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

The authors describe two cases of congenital indifference to pain in a man aged 34 years and a woman aged 23 years. The clinical manifestations in both cases fulfilled the criteria for the diagnosis of these disturbances.
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PMID:[2 cases of congenital analgesia]. 619 84

CSF from a patient with congenital indifference to pain was found to produce analgesia in the rat following intracerebroventricular injections. The analgesic effect was attenuated by pretreatment with naloxone suggesting the involvement of hyperactive endogenous opiate mechanisms in this patient.
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PMID:Intracerebroventricular injection of cerebrospinal fluid (CSF) from a patient with congenital indifference to pain induces analgesia in rats. 621 Feb 10

Previous research has shown chronic pain patients to have elevated scores on the Hypochondriasis (Hs), Depression (D), and Hysteria (Hy) scales of the MMPI. While high scores on these scales are generally considered to reflect neurotic symptomatology and emotional disturbance, their interpretation is more ambiguous within this patient population. Item-level and subscale analyses of these scales and the K scale (a measure of defensiveness) were performed in order to clarify the meaning of these elevated scores. In these analyses a pain group's endorsement of each item was compared with the responses of two control groups, one a general medical patient sample, the other consisting of first year college students. Items showing group endorsement differences of 10% or greater were interpreted as providing significant information about the pain sample. Analysis of the Hs items indicated that a significant portion of the pain group exhibited the vague and diffuse somatic complaining characteristic of hypochondriasis. While the D scale results revealed a considerable amount of depressive symptomatology (such as sleep disturbance, poor self-esteem, apathy, and feelings of unhappiness, anxiety, and dissatisfaction), they did not support the notion that pain patients have the personality characteristics associated with severe depression. Analyses of the Hy and K scales indicated that the pain patients were no more defensive than were either of the control groups, and that their responses did not conform to the classic hysterical pattern.
Pain 1982
PMID:Neurotic tendencies among chronic pain patients: an MMPI item analysis. 716 39

The exact nosological status of "congenital insensitivity to pain" remains in doubt. Possible pathological correlates of this clinical syndrome include sensory neuropathy, central lesions at the level of the reticular formation or dorsal horn of the spinal cord, or a central indifference to, or asymbolia for, pain. The reassessment of two members of a kindred previously reported more than 20 years ago as having congenital insensitivity to pain indicated that they in fact had an inherited sensory and autonomic neuropathy. Prolonged follow up and morphometric analysis of sequential nerve biopsies may be necessary to definitively establish this diagnosis.
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PMID:Congenital insensitivity to pain: a 20 year follow up. 752 56

We are reporting the cases of two brothers with congenital indifference to pain, previously reported by one of us in 1965. This represents a nearly 30-year follow-up. In this rare disorder of pain perception, all other sensory modes are intact. Management includes early recognition of the condition, prevention of injury, immobilization of injured extremities, and surgical correction of established deformities.
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PMID:Congenital indifference to pain: long-term follow-up of two cases. 754 19

Local complications of repeated injections of pentazocine are known among drug abusers. We hereby describe similar reactions in three patients who for several years had abused the opioid analgetic ketobemidone for chronic pain after abdominal surgery, and in six drug addicts who regularly injected ketobemidone tablets dissolved in water. In all nine patients an impressive clinical picture with disfiguring woody fibrosis and multiple irregular ulcers and scars surrounded by hyperpigmentation on the upper and lower extremities was seen. The skin lesions had been mistaken for aggressive forms of panniculitis, pyoderma gangrenosum or selfmutilation. Following direct questioning most patients admitted self-administration of the drug to the affected areas. The patients showed an apparent indifference about their extensive disabling skin disease, and no obvious complaints of pain, contrary to what might be expected from the pronounced tissue destruction and inflammation at the injection sites.
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PMID:[Skin lesions after injection abuse. Chronic changes caused by ketobemidone (Ketogan)]. 790 16

