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

A preliminary report is made on the use of videothoracoscopy to achieve pulmonary lobectomy in 16 patients, including 12 with centrally located pulmonary metastases and 4 with benign lesions (3 bronchiectases and 1 endobronchial hamartoma). Videothoracoscopy was performed on eight right-lower lobes, one middle lobe, two right-upper lobes, four left-lower lobes, and one left-upper lobe with a thoracoscope and conventional thoracic instruments. All patients received standard pulmonary lobe resection with lymph node clearance similar to that achieved with open thoracotomy. The mean operative time was 3 h (range, 2.5 to 4 h). Average blood loss was 100 mL and mean length of hospital stay was 6 days (range, 4 to 8 days). A combination of videothoracoscopy with use of conventional instruments resulted in similar performance but less chest wall interruption than in conventional pulmonary lobectomy. Videothoracoscopy showed safer and faster lung resection, which subsequently minimized the perioperative morbidity. Pain intensity was lessened, functional recovery was quicker, and hospital stays were shorter in the patients we reviewed.
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PMID:Thoracoscopic-assisted lobectomy. Preliminary experience and results. 787 63

A different and more in-depth approach is needed when treating an athlete suffering from low back pain than is the case when the same pathology affects a sedentary subject. In fact, pain symptoms may frequently arise only when there is functional overloading, while pain is absent or not disabling in normal daily activity. Treatment is also different for the athlete: complete functional recovery must take place in as short a period of time as possible, and it will often have to be finalized in relation to sports-related commitments. A group of 60 professional athletes were evaluated in order to examine the incidence and the features of lumbar pain. Attention was particularly paid to a functional evaluation of the spine by means of an accurate clinical examination and the use of the Metrecom system. The data obtained confirm the importance of changes in posture and in vertebral dynamics when the pain symptom occurs.
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PMID:Low back pain in athletes: pathogenetic mechanisms and therapy. 807 77

Idiopathic brachial neuritis (IBN) is a well-recognized clinical syndrome characterized by brachial pain followed by a patchy amyotrophy of muscles in the shoulder girdle and arm innervated by individual branches of the brachial plexus. Postsurgical IBN has not been widely recognized since Parsonage and Turner's original description in which 10% of patients had antecedent surgery. We present 6 patients who 1-13 days postoperatively developed signs and symptoms which met the clinical and electrophysiologic criteria for IBN. Postsurgical neuralgic amyotrophy is an under-recognized clinical entity which in most cases is ascribed to brachial plexus stretch injuries occurring during anesthesia. Early recognition of this condition may prevent unnecessary surgical exploration and allow for a more accurate prediction of functional recovery.
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PMID:Postsurgical idiopathic brachial neuritis. 1589 Feb 9

As 90% of patients with acute LBP recover within a 2-month period, irrespective of the type of treatment received, exercise probably plays little role in facilitating recovery from an acute episode of LBP. It may be a very important factor in both symptomatic and functional recovery in chronic LBP, as well as an integral factor in preventing recurrent injury. The most efficacious exercise regimen for treating LBP is currently unknown. Similarly, little is known about the efficacy of individual exercises. In certain patients, flexion or extension exercises may be inappropriate. A careful history and physical examination, observing the movements that cause pain, will assist the physician in tailoring the exercise programme to the individual patient to achieve the greatest likelihood of success. Communication between the patient, physician and therapist is vital to allow continual adjustment of the programme to best meet the patient's needs. As improvement occurs, more stressful exercises can be added to improve strength, endurance and aerobic fitness. Individualizing the exercise programme to the patient's symptoms and communication between the patient, therapist and physician lead to greater compliance with the exercise programme and a greater likelihood of improved outcome.
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PMID:Exercise for the low back pain patient. 814 43

In a randomized double-blind study involving 42 postmenopausal women with a displaced Colles' fracture, we investigated whether piroxicam, a nonsteroid anti-inflammatory drug, can reduce posttraumatic osteopenia and improve the rate of recovery. In an earlier study [3] we found a bone-sparing effect caused by piroxicam after external fixation of the rabbit hindleg. The patients were treated with a below-elbow paster slab for 4 weeks after the reduction. The bone mineral content of the forearm bones was measured with a single-photon absorptiometer 8 weeks after the fracture. There was a mean 7% bone mineral decrease in the radius and 5% in the ulna among the patients treated with piroxicam versus 10% in the radius and 7% in the ulna in the placebo group. However, this difference was not significant. Piroxicam did not decrease the rate of fracture healing. The patients who received piroxicam had significantly less pain during plaster treatment, but there was no difference in the rate of functional recovery between the groups.
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PMID:No effects of piroxicam on osteopenia and recovery after Colles' fracture. A randomized, double-blind, placebo-controlled, prospective trial. 832 40

