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At least 1,477 records · Page 82Linked to original sources
PubMed1982

Treatment of bladder pain with transsacral nerve block.

Fifteen patients with bladder spasticity and pain of three different etiologies were referred to the pain clinic by urologic specialists. These patients were refractory to all prior methods of treatment, excluding major surgical procedures. In a prospective study started in 1976, these patients were treated with transsacral nerve blocks using 0.25% bupivacaine and, in most cases, subsequent 6% aqueous phenol at the right S-3 ventral foramen. If indicated, transsacral nerve blocks were performed at other levels, as described in the text. Of the patients studied 53% have had significant or complete relief of pain for an average of 26.5 months. The associated morbidity was negligible and there was no mortality. This is in contrast to the morbidity and mortality associated with some major surgical "curative" procedures. The technique is proposed as a successful and economical approach to treatment that can be managed on an outpatient basis.

Bupivacaine↗
PubMed1984

Fasting breath hydrogen concentration: normal values and clinical application.

Excretion of hydrogen in breath commonly persists despite an overnight fast. Although elevation of hydrogen concentration above the fasting value after administration of a test sugar is evidence of malabsorption, the significance of the fasting value itself is unknown. We determined the normal limits of fasting breath hydrogen in healthy children and adults, and in patients with chronic diarrhea or recurrent abdominal pain. Fasting breath hydrogen in 221 healthy children and 9 healthy adults averaged 7.1 +/- 5.0 parts per million (mean +/- SD), exceeding 30 parts per million in less than 1%. No value exceed 42 parts per million. In 73 patients with recurrent abdominal pain and 76 patients with chronic diarrhea, fasting breath hydrogen was less than 42 parts per million in 97% and 83%, respectively. History and laboratory data were reviewed in the 15 patients where fasting breath hydrogen exceeded 42 parts per million. Seven had documented small bowel bacterial overgrowth and an additional 3 patients had radiographic evidence of intestinal stasis. Using test dinner meals, we prospectively evaluated the effect of previously ingested foods containing complex carbohydrates on fasting breath hydrogen. Dinner meals consisting of rice, wheat, or beans influenced fasting breath hydrogen values, but did not result in elevated fasting breath hydrogen in healthy individuals. Rice bread resulted in uniformly low fasting breath hydrogen values in healthy subjects (2.0 +/- 2.5 parts per million), but fasting breath hydrogen remained elevated in patients with bacterial overgrowth. Our studies indicate that conditions for measurement of the fasting breath hydrogen value may be standardized to improve discrimination between normal and abnormal values.

Abdomen↗
PubMed1983

Information processing in cutaneous nociceptors in relation to sensations of pain.

The phenomena of fatigue and sensitization have been observed in the responses to heat of A-fiber and C-fiber mechanoheat nociceptors (AMHs and CMHs, respectively). After heat stimulation that is sufficiently intense to sensitize AMHs, CMHs within the stimulated area become fatigued, which suggests a dominant role of AMHs in contributing to cutaneous hyperalgesia under these conditions. Mild heat injuries, on the other hand, not sufficiently intense to sensitize AMHs, result in a characteristic time course in development of sensitization of CMHs that is matched by similar changes in pain threshold and in magnitude ratings of pain. Although available evidence does not suggest a simple relation between the shapes of psychophysical magnitude scaling functions and the average responses of nociceptors, it does support the conclusions that CMHs encode the intensity of painful heating of skin and that the alterations in responses of CMHs after mild heat injury contribute to the observed changes in scaling functions during the development of hyperalgesia.

Hair↗
PubMed1981

Nevoid basal cell carcinoma syndrome: review of the literature and report of a case.

Any patient who has multiple cystic lesions of the jaws should be evaluated for the presence of other signs of nevoid basal cell carcinoma syndrome. The workup should include consultations with specialists in neurology, radiology, dermatology, medical genetics, and any other specialty areas where signs of symptoms may appear. It is not unusual for the oral surgeon to be the first practitioner to see such a patient, because initial complaints often refer to pain and swelling for an infected jaw cyst. The workup of this case and its treatment are typical for a patient with nevoid basal cell carcinoma syndrome.

Adult↗
PubMed1980

Depression masquerading as diabetic neuropathy.

Fifty-nine patients referred for painful diabetic neuropathy of the lower extremities were evaluated for depression and response to antidepressant drug therapy in a double-blind controlled study. All patients were found to have substantial degrees of depression during psychiatric interview and by Kupfer-Detre test scores (8.1 +/- 0.6, as compared with control values of 4.0 to 4.3 +/- 0.2). Treatment with imipramine hydrochloride or amitriptyline hydrochloride resulted in complete remission of lower extremity pains in all patients in 10 +/- 2 weeks, with concomitant relief of depression and return of depression test scores to 3.8. These results suggest that the syndrome of painful diabetic neuropathy of the lower extremities represents a depressive equivalent in a large proportion of cases and that treatment with imipramine or amitriptyline is a successful mode of therapy for such persons.

