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

We describe a schizophrenic man whose lack of pain and related objective signs of a perforated small bowel led to a delay in diagnosis and surgical intervention. A review of the literature suggests that both psychodynamic and specific biologic factors can produce atypical presentations in psychotic patients with illnesses in which pain is characteristically a prominent presenting symptom. While research into the cause of altered pain perception in psychotic patients is continuing, clinicians should maintain a high index of suspicion of serious medical illness when evaluating such patients.
Gen Hosp Psychiatry 1990 Sep
PMID:Pain insensitivity in schizophrenia. Case report and review of the literature. 221 Mar 50

The use of hypnosis was demonstrated on a psychiatric consultation-liaison service (CLS) in a broad spectrum of medically hospitalized patients. Hypnosis was employed as an adjuvant measure to traditional medical and psychologic treatment modalities. Tapes for autohypnosis were used for reinforcement. Twenty-nine women and eight men from 24 to 75 years of age were hypnotized for relief of depression, pain, anxiety, or side-effects from chemotherapy. Results were excellent (total to almost total relief of symptoms) in 68% of the patients, fair in 22%, and poor in 11% with no differences among the results with the various conditions. This report demonstrates that hypnotherapy can be an extremely useful tool in the medical management of patients on a CLS.
Gen Hosp Psychiatry 1990 Nov
PMID:Hypnosis on a consultation-liaison service. 224 22

We assessed multiple pain conditions and their association with affective disturbance, somatization, and psychological distress based on questionnaire data from a probability sample of 1016 enrollees of a large health maintenance organization. Respondents were asked about the presence of five pain conditions and were classified empirically in terms of dysfunctional chronic pain status based on pain severity, pain persistence, and pain-related disability days. Logistic regression analyses revealed a highly significant association between number of pain conditions reported and elevated levels of somatization as measured by the Symptom Checklist 90-Revised. Individuals with two or more pain conditions were at elevated risk of an algorithm diagnosis of major depression, while persons with a single pain condition did not differ from persons with no current pain conditions. Number of pain conditions reported was a better predictor of major depression than were important measures of pain experience, including pain severity and pain persistence.
Arch Gen Psychiatry 1990 Mar
PMID:Multiple pains and psychiatric disturbance. An epidemiologic investigation. 230 65

We tested the hypothesis that exposure to a stimulus resembling the original traumatic event would induce naloxone-reversible analgesia in patients with posttraumatic stress disorder (PTSD). Eight medication-free Vietnam veterans with PTSD and eight veterans without PTSD, matched for age and combat severity, viewed a 15-minute videotape of dramatized combat under naloxone hydrochloride and placebo conditions in a randomized double-blind crossover design. In the placebo condition, the subjects with PTSD showed a 30% decrease in reported pain intensity ratings of standardized heat stimuli after the combat videotape. No decrease in pain ratings occurred in the subjects with PTSD in the naloxone condition. The subjects without PTSD did not show a decrease in pain ratings in either condition. The results are consistent with the induction of opioid-mediated stress-induced analgesia in the patients with PTSD.
Arch Gen Psychiatry 1990 Jun
PMID:Naloxone-reversible analgesic response to combat-related stimuli in posttraumatic stress disorder. A pilot study. 235 Feb 6

1. Connective tissue massage produces relief of pain and increases microcirculation in a number of vascular beds. 2. The concentration of plasma beta-endorphins has been measured in 12 volunteers before and 5, 30 and 90 min after a 30-min session of connective tissue massage. 3. There was a moderate mean increase of 16% in beta-endorphin levels from 20.0 to 23.2 pg/0.1 ml (P = 0.025), lasting for about 1 hr with a maximum in the test 5 min after termination of the massage. 4. It is assumed that the release of beta-endorphins is linked with the pain relief and feeling of warmth and well-being associated with the treatment.
Gen Pharmacol 1989
PMID:Increase of plasma beta-endorphins in connective tissue massage. 252 75

