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

Extracorporeal shock wave lithotripsy (ESWL) has been the fundamental treatment applied to 88 patients with renal calculi in a solitary kidney. Epidemiological information is given, including lithiasis antecedents and associated pathologies as well as the etiology of the solitary kidney, location and size of stones. The initial treatment was ESWL in 83 patients, ureteroscopy in 2, surgery in 2, and percutaneous nephrolithotomy in 1. Three months after treatment in the ESWL group, 68 patients were completely free of stones and 15 had insignificant caliceal residual fragments. The rest of the patients were treated successfully using the above methods. The secondary complications of ESWL were colic pain (20 cases), fever (13 cases) and obstruction (9 cases).
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PMID:Treatment of lithiasis in the patient with a solitary kidney. 321 27

This article discusses some of the rationales for the medical management of colic during the initial treatment period. The issue of colic pain control and the masking of clinical signs that may indicate severe gastrointestinal disease is addressed. Therapeutic considerations related to dehydration, metabolic imbalances, hemostatic disorders, antimicrobial therapy, fecal consistency, gastrointestinal decompression, and regulation of intestinal motility are reviewed.
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PMID:Initial treatment of colic. 328 95

The management of the patient presenting to the Emergency Department with nephrolithiasis or renal colic should include evaluation of the patient for concurrent diseases, risk factors for stone formation, and possible etiologies for stones. Suspicion of ureterolithiasis is based on a cogent history and physical examination and reinforced by a finding of hematuria. Diagnosis should be based upon a promptly performed intravenous pyelogram, unless the patient is truly allergic to contrast media or has substantial risk of a contrast-induced renal failure. A solitary flat plate of the abdomen adds no useful information and is an unnecessary expense to the patient. Essential laboratory data include a urinalysis, CBC, and electrolyte, BUN, creatinine, and serum calcium levels. A urine culture should be obtained in all patients because urinalysis alone may not be sufficient to exlude a urinary tract infection. Initial treatment of the patient with an uncomplicated renal colic should include hydration, relief of pain, and reassurance. Evaluation by a consultant may be done as an outpatient on a nonemergent basis. If the colic has not resolved after 72 hours, hospitalization generally is recommended. If the patient has vomiting, dehydration, a complete obstruction, or a solitary kidney, hospitalization in indicated and urgent consultation recommended. If the patient has fever or other signs of infection, emergent consultation and immediate hospitalization are essential. Retained obstructing stones are generally managed by urologic consultants. It is in the care of the patient with the retained stone that greatest advances have been made in the past 10 years. Patients should be counseled that the retained stone no longer calls for extended hospitalization and convalescence.
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PMID:Nephrolithiasis. 329 30

In a prospective, double-blind, placebo-controlled study 18 patients were evaluated in regard to the effectiveness of glucagon to treat ureteral colic following extracorporeal shock wave lithotripsy. The study groups were comparable. There was no significant difference between glucagon and placebo in relief of pain or in the amount of gravel passed within 48 hours of treatment. We conclude that despite its desirable physiological attributes, glucagon has no demonstrable benefit in the treatment of ureteral colic following extracorporeal shock wave lithotripsy.
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PMID:Efficacy of glucagon in the relief of ureteral colic following treatment by extracorporeal shock wave lithotripsy: a randomized double-blind trial. 329 99

Experimental and clinical experience with compounds containing antimony have shown that the trivalent compounds are generally more toxic than the pentavalent ones. APT can cause severe pain and tissue necrosis and is therefore not given by intramuscular or subcutaneous injection. APT has the actions and uses of AST, but it is less soluble and more irritating than the sodium salt which is therefore more suitable for intravenous use. Trivalent antimony compounds are toxic when used topically. Adverse effects are similar for all trivalent compounds, and include nausea, vomiting, weakness and myalgia, abdominal colic, diarrhoea, and skin rashes, including pustular eruptions. Hypersensitivity reactions also occur. Respiratory symptoms include cough, dyspnoea, and chronic lung changes. Cardiotoxicity is the most important and may produce arrhythmias, myocardial depression and damage, Stokes-Adams attacks, heart failure, and cardiac arrest. Hepatic damage and necrosis, as well as blood dyscrasias, may occur. Toxic effects on the kidney may follow chronic use. Continuous treatment with small doses of antimony may give rise to symptoms of subacute poisoning, similar to those of chronic arsenic poisoning, due to accumulation of antimony in the body, especially if trivalent compounds are used, because of their long biological half-lives. Reproductive disorders and chromosome damage have been reported; antimony compounds are, therefore, potentially toxic to reproduction and have mutagenic, and oncogenic potential. Antimony compounds should, therefore, not be used during pregnancy or in the presence of hepatic, renal, or heart disease. Pentavalent antimony preparations especially the organic compounds, together with non-metallic synthetic preparations, such as the diamidines, have now replaced APT for use in leishmaniasis. Because of the toxicity of antimony compounds, investigations have been undertaken to reduce their adverse effects by combining them with chelating agents. These preparations appear to have reduced the toxic effects of antimony without affecting the efficacy of the preparations. Liposome-encapsulated antimony products have, more recently, been shown to be much less toxic because of the reduced dose of the antimony compound required for effective therapy. The historical uses of antimony were based on the belief that the topical and systemic adverse effects, for example, skin eruptions and diarrhoea and vomiting, were signs that the condition being treated was responding by being brought to the surface to relieve congestion at the diseased area. There is no evidence in topical use, but there is evidence that such use can cause severe reactions.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Toxicity of antimony and its compounds. 330 36