Morelli and Di Paola's thoracotomy allows to approach the pleural space with the only osteo-muscular sparing without any section of chest wall structures. With this kind of approach that we have been employing since twenty years, we report our experience about 82 cases recently operated on for both pulmonary and mediastinal disease. Unlike who don't consider this approach to allow adequate exposure of all endothoracic anatomic structures, it is our opinion that this thoracotomy not only allows every kind of operation in thoracic surgery, but is easy to perform and fast to repair. Moreover, postoperative pain is decreased, functional recovery is improved and patient can frequently be discharged earlier from the hospital with a very satisfactory aesthetic result.
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PMID:[Axillary thoracotomy: a simple and conservative approach to the thoracic cavity]. 832 64

We investigated the role of laminin in functional recovery of a peripheral nerve injury using electrophysiological and behavioral approaches on the rat sciatic nerve in vivo. These studies were complemented by neurofilament protein immunocytochemistry on the sciatic nerve 20 days after an operation, in which an 8-mm piece of the nerve was removed and replaced by a graft of laminin, its neurite outgrowth-promoting peptide, a control peptide, collagen, or by resuturing of the removed piece of the nerve. Electrophysiological measurements of muscle strength 4 months after the sciatic nerve transection showed that a laminin graft was as effective as neurorrhaphy in supporting functional recovery of an injured peripheral nerve. A laminin graft also significantly reduced autotomy in the operated animals. Immunocytochemistry confirmed that both a laminin graft and resuturing supported growth of the 200-kDa neurofilament-positive axons into the distal stump of the nerve within 20 days of operation. A graft with a neurite outgrowth-promoting peptide of the B2 chain of laminin supported similar axon growth, whereas another peptide graft also derived from laminin or a collagen graft did not support axon growth. All grafts allowed Schwann cell growth into the distal stumps of the nerves, but neurites accompanied them only in the regeneration-supporting grafts and in the resutured nerves. The Schwann cells of the regenerating nerves expressed high levels of the neurite outgrowth-promoting domain of the B2 chain of laminin, whereas the Schwann cells of the degenerating nerves failed to express this domain in the distal stumps of the degenerating nerves. These results provide the first in vivo evidence for the functional role of laminin in peripheral nerve regeneration. As the neurite outgrowth-promoting domain of the B2 chain of laminin is as efficient as laminin or resuturing in supporting a short-term recovery of an injured sciatic nerve, this area may be a regeneration-promoting domain of this glycoprotein. More importantly, as grafting significantly reduces post-traumatic pain behavior in the operated animals, the laminin graft surgery may provide a useful method for clinical restoration of the injured peripheral nerves.
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PMID:A laminin graft replaces neurorrhaphy in the restorative surgery of the rat sciatic nerve. 840 84

Of 46 patients, 30 with fresh fractures of the humerus, nine with non-unions and seven with pathological fractures were treated with a new locked intramedullary nail. Of 30 patients with a fresh humeral fracture, three were lost to follow-up. All fresh fractures healed within 4 months. Functional results of the fresh fracture group were excellent in eighteen patients and satisfactory in three patients. Two patients with Neer type 6 fractures had unsatisfactory shoulder function; in the four other patients poor shoulder function resulted from a pre-existing condition. Out of nine non-unions, six united within 6 months. The three other patients with atrophic non-union required bone-grafting later, after which consolidation was obtained. The long functional recovery period of the non-union group was related to the pre-existing limited shoulder function. The seven patients with a pathological fracture died within 8 months of operation. While alive they were free from pain and could be nursed well.
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PMID:Locked intramedullary nailing of humeral fractures. 840 48

1. The percutaneous posterior approach with laser to a herniated lumbar intervertebral disc--heralded as a "minimal invasion" treatment for the symptomatic relief of discogenic back pain and sciatica--is an alternative method for the treatment of protrusion of a lumbar disc and its associated radiculopathy. 2. Percutaneous diskectomy is considered in patients who have unremitting radiculopathy with a contained disc herniation. The particular criteria for patient selection includes: evaluation of the patient's pain, performance status, medication dependence, and duration of symptoms. The patient must have demonstrable neurological impairment, positive nerve root tension signs, and correlative findings on imaging studies. 3. Percutaneous laser diskectomy has multiple advantages: it is an outpatient procedure performed under local anesthetic; it is less traumatic than open diskectomy; there is no epidural fibrosis; and there is a quick functional recovery with minimal pain and few complications.
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PMID:Percutaneous laser diskectomy. An alternative method. 849 18

We compared two treatments for tears of the rotator cuff of 1 to 4 cm in size. One group of 22 patients had an arthroscopic subacromial decompression and rotator-cuff debridement; the other comparable group of 23 patients had open repair and acromioplasty. Review was at 2 to 5 years postoperatively. Both groups had similar pain relief and range of active forward flexion, with significant improvement from the preoperative condition. The open repair group scored better for function, strength and overall score, but patient satisfaction was similar in the two groups. We recommend the use of arthroscopic subacromial decompression and debridement for low-demand patients who require mainly pain relief and range of movement. Open repair is necessary if strength and functional recovery are the prime objectives.
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PMID:Arthroscopic debridement versus open repair for rotator cuff tears. A prospective cohort study. 849 10


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