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

Ventilation minute volume, tidal volume and cardiac frequency during submaximal exercise have been measured in healthy young soldier volunteers exposed to O-chlorobenzylidene malononitrile (CS) and ammonia gas in concentrations respectively of 0.16 to 4.4 mg.m(-3) and 50 to 344 mg.m(-3). The response of ventilation minute volume to the two gases is apparently similar; both gases cause a reduction of, on average 6%. With low doses this reflects a diminution in respiratory frequency whereas with higher doses it is due to a reduction in tidal volume which is accompanied by tachypnoea. The findings may result from stimulation successively of receptors in the larynx and of irritant receptors in the large airways of the lung. The pain which is a feature of exposure to CS but not to ammonia is due to stimulation of other so far unidentified receptors. Neither gas has a direct effect upon the exercise cardiac frequency.
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PMID:Ventilation, cardiac frequency and pattern of breathing during exercise in men exposed to O-chlorobenzylidene malononitrile (CS) and ammonia gas in low concentrations. 33 42

Myopathy may be associated with the syndrome of seroconversion in individuals infected by the human immunodeficiency virus (HIV) or may represent the initial symptom of AIDS. In 1990, 39-year old white, single homosexual who was admitted 1 month prior had experienced an episode of edema and pain in the left thigh that faded with the use of nonhormonal antiinflammatory drugs. 15 days later both forearms became enlarged accompanied by pain and erythema. Erythromycin and cefalexine were used without success. Intermittent fever started to appear before admission accompanied by dyspnea when straining. Examination showed tachypnea, oral candidiasis, and enlargement of both upper arms with pain and local erythema without articular involvement. Neurological examination revealed hypotonia and generalized hyperreflexia with intact muscle strength. Serology was positive for HIV, rheumatic activity tests were negative, and muscle biopsy indicated multifocal myonecrosis. Creatinine phosphokinase was 1019 IU (decrease to 44 IU after treatment), aldolase was 19 IU (decrease to 5.6 IU), and glutamic-pyruvic transminase was 50 IU (decrease to 22 IU). Radiography of the thorax indicated interstitial infiltration. Fiberoptic bronchoscopy indicated Pneumocystis carinii pneumonia. Sulfamethoxazole and trimetropim treatment cured the dyspnea and hypoxemia, but the enlargement of both arms progressed. Capillaroscopy indicated vasculitis that was treated without success with indomethacin (150 mg/day), for 7 days; prednisone (40-80 mg/day) for 10 days; and dexamethasone (280 mg/day) for 2 days. 6 days after methotrexate (50 mg/dose/week) treatment the fever disappeared and the enlargement in the extremities receded, but a lower dose of 7.5 mg caused the return of fever and edema in the right thigh. The myopathy remained asymptomatic for 5 months with a weekly dose of 15 mg of methotrexate.
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PMID:[AIDS and myopathy: report of a case and review of the literature]. 180 40

The history, physical examination, chest radiograph, electrocardiogram and blood gases were evaluated in patients with suspected acute pulmonary embolism (PE) and no history or evidence of pre-existing cardiac or pulmonary disease. The investigation focused upon patients with no previous cardiac or pulmonary disease in order to evaluate the clinical characteristics that were due only to PE. Acute PE was present in 117 patients and PE was excluded in 248 patients. Among the patients with PE, dyspnea or tachypnea (greater than or equal to 20/min) was present in 105 of 117 (90 percent). Dyspnea, hemoptysis, or pleuritic pain was present in 107 of 117 (91 percent). The partial pressure of oxygen in arterial blood on room air was less than 80 mm Hg in 65 of 88 (74 percent). The alveolar-arterial oxygen gradient was greater than 20 mm Hg in 76 of 88 (86 percent). The chest radiograph was abnormal in 98 of 117 (84 percent). Atelectasis and/or pulmonary parenchymal abnormalities were most common, 79 of 117 (68 percent). Nonspecific ST segment or T wave change was the most common electrocardiographic abnormality, in 44 of 89 (49 percent). Dyspnea, tachypnea, or signs of deep venous thrombosis was present in 107 of 117 (91 percent). Dyspnea or tachypnea or pleuritic pain was present in 113 of 117 (97 percent). Dyspnea or tachypnea or pleuritic pain was present in 113 of 117 (97 percent). Dyspnea or tachypnea or pleuritic pain or atelectasis or a parenchymal abnormality on the chest radiograph was present in 115 of 117 (98 percent). In conclusion, among the patients with pulmonary embolism that were identified, only a small percentage did not have these important manifestations or combinations of manifestations. Clinical evaluation, though nonspecific, is of considerable value in the selection of patients in whom there is a need for further diagnostic studies.
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PMID:Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. 841 19