Over a six-month study in general practice 43 patients were identified whose presenting symptom was chest pain thought to be cardiac in origin. The median time from the onset of pain to the general practitioner attending was 60 minutes. On the basis of history, examination and initial electrocardiogram these patients were assessed as unlikely or likely to be infarcting. Of this latter group 15 fulfilled the inclusion criteria for intravenous streptokinase, four commencing treatment at home and 11 on admission to the local general practitioner medical ward. Each received 1.5 mega units over 60 minutes. The median time from the onset of pain to the start of therapy was 120 minutes. Of the 28 patients clinically suspected of having sustained a myocardial infarct 24 proved positive--an over-diagnosis rate of 14%. No major problems were encountered following streptokinase.
J R Coll Gen Pract 1989 Feb
PMID:Streptokinase used in general practice. 255 90

This paper reports the incidence of dyspepsia in general practice, the characteristics of patients, the types of complaints presented and the management of the dyspeptic patient by general practitioners. Fourteen general practitioners in the Maastricht region of the Netherlands studied 318 consecutive patients presenting with dyspepsia. Two questionnaires were used: one filled in by the patient (82% response), the other by the physician (100% response). The diagnostic conclusions which were established after three months of follow-up were compared with the diagnostic hypotheses at the initial consultation. The annual consultation rate for dyspepsia was calculated as 27 per 1000 registered subjects. One third of the patients had an earlier history of dyspepsia. Almost all patients (95%) complained of pain, and 37% had been suffering from pain for more than three months before consulting the general practitioner. The general practitioner prescribed medication in 70% of cases; less commonly the patient was referred for x-ray (14%), endoscopy (13%) or to a specialist (11%). A higher age was associated with a higher probability of referral, and with the finding of organic disease. A history of ulcer disease was strongly correlated with the diagnosis of an ulcer during the current episode. The overall concordance between the general practitioner's diagnostic hypothesis at the initial consultation and the diagnostic conclusion after three months of follow-up was 78%; it was highest when minor pathology was suspected. We conclude that dyspepsia is managed well in general practice and is only rarely associated with major lesions. Dyspeptic patients referred to a specialist therefore constitute a highly selected population.
J R Coll Gen Pract 1989 Dec
PMID:How well do general practitioners manage dyspepsia? 255 5

In burn treatment, hypnosis has been used for the alleviation of pain, the prevention and treatment of anxiety and depression, and the acceleration of wound healing. The successful application of hypnosis decreases the extensive medication needed. Furthermore, it provides a tool to patients with which they may experience more control in situations that are often experienced as overwhelming. Notwithstanding these important applications and the very positive terms with which the results of studies are generally described, hypnosis has mostly been neglected as a tool to help burn patients. This article reviews the clinical and experimental evidence of the usefulness of hypnosis in the management of burns. Pain reduction and crisis intervention are promising applications. However, due to a lack of systematic and controlled research, more specific conclusions are precluded. In the controversial area of wound healing, claims for the effectiveness of hypnosis have been made on the basis of slim evidence and inconclusive studies. This hypothesis needs to be addressed in controlled experiments. In summary, systematic investigations are needed to confirm and supplement available clinical evidence. Recommendations for future research are given.
Gen Hosp Psychiatry 1989 Mar
PMID:Does hypnosis contribute to the care of burn patients? Review of the evidence. 265 Dec 12

1. The analgesic effect of ClX, nifedipine, metamizol, indoprofen and morphine in the pain induced by formalin injection (formalin test) was studied. 2. Attempts to demonstrate tolerance to ClX were unsuccessful. 3. In the analgesic test nifedipine and morphine are approximately 10 times more potent than ClX. 4. The present results suggest that the analgesic action of ClX is not mediated by mu 1, delta or kappa-opioid receptors and the anti-nociceptive effect of nifedipine may be associated with the blockade of the transmembrane inward movements of calcium.
Gen Pharmacol 1989
PMID:Analgesic action of clonixin, nifedipine and morphine using the formalin test. 274 98

The psychosocial characteristics of a 1983 population of hemophiliacs were described and compared to the 1978 patient population from the same hemophilia center to document any improvements that newer medical treatment and social programming were expected to bring and to compare the 1983 population of hemophiliacs to the general population. Findings included a reduction in the use of pain medication, an increase in the number of 18-35 year olds in school, and a decrease in the proportion of unemployed to employed workers. This updated profile will be helpful for professionals who are planning comprehensive programs for hemophiliacs, including those who have tested seropositive for AIDS.
Gen Hosp Psychiatry 1989 Jul
PMID:Social and economic indicators of well-being among hemophiliacs over a 5-year period. 274 27


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