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

We report on 3 patients with meningoradiculoneuritis (MRN) due to Lyme-borreliosis (LB), which presented clinically as vertebral disc herniation. In 2 cases the underlying infection was discovered only after unsuccessful neurosurgical treatment. In the differential diagnosis between MRN and disc herniation the following criteria are suggestive of MRN and should raise suspicion of a non-discogenic aetiology: History of tick bite or erythema chronicum migrans, fever or general malaise, mono- or oligoradiculopathy with absent or insignificant lumbar pain and complaints of a burning character of the radiating pain. In suspicious cases we recommend blood investigations including antibody determination against borrelia burgdorferi and CSF investigations including cell count and cytology, protein and glucose determination, nephelometry and isoelectric focusing to exclude MRN and other conditions that may mimic disc herniation.
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PMID:Meningoradiculoneuritis mimicking vertebral disc herniation. A "neurosurgical" complication of Lyme-borreliosis. 274 34

A series consisting of 32 women undergoing total abdominal hysterectomy received a standard narcotic-free anaesthetic. For the first 24 h postoperatively, eight were given the standard regimen of intramuscular morphine sulphate whilst the other three groups received continuous subcutaneous infusions of either morphine sulphate, ketamine hydrochloride or the two drugs combined. The amount of time they were pain free, the incidence of sleep and nausea, together with cardiovascular and respiratory changes were recorded. All three subcutaneous regimens produced significantly more pain-free readings than intramuscular morphine, but ketamine resulted in higher respiratory rates and less sleepiness. No patient reported psychomimetic side effects, but ketamine on its own produced feelings of malaise in three patients on the second postoperative day. Subcutaneous infusions provide better postoperative analgesia than intermittent intramuscular morphine. Ketamine on its own cannot be advocated, but combined with morphine it allows a single infusion rate to be used for all patients, decreasing the need for nursing and medical involvement.
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PMID:Subcutaneous ketamine analgesia: postoperative analgesia using subcutaneous infusions of ketamine and morphine. 277 59

It has been studied, by inquiry, the adverse reactions in the hospital personnel vaccinated against Hepatitis B with 3 doses of 20 mcg of the HB-VAX (MSD) vaccine. The 45% of the inquired people referred some kind of the side effects, more frequently after the first vaccinal dose. The local reactions incidency was larger than the general ones, but without any significant differences. The local pain and the asthenia, general malaise and myalgia were the more outstanding symptoms in both cases. The average duration of the adverse reactions was two days, not appearing any disorders in the laboral activity of the vaccinated. In our experience, the anti-Hepatitis B vaccine employed didn't offer superior risk to the observed with antiviral vaccines employed to prevent other diseases.
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PMID:[Adverse reactions to anti-hepatitis B vaccine in hospital personnel: results end experiences]. 297 76

Since 1968 the inflammatory stage of diverticular disease (acute and chronic diverticulitis) has been treated with tetracosactrin in one practice. This paper reviews 100 episodes treated in this way and compares these with 50 episodes treated with rest in bed and dietary measures. Abatement of pyrexia, swelling and tenderness, as well as relief of the symptoms of pain and malaise, were usually found to occur within 24 hours of the administration of tetracosactrin zinc (1 mg) intramuscularly. No complications directly attributable to this therapy have been observed, while the duration of the clinical illness has been reduced by more than half. In neither group were antibiotics found to influence the outcome.
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PMID:Diverticular disease treated with corticotrophin. 300 2

We identified 90 patients with tick-borne erythema migrans in the Union of Soviet Socialist Republics (USSR) in areas from the western Baltic Republics to the Maritime Territory on the Pacific Ocean. Symptoms associated with the erythema included fever, malaise and fatigue, headache, myalgias, arthralgias, or regional lymphadenopathy. Within two weeks to four months, 58 (64%) of the patients developed neurological abnormalities, particularly radicular pain, cranial neuritis, or lymphocytic meningitis, and four (4%) patients developed monoarticular or oligoarticular arthritis. We tested the sera from 35 Soviet patients by using an isolate from the United States. The serological data showed elevated IgM and/or IgG antibody titers to Borrelia burgdorferi in 2 of 10 patients with erythema migrans, 15 of 21 with neurological abnormalities, and 2 of 4 with arthritis. Our observations suggest that Lyme borreliosis occurs in diverse areas of the USSR.
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PMID:Lyme borreliosis in the Soviet Union: a cooperative US-USSR report. 317 Dec 26

