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)

We report six caucasian patients who had acute pain in the hip and marked limitation of all movement of the joint. Plain radiographs and CT of the pelvis showed calcification within the reflected head of rectus femoris. All six responded to accurate CT-controlled injections of corticosteroid and local anaesthetic with dramatic and prolonged pain relief, although one required a second injection for recurrence of symptoms after two months.
J Bone Joint Surg Br 1996 Sep
PMID:Acute calcific tendinitis of the rectus femoris. 883 78

Recent functional brain imaging studies with positron emission tomography (PET) suggest a preference of the right hemisphere, especially the anterior cingulate cortex (ACC), in affective processing of the clinical pain syndromes. We have investigated the central processing of cluster headache (CH) attacks provoked by sublingual nitroglycerin (NTG). In the cerebrum, provoked CH activated the ACC and the temporopolar region of the right hemisphere in addition to other regions. The regions activated in the ACC (Brodmann area (BA) 24 and 32) are involved in affective/cognitive processing of pain and willed attention. Our study discloses the preferential role of the right hemisphere in attributing emotional valence and attention to the suffering of pain. The findings support the theory of a right hemispheric specialisation in the mediation of withdrawal-related negative affect. The divergence of the distributed central processing between provoked cluster headache attack and experimentally induced acute pain indicates different central mechanisms for different types of pain.
Pain 1996 Sep
PMID:Right-lateralised central processing for pain of nitroglycerin-induced cluster headache. 889 32

The obstetric patient presents unique challenges to the anaesthesiologist. The physiologic changes in the mother during pregnancy and the anaesthetic implications of these changes, associated with the pathophysiologic conditions frequently superimposed on the pregnancy, distinguish the parturient from the other patients about to undergo anaesthesia and surgery. Furthermore, the obstetric patient may be in acute pain from labour and frequently needs urgent surgical intervention because of sudden changes in the condition of the mother or the fetus.
Acta Anaesthesiol Scand 1996 Sep
PMID:Preanaesthetic management of the obstetric patient. 890 13

Adrenal myelolipomas are usually small and asymptomatic tumors discovered incidentally. In a small number of cases, acute pain may develop secondary to intratumoral and/or retroperitoneal bleeding. We observed a large, surgically and histologically confirmed, myelolipoma of the right adrenal gland with spontaneous internal and external hemorrhage. CT demonstrated heterogeneity of the mass, obliteration of the surrounding fat planes, and retroperitoneal blood dissection. A literature review produced only 5 reports of ruptured myelolipoma with external hemorrhage.
Acta Radiol 1996 Sep
PMID:Retroperitoneal hemorrhage due to a ruptured adrenal myelolipoma. A case report. 891 77

We present a mathematical model for the phenomenon of wind-up (Mendell, 1966, Exper. Neur. 16,316-22) which occurs in many neurons. We concentrate on its occurrence in the substantia gelatinosa of the dorsal horns of the spinal cord, where it is connected with certain pathological and nonpathological pain states. The model is a development of the model by Britton & Skevington (1989, J. Theor. Biol. 137, 91-105) for Melzack & Wall's gate control theory of pain (1965, Science, New York, 150, 971-9; 1982, The Challenge of Pain, Penguin: Harmondsworth), modified to take account of more recent information. Its variables are the electric potentials of various cells in the midbrain and the spinal cord. Britton & Skevington's original model simulated many of the phenomena observed in acute pain in humans, but not the wind-up mechanism. This is not surprising, since this model did not include the N-methyl-D-aspartate (NMDA) receptors that are now recognized as being crucial to the phenomenon. Here we rectify this omission, and obtain good agreement between the model and experimental data on wind-up. The positive feedback that NMDA receptors exhibit is shown to be the essential feature in producing wind-up. As an independent test of the model we simulate a completely different experimental set-up, and obtain good qualitative agreement with data there. Finally, we present a prediction of the model that has yet to be tested experimentally.
IMA J Math Appl Med Biol 1996 Sep
PMID:The role of N-methyl-D-aspartate (NMDA) receptors in wind-up: a mathematical model. 892 89

The influence of anxiety on acute pain sensation was investigated, studying the relative contribution of endogenous opioids and attentional mechanisms. Thirty-six spider phobics received mildly painful electrical stimulation, while anxiety and focus of attention were manipulated within subjects. The opioid antagonist naloxone or placebo was administered between subjects to examine an analgesia owing to anxiety-induced endorphinergic activity. In contrast to earlier findings, attention towards pain failed to increase pain as opposed to distraction from pain, probably owing to a less effective attention manipulation. Furthermore, despite high levels of anxiety, subjective pain ratings were not influenced by anxiety, although heart rate responses were slightly inhibited. Accordingly, there was no increase in subjective or physiological pain responses as a result of naloxone, nor did beta-endorphin plasma levels rise during anxiety. The results suggest that phobic anxiety does not induce an opioid-mediated analgesia. Curiously, naloxone itself effected a dose-dependent analgesia compared to placebo during both high and low anxiety, which is compatible with the assumption of agonist properties of naloxone in the absence of opioid activity.
Behav Res Ther 1997 Sep
PMID:No evidence for opioid-mediated analgesia induced by phobic fear. 929 2