Adult↗
PubMed1978

Temporo-mandibular joint changes in renal osteodystrophy.

The radiologic study of temporo-mandibular joints in patients undergoing long-term haemodialysis has led to documentation of osteodystrophic changes in 6 patients: 2 were asymptomatic and 4 had referred to pain. The roentgenologic picture of this unusual abnormally varies from a simple decrease of bone density to resorption of the condylar head.

Adult↗
PubMed1995

[Simultaneous operations for both the repair of the aortic arch aneurysm and repeated CABG].

A 73-year-old female complaining of left thoracic pain was referred to our hospital. In 1988, she had the first CABG of the left circumflex coronary artery (CX) and right coronary artery. On admission in April 1994, chest X-ray and CT scan revealed a saccular aortic aneurysm, 5 x 5 cm in size, extending to the distal to the left subclavian artery. Coronary arteriography showed a patency of the CX graft, but 99% stenosis of the proximal left anterior descending branch (LAD) with delayed opacification. After the repeated median sternotomy, cardiac arrest was achieved with the aortic cross clamping and St. Thomas Hospital solution infusion. CABG to the LAD branch using a saphenous vein was accomplished. Following this, the replacement of the aortic aneurysmal lesion with a prosthetic graft was performed under the selective cerebral perfusion with deep hypothermia. Proximal anastomosis of the vein graft was completed during a rewarming period. The operation was performed without complications. Postoperative course was satisfactory except a few minor transient complications such as athelectasis of the left upper lobe and the intra-thoracic hematoma. After one month's hospitalization, she was discharged, and currently (six months postoperative) remains asymptomatic.

Aged↗
PubMed1994

[Rounded atelectasis: another pulmonary pseudotumor].

Rounded atelectasis or Blesovsky's syndrome (also called pleuroma, folded lung or shrinking pleuritis with atelectasis) is the association of plaque-like pleural fibrosis with a folding visceral pleura and nodular atelectasis of the underlying lung. It can mimic a peripheral lung tumor or a mesothelioma. Radiography and computed tomography (CT) show a characteristic opacity with a comet-tail sign. The pathogenesis in some of the cases is considered to be secondary to pleural effusions and in others to a contraction of a focus of pleural fibrosis, not associated with effusion. In many cases, there was a history of asbestos exposure. We report the case of a 44-year-old, man who had smoked and worked with materials containing asbestos. He referred thoracic pain of 6 months duration and dyspnea. An X-ray of the chest (Fig. 1, 2) and a CT scan (Fig. 3) revealed a round peripheral mass in the left lower lobe. A fine needle aspiration biopsy of the lung was performed revealing clusters of large atypical cells with abundant cytoplasm. A thoracotomy was decided upon and no frozen section was requested. Gross examination of the resected lobe (Fig. 4) demonstrated a 2.5 cm white, irregular, firm and retracting pleural plaque. On sectioning, a peculiar folding of the visceral pleura delimited by anthracotic pigmentation was noted below the fibrotic plaque. The folding extended perpendicularly deep into the parenchyma. It was possible to separate the folding and liberate the underlying parenchyma, which was firm, fibrotic and atelectatic. No tumor was found anywhere within the lobe.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy, Needle↗
PubMed1995

Comparison of self-reported fatigue in rheumatoid arthritis and controls.

OBJECTIVE: To compare self-reported fatigue in adults with rheumatoid arthritis (RA) with age and sex matched healthy controls without RA and to determine the relationships of fatigue to pain, sleep, functional status, depressive symptoms, and disease activity. METHODS: A sample of 51 patients with RA and 46 age and sex matched controls without RA completed self-administered questionnaires 3 times at 6-8 week intervals. Questionnaires included the Multidimensional Assessment of Fatigue scale, Sleep Survey, Health Assessment Questionnaire, and the Profile of Mood States. Patients had blood drawn for hematocrit (Hct) and C-reactive protein on the same day the questionnaires were completed. RESULTS: Fatigue scores were significantly higher in persons with RA compared to healthy controls. Fatigue did not change significantly in either group over time. Fatigue was strongly associated with poor sleep, functional disability, greater pain, more depressive symptoms, and lower Hct. CONCLUSION: The importance of assessing fatigue in RA is confirmed. Effective management is needed to control clinical manifestations of RA that were found to be strongly associated with fatigue such as poor sleep, functional disability, pain, depressive symptoms, and lower Hct.

Adult↗