Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Referred Pain”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,297 records · Page 72Linked to original sources
PubMed2000

MRI facilitated a diagnosis of endometriosis of the rectum.

A 51-year-old pre-menopausal Japanese woman suffering from chronic lower abdominal pain was referred to our hospital. A barium enema showed a stenotic lesion in the recto-sigmoid region, and a pelvic computed axial tomography (CAT) scan revealed a thickened rectal wall. A colonoscopic examination showed the rectum to be constrictive, but the mucosa appeared to be intact. Magnetic resonance imaging (MRI) with T1 high-intensity revealed a cystic lesion in the thickened wall of the rectum, which led us to suspect possible bowel endometriosis. Part of the biopsy specimen showed endometrial epithelium within the interstitial layer of histologically normal mucosa; finally, endometriosis of the rectum was diagnosed. The patient became asymptomatic after the initiation of hormonal treatment and later experienced spontaneous menopause. MRI was effective for diagnosis and the patient did not undergo unnecessary laparotomy. Although bowel endometriosis is generally diagnosed by means of resected specimens, in our patient, diagnosis was made using MRI and biopsy, and hormonal therapy had an effective role as a bridge to menopause.

Biopsy↗
PubMed2006

Incidental detection of malignant pleural effusion on sestamibi myocardial perfusion scan.

Incidentally the diagnosis of pleural effusions can be made with scintigraphic studies. We report a case of incidental detection of pleural effusion in sestamibi myocardial perfusion scan. A 64-year-old man with a history of chest pain was referred for Sestamibi myocardial perfusion scintigraphy. The review of cine data revealed an area of radiotracer accumulation in the left hemithorax. Subsequent chest X-ray and computed tomography revealed a relatively massive pleural effusion. Microscopic evaluation confirmed the malignant nature of pleural effusion, the origin of which was an ipsilateral pulmonary adenocarcinoma. As to our knowledge, it is the first report of sestamibi uptake in pleural effusion fluid. In our opinion, this finding could be explained by radiotracer uptake in the malignant component of the effusion. Reporting of these incidental findings could be important and sometimes can be resulted in determining previously unknown pathologies.

Adenocarcinoma↗
PubMed2006

A key cause of paraphimosis.

A 90-year-old man on hormonal treatment for invasive (T4) adenocarcinoma of the prostate presented as an emergency with a paraphimosis secondary to placement of four circumferential key rings around his penis. He had experienced referred penile pain from his prostate cancer, and to overcome this, had attempted to 'gate out' his pain by constricting his penis and thus stimulating the pudendal nerve. His treatment in our unit consisted of a penile local anaesthetic block, removal of the key rings with a ring cutter and manual reduction of the paraphimosis.

Adenocarcinoma↗
PubMed2005

Idiopathic Dyspepsia.

Idiopathic dyspepsia refers to pain and/or discomfort perceived in the epigastrium that is not secondary to organic, systemic, or metabolic diseases. Symptoms may overlap with those of gastroesophageal reflux disease and irritable bowel syndrome. Gastrointestinal motor disorders, hypersensitivity to mechanical or chemical stimuli, and psychosocial factors can act individually or in concert to induce the symptoms of dyspepsia. Accordingly, there is no single therapy, and treatment must be individualized. Eradication of Helicobacter pylori infection rarely achieves symptom improvement. Treatment of idiopathic dyspepsia should begin by reassuring the patient about the benign nature of the syndrome and educating them on the knowledge that has been achieved in recent years regarding potential causes of the syndrome. Both prokinetic and antisecretory drugs have been reported to improve dyspeptic symptoms, but results are not completely convincing. Although well-designed studies demonstrate superiority of proton pump inhibitors over placebo, it should be noted that patients with nonerosive gastroesophageal reflux disease were invariably included; when these patients are excluded, the benefit of antisecretory medications is questionable. We suggest that patients with idiopathic dyspepsia be initially treated according to the predominant symptom. Those with epigastric pain/burning should receive a trial with standard doses of proton pump inhibitors for 4 to 8 weeks, whereas prokinetic patients should be prescribed at recommended doses for similar periods of time to patients with nonpainful dyspeptic symptoms such as posprandial fullness, early satiety, nausea, or vomiting. Nonresponders may benefit from combination therapies or short trials with higher doses of drugs. Visceral analgesics and antidepressants can also be prescribed alone or in combinations with other therapeutic strategies. Recent studies demonstrate utility for psychologic therapy and hypnotherapy, although truly controlled studies are difficult in this area. Herbal medicines deserve further evaluation.

