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

It has been hypothesized that the endogenous opioid (endorphin) system is related to biologic stress responses. We have used general surgery as a naturalistic model for studying stress response in humans. Abdominal surgery, but not anesthesia induction, was associated with significant increases in plasma beta-endorphin immunoreactivity and cortisol. Both hormones decreased significantly during post-operative morphine administration. Baseline and mean surgery levels of plasma beta-endorphin immunoreactivity showed an inverse relationship with post-operative analgesic requirement. These data support involvement of the endorphin system in human stress response and in human endogenous analgesic mechanisms. Findings also support the concept that baseline or psychologically stimulated levels of arousal may also be an important determinant in the physiology of stress response and pain perception.
Gen Hosp Psychiatry 1983 Jul
PMID:The relationship of plasma cortisol and beta-endorphin immunoreactivity to surgical stress and postoperative analgesic requirement. 631 71

A randomized controlled trial of manipulation of the cervial spine was carried out on 52 patients in general practice, and the results were assessed symptomatically and goniometrically for three weeks. Manipulation produced a significant immediate improvement in symptoms in those with pain or stiffness in the neck, and pain/paraesthesia in the shoulder, and a nearly significant improvement in those with pain/paraesthesia in the arm/hand. Manipulation also produced a significant increase in measured rotation that was maintained for three weeks and an immediate improvement in lateral flexion that was not maintained.This is to our knowledge the first published formal trial of such manipulation and should increase interest in this form of treatment by the medical profession.
J R Coll Gen Pract 1983 Sep
PMID:Manipulation of the cervical spine--a pilot study. 635 60

Recent studies have demonstrated that the majority of cystic fibrosis (CF) patients are not at high risk for developing psychological problems. Clinical studies emphasizing the development of adaptive coping mechanisms in these patients have been suggested as a more appropriate line of research. The purpose of the present paper is to describe our experience in teaching various behavioral and stress management strategies to help CF patients. Behavioral counseling, relaxation training, and biofeedback have all been used with these patients to help them manage a number of problems more effectively. The predominant presenting problems have included elevated anxiety levels, sleeping difficulties, pain, and hyperventilation episodes. The typical treatment course with these patients is described and a case example is given to help elucidate the nature of behavioral interventions. Patient satisfaction ratings indicate that most patients view these techniques positively. Clinical observations suggest that the acquisition of behavioral coping skills may enhance the CF patient's perceived control of his/her situation, reduce the level of pain and anxiety, and enhance the quality of life.
Gen Hosp Psychiatry 1984 Jul
PMID:Behavioral interventions and stress management training for hospitalized adolescents and young adults with cystic fibrosis. 637 18

Nearly four per cent of the population over the age of 15 years in a Danish general practice reported episodes of low back pain at least once a year. A one-year follow-up of 72 patients provided data regarding symptoms, length of absence from work, use of analgesics and bed rest. An indication of the prognosis was reached by relating these data to the history (including occupation), symptoms and signs noted at the initial interview. The following factors indicated a long or relapsing course:1. More than three previous episodes of low back pain.2. Gradual onset of symptoms.3. Pain referred distal to the femur.4. More than four weeks' delay in reporting symptoms.Other factors of prognostic significance were difficulty in moving, onset in relation to work, absence from work, positive straight leg raising test and unilateral pain in the loin.
J R Coll Gen Pract 1981 Apr
PMID:Prognostic indicators in low back pain. 645 38

The effects of anaesthetics and analgesics on striatal neurons were examined in freely moving rats by recording extracellular action potentials of neurons in the striatum. Spontaneous multiple unit activity was reduced to less than 20% of control firing rates following either pentobarbital 35 mg/kg i.p., halothane 3%, chloral hydrate 400 mg/kg i.p., or urethane 1.5 g/kg i.p. Morphine 15 mg/kg i.p., decreased striatal neuronal firing whereas ketamine, 50 mg/kg i.p., excited striatal neurons. The only analgesic agent tested that did not significantly affect striatal neuronal firing was nitrous oxide (70% N2O/30% O2). These findings demonstrate that nitrous oxide is a suitable analgesic which can be used to alleviate stress and pain associated with immobilization procedures without appreciably altering spontaneous striatal discharge rates.
Gen Pharmacol 1984
PMID:Responses of striatal neurons to anesthetics and analgesics in freely moving rats. 652 62

