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)

An intense vaso-vagal reaction characterizes all the reflex induced cardiovascular syncopes. In these syndromes the vagal cardio-inhibitor effect on heart rate is more evident than the vasodilatation and fall in blood pressure. The vasodepressor mechanism is uncommon even in carotid sinus syndrome. We have studied 6 male patients, age range 56-73 years (mean age: 64) with recurrent vasodepressor syncopes. The following were always present during such episodes: generalized malaise, profound fatigue, pallor, cyanosis, copious sweating, lack of peripheral pulses, severe fall in blood pressure (BP) (systolic BP less than or equal to 50-60 mmHg or unrecordable), mental disorientation and/or syncope. The first diagnosis in our patients was carotid sinus syndrome, but, the clinical picture was quite different from classic carotid sinus syndrome: triggering factors were not present, the vasovagal episodes were longer, the syncopes more frequent and severe, and the VVI pacing uneffective. Further investigations, including computerized axial tomography, showed--in all these patients--a malignant tumour originally localized in or near the parapharyngeal space. We think that the symptoms of our patients can be attributed to parapharyngeal tumour and that the parapharyngeal space lesions are able to cause severe vasovagal attacks and syncope. The pathogenetic mechanism in this syndrome, due to neural irritation of the glossopharyngeal afferent fibres, is similar to the glossopharyngeal neuralgia-asystole syndrome, but it obviously doesn't involve pain-pathways since none of our patients had pain. Therefore, this syndrome differs from glossopharyngeal neuralgia- asystole syndrome in the presence of tumours and in the absence of neuralgia and initiating factors.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A new reflex cardiovascular syndrome: recurrent vasodepressive syncope caused by lesions or tumors of the parapharyngeal space. Etiopathogenesis, clinical picture, differential diagnosis with carotid sinus syndrome and glossopharyngeal neuralgia-asystole syndrome. Therapy by intracranial resection of the 9th cranial nerve]. 319 43

Venous thrombosis in an extremity, when extensive, can cause reversible tissue ischemia or frank gangrene even without arterial or capillary occlusion. Patients gradually or abruptly develop severe pain, extensive edema, and cyanosis of the extremity, nearly always in the legs. Gangrene can occur unless the venous obstruction is relieved. Such ischemic venous thrombosis can complicate surgery, trauma, childbirth, or prolonged immobility, but malignant neoplasms, either obvious or occult, are a major predisposing factor. The optimal therapy is anticoagulation and thrombectomy. Patients with venous gangrene may require amputation if extensive, deep-tissue destruction occurs. The mortality rate for ischemic venous thrombosis is about 40%, the cause of death usually being the underlying disease or pulmonary emboli.
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PMID:Ischemic forms of acute venous thrombosis. 330 May 67

From 1980 to 1984, a total of 2,329 people who alleged that they had been bitten by venomous snakes were admitted to 292 Italian hospitals having first aid stations. Three died. Most patients (62%) did not show any symptomatology of envenomation. The epidemiological and clinical aspects of 286 patients, out of 885 exhibiting signs and symptoms of snake bite envenomation, have been studied. The symptoms and signs were: oedema, gastro-intestinal symptoms, pain at the site of the bite, respiratory distress, leucocytosis, CNS depression, shock, fever, cyanosis, exanthema, ecchymoses, incoagulable blood, lymphangitis, melaena, thrombocytopenia, haematuria, and ophthalmoplegia. The bites were located only in the upper or lower limbs. Most were caused by Vipera aspis. The severity of envenomation of the 286 affected patients were: 45% minor, 30% mild, 14% moderate, 8% severe and 1% fatal. Most bites occurred in August. The commonest treatment before and during hospitalization was anti-venin.
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PMID:Venomous snake bites in Italy: epidemiological and clinical aspects. 338 30

