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

A case of squamous cell carcinoma of the left renal pelvis associated with chronic renal failure on hemodialysis is reported. The patient, a 59-year-old man, had undergone bilateral nephrolithotomy, in 1966, followed by right ureterolithotomy and bilateral percutaneous nephrolithotripsy, but residual stones existed. He suffered from left flak pain and fever, and computed tomography (CT) and magnetic resonance imaging (MRI) revealed left perirenal abscess in July 1994. Percutaneous drainage and antibacterial chemotherapy were performed, but his symptoms did not improve. Three months later, CT and MRI revealed a mass in the left perirenal space and destruction of the 12th thoracic vertebra, which were considered to be infectious changes. On November 9, 1994, left nephrectomy was performed. Histopathological diagnosis was moderately differentiated squamous cell carcinoma, grade 2, INF-gamma, pT4, pR1, pL0 and pV1. In spite of irradiation therapy, he died on January 19, 1995.
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PMID:[Squamous cell carcinoma of the renal pelvis associated with renal stones in a patient with chronic renal failure: a case report and a review of the Japanese literature]. 874 2

A 69-year-old female with a fourty-year history of rheumatoid arthritis visited Kobe University hospital with complaints of subcutaneous soft tumor on both hands and arthritic pain of both knees. She has been given 10 mg of predonisolone for several years and had a history of hydronephrosis. Her radiographs revealed periarticular calcification in the hands, shoulder joints and posterior thoracic wall. She had high titer of rheumatoid factor and both erythrocyte sedimentation rate (79 mm/hr) and C-reactive protein (12.79 mg/ml) were elevated. The examination of her serum showed the following values: Ca 7.9 mg/dl, P 5.0 mg/dl, 25 (OH) D3 < 3.6 pg/ml, 1 alpha-. 25 (OH)2 Vit D3 < 6.1 pg/ml, osmolality 974 mOsm/kg, BUN 61 mg/dl, creatinine 1.9 mg/ml, creatinine clearance less than 20 ml/min, indicating chronic renal failure. Intact PTH level was normal, although plasma parathyroid hormone-C (PTH-C) level increased. Together with these findings, it is suggested that metabolic disorders associated with chronic renal failure and tissue damages due to the severe rheumatoid arthritis led to the formation of diffuse soft tissue calcification.
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PMID:[A case report of systemic calcinosis associated with rheumatoid arthritis]. 877 93

Between March 1988 and June 1994, 35 popliteal to distal artery vein bypasses were done in 32 diabetic patients. There were 16 males and 16 females with an average age of 60 years. Eighteen patients (56%) had insulin dependent diabetes mellitus. Medical risk factors included coronary artery disease (CAD) in 15 (47%), hypertension in 15 (47%), chronic renal failure (CRF) in 9 (28%), and cigarette smoking in 10 (31%). Indications for revascularization were: non-healing ulcerations in 18 (51%), gangrene in 15 (43%), and rest pain in 2 (6%). The distal anastomosis was to the posterior tibial artery in 9, anterior tibial artery in 8, dorsalis pedis artery in 10 and peroneal artery in 8 cases. All the bypasses were done with autogenous saphenous veins (in-situ 11, reversed 17, and free non-reversed 7). The limbs were graded into three groups based on the preoperative angiographic evaluation of their pedal arch: patent arch (Grade "0"), partial occlusion of the arch (grade "1.5") and little or no arch visualized (Grade "3"). Eight limbs had Grade "0", 16 had Grade "1.5" and 11 had Grade "3" pedal circulation. Bypass follow up was done by clinical exam and color duplex surveillance (CDS) for a mean duration of 24 months. CDS identified 4 failing bypasses which were surgically revised and have subsequently remained patent. There were 3 bypass occlusions which resulted in a major amputation in 2 patients. Three additional major amputations were performed for persisting infection despite a patent bypass. By life table analysis the cumulative primary & secondary patency and limb salvage rates for this group of diabetic patients were 75% at 2 years, 89% at 3 years and 82% at 3 years respectively (S.E. < 10%). The 3 bypass occlusions, which occurred at 1 week, 5 weeks, and 20 months, were in patients with both CRF and Grade "3" foot circulation (significantly different outcome compared to the rest of the group, by chi 2 test, p < 0.05). Good results can be achieved in the majority of diabetic patients undergoing short popliteal-distal bypasses. However, the combination of chronic renal failure and very limited foot circulation (Grade "3") has a significant adverse outcome.
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PMID:Revascularization of the ischemic diabetic foot using popliteal artery inflow. 880 38

Since hemodialysis patients are at high risk for blood-borne viral infection such as hepatitis B and C virus infection, nursing staffs of the hemodialysis units have a significant occupational exposure to blood-borne virus infection. Furthermore, they are in danger of contacting occupational low back-pain because they have to take care of patients in a half-rising position. In addition, they may also suffer from burned-out syndrome because they have to look after all the chronic renal failure patients as well as run machines during the hemodialysis procedure. In this paper, we describe occupational danger to health of nursing staffs working in hemodialysis units.
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PMID:[Occupational dangers to health of nursing staffs in hemodialysis units]. 882 64

