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

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

In a consecutive series of 227 psychiatric hospital admissions, data were recorded in respect of the complaint of pain. Eighty-six (38%) had pain. Fourty-four (19%) mentioned it spontaneously and 49 (22%) had no relevant physical cause. Women were affected more often than men (P less than 0.01) and tended to complain more often of severe pain (P less than 0.01). Severe pain was more often reported spontaneously (P less than 0.02). Also, the longer pain lasted the more likely the patient was to report it spontaneously (P less than 0.02). Men more often had a relevant physical diagnosis (P less than 0.05) and the low back was the commonest site of pain in them. Pain was relatively often associated with diagnoses of anxiety and personality disorder and relatively infrequently with schizophrenia, organic brain syndromes and transient situational disturbances. It is concluded that whilst there is a strong association between pain and psychiatric illness, this is less prominent, paradoxically, in some of the more severe psychiatric disturbances.
Pain 1978 Apr
PMID:Significance of pain in psychiatric hospital patients. 64

Prior to undergoing diagnostic coronary angiography, 94 men responded to tests for the coronary-prone behavior pattern, anxiety, depression, and neuroticism. Independently, cardiologists rated cineangiograms by the percent of atheromatous luminal obstruction in four major coronary arteries. The patients with greater atheromatous obstruction scored significantly higher than those with lesser disease on all four scales of the test for the type A coronary-prone behavior pattern. Those with more seriously diseased vessels also scored significantly higher on anxiety and depression scales but significantly lower on a denial scale. Men rated as having more frequent and intense angina pain scored significantly higher on hypochondriasis, depression, and admission of symptoms than men less subject to ischemic pain. Multivariate statistical analyses revealed that the findings regarding extent of atherosclerosis are independent of anginal pain or congestive heart failure.
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PMID:Psychological correlates of coronary angiographic findings. 98 97

Disease patterns in RA vary between the sexes; the condition is more commonly seen in women, who exhibit a more aggressive disease and a poorer long-term outcome. Men, however, are more likely than women to die from extra-articular complications of rheumatoid disease. This chapter discusses the outcome and mortality studies that substantiate these conclusions and then examines the possible mechanisms that may account for them, including the HLA system, seropositivity, compliance, response to therapy and pain threshold. In particular, sex and sex hormones emerge as independent risk factors in rheumatoid disease. The epidemiological evidence points towards a peak age of onset of RA at the time of the menopause in women and towards later in life in men. Premenopausal women may fare better than postmenopausal women with RA. The possible protective effects of the oral contraceptive pill and the dramatic amelioration with pregnancy are well documented. In vivo and in vitro studies have demonstrated that sex hormones interfere with a number of the putative processes involved in the pathogenesis of RA, including immunoregulation, interaction with inflammatory mediators and the cytokine system, and direct effects on cartilage itself. All these observations point towards the importance of gonadal hormones. However, trials on the potential therapeutic use of sex hormones in RA are limited and, as yet, disappointing. Further work is necessary to determine whether the roles of sex hormones are as central protagonists or just supporting cast in the complex arena of rheumatoid disease.
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PMID:The effects of gender and sex hormones on outcome in rheumatoid arthritis. 156 36

Presenting signs and symptoms of 193 patients with choroidal melanomas (followed for up to 152 months) were recorded using retrospective chart review. Eighty patients (41%) had no symptoms (the melanoma was found during routine ophthalmologic examination in 65 patients and during treatment for other eye problem in 15 patients). We found 113 patients (59%) had symptoms (visual acuity or visual field defects, 77 patients; flashes or floaters, 30 patients; pain, 5 patients, and metastatic disease, 1 patient). The tumor size was related to the presence or absence of symptoms (chi-square, 10.6; P = .005). More tumors that presented with symptoms were medium sized (64%) than large (27%). Men had significantly more symptoms (chi-square, 4.1; P = .04). The right eye was more likely to be involved in patients with symptoms (chi-square, 7.3; P = .007). Kaplan-Meier survival analysis for age, sex, presence of tumor or retinal detachment in the macula, tumor location, presence of symptoms, laterality, and tumor size showed that only tumor size was related to a difference in incidence of metastasis (log-rank chi-square, 12.9; P = .002). With increased tumor height, the probability of developing metastasis was greater.
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PMID:Presenting signs and symptoms of choroidal melanoma: what do they mean? 163 29