A 17-year-old girl developed fever, cough and hemoptysis, as well as bouts of septic fever, dyspnea on exertion, cyanosis and weight loss. Opacification in the left lower lung was a persistent feature. Complement-fixation reaction to Aspergillus fumigatus was 1:80, and there were four precipitation lines against this fungus on immunoelectrophoresis. Aspergilli were also demonstrated in sputum and bronchial aspirate. Because the patient's condition deteriorated an atypical lingula resection was performed and cortisone treatment begun postoperatively. Subsequently all abnormal findings disappeared and the patient was cured. Two subsequent exposures to Aspergillum on the parental farm produced high fever, cough, dyspnea and thoracic pain. Histological examination of the lingular specimen revealed bronchocentric granulomatosis. In this case it was the rarely occurring morphological manifestation of an allergic bronchopulmonary aspergillosis without bronchial asthma.
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PMID:[Bronchocentric granulomatosis as a manifestation of allergic bronchopulmonary aspergillosis without bronchial asthma]. 359 64

Chronic obstruction of the iliac vein may be followed by severe pain, tense swelling and cyanosis of the affected lower limb on exercise (venous claudication). Four patients with venous claudication were examined by strain gauge plethysmography and isotope phlebography. One patient had earlier undergone vein by-pass surgery and one caval ligation. All patients had anatomically abundant, but functionally insufficient cross-over and collateral circulation as the cause of the venous claudication symptom. The venous emptying rate was below normal in all the affected limbs; the venous capacity was low in both limbs in 2 of the 4 patients. It is concluded that in venous claudication isotope phlebography confirms occlusion of the iliac vein and the presence of abundant cross-over veins. The pathologically slow venous return demonstrated by plethysmography in the affected and occasionally also in the unaffected limb, results from the fixed resistance of the cross-over veins.
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PMID:Chronic iliac vein obstruction as a cause of venous claudication. A plethysmographic and isotope phlebographic study. 374 Jul 93

Every time the tuberculosis is present and it is to be included in the differentialdiagnosis if the occasion arrises. In the anamnesis it is necessary to pay attention to specific diseases and the risk groups like patients with "21-day-cough", silicotics, "Contrast-articularis bronchitics", diabetics, so-called "persons with fibrotic lesions" and patients with frequent influenzal infections. The symptoms unclear gastric distress, want of appetite, indifferent loss in weight, uneasiness, slight vertigo and fast tiredness already give further references. Breath-pain, haemoptysis and subfebrile temperatures are already severe symptoms. A thorax X ray-photograph, tuberculin test, heamogram, sedimentation test and intensive search for mycobacteria, belong to the diagnosis. In extrapulmonary foci the search for mycobacteria is to try by swab, puncture, control of urine and menstrual blood. It is possible, that a histologic corroboration will be necessary. Unclear fever, headache and vomiting with or without dyspnoea, cyanosis and diaphragmatic lowness indicate a ocular reflection, liver biopsy and, in special case, a lumbar puncture without delay. Sooner or later the course of an unrecognized phthisis can result in death. It is necessary to fill up the gap between welltime diagnosis and death by unknown tuberculosis. That means: Thorough knowledge of matter, insight into the disease-course and inducement of all necessary diagnostic possibilities.
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PMID:[Diagnosis and course of tuberculosis especially from the viewpoint of clinically unknown deaths]. 407 12

A 27-year-old woman who used oral contraceptives for 2 years and had 2 incidents of blurred vision followed by painful "blood-red" fingers is described. Contraceptive treatment was stopped. Most fingers of both hands were characterized by bluish, cyanotic, apparent pregangrenous discoloration. All laboratory tests were within normal range except; latex agglutination (weakly reactive), LE preparation (weakly positive twice, normal once), globulin immunoeletrophoresis (slightly elevated IgM), and blood volume determination (500 ml deficit of whole blood). 500 ml daily of low molecular weight dextran for 4 days was the only treatment. Gradually over 2 weeks cyanosis and pain ebbed. The hypothesis that this thromboembolic trouble is linked to the pill is circumstantial, but episodes of blurred vision are symptomatic of retinal vessel thrombosis. Erythema or pain in finger tips is the first sign of difficulty and should produce cessation of the pill.
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PMID:Thrombosis of the digital vessels secondary to oral contraceptives. 463 86

