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

In 6 patients affected by spontaneous angina with S-T elevation and coronariographic findings of obstruction, intravenous administration of ergonovine maleate determined the same clinical and ECG patterns of spontaneous episodes. The coronary arteriography during pain showed a marked spasm with occlusion of a large coronary vessel in four patients. In 2 patients with atypical chest pain and normal coronariogram, E.M. did not induce pain, ECG abnormality or coronariographic alterations. The role of spasm in spontaneous angina is discussed.
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PMID:[Coronary artery spasm induced by the somministration of ergonovine maleate in subjects with spontaneous angina (author's transl)]. 101 Feb 29

This report is an example of tumor metastasis to the temporomandibular joint and its effect on pain, restriction of jaw movement, and the subsequent inability of the patient to function normally. Neoplasm is not the usual etiology of myofascial pain dysfunctionsyndrome and the muscle sparm component of this patient's jaw dysfunction was emphasizedby the relief of symptoms from the use of symptomatic reversible type therapy (tranquilizer, muscle relaxant, and heat). There was an overlay of stress-tension factors in this case history that contributed to the muscle spasm symptoms of the patient. There canbe other etiological factors in jaw dysfunction associated with TMJ pathology such asdevelopmental anomalies, trauma, arthritis, and neoplasm, but as a group they comprise only about 5% of TMJ dysfunction problems (D.M. Laskin, personal communication).
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PMID:Myofascial pain dysfunction syndrome involving tumor metastasis. Case report. 105

The cases of five young women who presented with severe pain and associated vascular changes in one foot are described. The pain was spontaneous in onset and lasted for days, and its severity was such that none of the patients were able to walk without disability. Arteriography in three patients revealed arterial spasm. All had a good response from lumbar sympathectomy on the affected side.
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PMID:Unilateral painful vasospasm in the lower limbs of young women. 105 97

In the light of 4 personal observations of PPPRINZMETAL's angina, a review has been conducted of the literature in the 15 years since the condition was first described. Although the formal diagnostic criteria for this form of angina simultaneously clinical, biological and electrical - anginal attacks occurring at rest, often at night, during which elevation of the ST segment is recorded which disappears at the end of the attack without any significant rise in enzyme levels (SGOT and CPK) - the frontiers of the syndrome appear to have widened since PRINZMETAL's description: - Severe proximal stenosis of the coronary arteries is not obligatory; they may be only slightly damaged or even healthy. - Prinzmetal's angina is by no means always "spontaneous" but is often induced, either by psychic factors, which explain the fixed time of the attacks, or by organic factors, e.g. cold drinks (Observation No.2). In this event it would appear safer to speak of angina or rest as opposed to angina of effort. - In contrast to what PRINZMETAL thought, effort tests may sometimes induce angina-type pain with elevation of the ST segment, and here the borderline between this syndrome and conventional angina with ST segment elevation after effort test (5% of cases) is less clear-cut. The two nosologic entities probably reflect the same physiopathological situation, i.e. acute myocardial ischemia, and may represent the same affection in different phases of development. The prognosis is equally bad. - Attacks of rinzmetal's angina are often accompanied by severe and sometimes fatal disorders of rhythm, and this influences the therapeutic approach. - The coronary spasm posited by PRINZMETAL and others before the advent of coronarography is indeed, in the majority of cases, the immediate cause of myocardial ischemia and anginal pain, without any preliminary increase in the energy requirements of the heart as in the conventional anginal attack. - A vasoactive substance present in the circulating blood at the beginning of the affection, which may be degraded and subsequently disappear and may be secreted by the pathologic coronary artery, was demonstrated in observation No. 4: this may, in conjunction with vagal hypertonia, be the causative factor in coronary spasm. Study of its pharmacodynamic properties is now in progress.
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PMID:[Prinzmetal's angor. Apropos of 4 cases. Review of the literature]. 108 Aug 80

The study of 46 patients with frequent anginal episodes characterized by S-T elevation (so called "variant angina pectoris") demonstrated that this type of electrocardiographic pattern does not characterize a homogeneous group of patients. In fact, while in some patients angina occurred only at rest, in others it occurred also on exercise. Sometimes ecgraphic alterations characterized by S-T depression were observed on the same leads which on other occasions had shown S-T elevation. The angiographic picture revealed: absence of significant coronary alterations in 10% of cases, stenosis greater than 75% in one main branch in 29%, in two branches in 39% and in three branches in 22% of cases. The hemodynamic monitoring carried out on 14 of these patients demonstrated that the ecgraphic modifications occur before the onset of the hemodynamic parameters which control myocardial O2 consumption. This suggests a primitive reduction of regional myocardial blood supply as a cause of the ischaemic episodes. The study of the regional myocardial perfusion with 201Tl technique in 6 patients confirmed this hypothesis. Coronary angiography carried out during an ischemic episode showed that the reduction of myocardial blood supply was caused by a spasm of a large coronary artery involving a long segment of the vessel, reversible by nitroglycerin administration. Aorto-coronary by-pass operation performed on 6 patients was followed by the disappearance of pain in two patients, even though the "by-pass" patency was angiographically proved in two patients.
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PMID:[Clinical coronarographic characteristics and pathogenetic mechanism of angina pectoris with s-t elevation (author's transl)]. 108 26

