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 young male foundry worker had headache, nonproductive cough, orthopnea, formication, rigor, fever, and substernal pain after exposure to concentrated metal fumes. Examination revealed bilateral basal rales. Serial spirometry suggested a transitory restrictive impairment with persistent mild to moderate obstructive impairment. Leukocytosis, hypoxemia, and the other symptoms resolved with no therapy other than the patient's removal from the polluted area.
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PMID:Case report: metal fumes fever. 64 59

Autopsy or surgical specimens from six patients with primary cardiac angiosarcoma seen at the Mayo Clinic (all in men) between 1939 and 1988 were studied (patients' ages, 31 to 80 years; mean 50 years). The symptoms were nonspecific and included dyspnea and thoracoabdominal pain in six; anorexia in five; fatigue, hemoptysis, or orthopnea in four; nausea and vomiting, fever, or weight loss in three; and night sweats in two. Cardiomegaly was present in five, and a pericardial effusion or density, a mass adjacent to the heart, or nonspecific ST-T wave changes were present in three. All six neoplasms arose from the right atrium and exhibited epicardial or endocardial extension; three produced obstructive intracavitary right atrial masses. Pulmonary metastatic lesions were noted in five patients. The cardiac neoplasm was diagnosed by computed tomography or magnetic resonance imaging in the three most recent patients, and surgical resection was performed in two of them. Mean survival was 6 months after presentation. Causes of death were pulmonary hemorrhage in three, thoracic metastasis in two, and hemopericardium in one. The diagnosis of primary cardiac angiosarcoma was established at operation in two patients and at autopsy in four. Despite diagnosis by noninvasive imaging procedures and aggressive early surgical intervention, survival was less than 6 months. Thus optimal therapy is unclear.
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PMID:Primary cardiac angiosarcoma: a clinicopathologic study of six cases. 154 8

We describe the clinical characteristics and actuarial survival of a consecutive cohort of 41 patients with rheumatoid arthritis and clinical pericarditis who were seen at the Mayo Clinic between 1970 and 1987 and followed up until death or through 1987. The survivors were followed up for a median of 5.1 years. Approximately three-fourths of our patients had acute pericarditis, the remainder having recurrent acute pericarditis, chronic pericarditis with effusion, or chronic constrictive pericarditis. Most patients had symmetrical joint swelling, morning stiffness, subcutaneous nodules, rheumatoid factor, and classic radiographic changes of rheumatoid arthritis. Common extra-articular features included fatigue, loss of weight, and fever. Dyspnea or orthopnea, typical pericardial pain, peripheral edema, tachycardia, tachypnea, a diminished mean blood pressure, a pericardial friction rub, jugular venous distension, rales, radiographic evidence of cardiomegaly and pleural effusions, and abnormal echocardiograms were the most common cardiac manifestations. An elevated erythrocyte sedimentation rate and anemia were other common laboratory findings. Our cohort demonstrated decreased survival in comparison with an age- and sex-matched North Central white population (from the upper midwestern United States), especially during the first year after diagnosis. Increasing age, the presence of other heart disease, an increasing total number of other extra-articular manifestations of rheumatoid arthritis, jugular venous distention, and a lower mean blood pressure were associated with decreased survival.
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PMID:Rheumatoid pericarditis: clinical features and survival. 231 40

Examples are reported of clinical cases confirming the difficulties of diagnosis of recurring form of thromboembolism of the minor pulmonary artery branches and the following leading signs of the disease are singled out: elevation of the temperature, tachy- and orthopnea, prolonged retrosternal pain, crepitation and moist rales over the lungs, inversion of the T-wave and depression of the ST segment in the right thoracic leads.
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PMID:[Difficulties in the diagnosis of the recurrent form of thromboembolism of the pulmonary artery branches]. 260 18

We report on thoracoscopic plication of the the paralyzed right hemidiaphragm of a 33-year-old woman with a history of reactive airway disease. The paralysis was secondary to transection of the phrenic nerve during right first rib resection for thoracic outlet syndrome 1 year prior to evaluation. By use of video-assisted thoracoscopic surgery (VATS), the diaphragm was plicated as with open thoracotomy. Postoperative recovery was uneventful, with minimal pain and early discharge. Preoperative symptoms of exertional dyspnea and orthopnea were significantly improved.
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PMID:Thoracoscopic diaphragmatic plication. 970 10