A 37-year-old man was admitted because of general malaise, slight fever, pain in the knee joint and lower extremities, polydypsia, polyuria and skin lesion in September, 1985. The white blood cell count was 16,920/cmm with 41% of abnormal lymphoid cells with convoluted nuclei, which were compatible with adult T-cell leukemia (ATL). The serum calcium level was 15.1 mg/dl, serum LDH 307 IU/l, and the titer of anti-ATLA antibody in serum x 160. The cell surface phenotype of abnormal lymphocyte was OKT-3+, OKT-4+ and OKT-8-. Therefore the diagnosis of acute ATL was made. He was treated with cisplatin because VEPA therapy was not effective. About five months after the start of chemotherapy, he entered remission with almost complete disappearance of abnormal lymphocyte. The remission continued over twenty-nine months with maintenance therapy by cisplatin alone. The clinical course of this patient suggests that cisplatin could be applied to a case of ATL which is refractory to the conventional treatment.
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PMID:[A case of acute adult T-cell leukemia with long-term remission by cisplatin therapy]. 317 45

An intense vaso-vagal reaction characterizes all the reflex induced cardiovascular syncopes. In these syndromes the vagal cardio-inhibitor effect on heart rate is more evident than the vasodilatation and fall in blood pressure. The vasodepressor mechanism is uncommon even in carotid sinus syndrome. We have studied 6 male patients, age range 56-73 years (mean age: 64) with recurrent vasodepressor syncopes. The following were always present during such episodes: generalized malaise, profound fatigue, pallor, cyanosis, copious sweating, lack of peripheral pulses, severe fall in blood pressure (BP) (systolic BP less than or equal to 50-60 mmHg or unrecordable), mental disorientation and/or syncope. The first diagnosis in our patients was carotid sinus syndrome, but, the clinical picture was quite different from classic carotid sinus syndrome: triggering factors were not present, the vasovagal episodes were longer, the syncopes more frequent and severe, and the VVI pacing uneffective. Further investigations, including computerized axial tomography, showed--in all these patients--a malignant tumour originally localized in or near the parapharyngeal space. We think that the symptoms of our patients can be attributed to parapharyngeal tumour and that the parapharyngeal space lesions are able to cause severe vasovagal attacks and syncope. The pathogenetic mechanism in this syndrome, due to neural irritation of the glossopharyngeal afferent fibres, is similar to the glossopharyngeal neuralgia-asystole syndrome, but it obviously doesn't involve pain-pathways since none of our patients had pain. Therefore, this syndrome differs from glossopharyngeal neuralgia- asystole syndrome in the presence of tumours and in the absence of neuralgia and initiating factors.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A new reflex cardiovascular syndrome: recurrent vasodepressive syncope caused by lesions or tumors of the parapharyngeal space. Etiopathogenesis, clinical picture, differential diagnosis with carotid sinus syndrome and glossopharyngeal neuralgia-asystole syndrome. Therapy by intracranial resection of the 9th cranial nerve]. 319 43

The clinical and serologic features and immune status of 39 homosexual men who had seroconversion to human immunodeficiency virus positivity were compared with 26 homosexual men who remained seronegative during a six-month period. An acute clinical illness occurred in 92.3% of seroconverted subjects and 40% of controls. The duration of illness was significantly greater in the seroconverters than the controls (10 + 4.4 days). A general practitioner was consulted by 87.2% of the seroconverters because of the illness, including 12.8% who were admitted to hospital, compared with 20% of controls. The most frequently reported symptoms in the seroconversion group were fever (76.9%); lethargy and malaise (66.7%); anorexia, sore throat, and myalgias (56.4% each); headaches and arthralgias (48.7% each); weight loss (46.2%); swollen glands (43.5%); retro-orbital pain (38.5%); and dehydration and nausea (30.8% each). Lymphadenopathy developed in 75% of seroconverters compared with 4% of controls. Changes in T-cell subsets were not found in controls, but the number of T4+ cells and the T4+/T8+ ratio decreased significantly in seroconverters.
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PMID:Characterization of the acute clinical illness associated with human immunodeficiency virus infection. 325 8

