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

Ergometrine test was undertaken on the 1--3d day after hospitalization in 49 patients with unstable angina pectoris. Pain or ECG changes were recorded in 90% of patients. Reactions with the rise of the ST segment and changes of the T wave on ECG were interpreted as "spastic" and were seen in 43% of cases. Myocardial infarction supervened during hospitalization in 19% of patients with "spastic reactions", and in 14.3% of other patients. Selective coronarography was performed in 33 patients. During coronarography the local spasm of one coronary artery supervening always at the site of organic stenosis was seen in 10 patients (30%). Spastic reactions in angina pectoris can be elicited relatively frequently, but nonspecific reactions are possible, with low tolerance of haemodynamic shifts caused by ergometrine. In the initial angina pectoris, immediately preceding myocardial infarction ergometrine may cause no reaction. An increased tendency of atherosclerotic coronaries to spasm plays a definite role in the development of unstable angina pectoris, in a part of patients only (or only in a certain phase of its course). Such reactions are not associated with a considerably increased danger of development of myocardial infarction.
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PMID:[Unstable stenocardia: the reaction to ergometrine administration]. 706 86

Ergometrine (ergonovine) tests were performed in patients with unstable angina on the 1st day of hospitalization, on 2nd--3rd days during which patients received only nitroglycerin sublingually for acute pain relief (33 observations), and after "stabilization" of their condition by calcium antagonists or/and beta-blockers (34 observations). Reactions to ergometrine were classified as spastic when pain was accompanied by ST segment elevations of T wave changes and as nonspecific when intravenous ergometrine resulted in ST segment depression and/or anginal attack. Spastic reactions to ergometrine observed in the acute period as a rule disappeared with "stabilization" of patients condition. Spontaneous rapid disappearance of spastic reactions was noted in 4 of 15 patients. Spastic reactions also disappeared in 13 of 17 patients while they were on active antianginal therapy. Disappearance of spastic reactions was observed more frequently in patients treated with calcium antagonists than with beta-blockers. Nonspecific reactions never disappeared spontaneously. Persisting despite therapy any positive reaction to ergometrine was prognostically unfavorable.
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PMID:[Unstable angina pectoris: results of repeated ergometrine tests]. 709 72

Spastic subluxation of 64 hips in 45 patients with cerebral palsy (CP) was reviewed in a 19-year follow-up. Varus osteotomy prevented dislocation in all patients. All nine hips that later dislocated were in quadriplegic patients who had not received treatment or who had had muscle releases. Dislocated hips had the most degenerative arthritis, pain, and the least movement. Subluxated hips also had more degenerative arthritis but approximately the same level of pain as reduced hips.
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PMID:Long-term follow-up of hip subluxation in cerebral palsy patients. 841 50

The biopsychosocial dimensions of esophageal diseases are recently being recognized. Globus sensation is not associated with augmented or spastic upper esophageal sphincter function, but patients do have a high level of somatic concern, anxiety, or depression. Spastic esophageal motility disorders are frequently triggered by both physiological and psychological stressors. In susceptible patients, anxiety increases the report of reflux symptoms, but not the actual amount of acid reflux, whereas relaxation therapy decreases both reflux symptoms and total acid exposure time. Patients with chest pain of unknown cause have increased somatic concern about heart disease, anxiety, depression, and esophageal specific visceral hypersensitivity to balloon distention. Psychotropic drug therapy to increase pain thresholds and modulate psychiatric disease and behavioral therapies are appropriate in selected patients with esophageal diseases.
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PMID:Psychophysiological interactions in esophageal diseases. 890 31