Invasion of the esophagus by Candida albicans probably occurs more frequently than the reported cases suggest. The disease usually occurs following immunosuppression but may occur after antibiotic therapy. It is heralded by the sudden onset of severe pain and dysphagia, and recovery or death from dissemination may occur. Roentgenographically, impaired motility is much more prominent than disordered motility or spasm. Narrowing, a cobblestone epithelium, and later, erosions and ulcerations are seen. Antifungal agents are adequate therapy.
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PMID:Esophageal moniliasis. A review of common and less frequent characteristics. 110 22

The concept of muscle pain-spasm-pain vicious cycle has been challenged on the basis of inability to find electrical activity in the presence of palpable changes in fibrositic muscle. We produced muscle pain in the wrist extensor and paravertebral muscle groups of seven healthy subjects by injection of hypertonic saline (0.3 ml of 6% NaCl solution). The time course of the integrated muscle action potentials, roughly paralleled the time course of the developed pain in all but one subject for each muscle group. EMG recordings were made on one subject using both surface electrodes with amplifier sensitivity of 10 muV/cm and needle electrodes with an amplifier sensitivity of 100 muV/cm. Sequential recording showed clear evidence of electrical activity from the surface electrode and high sensitivity whereas the combination of the needle electrode with lower sensitivity showed no electrical activity whatever. We conclude that even mild muscle spasm is accompanied by muscular hyperactivity which can be evaluated by appropriate EMG techniques. There appears to be no reason to challenge the widely accepted concept of pain-spasm-pain as stated by Travell, Rinzler and Herman.
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PMID:Electrical activity in muscle pain. 113 May 2

A review of 120 patients who had a discharge diagnosis of intermediate coronary syndrome showed 12 patients with documented transient ST elevation during spontaneous rest pain consistent with Prinzmetal's angina. Coronary arteriography showed severe proximal occlusive coronary atherosclerosis in nine of the patients, and normal or minimal disease in the other three patients. In two of these three, there was documented coronary arterial spasm with reproduction of symptoms during arteriography. Although a shorter history of chest pain, presence of an old myocardial infarction and a positive finding on electrocardiogram treadmill test tended to predict the patients with severe occlusive coronary artery disease, these methods were inadequate to select candidates for arteriography. All patients responded well to nitroglycerine while in the hospital. Five of the nine patients with coronary artery disease had coronary bypass operations, with two excellent, two fair and one poor result. One of the three patients with normal findings on coronary arteriograms died with refractory ventricular arrhythmia six months after study. The other two have had good-to-moderate relief of symptoms on long-acting vasodilators and propranolol. Current concepts of the syndrome of Prinzmetal's angina and ST elevation are reviewed. It appears that this syndrome has a wide spectrum of clinical presentations and coronary arteriographic anatomies.
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PMID:Prinzmetal's angina Clinical and anatomic aspects. 114 90

Since January, 1972, the authors have operated upon 4 patients with idiopathic diffuse exophageal spasm. Clinical details and barium studies are included. Extramucosal myotomy extending from the gastric fundus to the aortic arch was done in each case. Pre- and postoperative manometric studies were carried out in all. After operation in each patient the dysphagia and substernal pain disappeared and in 3 patients radiological patterns changed. The myotomy was associated with marked fall of contractile wave pressures in the body of esophagus. The basal pressures of the esophageal body elevated, in 2 cases fell after the myotomy; in 2 with normal preoperative pressure it remained unchanged. At the lower esophageal sphincter the resting and yield pressures remained similar to the preoperative readings but the myotomy produced a disappearance of the relaxation and contraction pressure. The authors conclude that with myotomy they cannot correct the nature of the functional disorder but, by reducing the amplitude of the waves and lowering the resting pressure if elevated, they can relieve the patient's symptoms.
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PMID:Pre- and postoperative manometric studies in diffuse esophageal spasm. 115 94

A corneal abrasion is the most common eye complication during general anesthesia and recovery. It is painful, may progress to inflammation of the uveal tract, and in the presence of contamination may lead to a serious infection. Both eyes may be involved, as the two reported cases show. Possible causes include mask friction on the open eye or other careless technics. Treatment includes local application of an antibiotic ointment and an eye pressure patch. In addition, a cycloplegic and mydriatic solution is instilled to prevent synechiae (in the presence of a secondary iridocyclitis) and to relieve the pain associated with spasm of the iris and ciliary muscle. Topical application of local anesthetics should be avoided, as they delay regeneration of corneal epithelium and may promote keratitis.
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PMID:Corneal injuries during general anesthesia. 117 Jul 81


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