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

Plasma levels of sulprostone, a synthetic prostaglandin E2 derivative, were measured along with assessment of platelet function and clinical effects of intramuscular injection in 4 patients. The 4 patients were given 500 mcgm, intramuscularly, of sulprostone to induce missed and therapeutic abortion in the second trimester of pregnancy. Half-life of sulprostone in plasma was 34 minutes (range 30-45), and the highest drug levels were found 10-20 minutes after injection (levels ranged from .25-.77 ngm/ml). Plasma levels diminished to zero after 120-240 minutes. Platelet count was unaltered throughout, although platelet aggregation did decrease slightly, but not significantly, about 20 minutes after injection. Side effects were gastrointestinal and adjudged minimal. An attempt to correlate plasma levels of sulprostone and labor pain or abortion-induction time was fruitless.
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PMID:Biological action and half life in plasma or intramuscular sulprostone for termination of second trimester pregnancy. 722 Jun 53

In common with any medical problem, careful assessment and an analytical approach are the keystones to effective symptom control in advanced cancer. When dealing with such symptoms the multi-faceted pathophysiology must be considered, and due attention paid to the affective component of pain and other symptoms. Adequate care given to history taking and a knowledge of the likely pathogenesis of symptoms in advanced cancer can prevent unnecessary investigations and fruitless trials of inappropriate symptomatic remedies. The treatment chosen should be the simplest effective regimen tailored to the individual patient. The importance of explanation to the patient cannot be overstated and is an integral part of any treatment and the sole component of many. This paper reviews the management of common symptoms in advanced cancer (dyspnoea, nausea and vomiting, constipation, anorexia-cachexia syndrome, hypercalcaemia, confusion, insomnia and depression.
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PMID:Control of common symptoms in advanced cancer. 808 Feb 22

The optimal management of empyema thoracis demands a fundamental knowledge of the pace and timing of the illness. Early free-flowing empyema should be drained by as dependent a drain as possible, while antibiotics directed against the underlying pneumonia are delivered. Late chronic empyema characterized by a constrictive rind intimately fused with the visceral pleura is best managed with an open decortication. Controversy exists when addressing the needs of the patient with a multiloculated acute empyema. Lengthy hospitalizations with prolonged chest tube drainage and administration of antibiotics likely will prove fruitless and culminate in open thoracotomy. The key to successful therapy lies in effective pleural evacuation and re-expansion of the lung. Intrapleural fibrinolytic therapy has been reported to produce excellent results in some centers and is a therapeutic option. Patients undergoing fibrinolytic therapy should be subjected to surgical drainage and debridement if significant improvement is not appreciated within 3 to 5 days. Early limited thoracotomy and thoracoscopic debridement theoretically accomplish the same end result. The advantages of thoracoscopy over limited thoracotomy are enhanced visualization of the pleural cavity and less postoperative pain and dysfunction.
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PMID:Thoracoscopic approach to the management of empyema thoracis. Indications and results. 881 17

Chronic pelvic pain has a prevalence of 15% to 30% of reproductive-age women. It causes a sizable minority of all gynecological visits, and is responsible for much physical and psychological suffering. Although laparoscopic inspection, plus treatment, for pelvic pain has been considered ideal, it is often unnecessary, fruitless, and even hazardous, besides being expensive. Therefore, empirical medical therapy has much to recommend it. Foremost is the fact that endometriosis is the most frequent source of chronic pelvic pain, and responds well to medical treatment. In fact, GnRH analogs (agonists) used for 6 months can reduce AFS endometriosis scores by one-half, with cure rates at 5 years of three-fourths of responders who had minimal disease and one-third of responders with severe disease. Danazol and oral contraceptives plus NSAIDs have been used, too. The latter treatment is best reserved for cases involving dysmenorrhea. The objections to empirical treatment-lack of exact knowledge of the entity being treated and the potential of overlooking cancer-are discussed here in the context of pain treatment, with an emphasis on history taking, diagnostic imaging, and careful observation.
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PMID:Chronic pelvic pain: presumptive diagnosis and therapy using GnRH agonists. 1043 11

