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

Solid internal fixation of fractures of the ribs and thorax producing a flail chest is described using a new technic which permits early mobilisation of the patient, immediate spontaneous respiration, abolition of pain, early respiratory physiotherapy, and reduces the danger of respiratory complications due to artificial ventilation, and permenent sequelae due to a secondary deformity of the thoracic cage. Our experience of the method has permitted us to determine its indications and limits.
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PMID:[Original surgical technic for the treatment of flail chest (author's transl)]. 59 93

Two kinds of stimuli were presented to the mother rat at random: the natural pain acoustic signal of its infant in response to electrical pain stimulation and the tape recording of the signal performed within the sound frequency region (up to 20 kHz). The mother rat was placed in a special long cage with two parts of different size. Her reaction was ethologically estimated. The natural pain signal proved to be more effective than its magnetic tape recording. The role of the spectrum ultrasound part of the pain acoustic signal is discussed.
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PMID:[Comparative evaluation of the response of rat-mothers to the natural pain squeaks of a ratling and to a tape recording of it]. 67 10

Morphine or naloxone injected twice a day (10 mg/kg/day) to rat females from 15 to 18 days of gestation had no effect on their litter size or body weight of pups. Time necessary for the female to bring pups into the nest from the opposite end of the cage, that is a characteristic of maternal care and negatively correlated with the mean body weight of the pup in the litter, did not change after treatment with drugs during gestation. Newborns treated with mu-opioid receptor ligands during intrauterine development had an elevated number of 3H-naloxone binding sites in the brain. However, the number of 3H-naloxone binding sites on the 9 and 16 days of life, as well as pain thresholds under electric stimulation of the tail at a month age were equal in these rats and offsprings of the intact or saline treated mothers.
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PMID:[Maternal behavior after the administration of morphine or naloxone to pregnant female rats and the pain sensitivity and brain mu-opioid receptors in the progeny]. 132 83

The goal of the study was to investigate the ultrasonic vocalization induced in freely behaving, naive rats by gentle touch with a human hand. Thirty-nine rats were tested in an unfamiliar experimental cage with repeatable hand touch. Vocalization appeared with an average latency of 4.6 +/- 5.0 s (SD). The nape of the neck was the most effective area, and after a couple of stimuli applied, 66.7% of rats emitted 21-32 kHz ultrasonic vocalization. It consisted of multiple series of long calls, about 70% of which exceeded 300 ms. The responses quickly habituated from session to session to extinction. Significantly more rats housed in single cages vocalized ultrasonically than animals housed in community cages. The long latencies of the vocalization, their appearance in multiple series to a single touch, and quick habituation to the stimuli indicate that 22 kHz ultrasonic vocalization of rats reflects a distress caused by a potential danger to the animal and it does not necessarily reflect physical discomfort or pain. This vocalization may, therefore, play an adaptive role in increasing chances of survival by conveying information about potential threats to other conspecifics.
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PMID:Ultrasonic vocalization of laboratory rats in response to handling and touch. 140 36

Vertebral compression fractures (VCFs) may be defined radiographically or as a clinical event. The prevalence of these fractures in women aged 50 and over has been estimated at 26% when defined as a reduction in vertebral height greater than 15%. Retrospective reviews of case records have shown a clinical detection rate of VCF in white women of 153/100,000 person years. Of these clinically detected VCFs, 84% were associated with pain. VCF may be defined as a clinical event characterised by loss of height and acute pain. The pain of acute fracture usually lasts 4 to 6 weeks with intense pain at the site of fracture. Chronic pain may also occur in patients with multiple compression fractures, height loss and low bone density but is probably due to structural changes or osteoarthritis. Radiographic VCF may not be symptomatic. The greater the deformity, the greater the likelihood of pain and disability. As height is lost, patients experience discomfort from the rib cage pressing downward on the pelvis. Patients develop a thoracic kyphosis, a lumbar lordosis, and a protuberant abdomen with prominent horizontal skinfold creases. The reduced thoracic space may result in decreased exercise tolerance and reduced abdominal space may give rise to early satiety and weight loss. Sleep disorders may also occur. Patients lose self esteem. Self care may become difficult. They are often depressed. They become fearful of further fracture. They have distorted body image and poor health perception. Patients with one vertebral fracture are at increased risk of peripheral fracture and further vertebral fracture. The aims of acute management are to reduce symptoms and mobilise the patient as quickly as possible.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The clinical consequences of vertebral compression fracture. 162 11

