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)

The authors review the advantages and disadvantages of general and regional anesthesia in bad clinical conditions. The purpose of this study was to evaluate the efficacy of Blended Anesthesia (association of general anesthesia with a regional technique) in 25 patients belonging to ASA classes II-III-IV, undergoing surgery for various disease. General anesthesia was provided by perfusion of propofol, after a peridural or subarachnoid continuous anesthesia was started. Patients were either in spontaneous or controlled ventilation. There were no cases of hypotension or other important side effects and the majority of patients judged good the anesthetic technique in regard to lack of pain, exhaustion and recall of operation.
 ...
PMID:[Intravenous anesthesia with perfused propofol combined with loco-regional spinal anesthesia]. 832 70

Pain is a complex, multidimensional perception with affective as well as sensory features. In part, it is a somatically focused negative emotion resembling perceived threat. Suffering refers to a perceived threat to the integrity of the self, helplessness in the face of that threat, and exhaustion of psychosocial and personal resources for coping. The concepts of pain and suffering therefore share negative emotion as a common ground. Examination of the central physiological mechanisms underlying pain, negative emotional arousal, and stress helps clarify the physiological basis of suffering and the causal influences of persistent pain and other stressors. Central mechanisms involve both limbic processing of aversive stimulation and disturbance of the hypothalamo-pituitary-adreno-cortical axis with consequent biological disequilibrium. The palliative care specialist can address suffering proactively as well as reactively by treating potentially chronic pain and symptoms aggressively and promoting the psychosocial well-being of the patient at every opportunity.
 ...
PMID:Suffering and its relationship to pain. 837 68

Work-related fatigue, pain and disorders in skeletal muscles have been related to prolonged static and dynamic activity. Such contractions have been shown to impair blood flow and increase muscle thickness and fluid. In the present study the effect of static and dynamic activity was evaluated from changes in masseter thickness as a measure of oedema, simultaneously with assessment of perceived pain/discomfort and cardiovascular responses. As static activity, fourteen young healthy women bit at 15% maximal voluntary contraction on bite-force transducers in the molar regions until exhaustion or 20 min at maximum (median endurance time 7.1 min). For dynamic activity, the same individuals chewed gum unilaterally until exhaustion or 40 min at maximum (all endured 40 min) with a cycle time of 725 ms, an average load of 9.3% of maximal electromyographic activity (maxEMG) and a peak mean voltage of 54.3% of maxEMG. Muscle thickness was measured by ultrasonography at the mid-portion of the ipsilateral masseter. Immediately after exercise, muscle thickness was significantly increased, more after static (14.0%) than dynamic (8.6%), and returned to pre-exercise values after 20-min recovery. Visual analogue scales (VAS) revealed the concomitant occurrence of pain (static 11.9 VAS%; dynamic 5.9 VAS%), and discomfort (static 8.1 VAS%; dynamic 5.9 VAS%), and both sensations decreased to pre-exercise values after 20-min recovery. Systolic blood pressure increased significantly, more during static (12.5%) than dynamic activity (4.3%), whereas heart rate rose significantly only during dynamic exercise (13.3%). Hence, activity was associated with muscular swelling and pain, and, despite the relatively small size of the masticatory muscles, also with general cardiovascular responses.
 ...
PMID:Ultrasonographic assessment of the swelling of the human masseter muscle after static and dynamic activity. 871 69

The authors present the results of denervation procedures treatment for 70 patients with persistent knee pain after total knee replacement, trauma, or osteotomy. In patients with total knee arthroplasty, aseptic loosening, sepsis, ligamentous instability, malalignment, and polyethylene wear had to be systematically ruled out as the source of pain. In patients with nontotal knee arthroplasty, arthrosis, synovitis, ligamentous instability, and meniscal derangement had been excluded as a source of pain. All candidates for the procedure had a successful selective nerve block. Sixty of the 70 (86%) patients were satisfied with the denervation procedure as judged by direct questioning and a reduction in their preoperative pain visual analog score of 5 or more points. The average Knee Society score improved from a preoperative mean of 51 points (range, 40-62 points) to a followup mean of 82 points (range, 15-100 points). Forty-nine of 70 (70%) patients had final Knee Society objective scores greater than 80. There was no difference in patient satisfaction whether the followup period was less than 2 years or more than 2 years. Selective knee denervation is indicated in the management of intractable knee pain after exhaustion of traditional approaches to any structural or infectious etiologies and after successful selective nerve block.
 ...
PMID:Partial denervation for persistent neuroma pain around the knee. 876 55

