Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Previous studies have shown that intravenous acyclovir does modify rash development, reduce viral shedding and alleviate acute pain in herpes zoster. To assess the clinical efficacy of an oral dosage regimen with 800 mg acyclovir five times daily, double-blind, placebo-controlled studies were carried out at three centres within the U.K., using a common protocol. According to inclusion criteria (immune competent patients over 60 years of age with a clinical diagnosis of herpes zoster with rash of no more than 72 h duration, no previous systemic antiviral treatment, no history of renal insufficiency) 205 patients were recruited after they had given their informed consent. Patients were randomly assigned to receive either two 400 mg tablets acyclovir (41 men, 59 women) or matching placebo (46 men, 59 women) five times daily for seven days. Treatment was predominantly domiciliary based. According to clinical assessment and pain score acyclovir recipients showed a significant benefit in terms of reduction in rash progression if treatment was started within 48 h of the onset of rash, and alleviation of pain during the acute phase of herpes zoster. Overall, the number of patients developing extradermal lesions was significantly lower in the acyclovir group than in the placebo group (p = 0.02). However, there were no significant differences in rash progression and pain response in patients with herpes zoster affecting the ophthalmic division of the trigeminal nerve in patients who received acyclovir (n = 21) compared to those who received placebo (n = 32). 12 acyclovir and 13 placebo recipients reported symptoms, predominantly gastrointestinal in nature, possibly or probably related to therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Infection 1987
PMID:Oral acyclovir for acute herpes zoster infections in immune-competent adults. 329 71

A traditional practice that has attracted considerable attention in the last decade is female circumcision, the adverse effects of which are undeniable. 70 million women are estimated to be circumcised, with serveral thousand new operations performed each day. It is a custom that continues to be widespread only in Africa north of the equator, though mild forms of female circumcision are reported from some Asian countries. In 1979 a Seminar on Traditional Practices that Affect the Health of Women and Children was held in the Sudan. It was 1 of the 1st interregional and international efforts to exchange information on female circumcision and other traditional practices, to study their implications, and to make specific recommendations on the approach to be taken by the health services. There are 3 main types of female circumcision: circumcision proper is the mildest but also the rarest form and involves the removal only of the clitoral prepuce; excision involves the amputation of the entire clitoris and all or part of the labia minora; and infibulation, also known as Pharaonic circumcision, involves the amputation of the clitoris, the whole of the labia minora, and at least the anterior 2/3 and often the whole of the medial part of the labia majora. Initial circumcision is carried out before a girl reaches puberty. The operation generally is the responsibility of the traditional midwife, who rarely uses even a local anesthetic. She is assisted by a number of women to hold the child down, and these frequently include the child's own relatives. Most of the adverse health consequences are associated with Pharaonic circumcision. Hemorrhage and shock from the acute pain are immediate dangers of the operation, and, because it is usually performed in unhygienic circumstances, the risks of infection and tetanus are considerable. Retention of urine is common. Cases have been reported in which infibulated unmarried girls have developed swollen bellies, owing to obstruction of the menstrual flow. Implantion dermoid cysts are a very common complication. Infections of the vagina, urinary tract, and pelvis occur often. A women who has been infibulated suffers great difficulty and pain during sexual intercourse, which can be excruciating if a neuroma has formed at the point of section of the dorsal nerve of the clitoris. Consummation of marriage often necessitates the opening up of the scar. During childbirth infibulation causes a variety of serious problems includind prolonged labor and obstructed delivery, with increased risk of fetal brain damage and fetal loss. A variety of reasons are advanced by its adherents for continuing to support the practice of female circumcision, but the reasons are rationalizations, and none of the reasons bear close scrutiny. The campaing against female circumcision is reviewed.
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PMID:A traditional practice that threatens health--female circumcision. 373 35

Two previously healthy adults, a man aged 69 and a woman aged 51 years, presented with spondylitis caused by Streptococcus agalactiae. One patient had fever and acute pain in the neck, the other progressive pain in the lower back. From cultures of blood and bone respectively. S. agalactiae was isolated. Both patients recovered after treatment with benzylpenicillin. S. agalactiae (group B streptococcus) is a wellknown cause of invasive infections in neonates and pregnant adults. Infections in nonpregnant adults are increasingly reported. Chronic conditions such as diabetes mellitus are strongly associated with disease caused by S. agalactiae.
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PMID:[Spondylodiscitis caused by Streptococcus agalactiae]. 919 May 11

The main objective was to develop a scoring system for easy use by the physician in daily clinical practice in deciding the appropriate treatment for his herpes zoster patient. Data from 635 patients who did not receive antiviral therapy were included in this analysis. Of these, 131 developed postherpetic neuralgia (PHN). Of the 29 variables tested univariately in this study, 15 showed a significant correlation with the incidence of PHN, but only six proved to contribute to the overall predictive power in the multivariate approach. Using two independent approaches, the model showed a very satisfactory performance in the validation sample. Patients without acute pain rarely developed PHN. In those with acute pain, being female, being over 50 years of age, having more than 50 lesions, having lesions of a hemorrhagic nature, having cranial or sacral localisation of the rash or having pain in the prodromal phase proved to be significant, multivariate factors. An easy-to-use scoring system used in a risk graph is proposed. These data should be useful in the individual treatment decision as well as in the design and analysis of therapeutic trials in herpes zoster.
Infection
PMID:A prognostic score for postherpetic neuralgia in ambulatory patients. 986 60

