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

A questionnaire has been completed by 99 patients referred for investigation of symptoms after gastric operations. The replies were analysed in an attempt to distinguish patients with a recurrent peptic ulcer from those with no recurrent ulcer. All cases were investigated by barium meal, endoscopy, and oral cholecystography. All recurrent ulcers were confirmed by reoperation and patients with gastric carcinoma, gallstones, or symptomatic hiatus hernia were excluded. The study was retrospective in 40 patients in whom the diagnosis was already confirmed when the questionnaire was analysed and prospective in 59 in whom the diagnosis was originally unknown. The replies were analysed with (a) a small computer using Bayes' theorem, (b) weighted tables, and (c) a discriminant analysis. The computer prediction of the prospective data was 85% accurate. The results of simpler methods were almost as good as the computer prediction, and questions related only to the severity of pain and vomiting accurately distinguished recurrent ulcer from other causes of dyspepsia in 81% of patients.
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PMID:A symptomatic discriminant to identify recurrent ulcer in patients with dysperpsia after gastric surgery. 5 52

A 22-year-old man with burning pain in the lower abdomen and rectal bleeding had a sodium pertechnetate Tc 99m scan. The scan showed an area of uptake in the right lower quadrant which at operation was found to be a Meckel's diverticulum. The ability of ectopic gastric mucosa within a Meckel's diverticulum to concentrate sodium pertechnetate Tc 99 m allows for this noninvasive diagnosis of some types of rectal bleeding, especially when the cause has escaped detection by conventional endoscopic and barium contrast examinations.
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PMID:Preoperative diagnosis of rectal bleeding in an adult using a radioisotope scan. 30 63

A case report and review of the problem of duodenal leiomyoma are presented. Although these lesions are rare and usually asymptomatic, they can present with symptoms of hemorrhage, obstruction, pain, and perforation. Barium roentgenographic examination may show filling defects of compressive lesions. Angiography shows a hypervascular, encapsulated lesion. Endoscopy may reveal a submucosal mass with central depression. At operation, it is important to distinguish the benign leiomyoma from leiomyosarcoma.
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PMID:Duodenal leiomyoma as a cause of gastrointestinal hemorrhage. 30 63

Blood flow disturbances in the gastrointestinal tract can lead to serious illness. They can be acute or chronic, their cause may be arterial or venous occlusion or hypotonia. Lesions of the gastrointestinal tract caused by ischemia depend on localisation, acuteness and degree of the blood flow disturbance. They may reach from focal and segmental ischemic lesions to extensive necroses of the entire intestinal tubes. The most serious ischemic disease is the embolic and thrombotic occlusion of the arteria mesenterica superior due to previous arterosclerotic damage. Infarction of a large part of the intestines and peritonitis can be the consequence. These patients' only chance of survival is early diagnosis--as a rule exclusively via angiography--and immediate surgery. Chronic occlusion of the arteria mesenterica superior leads to angina abdominalis which mainly occurs after food intake and can last for hours. The reason may also be a general arteriosclerosis. Men are affected more frequently and at a younger age than women. As a consequence of lowered intestinal blood flow these patients suffer from malabsorption and heavy weight loss. Conservative therapy is not effective. These patients, too, will have to be treated surgically after previous angiography. Vascular disease with decreased blood flow as its consequence can be found in a number of inflammatory diseases, in malign hypertensian, in collagen disease and in other more rare diseases as pseudoxanthoma elasticum or Ehlers-Danlos-syndrome. In the case of ischemic colitis arterial and more rarely venous occlusions cause decreased blood flow in the big bowel. A frequent consequence is colitis in the left colon which is characterized by acuteness, pain in the left side of the abdomen and by heavy rectal bleeding. Diagnosis is established by means of endoscopy, barium enema and angiography. Primarily therapy of ischemic colitis is of the conservative type. In severe cases with gangrene and peritonitis the colon has to be resected.
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PMID:[Disorders of the blood circulation in the gastrointestinal tract]. 32 26

Five hundred and four patients who had undergone hospital investigations were interviewed to find out how much information they had been given about the tests; their reactions before, during and after the test; and any after effects. In 74% of cases the tests had been satisfactorily explained. Patients were told more about complicated procedures such as cardiac catherisation than about routine ones such as venepuncture or barium meal examinations. The comments doctors made while performing the investigations were generally reassuring and were only rarely worrying or impatient. About half the patients suffered pain or discomfort during the test and rather more complained of after effects. Only 5% of patients said they would refuse the test again, though 36% said they would agree only reluctantly. Communication lies at the heart of the problem. Hospitals should consider issuing handouts on investigations to back up the doctor's information and to dispel myths. Staff should be more careful in concealing frightening-looking equipment, and if patients have to wait during investigations it may help reduce their anxiety if they are provided with something to occupy their time.
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PMID:Patients' reactions to their investigations: a study of 504 patients. 49 53

