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)

A 61 year old man complained initially about pain in the left lower leg with increasing swelling of the entire left leg. A slight swelling of the left ankle and knee and an erythematous skin change of 5 cm diameter developed and disappeared after a few hours. Two days later the patient complained about a sudden and massive weakness of the proximal skeletal muscles, progressive disturbance of swallowing, hoarseness and dark red to bluish erythematous skin eruptions on the right knee and buttock. An elevated creatinine-kinase and lactate-dehydrogenase were found. Dermatomyositis was diagnosed and treatment with high dose steroids initiated. Under this treatment the patients condition deteriorated dramatically. A treatment with plasmapheresis and cyclophosphamide was begun. A significant improvement occurred over three weeks. The patient was discharged, rehabilitated and remains free of symptoms on 10 mg cortisone. A neoplasm has so far not been detected.
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PMID:[Muscle weakness]. 826 41

Spontaneous hemorrhage of a parathyroid adenoma is a rare occurrence which may manifest with a variety of symptoms including cervical pain, hoarseness, respiratory distress, and dysphagia. We report a case of an elderly woman with a parathyroid adenoma diagnosed 10 years ago and for which she had refused surgery. Throughout this period her hypercalcemia was carefully monitored, and she experienced no symptoms or adverse sequelae from her disease. However, the patient subsequently presented with a 1 day history of a sore throat and a nonproductive cough followed by the acute onset of dysphagia. At this time she was found to have an anterior neck hematoma extending to the midthorax. Computerized tomography and direct laryngoscopy were suggestive of the diagnosis and neck exploration confirmed the presence of a large hematoma beginning at the site of the 3 x 4 cm parathyroid adenoma and extending into the left strap musculature. We report this case of spontaneous hemorrhage of a cervical parathyroid adenoma to bring to mind a rare etiology of acute pharyngoesophageal dysphagia.
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PMID:Acute pharyngoesophageal dysphagia secondary to spontaneous hemorrhage of a parathyroid adenoma. 843 23

Thirty-two patients with spasmodic torticollis were assessed quantitatively for posture deformity, tremor and range of neck movement, and qualitatively for pain and global subjective disability. All patients were then treated with intramuscular botulinum toxin injections into appropriate neck muscles. Fifty-three treatments were administered using dosages of toxin in the range of 50-100 U per muscle. The maximum dose administered at a single sitting was 280 U. The progress of the patients was assessed during an 18-month period. Seventy-five percent of patients showed documented improvement in both subjective and objective parameters and were considered treatment successes. Pain improved in 65%, posture in 65%, tremor in 50% and range in 46%. The side effects that occurred were transient and included fatigue, dysphagia, neck weakness, hoarseness and local pain. This study demonstrates that treatment with botulinum toxin is of significant benefit for the majority of patients with spasmodic torticollis.
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PMID:Effectiveness of botulinum toxin in the treatment of spasmodic torticollis. 846 37

Gemcitabine is a novel nucleoside analogue with activity in solid tumours. This study assessed the objective response rate to gemcitabine given weekly intravenously at a dose of 1250 mg/m2 for 3 weeks followed by 1 week of rest (one cycle) in chemonaive patients with inoperable non-small cell lung cancer (NSCLC). 161 patients with NSCLC were recruited from 10 sites in nine countries. Most patients had stage IIIb (31.3%) or IV (64.6%) disease, and 93.8% had a performance status of 0 or 1 according to the WHO scale. Of 151 evaluable patients, there were 3 complete responses and 30 partial responses lasting at least 4 weeks for an objective response rate of 21.8% (95% CI 15.5-29.3%). All responses were validated by an extramural Oncology Review Board. The mean duration of response was 8.8 months. The mean survival for all patients (16.1% of patients still alive 26 months after last patient started treatment) was 11.5 months. Improvements were also observed in secondary efficacy parameters such as performance status, weight, analgesic requirement, pain, and other disease-related symptoms including cough, dyspnoea, haemoptysis, anorexia, somnolence and hoarseness. Haematological and non-haematological toxicity was mild given the biological activity of gemcitabine. This study confirms gemcitabine as one of the most active agents in NSCLC with the added benefit of a modest toxicity profile and ease of administration on an out-patient basis. Gemcitabine is a suitable candidate for combination chemotherapy in patients with NSCLC.
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PMID:Activity of gemcitabine in patients with non-small cell lung cancer: a multicentre, extended phase II study. 866 35

We present a female patient of 42 years with hoarseness, irradiation of pain into the ear and feeling of fullness in the throat when speaking and swallowing. The symptoms lasted about 9 months and intensively last 10 days. The edema and redness as well as adduction of vocal cords was conformed by laryngoscopy. It was sure rheumatoid arthritis of the cricoarythenoid joint which reacted relatively good on prednisolone therapy.
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PMID:[Rheumatoid arthritis in the cricoarytenoid joint]. 869 96