The effects of neonatal exposure to delta-9-tetrahydrocannabinol (THC) on the adult animal brain neurochemistry and pain perception were evaluated. Newborn rat pups were culled to a litter size of 8 (males and females) and treated either with THC (2 mg/kg) or oil (control) daily, during days 1-4 after birth. After weaning, the THC-treated males were housed 4 per cage. During the juvenile period (day 50), the THC-treated animals exhibited significantly lower baseline tail-flick values (a measure of pain perception) than the control. However, as adults, the THC-treated animals exhibited significantly higher sensitivity to pain following 5 mg/kg morphine challenge. Furthermore, the THC-treated animals had significantly elevated beta-endorphin and methionine-enkephalin levels in almost all the brain areas sampled for the study. In addition, the neonatally THC-treated rats exhibited significantly higher levels of substance P (SP) and significantly lower levels of gonadotropin releasing hormone (GnRH) in the anterior hypothalamus-preoptic area. The SP and GnRH levels did not differ among the THC-treated and control animals in the medial basal hypothalamus. The results of this study indicate that even a very low dose of THC administered during the neonatal period has a long-lasting effect on the brain neurochemistry. In particular, neonatal administration of THC appears to alter functioning of the endogenous opioid system.
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PMID:Effect of early exposure to delta-9-tetrahydrocannabinol on the levels of opioid peptides, gonadotropin-releasing hormone and substance P in the adult male rat brain. 170 Sep 26

The physicochemical properties, pharmacology, pharmacokinetics, serum concentrations and clinical effects, adverse effects and contraindications, and dosage of transdermally administered fentanyl are described, and clinical studies evaluating the use of a transdermal fentanyl system in the treatment of postoperative pain and chronic cancer-associated pain are reviewed. After application of a transdermal system, fentanyl is absorbed into the skin beneath the patch, where a depot forms in the upper skin layers. Plasma fentanyl concentrations are barely detectable for about two hours after patch placement. Eight to 12 hours after patch placement, concentrations approximate those achieved with equivalent i.v. doses of fentanyl. Some studies comparing transdermally administered fentanyl with placebo in postoperative patients showed that the patients who received fentanyl required fewer supplementary analgesics and reported less pain than the patients who received placebo. However, the overall efficacy and safety of the transdermal fentanyl system for the treatment of postoperative pain have not been adequately evaluated. Studies of cancer patients showed that transdermally administered fentanyl appears to be effective in the management of chronic, cancer-related pain. Dermatological reactions to the fentanyl patch are generally transient and mild. Other adverse effects are those that are commonly associated with narcotic analgesics. The 25-micrograms/hr patch should be used for initial treatment in patients not previously treated with narcotics. The dosage may be gradually increased until effective analgesia is obtained. Although experience with the product is limited, transdermally administered fentanyl appears to be effective for the long-term management of cancer-related pain.
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PMID:Transdermally administered fentanyl for pain management. 825 54

The literature dealing with the magnitude, mechanism and effects of reduced FRC in the perioperative period is reviewed. During general anaesthesia FRC is reduced by approximately 20%. The reduction is greater in the obese and in patients with COPD. The most likely mechanism is the loss of inspiratory muscle tone of the muscles acting on the rib cage. Gas trapping is an additional mechanism. Lung compliance decreases and airways resistance increases, in large part, due to decreased FRC. The larynx is displaced anteriorly and elongated, making laryngoscopy and intubation more difficult. The change in FRC creates or increases intrapulmonary shunt and areas of low ventilation to perfusion. This is due to the occurrence of compression atelectasis, and to regional changes in mechanics and airway closure which tend to reduce ventilation to dependent lung zones which are still well perfused. Abdominal and thoracic operations tend to increase shunting further. Large tidal volume but not PEEP will improve oxygenation, although both increase FRC. Both FRC and vital capacity are reduced following abdominal and thoracic surgery in a predictable pattern. The mechanism is the combined effect of incisional pain and reflex dysfunction of the diaphragm. Additional effects of thoracic surgery include pleural effusion, cooling of the phrenic nerve and mediastinal widening. Postoperative hypoxaemia is a function of reduced FRC and airway closure. There is no real difference among the various methods of active lung expansion in terms of the speed of restoration of lung function, or in preventing postoperative atelectasis/pneumonia. Epidural analgesia does not influence the rate of recovery of lung function, nor does it prevent atelectasis/pneumonia.
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PMID:Perioperative functional residual capacity. 180 4