Nerve blocks and impulse augmentation represent two relatively noninvasive somatic procedures of use in the treatment of some chronic pain patients. In this paper the author outlines the clinical evidence for these procedures and the nature of the procedures. The author argues for their usefulness in modulating pain and their place within a more complete multi-disciplinary program.
Gen Hosp Psychiatry 1984 Jan
PMID:Treatment of chronic pain with nerve blocks and stimulation. 660 91

Previous studies have shown that brain serotonin is increased and noradrenaline decreased in acupuncture and transcutaneous nerve stimulation (TNS). Increases in available brain serotonin and decreases in noradrenaline enhance pain suppression. The present study tests the possibility that the widespread and prolonged cutaneous vasodilation which can be produced by low-frequency TNS in patients with peripheral circulatory insufficiency is similarly dependent on a central serotonergic pathway leading to sympatho-inhibition. The serotonin receptor antagonist cyproheptadine was given to 4 patients with either Raynaud's phenomenon or diabetic polyneuropathy, who all prior to drug administration responded to TNS with marked and prolonged cutaneous vasodilation in the ischaemic limbs. Cyproheptadine almost completely blocked the vascular response. Contrary to endorphin-serotonin mediated pain inhibition, vasoconstrictor inhibition is not antagonized by conventional, low doses of naloxone (Kaada, 1982a). However, the involvement of more naloxone-resistant opioid receptors in the vascular response cannot be excluded.
Gen Pharmacol 1983
PMID:In search of mediators of skin vasodilation induced by transcutaneous nerve stimulation: II. Serotonin implicated. 666 43

The role of hypnosis as a tool in the treatment of problems commonly encountered among medical and surgical patients is examined. Hypnosis is defined as a change in state of mind far more akin to intense concentration than sleep. Diagnostic implications of differences in hypnotic responsivity are explored, and scales suitable for use in the clinic are examined. Uses of hypnosis in treating anxiety, pain, childbirth, psychosomatic symptoms, seizure disorders, neuromuscular dysfunction, and habits are described and evaluated. The phenomenon of hypnosis is presented as a means of exploring the mind-body relationship in a controlled fashion, providing information of diagnostic importance while at the same time allowing hypnotizable patients to intensify their concentration and interpersonal receptivity in the service of a therapeutic goal.
Gen Hosp Psychiatry 1983 Dec
PMID:Hypnosis with medical/surgical patients. 666 57

This article briefly reviews behavioral and psychologic methods currently used to assess chronic pain patients. Assessment techniques designed to measure pain report, overt behavior patterns, and psychologic functioning are described. A variety of behavioral treatment procedures for chronic pain are also discussed. Treatment techniques can be grouped into two major categories: operant conditioning methods, and self-management strategies. Critical needs for future research are briefly identified.
Gen Hosp Psychiatry 1984 Jan
PMID:Behavioral and psychological approaches to the assessment and treatment of chronic pain. 669 27

For a nationwide study of terminal care, Gallup Polls took a sample of 950 general practitioners. Fourteen questionnaires could not be delivered; 376 doctors (40 per cent of the register) returned forms; 313 doctors (33.4 per cent) provided information on 301 home deaths and 292 hospital deaths and responded also to statements about care of the dying.The patients who died at home were well supported by the general practitioner and the family and neighbourhood network. Control of pain was perceived to be better at home. Patients dying at home were more likely to be aware of their impending death. General practitioners usually discussed the imminence of death with relatives, but few relatives and patients raised the question of terminating life. All the available major services were under-used. There was support for more hospices and for more spending on social services. Postgraduate medical education on care of the dying was considered to be inadequate.
J R Coll Gen Pract 1983 Jun
PMID:Death in practice. 688


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