The long term impact of pre-hospital thrombolysis in acute myocardial infarction on the subsequent development of heart failure symptoms was investigated in 362 consecutive patients. The pre hospital strategy, used in 61 patients, allowed for very early administration of streptokinase, within 1.2+/-0.6 (mean+/-S.D.) hours from pain onset. In contrast, 294 patients treated in hospital received lytic treatment within 2.0+/-0.9 hours. The pre hospital group showed faster reperfusion, as measured by the time to peak creatine kinase and to ST segment recovery, but only a slightly better ventricular function, as compared to hospital treated patients. Heart failure symptoms were significantly reduced in the pre hospital group during hospitalization and at long term follow up: there were less dyspnea, fatigue, orthopnea, nocturnal dyspnea, nocturia, peripheral edema and episodes of pulmonary edema. Angina was reduced as well. We conclude that the initial benefit of prehospital thrombolysis translates into long term reduction of heart failure symptoms, thus improving quality of life.
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PMID:Prevention of congestive heart failure by early, prehospital thrombolysis in acute myocardial infarction: a long-term follow-up study. 970 26

A 72-year-old man presented with a two-week history of exertional dyspnea and nonclaudicatory pain and swelling in the right lower leg. Elevating the leg for short periods had not helped. The symptoms had begun soon after he took a nonsteroidal anti-inflammatory drug for right shoulder pain but persisted after he stopped taking the drug. His history included two-pillow orthopnea, but that had not worsened in the last year. He had not experienced chest discomfort.
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PMID:A man with a swollen leg and abnormal globulins. 1008 23

An 80-year-old man presented with subjective fever, chronic cough occasionally producing scant yellow sputum, retrosternal pleuritic pain, and dyspnea on walking one block. Since symptom onset three months earlier, he had lost 20 pounds; he had had two loose stools a day, fatigue, malaise, and anorexia but not hemoptysis, nausea, vomiting, hematemesis, hematochezia, or melena. He denied paroxysmal nocturnal dyspnea or orthopnea. As far as could be ascertained, he not recently been exposed to tuberculosis or any other infectious disease. He had previously been seen at another clinic and had completed a 10-day trial of erythromycin (500 mg p.o. q12 h) without apparent change in symptoms.
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PMID:Pulmonary infiltrates in an elderly man. 1045 60

An isolated affection of the phrenic nerve is a rare feature in patients with neuralgic amyotrophy. We report 1 case each of bilateral and unilateral phrenic neuropathy. The first patient presented a sudden onset of severe respiratory failure without pain. The second patient developed intense pain in the neck and in the right shoulder followed by dyspnea on mild effort and orthopnea. Chest X-rays showed elevation of the diaphragm. Needle electromyography revealed denervation restricted to the diaphragm. The phrenic nerve conduction was within the normal range. The diagnosis of neuralgic amyotrophy may be particularly difficult when the palsy of the phrenic nerve appears without brachial plexus involvement or the typical shoulder pain of acute onset. In our patients, electrophysiological evaluation combined with radiographic studies, ventilatory parameters and biochemical analyses were helpful in establishing the diagnosis.
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PMID:Respiratory weakness in neuralgic amyotrophy: report of two cases with phrenic nerve involvement. 1107 7

Bilateral phrenic nerve paralysis (BPP) is a relatively rare disease manifested by slight dyspnea at rest and on exertion in the sitting and standing positions and by dyspnea in the supine position. A 67-year-old man, who was a painter, presented with severe pain in both shoulder regions that had evolved into orthopnea and forced him to sleep in a sitting position at night. Dyspnea and paradoxical respiratory movement in the supine position raised suspicions of BPP. The most striking feature in this case was that the rapid onset of pain in both shoulder regions was followed by BPP. The BPP was considered to be secondary to neuralgic amyotrophy (NA).
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PMID:Bilateral phrenic nerve paralysis manifested by orthopnea for 6 months in a patient with neuralgic amyotrophy. 2000 5


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