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

The ability to predict claudication pain during single-stage (S) and progressive (P) treadmill protocols from clinical measurements obtained at rest was examined. Peripheral hemodynamic measurements from the more severely diseased lower limb and medical history data were obtained from 56 claudicant patients during supine rest immediately preceding S (1.5 mph and 7.5% grade) and P (2 mph, 0% grade with 2% increase every 2 min) treadmill protocols. Distance walked to onset of claudication pain (CPD) and to maximal pain (MPD) during both protocols were recorded. The claudication distances during the S protocol were not correlated with either the peripheral hemodynamic or medical history variables. In contrast, CPD and MPD during the P protocol were predicted (P less than 0.05) by ankle/brachial systolic blood pressure index (ABI) (quadratic relationship), laterality of claudication pain (1 = unilateral, 2 = bilateral), and gender (1 = female, 2 = male) from the following regression equations: CDP (m) = 159.9 - (321.8 x ABI) + (445.6 x ABI2) - (93.5 x laterality) + (99.0 x gender), R = 0.74, R2 = 0.55, adjusted R2 = 0.53, SEE = 110.5, P less than 0.0001; and MPD (m) = 83.1 + (195.0 x ABI) + (174.0 x ABI2) - (76.4 x laterality) + (114.2 x gender), R = 0.76, R2 = 0.58, adjusted R2 = 0.55, SEE = 138.3, P less than 0.0001. It is concluded that the regression equations for the prediction of CPD and MPD may be used to quickly estimate the functional severity of peripheral vascular occlusive disease in clinical settings where treadmill testing is not feasible or is impractical.
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PMID:Prediction of claudication pain from clinical measurements obtained at rest. 154 4

The reliability of claudication pain and the metabolic and hemodynamic measurements of the lower limbs of patients with stable peripheral vascular occlusive disease (PVOD) were compared during and following single-stage (S) and progressive (P) treadmill tests. Ten patients (69.8 +/- 1.8 yr; X +/- SE) walked to maximal claudication pain twice a month for 4 months. Patients walked at 1.5 mph up a 7.5% grade (S test) and at 2 mph on a 0% grade, increasing by 2% every 2 min (P test). Distance walked to the onset of claudication pain (CPD) and maximal walking distance (MWD) were recorded. Foot transcutaneous oxygen tension (TcPO2) was measured before, during, and after exercise, while ankle systolic blood pressure (SBP) and the ankle-to-brachial SBP index (ABI) were measured before and after exercise. Intraclass correlation coefficients (R) of CPD and MWD during S tests were R = 0.53 and R = 0.55, respectively. In contrast, the respective R values during P tests were R = 0.89 and R = 0.93. Higher R values of foot TcPO2 were also obtained during and following P tests, while ankle SBP and ABI were highly reliable following both tests. It is concluded that the severity of PVOD is better assessed by P treadmill tests because clinical measurements are more reliable during exercise and recovery.
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PMID:Progressive vs single-stage treadmill tests for evaluation of claudication. 205 96

Neuropeptide FF (NPFF) is a neuropeptide with some antiopioid characters found in several mammalian species. In human brain it might be an important pain-regulating peptide. Using a specific and sensitive radioimmunoassay we found a mean concentration of NPFF in human cerebrospinal fluid (CSF) of healthy volunteers of 1.6 +/- 1.1 pg/ml (n = 19) and in chronic pain (CPD) patients of 1.4 +/- 1.2 pg/ml (n = 16). The NPFF concentrations in CSF and plasma did not correlate. There was no difference in the NPFF concentrations in CSF and plasma between CPD patients and healthy controls. NPFF in CPD patients did not correlate significally with any pain characteristic. This study provides evidence for the presence of NPFF in human brain, but does not support the hypothesis that chronic pain is a consequence of elevated production of NPFF.
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PMID:Neuropeptide FF-like immunoreactivity in human cerebrospinal fluid of chronic pain patients and healthy controls. 935 47

Practice profiles are reflective pieces written by nurses in practice and based on continuing professional development articles. This week Karen McDowell discusses wound management and pain control. CPD article NS14, Gould D (1999) Wound management and pain control. Nursing Standard. 14, 6, 47-54.
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PMID:Wounds and pain management. 1130 80