This study selected 205 subjects aged 55 years who had shoulder and/or back pain complaints to determine the relationship of somatic and nonsomatic pain experience to body build, physical fitness, bone mineral content, serum levels of gamma-glutamyltransferase, occupational workload and intelligence test, educational level, life success, social support, stress at work, monotonous work, and job decision latitude. Men with a somatic back pain drawing experienced more stress at work and had higher serum levels of gamma-glutamyltransferase, indicating a higher intake of alcohol and/or painkillers, but were more satisfied with their jobs compared with men who had a nonsomatic pain drawing. Women with obvious shoulder signs and symptoms and/or a somatic back pain drawing tended heavier than women without symptoms, had higher serum levels of gamma-glutamyltransferase, and found their jobs more mentally demanding than did women with shoulder and/or back pain experience but without obvious shoulder signs and symptoms and/or a nonsomatic back pain drawing.
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PMID:Somatic versus nonsomatic shoulder and back pain experience in middle age in relation to body build, physical fitness, bone mineral content, gamma-glutamyltransferase, occupational workload, and psychosocial factors. 168 13

Coaxial balloon dilation catheters recently have been introduced for transurethral dilation of the prostate. We applied endoscopically a specially designed high pressure, large diameter balloon catheter to patients with benign prostatic hyperplasia or primary bladder neck hyperplasia who presented with symptomatic, cystoscopic and urodynamic evidence of obstruction. We report our preliminary experience with 42 patients: 28 with benign prostatic hyperplasia and 14 with bladder neck hyperplasia. Six months after dilation 46% of the patients demonstrated at least a 25% improvement in subjective (symptom score) and objective (corrected peak flow rate) parameters, while 6 (21%) experienced excellent (greater than 50%) symptomatic improvement despite unchanged corrected peak flow rates and 3 (11%) showed significant (greater than 50%) improvement in corrected flow rate alone. At 1, 3, 6 and 12 months the symptom scores decreased by 70, 67, 61 and 59% (median) from pre-treatment levels. Men with benign prostatic hyperplasia fared better than those with primary bladder neck hyperplasia (74 versus 58% decrease at 6 months). Objective evaluation by corrected peak flow rates demonstrated 25, 24, 28 and 2% median improvement at 1, 3, 6 and 12 months, respectively. Patients with primary bladder neck hyperplasia had substantially greater increases than those with benign prostatic hyperplasia (47 versus 27% at 6 months). Immediately after dilation the serum prostate specific antigen level increased by at least 1.5 ng. per ml. in 16 of 22 patients, indicating significant tissue trauma. Complications included mild bleeding and pain for the initial 24 hours and transient urinary retention in 2 patients. Our experience demonstrates the safety of an endoscopic approach to balloon dilation of the prostate that allows the urologist to maintain a central role in the assessment of a new approach to the treatment of obstructed voiding dysfunction.
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PMID:Endoscopic balloon dilation of the prostate: early experience. 169 51

