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

Telemetry and conventional cardiotocography were compared by monitoring the labor of 60 patients with an uneventful pregnancy and delivery in the 38th-42nd week of pregnancy. 31 patients were monitored by telemetry and 29 by cardiotocography. The patients were matched for age (+/- 5 years), duration of pregnancy (+/- 7 days) and parity (I or II). The husband attended labor and delivery in 42% of the cases in the telemetry group and in 59% of the cases in the control group. Induction of labor by amniotomy was performed in 32% of the cases in the telemetry group and in 24% of the cases in the cardiotocography group. The patients monitored subjective pain every half hour during the opening phase. The telemetric patients were encouraged to sit or walk during the first stage. No maternal or fetal complications occurred. All infants were born in good condition with APGAR scores greater than or equal to 7 recorded at one and five minutes. There were 4 operative deliveries in the telemetry group and 5 in the control group. Indications for these were maternal or uterine exhaustion with the exception of two control patients where fetal asphyxia was suspected. The duration of the first stage of labor did not differ significantly between the telemetry and the cardiotocography groups. The telemetric patients received less analgesics than the controls but this difference was not significant. In spite of less analgesia in the telemetry group, the secondparas of the telemetry group experienced significantly less (p less than 0.01) labor pain than the controls. In addition, the secondparas of the telemetry group considered the present labor less painful than the previous one significantly more often than the controls. Among the primiparous patients there was no difference in the amount of pain experienced by the patients.
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PMID:The monitoring of labor by telemetry. 706 28

The involvement of endogenous morphines (enkephalins and endorphins) in the regulation of pain is demonstrated by the following experimental evidence: (a) their analgesic activities; (b) their distribution in the central nervous systems; (c) the effects of their modifiers, especially of their antagonists, on nociceptive reactions and (or) on various types of analgesia; (d) rare modifications of their brain levels in pain and (or) analgesic states. Besides the well-known facts, the following items are particularly stressed: the functional roles of hypothalamic structures and of the pituitary, the effects of antagonists, the variety of analgesia following noxious and (or) stressful stimuli, genetic and environmental factors, endogenous antinociceptive substances other than opioids, relations with biogenic amines. As a whole, endogenous morphines apparently filter the particular important sensory input represented by nociception and control the reactions to pain, allowing for adjusted behaviour, if the stimuli are avoidable, or for prevention or at least delay of exhaustion if the stimuli are unavoidable.
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PMID:Endogenous morphines and pain. 734 Apr 54

This study aimed at evaluating the influence of submaximal isometric contraction on pressure pain thresholds (PPTs) in 14 healthy volunteers before and after skin hypoesthesia. PPTs were determined with pressure algometry over m. quadriceps femoris before, during, and following an isometric contraction. Maximum voluntary contraction (MVC) was assessed using a computerized dynamometer. A contraction of 21% MVC was held until exhaustion (max: 5 min) and PPTs were assessed every 30 sec. A local anesthetic cream and a control cream were applied following a double-blind design and PPTs were reassessed. PPTs increased significantly at the start of contraction and continued to increase until the middle of the contraction period, then remaining at this level. After contraction PPTs decreased significantly but for 5 min remained slightly above precontraction levels. Anesthetic cream raised PPT at rest but not during and following contraction. The relative increase in PPTs during and immediately following isometric contraction was lower with anesthetic cream. Isometric contraction of m. quadriceps femoris increase PPTs during and following contraction. The results suggest that input from cutaneous and deeper tissues interacts with nociceptive activity set up by the pressure stimulus. Determining the degree of sensory modulation in muscle and skin in different chronic pain syndromes could become a functional method of patient assessment important for differential diagnosis, treatment evaluation, and follow-up.
Pain 1995 Jun
PMID:Modulation of pressure pain thresholds during and following isometric contraction. 747 92

