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

A linear relationship exists between the overpressure of inert gases in the tissues which is tolerated without symptoms, and the ambient pressure in the range between 1.0 and 50.0 bar. Sixteen subjects, all residents at normal atmospheric pressure and saturated with a nitrogen pressure of 0.75 bar, were decompressed to an ambient pressure of 0.47 bar (corresponding to an altitude of 6000 m above sea level) in 15 minutes. During a 3 hours' stay at this pressure breathing air, symptoms of hypoxia developed but not arthralgias. After hyperbaric exposures in the range between 4.0 and 5.1 bar breathing air, 103 subjects were decompressed and exposed to an ambient pressure between 0.60 and 0.85 bar after surface intervals of varying duration. In 31 of the 103 subjects, the ambient pressure was more reduced than according to the tolerated linear relation. 7 of these 31 subjects reported light pain in the shoulders of knees during the 2 hours' stay at the reduced ambient pressure. These trials demonstrate that the linear relationship between the ambient pressure and the overpressure of inert gas in the tissues tolerated without symptoms is also valid at altitude.
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PMID:[Decompression during lowered air pressure]. 608 47

Bleomycin is gaining increasing popularity in the treatment of warts, but its efficacy has not been examined in well-controlled studies. We evaluated bleomycin in a double-blind placebo-controlled crossover study in recalcitrant warts treated unsuccessfully by conventional methods. Patients were assigned alternately to placebo or bleomycin groups and treated by intralesional injections of bleomycin, 1 U/ml, or saline, at 2-week intervals. If warts persisted, patients were changed after two injections to the alternate group and retreated with up to two further injections. Forty patients entered the study. Of 151 warts treated with intralesional bleomycin, 123 were cured after one or two injections (81%). The cure rate for plantar warts (60%) was lower than that for periungual warts (94%) and warts elsewhere on the extremities (95%). Fifty-five warts were injected with normal saline; none was cured. Responding warts showed a hemorrhagic eschar and healed without scarring, atrophy, or pigmentary change. Pain was usually mild and patient acceptance superior to that with liquid nitrogen. There was no evidence of systemic toxicity. Bleomycin is highly efficacious in the treatment of recalcitrant warts, is convenient, and has high patient acceptance. Long-term safety requires further study.
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PMID:Bleomycin in the treatment of recalcitrant warts. 619 52

In this clinical trial of men with advanced prostatic cancer no longer responsive to hormone therapy 189 were randomized to receive estramustine phosphate, methotrexate or cis-platinum. Response evaluations were done in 158 cases. Objective response rates (complete, partial or stabilization of disease) were 34 per cent for estramustine phosphate, 36 per cent for cis-platinum and 41 per cent for methotrexate. Subjective parameters indicated a substantial advantage for pain improvement with methotrexate or cis-platinum over estramustine phosphate. Probabilities of continued response indicated some advantage for methotrexate and median response durations at this time were twice as long for methotrexate (32 weeks) as for cis-platinum (16 weeks), with estramustine phosphate intermediate (23 weeks). Survival rates for the original treatment randomization groups were not different at this time. Side effects of estramustine phosphate consisted primarily of nausea and vomiting and/or anorexia but to a lesser extent than with cis-platinum. These effects were somewhat less for methotrexate, for which the major side effects were stomatitis and leukopenia, as well as hepatic toxicity reflected by elevated serum glutamic oxaloacetic transaminase levels. Other side effects of cis-platinum were less than for methotrexate (no stomatitis), except for signs of renal toxicity (elevations in blood urea nitrogen and serum creatinine), which were greater. Methotrexate had a relatively high level of activity against metastatic, progressive, hormone nonresponsive prostatic cancer, with side effects that were substantial but manageable.
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PMID:Comparison of estramustine phosphate, methotrexate and cis-platinum in patients with advanced, hormone refractory prostate cancer. 634 29

