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

Standard whole virus influenza vaccine (1974-1976) containing 700 chicken cell agglutinating (CCA) units of type A (Port Chalmers/1/75) or Port Chalmers plus Scotland/840/74) and 500 units of type B (HK/8/73) antigens was found to produce excessive systemic toxicity in adult volunteers. Using experimental monovalent A and B vaccines, most of the observed toxicity was shown to be associated with the B antigen. Injection of 500 CCA units or more of B vaccine was followed within 10-16 hours by malaise and chills in approximately one-third of vaccines. Chills, malaise, and local pain were more common in volunteers lacking prevaccination serum HI antibody than in those in whom this antibody was present. Toxicity was not related to the presence of endotoxin or bacterial contamination of vaccine; it appeared to be "intrinsic" to the viral antigen. The mechanism for the toxicity in man may be the same as the direct pyrogenic effect of influenza antigen for rabbits previously observed by others. Detoxification of the B antigen by prolonged exposure to formalin reduced the side effects of a 500 CCA unit dose to acceptable levels without impairing its antigenicity.
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PMID:Systemic reactions to influenza B vaccine. 32 77

Ornithodoros (Alectorobius) coniceps (Canestrini 1890), which was briefly described from adult specimens from St. Mark's Cathedral, Venice, Italy, has been a confusing taxon. We redescribe and illustrate the adult and immature stages from St. Mark's Cathedral (topotypes) and elsewhere, list criteria to distinguish this species from others in the O. (A.) capensis complex, and provide data for 36 collections, chiefly from nest sites of wild and domestic pigeons in humid, rocky situations, and from a nest of the pallid swift, in Italy, France, Egypt, Kenya, Israel, Jordan, Afghanistan, Ukrainia, and Turkmenia. Other collections of small-sized adults and nymphs, lacking larvae, from pigeon, swallow, and swift nest in Nepal, India, and Sri Lanka, are tentatively assigned to this taxon. This is the only member of the O. (A.) capensis group not associated with marine or wading birds. Humans bitten by O. (A.) coniceps in buildings or caves may suffer from pain, edema, chills, and fever. BAku virus (Reoviridae) has been isolated from this tick in Uzbekistan, but most reports of other viruses and infectious agents are clouded by probable misidentification of O. (A.) maritimus as O. (A. coniceps. Published data on the life cycle and dynamics are reviewed briefly. Previously, this tick has not been reported from the Ethiopian Faunal Region (Kenya).
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PMID:The Ornithodoros (Alectorobius) capensis group (Acarina: Ixodoidea: Argasidae) of the palearctic and oriental regions. O. (A.) coniceps identity, bird and mammal hosts, virus infections, and distribution in Europe, Africa, and Asia. 48 69

The comfort was improved by better positioning on the operating table in six patients undergoing extensive hand surgery with axillary plexus block. Opposite to that we could show in 16 similar cases with traditional position during surgery some pain, chills and discomfort despite optimal block technique.
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PMID:[Modification of patients positions in operation table during regional anaesthesia (author's transl)]. 56 14

Chronic lumbar radiculopathy following spinal surgery is reported, in which 7 of 25 patients reviewed developed a postoperative syndrome immediately after their original surgery. Later, sometimes years later, all 7 patients developed severe chronic spinal arachnoiditis. This syndrome was characterized by transient violent spasms in the legs, muscle cramps, increased radicular pain, and often fever and chills. The recognition of this syndrome and a proposed method of treatment is discussed.
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PMID:Chronic spinal arachnoiditis. A postoperative syndrome that may signal its onset. 64 96

2 cases of unrecognized oviduct pregnancy receiving therapeutic abortion by uterine aspiration are reported. A 29-year-old white female, gravida 4, para 2 with a Dalkon Shield in place for 2 1/2 years and with 6 weeks amenorrhea received a therapeutic abortion. 3 days later the patient complained of fever and severe suprapubic cramps. Minocycline was given in the belief that the patient was suffering from endometritis. 17 days after uterine aspiration the pain increased. At laparoscopy a corpus luteum was seen in the left ovary and blood was present in the pelvis. Histological examination of the oviducts revealed signs of an aborted oviduct pregnant. A 2nd case concerned a 26-year-old white female, gravida 2, para 2, using the Ogino-Knaus method of contraception and who had a normal menses 7 weeks previously. 12 days after uterine aspiration the patient complained of continued vaginal bleeding, lower abdominal cramps, and chills. After uterine aspiration was repeated minocycline therapy was initated. 20 days after the initial aspiration the patient reported a return of vaginal bleeding and lower abdominal pain. Laparotomy revealed a ruptured oviduct. Histology showed salpingitis and fusion of the right fimbria and a large blood clot and trophoblastic villi in the lumen of the right ampulla. In the future it is suggested that histological examination of the aspiration should be performed to aid in finding oviductal or ovarian pregnancies.
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PMID:Case reports: unrecognized oviduct pregnancy and therapeutic abortion by uterine aspiration. 97 19