A prospective study with mild general analgesia and sedation together with local anesthesia during bone marrow harvest was performed. Thirty-one patients underwent 33 bone marrow collections. Pretreatment consisted of 100 mg meperidine i.m. and 20 mg diazepam i.m. 1 h before start of procedure. Eight patients got additional meperidine and diazepam during the procedure, all patients got lidocaine 1% locally. A mean volume of 1.321 was obtained with 42.5 punctures. Twenty-two patients had no complications, 4 vomited, 4 had easily correctable hypotension of short duration, one got oxygen for cyanosis of short duration. Acceptance was good in 23 patients, in 6 reasonably well, in two bad. Only one patient experienced pain problems, due to suction. Anxiety was no major problem due to good information before the procedure and mild sedation. This form of anesthesia for bone marrow collection is a safe procedure, it is generally well accepted by the patient and it can be performed on an out-patient basis.
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PMID:No narcosis for bone marrow harvest in autologous bone marrow transplantation. 638 70

Many errors in diagnosing simple fractures are made because of inadequate roentgenography and inexperience in interpretation. Two views are almost always needed, and in some cases more. An x-ray film of the opposite uninjured extremity may be helpful for comparison. In many instances, stress views can differentiate bone injury and ligament injury. The first physical examination after injury must be thorough, with a search for peripheral nerve injury and vascular injury. A cast should not be used if certain conditions are present, eg, severe dermatitis, circulatory problems, venous insufficiency, paraplegia. When applying a cast, care must be taken to position the body structure correctly, include only the joints necessary, avoid too tight application, and choose the proper cast length. Prolonged immobilization can result in joint stiffness or even disability. The patient should be warned about danger signals, such as pain, numbness, and cyanosis, and should be monitored regularly for complications.
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PMID:Pitfalls in simple fracture care. 707 2

A case of "effort thrombosis" of the subclavian vein which occurred in a young woman with severe thrombotic risk factors is reported. The manifestations of this syndrome are summarized, and recent concepts regarding the management of subclavian vein obstruction are discussed. The 33 year old woman was admitted with a 3 day history of rapidly increasing pain and swelling of her right upper extremity and right breast. She recalled no previous trauma but did indicate that her vocation required frequent exertion of her right (dominant) arm. The involved extremity exhibited easy fatigability with intermittent "tingling numbness" of the hand. She had been taking oral contraceptives (OCs) for 4 years. On admission she was smoking 2-3 packs of cigarettes daily with a 15 year smoking history. She had essential hypertension of 14 years duration which was treated with a thiazide diuretic. On physical examination, the patient's right breast was found to be twice the size of the left and exhibited tenderness, peau d'orange appearance, and superficial venous prominence. The right upper extremity exhibited venous prominence and mottled cyanosis and was edematous with an upper arm circumference that was 2.5 cm greater than the left. The involved axilla was tender, with no palpable venous "cord" or enlarged lymph nodes. Adson's maneuver was negative. Noninvasive impedance plethysmography showed no evidence of obstruction to venous outflow in the upper or lower extremities, but venography taken with the arms abducted to 45 degrees showed complete thrombotic obstruction of the right subclavian vein (shown in a figure). At first the patient was treated conservatively with bedrest, arm elevation, discontinuation of OCs, and heparinization. She became asymptomatic during the ensuing week, but a repeat venogram after 7 days of heparin therapy displayed complete obstruction of the right subclavian vein. The patient was discharged on warfarin sodium therapy which was continued for 5 months, during which time antithrombin 3 levels rose to 100% activity. During the year following hospitalization, the patient has experienced monthly episodes of mild aching in her right arm, unaccompanied by swelling or discoloration, following exertion of the extremity. Due to the fact that the etiology of effort thrombosis is now considered to be related to thoracic outlet compression, more emphasis is being placed on the use of phlebography to demonstrate compression points along the subclavian vein. Conservative management with anticoagulants continues to be the mainstay of therapy, but surgical treatment with early thrombectomy promises to decrease the chronic morbidity so common to this condition.
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PMID:"Effort thrombosis" of the subclavian vein associated with oral contraceptives. 731 65


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