Over the past several years, clinicians have become aware of the importance of maintaining a positive nitrogen balance in hospitalized patients. This has led to the widespread use of total parenteral nutrition (TPN). However, with increased experience with this form of nutrition, numerous potential complications have been uncovered. One of the complications demonstrated with increased frequency is that of abnormal liver function, manifested by elevated serum liver enzymes. This report describes a 44-year-old woman with rectal abscesses and possible inflammatory bowel disease who developed severe right upper quadrant pain, abnormally elevated liver enzymes, and elevated body temperature during her course of TPN therapy. These problems possibly were related to the TPN regimen. Once TPN therapy was discontinued, the patient's liver enzyme values and elevated body temperature began to return to baseline. She subsequently was discharged from the hospital. A follow-up visit to the physician's office revealed that all liver enzyme values had returned to normal, the pain had resolved, and she was recovering well.
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PMID:Acalculous cholecystitis and fever related to total parenteral nutrition. 643 83

Sixty-two patients with intractable pelvic pain secondary to malignancy arising in the pelvis received a total of 72 percutaneous retrograde arterial infusions with nitrogen mustard. Fifty-three (74%) injections resulted in marked relief of pain for an average period of six to eight weeks. Five (7%) produced no pain relief. Toxicity was mild. There were two severe complications and no deaths related to the procedure or the drug in this study. Percutaneous retrograde arterial infusion with nitrogen mustard is suggested as the preferred procedure in the attempt to control pelvic pain caused by malignancy, before resorting to spinal cordotomy or intrathecal alcohol injection.
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PMID:Arterial infusion of nitrogen mustard in the treatment of intractable pelvic pain of malignant origin. 644 64

The effects of N-nitrosothiazolidine (NNT) and N-nitrosomorpholine (NNM) on different biological parameters were investigated and compared. The oral LD50 value of NNT (1950 +/- 85 mg/kg) showed that it was about 6 times less toxic than NNM (LD50 = 320 mg/kg, po; Druckrey et al., 1967). Lethal and near-lethal doses (greater than or equal to 1500 mg/kg, po) of NNT caused central nervous system depression (reduced spontaneous motor activity, loss of righting and pain reflexes, without loss of consciousness), stereotypical behavior such as, purposeless chewing jaw movements lasting more than one hour, muscular rigidity, and in some rats, rare and brief clonic convulsions, 3 to 24 h after dosing. These neurotoxic signs, as a whole, were reminiscent of opioid intoxication. Rats that died after NNT-treatment had kidney necrosis in the distal tubules, but all survivors had normal kidneys. NNT (500 and 1000 mg/kg, sc) had no effect on the relative liver weights, but it inhibited liver mitosis at 24, 48, and 72 h after treatment. NNM (100 mg/kg, sc) decreased the relative liver weights on 3 posttreatment days; it inhibited liver mitosis after 24 h and enhanced it after 48 h in male rats. Both NNT and NNM increased the relative adrenal weights, but only NNM enhanced adrenocortical mitosis. In general, NNT had no effect on serum enzymes (SGOT, SGPT, LDH, HBDH), but it increased blood urea nitrogen (BUN) and serum creatinine 24 h after administration. Pretreatment of rats with 3 doses of NNT (150 mg/kg X d, po) increased the pentobarbital-induced sleep (PST) by 26% (not significant), while 3 doses of NNM (50 mg/kg X d, po) increased PST by 188%. In addition, NNM caused a severe centrilobular liver necrosis and glycogen depletion, associated with a marked rise in serum enzymes (SGOT, SGPT, LDH, HBDH) and fall in serum glucose. Compared with NNM, NNT, which was found in fried bacon (Kimoto et al., 1982; Gray et al., 1982), seemed to be a relatively nontoxic nitrosamine.
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PMID:Comparison of the acute toxicities of N-nitrosothiazolidine and N-nitrosomorpholine. 649 89