To clarify clinical significance of symptoms presented at the beginning of treatment, we analyzed the symptoms in 240 patients with non-small cell lung cancer treated with definitive radiation therapy. Symptoms were classified into four groups: no symptom (Grade 0), cough, sputum/hemosputum and fever up (Grade 1), chest pain and breathlessness (Grade 2), appetite loss, body weight loss, SVC syndrome, hoarseness, and pain in the upper limb/shoulder (superior sulcus tumor) (Grade 3), and their therapeutic outcomes were examined. The 2- and 5-year overall actuarial survival rates for patients with squamous cell carcinoma were 38.5% and 15.4% for Grade 0, 40.5% and 20.1% for Grade 1, 17.9% and 2.6% for Grade 2, and 15.8% and 5.3% for Grade 3. A statistical difference was noted in survival between Grades 0-1 and Grades 2-3 (P < 0.01), but was not seen between Grades 0 and 1, or between Grades 2 and 3. As for patients with stage III disease alone, the difference in survival was still significant between Grades 0-1 and 2-3 (P < 0.05). In patients with adenocarcinoma/large cell carcinoma, however, no obvious relationship was found between symptoms and prognosis, except for body weight/appetite loss. In conclusion, though the symptoms closely related to clinical stage and performance status and not an independent prognostic factor, chest pain and breathlessness correlated with poor therapeutic outcome as well as body weight loss and T3-4 related symptoms, while cough, sputum (hemosputum), and fever were favorable symptoms in patients with squamous cell carcinoma who received definitive radiation therapy.
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PMID:Clinical implication of symptoms in patients with non-small cell lung cancer treated with definitive radiation therapy. 871 67

The therapeutic profile on bone of nandrolone decanoate is that of inhibitor of bone resorption with temporary increase in bone formation, followed by an absence of suppression of bone formation, indicating uncoupling of bone resorption and formation. This results is an increase in bone mineral content at the proximal and distal radius, and in some patients at the lumbar spine. Furthermore, nandrolone decanoate increases calcium balance and muscle mass, diminishes vertebral pain and increases the mobility of the spine. Virilization occurred in around 50% of the patients (mainly hoarseness and/or hirsutism), and 9% of the patients dropped out because of this reason. A dose of 50 mg every 3 to 4 weeks is indicated in the treatment of osteoporosis in women, especially when they have low muscle mass, associated debilitating disease, and in patients with corticosteroid induced osteoporosis. It should only be prescribed after the age of 65 to 75 years to minimize the occurrence of clinical adverse effects and to increase its tolerability, which is higher in this group. Although some effects are reported on fracture rate, insufficient prospective data are available.
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PMID:Nandrolone decanoate: pharmacological properties and therapeutic use in osteoporosis. 884 59

Tracheobronchial ruptures are rare but potentially lifethreatening events. We report on the case of a 34-year-old suicidal unrestrained car driver, who developed subcutaneous and mediastinal emphysema and right-sided haematothorax following blunt thoracic trauma. Fibreoptical inspection of the tracheobronchial system revealed a rupture (approximately 2 cm in length) of the pars membranacea of the trachea ending shortly above the carina. CT-scan confirmed the diagnosis of mediastinal emphysema, tracheal rupture and, in addition, left-sided pulmonary contusion. A repair of the tracheal tear was performed by right-sided thoracotomy using a double-lumen tube. The left-sided double-lumen tube was used postoperatively to achieve respirator ventilation with low pressure on the tracheal lumen and on the suture of the tracheal tear. On the other hand, sufficient airway pressure with PEEP for the left lung showing contusion could be provided, using the endobronchial tube. The postperative course was without complications. The patient was on respiratory support for three days due to his-pulmonary contusion. Following final endoscopic control of the trachea he was discharged from the ICU one week after the trauma. The clinical and radiological signs of tracheobronchial ruptures are discussed (respiratory distress, haemoptysis, cyanosis, localised pain, hoarseness, coughing, dysphagia, stridor, subcutaneous emphysema and pneumothorax, tension pneumothorax, mediastinal emphysema). Fibreoptic bronchoscopy is the present gold standard for confirming the diagnosis. The surgical and anaesthesiological approach to the management of tracheobronchial ruptures is described reviewing the current literature.
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PMID:[Diagnosis and therapy of tracheal rupture after blunt thoracic trauma]. 928 31

Localized laryngeal amyloidosis is a rare laryngeal disease which accounts for less than 1% of all benign laryngeal tumors. The symptoms depend on where the amyloid deposit is located in the larynx. When the vocal cords are involved there may be some hoarseness; pain or increasing difficulty in inspiration may arise when, respectively, the aryepiglottic fold or subglottic space are involved. The present paper reports a case of laryngeal amyloidosis without any sign of systemic disease. It also deals with the principle diagnostic procedures to follow. After a review of the literature, emphasis is placed on how important it is to recognize laryngeal amyloidosis in order to achieve an appropriate diagnosis and plan therapy properly. Surgery is the main treatment using either endoscopy or an external neck approach. Recently CO2 laser surgery has been used successfully. Prognosis depends on both the size of the amyloid deposit and whether there is some simultaneous overall involvement.
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PMID:[Localized amyloidosis of the larynx]. 938 25

Voice endurance tests are often used to evaluate vocal fatigue or to test the suitability of an individual for voice demands. It is assumed that these tests help to identify subjects with laryngeal or vocal fatigue out of a population of persons with complaints of discomfort in the throat, recurrent hoarseness and decreased voice power. In this study we evaluated the Voice Interval Test with respect to its discriminative power by comparison of voice performances in 20 patients with a history of vocal fatigue with that in 12 healthy subjects. Voice performance was studied during the Voice Interval Test as well as during regular use of the voice on a working day by electroglottography (EGG), acoustic analysis and a self-rating scale for pain and fatigue. Despite the number of tests the data did not reveal any significant difference between the patients and the healthy subjects. Voice fatigue could therefore not be identified and the clinical relevance of the Voice Interval Test appears to be questionable.
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PMID:Are voice endurance tests able to assess vocal fatigue? 988 8


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