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

1. Not all tumor patients but only about 10% of ambulatory and 30-40% of hospitalized patients in a medical oncology department experienced pain. 2. Excruciating pain is extremely rare (1-2%), and pain in tumor patients does not always automatically mean "tumor progression". Quality and etiology of pain must be assessed and adequately treated. 3. The best and longest-lasting pain relief is experienced with specific antineoplastic therapy, even if only of palliative intention. 4. Local pain relief measures (by surgery, radiotherapy, nerve blocks) should be discussed prior to the introduction of unqualified chronic pharmacologic pain relief. 5. In chronic tumor pain with no possibility of specific or local treatment, effective pain relief by analgesic drugs represents the most valuable therapy left. 6. Pain prophylaxis (at appropriate dosage intervals) is advisable, preferably with oral analgesics and based on successful step-wise guidelines. 7. Effective pain therapy and prophylaxis foster ameliorated life quality and social integration and should not simply "switch off" the patients from the people caring for them. 8. The influence of the patient's psychological background on the intensity and/or frequency of pain should not be disregarded (problem solution).
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PMID:[Pain and pain relief in tumor diseases]. 618 12

In 44 patients with complex degenerative, traumatic, neoplastic and infectious disorders of the cervical spine an aggressive surgical approach was used, consisting of spondylectomy, radical microsurgical decompression and osteosynthesis. The patient group consisted of 23 patients with multisegmental cervical spondylosis, 9 patients with primary or metastatic malignant tumour disease spread along the cervical spine, 6 patients with complex cervical trauma and 6 patients with infection affecting one or more cervical segments. Considering the heterogeneity of the group of patients treated, a multitude of neurological symptoms and signs were present. Excruciating pain was the predominant symptom in 84% of the patients, followed by sensory and motor signs of varying degrees in 77% and 65% respectively. Involvement of the long tracts was present in 51%, gait disturbance in 49% and bladder disfunction in 28%. Considering the nature of the underlying disease, in the group with multisegmental cervical spondylosis (MSCS), advanced cervical myelopathy was the predominant clinical symptom, whereas in those patients with trauma, tumour or infection, pain was the leading symptom, followed by disturbed motor and/or sensory function. Altogether 59 vertebrae have been removed in the 44 patients. In 28 patients spondylectomy was performed at one level, in 15 patients at two levels and in one female tumour patient at three levels. In 34 patients an iliac crest bone graft was used and in 10 patients bone cement. Within the observation period, solid fusion was achieved in all patients. In one tumour patient screw loosening was demonstrable at follow-up, but the fusion remained stable. 2 patients with infectious disease required re-operation due to significant loosening of screws and plates. However, after re-stabilization solid fusion was achieved. Considering amelioration of specific pre-operative symptoms and signs, excruciating pain responded best to the stabilizing procedure, with improvement in over 90% of the patients, followed by improvement of sensory and motor deficits in 85% and 82% respectively. Improvement in pre-operative gait disturbance could be achieved in 81% of the patients, while disturbance of bladder function is less likely to improve after surgery with a positive response in only 58%. None of the patients became neurologically worse after surgery. With regard to the underlying disease, patients with MSCS and tumour had the best results with overall improvement in 62% and 75% respectively. While in patients with infection improvement could be achieved in 58%, improvement in trauma patients was demonstrable in only 34% while in 66% the pre-operative clinical status remained unchanged.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Spondylectomy, microsurgical decompression and osteosynthesis in the treatment of complex disorders of the cervical spine. 830 55

Complex regional pain syndrome (CRPS) is a regional neuropathic pain syndrome. Excruciating pain often interferes with patients' ability to function normally. Spinal cord stimulators (SCS) have been effective in treating pain along with signs of sympathetic overactivity in patients with CRPS. Implantation of SCS is a high-risk interventional procedure with the potential for serious bleeding and neurological consequences in the spine. Meticulous evaluation and careful optimization are needed in patients with bleeding disorders.
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PMID:Spinal Cord Stimulator Placement in Patient With von Willebrand Disease: A Case Report. 3197 22