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)

20 cases of pelvic actinomycosis associated with the use of an IUD have been reported. A case of a patient with IUD-associated pelvic actinomycosis, in which the organism was identified by histologic testing and culture, is reported. The 26-year-old woman, gravida 2, para 1, had had a therapeutic abortion in March 1971. She used a Dalkon Shield IUD from 1971 to April 1975. It was removed at that time because of menometrorrhagia. The patient noted pain in the lower left quadrant of her abdomen in June 1975. A mass in the left ovary was palpated on pelvic examination, but the patient refused further evaluation. The patient returned in August 1976 complaining of continued abdominal pain. On physical examination, she had a firm, slightly tender, 7 centimeter mass in the left adnexa, contiguous with the uterus. No other abnormalities were revealed in physical examination. There were 11,200 peripheral blood leukocytes per cubic millimeter with 73% polymorphonuclera cells and 6% band forms. A laparotomy was performed in August 1976, and a 5- by 2.5 centimeter tubo-ovarian abscess on the left side was found. Adhesions and clubbing of the right fallopian tube were observed during the operation. The left ovary and fallopian tube were excised. Inflammatory disease involving the right ovary and fallopian tube was evident, but the right adnexa was left in place in accordance with the patient's preoperative request. In October a 2nd laparotomy was performed, and the ovary and the right fallopian tube were removed.
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PMID:Tubo-ovarian Actinomycosis and the Use of Intrauterine Devices. 740 3

A 38-year-old woman in good health suddenly developed pain in the right chest and mild dyspnoea. She reported two bronchial infections in the preceding year. Physical examination revealed cyanosis of the lips and finger clubbing, slightly dulled percussion sounds and decreased breath sounds at the basis of the right chest, but no other abnormalities. Activity of the tumour marker CA 125 was raised (60 kU/l). The chest radiography showed a shadow in the right lower segment, resembling a high diaphragm. Computed tomography failed to separate the abnormal structure from the liver substance. Needle puncture discovered a small haemorrhagic effusion with mesothelial cells. Magnetic resonance imaging and a scintigraphy of the liver provided evidence that the mass was separate from the liver. At thoracotomy a tumour, 20 x 15 x 10 cm in size and connected by a pedicle to the pleura, was identified and excised. Immunocytochemical tests showed it to be a fibrous pleural mesothelioma without signs of malignancy. The patient was discharged 10 days postoperatively in good general condition.
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PMID:[Localized fibrous pleural mesothelioma. Value of image-producing methods for the differentiation from supradiaphragmatic tumors of the liver]. 811 9

Nineteen consecutive patients of pyogenic liver abscess (13 males, 6 females, mean age 45.2 +/- 6, 5 years) were studied over a period of 5 years for the clinical profile and therapeutic efficacy of percutaneous aspiration. Majority of them presented with spiking fever (94.7%), pain over right upper quadrant of abdomen (53.8%) and often with prostration and shock (31.6%). The onset has been rather acute in patients with multiple abscesses (7 cases). Ascites (10.5%), clubbing of fingers (15.8%) and splenomegaly (10.5%) were observed in cases with long duration of illness. There has been the polymorphonuclear leucocytosis (89.5%) and mild to moderate anaemia (52.6%). Jaundice (42.1%) was usually mild degree (serum bilirubin 4.6 +/- 2.4 mg/dl). The serum transaminases and alkaline phosphatase were raised in 94.9% of cases. Ultrasonography revealed predominantly hypoechoic (54.1%) areas with frequent distal acoustic enhancement and internal echoes (21.6%). Seven patients had multiple abscesses with 25 lesions (size 5.2 +/- 4.6 cms) situated mainly over antero-inferior segment of the right lobe (45.9%) of the liver. The blood and pus cultures demonstrated the micro-organisms (positive in 63.9% and 86.6% respectively) predominantly of bowel flora including facultative gram negative rods and anaerobes. Mortality was 26.5% and pleuro-pulmonary complications were the commonest (26.4%) one. 15 cases were treated by percutaneous aspiration, proper antibiotic and metronidazole with encouraging results (only two deaths). Complete resolution of abscess took place in 14.2 +/- 1.2 weeks (range 6 weeks to 7.5 months). It is emphasized that percutaneous needle aspiration is useful both for diagnosis and treatment of pyogenic liver abscess.
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PMID:Clinico-therapeutic profile of pyogenic liver abscess. 822 94

A 33-year-old man presented with a palmar aneurysm accompanied by painful ipsilateral clubbing finger in his right hand. Following resection of the aneurysm and arterial reconstruction with a cephalic vein graft, the pain in his fingers disappeared. Histologic examination identified the resected tissue as a true aneurysm. The clubbing finger was ascribed to chronic ischemia due to a stenotic lesion associated with palmar arch hypoplasia and aneurysm. The following is the first reported case of palmar aneurysm accompanied by ipsilateral clubbing finger.
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PMID:Palmar aneurysm accompanied by ipsilateral clubbing finger--a case report. 992 91

