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

Nonmobile caliceal stones cause pain more often than previously appreciated. The character and intensity of the pain differs from typical renal colic. Twenty-six patients with caliceal stones and pain underwent attempted treatment for pain control via stone removal or disintegration: 15 were treated with percutaneous stone extraction (PSE), 10 with extracorporeal shock-wave lithotripsy (ESWL), and 1 required open surgery after failing PSE. One patient had persistent pain after ESWL and subsequently underwent PSE; 25 of 26 patients had complete relief of pain. Morbidity was minimal. Patients with painful caliceal stones should be offered ESWL, followed by PSE if pain persists.
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PMID:Treatment of painful caliceal stones. 340 Jan 35

A 55 year-old woman was admitted to hospital in January 1981 with transient expressive dysphasia. Past personal history was unremarkable except for a six-month history of renal colic and thrombophlebitis in the veins of the right leg. Computed tomographic scan of the head and carotid angiogram revealed a left calcified temporoparietal tumor. Because of pulmonary embolism it was decided to refute a cerebral biopsy. The patient also declined radiotherapy. In May 1983, a thorough workup revealed an incomplete fracture of the first lumbar vertebra and a diffuse demineralization of the rachis and pelvis. Four weeks later she developed temporal epilepsy and pulmonary embolism. A whole brain irradiation (60 Gy) was performed in August 1983. The patient's condition remained clinically stable until December 1984 when she was readmitted to hospital with a severe weight loss, diffuse osseous pain and pancytopenia. A bone marrow biopsy from the iliac crest showed a diffuse tumor involvement. Peroxidase-antiperoxidase staining using monoclonal antiserum to glial fibrillary acidic protein was strongly positive in numerous tumors cells. The pathological diagnosis was bone marrow metastasis by glioma. She died in March 1985, 4 years and 3 months after the first admission to hospital. Autopsy was not performed. A literature search reveals only 9 cases of extraneural spreading of astrocytomas and glioblastomas in the absence of previous craniotomy with post-mortem examination. The authors also comment on the clinical, pathological and histogenic aspects of extraneural metastasis of gliomas.
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PMID:[Spontaneous bone marrow micrometastasis of a cerebral glioma. Immunohistochemical diagnosis in a biopsy sample and review of the literature]. 352 91

The analgesic efficacy and safety of parenteral butorphanol and meperidine were compared. The double-blind, randomized study involved 120 patients presenting with moderate to severe renal colic. Pain intensity and pain relief were evaluated by trained observers at fixed time intervals for four hours after study drug was administered. Eighty-three patients with documented upper urinary tract calculi were evaluated for efficacy. Butorphanol 4 mg was significantly more effective than butorphanol 2 mg and was equivalent to meperidine 80 mg. Overall efficacy assessments were "good" or "excellent" for 87 per cent, 72 per cent, and 85 per cent, respectively. There were no significant differences in side effects among treatment groups in the 83 evaluable and 27 inevaluable patients receiving study drugs. Butorphanol was effective and well-tolerated in this patient population, with important advantages over opiate analgesics.
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PMID:Comparison of butorphanol tartrate and meperidine in moderate to severe renal colic. 354 9

The pharmacokinetics of ketoprofen were evaluated in 29 patients suffering from acute renal colic following a single intravenous administration as a bolus or short infusion (1.5 and 2 hours), and after a loading dose and a 24-hour infusion. Serum concentrations of ketoprofen were measured by high pressure liquid chromatography. The mean (+/- SD) values of clinical parameters were as follows: distribution half-life = 0.34 +/- 0.19 h; elimination half-life = 2.05 +/- 0.58 h; kel = 0.968 +/- 0.282 h-1; k21 = 0.943 +/- 0.425 h-1; k12 = 1.004 +/- 0.708 h-1; volume of central compartment = 5.58 +/- 1.67L; volume of tissue compartment = 5.14 +/- 2.12L; plasma clearance = 5.10 +/- 1.14L/h. These results concur with previously published data obtained after oral or intramuscular administration. According to clinical observations, administration of a ketoprofen bolus suppressed pain within 5 to 30 minutes; the administration of a loading dose and a 24-hour infusion is almost never followed by a recurrence of pain, and this regimen was proposed as the dosage schedule of ketoprofen to treat renal colic.
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PMID:Clinical pharmacokinetics of ketoprofen after single intravenous administration as a bolus or infusion. 358 35

Renal colic malingerers feign symptoms of pain and hematuria, usually to obtain parenteral narcotics. These patients must be identified early to minimize waste of time and supplies by emergency department staff. However, they often use clever ploys to avoid undergoing diagnostic procedures that would unmask them and cut off their drug supply. These malingerers must be differentiated from patients with somatization disorders and those with hard-to-diagnose renal disease, which further complicates their detection. Fortunately, the informed physician can usually suspect the truth early and take steps to reach the proper "diagnosis."
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PMID:When renal colic is really malingering. 367 Dec 16