The incidence of different types of shoulder pain after open heart surgery was studied prospectively. Of 101 patients studied, 45 developed rheumatic symptoms during the first six weeks after the operation. Thirty eight patients reported pain in the region of the shoulder girdle with no loss of shoulder function (postpericardiotomy rheumatism). Three of these patients also had features compatible with the postpericardiotomy syndrome (fever, malaise, or pleuritic chest pain), and seven developed the syndrome without pain in the shoulder girdle. Of these 10 patients, one had generalised myalgia. Postpericardiotomy rheumatism alone was not associated with increased inflammation (measured by the erythrocyte sedimentation rate and concentration of C reactive protein); immunological tests including measurement of antibodies to cardiac muscle yielded inconclusive results. Replies to a postal questionnaire showed that symptoms of postpericardiotomy rheumatism were present for over three months in 18 patients and for six months or longer in 14. In view of the large number of patients now having open heart surgery postpericardiotomy rheumatism should be considered when patients report pain around the shoulders so that it is not misdiagnosed as angina.
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PMID:Rheumatic symptoms after cardiac surgery: a prospective study. 326 13

Long-term subcutaneous (s.c.) administration of recombinant Interleukin-2 (rIL-2) was evaluated in 18 patients with advanced malignancy who received escalating doses of rIL-2 (1.0-9.8 X 10(6) U/m2) s.c. five times per week for a median of 38 days (range 5-228 days). Prior to the s.c. phase of the study, 24 patients received low doses (50 or 350 mg/m2) of cyclophosphamide (CPM) i.v. on day 1 followed by 10 doses (days 5-9 and 12-16) of rIL-2 (1 X 10(6) U/m2) given by 6 h i.v. infusion. There were no major antitumor effects. Toxicity was not clearly dose-related, with pain and induration at s.c. injection sites, fatigue, malaise, and palpitations most often observed. Pretreatment baseline ranges (PBR), which are 95% prediction intervals that reflect both intra- and interpatient variability, were calculated for nine hematologic and immunologic variables derived from 21 of the 24 patients. While pretreatment with CPM had no significant effect on these variables during the i.v. phase of the study as compared to a prior study using an identical rIL-2 i.v. infusion schedule, prolonged administration of s.c. rIL-2 was associated with (a) enhancement of natural killer (NK) cytotoxicity against K562 in 13 of 21 patients (p less than 0.00001), (b) increases in cytotoxicity against K562 (15 patients) and against Daudi (9 patients) in the presence of 10 U/ml of rIL-2 (p = 0.007), (c) increases in the proliferative response in vitro to OKT3 and rIL-2 in 12 patients (p less than 0.00001), (d) lymphocytosis with increase in percentage of Tac (13 patients, p less than 0.00001), T8 (11 patients, p = 0.0005), and T9 (8 patients, p = 0.021) expression, and (e) eosinophilia. While initial rises in some of these variables occurred during the i.v. phase of the study, maximum increases for all variables except T9 positivity occurred during prolonged s.c. therapy. Nine of 10 patients studied while on therapy greater than 50 days had anti-rIL-2 antibodies in an enzyme-linked immunosorbent assay; in only one case was the antibody neutralizing. This study demonstrates that significant enhancement of cytotoxicity against both NK-sensitive and -resistant targets and improvements in T-cell mitogenic response occur with long-term administration of rIL-2. Further evaluation of long-term administration of tolerable doses of rIL-2 is warranted.
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PMID:Phase I trial of recombinant interleukin-2 and cyclophosphamide: augmentation of cellular immunity and T-cell mitogenic response with long-term administration of rIL-2. 326 71


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