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)

The present review of disk space infection in children agrees with that carried out in 1962.12 The physician who encounters a child with back or hip pain, irritability, and a change in walking pattern should always suspect an infection of the vertebral column, particularly in the presence of limited spine motion, spasm, and an elevated sedimentation rate. S. aureus still is the usual primary infecting agent. Treatment consisting of rigid immobilization of the spinal column during the acutely painful phase appears to be adequate therapy. The use of antibiotics is not generally recommended. Because of this, hospitalization is usually not prolonged unneccessarily. The rationable for the use of antibiotics in one atypical case included recurrence of clinical signs and symptoms despite immobilization. These included persistent pain and spasm associated with a high sedimentation rate. Disk space aspiration probably is no longer necessary or desirable in the usual patient in whom immobilization is generally effective. The prognosis for most patients is good. Occasionally spinal fusion should be considered in this young age group if mechanical backache persists after the infection has been cured. The findings and recommendations regarding management of this disease in children should not be applied to the adult.
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PMID:Disk space infections in children. 117 66

A 45-year-old Caucasian female patient with a clinical rehistory and ECG's conforming to the syndrome of variant angina as characterized by Prinzmetal is presented. ECG's recorded during spontaneous pain demonstrated ST-segment elevation and symmetrical peaking of the T-waves in the lateral precordial leads and short runs of ventricular tachycardia. Similar ECG changes were recorded during treadmill exercise- and hand-grip exercise-induced chest pain. An echocardiogram recorded during angina induced by hand-grip exercise demonstrated progressive flattening of septal motion. Multiple views of the coronary system by selective coronary cineangiography were normal with the patient at rest. Angina was then induced by hand-grip exercise and a repeat right anterior oblique view of the left coronary system revealed marked spasm of the left anterior descending artery proximal to the first septal perforator.
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PMID:Coronary angiographic, echocardiographic, and electrocardiographic studies on a patient with variant angina due to coronary artery spasm. 119 41

Spasticity is a hyper-excitable state of the reflex arcs in the spinal cord below the level of injury. Not only is the skeletal motor system affected, but bladder, bowel, blood pressure, and erection reflex mechanisms are also involved. Spasticity gradually emerges from the initial phase of spinal shock one to two months after the injury, and usually reaches a plateau of a mild to moderate degree in 3 to 4 months. Neurophysiological mechanisms indicate an increase in the alpha and gamma reflex systems and that central excitability through the interneurons is also involved in these systems. Excessive spasticity should be recognized as a substitute for pain in the spinal cord injured patient, as infections, calculi, pressure ulcers, and other normally painful conditions set off the hyper-sensitive reflexes causing more spasticity. Education and health maintenance is the best prevention of severe spasticity. Definitive treatment of incapacitating spasticity is to find and treat the underlying disease condition, as well as to introduce medication which will also suppress the spasm (Valium and/or Dantrolene). Muscle motor points and/or nerve blocks with neurolytic agents is perhaps the best technique for quietening excessive spasticity. Intrathecal neurolytic agents, anterior or posterior rhizotomies and cordectomies are not advocated even in severe incapacitating spasticity as they are too destructive. Selective longitudinal myelotomy is by far the best surgical technique for disrupting excessive spasticity, if any such procedure is to be done. Tendonotomies may be necessary in chronic contractures of joints after the muscle spasticity has been reduced. Excessive spasticity is not regarded as a normal state in the spinal cord injured patient. The cause should be sought and treated. Nerve destruction techniques should not be used unless medical and nursing techniques have failed. Prevention is so important and can be achieved by education, health maintenance, and especially motivation.
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PMID:Spasticity following spinal cord injury. 119 52

The device described presents an external hinge which is fixed by transosseous wires and reproduces as far as possible the normal kinematics of the joint. By removing all load from the joint surfaces and maintaining a constant predetermined space between them, the apparatus eliminates friction, prevents pain and muscle spasm, and minimizes abnormal mobility (or instability). It also permits gradual and controlled reduction of old traumatic or congenital dislocations or contractures. Once the bones are in proper relationship, the apparatus permits graduated, controlled, nearly frictionless motion about the correct axis so that a good range of motion is restored and joint surfaces of the proper shape are formed. Finally, ununited fractures close to the joint surface may be immobilized while joint motion is permitted. Experience gained with the apparatus has shown that the method described is physiological and not difficult, complications associated with its use being rare and not serious. The good results obtained with the use of the apparatus warrant its wider application.
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PMID:[Restoration of movement in the joints with the aid of a hinge-distraction apparatus]. 128 20