The scapulocostal syndrome, a hitherto insufficiently understood condition, was clinically studied in 201 cases. The main findings were: (i) pain was the presenting symptom in all cases and was mainly cervicobrachial (90%); (ii) the syndrome is a definable entity within the wide spectrum of fibromyalgia (fibrositis); (iii) the pain originates mainly from an enthesopathy of the serratus posterior superior muscle; and (iv) physical degeneration was present in 76.5% of patients. Conservative treatment, successful in 95.9% of cases, consisted of an intralesional injection of a steroid-analgesic-mixture of 1 ml Celestone-Soluspan (Scherag) plus 1.8 ml Xylotox E80A (Astra), and physical rehabilitation. It was deducted that the dyskinesia was mainly due to an overload of the scapulocostal articulation, forcing the rib cage down to exert a stretching force on the serratus posterior superior muscle. The operation of 'serratotomy' (severing the serratus posterior superior muscle) was performed with excellent results in 6 patients in whom conservative treatment failed, and is described here for the first time.
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PMID:The scapulocostal syndrome. 204 65

1. Responses of spinoreticular (SRT) and spinothalamic (STT) neurons located in the T7-T9 segments to cardiopulmonary sympathetic afferent (CPS) stimuli were studied in 27 cats that were anesthetized with alpha-chloralose. 2. CPS stimulation excited 32 SRT and 10 STT neurons. Each neuron was also excited by stimulation of the left greater splanchnic nerve (SPL) and had a somatic receptive field that was most commonly located on the upper abdomen and over the lower rib cage. An additional 12 SRT and 3 STT neurons received input from SPL and somatic structures but failed to respond to CPS stimulation. 3. CPS stimulation evoked early responses (23 cells) or both early and late responses (19 cells) that had average latencies of 12.7 +/- 1.8 and 88.2 +/- 13.1 (SE) ms, respectively. Latencies of responses to SPL stimulation were significantly shorter and averaged 8.1 +/- 0.9 and 46.1 +/- 7.1 ms. Magnitudes of early responses to SPL stimulation were significantly greater than responses to CPS stimulation; however, late responses were not different. 4. Responses to CPS stimulation were inhibited by a prior conditioning stimulus applied to SPL. Greatest inhibition occurred at a conditioning-test interval of 40 ms, and inhibition lasted for at least 300 ms. Inhibition of responses to SPL stimulation could be evoked by conditioning stimuli applied to CPS; however, the inhibition was significantly less than that evoked by SPL stimulation on responses to CPS stimulation. 5. Thirty-eight neurons were tested for responses to injection of bradykinin (4 micrograms/kg) into the left atrium. Discharge rate of 17 cells increased from 5 +/- 2 to 12 +/- 4 Hz. Four cells were tachyphylactic to repeated injections. Injections of bradykinin into the thoracic aorta did not significantly alter cell activity. Bilateral cervical vagotomy had no effect on responses to intracardiac bradykinin. 6. The results indicate that lower thoracic SRT and STT neurons are excited by CPS stimuli including noxious stimulation of the heart. However, comparison of these responses with previously reported responses of upper thoracic SRT and STT neurons indicate that there is a decrease in effectiveness of CPS stimuli from upper to lower thoracic segments. Convergence of CPS and abdominal inputs onto lower thoracic pain pathways could explain abdominal pain that is occasionally associated with cardiac disease.
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PMID:Cardiopulmonary sympathetic afferent excitation of lower thoracic spinoreticular and spinothalamic neurons. 207 72


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