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

Myocardial infarct in a 37-year-old woman treated with oral contraceptives (.1 mg mestranol and 1 mg ethynodiol diacetate) for 6 years is reported. The patient had received chest bruises in an auto accident 10 weeks before the infarct, but had experienced no pain at the time and had required no medical treatment. She noted chest pain, which disappeared after a short time, some 8 weeks after the accident. 10 weeks after the accident, she presented with typical signs of myocardial infarct; treatment included digitalis, diuretics, and a anticoagulants. Except for slight overweight and smoking (15 cigarettes daily) the patient had no heart risk factors. Coronary angiography revealed isolated subtotal stenosis of the left anterior descending artery. The etiology of the infarct is discussed.
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PMID:[The aetiology of myocardial infarction in young people. With special regard to nonpenetrating chest injury, oral contraceptives, smoking (author's transl)]. 121 17

A 16 year old teenager with chest pain came to the emergency room at Children's Hospital in Charleston, South Carolina. Her sharp, constant midsternal pain and breathing difficulties began the morning of admission. 1 week before admission, she experienced a similar but less intense pain which resolved spontaneously. She was taking low-dose, triphasic oral contraceptives (OCs) as treatment for severe dysmenorrhea and dysfunctional uterine bleeding. She had no family history of elevated lipids, blood or clotting disorders, and cardiovascular disease. She did not smoke. She was obese (137.3 kg). She had elevated blood pressure (147/33 mm Hg), a high low-density lipoprotein count (140 mg/dL), and a high total cholesterol count (237 mg/dL). Her tender right calf was larger than the left calf. She had decreased perfusion of the entire left lung and right lower lobe. A pulmonary angiogram revealed emboli, and ultrasound of the legs revealed a thrombus behind the right knee. The physicians discontinued the OCs. They administered 2 anticoagulants--intravenous heparin followed by oral sodium warfarin for 6 months. Her respiratory distress ended within several days. Her right calf was no longer tender after 1 week. The physicians discharged her on a low-cholesterol, low-fat diet. They suggested she reduce her weight and exercise more often. She did not experience another venous thrombosis or pulmonary embolus. It appeared that the OCs contributed to her thromboembolism; yet, she did lead a sedentary lifestyle and was considerably overweight. Even though thromboembolism is rare in adolescents with no underlying predisposition for cardiovascular disease and who do not smoke, physicians should watch for sizeable changes in blood pressure, lipids, and cholesterol level as well as symptoms of deep venous thrombosis and cardiovascular disease.
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PMID:Pulmonary embolus in an adolescent on oral contraceptives. 129 Jul 74

The lower limb length measurement is an important element for the diagnosis of mechanical or structural lumbar pain. Also it has been used for referral pain associated with hip or knee osteoarthritis or the groin and suprapubic areas. The aims of the present study were: 1) to measure the intra and inter observers variation; 2) to measure the intra-method variation using two different techniques for lower limb length measurement, one called the "apparent measure" (9) and comparing both with the radiological measurement technique. Two medical doctors, training on the techniques for lower limb measurement, performed the measurements. The exclusion criteria were flexion deformity of the hip or an overweight greater than 20% over the mean weight expected according to age and sex. A correlation coefficient and its 95% confidence interval (CI) were estimated, one tail test (Ho: r = 0.75). Seventeen patients fulfilled the inclusion criteria, 15 females and two males. The mean age was 35.8 years +/- 13.0 (SD). The correlation coefficient for the inter-observers variation using the "apparent measure" was 0.99 (CI = 0.985) and for the difference between legs it was 0.88 (CI = 0.10). The inter-observers variation for lower limb length measurement using the technique of "real measure" showed a correlation coefficient of 0.77 (CI = 0.95) and for the difference in length between legs it was 0.99 (CI = 0.85). The intra-observer correlation coefficient was 0.95 (CI = 0.85). The correlation coefficient for the inter-observer using the X-ray pictures was 0.98 (CI = 0.92).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Observer agreement in the measurement of leg length]. 152 54

Chronic neck pain is a relatively mild musculoskeletal condition, but common enough to be a possible public health problem. The distribution, determinants, and consequences of chronic neck pain have hitherto been described inadequately. In the Mini-Finland Health Survey, a representative population sample of 8,000 Finns aged greater than or equal to 30 years was invited to participate in a comprehensive health examination comprising an interview and a clinical examination; 90.2% complied. Predetermined criteria were used to diagnose major cardiovascular, musculoskeletal, respiratory, mental, and other disorders, regardless of other simultaneous disorders. Chronic neck syndrome was diagnosed in 9.5% of the men and 13.5% of the women. When adjusted for age and sex, the prevalence of the neck syndrome was associated with a history of injury to the back, neck, or shoulder and with mental and physical stress at work. Among those aged 30 to 64 years, overweight and parity were also significant determinants. Other musculoskeletal and mental disorders were associated with neck syndrome, and the association persisted after working conditions, injuries, overweight, and parity were adjusted for. There was some independent association between neck syndrome and disabilities, use of physician services, and use of pain killers.
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PMID:Prevalence, determinants, and consequences of chronic neck pain in Finland. 175 49