This study examines the efficacy and side effects of 15-methyl-prostaglandins F2alpha (PGF2a) free acid administered intramuscularly for midtrimester abortion. 50 healthy women aged 14 to 37 years and between 12 to 18 weeks gestation were randomly selected from the abortion clinic at the Los Angeles County/USC Medical Center, Women's Hospital to participate in the study. The prostaglandin preparation was supplied in ampules containing 1.1 mg. in 2.2 ml. of aqueous solution. The injection was given every 2 hours until the fetus was expelled or for a maximum of 12 injections. Vital signs of the patients were closely monitored. 46% (23) of the subjects aborted within 12 hours and 90% within 27 hours. Mean injection-abortion time was 13.5 hours (range, 5 3/4 to 27 hours). The effectiveness and rapidity of abortion was related with gestational age: the lower the gestational age, the shorter the abortion time. Women with more than 17 weeks gestation had a higher failure rate. Mean number of injections was 7.5. 5 patients failed to abort with prostaglandin alone, all of them primigravidas and weighing in excess of 150 lbs; supplemental therapy was provided. Side effects and complications associated with 15-methyl-PGF2a included: emesis (66%); diarrhea (76%); flushing (12%); chills (4%); fever of 100 degrees Fahrenheit (12%); pain requiring medication (16%); and blood loss (6%). The success of this method appears to be related to dosage; parity; gestational age; weight of patient; and frequency of administration. Although there were side effects, these were outweighed by rapid abortion time, mild contractions, and ease of administration. Asthma is the only medical contraindication to prostaglandin therapy.
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PMID:Midtrimester abortion with intramuscular injection of 15-methyl-prostaglandin F2alpha. 113 40

In a series of 136 cases of hydatid disease affecting various tissues and organs admitted to one surgical unit in the Medical City Hospital, Baghdad, and personally studied and treated by the author, the liver was involved in 94 cases (69-1 per cent) and intrabiliary rupture occurred in 15. Pain in the right upper abdominal quadrant associated with tenderness and rigidity, radiating to the back and right, shoulder, was the presenting feature in almost all the patients. Hectic fever was present in 14. Obstructive jaundice developed in all the patients at some stage of the illness, but was complete with clay-coloured stools in only half. Chills and rigors were present in 67 per cent, eosinophilia in 40 per cent, a positive Casoni's test in 87 per cent, itching with urticaria and weal formation in 20 per cent and a palpable mass in the liver in 67 per cent of cases. Operative treatment is mandatory in order to clean the mother cyst of hydatid membranes, debris and daughter cysts, to explore and clear the common bile duct and to ensure free biliary passage to the duodenum. Sphincterotomy is neither necessary nor advisable, and when the gallbladder is not invaded by the cyst it should be preserved.
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PMID:Intrabiliary rupture of hydatid cyst of the liver. 119 49

This case report of a 35-year-old white woman, gravida O, may represent the 1st report of tubo-ovarian aspergillosis. The long-term presence of an IUD may have been significant in the etiology. Increasing tenderness and pain in the lower abdomen of 1 week duration was reported. Fever and chills with nausea had been present 12 hours. An increased leukocyte count was found. Other physical findings were normal, except for the presence of a tender pelvic mass. Her last menstrual period had been 2 weeks prior to admission. A Lippes loop had been worn for 11 years and was still present. Intravenous fluids and antibiotics were given. At laparotomy a tuboovarian abscess and peritonitis were found. Multiple cultures were taken. After salpingo-oophorectomy drains were placed within the pelvis and abdomen. Microscopic sections of removed tissue showed compact masses of septate, branching mycelium. Cultures reported pure growth of aspergilli. A 10-day course of amphotericin-B and 5-flurocytosime therapy was given. The patient improved and is being followed as an outpatient.
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PMID:Mycotic tubo-ovarian abscess associated with the intrauterine device. 126 11

We report a series of 48 glomus tumours of the hand, which have been reviewed with an average follow-up of 4.5 years (2-14). The tumour was nearly always sited in the distal digit, para-ungual (22 cases), more rarely subungual or under the pulp, with an even distribution among the fingers. Diagnosis was made preoperatively in 37 of 47 tumours of the digits, based on clinical features: consistent eliciting of pain by touch, less often by chill and occasionally accompanied by vasomotor phenomena. The pain and therefore the tumour could be accurately located with the tip of a pencil (Love's sign); these symptoms are abolished by inflation of a tourniquet proximally (Hildreth's sign). In 40% of cases a small defect in the distal phalanx is visible on plain radiographs, as well as an enlargement of the subungual tissues when the tumour is dorsal. The surgical approach was usually para ungual, in a sub-periosteal plane. Tumours were small (3.3 mm) and rarely multiple (3 cases). In 46 cases the pain was relieved quickly and definitively. Two true recurrences occurred after 5 years, without a satisfactory explanation. Except for those cases with transungual approach, there was no aesthetic compromise. We maintain that careful clinical assessment provides the diagnosis in most cases. Plain radiographs, lateral and comparative, are useful. MRI scan may occasionally prove of diagnostic value. The lateral ungual approach permits complete excision and healing. Recurrence is rare.
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PMID:Forty-eight glomus tumours of the hand. Retrospective study and four-year follow-up. 128 22

We reviewed the records of 17 cases of Fournier's gangrene that had been diagnosed and treated in the Urology Service of the Marques de Valdecilla Hospital from 1982-1991. The series comprised male patients aged 32 to 77. Eleven cases (64.7%) were due to a known cause, above all infection. Most of the patients had factors that predisposed to the development and progression of the disease, predominantly diabetes mellitus (5 cases, 29.4%). The clinical features frequently corresponded to those of acute infection, with high fever, chills, pain, nausea and vomiting that could progress to a septic state. The local symptoms and signs included pain, swelling, erythema and necrosis, depending on the compromised area. Infection was usually caused by Gram-negative bacteria, particularly E. coli, although Gram-positive bacteria and anaerobes have been observed. Mixed bacterial infections have also been observed. Treatment must be instituted early using a combination of broad spectrum antibiotics that cover both aerobes and anaerobes, and wide surgical debridement of the compromised area. In some cases hyperbaric oxygen therapy may be warranted. The disease continues to be severe. In the present series, the outcome was favorable in 12 cases (70.5%) and there were 5 deaths (29.4%).
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PMID:[Our caseload in Fournier's disease]. 129 42


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