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

One hundred and twenty five patients, considered as having a bronchial carcinoma invading the chest wall, suffered from a thoracic pain in 40 cases. They were operated on by pneumonectomy (23), bilobectomy (5), lobectomy (83) and atypical resection (1). Resection was impossible in 13 cases (10.4%), for anatomical (10) or functional reasons (3). Considering the chest wall, an extra-pleural resection was performed in 49 cases, a muscular resection in 25 cases and a skeletal resection in 38 cases. Parietal invasion was microscopically confirmed for 78 tumours out of 112 resections specimens and for 10 tumours out of 13 which were not resected: 65 T3 N0, 8 T3 N1, 15 T3 N2. Operative mortality was 12.5%. Global survival was 62.8% at 1 year, 14.2% at 3 years, 11.1% at 5 years. Median survivals were 393 days after resections dating back to more than 5 years and 158 days when the tumours were not resected. Thoracic pain is a symptom of chest wall invasion in 87.5% of cases, but the invasion is symptomless in 24% of cases. Sensitiveness, specificity and predicting values of imaging modalities are discussed: on the whole the negative predictive values are feeble (0.23 to 0.42). The operative estimation is also uncertain, especially considering invasion limited to the extra-pleural space. Practically, a fixed tumour with broad and firm adhesion to the chest wall is an indication for chest wall resection which gives better results, although this advantage is not statistically significant. Surgical prognosis of T3 cancers is, in this series, much worse than the prognosis of T2 tumours. Mortality is analyzed according to its causes.(ABSTRACT TRUNCATED AT 250 WORDS)
Rev Mal Respir 1992
PMID:[Bronchial cancers invading the chest wall]. 143 93

One hundred twenty patients with osteoarthritis of the knees and hips were entered into a randomized, placebo-controlled, double-blind trial designed to evaluate the effectiveness of chondroitin sulfate (Structum). The three-month treatment phase was followed by a two-month treatment-free phase to allow evaluation of carry-over effects. The main endpoint was use of nonsteroidal antiinflammatory drugs (expressed as mg of diclofenac equivalent). At completion of the three-month treatment phase, patients taking chondroitin sulfate (4 capsules/day) were using significantly less NSAIDs; this decrease persisted throughout the two-month treatment-free follow-up phase. The other parameters studied including visual analog scale assessment of pain, the Lequesne pain-function index, and overall patient and physician assessments, all showed a similar significant tendency. Tolerance was outstanding and no patients required premature withdrawal. These findings indicate that chondroitin sulfate is useful for the treatment of osteoarthritis, both as an agent slowly effective against symptoms and to reduce the need for NSAIDs. The carry-over effect of the drug suggests that intermittent administration may be appropriate.
Rev Rhum Mal Osteoartic
PMID:[Chondroitin sulfate in the treatment of gonarthrosis and coxarthrosis. 5-months result of a multicenter double-blind controlled prospective study using placebo]. 148 36

Primary fibromyalgia may involve an anomaly in the metabolism of serotonin responsible for the sleep disorders and diffuse pain. Effectiveness of an agent with pure serotonin-agonist properties (fluoxetin hydrochloride) was evaluated in 23 patients during a three-month open study. Treatment had no effect on pain severity, number of tender sites, or pain score. Sleep disorders improved and 57% of patients believed the treatment was effective. Adverse events were recorded in 43.4% of patients, with the most common being nausea (21.7%). Effectiveness and tolerance of fluoxetin hydrochloride in fibromyalgia are mediocre. A double-blind placebo-controlled trail versus a placebo is needed to clarify these preliminary findings.
Rev Rhum Mal Osteoartic
PMID:[Evaluation of the effectiveness of serotonin (fluoxetine hydrochloride) treatment. Open study in fibromyalgia]. 148 40

The main purpose of this study was to analyze the relationship between clinical symptoms and roentgenographic changes in patients with incipient osteoarthritis of the knees (OA). One hundred and sixty-two patients (126 women, 36 men, mean age 59 years) with established osteoarthritis of the knee were examined. Patients performed subjective self-assessment using Lequesne's questionnaire (index of severity for OA of the knee) and had frontal and lateral roentgenograms of both knees. Validity of the indices as reflections of individual symptoms was documented. A statistically significant correlation was found between clinical and patient indices (r = 0.327, p < 0.0001) as well as a very weak correlation between the clinical and roentgenogram indices (r = 0.196, p = 0.286). However, there was no correlation between the patient index and roentgenogram index (r = 0.065, p = 0.47). For the assessment of severity and progression of the disease, items reflecting acute irritation (swelling, effusion, increased joint temperature, pain during passive motion) were more reliable than items reflecting chronicity (muscular atrophy, decreased range of motion, crepitus). This study confirmed that Lequesne's questionnaire is a suitable tool for assessing subjective symptoms as well as for generating a condensed measure of disease severity. In addition, sclerosis, narrowing and osteophytes were proved to be important features characterizing the OA process.
Rev Rhum Mal Osteoartic 1992 Oct
PMID:Correlation between knee roentgenogram changes and clinical symptoms in osteoarthritis. 149 37

