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

After cervical sprain not only pain and neuropsychological disturbances may occur, but also the following sequelae: cervical dystonia, and torticollis, dizziness, hearing loss for low frequencies, dysphonia and globus. Except for dystonia the symptoms often respond to manipulation of a blocked articulation between occiput and atlas or axis and the third cervical vertebra.
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PMID:[Little known sequelae of sprains of the cervical spine]. 1061 1

40 patients (39 women and 1 man) aged 13-66 years (mean 35.9 years) with solitary benign non-toxic thyroid nodule confirmed by clinical and hormonal examination, ultrasonography and fine needle aspiration biopsy, were treated with intranodular percutaneous 96% ethanol injection, performed under ultrasound guidance. There were 34 patients with solid nodule (including 4 patients) with solitary nodule in recurrent goitre after thyroidectomy) and 6 patients with cyst. The nodules were 7-60 mm (mean 31 mm) in diameter. 1 ml of ethanol was instilled per 1 cm3 of nodule tissue. 1-5 (mean 2.6) sessions were conducted at one month intervals. The early follow-up evaluation of the results (the evaluation of nodule size by means of clinical and ultrasound examination) was performed after 6 months, and the long-term one after 2 years since the last injection. A morphological evaluation was conducted according to the following scale: 1--nodule disappearance, 2--cicatricial nodule (solid structure in the ultrasonography and less than 0.5 cm in diameter), 3--nodule smaller by [symbol: see text] 50% of initial dimensions, 4--nodule smaller by < 50% of initial dimensions. A final follow-up evaluation revealed: nodule disappearance in 15 (37.5%) patients (Group 1), cicatricial nodule in 10 (25%) patients (Group 2), nodules smaller by [symbol: see text] 50% of initial dimensions in 7 (17.5%) patients (Group 3) and nodules smaller by < 50% of initial dimensions in 8 (20%) patients (Group 4). The results in Group 1 and 2 were defined as good (25 patients--62.5%), in Group 3 as satisfactory (17.5%) and in Group 4 as bad. The results of treatment of cysts and nodules in recurrent goitre were good or satisfactory. The following complications were observed: 1) pain during and after the injection in 29 (72.5%) patients, 2) subfebrile body temperature ap to 38 degrees C in 4 (10%) patients and fever up to 39 degrees C on the 1-st day after the injection in 2 (5%) patients, 3) ecchymosis in 1 (2.5%) patient, 4) temporary dysphonia in 2 (5%) patients, 6) temporary unilateral vocal cord paralysis and temporary Horner syndrome in 1 (2.5%) patient. It seems that percutaneous ethanol injection can be useful treatment method of solitary benign non-toxic thyroid nodules, both cysts and solid nodules, in patients who do not consent to surgical treatment or with contraindications to an operation.
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PMID:[The treatment of solitary thyroid nodules in non-toxic goiter with 96% ethanol injections]. 1062 66

An 18-year-old man was bitten on the hand by a snake he believed to be a Southern Pacific rattlesnake (Crotalus viridis helleri). Within minutes he developed generalized weakness, difficulty breathing, diplopia, dysphagia, and dysphonia. Neurological examination revealed ptosis and decreased motor strength. These symptoms partially improved after administration of Antivenin (Crotalidae) Polyvalent, but the patient continued to have difficulty walking for several days due to weakness. In addition to neurological symptoms, the patient also experienced pain immediately after the bite occurred and rapid swelling of the entire extremity, which extended beyond the shoulder. He complained of a metallic taste in his mouth and developed intense muscle fasciculations of the face, tongue, and upper extremities, which lasted for 2 days and did not improve with antivenin treatment. He exhibited laboratory evidence of coagulopathy and rhabdomyolysis. Although neurotoxins are known to occur in the venom of certain populations of rattlesnakes, only a few clinical reports describing severe neurological symptoms appear in the literature. To our knowledge, this is the first reported case of neurotoxicity associated with a suspected Southern Pacific rattlesnake envenomation.
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PMID:Neurotoxicity associated with suspected southern Pacific rattlesnake (Crotalus viridis helleri) envenomation. 1062 85

