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

The harmony of the occlusal components of the teeth, mandibular joint and muscles, were investigated in 180 human subjects by clinical, dental articulator, radiographic and electrodiagnostic methods. Significant correlations were found between disharmony of these components at median occlusal position (MOP), and with pain-dysfunction of the masticatory system. Using the standardized stimuli of opening the jaw wide and snapping it shut automatically into MOP, temporalis and masseter muscle co-ordination and somesthetic reflex effects were quantified. The interval from tooth contact (s) to reinstitution of EMG activity (x), and the EMG silent-period duration (SP), were prolonged in the patients but returned to within the control range with elimination of the pain-dysfunction. Muscle incoordination with mandibular dysfunction was prevalent in the patients, and the incidence of osteoarthritis was greatest in those with persistent symptoms. The hypothesis was supported that disharmony of MOP exists in pain-dysfunction patients--while successful occlusal therapy leads to the restoration of the harmony within the biologic range. This implies physiological significance to this hitherto clinically neglected occlusal position.
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PMID:The clinical significance of median occlusal position. 28 Jun 31

Postoperative physiatric treatment is an integral part of the replacement of hips, knees, ankles, shoulders, elbows, wrists, and digital joints. Neuromuscular substitution patterns and incoordination usually prevail after joint replacement because of the usual long-term expectation and experience of pain, limitation of motion, fatigue, weakness, and the unavoidable operative trauma. The goals of postoperative physiatric treatment, in line with those of joint replacement surgery, are relief of pain and reestablishment of comfortable, normal neuromuscular functions and their reasonable, safe application in appropriate activities of daily living and of locomotion. By close collaboration between the Department of Orthopedic Surgery and that of Physical Medicine and Rehabilitation, certain principles and detailed protocols of postoperative management have been developed over the last 10 years. These are described in some detail for each of the joint replacements. Optimal results can be achieved only through meticulous attention to physical and psychosocial details, with close cooperation and communication among the involved services and persons.
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PMID:Total joint arthroplasty: principles and guidelines for postoperative physiatric management. 47 Apr 59

The basic conservative therapy programs for elderly patients with arthritis include adequate physical rest and mental relaxation, analgesics, aspirin, and physical rehabilitation consisting of occupational and physical therapy with a good home therapy program providing appropriate balance between rest and activity. Proper protection from trauma and overuse of the involved joints, and appropriate nutrition can afford optimal improvement in health status and general resistance. Proper orientation of the patient regarding the nature of his disease and treatment program usually is required to obtain his full cooperation. A kind, encouraging, and understanding approach is most helpful in the elderly patient. Physical rehabilitation can help to relieve pain, decrease edema and deformities, improve muscle weakness and incoordination, and increase stamina. Difficulties with gait, transfers, and self-care can be solved or improved. Physical medicine and rehabilitation measures are important components of the challenging treatment of patients of all age groups who are afflicted with severe arthritis. It is most important to tailor these components of the treatment program to the problem presented by geriatric arthritic patients.
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PMID:Physical medicine and rehabilitation in the elderly arthritic patient. 83 12

Research regarding the effect of exercise on chronic benign axial pain is reviewed. Both chronic low back pain (LBP) and chronic neck pain are associated with weakness of the trunk and neck musculature; however, it is unknown whether weakness is a cause or effect. The relationship between incoordination of the neck or trunk musculature and chronic pain is unclear. Exercise is associated with improved strength and endurance and decreased pain in subjects with LBP but the literature is very sparse with respect to chronic neck pain. Range-of-motion is also diminished in those with LBP and improves with exercise, and is associated with abatement in symptoms. No evidence could be found regarding the effect of exercise on segmental motion. Exercise is also associated with improved function, however the mechanism whereby either pain report or function improves is unclear. A greater understanding of the role of exercise will require more specific studies of strength, coordination, motion, function, and pain.
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PMID:Therapeutic exercise in chronic neck and back pain. 138 24

