical parameters, ultra-sonography and ERCP--and the influence of endoscopic papillotomy on the course of biliary pancreatitis in 22 patients. A further 22 patients with alcoholic pancreatitis served as a control group. In the 22 patients with biliary pancreatitis, the case history pointed to biliary disease in 14 cases; in contrast to the patients with alcoholic pancreatitis, in none of these patients did excessive alcohol consumption precede the disease. Seven out of the 22 patients with biliary pancreatitis, but only 2 out of the 22 cases of alcoholic pancreatitis had a previous cholecystectomy. The pain was localized in the right upper abdomen in 60% of the biliary pancreatitis patients, as compared with only 32% of the patients with alcoholic pancreatitis. The laboratory parameters (serum amylases, SGOT, serum bilirubin and leucocytes) did not permit any differentiation between biliary and alcoholic pancreatitis. With respect to the biliary genesis of pancreatitis, the sensitivity of the ultrasound examination was about 68%. The endoscopic detection of a so-called "stone papilla", spontaneous suprapapillary bilio-duodenal fistula, or a blood-tinged papilla, was evidence in favour of a biliary cause of the pancreatitis. In 12 patients, the stones has passed spontaneously; 10 patients were submitted to endoscopic papillotomy for bile duct stones detected by ERCP, and the stones were removed in 9/10 patients. A worsening of the clinical picture by ERCP was not observed in any of the patients. The course of serum amylases, leucocytes and pain in the papillotomied patients corresponded to that in patients with spontaneous stone passage. The results of the present study show that endoscopic papillotomy with stone extraction represents, in most patients with biliary pancreatitis, a possibility for causal therapy, avoiding an emergency surgical intervention. In demonstrated cholecystolithiasis, cholecystectomy can be planned as an elective procedure.
 ...
PMID:[Biliary pancreatitis--diagnostic and therapeutic possibilities with ERCP and endoscopic papillotomy]. 638 6

Thirty patients with radiolucent stones in a radiologically functioning gall bladder were treated for up to two years with a combination of Rowachol (one capsule twice daily), a mixture of cyclic monoterpenes, and chenodeoxycholic acid (7.0-10.5 mg/kg/day). The patients were not selected for body weight or size of stones. All complete dissolutions diagnosed by oral cholecystography were confirmed or refuted by ultrasound examination. Control of symptoms was excellent, only one patient withdrawing from the study because of persistent biliary pain. No evidence of hepatotoxicity was detected biochemically, and diarrhoea due to chenodeoxycholic acid was minimal at this dose. Stones disappeared completely in 11 patients (37%) within one year and in 15 (50%) within two years. These results compared favourably with those obtained with similar doses of chenodeoxycholic acid alone, in particular those of the National Co-operative Gallstone Study (complete dissolution in 13.5% of patients at two years). Treatment with a combination of medium dose chenodeoxycholic acid with Rowachol for radiolucent gall stones is economical, effective, and likely to minimise persistent symptoms and adverse effects of treatment.
 ...
PMID:Pilot study of combination treatment for gall stones with medium dose chenodeoxycholic acid and a terpene preparation. 643 Mar 90

Post-traumatic cholecystitis occurs mostly in young males 8-16 days after severe injury. Gallstones are of no importance in its pathogenesis. Circulatory shock causes severe damage to the small bowel and the liver, particles of the destroyed cells becoming endogenous toxins. Presumably an increased excretion of lysosomal proteases in the biliary duct takes place. This excretion reaches the gallbladder via the accessory ducts and may cause necrosis. Pain in the right upper quadrant, septic temperature and an increase of leucocytes, bilirubin and gamma-GT in the serum suggest this complication.
 ...
PMID:[Post-traumatic cholecystitis]. 661 38

A retrospective study of 22 patients with cancer of the pancreas seen in a medical department was carried out. The mean age was 61.7 years, although the youngest was only 32 years. Weight loss, pain and jaundice were the most frequent presenting symptoms. Hepatomegaly and jaundice were the most common physical findings. The gall bladder was palpable in 27.3%. Serum alkaline phosphatase, bilirubin and ESR were raised in most cases. Ultrasound examination was done in 72.7% of cases and was diagnostic in 62.5% with 12.5% falsely negative. Five patients had CT scan of the abdomen, of which 4 were diagnostic. Percutaneous transhepatic cholangiogram was positive in all the 8 patients where it was carried out. The cancer was of the pancreatic head in 72.7%. Gallstones were present in 22.7%. Secondary tumour involvement of the liver was present in 40.9%. Laparotomy was performed in 11 patients of which only 2 had a curative procedure (Whipple's operation). The overall prognosis was very poor: 54.5% died during the same admission.
 ...
PMID:Cancer of the pancreas--a clinical study of 22 patients. 667 37

The National Cooperative Gallstone Study, a double-masked, placebo-controlled, therapeutic trial of chenodiol (chenodeoxycholic acid), provided an opportunity to study the natural history of cholelithiasis in patients who choose nonsurgical management. The major component of the study comprised 916 patients, 305 of whom were randomly assigned to receive a placebo for 24 months. Among these 305 patients, the probability of having biliary tract pain during the 24 months of prospective evaluation was significantly increased if the patient had had a history of biliary tract pain in the 12 months before entry into the study (69% versus 31%). Thirty-eight percent of patients had stone growth (greater than 0.5 cm3), and 18% had a spontaneous decrease in stone volume. Despite the high incidence of biliary tract pain, nonelective cholecystectomy was required in only 4% of patients during the 24 months.
 ...
PMID:The natural history of cholelithiasis: the National Cooperative Gallstone Study. 674 47


<< Previous 1 2 3 4 5 6 7 8 Next >>