Juvenile hyaline fibromatosis (JHF) is a rare autosomal recessive inherited condition presenting early in life and characterized by the accumulation of hyaline-like tissue in the skin as well as various organs. Gingival overgrowth is a significant oral manifestation. This paper highlights how early and essential periodontal intervention may be necessary to improve mastication and subsequent weight gain, and to eliminate pain and improve the patient's quality of life. Here we highlight the key features of this condition and demonstrate how appropriate surgical management can have a significant impact on a patient's wellbeing. CPD/CLINICAL RELEVANCE: Juvenile hyaline fibromatosis has a significant impact on patient wellbeing and it is therefore important that clinicians are able to recognize the condition and ensure that patients receive appropriate care and management.
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PMID:Juvenile Hyaline Fibromatosis: Impact of Periodontal Care on Quality of Life and a Patient Perspective. 2663 Aug 63

Tooth surface loss (TSL), the non-carious loss of tooth tissue, is considered pathological if the teeth involved experience sensitivity and pain, are functionally compromised or they detract from the patient's appearance. TSL is a common clinical finding in many patient groups, although differences between the primary and permanent dentition contribute to TSL occurring at a faster rate and with worse outcomes in the primary dentition. This case report presents localized abrasion and associated apical periodontitis affecting a single primary tooth in a 2-year-old infant following the misuse of a babies' dummy clip whilst teething. Abrasion is rare in the primary dentition. CPD/CLINICAL RELEVANCE: This article highlights an unusual presentation of dental abrasion affecting the primary dentition caused by a previously unreported foreign object; abrasion in this case was a side-effect of soothing the discomfort of teething.
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PMID:Dental Abrasion of Incisor caused by a Babies' Dummy Clip: A Case Report. 2663 Aug 66

Dental caries is a disease that affects many people, including children, and presents numerous challenges to healthcare providers. As clinicians it is important that we consider the advantages and disadvantages of treating carious primary teeth, and make an informed decision about when it is appropriate or not. This paper describes the background to the treatment of carious primary teeth, looking at the differences between primary and permanent teeth, and the relevance of this. It also suggests points to consider when looking at restoration survival studies, as the ability to appraise the literature critically is important for us all in this 'evidence-based' age. CPD/Clinical Relevance: Our early life experiences have the ability to shape our future attitudes and behaviour. Children with carious teeth require careful management so that pain and suffering is minimized, and positive attitudes towards dentistry are fostered.
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PMID:Materials for Paediatric Dentistry. Part 1: Background to the Treatment of Carious Primary Teeth. 2685 95

Acute trigeminal pain is a common presentation in the dental surgery, with a reported 22% of the US adult population experiencing orofacial pain more than once during a 6-month period. This article discusses the mechanisms underlying the pain experience, diagnosis and subsequent management of acute trigeminal pain, encompassing pre-, peri- and post-operative analgesia. The dental team spend most of their working lives managing patients and acute pain. The patient may present to the clinician in existing pain, which may often provide a diagnostic challenge. Prevention and managing intra-operative and post-surgical pain are implicit in providing your patient with optimum care. CPD/CLINICAL RELEVANCE: This paper aims to provide an overview of conditions that may present with acute orofacial pain and their management using the most recent evidence base. Intra-operative and post-surgical pain management are also scrutinized and evidence based treatment is recommended.
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PMID:Pain Part 3: Acute Orofacial Pain. 2696 46

TMDs are a complex collection of conditions which can have a significant impact on an individual's quality of life. The aetiology, diagnosis and management of TMDs will be described in this article with the hope of increasing a general dental practitioner's knowledge of these problems, thus helping them to institute simple, initial, conservative therapies for such patients. Diagnosis of TMDs can be simplified by following recent published clinical diagnostic criteria such as those outlined in this article. CPD/CLINICAL RELEVANCE: Pain and functional disturbances related to TMDs are common and require simple and pragmatic interventions for most patients. After providing a diagnosis, reassure patients that they do not have a sinister disease, and explain that the condition is usually self-limiting.
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PMID:Pain Part 6: Temporomandibular Disorders. 2702 1

Trigeminal neuralgia (TN) is also known as 'tic douloureux' (in French, 'painful twitch'). It is a rare chronic facial pain syndrome, characterized by severe, brief, stabbing, 'electric shock-like 'recurrent pain attacks felt in one or more divisions of trigeminal nerve innervation areas. So intense is the elicited pain that TN has a significant effect on a sufferer's quality of life, rendering many patients unable to consider a future with the ongoing threat of recurrent pain. The aim of this article is to discuss the diagnosis and management of this disabling facial pain condition. CPD/Clinical Relevance: As general medical practitioners may struggle differentiating TN from toothache, primary care dentists have an important role in excluding odontogenic cause of pain, diagnosing TN and referring patients to a facial pain clinic for further investigations and multidisciplinary team management.
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PMID:Pain. Part 7: Trigeminal Neuralgia. 2718 29


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