Opioids do not yield adequate analgesic effects in at least one-third of all patients suffering from chronic pain. Nonetheless, in contrast to former opinion there is no type of pain that is principally resistant to opioids, which means that the individual patient's response to opioid administration has to be investigated to determine adequate treatment. Opioids fail most frequently in cases of neuropathic, osseous or sympathetically maintained pain. In these cases there is an indication for early use of co-analgesics. The analgesic potency of anticonvulsives and tricyclic antidepressants has been best documented. A differential indication of the large number of possible coanalgesics should be determined with the help of a detailed pain history focussing on the pain quality. Similar to the WHO analgesic ladder used in (tumor) pain therapy, co-analgesic therapy should only be supplemented by invasive therapeutic procedures after various combinations and alternative substances have proven fruitless. Experience shows that this is necessary only for a small number of patients.
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PMID:[Co-analgesics in the treatment of chronic pain]. 1048 11

Affectivity plays an essential role in human life. It gives life its quality, and is responsible for what human beings have always considered to be main endeavor happiness. Still, looking for its description or organisation, in physiology or neurology, treatises is fruitless; there only one of its components is described pain, with no mention of pleasure. We wish to show, here, first, that pain and pleasure, depend of a same function, of which they are, of sorts, both extremities, and which in nothing but the most primitive function of the nervous system, and secondly, that this function in one of the components of an "affectivity center", which has its organisation in the limbic system. This center, integrating all the informations that arrives to the nervous system, triggers to each of them neuro-vegetative and neuro-hormonal informations that are "felt" by the organism, and thus transforms the information in a subjective feeling.
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PMID:[Pleasure, pain and affectivity in the nervous system]. 1056 Jan 66

Aseptic diskitis is relatively common. Several rheumatic diseases involving the spine may have this complication. As this condition mimic infectious diskitis, it is important to recognize it. Clinically, it is characterised by vertebral pain of an inflammatory nature, occasionally accompanied by fever and an increase in the erythrocyte sedimentation rate. Radiologically, the decrease in the articular space and the irregularity of the vertebral plates are of particular importance. Although uncommon, it is necessary to bear in mind this possibility when the etiological search for a possible infectious diskitis proves fruitless. A MEDLINE (1986-2000) and PUBMED (1966-2000) search of relevant articles was performed. Descriptors used were aseptic diskitis, spondylodiskitis, pseudodiskitis and pseudoarthrosis.
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PMID:Aseptic spondylodiskitis in rheumatic diseases. 1179 52

This interpretive-phenomenological study examined the lived experience of being on the waiting list for arthroplastic surgery of the knee or hip. Interviews reveal that respondents experience suffering in different ways: illness-, caring- and life-suffering. Suffering leads to a struggle in order to have their caring needs met and the struggle is often fruitless-against a faceless enemy-"the system". No one is there to answer their plea or the frustration they experience. This in combination with their present life situation may lead to a disrupted self-image. Finding or creating meaning in suffering appears to be a crucial issue in the struggling process. Respondents who are able to preserve or create meaning in life are able to reformulate their life-world and live a full life, in spite of severe pain and disability.
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PMID:Waiting for surgery; living a life on hold--a continuous struggle against a faceless system. 1592 85

The principal author was confronted few years ago with the case of a 38-year-old woman with a 5-month history of ill-defined L5 sciatic pain that was referred to an orthopaedic department for investigation and eventual surgical treatment for what was suspected to be herniated disc-related sciatica. Removal of her enlarged uterus found unexpectedly close to the sacroiliac joint upon lumbar MRI abolished her symptoms. Review of the literature showed that the lumbosacral trunk is vulnerable to pressure from any abdominal mass originating from the uterus and the ovaries. Physiological processes in the female patient and gynaecological diseases may be the source of sciatica, often not readily searched for, leading to fruitless investigations and surgical treatments. The aim of the paper is to highlight gynaecological and obstetrical causes of sciatica and sciatica-like symptoms. To prevent unproductive expenses and morbidity, a thorough gynaecological examination should be done even though neurological examination may be suggestive of a herniated intervertebral disc, and the cyclic pattern of pain related to menses should be routinely asked for.
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PMID:Sciatica in the female patient: anatomical considerations, aetiology and review of the literature. 1662 8

Pain is the most frequent cause of suffering and disability. The etiology of orofacial pain is still elusive. However, the etiology has to be ascertained for definitive treatment. Only after a systematic and careful evaluation can a treating surgeon be aware of the underlying cause. Though dental causes predominate in the diagnosis of orofacial pain, the rare cause of facial pain have to be excluded, which would prevent unnecessary and fruitless dental treatment. The present case is an example of a rare condition that may be overlooked during examination. This paper will describe a case of vague unilateral orofacial pain, the diagnosis of which zeroed down to an elongated styloid process.
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PMID:Facial pain due to elongated styloid process. 2401 20


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