Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During a 9-year period, we treated 13 patients with major fractures of bones of the distal carpal row creating instability of the corresponding carpometacarpal joints. Diagnosis of the injury was made early in only eight patients whose treatment consisted of open reduction, pin or screw fixation, and immobilization from 6 to 8 weeks. They showed no complications and had an excellent functional recovery. Diagnosis in five (38%) patients was delayed 1 week to 8 months after the accident. At initial presentation, symptoms included pain, loss of grip strength, and mild limitation of finger motion. In three patients an acute carpal tunnel syndrome developed a few days after the accident. Two had established nonunions of the capitate and the hamate. Treatment consisted of open reduction, bone grafting, fixation with multiple pins, and immobilization until fracture consolidation. Results in this group were good in one, moderate in three, and poor in one.
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PMID:Transcarpal carpometacarpal dislocations, excluding the thumb. 238 May 13

One hundred consecutive patients treated with shoulder surgery were studied to determine their functional recovery. Their average age was 47.3 years, and the average follow-up period was ten months. Clinical grading of muscle strength was compared pre- and postoperatively with objective testing using the Cybex II Isokinetic System, with subjective functional assessment by dictation, and with the ability of the patient to return to work. The clinical grade of muscle strength increased postoperatively by approximately one-half of a grade in both forward flexion and external rotation. However, various Cybex parameters did not significantly improve. The postoperative values were significantly less for the operated side than for the uninvolved side. Only weak statistical correlations were found between the clinical muscle grading and objective Cybex evaluation. Pain relief was obtained in 87% of the patients. Eighty-six percent of the patients returned to work, although 43% returned to light duty only. Thirty-two percent of patients reported full recovery, while 58% had decreased but satisfactory function. The study showed that although the clinical assessment of muscle strength improved early after shoulder surgery, the clinical grading of muscle power did not correlate well with objective parameters of strength, endurance, ability to work, or functional assessment. Strength did not recover to the level of the uninvolved opposite shoulder. Endurance, which is not measured by clinical grading, may decrease. Longer follow-up and rehabilitation periods are required to optimize results.
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PMID:A comparative study of clinical muscle testing and Cybex evaluation after shoulder operations. 239 42

A series of 92 thyroid cancer patients treated in collaboration between the Nuclear Medicine and the Oncological Radiotherapy Departments of the Turin Mauriziano Hospital is reported. The age, sex, histotype and stage of the various groups of patients subdivided by therapeutic indications were analysed. In 17 patients, treatment was carried out for pain killing purposes on particularly painful secondary bone localisations with good results symptomatologically and from the point of view of functional recovery. In 21 patients with unfavourable histology who did not take up radioiodine, external radiation treatment was carried out for palliative reasons with, in some case, a lasting effect. In the other 44 patients although generally speaking, at advanced stages of the disease and often in the presence of invasive and anaplastic secondary manifestations, total survival with the two treatments combined was about 55% (24 cases) of whom 75% (18 cases) are alive 5 years later.
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PMID:[Role of radiotherapy in the treatment of carcinoma of the thyroid gland]. 246 Aug

The ureteropelvic junction (UPJ) is the most common site of upper urinary tract obstruction. We report on 46 adult patients (50 renal units) that had been treated for a UPJ anomaly at our department over a 10-year period. The most common clinical manifestations observed were lumbar pain and/or colic (82.6%) and infection (34.8%). Genitourinary malformations were observed in 21.8% of the patients. The following treatment modalities were performed: 8 nephrectomies, 39 repair surgery procedures, 3 renal units with mild dilatation and no obstruction did not undergo surgery and were closely followed. The Anderson-Hynes pyeloplasty procedure was performed in 37 (95%) renal units and the Foley Y-V plasty in 2 (5%). The most important complications were anastomotic stricture (4) and urinary fistula (2). Overall, the results of repair surgery were good in 69.2%, fair in 20.5% and poor in 10.3% of the cases. Better results were achieved in those cases with moderate (86% good results) than in those with severe (47% good results) dilatation. Following pyeloplasty, 95% of the patients were pain-free, 1 (2.3%) patient had episodes of symptomatic infection and deterioration of renal function was observed in only 1 patient with a single kidney and severe chronic renal failure prior to surgery. At 2 years, dilatation had improved in 64%, remained unchanged in 31%, and became worse in 5%. In the management of pyelocaliceal dilatation, we believe it is fundamental to clearly establish the presence of obstruction and predict the functional recovery of the obstructed kidney. Our diagnostic and therapeutic approach is described. For upper urinary tract dilatation, the following is performed: simple or diuresis IVP, diuresis renography, ultrasonography and CUMS (if reflux is suspected). When doubts exist or when the results are unclear, pressure flow urodynamic studies are performed. Thus, we perform repair surgery in dilatations with functional obstruction to avoid progressive renal deterioration. The literature on the diagnostic techniques for the assessment of obstruction and functional recovery is reviewed.
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PMID:[Obstruction of the pyelo-ureteral junction in adults. Diagnostic and therapeutic management]. 249 Mar 47