Pneumococcal arthritis generally presents as non-destructive monoarthritis, although some underlying metabolic disorders such as liver failure and diabetes have been suggested to represent a risk factor for severe joint disease. Here we report a case of destructive pneumococcal arthritis of the left hip joint in a patient suffering from chronic renal failure treated with hemodialysis for ten years. Inspite of effective anti-pneumococcal antibiotic treatment, the patient with preexisting renal osteopathy and a mild osteoarthritis continued to suffer from severe and disabling pain of the left hip. This case demonstrates that pneumococcal joint infection in patients with underlying uremic bone disease can lead to quick deterioration of the affected joint.
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PMID:Destructive pneumococcal septic arthritis in end-stage renal disease. 934 43

Children with chronic renal failure are frequently exposed to painful invasive procedures. Ointments containing lignocaine-prilocaine, when used before intravenous punctures, have been reported to lessen the pain sensation. The aim of this study was to interpret the effectiveness of lidocaine 2.5% ointment in preventing pain when used before venous and arterial punctures in children undergoing a haemodialysis programme for chronic renal failure. Eight children were included in this study. The pain level was identified by the patients using a linear analogue scale. When topical anaesthetic and placebo were compared, there was no statistical difference in interpretation of pain during arterial (P > 0.4), venous (P > 0.375) or both (P > 0.4) procedures. We conclude that lidocaine 2.5% ointment is not effective in preventing pain in children undergoing long-term haemodialysis. In these patients some other factors, like psychological factors, puncture technique and needle size must be taken into consideration for the prevention of pain.
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PMID:Topical anaesthesia in haemodialysis: evaluation of topical anaesthesia with lidocaine during vascular access in children undergoing long-term haemodialysis for chronic renal failure. 935 32

Among the various dermatologic abnormalities that can be associated with advanced chronic renal failure and dialysis therapy, pruritus is certainly the most disturbing disorder. Pruritus is an unpleasant, vexing sensation that provokes an intense desire to scratch. In the past the pruritus was considered from the neurophysiologic point of view as a submodality of pain, but more recent research showed that pain and pruritus are sensations which are carried through different populations of primary sensory neurons. The causes of pruritus in uremic patients are still unknown: xerosis, intradermic microprecipitation of divalent ions, hyperparathyroidism, peripheral neuropathy, allergic reactions and hypersensitivity, histamine and others have been considered as pathogenetic factors. The uncertainty on the causes is in part responsible for the different approach and results, unsatisfactory in many cases. In this paper we will review the neurophysiology, the pathogenesis and the possible therapeutic approaches to uremic pruritus.
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PMID:[Uremic pruritus]. 943 34

A 37-year-old woman with chronic renal failure developed pain in the right flank during haemodialysis followed by rapid and dramatic deepening of pigmentation. Investigation indicated that the cause was severe haemolysis most probably due to mechanical damage to red blood cells passing through a stenosis in a dialysis blood line. Severe haemolysis should be suspected in subjects who suffer rapidly increasing pigmentation during dialysis. Such severe haemolysis should be recognized and treated rapidly since it may produce life-threatening systemic problems.
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PMID:Sudden deepening of pigmentation during haemodialysis due to severe haemolysis. 947 Sep 23

The purpose of this study was to determine the clinical characteristics of chronic renal failure patients who developed hand ischemia in the limb carrying the dialysis angioaccess. A retrospective review of the charts of 352 patients who underwent 409 upper extremity arteriovenous access, and who were subsequently diagnosed as steal syndrome, was performed at the Emory University Hospital between February 1992 and January 1997. Hand ischemia occurred after 13 of 299 arteriovenous grafts (4.3%) and after 2 of 110 direct forearm arteriovenous fistulas (1.8%). Six patients developed ischemic manifestations immediately postoperatively, 2 in the first week, 4 after 1 month, and 1 after 1 year. Thirteen occurred in association with the primary access procedure. Two cases occurred following graft thrombectomy and outflow dilatation. Seven patients were mildly symptomatic with dialysis-induced pain, coldness, or numbness; 8 patients developed severe ischemic manifestations in the form of sensory loss in 3, severe intolerable pain with impalpable pulse in 3, and digital gangrene and amputation in 2, one of whom developed an unhealed amputation stump and required a higher amputation level with satisfactory healing of the revised stump. Three patients were treated conservatively, 6 by banding, 4 by ligation, 1 by embolization, and 1 by distal ligation and bypass operation. Clinical characteristics of patients with hand ischemia included long-standing insulin-dependent diabetes (10), chronic hypertension (12), peripheral arterial disease (14; 93.3%), coronary artery disease (8), and systemic lupus erythematosis (1). Severe peripheral arterial diseases are commonly found and may be markers for risk of hand ischemia after access surgery.
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PMID:Incidence and characteristics of patients with hand ischemia after a hemodialysis access procedure. 953 65

Records of 183 patients with renal stones managed at Hospital Universiti Sains Malaysia between 1985 and 1995 were retrospectively evaluated. The commonest symptom was lumbar pain which may be associated with either frequency, blood stained urine or dysuria. One hundred and sixty-one patients (88%) had upper tract stones while the remainder had lower tract stones. Positive urine cultures were seen in 33 patients. The commonest organism isolated was Escherichia coli followed by Klebsiella aeruginosa and Staphylococcus aureus. Almost all of our patients had renal impairment at presentation and 70% of them progressed to chronic renal failure. In contrast to previous findings, the pattern of renal stone in this region is similar to that described in Western society. Its effect on renal function is serious and hence warrant special attention.
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PMID:Renal stones in Kelantan, Malaysia--has the pattern changed? 956 23


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