Twenty women aged 18-76 years (mean 42 +/- 23 years) with solitary benign toxic thyroid nodule were treated with intranodular percutaneous 96%-ethanol injection, performed under ultrasound guidance. 1 ml of ethanol was instilled per 1 cm3 of nodule tissue. 2-5 (mean 3.1) sessions were conducted every month. The early follow-up evaluation of the results (the evaluation of nodule size by means of clinical and ultrasound examination) was performed in 6 months, and the long-term one in 2 years after last injection. A morphological evaluation was conducted according to the following scale: 1--nodule disappearance, 2--cicatricial nodule (solid structure and less than 0.5 cm in diameter), 3--nodule smaller by [symbol: see text] 50% of its initial dimensions, 4--nodule smaller by < 50% of its initial dimensions. A functional evaluation was carried out according to the following scale: I--permanent euthyroidism, II--permanent decrease of hyperthyroidism, III--no functional effect. A final follow-up evaluation revealed: nodule disappearance in 2 (10%) patients (Group 1), cicatricial nodule in 8 (40%) patients (Group 2), nodules smaller by [symbol: see text] 50% of its initial dimensions in 2 (10%) patients (Group 3) and nodules smaller by < 50% of initial dimensions in 8 (40%) patients (Group 4). The results in Group 1 and 2 were defined as good (50%), in Group 3 as satisfactory (10%) and in Group 4 as bad; and I--permanent euthyroidism in 16 (80%) patients, II--permanent decrease of hyperthyroidism in 1 (5%) patient, III--no functional effect in 3 (15%) patients. 2 patients in whom new nodules appeared and 1 patient with bad morphological and no functional treatment effects were operated on. A histological examination revealed haemorrhagic necrosis surrounded by fibrous tissue in removed nodules. The following complications were observed: 1) pain during and after the injection in 15 (75%) patients, 2) subfebrile body temperature in 3 (15%) patients and fever up to 39 degrees C on the 1-st day after the injection in 1 (5%) patient, 3) local ecchymosis in 1 (5%) patient, 4) temporary dysphonia in 1 (5%) patient. It seems that percutaneous ethanol injection treatment can be an useful treatment method of solitary benign toxic thyroid nodules in patients who do not give their consent to surgical or 131I treatment or with contraindications to an operation or radioiodine therapy.
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PMID:[Treatment of solitary toxic thyroid nodules with the use of percutaneous ethanol injections]. 1080 16

The role of botulinum toxin as a therapeutic agent is expanding rapidly in otolaryngology. Botulinum toxin is a protease that blocks the release of acetylcholine from nerve terminals. Its effects are transient and nondestructive, and largely limited to the area in which it is administered. These effects are also graded according to dose, allowing for individualized treatment of patients and disorders. Botulinum toxin has been used primarily to treat disorders of excessive or inappropriate muscle contraction. In the field of otolaryngology, these include spasmodic dysphonia, oromandibular dystonia, and blepharospasm; vocal tics and stuttering; cricopharyngeal achalasia; various tremors and tics; hemifacial spasm; temporomandibular joint disorders; and a number of cosmetic applications. Botulinum toxin treatment has recently begun to show some benefit in the control of pain from migraine and tension headache. It may also prove useful in the control of autonomic dysfunction, as in Frey syndrome, sialorrhea, and rhinorrhea. In over 20 years of use in humans, botulinum toxin has accumulated a considerable safety record, and in many cases represents relief for thousands of patients unaided by other therapy.
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PMID:Botulinum toxin: basic science and clinical uses in otolaryngology. 1121 Aug 64

Spontaneous retropharyngeal hematoma is an uncommon entity that is difficult to diagnose and may progress rapidly to airway obstruction. We report a case of a 53-year-old man with acute onset of retropharyngeal pain, dysphonia, and dysphagia after vomiting. On CT, a nonspecific retropharyngeal collection was seen. MR imaging demonstrated blood products, suggesting a diagnosis of retropharyngeal hematoma, and the patient was managed conservatively. MR imaging allowed specific diagnosis of a rare condition that is otherwise difficult to diagnose without surgical intervention.
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PMID:Spontaneous retropharyngeal hematoma: diagnosis by mr imaging. 1141 22

The aim of the study was to investigate the features of xerostomia in patients with advanced cancer. The protocol involved completion of the Memorial Symptom Assessment Scale, and measurement of the unstimulated whole salivary flow rate (UWSFR) and the stimulated whole salivary flow rate (SWSFR). One hundred twenty patients participated in the study. Xerostomia was the fourth most common symptom (78% of patients). It was associated with a poor performance status (P = 0.01). The usual cause of xerostomia was drug treatment. There was an association with the total number of drugs prescribed (P = 0.009): the median number of xerostomic drugs prescribed was 4. Xerostomia was ranked the third most distressing symptom. Its severity was correlated with the severity of oral discomfort, dysgeusia, dysmasesia, dysphagia, dysphonia, and anorexia. The UWSFR was a relatively sensitive, but nonspecific, investigation. In contrast, the SWSFR was a relatively specific, but insensitive, investigation.
J Pain Symptom Manage 2001 Oct
PMID:Xerostomia in patients with advanced cancer. 1157 98

