Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty consecutive patients undergoing transabdominal chorionic villus sampling (CVS) and 52 undergoing amniocentesis completed a questionnaire following the procedure to determine the amount of pain they experienced. Mild pain, discomfort only or no pain was reported by 96% undergoing amniocentesis and 90% with CVS. Moderate or severe pain was reported after completion of the CVS by 8% and following amniocentesis by 2%. Both procedures were well tolerated.
 ...
PMID:Pain with amniocentesis and transabdominal CVS. 208 84

Eighty-eight bipolar Bateman hip endoprostheses for medial femoral neck fractures were implanted. The average age of the patients was 75 years. Intrahospital results proved the morbidity and mortality rates to be well within acceptable limits. Thirty patients were followed during periods of 12-74 months (median, 33 months). According to Charnley evaluation, mobility was excellent and very good in 20 patients (86%). Good function was present in 63% of patients. The majority of patients belonged to category C as defined by Charnley. Mild pain was present in 19 patients (63%); in only two cases, involving severe rheumatoid arthritis, pain was clearly related to sinkage. Radiographically, no visible protrusion or socket wear was present. Periarticular ossification occurred in 19 patients, but this did not impair function.
 ...
PMID:Experience with bipolar prosthesis in femoral neck fractures in the elderly and debilitated. 229 84

Thirty-three anterior staple capsulorrhaphies of the shoulder were reviewed at an average 49.7 months postoperatively (range 12 to 127 months); one postoperative dislocation occurred. The patients' quality of athletic participation improved with surgical therapy in 50%, remained the same in 38%, and was lowered in 12%. Average loss of external rotation was 11.4 degrees with the arm adducted and 13.9 degrees with the arm abducted 90 degrees. A positive apprehension sign persisted in 50%. Shoulder function was good or excellent in 84%. Mild pain was admitted by 55%, moderate pain by 6%, and severe pain by 3%. Staple malpositioning or loosening was identified in 12 shoulders; six of these patients had attributable clinical problems. Biomechanical studies in porcine bone were used to demonstrate that predrilling facilitates proper staple positioning without compromising staple fixation strength and, in a synthetic trabecular model, that a 5 degrees variance in the alignment of the staple holder during staple insertion weakens the fixation strength by 51% (P less than .001). The operation usually prevents recurrent dislocation, permits recovery of normal (or near normal) shoulder motion, and allows satisfactory return to competitive athletics. If staple malpositioning and loosening occur, they may cause clinical problems, including degenerative arthritis. Though most patients (92%) stated they would again have the operation, when practical, we recommend other methods of repair of capsule and labral detachment.
 ...
PMID:Anterior staple capsulorrhaphy for recurrent dislocation of the shoulder: a clinical and biomechanical study. 234 30

From 1979 to 1984, 27 skiers who were either present or past members of the United States Ski Team or professional skiers had 30 ACL tears that were repaired primarily. Only two of the repairs were augmented with autogenous patellar tendon grafts. Five patients had complete knee dislocations, including tears of both cruciate ligaments. Nineteen patients had a concomitant extraarticular iliotibial band tenodesis. Twenty-seven knees (24 patients) were followed an average of 57.6 months postoperatively. Recreational skiing was resumed at 5.4 months on average, and in ski racing and pivot-requiring sports all but three patients resumed participation at an average of 9.1 months. In 78% of the knees there was pain-free function. Mild pain was reported in 19%, the majority of which (4/5) was related to vigorous activity. Of the total, only two knees were reported to have a sensation of giving way. On clinical examination 85% (23/27) had normal pivot shift examination with no evidence of abnormal motion. Four percent (1/27) had a 1+ test and 11% (3/27) had "glides." Arthrometer measurements revealed an average of 7.76 mm anterior displacement with 20 pounds of force on the knee with an ACL repair as compared to 5.56 mm on the uninjured knee. The laxity measurements of knees with repaired ACLs fell within the range reported for uninjured knees in the normal population. Five patients had reinjuries to the ACL at an average time of 28 months postoperatively, with two of five undergoing rerepair. Only one patient had an iliotibial band tenodesis to supplement the original ACL repair.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Anterior cruciate ligament repairs in world class skiers. 367 67

