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)

St Christophers' Hospice near London is now internationally known as a special centre for the care of terminally ill patients. In these cases, the relief of symptoms is paramount, and prominent among those symptoms is pain. Such pain can almost always be relieved without euphoria or lessening of consciousness. More than 60% of patients admitted to St Christopher's complain of pain, and the scheme of management outlined below results in substantial or complete relief of pain in all of them. Addiction does not occur when control of the patient's pain is part of the pattern of total care. The author considers management of pain of varying severity, together with associated symptoms such as vomiting, anorexia, dry mouth and hiccup, dyspnoea, cough, anxiety and depression, insomnia, constipation and diarrhoea.
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PMID:Drug control of common symptoms in the terminally ill patient. 6 49

Giant cell arteritis, which is probably due to disturbed immune mechanisms, has a spectrum of clinical symptoms in elderly people. In nearly all cases such general signs as loss of appetite, loss of weight and fever are present. The sedimentation rate is almost without exception about 100 mm in the first hour. The two most frequent and typical clinical syndromes are polymyalgia rheumatica and cranial arteritis. The polymyalgia rheumatica is characterized by periarticular pain which is mostly symmetrical and accentuated in the shoulder girdle. Increasingly severe temporal headache and ocular distrubances are found with cranial arteritis in more than 50% of cases. A combination of both diseases is frequent. Other arterial branches are rarely involved. The course of the disease is over a period of 1 1/2 to 2 years. Treatment with corticosteroids is indicated mainly because of the severe ocular complications with blindness. It should begin immediately, be intensive and last over a long period. Regular followup is necessary over several years in order to avoid relapses.
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PMID:Giant cell arteritis (cranial arteritis, polymyalgia rheumatica). 8 Dec 71

A hospice-care program offers an opportunity to provide effective palliative care for patients terminally ill with malignant disease and to develop improved methods for coping with the problems of the dying patient. All patients for whom antitumor therapy does not offer a reasonable possibility of cure are eligible for Church Hospital's multidisciplinary program, the focus of which is on both the patient and his family. Acceptance by medical staff, patients and families has been enthusiastic. Both conventional and unconventional methods can be helpful in making terminally ill patients more comfortable. Much has been learned about the control of pain in such patients. Intestinal obstruction can often be managed non-operatively without the use of nasogastric tube. Other common symptoms such as weakness, anorexia, depression, dyspnea, etc. can be relieved with varying degrees of success. An objective of the program is to allow the patient to be at home for most of his terminal illness and to die there if possible. By utilizing patient and family instruction, visiting nurses and home health aides, approximately two-thirds of the patients in the program at any given time are at home. Basing the program in an acute care hospital has allowed coordination with the curative treatment of malignant disease and effective use of radiation and chemotherapy for palliative purposes. The organizational structure, financing, facilities and clinical experience with 100 consecutive patients of the Church Hospital hospice-care program are described.
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PMID:Experience with a hospice-care program for the terminally ill. 8 9

A case of alcoholic ketoacidosis in a 23-year-old chronic alcoholic, gravada V, para IV, is reported. Symptoms were constant, severe, nonradiating pain with crampy exacerbations, anorexia, nausea and vomiting. The patient had a tender and irritable full-term uterus. She was treated inhospital with vigorous fluid therapy and 5% dextrose in normal saline, sodium bicarbonate, glucose and insulin and showed improvement overnight. Alcoholic ketoacidosis has not been reported in pregnant women. Metabolic derangements combine to produce ketoacidosis more readily in the pregnant alcoholic. Differentiation of alcoholic ketoacidosis and diabetic ketoacidosis is important since treatment varies. For alcoholic ketoacidosis, treatment is vigorous rehydration with dextrose-saline while diabetic ketoacidosis usually requires multiple therapeutic modalities.
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PMID:Alcoholic ketoacidosis in a pregnant woman. 11 97

Twenty volunteers were inoculated with various doses of human serum containing Phlebotomus fever virus (Sicilian type) to determine their clinical and serologic responses as well as the human infectious dose50 of the virus. All infected subjects developed fever which varied in duration from 6 to 74 hours. The most common symptoms during sandfly fever were headache, anorexia, myalgia, photophobia, low back and retro-orbital pain. Infected individuals developed a marked leukopenia characterized by an initial lymphopenia followed by protracted neutropenia. Little complement fixing antibody was detected in convalescent sera but most subjects developed significant rises in hemagglutination inhibiting antibodies. All infected subjects developed specific neutralizing antibodies with titers ranging from 1:40 to 1:2,560. Of the three serologic tests performed, the plaque reduction neutralization method appears to be the most sensitive test for detecting antibodies to Phlebotomus fever viruses.
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PMID:Clinical and serologic responses of volunteers infected with phlebotomus fever virus (Sicilian type). 18 Aug 44

Fifty-five hepatocarcinomas were found in a review of approximately 7,500 surgical biopsies done on Nigerian Igbos during a period of 6 years. The male: female ratio was 2.9:1 and the age peak was between 20 and 49 years. The main symptoms were abdominal swelling, pain, emaciation, jaundice, fever, anorexia and diarrhea. Physical examination revealed a palpable liver in nearly all patients. Two patients presented acutely with hemoperitoneum due to rupture of necrotic tumor nodule. Cirrhosis was found in 60% of the adequately sized specimens. In comparison with published data, this series from an ethnic group in Nigeria, West Africa, reveals both similarities and dissimilarities which are noteworthy.
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PMID:Biopsy study of hepatocarcinomas in Nigerian Igbos. 19 27