Some 250 million cases of sexually transmitted disease (STD) occur each year, and in some countries 1 or even 2 women in every 10 are infected with an STD. STDs are likely to reach an advanced stage before women notice them. The consequences of STDs are devastating, according to a report by the Population Information Program of the Johns Hopkins School of Public Health, and they include stillbirths, blinding eye infections in the newborn, chronic female abdominal pain, ectopic pregnancy, and infertility. There are social consequences for women such as divorce, and husbands may abandon infertile wives. Gonorrhea and chlamydia can cause both severe inflammation of the pelvis with acute pain and possible infertility. Pelvic inflammatory disease can permanently scar the fallopian tubes, increasing the risk of ectopic pregnancy, which can be fatal when the fallopian tube ruptures. Babies born to mothers with gonorrhea and chlamydia are likely to develop eye infections that may make them blind. Chlamydia infection in pregnant women may also cause premature rupture of the membranes, sepsis, and the death of premature neonate. Infection may spread to the lungs of newborns, leading to chlamydial pneumonia. Syphilis can cause spontaneous abortion, stillbirth, neonatal death, or congenital syphilis in the infant. Trichomoniasis and herpes can also be transmitted from mother to fetus. And infection with an STD increases the risk of infection with the human immunodeficiency virus (HIV). The World Health Organization (WHO) recommends that prenatal care should always include checks for STDs. A WHO Technical Working Group on Care of Mother and Baby has stressed the importance of detecting and treating STDs in pregnant women. The working group urged training of health workers to distinguish between STDs and other infections. The group, which met July 5-9, 1993, outlined health center strategies for prevention and treatment.
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PMID:STDs infect 250 million a year. 1234

The aim of this study was to identify and analyze the nursing diagnoses for patients in the immediate postoperative period of laparoscopic cholecystectomy. We elaborated and validated an instrument for data collection and registration. Fifteen 15 adult patients were evaluated in the immediate postoperative period of laparoscopic cholecystectomy, four men and 11 women, with average age of 45 years. Identified nursing diagnoses were: Impaired Skin Integrity (100%), Risk for Infection (100%), Sensory/Perceptual Alterations (100%), Risk for aspiration (100%), Risk for Ineffective Breathing Pattern (80%), Hypothermia (60%), Risk for Altered Body Temperature (40%), Altered nutrition: more than body requirements (33,3%) and Acute pain (26,7%). All patients were admitted in ambulatory regimen and were discharged from Post anesthesia Care Unit, still presenting the nursing diagnoses of Impaired Skin Integrity and Risk for infection.
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PMID:[Nursing diagnoses of patients in immediate postoperative period of laparoscopic cholecystectomy]. 1692 96

Acute mechanical symptoms due to excess retained cement in the posterior compartment of the knee joint following unicondylar knee arthroplasty (UKA) are uncommon. Infection, aseptic loosening, polyethylene wear and progressive arthritis are well-documented complications of UKA procedure. We present a patient with acute pain and 'clicking' sensation in the knee joint due to cement extrusion in the posteromedial compartment after UKA. Full functional recovery was achieved after arthroscopic removal of the cement debris. Of retrospectively screened 43 UKA cases, asymptomatic cement extrusion was detected in 8 patients in the posteromedial compartment on direct X-rays. Careful inspection of components is essential to minimize the risk of cement extrusion into the posterior compartment and perioperative fluoroscopy may be helpful during UKA procedure.
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PMID:Excess retained cement in the posteromedial compartment after unicondylar knee arthroplasty. 2399 19

Sickle cell disease causes acute and chronic illness, and median life expectancy is reduced by at least 30 years in all countries, with greater reductions in low-income countries. There is a wide spectrum of severity, with some patients having no symptoms and others suffering frequent, life-changing complications. Much of this variability is unexplained, despite increasingly sophisticated genetic studies. Environmental factors, including climate, air quality, socio-economics, exercise and infection, are likely to be important, as demonstrated by the stark differences in outcomes between patients in Africa and USA/Europe. The effects of weather vary with geography, although most studies show that exposure to cold or wind increases hospital attendance with acute pain. Most of the different air pollutants are closely intercorrelated, and increasing overall levels seem to correlate with increased hospital attendance, although higher concentrations of atmospheric carbon monoxide may offer some benefit for patients with sickle cell disease. Exercise causes some adverse physiological changes, although this may be off-set by improvements in cardiovascular health. Most sickle cell disease patients live in low-income countries and socioeconomic factors are undoubtedly important, but little studied beyond documenting that sickle cell disease is associated with decreases in some measures of social status. Infections cause many of the differences in outcomes seen across the world, but again these effects are relatively poorly understood. All the above factors are likely to account for much of the pathology and variability of sickle cell disease, and large prospective studies are needed to understand these effects better.
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PMID:Environmental determinants of severity in sickle cell disease. 2634 24

Infections are a common cause of hospitalization for patients with opioid use disorder (OUD), and hospital admissions are rising in the context of the worsening US opioid crisis. Infectious disease (ID) physicians are frequently the first point of medical contact for these patients. In this article, we discuss the integration of evidence-based management of OUD and patient-centered care of hospitalized persons with acute injection-related infections. We describe the following components of a comprehensive approach for OUD with inpatient ID consultations: (1) how to screen for OUD; (2) how to initiate the 3 US Food and Drug Administration-approved medications for OUD (buprenorphine, methadone, and extended-release naltrexone); (3) how to manage acute pain and opioid-related conditions; and (4) how to link and integrate ID and OUD treatment after hospital discharge. These strategies reduce unplanned discharges and increase completion of recommended antimicrobial regimens.
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PMID:Beyond Antibiotics: A Practical Guide for the Infectious Disease Physician to Treat Opioid Use Disorder in the Setting of Associated Infectious Diseases. 3199 54