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

Seven patients with duodenal diverticulitis were evaluated by computed tomography (CT) and various other abdominal imaging techniques. The series included four men and three women who ranged in age from 47 to 84 yr (mean: 65 yr). They had presented with epigastric or periumbilical pain, low-grade fever, leukocytosis, and loss of appetite and weight due to postprandial cramps or vomiting. In each instance, the abdominal CT examination proved crucial in the diagnosis of duodenal diverticulitis, with contained perforation or inflammatory changes involving the adjacent structures. Five patients underwent laparotomy while two others were treated conservatively with antibiotics and/or percutaneous drainage of peridiverticular abscess. The clinical and radiological features of this uncommon entity are herein described, along with a brief review of the medical literature regarding the current approach to its diagnosis and management.
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PMID:Diverticulitis of the duodenum: clinical and radiological manifestations of seven cases. 185 64

The goal of this study was to identify the symptoms of patients with advanced cancer. One hundred consecutive patients referred to the Palliative Care Service at the Cleveland Clinic Foundation were studied using a standard tool that included questions on 38 specific symptoms. The most common symptoms were pain, weight loss, and anorexia. Significant findings also included that women had more frequent and severe gastrointestinal complaints than men. These do not appear to be related to specific cancer primary sites.
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PMID:Common symptoms in patients with advanced cancer. 187 42

Carboplatin, a new analogue of cisplatin, was administered into the serous cavity in nine primary lung cancer patients with malignant effusion, consisting of six malignant pleural effusions, two malignant pericardial effusions and one malignant ascites. Clinical effects, toxicities and pharmacokinetics were studied. The doses of carboplatin were 300 mg/m2 in seven patients, 200 mg/m2 in one patient and 1,100 mg/body in one patient. In seven evaluable patients, consisting of four non-small cell lung cancers and three small cell lung cancers, the response rate was 85.7% with 3 CR cases, 3 PR cases and 1 NR case. As toxicities, thrombocytopenia was observed in 57.1%, leukopenia in 57.1%, anemia in 71.4%, anorexia in 42.9%, nausea or vomiting in 28.6%, and low grade fever in 14.3%. However local pain, renal or liver dysfunction were not observed. The pharmacokinetics of free platinum concentration was analyzed with a two-compartment model (t1/2 beta = 18.60 hours) and 14.8% of total platinum remained free in effusion 24 hours after intracavitary administration. A high level of free platinum in effusion was maintained over a long period after carboplatin administration. This method was considered to be effective for the treatment of malignant effusion from the viewpoint of pharmacokinetics and less toxicity.
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PMID:[Evaluation of carboplatin administration into the serous cavity in the treatment of malignant effusion]. 187 19

We describe the symptoms, physical findings, treatment interventions, risk factors, and length of survival in persons with pancreatic cancer referred to a palliative care service (PCS) in a tertiary care facility. Data were collected prospectively over a 2-yr period using a standard clinical assessment tool in 39 patients with unresectable pancreatic cancer. Common symptoms include pain (82%), anorexia (64%), early satiety (62%), xerostomia and sleep problems (both 54%), and weight loss (51%). Analyzed retrospectively, 82% had at least one known risk factor for the development of pancreatic cancer. Twenty-five people presented to the PCS within 1 mo of diagnosis; in this group, length of survival was analyzed according to the presence of specific symptoms, and a significant inverse relationship between the presence of dyspnea and length of survival was found. As there is no effective treatment for surgically unresectable pancreatic cancer, palliation of common symptoms should be the primary emphasis of therapy.
J Pain Symptom Manage 1991 Aug
PMID:Symptoms of pancreatic cancer. 188 Apr 37

Fifty-three children (mean age 6.4 at diagnosis, 12.8 years at completion of questionnaires) identified as having acute lymphoblastic leukaemia (48) or non-Hodgkin lymphoma (5) during the 11-year period of 1976-1986 participated in the present study. Patients' and parents' perceptions of malignancy-related changes in significant relationships, of treatment-related problematic events, as well as of the quality of care provided during induction and maintenance-therapy were assessed using questionnaires. The results indicated mainly positive changes in significant relationships during the chemotherapy. However, concurrent stressful life events affected the relationships adversely. Alopecia (hair loss) was the most problematic disease-related event for the patient and the patient's anorexia for the parents. Patients' complaints were most often about the quality of care during induction, namely pain, fear and insufficient information. Parents' complaints were about the lack of continuity in the staff-patient relationship during maintenance-therapy.
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PMID:Perceptions of problematic events and quality of care among patients and parents after successful therapy of the child's malignant disease. 192 88

Approximately 500,000 people die of cancer in the United States each year. Most attention has focused on curative approaches to cancer management. Despite the fact that 80% of persons with advanced cancer suffer from chronic pain and an equal number have a major problem with anorexia and weight loss, little systematic evaluation of these problems has been conducted, although they have a high medical, psychological, and socioeconomic impact. The need for a palliative care service (PCS) at the Cleveland Clinic Foundation was originally identified by physicians within the Department of Hematology and Medical Oncology. During 1987, a pilot study was conducted to evaluate the service, define its potential patient base, and assess its impact on patient care. It is astonishing that so little attention has been paid to this area by the major institutions and organizations involved in care of patients with advanced cancer, despite the hundreds of thousands dying of the disease each year. A dedicated palliative care service would therefore seem appropriate in any major medical institution dealing with significant numbers of cancer patients. It also seems appropriate that the provision of a PCS should be part of the requirements for a comprehensive cancer center, if a center is to claim to provide the entire spectrum of services, from diagnosis until death.
J Pain Symptom Manage 1990 Oct
PMID:Continuing care in a medical center: the Cleveland Clinic Foundation Palliative Care Service. 207 77