In our department we have reviewed the use of ergonovine maleate as a provocative agent for inducing coronary spasm during coronary arteriography. From January 1978 to December 1991 the test has been performed in 116 patients. According to their symptoms, the patients were divided into 4 groups: (A) patients with exertional angina: 16 patients (13.8%), (B) patients with angina at rest: 64 patients (55.2%), (C) patients with atypical chest pain: 29 patients (25%), and (D) patients with previous myocardial infarct: 7 patients (6%). We have subdivided the patients with angina at rest, according to the electrocardiogram recorded during pain, into: (1) 16 patients with ST-segment elevation; (2) 14 patients with ST-segment depression or T wave inversion; (3) 5 patients with electrocardiogram unchanged during angina; (4) 29 patients with no electrocardiogram recorded during angina. In 67 patients (57.7%) the coronaries were normal, 17 patients (14.6%) had mild irregularities, 26 patients (22.4%) had non critical fixed obstructions (< or = 70%), and in 6 patients (3.5%) there were fixed coronary narrowings > or = 70%. The left ventricle was normal in 85 subjects (73.2%), hypo or akinetic in 31 (26.8%). After routine coronary angiography and ventriculography, ergonovine maleate, 0.05 up to 0.4 mg, was given intravenously. The ergonovine test was considered positive when a focal spasm narrowed a normal coronary artery, or one with a mild fixed obstruction (< or = 50%) to more than 70%, or when a 70% stenosis became occluded. The development of angina and/or electrocardiographic changes were not taken as a criteria of positivity. Thirteen tests (11.2%) were considered positive.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The use of ergonovine in the hemodynamics laboratory]. 129 54

Vasospasms are inappropriate constrictions of small vessels leading to a variety of clinical pictures depending on the location of such spasms. Although the pathophysiological mechanism is not yet well understood, we know some factors able to provoke spasm in patients with appropriate predisposition like hemorrhage, coldness, emotional stress and others. Such vasoconstrictions provoke normally relative mild symptoms like cold fingers, or pain as in variant angina and in only very rare cases, to irreversible structural damage such as myocardial infarction. There is not much known about the involvement of the eye in vasospastic disorders. Retinal migraine is a known entity but occurs quite seldom. If one looks for it, one can often find (mostly reversible) visual field damage in patients with vasospastic disorders. This might be a sign of a reversible functional damage most probably due to a decreased circulation in the optic nerve head or the surrounding choroid. In most of these patients the optic nerve head looks normal, sometimes slightly pale. In patients with the so-called normal-tension glaucoma however, the prevalence of vasospastic disorders, is very clearly increased. This leads to the hypothesis that recurrent vasospasm in the eye may, in some cases, finally lead to structural damage, presenting itself phenomenologically as normal-tension glaucoma. Therefore treatment or selected normal tension glaucoma patients with calcium-channel-blockers is helpful, as has been proven in prospective studies.
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PMID:Psychophysical mechanisms and treatment of vasospastic disorders in normal-tension glaucoma. 129 7

To evaluate the efficacy of the nonsteroidal anti-inflammatory drug etodolac, a comparative, double-blind study versus piroxicam was carried out. Two homogenous groups (in terms of age, sex, time since last crisis and duration of present episode) of patients suffering from acute lumbar pain were treated during one week with either etodolaco, 300 mg b.i.d. (n = 30) or piroxicam 20 mg/day plus placebo (n = 31). Diagnosis was confirmed by history, physical examination, and Rx studies. Several clinical parameters were assessed prior and after treatment. All 61 patients completed the study. Adverse drug reactions were evaluated in the final visit. No significant differences were established between groups in relation to efficacy. Compared to baseline, statistically significant relief of symptoms was achieved in both groups, for pain intensity (p < 0.005); sleep quality (p < 0.005); paravertebral muscles spasm (p < 0.005) and spinal range of motion (p < 0.005). Patients treated with etodolac exhibited significantly less adverse reactions than those on piroxicam (p < 0.025).
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PMID:[Etodolac versus piroxicam in the treatment of acute lumbago. Double-blind study]. 130 12

