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

Traumatic rupture of the diaphragm is diagnosed during the acute stage in only 50% of the cases. The reasons for this failure are that in many of these cases clinical symptoms of damage to abdominal organs or of injuries to the limbs predominate. Traumatic rupture of the diaphragm is usually the result of an indirect trauma. Clinical signs of extensive prolapse of viscera into the thoracic cavity are: dyspnoea, tachycardia, cyanosis or intestinal sounds heard over the thorax during auscultation. Once the diagnosis has been established surgical repair should follow. During the acute stage laparotomy is preferable; thoracotomy is indicated during the chronic stage. Post-operative symptoms are: dyspnoea during exercise, pain in the affected half of the chest and roentgeno-kymographically demonstrable restrictions of movement in the ruptured side of the diaphragm.
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PMID:[Traumatic rupture of the diaphragm (author's transl)]. 46 30

We present a study of 151 persons working in slate-pencil manufacturing industries located in the Mandsaur district of Madhya Pradesh, India. Cough, dyspnea, and pain in the chest were the important symptoms. Cyanosis, rhonchi, and crepitations were found in varying numbers of cases. The chest x-ray films were abnormal in 85 cases.
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PMID:Silicosis in slate pencil workers. A clinicoradiologic study. 83 63

In approaching a patient suspected of peripheral vascular disease the following signs and symptoms are of key importance (16): 1) Pain in the extremity which is induced by exercise and relieved by rest; pain which is influenced by posture is localized to one digit, is unilateral or is paroxysmal. 2) Impaired pulsations of peripheral arteries. 3) Abnormal color of the skin, particularly when affected by raising or lowering the part. 4) Gangrene, ulceration, impaired nail and hair growth, excessive calluses, or paronychial infections. 5) Unusual warmth or coldness. 7) Swelling, atrophy, or difference in length of extremity. 8) Ausculatory evidence of arteriovenous fistula. 9) Cyanosis or unusual pallor of digits when immersed in cold water. 10) Peripheral neuritis.
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PMID:Occlusive arterial disease in the lower leg and foot. 103 Jul 26

The subject of spontaneous aortocaval fistula due to a ruptured abdominal aortic aneurysm into the inferior vena cava is reviewed and discussed. An interesting case is presented with particular emphasis on the pre-operative findings which include lower body cyanosis; pain, numbness, and paralysis of the lower extremities; a cyanotic partial penile erection; and moderate shock. The cause of this syndrome is postulated.
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PMID:The large spontaneous aorta inferior vena caval fistula. 122 66

Effort thrombosis of the subclavian vein (Paget-Schroetter syndrome) has long been considered a primary thrombotic process, but recent experience suggests that it may commonly result from repeated mechanical compression. Increased awareness of the pathophysiology of this syndrome can allow timely, improved diagnostic screening and the use of specific surgical intervention to relieve the venous consequences. During the past 15 years we have treated six patients with mechanical compression in the thoracic outlet causing surgically correctable venous occlusive problems. There were four men and two women with an average age of 38 years (range 26 to 53 years). All patients exhibited pain, swelling, and cyanosis of the upper extremity, with worsening venous congestion on abduction of the arm. Five of six patients were originally treated for effort thrombosis of the subclavian vein with arm elevation and anticoagulation; two also underwent immediate thrombolytic therapy with urokinase. Venography was prompted in each case by positional symptoms during follow-up and showed irregular stenosis of the subclavian vein adjacent to the first rib. All patients underwent extended first rib resection and circumferential venolysis (one patient underwent bilateral procedures); one was performed through a transaxillary approach, two through a supraclavicular approach, and four through a new, "paraclavicular" approach. All subclavian veins appeared normal after venolysis. Five of six patients also underwent complete scalenectomy and brachial plexus neurolysis. In each patient, venous and neurogenic symptoms resolved and venography confirmed a patent subclavian vein, with follow-up ranging from 11 months to 13 years (mean 3.8 years).
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PMID:Circumferential venolysis and paraclavicular thoracic outlet decompression for "effort thrombosis" of the subclavian vein. 850 93

