Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Invasive candidal infections are encountered with increasing frequency in compromised hosts but bone infection is uncommon. A woman with systemic lupus erythematosus and end-stage renal failure managed by continuous ambulatory peritoneal dialysis developed a painful thoracic kyphosis and a lytic lesion in the vertebral bodies of T10 and T11. Blood cultures were sterile but bone biopsy material contained Candida albicans which also grew on culture. Circulating immune complexes were measured in high levels and contained candida antigens and specific anti-candida antibody as determined by isoelectric focusing, immunoblotting and immunoprinting techniques. Pain persisted after anti-fungal therapy had sterilized the lesion necessitating surgical excision of affected vertebrae, kyphosis correction and iliac crest bone grafting. The titres of circulating immune complexes and anti-candidal precipitins closely paralleled the clinical course.
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PMID:Candida albicans vertebral osteomyelitis in chronic renal failure. 342 76

The authors evaluated a new protocol of neoadjuvant chemotherapy for osteosarcoma, easier to manage and different from T10. The good results obtained with the postoperative ADR-CDDP association led us to undertake a pilot study between 1982 and 1984, using ADR-CDDP as preoperative chemotherapy. The records of sixteen patients were available for follow-up. The average age of the patients was 19.9 years. Patients received two or three preoperative courses, and a total of six identical courses. Tolerance was good. Pain usually disappeared but this was often misleading because associated with radiological and/or clinical tumor progression, low histological necrosis or poor outcome. The continuous disease-free survival actuarial rate was less than 57 and 40% at 18 months and two years respectively. The actuarial survival rate was 87% at one year and 65% at two years respectively. Disappointing results of this preoperative protocol, compared to results with the SO4 78 or T10 protocols for example, led to publish these data early in order to underline their potential dangers. As a result, we stopped our study. The charter of pilot studies justifies this publication. As well, these data point out the necessity of very close follow-up of neoadjuvant chemotherapy by sophisticated medical imaging. Neoadjuvant chemotherapy, if ineffective, must be stopped early, and should lead to surgery, followed by adequate postoperative chemotherapy.
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PMID:[Pre and postoperative chemotherapy of osteosarcoma with an adriamycin-cisplatin combination. Risks of a neoadjuvant chemotherapy which is not sufficiently effective]. 346 71

This study analyzed 87 athletes attending the Para Olympic Games at Stoke Mandeville in 1984. All athletes had had complete neurologic lesions between the levels of T10 adn L2. Clinical details were obtained from each athlete. Assessment then consisted of measurement of spinal movement in the sagittal plane using spondylometers and movement in the rotation plane using a rotameter. Body trunk strength was measured with the athletes in their own wheelchairs using a myometer. This gave a recording of kilograms of force. Trunk balance was assessed on both a static and a dynamic basis. The age, sex, follow-up period, and body weight for both spinal fusion and conservatively treated groups were similar. There was little difference in the incidence of pain between those treated by conservative and operative methods. There was statistically significant difference in the range of sagittal plane and rotation movement. There was no difference in flexor trunk power measured with the myometer between the two groups, but when extensor power was measured it was found to be 25% less in the spinal fusion group. There was no difference between the two groups when tested for static and dynamic trunk balance. Two other athletes who had had spinal fusions extending from the upper thoracic region to the sacrum showed unusually poor trunk stability. Overall, this study demonstrates that spinal fusion, particularly over multiple segments in complete paraplegics, has a deleterious effect not only on spinal movement but also on body trunk strength.
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PMID:Long-term results of conservative and operative management in complete paraplegics with spinal cord injuries between T10 and L2 with respect to function. 366 58

A 58 year old man was admitted with a pseudo-coronary pain. Cardiological investigations (ECG, chest X-ray, enzymes) were normal. Pain however was exacerbated by movement, coughing and pressure over T4 to T10 vertebrae. On the 4th day, the patient developed a weakness of the right lower limb which worsened 15 days later. On examination there were in the right lower limb a combination of central (Babinski sign) and peripheral signs (diminished deep reflexes, loss of sensation to all modalities ipsilateral to the paralysis). Metrizamide myelography was within normal limits. Spinal angiography revealed a dural arteriovenous fistula draining into spinal veins, at the level of T5. Following the removal of the fistula, the pain disappeared and the other symptoms and signs improved.
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PMID:[Thoracic pain and arteriovenous fistula of the spinal cord]. 652 15

15 consecutive patients with osteosarcoma underwent preoperative chemotherapy with high dose methotrexate (HDMTX) containing regimens according to the T7 or T10 protocols of ROSEN, Preoperative chemotherapy was well tolerated and did not impair surgical procedures. 67% of the patients responded clinically with reduction of pain and tumor size. Histologic examination of the tumor after preoperative chemotherapy revealed extensive necrosis in 53% of patients. In a retrospective analysis, patients with extensive necrosis (group B) were compared with those with little or no necrosis (group A). Patients from group B had a longer relapse free and overall survival period than group A. In addition, patients of group A had significantly higher initial levels of alkaline phosphatase than group B. The incidence of a 2.5-fold increase of the transaminases 2-3 days after HDMTX was significantly greater in patients of group B compared to group A. In the absence of documented necrosis after chemotherapy according to the T7 or T10 protocols, further use of HDMTX is not indicated. New aspects on the treatment of osteosarcoma, derived from recent publications, are discussed.
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PMID:[The Zurich experience with preoperative high-dose methotrexate in osteosarcomas]. 657 41