Journal Article↗
PubMed1984

Increase in 5-HT synthesis in the dorsal part of the spinal cord, induced by a nociceptive stimulus: blockade by morphine.

The effects of a nociceptive peripheral stimulus and/or morphine upon endogenous tryptophan levels (TRP), specific activity of tryptophan (S.A. of TRP) and serotonin (5-HT) synthesis in the dorsal and ventral spinal cord, the brainstem and the forebrain were investigated in anaesthetized rats. Whereas endogenous TRP and S.A. of TRP were not found to be affected by any of the manipulations described below, 5-HT synthesis was markedly altered. The application of a prolonged and intense nociceptive electrical stimulus to the tail induced a rise in 5-HT synthesis which was dependent on the part of the CNS considered, with the dorsal cord being the most sensitive (25%), the ventral cord and the brainstem being effected to a lesser extent (14% and 16% respectively), and the forebrain not being affected significantly. By contrast, the application of a prolonged and innocuous electrical stimulus on the tail was not followed by any detectable changes in 5-HT synthesis. Morphine administration (1 mg/kg; i.v.) did not significantly alter 5-HT synthesis in the four CNS regions considered. Nevertheless, the same morphine dose did induce a highly significant (P less than 0.005) reduction in the increase in 5-HT synthesis induced by the nociceptive stimulus, both in the dorsal cord and in the brainstem. Such an effect was not seen in the ventral cord. The specificity of these morphine effects was demonstrated by their naloxone reversibility; on the other hand, naloxone alone failed to modify the stimulus-induced increase in 5-HT synthesis seen in the dorsal cord and the brainstem. The results, particularly those concerning the dorsal cord, are discussed with reference to pain mechanisms and morphine analgesia. They suggest that peripheral nociceptive messages induce an increased activity in some bulbo-spinal 5-HT pathways and that a low dose of morphine can counteract such an effect. It is proposed that exogenous opiates exert a complex regulation of bulbo-spinal 5-HT pathways. Functional significances of these processes are discussed.

Afferent Pathways↗
PubMed1988

Restraint-induced analgesia in the CD-1 mouse: interactions with morphine and time of day.

The tail-flick response of adult male CD-1 mice was used to assess the analgesic properties of restraint alone and in combination with morphine during the diurnal and nocturnal periods. Mice were restrained in conical metal devices that allowed a change in position from supine to prone but not from front to back. Restraint induced an analgesia equipotent to a 2.5 mg/kg dose of morphine within 0.5 h of its initiation. Although habituation occurred over the restraint period a pronounced analgesia was still evident at the end of the 3 h test period. The habituation to restraint-induced analgesia was more rapid at night. Although the basal tail-flick latency to thermal stimulation was decreased during the nocturnal period the time of day did not alter the degree of analgesia induced by either restraint or morphine. Morphine induced a dose- and time-dependent analgesia during both the diurnal and nocturnal periods and this analgesia was potentiated by restraint stress only during the nocturnal period. Naloxone at high doses (10.0 or 20.0 mg/kg) blocked the analgesia induced by morphine but did not totally block the analgesia induced either by restraint or morphine plus restraint. These data suggest the potentiation of an opiate effect by stress may depend on habituation or tolerance to the stressor.

Analgesia↗
PubMed1995

Central nervous system effects of subdissociative doses of (S)-ketamine are related to plasma and brain concentrations measured with positron emission tomography in healthy volunteers.

