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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of trigeminal neurinoma with marked extracranial extension is reported with a review of the literature. A 60-year-old female noticed numbness over the left side of the face during the proceeding 15 years. Two years prior to admission, she began to complain of itching and lancinating pain at the left lateral aspect of the nose. Neurologic examination on admission revealed diminished corneal reflex on the left side and hypesthesia in the distribution of the left trigeminal nerve. There was no weakness or atrophy of the ipsilateral masticatory muscles. The remaining cranial nerves and cerebellar functions were normal. Craniograms showed destruction of the left petrous apex, enlargement of the left superior orbital fissure and an extensive bone defect in the floor of the left middle cranial fossa. CT disclosed a huge heterogeneously enhancing mass lesion in the left middle cranial fossa, which extended posteriorly into the left cerebellopontine angle and inferiorly into the pterygoid and infratemporal fossae. Cerebral angiograms revealed medial displacement of the left internal cerebral artery in the ganglionic, cavernous and supraclinoid portions, and elevation of the left middle cerebral artery in the sphenoidal portion. Although the left meningohypophyseal trunk was dilated, no tumor stain was observed. A transantral biopsy specimen provided the diagnosis of neurinoma with Antoni type A tissue. The patient was followed up at the outpatient clinic as radical operations were not agreed upon. Eight cases of trigeminal neurinoma with extracranial extension are reviewed including the presented case. There were two males and six females, and the age varied from 16 to 65 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of trigeminal neurinoma with marked extracranial extension]. 332 32

Since its introduction to North America in 1942, the use of epidural catheter analgesia has increased dramatically. Improved equipment, methods and medications have broadened its application to include among others, surgical anesthesia, chronic pain relief and the management of postoperative pain. Numerous techniques for epidural puncture and insertion of the catheter have been described. Although complications have been associated with placement of an epidural catheter, these are rare when performed by an experienced anesthesiologist. Epidural analgesia was first accomplished by blockade with local anesthetics. Bupivacaine has been called the local anesthetic of choice for epidural infusion. Bolus administration of epidural local anesthetics gives effective analgesia; however, its use is limited by brief duration and occasionally severe hypotension. Epidural local anesthetics have been administered by continuous infusion in an attempt to minimize side effects. Nevertheless, hypotension, as well as motor block, numbness, nausea and urinary retention have occurred. Epidural analgesia with local anesthetics is effective in relieving postoperative pain, but its safety and feasibility have been questioned because of the frequent, potentially serious side effects. These problems led to trials of epidural narcotics for postoperative pain management. The exact site of action of epidural narcotic analgesics is debatable; however, the bulk of evidence supports a direct spinal action. Epidural narcotics appear to specifically inhibit nociceptive stimuli. The prolonged and profound analgesia that occurs with epidural narcotics relative to parenteral administration is due to a higher concentration of drug reaching the CSF through the epidural route. Since nervous transmission is not completely blocked this technique cannot provide anesthesia during operation. Morphine has been the most frequently used narcotic for epidural analgesia. Results of several recent, randomized double-blind studies have shown that epidural narcotics give adequate analgesia comparable with that observed with epidural bupivacaine. Epidural morphine provides a greater duration of analgesia and may cause fewer side effects. Improved analgesia has been reported when epidural narcotics are used in combination with local anesthetics. Continuous administration of low dosage epidural narcotics has been shown to have less frequent side effects than bolus administration. Nevertheless, pruritus, urinary retention, hypotension and severe respiratory depression have been reported with both methods.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Epidural catheter analgesia for the management of postoperative pain. 351 98

Anaphylaxis is a systemic reaction which can be very dangerous in many patients. In addition to the most common antigens (drugs, venoms, foods), physical exercise can provoke anaphylaxis in the sensitized patients. The mechanism of this reaction is still unknown. In this report, we describe a case of exercise-induced anaphylaxis in a 25 year old female who had experienced two syncopal attacks during strong physical activity. On other occasions she had noticed that prolonged work would cause urticaria, pruritus and numbness. During hospitalization, on two occasions a treadmill stress test induced bronchial spasm, urticaria and hypotension. We believe that the association of urticaria and anaphylaxis would suggest the possible presence of a vasoactive substance released from the mast-cells and basophil leucocytes.
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PMID:Systemic anaphylaxis induced by physical exertion: a case report. 379 10