Medicine is not a science. It is an art that uses science to explore what William Harvey called "nature's closest secrets," that we may better minister to her children. We still need to remove some crackpot theories that have crept in, such as "holism." Even neurosurgery has a few. But we are beginning to humanize the traditional detached indifference and become the doctors we were meant to be. Our patients will be better for it. Society will be better for it. We will be better for it [1320]. In discussing the women's liberation movement in America, Reverend William Sloan Coffin once stated, "The woman who most needs liberating is the woman who lives inside of each man." This, I think, is the great awakening that the increasing influence of female physicians has brought about. Early twentieth century physicians, armed with a new science, became efficient fighters of disease. Disease was the enemy, the cure was the victory, and the patient was too often merely the environment in which the encounter was fought. This is what was taught in medical school and residency. It was necessary to learn the lesson well in order to be protected against the pain of others and to abort any insidious tendency to identify with their misery. Many teachers believed in preventing the enervating perils of "emotional involvement." This is not to say that physicians were unkind to their patients, merely that they kept their distance. Patients were treated with respect and even with a kind of formalized dignity. Physicians were as gentle as they knew how to be. But they were men apart. They towered over the sick as an adult towers over a child. Today something within men is being liberated. To a great extent, I believe that women physicians have been essential in bringing this change to medicine. We now know that physicians are not compromised by allowing themselves to feel some of what their patients feel. They are strengthened by it. A patient's life, the setting of his illness, the rending of his soul, the anguish of his family and the hope for his recovery have all become as much a part of good care as knowledge of the serum sodium and what to do about it. Men have become better nurturers, more empathetic. And the thing that is being liberated from inside men is something that society has always seen as a feminine quality. The peak of the healer's art is in bringing both science and empathy to bear on disease. This is what being a physician should mean.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:What's a woman doing in a place like this? 809 Dec 97

Absence of basic pain behaviors when an injury or illness is typically painful suggests that the experience of pain may be significantly altered. In the present study third-party reporting of injury/illness incidents was used to estimate the incidence of pain insensitivity/indifference and provide evidence of its impact. A significantly elevated pain threshold was noted for 25.2% of 123 individuals with developmental disabilities. Those with more severe mental retardation were also more likely to display signs of pain insensitivity or indifference. These individuals risk avoidable death and increased physical disability as a result of failure to recognize and respond to illnesses and injuries that would be painful for others. Implications for rehabilitation practitioners and medical personnel were discussed.
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PMID:Incidence of significantly altered pain experience among individuals with developmental disabilities. 819 8

The hypothesis of this paper states that at least some suicidal individuals are characterized by a disposition toward dissociation manifested in relative insensitivity to physical pain and indifference to their bodies. Three main topics are discussed: dissociation and suicide, psychological aspects of pain, and pain and suicide. Various theoretical and experimental studies suggest that certain stress conditions lead to the development of dissociative tendencies, and that once these tendencies are established, they become an integral part of suicidal behavior. Psychological variables that affect pain tolerance are presented and they include perception, motivation, emotions, and behavioral and cognitive strategies of pain control. These can increase tolerance of pain in suicidal individuals, making the suicidal act possible. The specific relationships of pain and suicide are then introduced through an examination of pain analgesia in the phenomenon of self-harm. The integration of the material suggests that early and continuous stress lead to the simultaneous development of dissociative tendencies (including indifference to the body and pain) and heightened vulnerability to stress. These dispositions may facilitate suicidal behavior in the face of mounting intolerable stress, helplessness, and hopelessness. Preliminary empirical support for the present hypothesis is cited. This hypothesis shifts the focus of attention from the question of what causes suicide to what facilitates suicide, and in so doing suggests new directions for research and therapy.
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PMID:Dissociation, physical pain, and suicide: a hypothesis. 820 10

Neuropathic joint disease or Charcot joints are a chronic form of a degenerative arthropathy that is associated with decreased sensory innervation of the involved joints. Neuropathic arthropathies are considered to be an accelerated osteoarthritis that is precipitated by trauma to a joint not protected by its proprioceptive or nociceptive reflexes. This process continues until destruction of the joint occurs. The etiology of Charcot joints has varied throughout history as different diseases have become less or more prominent. Some of the offenders include diabetic neuropathy, tabes dorsalis, syringomyelia, and congenital indifference to pain. The morphology and pathogenesis of this condition has intrigued the minds of many, including Musgrave, Charcot, Virchow, Eloesser, Soto-Hall, and Key.
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PMID:A short history of neuropathic arthropathy. 822 48


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