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

An analysis of 135 consecutive shoulder injuries seen in one clinic during a single ski season revealed anterior dislocation to be the most common ailment, constituting 52% of the total. Rotator cuff tears accounted for 20% of the total, followed by acromioclavicular (AC) separations (18%) and a miscellaneous group of contusions and isolated fractures comprising the other 10%. All of the shoulder dislocations were anterior, most were primary (81%) and men (83%) were involved more frequently. Twenty-four percent of the dislocations were thought to be equipment related. At follow-up examination three to four years after injury, a significant number (41%) were still symptomatic either from a recurrence (18%) or pain and weakness (23%). Patients with rotator cuff tears tended to be about ten years older than the average skier. Their injuries were usually a result of a fall on ipsilateral arm and were not equipment related. Of the 13 patients responding after a three-year follow-up period, most (10/13) were asymptomatic. There were 24 AC separations. All resulted from a direct fall on the shoulder. Sixty percent were first degree, 22% were second degree, and 18% were third degree. About one-third of the respondents with first and second degree injuries were still having significant pain at three-year follow-up examination. The most frequent isolated fracture was a minimally displaced fracture of the greater tuberosity (only three cases in 135 injuries), but this same fracture occurred in 10% of the shoulder dislocations.
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PMID:Skiing-related injuries to the shoulder. 381 53

A hierarchy of release decision theories for both tibia fracture and knee ligamentous injury are defined and simulated on a computer. Moment loading data, recorded during actual skiing by the microcomputer-based ski binding system described in Part I, are processed by the various release decision theories. At the bottom of the hierarchy is the simplest theory which treats boot loading as quasi-static and compares moment components to threshold levels. Another stage of the hierarchy defines an analytic expression for a combined loading failure locus. Note that this is the first formulation of a combined loading release decision theory. Yet another stage of the hierarchy computes bone moments via dynamic system leg models. The various release decision theories are evaluated by comparing processed results to both pain and bone failure limits. For the data generated by the field tests conducted to date, the simplest release decision theory satisfied the retention requirement for pain limits in the presence of muscle activity for both torsion and forward bending. For pain limits in the absence of muscle activity the retention requirement was not satisfied however. Another result is that leg dynamics are significant. A final result is that combined loading considerations lead to a more conservative theory.
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PMID:A microcomputer controlled snow ski binding system--II. Release decision theories. 401 25

In a retrospective study, we examined twenty-eight patients who had had an arthrodesis seventeen to fifty years previously (average, thirty-five years). Hip and knee ratings were obtained, as well as anteroposterior and flexion-extension radiographs of the lumbar spine and standing anteroposterior radiographs of the knees and hips. About 60 per cent of the patients had pain in the ipsilateral knee (average time to onset, twenty-three years after arthrodesis), and a similar percentage had back pain (average time to onset, twenty-five years after the operation). Pain in the contralateral hip occurred in approximately 25 per cent of the patients (average time to onset, twenty years after arthrodesis). Only one patient was unemployed due to disabling pain in the back or knee. Seventy per cent of the patients could walk more than one mile (1.6 kilometers), and a similar percentage could sit comfortably for at least two hours. Seventy-five per cent of the patients had anteroposterior laxity of the ipsilateral knee, and 80 per cent had mediolateral laxity. The patients whose hip was fused in some abduction more frequently had pain in the ipsilateral knee and the back, and they had greater degenerative changes in the ipsilateral knee than the patients whose hip was fused in adduction or in the neutral position. Six patients had undergone total hip arthroplasty for pain in the back or the ipsilateral knee, or both, and all had marked relief of back pain, while two of four had relief of pain in the knee. Two patients had a total knee arthroplasty for relief of pain in the ipsilateral knee.
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PMID:Hip arthrodesis. A long-term follow-up. 407 3

A surface EMG diagnostic protocol was developed to assess the neuromuscular/postural contributions to pain states. The EMG activity of the right and left aspects of 11 muscle groups were monitored while the patient was in the sitting and standing positions. The diagnostic protocol was evaluated by comparing the patterns of EMG activity in four diagnostic groups: headache only, neck/shoulder/upper back pain only, low back pain only, and mixed pain states. The results suggest that (1) bilateral levels of EMG activity in the frontalis and masseter groups are of primary importance for the headache patients, (2) the discrepancy between the right and left EMG activity in the lumbar and cervical paraspinal muscle groups are of primary importance for low back pain patients, (3) position (sit/stand) may provide important diagnostic information, and (4) the data appear to support the notion of a postural disturbance as a contributing factor in low back pain.
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PMID:EMG scanning in the diagnosis of chronic pain. 622 39

Seventy out-patients with acute back pain participated in a double-blind comparative trial of the clinical efficacy and tolerance of orally administered meptazinol and diflunisal. Half of the patients received 200 mg meptazinol or 250 mg diflunisal 4-times daily for up to 3 weeks, depending on the duration of pain. Patients were examined 4 times at 1-week intervals for their capability to do daily tasks, for their capacity for forward bending, thoraco-lumbar torsion, straight leg raising, static hip flexion and sit-ups, and for subjective assessment of pain. Side-effects were recorded on a questionnaire. Both treatments produced marked improvement in most of the parameters assessed, often within the first week and, overall, the results were similar with the two drugs. Few side-effects were reported and those that were recorded were slight and similar in incidence apart from nausea in 5 meptazinol-treated patients and smarting and burning on urination in 2 patients receiving diflunisal.
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PMID:Double-blind parallel study of meptazinol versus diflunisal in the treatment of lumbago. 623 53