Medical records of 59 patients (9 females and 50 males), who presented to sports medicine clinics at the Australian Institute of Sport and the University of British Columbia between 1985 and 1990 and who were diagnosed as suffering osteitis pubis, were reviewed and comparison of data obtained was made with the literature. Women average 35.5 years of age (30 to 59 years) and men 30.3 years (13 to 61 years). Sports most frequently involved were running, soccer, ice hockey and tennis. Clinical presentations of osteitis pubis fell into 4 main groups. 'Mechanical' (sport-related) was the largest group (n = 48), followed by 'obstetric' (n = 5), 'inflammatory' (n = 4) and 'other' (n = 2). Period of follow-up averaged 10.3 months (1 to 20 months) in women and 17.5 months (2 to 96 months) in men. Full recovery, when documented, averaged 9.5 months in men and 7.0 months in women. Osteitis pubis recurred in 25% of these men and none of these women at follow-up. The most frequent symptoms were pubic pain and adductor pain. Men also presented with lower abdominal, hip and perineal or scrotal pain; women with hip pain. Most common signs were tenderness of the pubic symphysis and tenderness of adductor longus muscle origin. Men also revealed tenderness of one or both the superior pubic rami and evidence of decreased hip rotation (unilateral or bilateral). Evidence of pelvic malalignment and/or sacroiliac dysfunction was frequently seen in both men and women. There was poor correlation between radiographic and isotope bone scan findings and the site and duration of symptoms and signs. Femoral head ratios were estimated on 30 hips in the series and 2 were judged to be at the upper limit of normal, perhaps indicating a form of epiphysiolysis producing tilt deformity of the head of the femur. It is clear that osteitis pubis in athletes is not uncommon and that factors such as loss of rotation of hips and previous obstetric history are important in the aetiology and management of this condition. Pelvic infection, which was believed to be the primary factor of osteitis pubis in the literature up until the 1970s, plays a very small role in this condition in athletes.
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PMID:Osteitis pubis in athletes. Infection, inflammation or injury? 178 77

To study women's emotional and coping response after loss of pregnancy, a group of 121 women who had participated in the National Institute of Child Health and Human Development collaborative Chorionic Villus Sampling and Amniocentesis Study and who had elective abortion or miscarriage were interviewed. The group was mainly white, married, university educated, and affluent. They lost their pregnancy at mean 13.7 weeks gestation. They were interviewed with a semi structured telephone interview at 1-2 and again at 6 months after the event. The quality of the marriage was judged by the Dyadic Adjustment Scale, and each women also completed a Partner Support Scale and the Profile of Mood States. The women's scores on partner support were close to the norm soon after the loss, but declined slightly (p = .03) at 6 months. Qualitative results of the interviews pointed out several differences in the experience between women and their partners: women experienced the pain, inconvenience, and physical recovery; women felt grief for a longer period, and they tended to express their feelings verbally. Women noted that men often either expressed less distress or were less verbal. Men's coping styles included intellectualizing and physical acting-out, e.g., purchasing a motorcycle. Descriptions of couples' coping patterns evidenced some struggle in achieving understanding after the loss. These interviews suggest that most couples who lose a pregnancy do not need therapeutic intervention from a mental health provider, but some may benefit by supportive follow-up, education about the impact of genetic disorders on families, and assistance on decisions about future pregnancies or dealing with the decision not to have children.
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PMID:Women's voices after pregnancy loss: couples' patterns of communication and support. 180 22

In 1986-87, a qualitative research project was done in Thailand, Egypt, Indonesia, and the Dominican Republic to expand knowledge of the acceptability of NORPLANT contraceptive implants beyond continuation rates. In each of the 4 studies, in-depth interviews or focus group discussions were held with current NORPLANT users, potential acceptors, discontinuers, husband of women in the 3 groups, and service providers. The 4 countries were chosen because of their diverse cultures and religions. Most participants favored family planning. Many had used other contraceptives. Men and women in all countries were worried that oral female contraceptive agents (the pill) caused cancer. There were many objections to the IUD. In all countries but Thailand, there was little knowledge of NORPLANT. In the Dominican Republic, NORPLANT was used mostly as a child spacing method. In Indonesia, it was used for child spacing and termination of childbearing. Perceived advantages were alike in all countries. Pain during insertion and removal was a big concern of potential users. Men and women in all countries said that religion and traditional beliefs did not influence their family planning decisions. But many said that religion influenced their tolerance of side effects. In Egypt and Indonesia sterilization is unpopular because it is seen as violating Islamic law. Irregular bleeding was the major side effect and the main reason for discontinuation. Many satisfied users felt that the advantaged outweighed the side effects. Primary reasons for removal in all countries were irregular bleeding, amenorrhea, and the desire to give birth. The need for information was mentioned in all countries. In Egypt, Indonesia, and Thailand services providers reported the need for more thorough training in insertion and removal as well as continuing education sessions.
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PMID:Assessing the acceptability of NORPLANT implants in four countries: findings from focus group research. 211 94


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