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

The value of preanesthetic assessment of anemia and analysis of the hemoglobin level prior to a minor pediatric surgery has been recently questioned in some reports. This study was to retrospectively analyse 8859 pediatric patients who underwent minor surgery in the period from January 1987 to December 1990 in our hospital. They were all ASA class I-II in physical status with age ranging from one month to 19 years. Those patients with their hemoglobin values determined at other laboratories or hospitals in spite of our recognition and those suspected of having an immune or oncologic disease were excluded from this study. The mean hemoglobin value of the patients under study was 12.99 +/- 0.82 g/dl. 0.62% of the patients (55) were found to have hemoglobin values less than 10 g/dl which were similar to the results obtained by Wood et al (0.7%) in 1981 and Roy et al (0.5%) in 1990. Among the 55 anemic patients, 41 (74.5%) were at the age between 2 to 4 months (within the physiologic anemic period of infancy). Sampling of blood for routine preanesthetic hemoglobin determination which caused discomfort and pain was often rejected by pediatric patients and struggle for escape also upset the children very much. Based on the results from our analysis, we suggest that in healthy pediatric patient scheduled for minor surgery routine hemoglobin test could be excluded. Hemoglobin test is selectively performed in a patient is anemic or under suspicious circumstances. The value and shortcomings of selective hemoglobin test before surgery require further evaluation.
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PMID:Is routine preanesthetic hemoglobin test necessary in minor pediatric surgery? 130 89

Osseous lesions of the cervical spine present a spectrum of histopathology varying from benign to highly malignant tumors. Vertebral body resection and reconstruction are possible at all levels of the cervical spine. This affords decompression of the spinal cord even with anterior or anterolateral masses. Resection of the posterior arch or vertebral body should be followed by internal fixation with Halifax clamps, Roy-Camille plates, or Ransford rods posteriorly with a bony fusion or by Caspar plates, strut grafts, or acrylic anteriorly. Restoration of spinal alignment must be carefully planned to correct any structural deficits. In those patients who are not considered as surgical candidates, steroids, chemotherapy, or radiation remain effective alternatives in attempting to relieve pain or reverse neurologic deficits. Earlier awareness and evaluation for this group of patients will afford relief of pain, reversal of neurological deficits, stabilization of the cervical spine, and early immobilization.
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PMID:Osseous lesions of the cervical spine. 200 15

The comments by Gray, Gelder, Liebowitz, Eysenck, Nurnberger, Roy and Linnoila are discussed. Most of the recommendations in the comments have already been carried out and the others are under way. Specifically, practical assessment instruments have been developed, and their psychometric properties are under investigation. Explicit criteria for systematic diagnosis of personality disorders have been developed. Longitudinal studies have been carried out to evaluate the predictive validity of the scales. Empirical tests have confirmed the predicted relationship between novelty seeking and somatic anxiety, as well as between harm avoidance and cognitive anxiety. A more detailed model of the underlying neural processes has been described. Growing evidence of norepinephrine's role in reward dependence has been reported. Finally, a more comprehensive learning model has been developed that can account for both the higher-order and the lower-order factor structure of personality in terms of specific stimulus-response characteristics. Several commentators have provided additional evidence supporting the predicted role of the monoamines in modulating personality and learning. Finally, predictions from my model about pain sensitivity, stimulus intensity modulation, and the factor structure of personality have been compared to those of Gray and Eysenck. The predictions are confirmed for my model, but not those of Gray or Eysenck.
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PMID:A unified biosocial theory of personality and its role in the development of anxiety states: a reply to commentaries. 290 36

A new case of sub-occipital Pott's disease is reported: a 26 year old, coloured male patient from Senegal was admitted for: cervical pain of 6 month duration, neck stiffness, dysphagia, left XII paralysis and left hemiparesis. The radiological study found an anterior atlanto-axial subluxation, basilar impression, and increased thickness of the retropharyngeal soft tissue, lysis of the left occipital condyle and the left lateral mass. CT scan study revealed a retropharyngeal mass and an epidural contrast-enhanced lesion at the C2 C3 C4 levels. Chest-X ray showed one tuberculous lesion at the right apex. The research of Acid Fast Bacilli in gastric secretion samples and the results of the retropharyngeal mass puncture were positive. An antituberculous trichemotherapy was started. After early reduction by skull tongs traction, an occipito-cervical arthrodesis by Roy Camille plates was performed, followed by the wearing of a minerva plaster jacket and then a plastic collar. Each one for a 5 month period. One year later, there remained only a left XII paralysis, but the bony reconstruction was not yet obvious on tomography. A survey of the literature of 70 cases of sub-occipital Pott's disease has pointed out these findings: cervical pain (98%), neck stiffness (82%), Atlantoaxial subluxation (68%), thickened prevertebral soft tissue shadow (77%), lateral mass lysis (48%) other tuberculous focus (29%). The main therapeutic trends are: early and long-lasting antituberculous poly-chemotherapy, early reduction of subluxations, prolonged contention for slight osteolytic lesions and for major: lytic lesions, a posterior surgical procedure either by bone graft combined with wires or preferably fusion by means of occipito-cervical plates. The removal of abscess is discussed.
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PMID:[Suboccipital Pott's disease]. 344 87