Diagnosis and follow-up treatment of reflex sympathetic dystrophy is difficult because of the subjective, nonspecific nature of its primary symptom, burning pain. Early diagnosis and aggressive treatment of reflex sympathetic dystrophy with epidural nerve blocks improves clinical resolution. Temperature difference between extremities and dependent cyanosis are reliable objective signs for clinical diagnosis and the evaluation of progress for treatment for reflex sympathetic dystrophy.
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PMID:Reflex sympathetic dystrophy. Objective clinical signs in diagnosis and treatment. 178 13

To ensure good exposure of operative field and to reduce the complications of low anterior resection of rectal carcinoma with transpubic approach, we modified Ackerman's method and operated on 18 patients with middle and lower rectal carcinoma at the level of 4-8 cm above the anus. 1cm width of the inferior part of the pubic symphysis was preserved. Results were compared with 19 patients operated on in the original way. Dissection of the arcuate ligament, penis suspensory ligament and penis nerve under the lower pubic margin was avoided, so that cyanosis of the penis, perineum and occurrence of sexual dysfunction were reduced, and the period of postoperative pain was shortened. 89% of patients operated in this way enjoyed good defecating function. We suggest that this procedure is indicated in all patients with rectal carcinoma located 4-7 cm above the anus with the exception of mucinous carcinoma.
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PMID:[Modified super anterior resection of rectal carcinoma with transpubic approach]. 181 54

Catfish skin toxin and the venom from their dorsal and pectoral spines may cause a menacing sting. Although these stings are often innocuous, severe tissue necrosis may occur. The hand is the most common site of catfish stings. Two cases of catfish stings of the hand are presented. In one of these cases gangrene of the long and small fingers developed requiring amputation. Symptoms are caused by hemolytic, dermonecrotic, edema-promoting, vasospastic, and lethal components of the venom and skin toxins. Local or regional anesthesia is administered to relieve pain and vasospasm. Empiric intravenous antibiotics are administered to cover common aquatic organisms. Wounds with progressive worsening of erythema, swelling, pain, or cyanosis should be irrigated to wash out residual toxin, and debrided of any retained spine fragments or necrotic tissue.
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PMID:Catfish stings to the hand. 202 46

Southall and coworkers have demonstrated in a recent study that attacks of lifelessness with sudden and severe hypoxemia and cyanosis are caused by a combination of respiratory arrest in expiration, and a right-to-left shunting of the blood through the lungs due to increased pulmonary vascular resistance. This mechanism is thought to be the cause of death. They have also defined the precipitating factors which are sudden, naturally occurring stimuli causing fear, anger or pain. They underline the importance of elements of surprise and unexpectedness. These observations lend strong support to the "fear paralysis" hypothesis proposed in 1986 by Kaada and Gabrielsen. We stressed that the process leading to death was triggered on by emotional factors (first and foremost fear). Stimuli evoking fear are any threat perceived as a danger. Actual stimuli in infants are restrained movement, sudden and unexpected noises, sudden exposure to strange environments and persons. Elements of surprise and novelty were similarly emphasized. The reflex is suppressed by the administration of anxiolytic drugs like clonidine and amitriptyline.
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PMID:[Sudden infant death--an emotional trigger mechanism]. 227 50

Rendering an expert opinion on causalgia, after having clear determined it as the disease, poses many problems to the examiner. One ought to make this diagnosis with its serious consequences only under the following conditions: --when it is a case of a mostly partial trauma of a nerve with considerable intermingling of sympathetic fibres; --when the pains have a burning and primarily superficial character; --when the pain appear soon (hours, mostly days or weeks, more rarely months afterward) after the trauma; --when the pains are accompanied by considerable vasovegetative symptoms (cold sweats, cyanosis, hyperhidrosis and others). Secondary algodystrophic changes (muscle, joints, bones, and skin) are to be considered. In quantitatively judging the effects, an over-evaluation, as well as an underevaluation, is to be avoided by all means. Therapeutic effects and spontaneous remission after six to twelve months are to be considered. An exemplary case, in which a deterioriation of the capacity to work from 20 to 100% (!) was assumed, showed the need for taking the personality structure of patient into consideration.
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PMID:[Causalgia in neurologic expert assessment]. 239 34


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