Plasma concentrations, maximum regional brain concentrations, and specific regional binding in the brain after administration of 0, 0.1, and 0.2 mg/kg doses of (S)-ketamine were measured in a randomized, double-blind, crossover study in five volunteers and were related to induced effects such as analgesia, amnesia, and mood changes. Specific binding in the brain was assessed by simultaneous administration of (S)-[N-methyl-11C]ketamine quantified by positron emission tomography. High radioactivities in the brain corresponded to regional distribution of N-methyl-D-aspartate receptor complexes. A significant and dose-dependent reduction of binding was measured as a result of displacement of (S)-[N-methyl-11C]ketamine. Memory impairment and psychotomimetic effects were related to dose, plasma concentration 4 minutes after administration, and decreased regional binding of (S)-ketamine in the brain and were consistently seen at plasma and maximum regional brain (S)-ketamine concentrations higher than 70 and 500 ng/ml, respectively. The magnitude of specific binding of (S)-ketamine, measured with positron emission tomography, can be related directly to drug effects.

Adult↗
PubMed1989

14-and-6 Hz positive bursts in childhood encephalopathies.

14-and-6 Hz positive bursts, a benign epileptiform variant, have also been described in comatose children with liver disease, chiefly Reyes syndrome. To determine the incidence of this pattern in children in stupor or coma, 154 portable EEGs in 111 children with mental status changes were reviewed. Seven children showed 14-and-6 Hz bursts in the setting of moderate to marked background slowing. They were similar to positive bursts seen in normals in location, duration, morphology, frequency and repetition rate. They differed in being readily activated by stimulation. The etiology was toxic/metabolic in 4 cases, primary cerebral insult in 2 cases and a combination of the two in 1 case. Amongst an age-matched control population, 5 of 75 showed 14-and-6 Hz positive bursts in stage I or II sleep. There were no statistically significant differences in incidence rates between the 2 groups. 14-and-6 Hz positive bursts may occur in diverse encephalopathies of childhood, not just Reyes syndrome. The similar incidence rate, morphology and topography to normals suggest that the presence of these wave forms in encephalopathies represents persistence of a normal EEG feature rather than an expression of some underlying pathophysiological process.

Acoustic Stimulation↗
PubMed1989

A comparison between different models of the relation between recorded intradental nerve impulse activity and reported pain in man.

In this study three different models of the relation between intradental nerve impulse activity (INA) and pain report, expressed by finger-span (FS), in man were investigated. The techniques were (i) a previously described mathematical model, (ii) the relation between the Areas of INA and FS and (iii) the relation between the Peaks of INA and FS. Their usefulness in 533 clinical experiments on 15 subjects were evaluated by means of a statistical analysis of the variability and accuracy of the models. It was shown that the mathematical model was the most accurate and stable method of the three different methods investigated. This was indicated by, among other things, a significantly smaller variability for the mathematical model within experimental sessions than between sessions. The two other methods were found to be of less scientific value since they had an undesired high variability within sessions, and also showed contradicting results during control conditions.

Adult↗
PubMed1993

Benign osteoblastoma associated with an aneurysmal bone cyst of the mandibular ramus and condyle.

This article reviews the clinical behavior, the histologic conditions, and the treatment of a benign osteoblastoma associated with an aneurysmal bone cyst of the mandibular condyle and ramus. A 14-year-old boy, otherwise healthy, was referred for pain and enlargement in his right temporomandibular joint-cheek region. The swelling was firm and tender, a slight facial asymmetry was present, and the mouth-opening capacity was reduced. During a 6-weeks period from the primary examination to surgery the lesion expanded extensively, anesthesia appeared in the right inferior alveolar nerve and a lateral open bite developed on the affected side. Computed tomography displayed a total destruction of the right mandibular condyle and ramus to the level of the mandibular foramen. The lesion was radiolucent without distinct borders to adjacent bone. Surgery revealed a bluish, well-vascularized predominantly cystic tumor. The lesion included the temporomandibular joint disk but without overgrowth to the temporal component. After resection of the lesion, the condyle and the mandibular ramus was reconstructed with the use of an autogenous costochondral graft. The postoperative healing was uncomplicated. At follow-up 2 years after surgery the boy was free of recurrence with normal motor and sensory nerve function.