In anaesthetized rats and cats, the effects of the piperazine derivative CGP 29030A on the discharges of functionally identified dorsal horn neurons and gamma-motoneurons was studied. The compound exhibited a marked inhibitory action on presumably nociceptive dorsal horn neurons that processed input from high-threshold mechanosensitive receptors in the skin and deep somatic tissues (muscle, tendon, joint). Significant effects were obtained at a dose of 10 mg/kg p.o. and higher; the onset of action was fast (approximately 10 min). In contrast to presumably nociceptive dorsal horn neurons, cells having input from low-threshold mechanosensitive receptors in the skin and deep tissues were not affected by the compound. Thus CGP 29030A has a quite specific action on dorsal horn neurons that probably mediate pain. Systemic effects on the blood pressure and on the activity of sympathetic efferent fibres did not occur. The lack of effect of CGP 29030A on nociceptive neurons in spinalized animals suggests that the site of action is not the segmental spinal cord but the supraspinal CNS. gamma-motoneurons supplying the gastrocnemius-soleus muscle were likewise inhibited by the compound but at a higher dose (equal to and exceeding 30 mg/kg). The data show that CGP 29030A is a compound with marked and specific analgesic action. As it also inhibits gamma-motoneurons, CGP 29030A may be of benefit in the treatment of painful disorders which are complicated by increased motor activity (cramp, spasm).
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PMID:Effects of a novel piperazine derivative (CGP 29030A) on nociceptive dorsal horn neurons in the rat. 130 69

Fifteen patients were treated in a Phase I study of intracarotid carboplatin (200-400 mg/m2) in 5% dextrose and water infused over 15 to 30 minutes through a transfemoral catheter with a 0.2-micron inline filter. This study was done because intravenous carboplatin has less neurotoxicity than cisplatin and is active against brain tumors. Eleven men and four women ranging in age from 37 to 72 years (median, 59 years) were treated. The Eastern Cooperative Oncology Group performance status was 1 in 3, 2 in 4, and 3-4 in 8 patients. Eight patients had one to three previous chemotherapy regimens; previous radiotherapy had failed in 13 patients. The response of patients in the Phase I study follows: glioblastoma, 6 failed; not evaluated because of early death from pulmonary embolus, 1; recurrent Grade II and III glioma, 1 stable (minor response with neurologic improvement) and 2 failed; malignant oligodendroglioma, 1 failed; brain metastases from nonsmall cell lung cancer, 1 partial remission, 1 stable (minor response), and 1 failed; brain metastases from unknown primary, 1 stable (minor response with neurological improvement). Median survival was 9 weeks. Nausea was mild to moderate. One patient had granulocytopenia, and 2 had thrombocytopenia (mild). At 200 mg/m2 (2 patients), 1 had a focal seizure. At 300 mg/m2 (9 patients), 2 with abnormally small arteries had severe pain early in the treatment and posttreatment ipsilateral conjunctival edema, decreased vision, and cerebral edema (with partially reversible increased hemiparesis); 1 other had mild decrease in ipsilateral vision and 1 had transient aphasia on removal of the catheter (possibly the result of a vascular spasm).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Phase I study of intracarotid administration of carboplatin. 131 64

Back spasm, or spasm of the back muscles, is the commonest adverse reaction encountered after chemonucleolysis. In order to overcome this troublesome complication, the authors present a new 'paradiscal injection technique'. After the injection of chymopapain into the affected disc, the needle is withdrawn to just outside the annulus. Bupivacaine is injected into the paradiscal 'space' which acts upon the paravertebral muscles. Eighty consecutive patients have been treated by chemonucleolysis with paradiscal injection for pain relief. All patients were discharged the same day or the following day and no immediate complications occurred. When reviewed 3 weeks later, only three (3.8%) patients complained of back pain (which was different in character to that present before the injection or was exacerbated by the injection). Pain persisted in the same patients until 6 months after the injection but was negligible. None of the remaining patients had developed back pain as a result of chymopapain. The authors suggest that the addition of paradiscal injection of bupivicaine after cymopapain injection can reduce the incidence of spasm of the back muscles. This technique is a major contribution to increasing the efficacy of chemonucleolysis for the treatment of herniated lumbar disc.
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PMID:A new paradiscal injection technique for the relief of back spasm after chemonucleolysis. 138 53


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