We evaluated postoperative pain relief and the incidence of side effects of three methods of thoracic epidural analgesia. Ninety patients, divided into three equal groups, received postoperative analgesia after thoracic surgery either as intermittent epidural injections of bupivacaine (25 mg/5 ml, 0.5% solution) as needed, or, intermittent epidural injections of morphine (5 mg/5 ml of normal saline, 0.1% solution) as needed, or continuous epidural infusion of morphine (0.1 mg, in 1 ml of normal saline) per hour supplemented with intravenous morphine (2 mg) upon request. Pain relief was evaluated by each patient on a pain scale visual analogue and by pain relief questionnaire for a period of 72 hr. Postoperative pain relief was achieved equally with these three methods of epidural analgesia in all patients with no significant difference between groups. Intermittent epidural injection of bupivacaine relieved pain for 4.9 +/- 1.9 (SD) hr/injection and was associated with urinary retention in all patients, with numbness and weakness of the hands in 12 patients, and with severe hypotension in 7 patients. Intermittent epidural injection of morphine relieved pain for 5.8 +/- 2.3 hr/injection and was associated with urinary retention in all patients, with pruritus in 12 patients, and with central narcosis and respiratory depression in 8 patients. Continuous epidural infusion of morphine with occasional intravenous morphine (2 mg) supplementation also effectively relieved postoperative pain and was associated with minimal systemic side effects. One patient complained of pruritus, and two patients developed urinary retention.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Continuous epidural infusion of morphine for treatment of pain after thoracic surgery: a new technique. 646 62

Occupational exposure to fenvalerate, a synthetic pyrethroid insecticide, has been reported to cause paresthesia. An assay was devised in our laboratory for subjective grading of the sensation produced by the topical application of this compound. The present double-blind study compared human discrimination of topically applied technical fenvalerate, the heavy-ends fraction of fenvalerate, and ethyl alcohol (vehicle). Both forms of fenvalerate showed a statistically significant increase in inducing paresthesia over the vehicle alone. The onset of the cutaneous sensations occurred at one hour, peaked at three to six hours, and lasted approximately 24 hours. Numbness, itching, burning, tingling, and warmth were the most frequently reported sensations. The difference between the two fractions of fenvalerate was not statistically significant.
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PMID:Paresthesia from cutaneous exposure to a synthetic pyrethroid insecticide. 672 39

The complications that developed in 1,800 patients who underwent 2,631 fluorescein angiographies (FAs) were reviewed. In 5.4% of the patients, complications developed during 4.4% of the FAs. The patients with complications were ten years younger than the average patient undergoing the test. The rate of complications was twice as high in the male patients. Skin testing seems useless in attempting to predict allergic reactions in susceptible patients. Only one life-threatening situation, acute pulmonary edema, was found. Cases of numbness of the thumb, thrombophlebitis, pruritus of the soles and hands, and "hay-fever"-like reactions are also reported. A case of a patient in whom myocardial infarction developed one hour following the test is also discussed, but it is not believed to have been directly caused by the fluorescein injection.
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PMID:Low incidence of side effects following intravenous fluorescein angiography. 712 38

In 13 full-term primipara in active labor an initial single dose of preservative-free meperidine (100 mg) diluted in 10 ml of saline was injected epidurally (L2-3). In another 13 full-term parturients in active labor, 10 ml of bupivacaine 0.25% was used. Pain was scored by the linear analog scale. Onset of analgesia was 5.3 +/- 2.8 minutes following administration of meperidine, and 12.9 +/- 6.9 minutes following bupivacaine (p less than 0.01). Pain score decreased to 0 in 12 of 13 patients following meperidine administration and in six of 13 patients following bupivacaine (p less than 0.01). Satisfactory analgesia lasted 160.8 +/- 90.3 minutes following meperidine, and 103.5 +/- 42 minutes following bupivacaine administration (p less than 0.01). Subsequent supplementation by intermittent doses of 10 ml of bupivacaine 0.25% was more effective and less frequent following meperidine than following bupivacaine administration. Maternal sedation, nausea, and itching occurred frequently following administration of epidural meperidine, whereas hypotension, numbness, and motor dysfunction followed bupivacaine. In neither group was significant respiratory depression observed. All parturients delivered vaginally, 288 +/- 212.6 minutes following meperidine and 348 +/- 195.8 minutes following bupivacaine administration (p greater than 0.05); the neonates showed normal Apgar scores and neurobehavioral responses. Epidural meperidine, supplemented by subsequent bupivacaine as indicated, provides maternal sedation and satisfactory analgesia, and it diminishes the requirements of bupivacaine supplementation. The technique is advantageous in the parturient primipara.
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PMID:Epidural meperidine-bupivacaine for obstetric analgesia. 720 Dec 68

