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Query: UMLS:C0030193 (
pain
)
261,466
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The case of a 16 years old female with uncorrected Tetrology of Fallot, who operated for intracranial lesion in parieto frontal area with midline shift is presented. She had right ventricular hypertrophy,
clubbing
, central and peripheral cyanosis. Patient was anaesthetized keeping all measures required to avoid haemodynamic swings, tachycardia, desaturation, acidosis and dehydration. Pre-operative antibiotic cover was given to prevent bacterial endocarditis. Neurosurgeon, Paediatric cardiologist, Anaesthesiologist and Intensivist were involved in the preoperative planning and management of the patient. Haemodynamics were maintained and managed by monitoring continuous arterial line secured pre-induction and central line after induction. During surgery
pain
was controlled with fentanyl boluses intraoperatively and post operatively by tramadol infusion. Patient was extubated post operatively in the recovery room fulfilling the extubation criteria. She remained haemodynamically stable throughout the course. She was discharged on 5th post operative day from the hospital on SpO2 of 70-80% at room air.
...
PMID:Anaesthetic management of craniotomy for intracranial lesion in a child with uncorrected tetrology of fallot. 2386 49
Pachydermoperiostosis as the primary form of hypertrophic osteoarthropathy is a rare hereditary disorder with a number of characteristic findings, e.g. periosteal hypertrophy, digital
clubbing
and pachydermia. Further typical symptoms include arthritic manifestations in all major joints. Literature review showed that therapeutical approaches usually focus on medical therapy alleviating chronic polyarthritis by controlling inflammation. In the case presented in this report anti-inflammatory therapy appeared to have been insufficient since knee arthritis persisted. Arthroscopic synovectomy and radiosynoviorthesis were performed consecutively. Postoperative and follow-up examinations indicate that this combined therapy reduces
pain
, increases range of motion and improves overall mobility, and is thus of lasting benefit to the patient.
...
PMID:Arthroscopic synovectomy and radiosynoviorthesis: a treatment option for recurrent arthritis symptoms in patients with pachydermoperiostosis. 2387 13
This case presents a patient with congenital cyanotic heart disease in whom secondary hypertrophic osteoarthropathy was diagnosed. The symptoms of severe bilateral leg pain started 2 months before hospital admission. The presence of
clubbing
, painful swelling of the lower limbs and his comorbid condition roused the suspicion of hypertrophic osteoarthropathy and a skeleton radiograph of the lower limbs was performed. The last showed changes consistent with periosteal new bone formation, so a non-steroid anti-inflammatory drug was started with complete resolution of the debilitating
pain
. Hypertrophic osteoarthropathy is an uncommon disease that may be genetically acquired or secondary to other conditions affecting lungs, heart, liver or bowel. Considering it elusive pathogenesis, treatment options are scarce and symptomatic relief is still the main objective.
...
PMID:Hypertrophic osteoarthropathy and congenital heart disease: this is not casual. 2404 86
Osteoid osteoma is an uncommon benign tumor and causes severe
pain
, being worse at night, that responds dramatically to nonsteroidal anti-inflammatory medications. An osteoid osteoma of the toe is very rare and arising in a pedal phalanx may be difficult to diagnose. A 34-year-old male has local swelling and tenderness but there were no hyperemia, temperature increase, or
clubbing
. There was a 2-month history of antibiotic treatment with suspicion of soft tissue infection in another clinic. The osteoid osteoma was completely excised by curettage and nidus removal with open surgical technique. The patient was followed up for 63 months with annual clinical and radiographic evaluations. There was no relapse of the
pain
and no residual recurrent tumour. Osteoid osteoma may be difficult to distinguish from chronic infection or myxedema. The patients may be taken for unnecessary treatment. The aim of the treatment for osteoid osteoma is to remove entire nidus by open surgical excision or by percutaneous procedures such as percutaneous radiofrequency and laser ablation. Osteoid osteomas having radiologic and clinical features other than classical presentation of osteoid osteoma are called atypical osteoid osteomas. Atypical localized osteoid osteomas can be easily misdiagnosed and treatment is often complicated.
...
PMID:Osteoid osteoma of distal phalanx of toe: a rare cause of foot pain. 2532 36
Background
. Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by abnormal proliferation of the skin and bony structures at the distal extremities resulting in digital
clubbing
, periosteal bony reaction, and joint effusion. It can be primary (idiopathic) without any clear identifiable etiology as well as secondary to variety of systemic diseases most notably lung pathology.
Case Presentation
. We describe a rare case of primary idiopathic osteoarthropathy in a male patient who presented with severe
pain
and tenderness in his legs. His history was significant for long standing alcoholism. Physical examination showed severe fingers and toes
clubbing
. He reported similar changes in his mother. Clinical and radiological findings were remarkable for distal leg tenderness and diffuse periosteal bony reactions, respectively. Computerized tomography scan failed to show any pathology apart from fatty liver infiltration. In the absence of obesity or diabetes, this was consistent with alcoholic steatosis. He was started on nonsteroidal anti-inflammatory drug which dramatically improved his symptoms.
Conclusion
. Primary hypertrophic osteoarthropathy should be considered in a previously healthy person presenting with bony
pain
and finger
clubbing
especially after ruling out the common secondary causes. Moreover, alteration of prostaglandin metabolism secondary to alcoholic consumption might be a contributing factor.