The aim of this quasi-experimental study was to examine the effects of maternal pethidine during labour on the developing breast feeding behaviour in infants in the first 2 h after birth compared with infants not exposed to pethidine. Forty-four healthy infants were observed immediately after birth. They were placed skin-to-skin on their mothers' chests. The development of mouth and sucking movements as well as rooting behaviour and state of sleep/wakefulness were noted. The observer was blind as to the pain relief the mother had received during labour. Of the 44 mothers 18 had received pethidine. The main findings were that infants exposed to pethidine had delayed and depressed sucking and rooting behaviour. In addition, a smaller proportion of infants exposed to pethidine started to suckle the breast. Rooting movements which are expected to be vigorous at 30 min after birth were affected both by administration of pethidine and a longer second stage of labour. It is suggested that the differences found in sucking behaviour may be a central effect of pethidine. Depression of rooting movements in the pethidine group may be caused by exhaustion due to a longer second stage of labour and administration of pethidine. It is recommended that pethidine-exposed mother-infant couples stay together after birth long enough to enable the infant to make the choice to attach or not to attach to the nipple without the forceful helping hand of the health staff.
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PMID:Effects of maternal pethidine on infants' developing breast feeding behaviour. 775 97

Ultrasound scanning was performed at three sites above the fossa supraspinata on nine healthy subjects and five patients with myofascial shoulder pain. This method produced a well-defined depiction of the soft tissue layers above the fossa supraspinata and reproducible muscle thickness measurements. In the healthy subjects the average distance from the skin surface to the trapezius muscle was 7.7 mm and the average thickness of the trapezius muscle was 5.3 mm, and the average thickness of supraspinatus muscle was 20.0 mm. The supraspinatus muscle was thinner at the medial measuring site than at the other two sites. In contrast, a tendency towards a larger distance was seen from the skin to trapezius muscle at the medial measuring site than at the other two sites. No statistical differences were found between the two groups of subjects either at rest or during brief shoulder abductions. All the subjects performed a 30 degrees unilateral isometric shoulder abduction test to exhaustion. The median endurance time was 33 min for the healthy subjects and only 5 min for the patients. The ratings of perceived exertion (RPE) were in line with this, since the increment in RPE with time was larger for the patients than for the healthy group. The reduced shoulder abduction endurance time in the patient group may have been related to impaired muscle function and/or pain development. During the 33-min shoulder abduction in the healthy subjects, the thickness of supraspinatus muscle increased by 14%, indicating muscle swelling, whereas the thickness of trapezius muscle remained constant.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effect of prolonged isometric contractions on muscle fluid balance. 787 42

Gainful employment-related performance capacity is a central but rarely considered category of practical social medicine. Its evaluation belongs to the workday routine of social physicians. Special difficulties arise if chronic pain disorders are to be evaluated, especially in chronic "nonspecific" cases, i.e. in the absence of biomedically relevant signs. Employment-related performance is conceptualised as a multidimensional construct with several latent variables. It integrates and extends the domains of "impairments" and "disabilities" of the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) of WHO. Three basic dimensions are distinguished: one comprising biomedical, the other psychological, the third function-related variables. They are specified within a multidimensional model of employment-related performance. This includes different components of the perception and appraisal of pain, concomitant bodily complaints (e.g. vital exhaustion), psychological impairments as helplessness or anxiety, special facets of the pain behaviour, and functional limitations and allows an estimate of the chronification and prognosis of the pain problem. Some diagnostic measures are still inadequate in respect of established clinimetric standards. In particular, assessment of functional limitations requires further development and research.
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PMID:[Work capacity--a central category of practical social medicine]. 814 99