Adolescent↗
PubMed1988

Syndrome of intradiscal lumbar herniation. Clinical presentation and management.

A syndrome of intradiscal lumbar herniation not associated with nerve root compression is described. The patients have a history similar to that seen in classic disk herniation, except the paresthesias and pain are "referred" roughly in a dermatomal distribution. On examination, limitation of range of motion of the back secondary to muscle spasm is noted; however, a positive straight leg-raising test result is not. Objective neurological findings are much less obvious than with radiculopathy. These patients may have "weakness" from lack of effort on their part during the examination. There is noted asymmetry in appropriate reflexes and also in the sensory examination. Standard imaging examinations are equivocal. If explored surgically, the findings are relatively unimpressive. These patients, if correctly identified, may be candidates for percutaneous nuclectomy.

Humans↗
PubMed1984

Normal CSF levels of met-enkephalin-like material in a case of naloxone-reversible congenital insensitivity to pain.

In a case of naloxone-reversible congenital insensitivity to pain, met-enkephalin-like immunoreactivity in the CSF was in the normal range and not affected by the administration of naloxone. Chromatographic analysis of the met-enkephalin-like material revealed that it corresponded to at least two classes of molecules. A clear difference in the relative proportions of these two classes was detected in the CSF of the patient insensitive to pain when compared to controls. The possible functional significance of this alteration is discussed in relation to the well known antinociceptive action of enkephalins.

Adult↗
PubMedDate not supplied

Differences in human evoked potentials related to olfactory or trigeminal chemosensory activation.

The aim of the present study was to determine, whether there are differences in the topographical distribution of chemosensory evoked potentials (CSEPs) due to stimulation with different odorous substances. The odorants used in the study which mainly excited the olfactory nerve were vanillin and acetaldehyde; those which additionally excited the trigeminal nerve were sulphur dioxide and ammonia. Twelve subjects participated in the study. The subjects separately estimated the intensity of the odorous and of the painful/pricking sensation caused by the stimuli, and described the odorous qualities in their own words. CSEPs were recorded from 7 positions. After stimulation with "olfactory" substances maximum CSEP amplitudes were recorded at parieto-central sites, and after stimulation with "trigeminal" substances maximum amplitudes were obtained at the vertex. Following stimulation with ammonia and sulphur dioxide amplitudes were largest contralateral to the stimulated nostril. In contrast, little difference in CSEP amplitudes was observed between hemispheres after stimulation with vanillin or acetaldehyde. Thus, the topographical distribution of CSEP amplitudes may provide information with regard to the sensory system (olfactory or trigeminal) activated by the presentation of an odorous stimulus.

Acetaldehyde↗
PubMed1992

Sensory thresholds for vibration, perception and pain in diabetic patients aged 15-50 years.

The sensory thresholds for vibration, perception and pain were measured in 375/395 of all diabetic patients aged 15-50 years in Umeå county (population 118,500), 79% of whom had type 1 diabetes mellitus (DM). The results were compared with those from 100 healthy control subjects. Both type 1 and type 2 diabetic patients had significantly elevated sensory thresholds compared to control subjects. In multiple regression analysis, patients with type 1 DM had significant associations between elevated sensory thresholds and age, duration of diabetes, height but not with smoking. Type 2 diabetic patients had a significant association only with height and control subjects with age and height. Thresholds were significantly higher in men than in women with type 1 and type 2 DM and in control subjects but were no longer significant after normalizing for height. Thus, age, duration of DM and tall stature appear to be major risk factors and smoking a minor risk factor for elevation of sensory thresholds both in type 1 and type 2 DM and also in healthy control subjects. Gender differences depend on differences in height.

Adolescent↗
PubMedDate not supplied

Diminished nociceptive response in mice following immunization with neurokinins.