We investigated motor function and pain sensation in the gracile axonal dystrophy (GAD) mutant mouse, using the tail-flick test and the rotarod test. GAD (gad/gad) and normal sib mice (gad/+ or +/+) were used between 5 and 11 weeks of age, during which time the behavioral signs of GAD mice shifted from sensory ataxia (about 4 to 8 weeks of age) to paresis (after about 9 weeks of age). In the tail-flick test, significant shortening of latency was observed at 6 and 8 weeks of age in female GAD mice, in comparison with normal female mice. This may be related to dysfunction or degeneration of axons in the fasiculus gracilis, whose collaterals are thought to control the transmission of nociceptive information. In the rotarod test, a cumulative chi 2 test showed significant reduction in the performance times of GAD mice beginning at 5 and 6 weeks of age in males and females, respectively, indicating that the rotarod test can detect the development of motor incoordination as early as these ages. The performance times of GAD mice dropped sharply from 9 weeks of age onwards, and this is believed to reflect the progression of paresis. The rotarod test therefore appears to be a good method of quantifying behavioral changes in GAD mice and to be applicable both to objective selection of GAD mice before 8 weeks of age and to evaluation of drugs to treat ataxia or paresis.
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PMID:Behavioral study on the gracile axonal dystrophy (GAD) mutant mouse. 145 62

Complaints in the otolaryngologic region, that cannot be referred to an otolaryngological pathologic process, are often caused by or combined with craniomandibular dysfunctions. As a rule these complaints are not the result of direct mechanical irritation of the articular tissues, but the effect of neuromuscular incoordination and spasms. Consequently the term "Costen's syndrome" is obsolete and should be used no more. In many cases the interaction of otolaryngological symptoms and craniomandibular disorders can only be proved ex iuvantibus. Occlusal equilibration combined with physical and physiotherapeutic treatment are approved methods to normalize neuromuscular function and eliminate muscle tension and pain.
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PMID:[Functional craniomandibular disorders and ENT-symptoms]. 181 53

As mentioned previously, both MS and PML are demyelinating conditions of the CNS and pose diagnostic difficulties in their differentiation because of similarities in their clinical findings. However, certain features unique to each of these diseases are helpful in clinical diagnosis. MS, unlike PML, is a disease of unknown cause. Polygenetic influences in combination with exposure to an environmental agent and immune-mediated factors may be operative in the pathogenesis of MS. Age of onset peaks in the third to fourth decades with a predominance in women, as contrasted with PML, which peaks in the fifth to sixth decades in most non-AIDS-associated cases with a slight predominance in men. MS is more prevalent in areas farther from the equator: North America, Europe, Australia, and New Zealand. Common initial symptoms seen in MS include bilateral limb weakness (with the legs being affected twice as often as the arms), hyperreflexia, spasticity, optic neuritis, diplopia, incoordination, and paresthesias. (Paresthesias are typically found in the lower limbs in a symmetric pattern, but may follow no obvious anatomic distribution and often do not correspond to the distribution of sensory symptoms. Vibration and position sense are more frequently disturbed than pain and temperature.) Intellectual impairment and mental deterioration are uncommon early in MS, whereas they are a more frequent initial presentation in PML. In addition, the presence of speech impairment and monoparesis or hemiparesis with homonymous hemianopsia is more suggestive of PML. Brain stem involvement is infrequent.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic encephalitis caused by leukoencephalopathy. 222 61

A stroke with a somewhat unusual neurologic formula was correlated with a small linear high-intensity T2 focus in the lateral tegmentum of the lower third of the pons. The clinical features included dysarthria, staggering gait, incoordination of handwriting, right facial weakness, nystagmus, ocular overshoot, right appendicular ataxia, and left-sided dissociated sensory loss for pain and temperature. Lacunar lesions of the tegmentum in the region of the pontomedullary junction, while not uncommon, have not been studied pathologically and have not been reported in the magnetic resonance imaging literature, to my knowledge.
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PMID:Lacunar infarct of the tegmentum of the lower lateral pons. 271 52