The case of a 48-year-old patient is presented, suffering from persisting pain in the right lower leg for more than a year following a distortion of the ankle. The patient was known to have a history of severe asthmatic disease. Conventional X-rays showed a periostitis of the lower tibia and fibula. To exclude a malignant process, an open biopsy was performed. Neither tumor nor any histological signs of chronic inflammation were found. The patient claimed to have a similar pain in the contralateral lower leg 5 months after initial biopsy. X-rays again showed signs of a periostitis of the tibia and fibula. Furthermore, an increase in isotopes in this area was found in a performed bone scan. Diagnosis of osteoarthropathia hypertrophicans was confirmed 2 years after onset of the first symptoms. Pathogenetic variables both of the primary and secondary forms of hypertrophic osteoarthropathy (HOA) are as yet not completely clarified. Secondary hypertrophic osteoarthropathy (SHOA) may be defined as a syndrome of the long bones with clubbing of the fingers and toes, and occurs in the process of chronic lung and mediastinal disease. We conclude that HAO detection may contribute to early detection of lung disease, especially bronchopulmonary cancer, before it becomes clinically and radiographically manifest.
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PMID:[Secondary hypertrophic osteoarthropathy. Differential diagnosis of post-traumatic ossification of the interosseous crural membrane]. 1096 48

This is a case of a 70 year old male patient suffering from bilateral leg pain for 2 months. Physical examination disclosed clubbing. X-rays of the legs showed bilateral periosteal elevation with subperiosteal bone formation. 99TM-diphosphonate bone scan was negative. A search for malignancy revealed pleomorphic carcinoma of the right lung. Pain symptom disappeared 2 days after resection of the tumor. Repeated X-rays of the legs, three and a half months later showed no change and the clubbing persisted. Hence, unexplained bilateral leg pain should raise suspicion of hypertrophic osteoarthropathy, and elicit a search for secondary disease especially lung tumor. It is interesting to point out the negative bone scan and the rapid resolution of patient symptoms after resection of the tumor.
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PMID:[Pleomorphic carcinoma of the lung heralded as bilateral leg pain]. 1130 47

Thyroid acropachy is an extreme manifestation of autoimmune thyroid disease. It presents with digital clubbing, swelling of digits and toes, and periosteal reaction of extremity bones. It is almost always associated with ophthalmopathy and thyroid dermopathy. During a 26-yr period at our institution, of 178 patients with thyroid dermopathy, 40 had acropachy. Clubbing associated with thyroid dermopathy (pretibial myxedema) was seen in 35 patients. Clubbing usually was not a patient complaint and was noted only by clinical observers. Four of eight patients with hand and extremity radiographs had periosteal reaction. Seven had associated extremity and joint pain; this pain was absent at long-term follow-up. Half of the patients required systemic corticosteroid therapy, 53% required transantral or transfrontal orbital decompression for severe ophthalmopathy, and 18% had the elephantiasic form of dermopathy. Cigarette-smoking rates were 81% for women and 75% for men (mean, 28 pack-years). All 13 patients who had thyroid-stimulating Ig measurement had high titers. Long-term follow-up (median, 12.5 yr) revealed that acropachy was not a complaint in follow-up visits or questionnaires. The data suggest that thyroid acropachy is an indicator of severity of ophthalmopathy and dermopathy. It is a source of clinical concern only if dermopathy is persistent and severe.
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PMID:Thyroid acropachy: report of 40 patients treated at a single institution in a 26-year period. 1246 33

Three patients with pachydermoperiostosis are reported. All patients presented with moderate pain and swelling in multiple joints unresponsive to treatment, characteristic facial features which were marked in two cases, clubbing of nails and enlargement of distal parts of the extremities. One patient had spondylolisthesis of L5-S1 vertebrae, an association not previously described in this syndrome. The natural history of the disease is reviewed and the differential diagnosis is discussed.
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PMID:Pachydermoperiostosis: Three case reports. 1246 46

We report a case of a family with a variant form of primary hypertrophic osteoarthropathy (HOA) restricted to the lower extremities without digital clubbing or cutaneous changes. Three family members suffered from pain, swelling and hyperhidrosis of both feet. X-rays showed destruction and osteoproliferative changes of the metatarsal bones with periostal hyperostosis close to the talus. There was an increased 99m-Tc-MDP uptake in the early phase of bone scintigraphy. Fibrosis of the marrow with stimulated osteoclastic resorption and the presence of detritus synovialitis were visible in a bone and joint biopsy. All known infectious, neurologic, metabolic and malignant diseases, which affect the bone and joints, were excluded.
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PMID:A family with a variant form of primary hypertrophic osteoarthropathy restricted to the lower extremities. 1281 67

Facial pain can, on rare occasions, be the presenting symptom of lung cancer. This report describes a patient with non-metastatic lung cancer, which was associated with attacks of debilitating facial pain, presenting as cluster headache. Moreover, 32 reported cases of lung cancer-related facial pain (including the present one) are reviewed, and their clinical features are summarized. The facial pain is almost always unilateral, and is most commonly localized to the ear, the jaws, and the temporal region. The pain is frequently described as severe and aching, and may be continuous or intermittent. Aggravation and expansion of the pain, digital clubbing, increased erythrocyte sedimentation rate, and hypertrophic osteopathy, may contribute to the diagnosis. Referred pain, due to invasion or compression of the vagus nerve, as well as paraneoplastic syndrome secondary to the production of circulating humoral factors by the malignant tumor cells, is implicated in the pathophysiology of facial pain associated with non-metastatic lung cancer. Radiotherapy and tumor resection with vagotomy are very effective in aborting the facial pain. Thus, lung cancer should be included in the differential diagnosis of facial pain that is atypical and/or refractory to treatment.
J Orofac Pain 2003
PMID:Facial pain as first manifestation of lung cancer: a case of lung cancer-related cluster headache and a review of the literature. 1455 96


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