Anaesthetists, using basic scientific concepts of peripheral opioid activity, try to improve regional anaesthesia and postoperative analgesia by injecting opioids, with or without local anaesthetic, close to nerve trunks or nerve endings. To test the evidence that peripherally applied opioids (all except intra-articular) have an analgesic effect outside the knee joint. Systematic search for published reports of randomised controlled trials in the period 1966-1996 (MEDLINE, EMBASE, Oxford Data Base, reference lists) which compared efficacy of peripheral opioids with placebo, local anaesthetic, or systemic opioids in acute pain. Reports of pethidine or intra-articular opioids were not included. Data on intraoperative efficacy (onset, quality, duration of sensory block), and postoperative efficacy (pain intensity, analgesic consumption) were extracted. Statistical significance as indicated in the original reports and clinical relevance of differences between opioids and controls were taken into account to estimate qualitatively overall efficacy. Twenty-six trials with data from 952 patients were analysed. Opioids used were morphine (16 trials), fentanyl (8), alfentanil (1), buprenorphine (1), and butorphanol (1). Of four experimental pain trials, two reported a statistically significant difference in favour of the opioid. In 22 clinical trials efficacy of opioid injections into the brachial plexus (10), Bier's block (4), perineural (3), or other sites (5) was tested. Five of 10 clinical trials measuring intraoperative efficacy reported statistically significant efficacy with opioids compared with control; none of them were judged to be clinically relevant. Five of 17 clinical trials measuring postoperative efficacy reported a significant difference in favour of the opioid; none was judged to be clinical relevant. Trials of lower quality were more likely to report increased efficacy with opioids. Adverse events related to the route of administration were not reported. These trials provide no evidence for a clinically relevant peripheral analgesic efficacy of opioids in acute pain.
Pain 1997 Sep
PMID:Analgesic efficacy of peripheral opioids (all except intra-articular): a qualitative systematic review of randomised controlled trials. 931 71

Many patients still suffer from unnecessary pain in the postoperative period. Waiting for new technologies or drugs will not improve the status of acute pain management. The establishment of an acute service is needed to reduce the incidence of postoperative pain. Acute pain therapy is one of the great challenges we have to take up.
Anaesthesist 1997 Sep
PMID:[The quality of postoperative pain therapy]. 941 69

Nociception is a protective system of the body which prevents it from injury and tissue damage. Human beings respond to noxious stimuli by moving away. They learn by pain to avoid these situations in future. Shortly after major injury, there is a limited analgesic period allowing the body to flee the area of danger, later on, emerging pain compels the body to rest and supports recuperation. While acute pain has a certain meaning, chronic pain does not. It induces a comprehensive suffering including loss of initiative, appetite and vigilance. It reduces life-quality, often accompanied by depressive moods. Acute pain causes changes in the central nervous system leading to an increased sensitivity of nociception (hyperalgesia). During healing, the central processing of noxious stimuli is normalised taking minutes to weeks. Sometimes, unknown factors initiate chronification of pain. Changes on a molecular level in peripheral tissue as well as in the central nervous system induce "cellular early genes", a synthesis of c-fos, c-jun and other proteins favouring the chronification of pain. All efforts have to be made to depress or interrupt such a development. One of the first steps to pain prophylaxis in a hospital is an optimal surgical technique: incision, extension, limited tissue damage and minimal invasive surgery should guarantee the smallest impairment of the nociceptive system possible. However, nociceptive input is intense and of long duration and leads to central sensibilisation. Postoperative pain has lost its function as surgery anticipates healing. Pain induces a reduction of ventilation, circulation, digestion and increases the risk of other disorders. There is need of aggressive pain treatment for humanitarian reasons and for reasons of late sequelae like permanent pain and increased reduction of function. This is of pivotal importance in patients with amputations or sympathetic reflex dystrophy (SRD). Antinociception is best provided by regional anaesthesia technique with a combination of local anaesthetics and opioids which results in better outcome. Hence, regional anaesthesia techniques are strongly indicated in those patients. Good antinociception may be even more important than it is assumed today. Anand demonstrated a lower morbidity and mortality in 45 newborns undergoing cardiothoracic surgery, when general anaesthesia was performed with high-dose sufentanil versus halothane supplementary doses of morphine. Anaesthesiologists have to reconsider the quality of general anaesthesia: the antinociception of their regimen.
Anaesthesist 1997 Sep
PMID:[Neurophysiological aspects of pain and its consequences for the anesthetist]. 941 70

Tolosa-Hunt syndrome (THS) is a condition that includes recurrent attacks of retro-orbital, steady, and severe pain usually as the presenting symptom. Symptoms may include spontaneous recurrence of pain, chronic pain, and cranial nerve dysfunction that are responsive to steroid treatment. A patients with THS is described, with findings on craniotomy and biopsy, and the typical presentation of acute pain and recurrence of pain associated with response to steroid treatment. An overview of pain in this condition is presented.
J Pain Symptom Manage 1998 Sep
PMID:Pain in Tolosa-Hunt syndrome. 976 23


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