The diagnostic features of acute pulmonary embolism among 72 patients greater than or equal to 70 years old were evaluated and compared with characteristics of pulmonary embolism among 144 patients 40 to 69 years and 44 patients less than 40 years old. Syndromes characterized by either 1) pleuritic pain or hemoptysis, 2) isolated dyspnea, or 3) circulatory collapse were observed with comparable frequency among patients greater than or equal to 70 years old and younger patients. One of these presenting syndromes occurred in 64 (89%) of the 72 patients greater than or equal to 70 years old. Those who did not show these syndromes were identified on the basis of unexpected radiographic abnormalities, which may have been accompanied by tachypnea or a history of thrombophlebitis. Among the 72 patients greater than or equal to 70 years with pulmonary embolism, dyspnea or tachypnea (respirations greater than or equal to 20/min) occurred in 66 (92%), dyspnea or tachypnea or pleuritic pain in 68 (94%) and dyspnea or tachypnea or radiographic evidence of atelectasis or a parenchymal abnormality in 72 (100%). Complications of angiography were evaluated among patients with and without pulmonary embolism. Major complications of pulmonary angiography among patients greater than or equal to 70 years old (2 [1%] of 200) were not more frequent than among younger patients (6 [1.1%] of 562) (p = NS). However, renal failure (major or minor) was more frequent in patients greater than or equal to 70 years old than in younger patients (6 [3%] of 200 versus 4 [0.7%] of 562) (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnosis of acute pulmonary embolism in the elderly. 193 45

Pericarditis and cardiac tamponade are very rare complications of inflammatory disease of the bowel. A case of a patient with ulcerative colitis, who subsequently developed pericarditis, cardiac tamponade and pleural effusion during a latent phase of the baseline disease, is presented. At the same time, the papers published on this subject are reviewed. The presence of dyspnea, tachypnea, of pleuritic pain in patients with ulcerative colitis must be taken into consideration, and all the tests necessary to study a pleuropericardial pathology should be performed.
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PMID:[Acute pleuropericarditis and cardiac tamponade as extraintestinal complications of ulcerative colitis]. 210 13

Endogenous opioid peptides have been implicated in the regulation of pain perception, behaviour, gastrointestinal activity and other physiological responses. However, the functional role of these peptides in the horse has yet to be elucidated. The opioid antagonist, naloxone, is often administered to infer endogenous opioid effects. In the present study, naloxone (0.75 mg/kg bodyweight) was administered to eight Thoroughbred racehorses and a number of behavioural and autonomic responses were measured. Naloxone produced rapid onset diarrhoea, restlessness, abdominal checking, tachycardia, tachypnoea, paradoxical yawning and diaphoresis. These responses described an acute abdominal distress syndrome similar to spasmodic colic. Results from this study suggest that, in the horse, endogenous opioids: 1) influence behaviour, 2) modify intestinal activity and sensation, and 3) if perturbed, may be involved in pathophysiology of colic.
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PMID:Naloxone-induced abdominal distress in the horse. 220 19

