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

The Burkitt's tumor is a neoplastic disease which occurs mostly in the tropics. Sporadic cases however are distributed all over the world. This undifferentiated lymphosarcoma predominates in children. Extralymphnodal in origin, quick growth and lack of pain are very characteristic signs. Unattended most of the patients die within a few months. Cytostatic treatment in connection with x-ray therapy and surgical proceedings show some results. The Epstein-Barr-virus is incriminated to play a causative role in the pathogenesis of Burkitt's lymphoma. But the experimental proof of its oncogenic activity in human beings has not yet been demonstrated. The problem of an active immunization is to be controlled.
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PMID:[Burkitt's lymphoma]. 19 41

It is proposed that there are three fundamental adaptive systems that have developed in the course of evolution. One of these, learning, is the only one that is widely recognized. The other two consist of regulation of the energetic aspect of stimulation, and integration of the data of experience into an organized conceptual system. Corresponding to each of the three basic adaptive systems are three basic types of disorder, namely maladaptive learning, which is by far the most common source of behavioral problems; overstimulation, as in the traumatic neurosis; and collapse of the individual's conceptual integrative system, as in acute schizophrenic disorganization. Just as relearning is a natural adaptive process for correcting problems produced by learning, there are inherent processes for correcting the disorders produced by overstimulation and by a maladaptive integrative system. The present article is concerned with the natural process for correcting a poorly organized conceptual system. A second article (Epstein 1978) will be devoted to the natural process of coping with the energic aspects of stimulation. An acute disorganizational state can provide an opportunity for a new and more effective conceptual system to develop. As a desperate remedy, it is often unsuccessful. Nevertheless, an orderly process can be discerned in such states that can enhance the likelihood that new, and dissociated old, material will be assimilated into a new organization. If all goes well, the new organization will be more resilient than the old one; it will be better able to accomplish the functions of an implicit theory of reality, which are to integrate the data of experience, to maintain a favorable pleasure-pain balance, and to maintain self-esteem.
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PMID:Natural healing processes of the mind: I. Acute schizophrenic disorganization. 46 44

These 53 operated patients were divided into 2 groups: 29 had an intermittent claudication as Verbiest first described it soon as 1949, whereas 24 had permanent radicular pain in legs as Epstein emphasized it. We think emulsified Duroliopaque myelography to be the best investigation to make sure the diagnosis and to forecast the operative tactics: we gave up Dimer X myelography which occasioned serious complications in 2 cases and gas myelography which seems to us inadequate to this radicular pathology. Total-Body Scanner is rather an elegant method but a discontinuous one. The radiographic and operative findings have shown the stenosis of the lumbar canal to be congenital in 5 cases, development in 20 cases, degenerative in 27 cases (with 15 pseudo-spondylolisthesis) and tabetic in one case. A disc herniation was found in 25 cases over 53. The extent of the bone resection has been in relation with clinical picture, myelography and mainly operative findings, aiming at a "cut-to-measure costum". In every case the initial laminectomy was made easier by trenching the thickened laminae on each side of the spinal process prior to remove it. Only soft disc hernations were removed; the dura was never opened; no vertebral fusion was performed; for 2 years we have tried to avoid the "laminectomy membrane" by interposing an autogenous fat and aponevrotic graft between the dura and the overlying paraspinal muscles. The operative results are satisfactory with 75% of excellent and good; they are much better in patients with intermittent claudication than in those with permanent radicular pain. It is a question of functional surgery in one case, of pain surgery in the other. The major trick seems to us to be that of the associated disc hernation with the risk of missing the narrow canal.
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PMID:[The narrow lumbar canal: 53 operated cases (author's transl)]. 54 93

Sleep physiology, viral serology and symptoms of 14 patients with chronic fatigue syndrome (CFS) were compared with 12 healthy controls. All patients described unrefreshing sleep and showed a prominent alpha electroencephalographic nonrapid eye movement (7.5-11.0 Hz) sleep anomaly (p less than or equal to 0.001), but had no physiologic daytime sleepiness. There were no group differences in Epstein-Barr virus (EBV) antibody titers. The patient group had more fibrositis tender points (p less than 0.0001), described more somatic complaints (p less than 0.0001), and more depressive symptoms (p less than 0.0001). Patients with CFS do not show evidence for a specific chronic EBV infection, but show altered sleep physiology, numerous tender points, diffuse pain, and depressive symptoms. These features are similar to those found in fibromyalgia syndrome.
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PMID:Sleep, Epstein-Barr virus infection, musculoskeletal pain, and depressive symptoms in chronic fatigue syndrome. 132 33