Spontaneous medialstinal emphysema (pneumomediastinum) and pneumopericardium may be defined as the presence of free air or gas in the mediastinal structures and in the pericardial sac without an apparent precipitating cause. It most frequently occurs in young healthy adults without serious underlying pulmonary disease. Although pneumomediastinum and pneumopericardium is often asymptomatic, it may cause pain in the neck and chest, dysphonia and shortness of breath. Treatment is supportive unless the patient has a history of trauma from foreign body aspiration. The course of spontaneous pneumomediastinum and pneumopericardium is usually benign and self-limited. A case of spontaneous pneumomediastinum, pneumopericardium and subcutaneous emphysema in a 20-year-old male is reported in this paper.
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PMID:A case of spontaneous pneumomediastinum and pneumopericardium in a young adult. 1176 80

Glossopharyngeal neuralgia is an uncommon craniofacial pain syndrome that is occasionally associated with cardiac syncope. However, we relate Chiari I syndrome as a cause of this clinical picture for the first time in the literature. The authors analyze the relevant literature and discuss the pathogenesis and treatment of associated syndromes. We describe the case of a 45-year-old female patient who presented with a 3-year history of left glossopharyngeal neuralgia with occasional dysphagia and episodes of syncope when eating or swallowing. The pain was not disseminated to the right side and was fairly well controlled by carbamazepine. The syncopal attacks had a duration of about 10 sec. Neurological examination elicited a faint dysphonia associated with paradoxical dysphagia. The cranial magnetic resonance imaging scan showed a bilateral herniation of the cerebellar tonsils through the foramen magnum, more evidently on the left side. The patient received a suboccipital craniectomy and resection of the posterior arch of C1. The dura mater was opened, and we found both tonsils displaced into the foramen magnum extending caudally toward the C1 level. Both tonsils were compressing the brainstem and especially the low cranial nerves bilaterally. The lower cranial nerves were compressed between the posterior inferior cerebellar artery (PICA) and the herniated cerebellar tonsil on both sides. Both PICAs were dissected by microsurgical technique and all the arachnoid adherences were cut. The left tonsil was resected by means of ultrasonic aspirator. Duraplasty was performed with the occipital pericranium. The paroxysmal pain attacks and the syncopal picture disappeared immediately after the operation. The patient was discharged on the 7th postoperative day. One year later, she was free of symptoms. This case provides clinical evidence of close connections between the glossopharyngeal and vagus nerves, which control visceral sensation; and compression of the IX and X nerves between the herniated tonsil and PICA or vertebral artery may cause an irritative sensory phenomenon, which is the origin of the algic sensation and the cardiac syncope by means of cross talk between the fibers of the same nerve.
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PMID:Chiari type I presenting as left glossopharyngeal neuralgia with cardiac syncope. 1195 73

Among 4200 consecutive patients admitted to three hospitals with acute ischemic stroke, we found only 11 patients in whom magnetic resonance imaging (MRI) had proved that they had medial medullary infarction (MMI). In our centers, patients with MMI were less than 1% of those with vertebrobasilar stroke. The infarcts documented by MRI were unilateral in 10 patients and bilateral in one. On clinico-topographical analysis there were four clinical patterns: (1) Classical Dejerine's syndrome was the most frequent, consisting of contralateral hemiparesis, lemniscal sensory loss and ipsilateral lingual palsy in 7 of the eleven patients. (2) Pure hemiparesis was present in 2 patients; (3) Sensorimotor stroke was present in 1 patient with contralateral hemiparesis, hypesthesia and mild decrease in pain sensation without lingual palsy; (4) Bilateral MMI syndrome in 1 patient, accompanied by tetraparesis, bilateral loss of deep sensation, dysphagia, dysphonia and anarthria. Presumed causes of MMI were intrinsic branch penetrator artery disease with concomitant vertebral artery stenosis in 6 of the 11 patients, vertebral artery occlusion in 2, dolichoectatic vertebrobasilar arteries in 2, a source of cardiac embolism in 1. Prognosis at 3 months was favorable in 8 patients, but the patient with bilateral MMI syndrome had persisting motor deficit causing limitation of daily activities, and 2 died from systemic causes. The classical triad of acute MMI facilitates the diagnosis, although the recognition of this syndrome in patients with incomplete manifestations can be difficult and occurs more frequently than commonly thought. Moreover, vertebral artery atherosclerosis and branch atheromatous disease of the penetrating arteries are the main causes of medullary infarction.
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PMID:Spectrum of medial medullary infarction: clinical and magnetic resonance imaging findings. 1195 73


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