A 69 yr old man was admitted with a 10 day history of fever, arthromyalgia, dyspnoea, dry cough and pleuritic pain. Temperature was 38 degrees C; tachypnoea 36 rpm. Extensive crackles were audible over both upper lung fields. Chest X-ray showed bilateral alveolar infiltrates. Forced vital capacity was 49% of predicted, and carbon monoxide transfer coefficient was 32% of predicted value. The patient had been taking carbamazepine for one month because of a trigeminal neuralgia. After withdrawal of the drug he gradually recovered.
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PMID:Carbamazepine and the lung. 229 88

We describe the clinical characteristics and actuarial survival of a consecutive cohort of 41 patients with rheumatoid arthritis and clinical pericarditis who were seen at the Mayo Clinic between 1970 and 1987 and followed up until death or through 1987. The survivors were followed up for a median of 5.1 years. Approximately three-fourths of our patients had acute pericarditis, the remainder having recurrent acute pericarditis, chronic pericarditis with effusion, or chronic constrictive pericarditis. Most patients had symmetrical joint swelling, morning stiffness, subcutaneous nodules, rheumatoid factor, and classic radiographic changes of rheumatoid arthritis. Common extra-articular features included fatigue, loss of weight, and fever. Dyspnea or orthopnea, typical pericardial pain, peripheral edema, tachycardia, tachypnea, a diminished mean blood pressure, a pericardial friction rub, jugular venous distension, rales, radiographic evidence of cardiomegaly and pleural effusions, and abnormal echocardiograms were the most common cardiac manifestations. An elevated erythrocyte sedimentation rate and anemia were other common laboratory findings. Our cohort demonstrated decreased survival in comparison with an age- and sex-matched North Central white population (from the upper midwestern United States), especially during the first year after diagnosis. Increasing age, the presence of other heart disease, an increasing total number of other extra-articular manifestations of rheumatoid arthritis, jugular venous distention, and a lower mean blood pressure were associated with decreased survival.
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PMID:Rheumatoid pericarditis: clinical features and survival. 231 40

Two macroscopic term neonates are described who presented with uncomplicated tachypnoea immediately following vaginal delivery. The tachypnoea was not associated with lung injury, metabolic, endocrine or cardio-respiratory disease but with multiple unilateral posterior rib fractures. The neonatologist should be aware that neonatal tachypnoea immediately after vaginal term delivery, especially in macrosomic infants, may be caused by the pain of fractured ribs. The diagnosis can be made only by careful inspection of the ribs on chest X-ray.
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PMID:Rib fractures as a cause of immediate neonatal tachypnoea. 395 37

We have prospectively treated 36 patients with flail chest using a treatment protocol for limited use of mechanical ventilation. Age of the patients ranged from 6 months to 83 years. Patients were divided into three groups dependent upon their clinical presentation and need for respiratory support: Group I patients had severe pulmonary dysfunction-tachypnea, dyspnea, arterial PO2 less than or equal to 60 torr, arterial PCO2 greater than or equal to 50 torr or shunt fraction greater than or equal to 25%. Group II patients had no pulmonary dysfunction but did require temporary respirator support for an associated injury. Group III patients had no pulmonary dysfunction. Thirteen patients were assigned to Group I. They required respiratory support for an average of 10.5 days; 11 of the 13 had complications, and there were two deaths in this group resulting from a combination of respiratory failure and myocardial infarction. Seven patients were assigned to Group II. six patients were extubated immediately postoperatively; one patient with a head injury was hyperventilated for 48 hours to reduce intracranial pressure and then extubated. Sixteen patients were assigned to Group III. Fifteen required no ventilatory support. One 83-year-old man developed pneumonia and was mechanically ventilated for 31 days. Early effective pain control and chest physiotherapy were critical to success and were used in all patients. Increase in respiratory rate, fall in tidal volume or vital capacity, and increased pain were used as criteria for administration of analgesia. Nonventilatory therapy of flail chest reduces morbidity, mortality, and hospital cost.
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PMID:Selective use of ventilator therapy in flail chest injury. 700 49


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