In summary, Wegener's granulomatosis is a systemic illness that is characterized pathologically by necrotizing granulomatosis and vasculitis. Lethal midline granuloma is not a pathological term. Lethal midline granuloma is a clinical term, and in reality, lethal midline granuloma has been proven to be polymorphic reticulosis and not Wegener's granulomatosis. Polymorphic reticulosis is now understood to be a T-cell lymphoma. Further study of these malignant lymphomas has shown that these T-cell lymphoproliferative disorders may be causally associated with Epstein-Barr virus. Although there is strong association between autoantibodies against cytoplasmic constituents of neurophils and monocytes in patients with active Wegener's granulomatosis, the exact pathogenic mechanism in Wegener's granulomatosis and the etiology is still unknown. IgG-C-ANAC (C-ANAC stands for Classical/Cytoplasmic Anti-Neutrophil Cytoplasm Antibodies) increases with increasing disease activity from undetectable levels to up to 95% of active Wegener's granulomatosis patients. Rhinologic symptoms in Wegener's granulomatosis include progressive nasal obstruction, bloody rhinorrhea with crusting, and vague pain and tenderness of the nasal dorsum. Usually these patients have mucosal ulcerations of the nose with or without a septal perforation. Other areas of the head and neck can be involved, and they include orbital, otologic, oral, and subglottic involvement. Hallmarks of malignant lymphoma (polymorphic reticulosis) when it involves the upper airway include rapid localized destruction of the nose, orbit, paranasal sinuses, and hard palate. Treatment for Wegener's granulomatosis includes antimicrobial agents in addition to a regimen of cyclophosphamide and glucocorticoids. The treatment for malignant lymphoma (polymorphic reticulosis) is primarily radiation, especially when confined to one site.
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PMID:Fireside conference 19. Wegener's granulomatosis and lethal midline granuloma. 138 98

Fatigue, pain, and emotional upset remain the most common problems affecting humanity and for which we still know so very little. Chronic fatigue syndrome is most likely a number of as yet unproven various undifferentiated illnesses that are exceedingly difficult to distinguish from depression. There probably is a subset of patients with CFS who do have true immune dysfunction and persistent viral infection, and this particular group of patients should be further investigated. This group is the minority of patients who present with chronic fatigue. Although chronic fatigue syndrome may be the result of an organic illness in psychologically susceptible individuals, it remains most important to assess underlying psychologic factors that then need to be addressed. These factors may very likely have a profound effect on immune function, but more research is needed in this area. The diagnostic evaluation of patients with chronic fatigue syndrome should initially focus on causes for fatigue other than Epstein-Barr viral infection. Significant underlying medical conditions should be ruled out, and extensive inquiry into symptoms suggestive of depression and anxiety should be aggressively pursued. Treatment should include psychiatric support and counseling, good nutrition, adequate rest, and a gradual increase in activity. Anti-inflammatory agents and serotonin-replenishing antidepressants are helpful when muscle pain and tenderness are a major part of the patient's symptoms. Psychoactive drugs are useful when indicated. Low doses of antidepressants such as doxepin (10-25 mg at night) are generally well tolerated and have shown efficacy in numerous patients, although there are no reports of controlled trials.
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PMID:Chronic fatigue and depression in the ambulatory patient. 187 21

Angina pectoris is the cardinal symptom of coronary heart disease and is a symptom with which physicians are very familiar. The clinical diagnosis of ischaemic heart disease is often based largely on a history of typical chest or arm pain, and the major therapeutic endeavour in such patients is directed towards abolition or amelioration of angina. Indeed physicians have, at least up until recently, been confident in assuming that angina is a reliable marker of ongoing ischaemia and that success of medical or surgical treatment of coronary heart disease can be accurately gauged according to improvement or disappearance of anginal symptoms (Cohn & Braunwald, 1988). However, the results of a number of important clinical studies, reported over that last 10 to 15 years, appear to challenge these traditional medical assumptions. In many patients with coronary heart disease, acute episodes of myocardial ischaemia are frequently unaccompanied by angina, often referred to as "silent myocardial ischaemia" (Epstein et al., 1988; Fox, 1988; Cohn, 1985; Maseri, 1985). It has to be pointed out that not all painless ischaemic episodes are truly silent. Instead of experiencing pain during some episodes of acute myocardial ischaemia, patients may, on occasion, instead report symptoms such as dyspnoea or palpitations (these symptoms being known as "anginal equivalents") (Cohn & Braunwald, 1988). Nevertheless, the great majority of painless ischaemic episodes are, truly silent and not accompanied by "anginal equivalents", which has led to the trend in the recent literature to regard the terms "silent" and "painless" myocardial ischaemia as synonymous.
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PMID:Silent ischaemia: an update on current concepts. 195 49

