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)

Patients with functional GI disorders (FGIDs) are commonplace in the gastroenterologist's practice. A number of these patients may be refractory to peripherally acting agents, yet respond to central neuromodulators. There are benefits and potential adverse effects to using TCAs, SSRIs, SNRIs, atypical antipsychotics, and miscellaneous central neuromodulators in these patients. These agents can benefit mood, pain, diarrhea, constipation, nausea, sleep, and depression. The mechanisms by which they work, the differences between classes and individual agents, and the various adverse effects are outlined. Dosing, augmentation strategies, and treatment scenarios specifically for painful FGIDs, FD with PDS, and chronic nausea and vomiting syndrome are outlined.
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PMID:Central Neuromodulators for Treating Functional GI Disorders: A Primer. 2834 92

Bone metastases of the long bones often lead to pain and pathological fractures. Local treatment consists of radiotherapy or surgery. Treatment strategies are strongly based on the risk of the fracture and expected survival.Diagnostic work-up consists of CT and biopsy for diagnosis of the primary tumour, bone scan or PET-CT for dissemination status, patient history and blood test for evaluation of general health, and biplanar radiograph or CT for evaluation of the involved bone.A bone lesion with an axial cortical involvement of >30 mm has a high risk of fracturing and should be stabilised surgically.Expected survival should be based on primary tumour type, performance score, and presence of visceral and cerebral metastases.Radiotherapy is the primary treatment for symptomatic lesions without risk of fracturing. The role of post-operative radiotherapy remains unclear.Main surgical treatment options consist of plate fixation, intramedullary nails and (endo) prosthesis. The choice of modality depends on the localisation, extent of involved bone, and expected survival. Adjuvant cement should be considered in large lesions for better stabilisation. Cite this article: Willeumier JJ, van der Linden YM, van de Sande MAJ, Dijkstra PDS. Treatment of pathological fractures of the long bones. EFORT Open Rev 2016;1:136-145. DOI: 10.1302/2058-5241.1.000008.
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PMID:Treatment of pathological fractures of the long bones. 2846 40

The presence of intramuscular fat (IMF) in the cervical spine muscles of patients with whiplash associated disorders (WAD) has been consistently found. The mechanisms underlying IMF are not clear but preliminary evidence implicates a relationship with stress system responses. We hypothesised that if systemic stress system responses do play a role then IMF would be present in muscles remote to the cervical spine. We aimed to investigate if IMF are present in muscle tissue remote (soleus) to the cervical spine in people with chronic WAD. A secondary aim was to investigate associations between IMF and posttraumatic stress symptom levels. Forty-three people with chronic WAD (25 female) and 16 asymptomatic control participants (11 female) participated. Measures of pain, disability and posttraumatic stress symptoms were collected from the WAD participants. Both groups underwent MRI measures of IMF in cervical multifidus and the right soleus muscle. There was significantly greater IMF in cervical multifidus in patients with WAD and moderate/severe disability compared to controls (p = 0.009). There was no difference in multifidus IMF between the mild and moderate/severe disability WAD groups (p = 0.64), or the control and mild WAD groups (p = 0.21). IMF in the right soleus was not different between the groups (p = 0.47). In the WAD group, we found no correlation between PDS symptoms and cervical multifidus IMF or between PDS symptoms and soleus IMF. Global differences in IMF are not a feature of chronic WAD, with differences in IMF limited to the cervical spine musculature. While the mechanisms for the development of IMF in the cervical spine following whiplash injury remain unclear, our data indicate that local factors more likely contribute to these differences.
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PMID:Intramuscular fat is present in cervical multifidus but not soleus in patients with chronic whiplash associated disorders. 2979 90

Lesions of the long head of the biceps brachii tendon (LHBT) are a common source of shoulder pain and dysfunction. Although the exact role of the LHBT in shoulder biomechanics is not clearly understood, pathological involvement of this tendon is a well-known pain generator and frequently the clinical presentation consists of both anterior pain and flexion loss. The initial treatment for lesions of the LHBT should be nonoperative, but if that fails or if the LHBT lesion is combined with rotator cuff lesions or other lesions that need to be repaired surgically, surgical intervention is indicated. Tenotomy and tenodesis of the LHBT are 2 classic representative treatments with confirmed results. Tenodesis may be especially beneficial for patients younger than 50 years old or those who perform strenuous labor. The procedure is performed arthroscopically with the following steps. Step 1: A standard posterior viewing portal and an anterior working portal are made. Step 2: After confirmation of the LHBT lesion inside the glenohumeral joint, number-1 polydioxanone (PDS) suture is passed through the tendon before tenotomy is performed just above the superior labrum. Step 3: The tenotomized tendon is pulled out through the anterior portal by gentle traction on the attached PDS suture. A Krackow whip-stitch with nonabsorbable suture is made in the tendon. Step 4: A 7 to 8-mm drill-hole is made in the intertubercular groove of the humeral head just proximal to the insertion of the subscapularis tendon. Step 5: The suture is tightly tied to the distal hole of a 7.0-mm BioComposite SwiveLock Interference Screw (Arthrex). Step 8: The interference screw with the tenotomized end is inserted into the drill-hole. LHBT tenodesis lessens the cosmetic problem of Popeye deformity that is seen after tenotomy. Also, elbow motor power including flexion and supination is preserved.
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PMID:Arthroscopic Tenodesis of the Long Head of the Biceps Tendon. 3023 54


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