...
PMID:Primary Idiopathic Osteoarthropathy: Could It Be Related to Alcoholism? 2811 7
Objective:
Epidermolysis bullosa (EB) is an orphan disease that affects about half a million people worldwide, but may not be familiar to all clinicians. The authors' goal was to present a short description of this condition and current research in the form of a narrative review.
Methods:
The authors reviewed the literature on epidermolysis bullosa in order to describe the condition and current genetic research.
Results:
There are at least 31 subtypes of EB, including junctional EB, dystrophic EB, and Kindler syndrome. Genetic research is crucial in finding strategies to manage and possibly cure EB, which is often undiagnosed or misdiagnosed. EB may present in newborns and may persist over the course of a lifetime. Serious complications can occur with EB, including chronic blisters, wounds, ulcers, pruritus,
clubbing
of hands and feet, and amputations.
Pain
is frequently reported. About 80 percent of patients with recessive dystrophic EB will succumb to squamous cell carcinoma by age 55. Promising directions for future research include genome editing, gene therapy, and cell-based therapies.
Conclusion:
Our growing understanding of genetics and cell therapies may lead to promising therapeutic advances to treat this challenging condition.
...
PMID:Raising Awareness Among Healthcare Providers about Epidermolysis Bullosa and Advancing Toward a Cure. 2867 Mar 57
Hypertrophic osteoarthropathy is commonly associated with malignancies of the lungs and stomach. A few cases associated with epithelioid hemangioendothelioma, a rare vascular soft tissue neoplasm, have been reported. Presented here is the first report of a case of hypertrophic osteoarthropathy as the initial symptom of epithelioid hemangioendothelioma of the mediastinum. A 64-year-old woman presented with
pain
around the long bones and diffuse puffiness of bilateral hands and feet. She had a history of multiple malignancies, all of which were in remission. She had
clubbing
of her fingernails and toenails. Her chest X-ray was negative. A positron emission tomography (PET) scan performed showed metabolically active soft tissue that extensively infiltrated the mediastinum, with several sites of disease involving the pericardium. Mediastinal biopsy and subsequent pleural fluid cytology obtained by thoracocentesis was consistent with metastatic epithelioid hemangioendothelioma. Our case supports that the PET scan has a valuable role in localizing malignancies in such patients who present with hypertrophic osteoarthropathy and no lung or stomach involvement.
...
PMID:Case of mediastinal epithelioid hemangioendothelioma associated with hypertrophic osteoarthropathy and literature review. 2892 Feb 23
Pachydermoperiostosis (PDP), otherwise known as primary hypertrophic osteoarthropathy, is characterized by digital
clubbing
, pachydermia and subperiosteal new bone formation. Joint pain, polyarthritis, cutis verticis gyrata, seborrhea, and hyperhidrosis are frequently associated to this condition. We report a 17-year-old boy presented with
pain
and swelling of knees and ankles, and progressive thickening of skin face with seborrhea from about 4 years. At the admission he also showed digital
clubbing
of both hands and feet and palmoplantar hyperhidrosis. We hypothesized PDP and molecular analysis confirmed diagnosis showing a novel mutation in a homozygous state in the SLCO2A1 gene coding for prostaglandin transporter. He started therapy with hydroxychloroquine with a great improvement in joint pain and skin conditions. This is the first reported case of PDP who was successfully treated with hydroxychloroquine, with effects not only on arthralgia but also, surprisingly, on skin conditions.
...
PMID:A novel homozygous mutation in the SLCO2A1 gene causing pachydermoperiostosis: Efficacy of hydroxychloroquine treatment. 2968 Oct 86
We report the case of a 29 year old male who presented with burning
pain
in the tips of fingers of left hand and recurrent episodes of amarausis fugax. Examination revealed polycythemia, unilateral
clubbing
with positive Adson's test in left upper limb. Evaluation revealed thrombosis of the left subclavian artery in CT angiography. Polycythemia rubra vera was found to be the underlying cause.
...
PMID:Polycythemia Rubra Vera Presenting as Unilateral Clubbing Due to Left Subclavian Artery Thrombosis. 3047 69
Lemierre syndrome is characterized by septic thrombophlebitis of the internal jugular vein, after an oropharyngeal infection, with septic embolization to the lungs or other organs. This case report describes a 37-year-old female patient who presented with edema and
pain
in the right hemiface with onset 3 days previously and progressive fatigue and dyspnea since the previous day. She had had tooth 48 extracted 3 days previously. Physical examination at admission found tachypnea, with 60% saturation (in room air), edema at the angle of the right mandible, diffuse reduction of vesicular murmur, and calves free from
clubbing
. Angiotomography of the chest and laboratory tests were compatible with septic emboli, and cervical computed tomography confirmed a diagnosis of septic thrombophlebitis of the internal jugular vein. She was managed with antibiotics and given treatment for her symptoms. Lemierre syndrome most often occurs in young men and there is embolization to the lungs in up to 97% of cases. Rarely, the etiology of this syndrome may be tooth extraction. Computed tomography is the imaging method most often used for diagnosis and treatment is basically antibiotic. Surgery is thus rarely necessary.
...
PMID:Lemierre syndrome: case report. 3078 54
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