One hundred consecutive patients admitted to the National Spinal Injuries Centre, Stoke Mandeville Hospital, with pressure sores were studied to assess the relative importance of factors known to predispose to the development of scores. Loss of feeling was critical, because patients were unable to appreciate pain when the sore was developing. Risk of developing a sore increased with age, but duration of the paralysis was of equal importance. After discharge from hospital the presence of a caring relative or friend was essential for survival. Many patients developed sores because of poor facilities at home or inappropriate advice from those who looked after them. An even more distressing factor was the number of patients who developed sores in hospital owing to inadequate nursing care. There are relatively few paralysed patients in the community, but the lessons learnt in this study may be applied to all patients with orthopaedic injuries and to geriatric patients with limited mobility. Nursing and medical staff must turn patients regularly and ensure that there is proper equipment to relieve pressure on the skin. Patients should not be allowed to sit in a chair if they develop a sacral or trochanteric sore. More effort should be directed towards the appropriate education of patients, their relatives, and all those who are concerned with their welfare.
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PMID:Aetiology of pressure sores in patients with spinal cord injury. 643 84

This article examines the vidente, or seer phenomenon in the Peruvian Amazon city of Pucallpa, Peru, where fieldwork was conducted in 1977 and 1979. With the discovery of natural opiate-like substances in the body, called endorphins, researchers in the brain sciences were intrigued by man's ability to create his own opiate-like response to pain, ecstacy and stress. Paranormal phenomena, often called psi, are believed to occur by large numbers of people. Close work was done with an urban healer, don Hilde, who used the plant hallucinogen, ayahuasca, for many yers. The healing milieu, present background information on Pucallpa City, don Hilde's biography and his activities as a vidente in connection with his hallucinogen use are described. Don Hilde's relationship with a mystical-philosophical organization and its influence on his paranormal activities and patient interactions are examined. The single most important function of plant hallucinogens in the Amazon area is to divine the future. Ayahuasca is used to treat magical illness in Iquitos and Pucallpa where illness is believed to have a mother spirit. The patients sit in a cirlce in rain forest clearings where they all drink the drug, believing the plant's spirit enters them. Healers like don Hilde are sought out by patients because of reputed vidente qualities and abilities as seers and because, on the daily level of interaction, their abilities are reaffirmed. In this case study, the healer derives a long shamanic healing tradition where he used plant hallucinogen drugs. He entered into organized mystical activities to enhance his personal power and to intensify his access to altered states of consciousness. Access to the supernatural realm is important to both the healer and the client in harnessing the source of divinity.
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PMID:The vidente phenomenon in third world traditional healing: an Amazonian example. 653 48

Telemetry and conventional cardiotocography were compared by monitoring the labor of 60 patients with an uneventful pregnancy and delivery in the 38th-42nd week of pregnancy. 31 patients were monitored by telemetry and 29 by cardiotocography. The patients were matched for age (+/- 5 years), duration of pregnancy (+/- 7 days) and parity (I or II). The husband attended labor and delivery in 42% of the cases in the telemetry group and in 59% of the cases in the control group. Induction of labor by amniotomy was performed in 32% of the cases in the telemetry group and in 24% of the cases in the cardiotocography group. The patients monitored subjective pain every half hour during the opening phase. The telemetric patients were encouraged to sit or walk during the first stage. No maternal or fetal complications occurred. All infants were born in good condition with APGAR scores greater than or equal to 7 recorded at one and five minutes. There were 4 operative deliveries in the telemetry group and 5 in the control group. Indications for these were maternal or uterine exhaustion with the exception of two control patients where fetal asphyxia was suspected. The duration of the first stage of labor did not differ significantly between the telemetry and the cardiotocography groups. The telemetric patients received less analgesics than the controls but this difference was not significant. In spite of less analgesia in the telemetry group, the secondparas of the telemetry group experienced significantly less (p less than 0.01) labor pain than the controls. In addition, the secondparas of the telemetry group considered the present labor less painful than the previous one significantly more often than the controls. Among the primiparous patients there was no difference in the amount of pain experienced by the patients.
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PMID:The monitoring of labor by telemetry. 706 28

Thirty patients with chronic pyogenic or tuberculous arthritis of the hip treated by Girdlestone's excision arthroplasty were reviewed two to seven years after operation. There was marked or complete relief of pain in 29, control of infection in 27, squatting and sitting cross-legged was possible in 27, and 16 were able to stand on the operated limb. Overall results were good in 16, fair in nine, and poor in five. Tuberculous disease was not reactivated and the use of traction for 12 weeks and a weight-relieving caliper for 12 months after operation helped to reduce the shortening to an average of 3.8 centimetres. Excision arthroplasty is considered a sound operation to restore the ability to squat and sit cross-legged.
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PMID:Excision arthroplasty for tuberculous and pyogenic arthritis of the hip. 720 69

The influence of maternal position during labor on comfort and uterine efficiency was studied by contrasting the influence of sitting in a chair with lying on the side during the first stage of labor. Nineteen primigravidas alternated between these two positions at 30 minute intervals for as long as this was possible during their labors. There was a significant difference in their preference to sit up during early labor (less than 6 cm dilation) and lie on their side during late labor (greater than 6 cm dilation). Uterine efficiency, however, was significantly less (p less than 0.05) in early labor in the sitting position than on the side. After labor was well established, ie after 6 cm dilation, the efficiency of uterine contractions to dilate the cervix was not significantly different between the 2 positions although it was less in the sitting position. The lateral recumbent position was accompanied by more efficient labor and was preferred by most women in late labor. Localization of pain and fetal position also seem to be associated with maternal position preference, and both factors require further investigation.
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PMID:Maternal positions in labor: analysis in relation to comfort and efficiency. 732 78


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