The authors report their experience in the treatment of malunited fractures of the spine. After eliminating reducible lesions, the methods of treatment used for fixed irreducible lesions are described. In the cervical spine, the approach is anterior, and includes corporectomy to decompress the medullary canal. It is often impossible to restore cervical lordosis but this is not essential. In the dorsal, dorsolumbar and lumbar spines, experience has demonstrated the inadequacy of isolated anterior and posterior surgical approaches, so a combined approach is proposed aimed at achieving good results, both neurological and mechanical. Reconstruction of the vertebral body is carried out by anterior grafting using bank bone from femoral heads, while fixation is achieved posteriorly by the use of Roy-Camille plates. Indications are carefully considered, taking into account that progression is always a possibility in patients with no neurological deficit. The results are analysed in 14 cervical lesions and 10 dorsolumbar lesions. This operative treatment frequently produced stabilisation as well as the regression of pyramidal signs, but recovery of medullary lesions was never observed. The relief of pain, however, was a constant finding.
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PMID:The surgical treatment of post-traumatic vertebral deformities. 361 Jun 8

Surgical treatment of lesions of the vertebral column is indicated for concomitant disturbed neurological functions showing an increasing tendency. In cases of a primary complete transverse paralysis, an improvement cannot be expected. The influence of the applied paraspinous plates on the rehabilitation is judged differently. The operation is carried out from a dorsal access. After laminectomy and decompression of the spinal marrow or cauda, stabilisation is effected by means of two paraspinous osteosynthesis plates similar to the method after Roy- Camille . Our own procedure is described, the results are demonstrated by the example of seven patients treated in this way. The authors are of the opinion that it is justified to continue employing this method and extend the range of indications to include also severe instable luxation fractures of the thoracic and the lumbar part of the vertebral column without disturbed neurological functions being present . The care of such patients is facilitated by the fact that pain is improved and degenerative changes and late damage prevented.
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PMID:[Surgical stabilization of fractures of the thoracic and lumbar portion of the spine using paraspinal metal plates]. 673 Jul 89

Thirty patients underwent fixation of the thoracic and lumbar spine from 1986 to 1990 using the Roy-Camille pedicular screw fixation system. The spine was stabilized for a variety of pathologic entities including fracture, tumor, spondylolisthesis, postlaminectomy instability, and pseudarthrosis. All but one patient obtained solid fusion based on radiographic and clinical criteria with an average follow up of 19.5 months. All patients reported subjective improvement in preoperative pain levels. There were no neurologic complications associated with the surgical procedure. Roy-Camille plate fixation appears to offer a stable surgical construct in the treatment of thoracic and lumbar spine instability.
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PMID:Internal fixation of the thoracic and lumbar spine using Roy-Camille plates. 832 57

The purpose of this study was to examine the adequacy (operational, empirical, and pragmatic) and scope of the Roy adaptation model and the gate control theory of pain to guide the cross-cultural study of pain. The sample consisted of 60 Mexican-American and Anglo-American women undergoing elective cholecystectomy. The conceptual-theoretical-empirical structure developed by Fawcett and Downs (1986) provided the framework for designing the study. Operational adequacy was determined by examining the reliability and validity of the empirical indicators used; it was judged adequate. Empirical adequacy was evaluated by comparing empirical data to hypothesized expectations. Only some of the conceptual-theoretical relational statements were supported. Pragmatic adequacy was assessed by determining whether innovative practice strategies might be derived from the data; several were recommended. Finally, the scope was determined by examining the variables identified by the model and several additional variables. Scope was judged adequate to the current stage of the model's development.
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PMID:The adequacy and scope of Roy's adaptation model to guide cross-cultural pain research. 836 11

Guided by the Roy Adaptation Model of Nursing, the relationship of children's age, gender, exposure to past painful experiences, temperament, fears, and child-rearing practices to their pain responses to a venipuncture was examined. A sample of 94 children aged 8 to 12 years and their female caregivers were recruited from three outpatient clinics. During the venipuncture, children's behavioral and heart rate responses were monitored; immediately after, their subjective responses were recorded. Canonical correlation revealed two variates. In the first, age and threshold (temperamental dimension) correlated with pain quality, behavioral responses, and heart rate responses, explaining 12% of the variance. In the second, age, the temperamental dimensions of distractibility and threshold, and medical fears explained only 5.7% of the variance in pain quality and heart rate magnitude. Significant correlations between pain intensity, quality, behavioral responses, and heart rate responses support the multidimensionality of pain.
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PMID:Correlates of pain-related responses to venipunctures in school-age children. 917 4

Preterm infants are not physiologically or developmentally prepared for life outside the supportive environment of the mother's womb. Their response to stimuli is often immature and disorganized rather than adaptive. The Roy Adaptation Model's theory of an adaptive person may provide a framework for nurses to assess, plan, and evaluate nursing care for fragile preterm infants. The article examines actual and potential stressors of the premature infant; describes commonly observed disorganized, ineffective responses; and proposes a clinical tool (the STRESS tool: signs of stress, touch interventions, reduction of pain, environmental considerations, state, and stability) that nurses can use when caring for medically fragile infants.
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PMID:Preterm infants and STRESS: a tool for the neonatal nurse. 921 64


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