Spastic disorders of the esophagus are found in up to 50% of patients referred for manometry, therapy representing the most prevalent motility disorders in clinical practice. They share in common their manifestations of hypermotility, one of two principal types of esophageal motor dysfunction. Diffuse esophageal spasm is segregated from the nonspecific spastic disorders because of its demonstrated interference with bolus transit. However, the overlap among the spastic disorders in manifestation, course, and management is great; segregation of any disorder within this group is not of paramount importance. Spastic disorders, pain reproduction with provocative testing, and psychological abnormalities are coprevalent in patients with unexplained symptoms, but a cause-effect relationship of the motor abnormalities with the other findings is not established. The physician's charge in determining the relevance of a spastic disorder to the clinical presentation and for creating a treatment plan is to establish a direct relationship of motor dysfunction with symptoms-a task that may require correlation of transit abnormalities with symptoms using tests other than manometry. A variety of treatment options, invasive and noninvasive, are available today for patients who have spastic disorders, and each is effective in appropriately selected candidates.
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PMID:Spastic disorders of the esophagus. 919 29

Peripheral nerve blockade is one of the therapeutic options for spasticity of various muscles. Percutaneous nerve stimulation allows accurate location of nerves and neurolysis can be performed using intraneural injection of 65% ethanol or 5 to 12% phenol. Spastic contraction of various muscle groups is a common source of pain and disability which prevents efficient rehabilitation. Neurolytic blocks are possible in most of motor nerves of the upper and lower limbs and main indications are spastic sequelae of stroke and spinal trauma but also of multiple sclerosis, cerebral palsy and chronic coma. The use of percutaneous nerve stimulation allows accurate location and four nerves are more frequently treated: pectoral nerve loop, median, obturator and tibial nerves. In patients with spasticity of the adductor thigh muscles, nerve blocks are performed via a combined approach using fluoroscopy and nerve stimulation to identify the obturator nerve. No complications occur and minor side effects are transient painful phenomena during injection. These approaches have proved to be accurate, fast, simple, highly successful and reproducible. Percutaneous neurolytic procedures, should be performed as early as possible, as soon as spasticity becomes painful and disabling in patients with neurological sequelae of stroke, head trauma or any lesion of the motor neurons.
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PMID:[Alcohol neurolytic blocks for pain and muscle spasticity]. 1274

Spastic drop foot can be managed by physical measures, local pharmacological agents, oral anti-spastic drugs and surgical procedures. Recent studies have documented the clear effect of botulinum toxin type A (BTX-A) in the treatment of the spastic drop foot, particularly by reducing the resistance against passive movement and increasing the range of motion. Functional benefit and pain reduction have also been observed. The use of BTX-A is safe and free of serious side effects. Individual realistic treatment goals must be defined by the rehabilitation team before the treatment. Possible purposes of the treatment are the achievement of a straight foot to allow weight bearing or application of an orthosis and to reduce the premature activation of the calf muscles during gait. Other treatment goals are the facilitation of nursing care, as well as physical and occupational therapy. BTX-A injections can reduce pain, and prevent pressure ulcers or surgical interventions. Early physiotherapy or occupational therapy may increase the treatment effect of BTX-A. Close cooperation between the neurologist, physiotherapist, occupational therapist, nursing staff and other multidisciplinary rehabilitation team members is essential to maximize the benefit for the patients.
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PMID:[Treatment of the spastic drop foot with botulinum toxin type A in adult patients]. 1550 49

Peripheral nerve blockade is one of the therapeutic possibilities to treat spasticity of various muscles. Percutaneous nerve stimulation allows accurate location of nerves and neurolysis can be performed using intraneural injection of 65% ethanol or 5 to 12% phenol. Spastic contraction of various muscle groups is a common source of pain and disability which prevents from having efficient rehabilitation. Test-blocks as well as neurolytic blocks are possible in most of motor nerves of the upper and lower limbs and main indications are spastic sequelae of stroke and spinal trauma but also of multiple sclerosis, cerebral palsy and chronic coma. The use of percutaneous nerve stimulation allows accurate location and four nerves are more frequently treated: pectoral nerve loop, median, obturator and tibial nerves. In patients with spasticity of the adductor thigh muscles, nerve blocks are performed via a combined approach using fluoroscopy and nerve stimulation to identify the obturator nerve. No complications occurred and minor side effects are transient painful phenomena during injection. These approaches proved to be accurate, fast, simple, highly successful and reproducible. Percutaneous neurolytic procedures should be done as early as possible, as soon as spasticity becomes painful and disabling in patients with neurological sequelae of stroke, head trauma or any lesion of the motor neuron.
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PMID:[Peripheral neurolytic blocks and spasticity]. 1595 Jan 14