This study aimed at evaluating the influence of submaximal isometric contraction on pressure pain thresholds (PPTs) in 14 fibromyalgia (FM) patients and 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 22% MVC on average 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. In healthy volunteers PPTs increased during contraction (P < 0.001), then decreased after the end of contraction (P < 0.001) but remained above precontraction values during the 5 min of post-contraction assessments (P < 0.001). In FM patients PPTs decreased in the middle of the contraction period (P < 0.05) and remained below precontraction levels during the rest of the contraction period (P < 0.05) and during the 5 min of post-contraction assessment (immediately post-contraction NS; 2.5 min post-contraction P < 0.01; 5 min post-contraction P < 0.05). The normalized PPTs were significantly lower in patients than in controls during contraction (start P < 0.01; middle P < 0.001; end P < 0.001) and at all times during post-contraction assessments (P < 0.001). Anesthetic cream raised PPTs at rest in controls (P < 0.01) but not in FM patients, and did not influence contraction or post-contraction PPTs in either group. Therefore, the increased pressure pain sensibility in FM patients is more pronounced deep to the skin. The observed decrease of PPTs during isometric contraction in FM patients could be due to sensitization of mechanonociceptors caused by muscle ischemia and/or dysfunction in pain modulation during muscle contraction.
Pain 1996 Mar
PMID:Modulation of pressure pain thresholds during and following isometric contraction in patients with fibromyalgia and in healthy controls. 878 4

The care of elderly relatives with dementia is not any longer a job exclusively done by women nevertheless the care for three quarters of patients is mainly provided by women. This study comprises 70 persons consulting the "Alzheimer Advice Centre" in Leipzig. The aim was to examine the difference between nursing men and women with regard to the way they experience their situation. Independent of sex nursing persons experience their job as a strain. Especially spouses suffer from depressive disorders, states of exhaustion and pain in arms and legs. Nursing spouses differ in their ways of coping with regard to their sex. Wives experience the symptoms of dementia and the limitation of personal freedom as stressing whereas husbands pick out as a central theme the worries about their wives. Men use instrumental support in the nursing situation more often than wives. Altogether mainly women provide care. Sometimes they even take care of several persons. Therefore the resulting strains and limitations are to be regarded as special problems of women.
 ...
PMID:["I never feel free"--women care for the demented husband, father or mother]. 901 54

Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) has been introduced to improve outcome of CPR after cardiac arrest. Usually, ACD-CPR is performed with the rescuer kneeling beside the patient (ACD-B), but ACD-CPR with the rescuer in standing position (ACD-S) has been taught and applied in some centres in addition to conventional ACD-CPR (ACD-B). The aim of this randomised and cross-over study was to evaluate the new technique of ACD-S and to compare it with conventional ACD-B. Twelve professional rescuers (aged 30.8 +/- 7.9 years) applied both methods of ACD-CPR on a manikin. We obtained the following results. (1) Duration of CPR performance was comparable for ACD-S (13.2 +/- 7.1 min) and ACD-B (15.5 +/- 10.2 min, P = 0.48). (2) Pain in the upper extremity and pain in the vertebral column were the main reasons for break-off by the rescuers. Exhaustion was judged to be similar during ACD-S (5.3 +/- 2.3) and ACD-B (6.2 +/- 2.1; on a rating scale with 1 = no and 9 = complete exhaustion). (3) Oxygen consumption was significantly higher during ACD-S (P < 0.005), whereas heart rate and lactate levels did not differ. (4) Decompression forces were lower than compression forces. The averaged decompression forces in both methods were similar during the first 2 min and the last min. Compression forces decreased in ACD-S from 55.1 to 48.9 kp (P = 0.002) and in ACD-B from 52.8 to 47.0 kp (P = 0.069). We conclude that ACD-CPR in standing position can be considered equal to ACD-B in view of maximal duration of CPR, exhaustion of the rescuers and decompression forces. The decrease of compression forces in ACD-S and ACD-B as well as the difference between compression forces in ACD-S and ACD-B seem to be of no clinical relevance, and exhaustion was judged to be similar despite oxygen consumption being higher in ACD-S than in ACD-B.
 ...
PMID:Active compression-decompression cardiopulmonary resuscitation in standing position over the patient: pros and cons of a new method. 905 17