A new assessment of quality of life (QOL) was made for cancer patients. The QOL assessment consists of 12 items: pain; nausea; constipation; general fatigue; sleep; eating; activity; a daily life pattern; conversation; treatment acceptability; satisfaction at the present status and family exhaustion. Ranges of scores are one (best) to five (worst). For visual expression of QOL, the author made an original method called "QOL diagram", drawn with a circle which has 12 diverging lines marked five points indicating the score for each item. QOL changes after cancer pain control with either oral or intravenous morphine were examined in 22 adult cancer patients by the QOL assessment. Laxatives and anti-nausea drugs were mostly prescribed at the same time in order to avoid side effects of morphine. QOL was evaluated and recorded by the author through an individual interview with each patient. It was observed that the psychological factors were improved along with pain relief. Although items such as general fatigue, nausea, constipation, sleep and eating did not change considerably at first, they improved well with time in the oral morphine group. On the other hand, there was no marked time-dependent change in the intravenous morphine group. Items such as activity, a daily life pattern and conversation were rather negative than positive. These items seem to be more important to improve QOL of the cancer patients, in particular, whose general status is relatively good. In conclusion, the QOL diagram helped us to follow subtle changes of status and needs of cancer patients. And it enables us to easily assess risks and benefits of the treatment plans including palliative care and home supportive programs. It is designed for both patients and medical staffs to use easily and repeatedly. However, the further evaluation and refinement will be needed to verify validity and reliability of the QOL diagram before a routine clinical application.
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PMID:[A new assessment of quality of life (QOL) for cancer patients]. 815 53

Nine men [24.6 (SEM 1.1) years] carried out isometric contractions (IC) of the right elbow flexors at 50% and 100% of the maximal voluntary contraction (MVC). At 50% MVC they had to maintain IC until the limit time (isotonic IC: IIC50) and beyond for as long as possible (anisotonic IC: AIC50). At 100% MVC, IC was anisotonic since the decrease in force was immediate (AIC100). Measurements of the force, the integrated electromyogram (iEMG) and the heart rate (fc) were made during the entire period of contraction. There was a linear relationship between the iEMG increase and the fc increase for IIC50 and AIC100. This relationship was not found for AIC50. The role played by the peripheral information would seem to have become more important in fc regulation when the isotonic IC preceding the anisotonic IC was sufficiently long (submaximal IIC). It would seem that the idea of muscle exhaustion at the limit time was only relative, and depended greatly on the subject's motivation and his capacity to endure a certain degree of pain.
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PMID:Changes in the heart rate and electromyogram beyond the limit time of an isotonic isometric contraction. 822 31

Because of their considerable socioeconomic costs rheumatic symptoms are a major concern in industrialized nations. Our study provides data on the prevalence of rheumatic symptoms in the general population and on their physical and psychosocial impact. We performed a survey of 1814 randomly selected non institutionalized persons, aged 40 to 69 years, living in the Federal Republic of Germany. The selected subjects were asked whether they had pain in one or more of the following sites: neck/back, joints of upper extremities, joints of lower extremities. Physical and psychosocial disability was assessed using a multidimensional questionnaire that included a German version of the Arthritis Impact Measurement Scales (AIMS) and validated instruments concerning psychosocial dimensions of health status. The prevalence of rheumatic symptoms increases between 40 and 59 years and decreases thereafter. Rheumatic symptoms are more frequent in women than in men. The predominant pain localization is the back. Individuals reporting pain in one region (back, upper and lower extremities) often feel pain in other areas as well and often suffer from additional symptoms such as weakness and sleep disturbance. We found significant disabilities in physical (mobility, activities of daily living, physical activities) and psychosocial (depression, anxiety, exhaustion, family problems) dimensions of health status in subjects reporting rheumatic symptoms.
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PMID:[Epidemiology of rheumatic complaints in Germany. Data on the prevalence and physical and psychosocial disability]. 825 19

The PPS is now a well-recognized entity encompassing the late manifestations that occur because of previous poliomyelitis. Common signs and symptoms include fatigue, cold intolerance, joint deteriorations with pain, and prominent neurologic problems that include new weakness, muscle pain, atrophy, respiratory insufficiency, dysphagia, and sleep apnea. It is estimated that there are 1.63 million polio survivors in the United States and that half of them will develop PPS. PPS and PPMA usually begin 30 to 40 years after the acute illness and are very slowly progressive. The etiology is unclear, although premature exhaustion of the new sprouts that develop after acute poliomyelitis and of their motor neurons appears most likely. Less likely is a persistent polio-virus infection or an immune-mediated problem. Treatment is primarily supportive, although nonfatiguing strengthening exercise may improve strength over the short term. The long-term effects of this type of exercise remain to be clarified.
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PMID:Post-polio syndrome: an update. 827


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