A 52-year-old male developed hypertrophy of the right calf after several bouts of right lumbar pain with sciatica. Electromyography disclosed evidence of demyelination in the territories of the right S1 and S2 roots. Microscopic studies showed both atrophic muscle fibers scattered among fibers of normal caliber and a large number of hypertrophic fibers. Post-sciatica hypertrophy of the calf is a true muscle hypertrophy with muscle weakness. Electromyography may show unusual tracings with repeated complex bursts or continuous activity of motor units. Muscle enzyme levels may be elevated. The size of hypertrophied fibers varies across cases. The cause of the muscle fiber hypertrophy may be either stretching due to the action of antagonists or unusual electrical activity.
Rev Rhum Mal Osteoartic 1992 Oct
PMID:[Sciatic radiculalgia with muscular hypertrophy]. 149 39

A new case of SAPHO syndrome with lesions confined to the spine and concomitant enterocolitis reported. Only eight cases of this rare combination have been published to date. Bone involvement consisted in sclerosis of vertebral bodies of T10 and T11, raggedness of the vertebral plateaux from T7 to T10, and thick syndesmophytes bridging the vertebrae from T7 to T11. Erythrocyte sedimentation rate was 108 in one hour. Systemic corticosteroids were given after failure of nonsteroidal antiinflammatory agents and recurrence of iritis. Pain resolved promptly and the erythrocyte sedimentation rate returned to normal. This case is unusual both because this combination of diseases is rare and because virtually complete resolution of vertebral sclerosis was noted after one year of corticosteroid therapy. Possible relationships between the SAPHO syndrome and the group of spondylarthropathies are suggested and discussed.
Rev Rhum Mal Osteoartic 1992 Oct
PMID:[Bone condensation and enterocolitis: SAPHO syndrome. Apropos of a case]. 149 42

The authors report sixteen consecutive cases of erythromelalgia, an infrequent disease in which local heat, redness, and pain develop in the hands and/or feet in recurrent attacks. The disease was essential in nine patients; in the remaining seven, the cause was a myeloproliferative syndrome (polycythemia vera in 3 cases and thrombocythemia in 1 case) or a drug (bromocriptine, nicardipine, and nifedipine, one case each). Acetylsalicylic acid was effective in only six of the nine essential cases. Intravascular platelet activation and aggregation with plugging of the arterioles has been suggested as the mechanism of erythromelalgia in patients with myeloproliferative disorders. Other, as yet unelucidated pathophysiologic events underlie the juvenile-onset forms, which usually fail to respond to acetylsalicylic acid.
Rev Rhum Mal Osteoartic 1992 Apr
PMID:[Erythromelalgia in adults. Apropos of 16 cases]. 149 72

Two cases of osteoid osteoma which became clinically apparent after a prolonged silent period are reported. One was located in the tibia in a 30-year-old female and the other in the femur in a 26-year-old male. Both developed after a surgical procedure, at the site of the operation; one was located on the track of an internal fixation screw. Diagnosis was delayed despite the suggestive timing of the pain; isotopic scanning, CT scan and angiography provided suggestive data and diagnosis was confirmed by histologic studies. A review of the literature found 13 other cases meeting the following criteria: initial trauma, silent period, suggestive pain, discovery of an osteoid osteoma at the site of the trauma, and recovery following surgical treatment. The role of the trauma is discussed.
Rev Rhum Mal Osteoartic 1992 Apr
PMID:[Post-traumatic osteoid osteoma. Apropos of 2 cases and review of the literature]. 149 75

The authors report the case of a 35-year-old woman undergoing surgery in 1976 for a bronchial carcinoid tumour, considered to be benign. Twelve years later, diagnostic evaluation of liver metastases led to the discovery of an asymptomatic lesion of D10, the CT scan and NMR appearances of which were suggestive of osteonecrosis, a diagnosis confirmed histologically. Investigations were repeated 2 years later because of spinal pain. While NMR and CT scan remained compatible with bone necrosis, biopsy on this occasion confirmed the presence of carcinoid tumour. These rare tumours metastasise little. Secondary bone deposits, essentially axial, are of an osteoblastic nature. The lesion seen in our patient was closer to idiopathic bone infarcts or those associated with Gaucher's or sickle cell diseases than to classical vertebral osteonecrosis. The relationship between vertebral necrosis and metastasis remains obscure.
Rev Rhum Mal Osteoartic 1992 Feb
PMID:[Osteonecrosis, metastases and bronchial carcinoid]. 160 26

An 83-year-old lady was admitted for bilateral pain and weakness of the shoulder and hip girdles. These symptoms suggested a Polymyalgia rheumatica (PMR) but there was no response to corticosteroids. A pulmonary adenocarcinoma without any metastasis was then diagnosed. The excision of this tumor was followed by prompt and complete recovery. The erythrocyte sedimentation rate became normal within a few days, also. Such an issue seems to prove that PMR may occasionally be associated with neoplasia. This association appears anecdotal in the literature and remains without clear explanation.
Rev Rhum Mal Osteoartic 1992 Feb
PMID:[Polymyalgia rheumatica and pulmonary cancer: paraneoplastic syndrome]. 160 29


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