In ten patients, who underwent ESWL of renal calculi and had severe ureteral colic due to acute obturation of the ureteral lumen by larger stone fragments, i.v. glucagon injections combined with laevulose infusion were applied. All patients reported relief of pain and discomfort within 15-20 minutes after glucagon injection. Position of the stones in the ureter was regularly checked. No particular adverse effects of glucagon were noted. Glucagon increases GFR and diuresis and exhibits spasmolytic effect on the smooth muscle of the ureteral wall, thus facilitating the passage of stone fragments after ESWL. In certain cases and with certain indications we recommend the method as highly effective.
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PMID:A new method for the management of ureteral colic after extracorporeal shock wave lithotripsy. 340 92

Records of 20 horses with small intestinal disease causing acute colic and affecting the proximal portion of the small intestine were examined retrospectively. The disease was characterized by severe to moderate pain, which was replaced by depression, fever, gastric reflux, slight distention of the affected small intestine, leukocytosis, and high concentrations of total protein in the peritoneal fluid. Grossly, the affected intestines were hemorrhagic and had yellow discoloration. Histopathologic findings included submucosal edema, neutrophilic infiltration of the submucosal and laminal propria, and mucosal slough at the villous tips. Advanced lesions were characterized by mucosal sloughing with transmural edema, hemorrhage, fibrin deposition, and necrosis. No cause was determined. In 6 horses, bypass of most of the affected small intestine was helpful by alleviating the severe gastric reflux.
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PMID:Hemorrhagic fibrinonecrotic duodenitis-proximal jejunitis in horses: 20 cases (1977-1984). 355 72

Familial Mediterranean fever (FMF) has been observed in a Swiss child without ethnic predisposition. The case is analyzed and the current literature briefly reviewed. Recurrent attacks of fever, accompanied by abdominal pain, colic and arthritic symptoms, and often by pleuritic pain and a transitory skin rash, are the hallmarks of FMF, which is predominantly seen in ethnic groups of the Mediterranean area, notably Sephardic Jews, Turks and Armenians. However, it rarely occurs among individuals without an ethnic predisposition. Its most ominous manifestation is amyloidosis, which leads to chronic renal failure within a matter of years. Thanks to colchicine treatment, which is now widely accepted, patients often lead normal lives, and it appears that amyloidosis can be prevented.
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PMID:[Familial Mediterranean fever. Study of a Swiss child]. 356 45

Congenital cystic dilatation of the intrahepatic biliary ducts, known as Caroli's disease, is rarely recognized in general surgical practice and often overlooked. Until now little more than a hundred cases have been described although modern diagnostic procedures disclose more frequently new ones. Three patients with this anomaly have been treated by the authors during the past years and the different aspects concerning diagnosis and treatment are discussed and compared with existing information. In all three patients colic pain in the upper abdomen was the first symptom reported in the first years of life. In one patient jaundice and fever were associated with the abdominal pain and cholangitis developed a secondary biliary cirrhosis. Somatic underdevelopment, consequence of the cirrhosis in this child was observed. In two patients an intrahepatic hepaticojejunostomy was performed and a left hepatectomy in the third. In the two older children intrahepatic gallstones were found; in the younger one no stones were found inside the dilated ducts.
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PMID:[Cystic dilatation of the intrahepatic bile ducts (Caroli's disease)]. 356 75

Extracorporeal stone disintegration using a chemical explosive (10 mg. lead azide) as an energy source of underwater shock waves was performed in 105 patients 11 to 72 years old who had stones in the upper urinary tract. We used a prototype disintegrator in this series. The over-all rate free of stones 3 months after treatment was 82 per cent. Shock wave therapy was performed alone in 77 patients (73 per cent), while the remainder required combined treatment with percutaneous and/or transurethral lithotripsy. The most common complications were colic pain (30 per cent) and fever (23 per cent). In 4 patients other complications, that is bacteremia, gastrointestinal bleeding, ureteral injury and subcapsular renal hematoma, were observed but they were treated conservatively with no serious adverse effects. Our study demonstrates the safe use of this method for clinical treatment.
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PMID:Clinical application of extracorporeal shock wave lithotripsy using microexplosions. 357 73


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