The present study investigated cardiovascular responses to three different laboratory stressors in either low or high heart rate reactors. It was predicted that there would be stimulus specific responses for either a mild pressure pain, mental arithmetic, or projective test stimulus. Mild pain was to reflect a passive coping condition, and mental arithmetic an active one while the projective test was to represent an ambiguous stimulus condition permitting idiosyncratic behavioral responding. Blood pressure and heart rate responses revealed the predicted small response to mild pressure pain and the predicted stress response to mental arithmetic. Low and high heart rate reactors did not differ in response to mild pain or the projective task but differed greatly in response to the arithmetic task. The data further indicated that low heart rate reactors responded with a larger response in blood pressure and heart rate to the projective test than to the mental arithmetic, whereas the high heart rate reactors displayed an inverse pattern. Psychological trait or situational, behavioral variables failed to predict the physiological response.
 ...
PMID:Cardiovascular response as a function of predisposition, coping behavior and stimulus type. 391 Aug 6

Twenty-eight patients with metaphyseal nonunion were evaluated retrospectively. Initially, all patients were thought to have healing of their fractures. Mild pain and/or instability with weightbearing or discomfort localized around the hardware were common symptoms of this nonunion; however, substantial pain was not a predominant feature. In the majority of cases, routine roentgenograms were not helpful in establishing the diagnosis. Overlapping hardware made visualization difficult; furthermore, the presence of a callus gave a false impression of fracture healing. Tomograms were done in 13 patients, but were not helpful in four patients. Stress views and examination under fluoroscopy were reliable means of making this diagnosis, particularly around the knee region. It was done, however, only in a few patients. Subtle changes in the position of hardware or the position of the fragments are also an indication of failure of union. The average time from the initial injury to the diagnosis of nonunion was 36 weeks. Five patients whose pain was attributed to the hardware were found to have a nonunion intraoperatively at time of attempted hardware removal. In one patient, the nonunion was diagnosed during a quadricepsplasty. In two patients, the diagnosis was missed a second time following revision of fixation and bone grafting. Diagnosis of metaphyseal nonunion requires a high index of suspicion, because it occurs among all age groups. It is not as rare as previously described and poses many difficulties. The authors recommend the use of additional studies, including tomograms or stress views, oblique to establish difficult diagrams.
 ...
PMID:Metaphyseal nonunion: a diagnostic dilemma. 786 50

Recent evidence has documented the deleterious physiologic effects of pain. The treatment of pain in children may be guided by a step-wise approach depending on its severity (Table 2). Mild pain can generally be controlled with a NSAID, such as ibuprofen, whereas moderate pain may require the addition of an orally active narcotic. Several approaches may be taken for the treatment of severe pain, including regional anesthetic techniques or the use of PCA to deliver intravenous narcotics. When such techniques fail, consultation with specialists in the field of pediatric pain management may be helpful.
 ...
PMID:Pain management of the pediatric patient. 812 54

Well known complications of proximal interphalangeal joint fractures and fracture dislocations are stiffness, chronic instability, and degenerative arthritis. The Compass PIP Hinge is a dynamic external fixator that allows protected proximal interphalangeal mobilization after closed reduction, open reduction and internal fixation, volar plate arthroplasty, or other salvage procedures. To help avoid these problems, 20 patients, 12 treated within 2 weeks of injury (Group I) and 8 treated more than 4 weeks after injury (Group II), are reported. Articular surface involvement among Group I cases averaged 66% (range, 50%-90%), and postoperative proximal interphalangeal motion for this group averaged 9 degrees to 82 degrees. Mild pain with heavy use was present in 3 patients, and 9 patients were pain free. Postoperative proximal interphalangeal motion for Group II averaged 21 degrees to 77 degrees. Pain was moderate to severe in 2 patients, mild with heavy use in 1 patient, and none in 5 patients. One patient from Group II underwent surgery to convert to a silicone proximal interphalangeal arthroplasty because of painful degenerative arthritis. It is concluded that there is a role for hinged external fixation in treating unstable proximal interphalangeal fracture dislocations. Outcomes in acute injuries are superior to those in chronic or salvage cases.
 ...
PMID:Hinged device for fractures involving the proximal interphalangeal joint. 864 Oct 76