Predictors of isometric endurance of shoulder abduction were investigated in 18- to 75-year-old women (n = 59, mean age 48 years) and men (n = 53, mean age 46 years) with unilateral rotator tendinosis of the shoulder (median duration 1-2 years). They were asked to keep both shoulders abducted at 45 degrees, both wrists loaded with 2 kg, for as long as possible. The average force exerted to keep the required position was 17% higher in men compared to women. Mean times to exhaustion were: 103 seconds (SD 109) for the involved shoulder and 160 seconds (SD 81) for the uninvolved shoulder in women; compared to 159 seconds (SD 109) and 289 seconds (SD 109) in men. Increased pain, emotional distress and disability were associated with decreased endurance in the involved shoulder. Gender and emotional distress were the most powerful predictors of time to exhaustion in the uninvolved shoulder, and accounted for 41.7% of the total variance (R2). Age, body weight, self-efficacy for pain and active coping were poor predictors. This study indicates that isometric endurance is a psychophysiological measure in patients with shoulder pain. Reported pain, emotional distress and disability should be taken into account for interpretation of results.
 ...
PMID:Influence of anthropometric and psychological variables pain and disability on isometric endurance of shoulder abduction in patients with rotator tendinosis of the shoulder. 912 46

Variations in the levels of muscle hemoglobin and of myoglobin oxygen saturation can be detected non-invasively with near-infrared spectroscopy. This technique could be applied to the diagnosis of chronic compartment syndrome, in which invasive testing has shown increased intramuscular pressure associated with ischemia and pain during exercise. We simulated chronic compartment syndrome in ten healthy subjects (seven men and three women) by applying external compression, through a wide inflatable cuff, to increase the intramuscular pressure in the anterior compartment of the leg. The tissue oxygenation of the tibialis anterior muscle was measured with near-infrared spectroscopy during gradual inflation of the cuff to a pressure of forty millimeters of mercury (5.33 kilopascals) during fourteen minutes of cyclic isokinetic dorsiflexion and plantar flexion of the ankle. The subjects exercised with and without external compression. The data on tissue oxygenation for each subject then were normalized to a scale of 100 per cent (the baseline value, or the value at rest) to 0 per cent (the physiological minimum, or the level of oxygenation achieved by exercise to exhaustion during arterial occlusion of the lower extremity). With external compression, tissue oxygenation declined at a rate of 1.4 +/- 0.3 per cent per minute (mean and standard error) during exercise. After an initial decrease at the onset, tissue oxygenation did not decline during exercise without compression. The recovery of tissue oxygenation after exercise was twice as slow with compression (2.5 +/- 0.6 minutes) than it was without the use of compression (1.3 +/- 0.2 minutes).
 ...
PMID:Near-infrared spectroscopy for monitoring of tissue oxygenation of exercising skeletal muscle in a chronic compartment syndrome model. 919 80

At the Clinic for Orthopedic Surgery and Traumatology in Novi Sad, 79 adult patients with osteoarthritic hip dysplasia underwent total joint replacement surgery in the period 1984-1993. 45 patients were followed-up for an average time of 4.2 years. The results obtained have been evaluated following the criteria of Postel-Merle-d'Aubigne's hip rating system. After surgery 37 (82.2%) patients had minimal or no pain at all, while the hip flexion was over 75 degrees in 35 (75.5%) patients. 9% of patients could not walk longer than 20 minutes with a flexion under 50 degrees. Firm footfall and slight limp in exhaustion occurred in 35 (75.5%) patients, while 7 (15.5%) patients were extremely unstable and were able to get about on crutches. The gathered results confirm that total hip replacement in patients with osteoarthritic dysplastic hip improves stability and hip joint movement as well as pain reduction.
 ...
PMID:[Arthroplasty in the treatment of congenital anomalies of the hip in adults]. 922 83


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>