Oxygen consumption (VO2) and minute ventilation (VE) were measured between and during uterine contractions in the first stage of labor before and after lumbar epidural analgesia (LEA) in 11 women who served as their own controls. VO2 and VE between contractions were essentially unchanged by LEA to a T10 or higher sensory level. Before LEA, both VO2 and VE were increased significantly during contractions by 63% and 74% respectively, whereas following LEA there was no significant increase in VO2 or VE during contractions. In the second stage of labor, VO2 and VE were measured in seven patients electing to have no analgesia or sedation and in 10 patients having complete pain relief produced by LEA. Measurements were obtained 5-10 min before delivery. During contractions with pushing, VO2 and VE were decreased by 25% and 31%, respectively, in patients having LEA as compared with patients having no analgesia or sedation. These results suggest that the increase in VO2 and VE are due primarily to pain associated with uterine contractions and that LEA decreased the work of breathing and the oxygen consumption of the parturient in both the first and second stages of labor.
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PMID:Minute ventilation and oxygen consumption during labor with epidural analgesia. 663 50

A multivariate analysis of inadequate extradural analgesia was carried out prospectively on 1051 patients undergoing lumbar extradural anaesthesia for surgery performed on structures innervated by T10-S5. Ninety-six patients (9%) experienced pain during surgery. Age, extradural fentanyl, diazepam sedation and duration of surgery had no significant influence. We found some weak evidence that the type of surgery affects the risk of feeling pain. The probability of pain increased with increasing weight, except in overweight women, and was significantly greater for both shorter and taller patients, relative to patients of average height. The probability of pain decreased with increasing dose of local anaesthetic, increasing spread of extradural analgesia, addition of adrenaline, and fentanyl or thiopentone sedation. In conclusion, patient-, surgery- and anaesthesia-related factors influence the risk of inadequate extradural analgesia. If such factors are taken into account, an increase in the success rate may be anticipated.
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PMID:A multifactorial analysis to explain inadequate surgical analgesia after extradural block. 754 42

We describe two patients who developed neurological side effects as part of the spectrum of nitritoid reactions. Both reactions occurred late in the course of treatment. The first patient developed mild nitritoid symptoms and pain in a band-like distribution, corresponding to T10-T12 dermatomes, shortly after gold sodium thiomalate (GSTM) injection. Further injections were followed by similar symptoms in addition to paraesthesiae and altered pin-prick sensation of anterior thigh and legs with no residual deficit. She has had no further episodes since substitution of aurothioglucose. The second patient experienced mild nitritoid symptoms following several GSTM injections prior experiencing a cerebrovascular accident within several hours of her next injection. She subsequently haemorrhaged into the infarcted area with residual neurological deficits. These cases highlight that nitritoid reactions can be severe and may be heralded by milder symptoms. Patients who develop these reactions whilst receiving GSTM can be successfully changed to aurothioglucose.
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PMID:Neurological side effects in two patients receiving gold injections for rheumatoid arthritis. 758 10

A 36 years-old male with AIDS, presented with left hemiparesis revealing a right parietal tumour. Stereotactic biopsy demonstrated a malignant non-Hodgkin's lymphoma. His condition partially improved following radiotherapy and chemotherapy. Three months later he was re-admitted with progressive bilateral root pain and urinary incontinence resulting in paraplegia with sensory loss below T10. He died one month later from generalized sepsis. Neuropathology confirmed an immunoblastic B-cell malignant non-Hodgkin's lymphoma in the white matter of the right parietal lobe and revealed a centrospinal localisation of the lymphoma in the thoracic cord at T10. There was no visceral localisation of the tumour. Secondary spread to the spinal cord of malignant non Hodgkin's lymphomas, usually causes meningo-myelo-radiculitis. Intraspinal deposits of primary cerebral lymphomas are uncommon and have never been previously described in AIDS, to our knowledge. Their pathogenesis is unclear. In our case, neuropathological findings are consistent with diffusion of the primary tumour to leptomeninges and secondary infiltration of the spinal cord along the perivascular spaces.
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PMID:[Intramedullary localization of a primary cerebral lymphoma in AIDS]. 774 1

Between August 1989 and July 1992 a total of 22 patients (64 treatments) with inoperable or recurrent deep seated pelvic tumours were treated with regional hyperthermia and radiotherapy. The 70 Mhz Coaxial TEM applicator with its characteristic open waterbolus was used as heating device. The main objective of this pilot study was to evaluate the feasibility, toxicity and temperature data. The results showed that the major treatment limiting factors were insufficient power and systemic stress. Local pain was observed in only 10% of all treatments. Most of the treatments resulted in elevated systemic temperatures with the overall mean maximum oesophagus temperature reaching 38.9 +/- 0.7 degrees C, however, in only 6% of these treatments this was found to be treatment limiting. From the measured data the following intratumoral temperatures were calculated: T90 = 39.9 +/- 1.0 degrees C; T50 = 40.7 +/- 1.0 degrees C; T10 = 41.4 +/- 1.0 degrees C. In addition, the overall mean average normal tissue temperatures were determined: Trectum = 40.8 +/- 0.7 degrees C; Tvagina = 41.3 +/- 0.9 degrees C; Turethra = 40.8 +/- 0.9 degrees C. The temperatures in normal tissue were frequently higher than in tumour, indicating that a large volume was heated. The open waterbolus allows strong cooling, but the strategy was changed during the study: higher systemic temperatures were allowed to improve the pelvic temperatures. This pilot study proved that the open waterbolus is clinically a success, because it offers patient comfort and SAR-steering by patient repositioning, and that regional hyperthermia with the Coaxial TEM is feasible.
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PMID:Regional hyperthermia of pelvic tumours using the Utrecht 'Coaxial TEM' system: a feasibility study. 779 Jul 33


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