The purpose of this prospective study was to evaluate the incidence of postoperative pain after intracanal procedures based on an antimicrobial strategy. Data were examined from 627 teeth that had necrotic pulps or required retreatment. Information was obtained for each patient treated with regard to presence of preoperative pain. Occurrence of periradicular bone destruction detected by radiographs was also recorded. The operators consisted of undergraduate students, who were in their first year of clinical training. Root canals were instrumented and then medicated with a calcium hydroxide/camphorated paramonochlorophenol paste. No systemic medication was prescribed. Approximately 1 week after the initial appointment, patients were asked about the occurrence of postoperative pain and the level of discomfort was rated as no pain, mild pain, moderate pain, or severe pain. Data were statistically analyzed using the Chi-square test. Mild pain occurred in 10% of the cases, moderate in 3.3%, and severe (flare-up) in 1.9%. Postoperative pain was significantly associated with the treatment of previously symptomatic teeth without periradicular lesions (p < 0.01). No other correlations were detected between the occurrence of postoperative discomfort and other clinical conditions. There was also no difference regarding the incidence of postoperative pain between treatment and retreatment (p > 0.01). The intracanal procedures used in this study to control root canal infections showed a small incidence of postoperative pain, particularly flare-ups, even performed by inexperienced undergraduate dental students.
 ...
PMID:Incidence of postoperative pain after intracanal procedures based on an antimicrobial strategy. 1206 29

Although therapeutic management of hypertrophic scars and keloids using contact or spray cryosurgery has yielded significant improvement or complete regression of hypertrophic scars and keloids, it requires one to 20 treatment sessions. This study was designed to assess the clinical safety and efficacy of an intralesional needle cryoprobe method in the treatment of hypertrophic scars and keloids. Ten patients, ranging in age from 3 to 54 years, with a total of 12 hypertrophic scars and keloids of more than 6 months duration and of diverse causes, were included in this study. The 18-month trial evaluated volume reduction of the hypertrophic scars and keloids after a single session of intralesional cryotherapy. Objective (hardness and color) and subjective (pain/tenderness and itchiness/discomfort) parameters were examined on a scale of 0 to 3 (low score was better). Pretreatment and posttreatment histomorphometric studies of the collagen fibers included spectral picrosirius red polarization and fast Fourier transformation orientation index. A specially designed cryo-needle was inserted into the long axis of the hypertrophic scars and keloids so as to maximize the volume of the hypertrophic scars and keloids to be frozen. The cryo-needle was connected by an adaptor to a cryogun filled with liquid nitrogen, which was introduced into the cryoprobe, thereby freezing the hypertrophic scars and keloids. After the hypertrophic scars and keloids were completely frozen, the cryoprobe defrosted and was withdrawn. An average of 51.4 percent of scar volume reduction was achieved after one session of intralesional cryosurgery treatment (average preoperative hypertrophic scars and keloids volume, 1.82 +/- 0.33; average posttreatment volume, 0.95 +/- 0.21; p < 0.0022). Significant alleviation of objective and subjective clinical symptoms was documented. Mild pain or discomfort during and after the procedure was easily managed. Only mild local edema and epidermolysis, followed by a short reepithelialization period, were evident. During the 18-month follow-up period, there was no evidence of bleeding, infection, adverse effects, recurrence, or permanent depigmentation. The histomorphometric analysis demonstrated rejuvenation of the treated scars (i.e., parallelization) and a more organized architecture of the collagen fibers compared with the pretreated scars. This study demonstrated the increased efficacy of this method as a result of increased freezing area of deep scar material compared with that obtained with contact/spray probes. As a result, fewer treatment cycles are needed. Because the reepithelialization period is short, treatment intervals, if any, can be shortened to 2 to 3 weeks. This intralesional cryoneedle method is simple to operate and safe to use, it necessitates less postoperative care of the wound, and it can easily be added to any preexisting cryosurgical unit.
 ...
PMID:Intralesional cryotherapy for enhancing the involution of hypertrophic scars and keloids. 1271 43


1 2 Next >>