Based on a study of 400 patients (272 patients with herpes zoster and 128 with postzoster neuralgia), the subcutaneous injection of triamcinolone in saline is concluded to be a safe and effective measure for reducing pain. The acute eruption and symptoms of herpes zoster cleared in an average of less than four days. Postzoster neuralgia developed in only 2.9% of the patients, although nearly 70% of these patients were more than 50 years of age. In cases of postzoster neuralgia, 35% cleared completely; 28.9% improved enough so that they could live with the occasional pain, itching, or numbness, and therapy was not beneficial for an additional 15.6%, and it failed in 18.7% of the cases. The results were satisfactory in 63.9% of the patients, and the side effects were minimal.
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PMID:Treatment of herpes zoster and postzoster neuralgia by subcutaneous injection of triamcinolone. 720 70

We prospectively studied side effects about 54 patients with chronic hepatitis C treated with 3 to 10 MIU a day of interferon (IFN) alpha, which was administrated for 16 to 24 weeks. Every day, all of them wrote down every symptoms, by themselves, during its treatment. Any symptoms occurred in all patients and each incidence of symptoms such as fever, fatigue, headache, anorexia, arthalgia, myalgia, chill, itching, insomnia, nausea, numbness of hand and foot, irritability, diarrhea, eye ball pain, vomiting, were all higher than those which have been reported by some papers in Japan. So, it was considered that the symptom self-wrighting method by patient was useful to evaluate the entity of side effects. Furthermore, we studied 26 patients, who discontinued IFN treatment because of side effects and analyzed the background factors. Each incidence of symptoms of these patients were not always compatible to those incidences. But by observation of those symptoms, we could know severe side effects earlier.
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PMID:[Clinical analysis of patients with chronic hepatitis C who discontinued interferon treatment because of side effects--our experiences and recent reports]. 752 35

The coronal incision used for brow lift procedure has a high rate of localized alopecia, widening, and depression of the scar at the suture line. Other sequelae of the standard coronal brow lift incision procedure are "stretch-back" with a recurrent brow ptosis, poor brow elevation, and numbness beyond the incision line. Factors causing alopecia are tension, use of a monopolar cautery, use of key sutures with undue tension, one-layer closure, and sutures left too long. Recurrent brow ptosis may be due to anterior displacement of the posterior scalp flap, stretching of the anterior frontal skin flap, or insufficient power of the weakened frontalis muscle. Poor brow elevation may be due to unsatisfactory dissection on the glabella and orbital rims. Numbness and itching beyond the incision line are due to a low coronal incision. To avoid these problems, the following principles were followed: (1) If not contraindicated, the incision is made high on the vertex of the head, posterior to a biauricular line. (2) The pericranium is included in the frontal flap starting at the incision lines. (3) The subperiosteal dissection is continued down to the orbital rims and nasal bones. (4) The release of the periosteum at the arcus marginalis or just above allows repositioning of the brow structures. (5) The inelastic pericranium maintains the position of the elevated structures and avoids stretching of the frontal skin. (6) The integrity of the frontalis muscle is maintained completely. (7) Two large triangles of scalp resected in the posterior flaps allow fixing the position of the posterior scalp and match better the length of the anterior flap. (8) The galea periosteal rim flap allows anchoring of the frontal flap to the undersurface of the posterior scalp flap. This stabilizes the closure with minimal tension on the hair-bearing portion of the scalp. The wide surface of contact avoids depression and widening at the suture line. (9) Closure with skin staples avoids constriction of the hair follicles. (10) Hemostasis is done with a bipolar cautery. (11) No through-and-through key sutures are used. Some of these principles were introduced to the endoscopic subperiosteal forehead lift. The modifications mentioned above have been used in 92 open brow/face lift procedures with excellent aesthetic and functional results and minimal complications.
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PMID:The anchor subperiosteal forehead lift. 1130 18


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