Female BALB/C mice were immunized with various neuropeptides and later tested on a hot plate apparatus for responses to nociceptive stimuli. Animals immunized with substance P, neurokinin B (NKB) or fragments of either peptide were found to spend significantly longer periods of time on the hot plate than controls. Subjects treated with substance K (NKA), its N-terminal fragment or neuropeptide Y were not different from controls. Finally, mice injected with histamine or the EXON-4-related peptide were also found to exhibit delayed responses in this test situation. These results suggest roles for SP, NKB, EXON-4-related peptide and histamine in sensory processing and transmission.

Analgesia↗
PubMed1985

Electrical stimulation in the measurement of cutaneous sensibility.

A portable constant current electrical stimulator with bipolar felt disk electrodes was developed for quantitative assessment of cutaneous sensibility. The new method was used in the measurement of thresholds for perception and pain in healthy volunteers. The mean values of the threshold for perception in different areas of the body varied between 1.0 and 2.0 mA (S.D. +/- 0.2-0.6 mA) and those of the threshold for pain between 2.5 and 4.3 mA (S.D. +/- 0.5-1.7 mA). There was no difference between the left and the right side. The interindividual range of the perception threshold varied from 0.4 to 3.0 mA and that of the pain threshold from 1.2 to 6.0 mA. Within a limited area of the body the reproducibility of the measurements was high both for the thresholds for perception and for pain. Anterolateral cordotomy caused a marked rise in the threshold for pain in the analgesic area of the body, whereas the threshold for perception did not change. It is hypothesized that the threshold for perception reflects an activation of A beta fibers and the threshold for pain an activation of A delta fibers. The new method is considered to be valuable in clinical neurology and neurosurgery.

Adolescent↗
PubMed1991

Situational and psychophysiological factors in psychologically induced pain.

To investigate pain that occurs in the absence of painful stimulation, normal subjects were connected to a sham stimulator and were told that a headache could occur as a result of the electrical current they would receive. Half of the subjects who received this suggestion reported pain. The frequency and intensity of pain reports in a group which was given prior pain experience as a reference point in reporting pain and in a group which was exposed to a manipulation designed to reduce intentional deception were not significantly different from the pain reports of a group not exposed to these manipulations. The frequency of pain reports in subjects not connected to the sham stimulator but still asked to report pain was 25% which was significantly less than the frequency for subjects who were told there would be stimulation to the head. Pain ratings increased as the settings of the sham stimulator were increased. Subjects who reported pain had significantly fewer electrodermal responses to tones signaling them to prepare for a reaction time task. The results suggest that pain can be produced in the absence of peripheral stimulation. The pain does not appear to be due to intentional deception or the lack of a standard for comparison, but is strongly influenced by environmental cues. Psychophysiologically, pain responders were less attentive to signal stimuli.

Adult↗
PubMed1991

Effects of vagal afferent stimulation on cervical spinothalamic tract neurons in monkeys.

The purpose of this study was to determine if electrical stimulation of vagal afferents inhibited activity of primate spinothalamic tract (STT) neurons located in cervical segments of the spinal cord. Previous studies show vagal inhibition of STT neurons in more caudal segments of the cord, which receive visceral spinal inputs and somatic inputs from proximal body regions. We hypothesized that activation of vagal afferents would inhibit cervical STT neurons that were excited by cardiopulmonary sympathetic afferents and not inhibit those cells inhibited or unaffected by this visceral input. Because visceral pain is referred to proximal somatic fields, we also hypothesized that STT neurons with excitatory somatic fields confined to distal areas would not be inhibited by vagal stimulation. In 42 cervical STT neurons, we found no difference in effects of vagal stimulation between cells excited or not excited by stimulation of cardiopulmonary sympathetic afferents. Responses to vagal stimulation also were the same for cervical STT cells with proximal or distal somatic fields. Furthermore, there was no difference in the inhibitory effects of vagal stimulation in cervical as compared to thoracic STT neurons. We concluded that vagal afferent stimulation causes a general inhibitory effect at all levels of the spinal cord on neurons which transmit nociceptive information.

Animals↗