In many cases of chronic intractable pain without any discernible causes, when both Western medical treatment and acupuncture treatment failed to eliminate the pain, this pain is often due to the unrecognized presence of viral or bacterial infection. Even effective anti-viral or bacterial agents often fail to eliminate or inhibit the infection, as these drugs may also fail to reach the most painful area where often unrecognizable circulatory disturbances co-exist. Using the Bi-Digital O-Ring Test Molecular Identification Method, we were able to localize substance P and thromboxane B2 (a good indicator of the presence and degree of circulatory disturbances) in the painful area along with virus or bacteria. Based on the Bi-Digital O-Ring Test localization method for specific substances or microbes, the author has successfully treated cases of chronic intractable pain by the combination of anti-viral or bacterial agents with either manual acupuncture, electro-acupuncture or transcutaneous electrical stimulation through a pair of surface electrodes. Among a variety of infections, the most common cause of severe intractable pain was herpes simplex virus, and the most common bacterial cause of intractable pain of moderate degree was campylobacter. In addition, chlamydia was a very common cause of mild intractable pain. When peripheral nerve fibers are hypersensitive from nerve injury due to viral infection, in addition to the drug therapy for infection, use of Vitamin B1 25 mg., 2 times a day for an average adult often accelerates recovery time. As an anti-viral agent for the herpes virus family, the author found that EPA (Omega 3 fish oil, Eicosa Pentaenoic Acid, C20:5 omega 3), at doses between 180 mg. and 350 mg (depending upon body weight) 4 times a day for 2 to 6 weeks, without prescribing the common anti-viral agent Acyclovir, often eliminated the symptoms due to viral infection including all well-known types of the herpes virus, such as herpes simplex virus, Epstein-Barr virus, and cytomegalovirus. Epstein-Barr virus and cytomegalovirus are usually not associated with intractable severe pain, but they are often associated with a recurrent burning or itching sensation and they can cause intractable frequent muscle twitching. Viruses belonging to the herpes family almost always exist between the midline of one side of the spinal cord and the midline of the front of the body where these nerves from the spinal cord end and the same virus is localized only on one side of the body at the same spinal level.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Treatment of acute or chronic severe, intractable pain and other intractable medical problems associated with unrecognized viral or bacterial infection: Part I. 197 80

The chronic fatigue syndrome is a poorly defined symptoms complex characterized primarily by chronic or recurrent debilitating fatigue and various combinations of other symptoms, including psychological symptoms, sore throat, lymph node pain, headache, myalgia, arthralgias. Psychological disturbances, ranging from mild depression or anxiety to severe behavioral abnormalities, are always present. Chronic fatigue syndrome is the name that more accurately describes this symptom complex of unknown cause. A viral aetiology has long been hypothesized: many viruses are potential candidates, including any of the 23 Coxsackie A or 6 Coxsackie B viruses, herpes viruses, particularly Epstein-Barr virus and varicella. These studies, though interesting, remain unconvincing because of methodological flaws such as a poor case definition and inadequate control groups. This syndrome may represent an infection by a yet unidentified virus. It is more likely due to an abnormal immune response toward different intracellular pathogens. There is no treatment to ameliorate the chronic fatigue syndrome. Epidemiological studies are essential with explicit operational case definition before progress can be made in the management of this distressing disorder.
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PMID:[The chronic fatigue syndrome. A multifactorial approach and the treatment possibilities]. 207 78

The clinical profile of cluster headache, in Italy better known as "Horton's histaminic headache" is described. The Author makes an inventory of all pathogenetic theories about this excruciating pain syndrome that strikes men more than women. On the basis of findings of the Author and his School over a ten-year period, there is a "periodic lack of immunitary oversee". The salient points of various stages of this study are: low frequency of HLA-B14 antigen with, in contrast, high frequency of the HLA-DR5 antigen of the major histocompatibility system. The HLA B18 antigen of the same major histocompatibility system has been found in patients who respond to lithium therapy. A lack of the HLA-B18 antigen has been found in cluster headache patients who are "non-responders" to lithium therapy. Low titers of antibody response in the pain free periods of these subjects, and high titers in the painful periods has also been found in the serum of cluster headache patients; the lack of alpha 1-antitrypsin in basal conditions; increase of IgE (PRIST) values in painful periods; high titers of C1qSp and KgBt circulating immuno-complexes. The cellular immunity studies of the patients showed an increase of the leukocyte subpopulations Leu7+ and Leu M3+. Besides, the natural killer function that contributes to the defense-mechanism against viral disease, was very low. High titers of anti-herpes simplex 1 and 2 viruses and anti-Epstein-Barr virus have been found in cluster headache patients and in a few observations of Burkitt's lymphoma with associated cluster headache, studied in Sahel area too.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:New findings in cluster headache. 215 Apr 89


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