Reconstructive hand surgery improves the ability to meet the needs of daily life and the independence of patients who have lost their upper extremity function due to cervical spinal cord injury. Tendon transfer procedures provide the potential to restore key functions, such as elbow and wrist extension or hand grip control, ameliorate joint balance, reduce pain in spasticity and prevent joint contractures. The choice of the optimal donor muscle should be based on a thorough understanding of the biomechanical principles of the muscle-tendon unit. Intraoperative sarcomere length measurements allow to predict and set the optimal muscle-tendon unit length during reconstructive upper extremity surgery in order to prevent overstretch which may lead to insufficient active force generation. Macro-proteins and the extracellular matrix are in charge of the muscle ultrastructure, elasticity and thus passive muscle tension. Spastic muscles are characterized by greater stiffness, a shorter sarcomere length and an extracellular matrix with inferior mechanical properties. Basic science research and clinical studies in cooperation with international centers are of great importance to promote the development of refined techniques of surgical reconstruction and postoperative rehabilitation of upper extremity function in tetraplegic patients.
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PMID:[New concepts in reconstruction of arm and hand function in tetraplegia--basic research and clinical application]. 1614 30

Lower dyspeptic syndrome is a bowel disease manifesting namely with pain or sensation of abdominal discomfort and bowel movement problems (changes in the frequency and stool consistency). Symptoms include sensation of intraabdominal pressure and fullness, diarrhoea (with or without pain), sensation of incomplete defecation, constipation or bowel movement problems (with or without pain), irregular stool, collywobbles and bowel content flow (borborygia with spasms), meteorism, flatulency. Prevalence of the Irritable Bowel Syndrome in the European population is estimated to be 5 to 25 %. In the Czech Republic the total prevalence of dyspepsias is about 13 %. To the pathogenesis of the lower dyspeptic syndrome contribute: 1. abnormal motility, 2. abnormal visceral perception, 3. psychosocial factors, 4. luminal factors, 5. imbalance of neurotransmitters and/or intestinal bacteria and 6. possible inflammatory changes of the intestinal mucosa. Infectious diarrhoea is one of the causes. Functional bowel defects represent various combinations of chronic and recurrent symptoms from the digestive tract which cannot be explained by structural or biochemical abnormalities. Irritable bowel syndrome is a functional defect manifesting with abdominal pain, intestinal dyspepsia and compulsive defecations. Subtypes with typical symptomatology are characterized by circumstances which bring about pain and compulsive defecations (morning fractional defecation, postprandial defecation, debacles). Functional diarrhoea manifests with diarrhoea without intensive pain. Spastic obstipation manifests by abdominal pain, obstipation, compulsive defecations are absent, stool is cloddish, fragmented by spastic haustration, or it has a ribbon-form. Changes in the intestinal chemism include fermentative and putrefactive dyspepsia. Among the incomplete and atypical forms the isolated meteorism, irregular defecation, flatulency, abdominal pain--syndrome of the left or right epigastium or the syndrome of the right hypogastrium can be included. In patients with typical set of symptoms the working diagnose of the lower dyspeptic syndrome can be done by general practitioner. Complete history of the disease can reveal possible extra abdominal cause of dyspepsia, recognise alarming symptoms and consider circumstances elevating or lowering the probability of functional problems. Functional bowel problems have usually long-term character and represent clinically demanding challenge. Only few therapeutic regimens are successful and the therapy aimed at the abolishment of one symptom need not bring general improvement. For the clinical studies of the therapy of functional bowel problems significant placebo effect is typical. Quoad vitam prognosis is good, quoad sanationem it is rather doubtful.
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PMID:[Lower dyspeptic syndrome. Recommended diagnostic and therapeutic procedures for general practitioners 2006]. 1731 May 80


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