Pathological overgrowth of the epidural fat in the spine has been described and reported nearly exclusively in patients either with Cushing's syndrome or on chronic intake of glucocorticoids for a variety of clinical disorders. The authors report four patients with documented spinal lipomatosis (three pathologically and one radiologically). Only one of these patients received corticosteroids, and none had an underlying endocrinological abnormality. All four patients were adult males with a mean age at onset of symptoms of 43 years (range from 18 to 60 years). The symptoms ranged from simple neurogenic claudication and radicular pain to frank myelopathy. Myelography followed by computerized tomography were instrumental in the diagnosis of the first three patients; the fourth was diagnosed by magnetic resonance imaging. The thoracic spine was involved in two cases and the lumbosacral area in the other two. The different treatment modalities were tailored according to the symptomatology of the patients. These included weight reduction of an overweight patient with minimal neurological findings in one case and decompressive laminectomy and fat debulking to achieve adequate cord decompression in the remaining three cases. Two patients improved significantly, the condition of one stabilized, and the fourth required a second decompression at other spinal levels. The various modalities of treatment and their potential complications are discussed.
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PMID:Idiopathic and glucocorticoid-induced spinal epidural lipomatosis. 191 20

Obesity was confirmed as a possible aetiological and certainly promoting factor in the development of osteoarthritis (OA). One of the first clinical symptoms of OA is pain which does not always correspond with the X-ray picture of the damaged joint. The authors examined 11,124 obese subjects where they investigated X-ray changes of the hip joints, knees and heels and selected clinical symptoms. They correlated them with the degree of obesity, the duration of obesity and the subjects age. They revealed a direct correlation between the development of OA and all the investigated parameters. An alarming finding was that arthritis changes developed in the hip joints also in half the subjects with minor overweight and in particular that in one third of the obese subjects in the second and third decade pathological changes of the joints are present without causing subjects complaints. During a prolonged reducing regime attention must be paid to the possible development of osteopenia which may be also the source of pain. Obese subjects suffer pain also from nodes of non-inflammatory proliferated subcutaneous adipose tissue, venous insufficiency and trophic skin changes.
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PMID:[Pain and osteoarticular changes in obese persons]. 201 64

A heel orthosis combining the principles of weight redistribution and shock attenuation was dispensed to 30 subjects with heel pain. Relief or cessation of pain occurred in 73% of the cases. The factor most clearly and significantly associated with the effectiveness of the orthosis was a lesser degree of overweight. Within this prescriptive guideline, such a device has the potential of becoming a cost-effective and time-efficient way of treating heel pain of mechanical origin.
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PMID:Improvements in the design of viscoelastic heel orthoses. A clinical study. 227 36

Nineteen total knee arthroplasties in 16 patients were performed using a new prosthesis designed specifically for uncemented, press-fit fixation without any provision for tissue ingrowth. This design may be suited for use in patients with juvenile rheumatoid arthritis, postseptic knees, failed total knee arthroplasties with large bone stock deficiencies, and young, active, overweight individuals. Preservation of bone stock is possible because the fixation stems are nails rather than larger cement pegs, removal for revision is easier without cement, sequestration of microbes within cement cannot occur, and bone graft may be continually loaded with this type of prosthesis. Pain relief, discarding crutch support, operative blood loss, and corrective alignment were equivalent to results obtained with cemented arthroplasty. Seventeen of the 18 knees available for review (average follow-up period, 3 years, 7 months; range of follow-up period, 2 years, 10 months to 4 years, 11 months) were pain-free. Range of motion averaged -2 degrees of extension to 101 degrees of flexion. Ambulation was unrestricted and unsupported in the majority of patients. Radiographic evaluation showed the development of increased bone density under the tibial plateau as well as a sclerotic line at the ends of the femoral and tibial stems. This observation gives support to the theory that multiple microtrabecular fractures with healing form a new supportive "subchondral bone plate." There was one incidence of tibial subsidence. Prosthesis migration and loosening were not observed.
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PMID:Uncemented press-fit total knee arthroplasty. 229 85

A retrospective study has been carried out on 149 patients with hypertrophic breasts operated on during the period 1977 to 1979 using Skoog's technique of reduction mammaplasty. Both physical and psychological symptoms were investigated as well as the follow-up results of the operation as a whole, as judged by the patient herself. The observation time was 5 years and the average age of the patients was 39 years. 75% of the women were overweight or obese. The symptoms the middle-aged women indicated preoperatively to be caused by the hypertrophic breasts were pain in the neck, shoulders and back regions, and indenting bra straps, while psychological and cosmetic reasons were more common in younger women. The average reduction per breast was 1,100 g with 3,800 g as the largest total reduction. There was a positive correlation between the age of the patient and the tissue reduction, and a significant correlation between overweight and the amount of tissue reduced. Complications were more often seen when more than 1,500 g mammary tissue were removed or when the operation time exceeded 3.5 h. Infections, nipple necroses and pronounced scars were also positively correlated to overweight. The preoperative symptoms were cured or improved to 80-100%. 95.3% of the women were very satisfied (65.1%) or satisfied (30.2%) with the follow-up results while only 4.7% considered the results to be less satisfactory.
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PMID:The effect on the preoperative symptoms and the late results of Skoog's reduction mammaplasty. A follow-up study on 149 patients. 238 25

A case is reported of acute renal failure occurring after prolonged abdominal aortic bypass surgery in an overweight 69-year-old male patient. Preoperative serum creatinine concentration was normal. Surgery lasted for 6 h, and infrarenal aortic cross-clamping 2 1/2 h. The patient complained of important lumbar pain immediately after the operation. In the same time, oliguria and acute renal failure also developed (creatinine: 464 mumol.l-1; urea: 13 mmol.l-1). Rhabdomyolysis caused by the kidney-bridge was confirmed by the elevated blood creatine phosphokinase levels (16,000 IU.l-1 on the second postoperative day). A 99 m-Technetium methylene-diphosphonate imaging on the 10th postoperative day exhibited diffuse fixation in the paravertebral lumbar and thoracic muscles, extending from Th8 to L3. The acute renal failure regressed completely after haemodialysis.
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PMID:[Peroperative rhabdomyolysis caused by compression of a kidney-bridge. Value of muscular scintigraphy]. 253 65


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