Twenty-two cases of probable esophageal or pharyngeal foreign body seen at an emergency service were studied retrospectively, using 15 predetermined factors chosen to detect or anticipate the acute consequences of foreign body ingestion. Three findings were particularly predictive: 1) foreign body visualized directly or on plain x-ray films; 2) hypersalivation; 3) obstruction or foreign body image in the esophagus on barium swallow. No patient with none of these three abnormal findings, even in the presence of localized pain increased by swallowing, received further treatment, and no complications developed. All patients with any one of these three findings underwent direct foreign body removal (four cases) or esophagoscopy (11 cases). Five esophageal foreign bodies passed spontaneously into the stomach before esophagoscopy; four foreign bodies were removed, and two esophagi were abnormal (stricture, myasthenia gravis). In two cases no foreign body was found. Hypersalivation was the only finding always associated with an abnormal esophagoscopy. Particular attention must be paid to the interpretation of plain x-ray films, with regard to probable foreign body location at the cricopharyngeal constriction and to indirect signs such as fluid levels, soft tissue swelling, free air, if small foreign bodies are not to be missed.
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PMID:Suspected esophageal foreign body -- choosing appropriate management. 51 15

Rate of emptying of the stomach before and after injury was studied by feeding dogs with barium and taking X-rays at regular intervals before and following injury. The injured extremity was not protected in the first group of dogs, and was protected by a cast or splint in the second group. The dogs in a third group were sedated with Nembutal. As compared to control the emptying of the stomach after trauma was markedly delayed or even stopped in the first group and was accelerated in the second group. It was very slow before and after trauma in the Nembutal group. The delay noted in the first group was not related to the time of trauma, but to the time of developing severe pain, swelling, and shock. Mechanical immobilization appeared to be the most important method of preventing the delay of emptying of the stomach after injury; sedation slowed down normal function of the stomach.
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PMID:Relationship between trauma to the extremities and stomach motility. 59 40

Duodenal ulcer is a common disease which places heavy demands on health care costs. The aetiology is unknown, but its pathogenesis is related to acid secretion. The characteristic symptom is chronic epigastric pain which precedes meals, occurs one to three hours after food, and one to two hours after retiring. The pain is relieved by food or antacids. Barium meal remains the prime investigation, but flexible endoscopy allows accurate visualization of the ulcer particularly in a scarred deformed duodenum. Complications include haemorrhage, perforation and obstruction. Time-honoured therapy including diet, antacids and anticholinergics simply relieves pain, whilst newer drugs (Tagamet, De-Nol, and Duogastrone) are effective in healing the ulcer. Surgery is indicated for complications or inadequately relieved pain.
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PMID:Duodenal ulcer. 73 57

Surgical management of osteoarthritis, aseptic necrosis and rheumatoid arthritis has been revolutionized by the introduction of acrylic cement-stabilized joint surface replacement. Although single joint surface replacements have been employed extensively for more than half a century, total surface replacement operations with a wear-resistant high-density polyethylene and noncorrosive stainless steel stabilized by acrylic cement were introduced only a little more than 12 years ago. This evolved with Charnley's discovery of the high level of bone tolerance for acrylic cement. Acrylic cement made it possible mechanically to bond artificial joint surfaces to the bone ends and produce an insensitive Charcot-like functioning joint. A barium sulfate additive makes the cement radiopaque for visualizing the bone-cement interface. Barium sulfate additive also lowers the polymerization temperature and opens the polymer for influx of interstitial fluids. Antibiotics have also been added to the cement for prevention and treatment of infection of the surrounding tissues. In aged individuals with cardiovascular disease, the absorption of the acrylic monomer depresses cardiac output and produces hypotension for 2-5 minutes after impaction of acrylic cement into spongy bone. The hypotension has been minimized by cautious fluid replacement and maintenance of adequate blood volume before, during and after the operation. Approximately 30,000 total hip arthroplasties are performed in the United States annually in patients older than 50 years of age with fractured femoral head replacements, bilateral rheumatoid arthritis, old neglected congenital dislocations of the hip or osteonecrosis with and without osteoarthritis. The pain relief is more complete and the functional improvement more predictable than in any other previously recommended surgical operation for the purpose. For this reason, total hip arthroplasty has almost completely supplanted mold-arthroplasty, osteotomy, capsulotomy (hanging hip) and resection of the femoral head. Hemiarthroplasty in the form of femoral head replacement still is the procedure of choice in patients with fractures of the neck of the femur and a normal acetabular articular cartilage, irrespective of age. As a countermeasure against loosening of the prosthesis in patients with osteoporosis and a hollow proximal end of the femur, the stem can be stabilized with acrylic cement. A standard replaceable femoral head for subsequent conversion of femoral head replacement to total hip arthroplasty is an important consideration and presently is under investigation in several medical centers.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Acrylic cement stabilized joint replacements. 80 82

Volvulus of the sigmoid colon is a very uncommon cause of acute obstruction in children. Although common in adults in India, it was found to account for only 0.8 per cent of all acute obstructions in infants and children in this institution. It causes a proximal torsional obstruction of the colon with an acute onset of symptoms. The onset of volvulus is characterized by colicky pain over the left lower quadrant, vomiting, tenderness, and rigidity in te left lower quadrant. A scout film of the abdomen may be inconclusive, but a barium-enema examination is diagnostic. The number of cases reported is too small to allow conclusions about the best treatment for children who have sigmoidal volvulus.
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PMID:Sigmoidal volvulus in childhood: report of two cases. 83 63


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