This study was undertaken to measure the blood concentrations of bupivacaine associated with a single loading dose followed by continuous epidural infusion for the management of the pain of labor and delivery with special reference to the potential for accumulation and toxicity. Four-milliliter venous blood samples were obtained every 15 min following the loading dose until delivery. If inadequate analgesia was observed just prior to delivery, an additional dose of bupivacaine was administered. Bupivacaine concentrations were measured using a double extraction technique followed by gas chromatographic analysis using a nitrogen-specific detector. Clearance, volume of distribution, and rate of absorption were estimated from the blood concentration time data and were 43.39 +/- 11.46 L/h, 67.56 +/- 17.66 L, and 8.97 +/- 3.69 h-1, respectively. Peak serum bupivacaine concentrations were 0.68 +/- 0.14 microgram/ml and occurred 0.58 +/- 0.25 h following administration of the loading dose. The duration of bupivacaine infusion was 3.42 +/- 0.80 h. Serum bupivacaine concentrations at delivery or just prior to administration of a supplemental delivery dose were significantly lower than the peak concentration in all patients (p less than 0.001). Fetal-to-maternal serum concentration ratios were found to be 0.44 +/- 0.16 for the six patients requiring a supplemental delivery dose and 0.44 +/- 0.13 for the six patients receiving bupivacaine only by infusion. The data reported here illustrate that epidural analgesia for labor and delivery achieved using a single 50-mg loading dose followed by a continuous infusion of 12.5 mg/h of bupivacaine will not result in maternal or fetal accumulation or toxicity.
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PMID:Serum bupivacaine concentrations in term parturients following continuous epidural analgesia for labor and delivery. 651 1

Substantial relief of discomfort may be anticipated by most patients suffering from pelvic and lower-extremity pain who are treated by arterial infusion of nitrogen mustard. Seventy-three patients with intractable pain secondary to malignancy arising in the pelvis received 83 percutaneous pelvic arterial infusions of this drug. Sixty infusions (72%) resulted in marked relief from pain for periods averaging 6-8 weeks. Advantages of the procedure are low toxicity, relative simplicity and availability of technique, and an acceptable rate of complications with minimal morbidity. Patients experiencing satisfactory results may expect significant relief from a second infusion for recurrent pain. The most rewarding result is the freedom from the cyclic return of pain characterized by oral and intramuscular analgesic therapy. Little or no relief can be expected in patients with pain caused by compression fractures of the vertebrae, or where the tumor burden is so great that adequate perfusion of the involved nerves is not possible. One should consider this procedure for controlling pain before resorting to the more dangerous and potentially disabling techniques of spinal cordotomy or intrathecal alcohol injection.
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PMID:The use of nitrogen mustard in the treatment of intractable pelvic pain. 664 7

This is a retrospective review of 233 patients who had surgical exploration for proven or suspected malignant lesions of the exocrine pancreas and periampullary structures. There were 24 patients with carcinoma of the ampulla or duodenum, 12 with carcinoma of the bile duct, and 197 with lesions of the pancreas. Among the latter group, 128 patients had carcinoma diagnosed at initial operation (31 by duodenopancreatectomy, 33 by liver, and 64 by other biopsies), and 69 patients had suspected carcinoma of the pancreas without histological proof. History of jaundice, pruritus, nausea/vomiting, total weight loss, duration of pain, and values of blood urea nitrogen, bilirubin, alkaline phosphatase, and albumin were significantly different among the various groups. Patients who had resection of carcinoma of the duodenum or ampulla had the best 5-year survival rate (39 +/- 12%). Among patients with resectable or nonresectable carcinoma of the pancreas, some of the symptoms and laboratory tests studied had prognostic significance.
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PMID:Clinical and laboratory findings of carcinoma of the pancreas and periampullary structures. 669 85

From mid-May to mid-July 1980, 363 anaesthesias were carried out in the refugee camp Khao I Dang on the border between Thailand and Kambodia. These were done in a tropical climate under difficult conditions. The patients were refugees, mostly injured in the war. Regional anaesthesias were generally preferred as they are safer for the patients and not so much surveillance is necessary. For general anaesthesia ketamine combined with diazepam and in most cases assisted respiration by a combination of nitrogen oxide - oxygen and halothane were selected. Anaesthesia was induced by thiopental or diazepam on patients with eclampsia or head injuries or toxic goitre. Apart from a laryngospasm no other severe complication occurred. To reduce pain after an operation, ketamine infusion was successfully employed in isolated cases.
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PMID:[Anesthesiological care in a field hospital in Thailand with special regard to ketamine (Ketanest)]. 685 98


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