Nutritional therapy of the cancer patient by the oral route includes management of factors that may cause anorexia, attempts to modify the patient's eating behavior, and the offering of nutritional supplements to the patient. Anoretic factors for which specific strategies may be employed include taste abnormalities, pain, nausea, and depression. Modification of the patient's eating behavior involves patient education, monitoring, and feedback. Education includes nutritional instruction and instruction in favorable patterns for mealtime eating and stimulation of snack eating. Snack eating includes the use of nutritional supplements, and patient acceptance of commercially available supplements was studied. When synthetic chemically defined nutritional products were compared with milk-based product, patients preferred the milk-based product. Intercomparisons between milk-based products showed slight differences in preference ranking among these products and also differences between patients and controls in their relative order of ranking. Preference testing may be useful in assisting the health care team in selecting the optimal nutritional supplement to offer each patient.
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PMID:Oral feeding in the nutritional management of the cancer patient. 26 17

The results obtained with a new hormone therapy using medroxyprogesterone acetate (MAP) in previously untested single and total doses in the treatment of advanced breast cancer are reported. Fifty-two postmenopausal patients were treated with an average total dose of 40 g of MAP for a period of 30 days. Nineteen of 44 patients (43%) had complete or partial remission, while the disease remained unchanged in nine of 44 patients (20%). Disease progression occurred in 12 of 44 patients (27%). Partial or complete remission occurred in 12 of 18 (67%) and four of six (67%) of the patients with dominant osseous and soft tissue metastases respectively. Three of ten (16%) of those with visceral metastases had remission. The average duration of remission was 7 months. Average survival times were 15.5 months for patients with remission, 8 months for those with no change, and 2.5 months for those with disease progression. From a subjective standpoint, pain was reduced significantly or disappeared in 34 of 36 patients (94%); this was also the case with respect to dyspnea (13 of 16 patients [81%]), anorexia (24 of 29 [83%]), asthenia (28 of 35 [80%]), and walking impairment (15 of 24 [63%]). When relapse occurred, patients previously treated with massive doses of MAP received further treatment with higher doses of MAP; four of 22 (18%) of the patients attained partial remission once again. Positive effects were also seen in subjective performance status, body weight, and EKG. We also describe the new clinical and toxicologic features of this treatment.
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PMID:A possible new approach to the treatment of metastatic breast cancer: massive doses of medroxyprogesterone acetate. 35 Mar 87

The results obtained with a new hormonal treatment schedule involving the administration of medroxyprogesterone acetate in single and total doses never before used in the treatment of advanced breast cancer are reported. The results concern 100 patients, 13 of which in premenopause and 87 in postmenopause stage. 79 patients were treated with a single daily dose of 1500 mg i.m. for 30 days, subdivided into 2 equal doses administered at intervals of 12 hours, while 21 patients were treated with a dose of 2000 mg/day using the same modalities. In the 13 premenopausal patients, complete or partial objective remission was observed in 12/13 (92%) of cases, while the disease advanced in one of the patients (8%). Of the 87 postmenopausal patients, complete or partial objective remission was observed in 40/87 (46%) of cases, minimal remission in 9/87 (10%), while 18/87 (21%) remained stationary. The disease advanced in 20/87 (23%) of patients. In patients where metastasis mainly affected the bones and soft tissues complete or partial remission occurred in 41/52 (79%) of cases. Those where visceral metastasis was prevalent showed remission in 3/33 (9%) of cases. Median duration of remission was 6 months (range: 3--27). A significant reduction of pain was noticed in 68/74 (92%) of cases, of dyspnea in 20/25 (80%), of anorexia in 45/53 (85%), of asthenia in 49/70 (70%) and of restriction of movement in 24/39 (62%). On the basis of the present results, treatment with massive doses of medroxyprogesterone acetate should be considered: a) as first therapeutic measure in the treatment of postmenopausal patients with prevalent lesions in soft tissues and bones; b) as a subject of a particular study in premenopausal patients with breast cancer in an advanced stage, and c) as a possible alternative to polychemotherapy in the treatment of micrometastasis following mastectomy.
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PMID:[High-dosage gestagen treatment in the therapy of advanced breast cancer]. 39 71

The effects of synthetic salmon CT, administered subcutaneously and intermittently (1 MRC U/kg/day for 15 days/month over 6 months) were investigated in 15 uremic patients on regular dialysis treatment (RDT), all presenting various degrees of osteodystrophy. Clinically, osteoarticular pain disappeared in 8 out of 10 cases; 1 patient with rib fractures had a rapid calcification of the bone fracture repair tissue. No significant changes were found in serum calcium and PTH levels. Phosphotemia showed a significant decrease within the first 20 days. The varying individual hypophosphatemic response proved to be related to the initial level of phosphatemia. The alkaline phosphatase, when increased, showed a decrease to the normal range. A significant decrease in osteoclastic hyperactivity (active resorption surface, osteoclast index) and a slight increase in osteoblastic pool (active osteoid surface) were documented. No change was noted when osteomalacia predominated. Side effects included: anorexia, nausea, vomiting, face flushing. Our data suggest that salmon CT may be usefully employed in chronic uremic patients on RDT, when secondary hyperparathyroidism predominates.
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PMID:Effect of calcitonin on bone lesions in chronic dialysis patients. 49 16


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