Midazolam, a water soluble bensodiasepine, has proven to induce a sleep pattern and amnesic effect that makes it preferable for use as a premedication for outpatient surgery. Used in addition to the regular anesthesia, Midazolam obviates the ineffectiveness of the analgesic drug. Since 1970, neuroleptic analgesia has been used as a method of outpatient anesthesia. Unfortunately, neuroleptic analgesia has provided inadequate coverage of pain relief causing pain and discomfort to patients. When a sedation and anxiolytic premedication are used, the patient acceptance increases. In a study in Ramathibodi hospital, Bangkok, Thailand effectiveness of midazolam as a premedication drug in laparoscopic interval sterilization, 150 women capable of reproduction and who were schelduled for the operation were studied. All of the women received 15mg midazolam orally either 60 or 90 minutes before the operation. The women were divided into 3 groups of 50 classified by the type of analgesic administered (tramadol or pethidine). Heart and respiratory rates and blood pressure were measured prior to, during, and after the operation. No difference in the rate of amnesia was found among the 3 groups, and a rate of 36% of amnesia was found in the study. Those results were lower than earlier reports, possibly due to circumstances at the hospital such as lack of coordination between administration of the medication and timing of the surgery.
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PMID:Amnesic effect of midazolam as premedication in interval laparoscopic sterilization. 318 58

The pharmacological actions of N-(2,6-dimethylphenyl)-8-pyrrolizidineacetamide hydrochloride hemihydrate (SUN 1165), a new antiarrhythmic agent, on the central nervous system were studied in various experimental animals as compared with those of disopyramide, mexiletine and lidocaine, and the following results were obtained. 1. Acute toxicity of SUN 1165 in mice was similar to that of mexiletine, and twice as potent as compared with that of disopyramide and lidocaine. Main acute toxic symptoms of SUN 1165 were muscle relaxation, ataxia, clonic convulsions, tremor and a decrease in spontaneous activity in mice, rats and rabbits. In addition to these symptoms, vomiting in dogs was observed. These toxic symptoms were similar to those of lidocaine. In the case of disopyramide, ataxia, tremor and a decrease in spontaneous activity were observed in mice and rats. On the other hand, mexiletine caused central nervous excitatory symptoms, that is, tremor, Straub tail, clonic convulsions, jumping, running and opisthotonus in mice and rats, and vomiting in dogs. 2. SUN 1165 even at large doses (50-100 mg/kg p.o.) exerted no significant effects on the following changes: hexobarbital-induced induced hypnosis, oxotremorine-induced tremor, apomorphine-induced hypothermia, reserpine-induced ptosis and hypothermia, 5-hydroxytryptophan syndrome and fighting behavior in mice, and conditioned avoidance response in rats. 3. An ineffective dose of SUN 1165 (12.5 mg/kg p.o.) on spontaneous locomotor activity was lower than of disopyramide and lidocaine, however, higher than that of mexiletine. 4. SUN 1165 at large doses showed antagonistic action on toxic extensor seizures induced by maximal electroshock, picrotoxin, or strychnine in mice, but anticonvulsive effects of SUN 1165 were less potent than those of mexiletine and lidocaine. SUN 1165 had no effect on clonic convulsions induced by pentetrazol and pictrotoxin in mice, while both mexiletine and lidocaine prolonged the duration of clonic convulsions. 5. The muscle relaxant effect of SUN 1165 (50%-toxic dose, TD50 = 30 mg/kg p.o.) was more marked than that of lidocaine (TD50 = 92 mg/kg p.o.) on traction test in mice. However, effect of SUN 1165 (TD50 = 62 mg/kg p.o.) on motor incoordination was similar to that of disopyramide, mexiletine and lidocaine on the rotarod test in mice. 6. The analgesic effect of SUN 1165 was as weak as that of disopyramide, mexiletine and lidocaine on chemically and mechanically-induced pain response in mice.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:General pharmacological studies on N-(2,6-dimethylphenyl)-8-pyrrolizidineacetamide hydrochloride hemihydrate. 1st communication: effect on the central nervous system. 319 80


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