The total gastrectomy, as known can expose to some sequences which form on a pathophysiologic and clinic plain syndrome of "AGASTRIC". The most paradigmatic of these disturbances are the weight loss, the pain, the dyspepsia, the anorexia, can be erroneously interpreted as a recurrence of the neoplasm illness. On the base of these disturbances, there are some pathophysiological alterations associated to the resection. The postprandial distension syndrome, the dumping, the diarrhea, the anemia, can be relieved by an appropriated hygienic-diet therapy. The reflux of biliopancreatic secretion into the esophagus, the disturbances related to the duodenal exclusion, the accelerated transit can be loosed or reduced by a correct technic, while the cloridopeptic deficiency is obviously unresolvable. From 1981 till 1988, 43 patients were submitted to a total gastrectomy for adenocarcinoma (29 M, 14 F), having a middle age of 62 years: 30 with a radical intent (Ro), and 13 palliative. Besides 10 of the Ro group were submitted to a enlarged intervention. The digestive continuity was renewed through an interposition of isoperistaltic jejunal loop according Mouchet-Camey in 23 cases, by use of a dysfunctional loop according Roux en-Y in 5, and by esophagus-jejunal T-L anastomosis such omega, according Horloff in 2 cases. There were registered one decrease for A.R.D.S. All the patients were been followed according the follow-up protocol, for monitoring neoplasm evolution of the illness and the eventual metabolic-functional disturbances. In the periodic postoperative control all the patients with Mouchet-Camey reconstruction had no evidenced dumping syndrome, neither cases of malabsorption of the essential nutritive principles, with constant recover of the weight.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Digestive continuity, after total gastrectomy for cancer, via the interposition of a jejunal loop]. 208 78

A prospective study of 41 patients (24 male and 17 female) aged over 40 years with iron deficiency anemia and hookworm infection was performed by endoscopy and barium enema to determine the incidence of GI lesions. Alcohol ingestion, smoking, abdominal pain, anorexia, loss in weight, bowel habit change, analgesic consumption and stool occult blood test were analyzed for their positive predictive value of GI lesions. The mean age of the patients was 62.8 years (SD = 10.1). The mean hemoglobin was 5.99 gm.% (SD = 1.9). Twenty patients (48.8%) had GI lesions. The lesions included 10 erosive gastritis, 1 erosive duodenitis, 5 gastric ulcers, 2 duodenal ulcers, 1 carcinoma of stomach and 1 carcinoma of colon. Gastric ulcer, duodenal ulcer and carcinoma were regarded as significant lesions. Abdominal pain was found in 16 of the 20 patients with GI lesions and 8 of the 21 without GI lesion (Chi square with Yate's correction, x2 = 5.78 p = 0.02). Four of the 17 patients without pain had GI lesions but only one of these 4 (5.8%) had gastric ulcer. Abdominal pain had an 80% sensitivity and 62% specificity for the positive prediction of GI lesions based on the above findings. GI investigation is recommended for all patients with abdominal pain. In those without pain, treatment of hookworm and iron therapy with follow-up may be justified.
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PMID:Gastrointestinal lesions in patients over 40 years of age with iron deficiency anemia and hookworm infection. 209 22

We made a survey among physicians of primary care teams (PCT) from Vizcaya to assess their opinion about the care of the patient with cancer in the terminal period. A total of 85% of the surveyed physicians responded; 70% considered that the care given was inadequate; 90% thought that the patients wishes to die at home. 50% felt that the patient should know the diagnosis, although 85% believed that it was virtually always unknown to him in practice. The most commonly found symptoms were anorexia, asthenia, pain, depression and anxiety, which resulted in serious management difficulties for 25-45% of physicians. 65% were assisted by nurses. The participation of the rest of the team and of specialists was irrelevant. Most felt frustration (59%) and dissatisfaction (78%) with those patients. The physicians find great difficulty to communicate with the patient, and need more information, training and cooperation. Is should be clear that the aim is the well being of the patient, thus diminishing the frustration of the professionals.
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PMID:[The care of the terminal patient as viewed by the family physician]. 1699 Dec 26

Various types of partial mandibulectomy and maxillectomy techniques can be performed to control local tumor growth, but various intraoperative and postoperative problems and complications are associated with these techniques. Intraoperative complications relate mainly to technical problems. Postoperative complications include incisional dehiscence, infection, injury to salivary ducts, subcutaneous emphysema, mandibular instability, abnormal salivation with secondary cheilitis or dermatitis, anemia, pain and discomfort, lingual dysfunction and prehension difficulties, anorexia, ocular problems, cosmetic defects, local tumor recurrence, and distant metastatic disease. The surgeon should be aware of these potential complications and have a clear understanding of their prevention and treatment.
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PMID:Results and complications associated with partial mandibulectomy and maxillectomy techniques. 213 89


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