It is usually assumed as a result of experiments that post-obstructive and hydronephrotic atrophy are due to raised intrapelvic pressure. In acute ureteric obstruction raised intrapelvic pressure is associated with renal colic; the absence of pain in chronic obstruction has been a stumbling block to acceptance of the back pressure theory. In ureteric obstruction due to bladder carcinoma the complete spectrum of nephrographic appearances ranging from those of high pressure obstruction to low pressure obstruction is seen in the absence of pain. This shows that acute ureteric obstruction may be painless and therefore post-obstructive and hydronephrotic atrophy may be preceded in man by a raised intrapelvic pressure. This removes the stumbling block.
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PMID:The urographic appearances of ureteric obstruction secondary to bladder carcinoma. 375 24

Results of 322 patients treated with extracorporeal shock wave desintegration are reported (277 patients treated with the Dornier lithotripter, 45 patients treated with Solonithe using ultrasonic stone location). Lesions treated included 168 caliceal, 111 pyelic, 23 ureteral and 21 coralliform calculi. 45 patients presented multiple and 28 bilateral renal lithiasis. Stones were mainly between 10 and 20 mm in diameter (157 patients) but were less than 10 mm in size in 110 cases and more than 20 mm in 55. For poorly opaque stone, lithotripsy was performed after ultrasound localization with the Sonolithe apparatus. The Dornier machine was used to treat 277 patients during 308 sessions, equivalent to an 11% repeat rate. Fragmentation was excellent in 84% of cases after a single session, and 5% of stones could not be fragmented and required complementary therapy. Out of 200 patients reviewed after 3 months, only 8% had residual fragments (92% success rate), 5% having to undergo auxillary endoscopic manoeuvres: stenting ureteral catheter (4 cases); percutaneous nepholithotomy (3 cases); ureteroscopy (7 cases). Septic complications (6 patients) responded well to antibiotic treatment. Renal colic or pain was recorded in 25% of cases. One kidney was non-functional at 3 months due to distal ureteral obstruction without subsequent dilatation of the collecting system. Out of 45 patients treated with the Sonolithe, 3 (6.6%) were failures of fragmentation and 85% had satisfactory results. After a minimum follow up of 3 months, 20/22 patients were free of residual calculi, and there were no complications.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Extracorporeal lithotripsy by shock waves. Initial results (322 cases)]. 377 46

A double-blind randomized, clinical trial was conducted in 43 patients to evaluate the efficacy of sublingual nifedipine in the treatment of pain in renal colic. Comparison was made with a combination of dipyrone, pitofenone and fenpipramide, which is usually administered intravenously in Spain. With nifedipine, pain completely disappeared in 44% of the cases, and with the combination of drugs, in 89% (p less than 0.005). More adverse effects were noted with the combination than with nifedipine. Both treatments brought about a slight drop in arterial pressure without leading to hypotension in any case. There was no change in heart rate. The possible causes of the relatively low level of success with nifedipine were analyzed. The possibility of using nifedipine under certain circumstances in which other drugs are contraindicated or when their administration is unfeasible is suggested.
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PMID:Nifedipine in the treatment of renal colic. 377 99

Intravenous indoprofen (400 mg), a cyclooxygenase inhibitor, was compared with intramuscular oxicodone hydrochloride (= oxicone 10 mg), a narcotic analgesic agent, in regard to efficacy and side effects in the treatment of renal colic. Oxicone was combined with papaverine (20 mg). Patients were randomized to either treatment, and the drugs were given in double-dummy fashion, i.e. one injection of active drug plus one placebo injection. Pain intensity before and after treatment was registered by the patient (visual analog scale) and by a nurse, who also registered side effects. Oxicone was given to 46 patients and indoprofen to 48. The groups did not differ in body weight, age, sex distribution, or pretreatment intensity of pain. More patients required additional treatment in the oxicone than in the indoprofen group (19 v. 10). At 2-5 min after injection, pain reduction was greater with indoprofen, and more patients in this group had pain relief after 3-5 hours. Side effects were less frequent with indoprofen than with oxicone (1 v. 20 patients), in particular from the central nervous system. This difference probably was related to indoprofen's slow and poor penetration of the blood-brain barrier. The study affirmed that non-narcotic cyclooxygenase inhibitors can replace narcotic analgesics for acute pain alleviation in renal colic. Indoprofen seems to be a useful alternative, with low risk of central nervous side effects.
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PMID:Comparison of a narcotic (oxicone) and a non-narcotic anti-inflammatory analgesic (indoprofen) in the treatment of renal colic. 389 Apr 35

A prospective study compared the diagnostic accuracy of sonography and excretory urography in determining the cause of acute flank pain in 61 patients. Forty-one patients had urinary tract stone disease. Of these, five had nonobstructing renal stones and 36 had obstructing stones. A correct diagnosis was made by urography in 85% and by sonography in 66%. Small stones at the ureterovesical junction were more accurately diagnosed by sonography (79%) than by urography (68%). In all the patients where sonography failed to detect the offending stone, the stone was calcified and evident on the plain radiographs. There were no false-positive diagnoses in the patients clinically judged to have passed a renal stone (nine patients) or whose pain was arising outside of the urinary tract (five patients). Neither sonography (17%) nor urography (50%) was accurate in diagnosing acute pyelonephritis in the six patients with this diagnosis. Although sonography is not as accurate overall as urography in acute flank pain, it is a viable alternative in those with recurrent renal colic due to stone disease and in the pregnant patient.
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PMID:Sonography vs. excretory urography in acute flank pain. 389 Apr 87


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