Thirty athletes with muscular contractures were enrolled in a double-blind study of dantrolene sodium and placebo to evaluate the decontracture activity and tolerance of the drug after eight days of treatment. The efficacy of the drug was assessed by studying pain at rest, during movement, and during pressure, as well as muscular tension and functional recovery. Twenty-eight patients completed the study. At the end of treatment, a decrease in pain was observed at rest (71.4% of patients treated with dantrolene and 21.4% of placebo-treated patients), during movement (78.6% and 35.7%, respectively), and during compression. The most noticeable effects were seen in the reduction of muscular tension (100% in the patients treated with dantrolene sodium and 35.7% in the placebo-treated patients) and in functional recovery (100% and 28%, respectively). In addition to the clinical study, an evaluation of the effects of dantrolene and placebo on overall performance and on the action of the respiratory system was conducted with six healthy subjects by means of basal respiratory measurement and ergospirometry before and after single-dose treatment. This study showed that dantrolene sodium is useful in the treatment of traumatic contracture, and that it does not alter an individual's overall performance. Dantrolene sodium represents a valid treatment to accompany analgesic, anti-inflammatory, and rehabilitation therapy of posttraumatic lesions in athletes.
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PMID:Dantrolene sodium in traumatic muscle contracture: double-blind clinical and pharmacological trial. 268 86

The reflex sympathetic dystrophy syndrome (RSDS) is an excessive or exaggerated response of an extremity to injury, manifested by burning pain, vasomotor disturbances, delayed functional recovery and trophic changes. The most common precipitating event is trauma. Early initiation of treatment improves therapeutic success. We describe three patients with RSDS, and discuss the prevalence, diagnosis and treatment of this condition. Physicians in primary care, traumatology and occupational medicine clinics should be aware of the clinical characteristics of this infrequent complication of limb trauma in order to avoid unnecessary diagnostic procedures and delay in treatment.
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PMID:Reflex sympathetic dystrophy syndrome following minor trauma. 270 23

Ten cases of complete rupture of the collateral ligaments of the metacarpophalangeal finger joints are reported. The nature of this injury, the pre-operative morbidity and the intra-operative pathology are analysed. In all cases surgery was performed with satisfactory results. Operation is indicated for joint stability, grip and pinch strength, pain control and early functional recovery.
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PMID:Operation for collateral ligament ruptures of the metacarpophalangeal joints of the fingers. 272 26

Indications for use of the intramedullary interlocked humeral nail are: pathologic fractures, including those with severe osteopenia alone; nonunions, especially those with bone atrophy and/or marked osteopenia; and humeral shaft fractures with comminution, bone loss, or other causes of instability not controlled by conventional treatment methods. In this series, eight patients were treated by intramedullary interlocked humeral nail. Follow up ranged up to 30 months, with an average of 12 months. Five of six patients in this series who had the potential to unite their fractures did so. The remaining patient had a painless fibrous union. While the two patients with pathologic fractures of the humeral shaft caused by malignant tumors did not unite their fractures, the pain relief, functional recovery, and lack of postoperative morbidity justified the operative procedure.
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PMID:Interlocked intramedullary nailing of the humerus. 291 42

Complete ring avulsion amputation (class III) injuries are difficult management problems, especially when they occur in heavy manual workers. By excising the bit of bone detached with the skin tube, opening up the skin tube into a flap and replanting it onto the proximal stump, two such cases were salvaged successfully, with early recovery of function. The fingers were shortened by 1.5 cm, had a normal nail, touch sensation and absence of cold intolerance and pain. Both of the patients returned to work in 4 months.
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PMID:Salvage of the ring avulsed finger in heavy manual workers. 291 15

Newborn rats received intraspinal injections of 6-hydroxydopamine to enduringly deplete spinal norepinephrine (NE). When tested in adulthood for pain sensitivity with a hot water-tail immersion procedure, this neonatal spinal NE lesion lowered tail flick latencies of females but not males. It was postulated that this sexually dimorphic sparing or recovery of function reflected the development of denervation supersensitivity for males but not females. Contrary to expectation from such an hypothesis, females, not males, showed exaggerated sensitivity to the analgesic effects of a test dose of clonidine. Furthermore, neither males nor females showed an increased number of spinal cord binding sites for (3H)para-amino-clonidine [(3H)PAC]. These receptor binding data failed to indicate proliferation of the spinal alpha two adrenoceptor in either sex. That the lesioning of spinal NE terminals did not reduce (3H)PAC binding sites suggests that the spinal alpha two adrenoceptor does not reside exclusively on NE terminals. This is consistent with current conclusions concerning the alpha two adrenoceptor in the cerebral cortex.
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PMID:Neonatal 6-hydroxydopamine lesion of spinal noradrenergic terminals: nociception, clonidine analgesia and spinal alpha two adrenoceptors. 303 74


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