Search

Pain descriptions are influenced not only by a particular pain, but also by the level of the arousal of the brain stem prior to the pain experience, the patient's emotional state, and language idiosyncrasies and ethnically determined behaviors. With recent advances in functional brain imaging, the complexity and plasticity of the brain, along with its anatomical and functional reorganization in the presence of chronic pain, are being subjected to more sophisticated and intensive investigation. A visual analogue scale (VAS), where a patient rates pain using a scale of 0 to 10, or other similar numerical scale is therefore helpful in assessing the patient's personal interpretation of the severity of what they are experiencing. Orofacial pain can also be referred to another site, as happens in dental and muscular pains, or can migrate from site to site, as is common in trigeminal neuropathic orofacial pain.

Background: Onchocerciasis is a disease with a spectrum of manifestations suffered by different infected people. Based on individual perceptions and manifestations presented, demand for the drug Ivermectin was due to different motives and priorities during mass distribution programmes. Subjects and Method: This study presents findings from a sample of 594 persons out of a total of 35,763 treated individuals who voluntarily demanded Ivermectin treatment during a community-based Ivermectin distribution exercise. The distribution, which took place in 2008, was mass distribution of the microfilaricide to control onchocerciasis in endemic communities of Ezinihitte in the Imo River Basin of Nigeria. The subjects who were selected by quota sampling procedure on the basis of community and gender, were asked to rank-order six plausible reasons for seeking treatment in terms of their order of importance in motivating them to demand Ivermectin. Results: “To gain treatment and prevention of Skin Problems” and “Desire to be De-wormed” ranked first and second respectively. “To gain promotion of general wellbeing” and “To improve state of vision and prevent blindness” ranked third and fourth respectively. In the fifth and sixth rank-order positions were “To prevent hanging groin” and “to prevent/relieve enlargement of the scrotum or clitoris” in that order. A test of hypothesis to determine if there was significant agreement among treated persons on the rank order of importance of their reasons for demanding Ivermectin gave a Kendall's Coefficient of Concordance of W = 0.62, p

A case of progressive external ophthalmoplegia is described, in which the onset of the illness was at 28–30 years, with fatigability and muscular pains in the lower limbs as presenting symptoms. At 36

A series of rabbits was subcutaneously injected with three measured doses of killed cultures of two strains of Bacterium pneumosintes derived from the nasopharyngeal secretions of influenza patients. These rabbits were subsequently tested for the development of serum antibodies and for the presence of an induced immunity to the living organisms, with the following results. The serum of eleven of fifteen rabbits, tested from 10 to 27 days after the final subcutaneous injection, specifically agglutinated Bacterium pneumosintes, whereas normal rabbit serum did not. Nineteen vaccinated rabbits were subjected to protection experiments. Two of them were unaffected by an intratracheal injection of Bacterium pneumosintes, contained in the lung tissues of previously infected animals, in a dose which typically affected the control rabbits. Fifteen of the other seventeen proved to be completely resistant when tested by intratracheal injections of Bacterium pneumosintes cultures that produced typical infections in the controls. Ten of these fifteen rabbits were injected intravenously with living cultures of pneumococcus, Streptococcus hamolyticus, or Bacillus pfeifferi in doses which were non-infective under normal conditions, but infective, as experience has shown, in the presence of a primary lesion caused by Bacterium pneumosintes. In none of these animals did infection develop. The two remaining rabbits of the seventeen were not protected against Bacterium pneumosintes by the vaccination, and they further developed a secondary pulmonary infection with Bacillus pfeifferi after its intravenous injection. Control rabbits similarly injected intratracheally with Bacterium pneumosintes, and then intravenously with the pneumococcus, streptococcus, or Bacillus pfeifferi in doses that had proved non-infective for normal rabbits, uniformly developed a secondary infection with these organisms. The mildness of the local reactions and the absence of general signs, following vaccination with Bacterium pneumosintes, indicate that similar injections would be well tolerated in man. There is no evidence that the subcutaneous injection of large doses of the heat-killed organisms reduces the resistance of the animal body to infections with other bacteria. In single rabbit experiments the resistance to intravenously injected pneumococci, streptococci, or Bacillus pfeifferi has been found unreduced immediately after vaccination with Bacterium pneumosintes.

Inherited enzyme deficiencies resulting in defective muscle-glycogen breakdown should be considered as a possible cause of muscular pains, stiffness, and weakness on exertion, when no vascular, neurological, or other recognised cause is apparent. Measurement of the venous blood-lactate concentration before and after "ischaemic exercise " is a useful screening test, and a muscle biopsy should be performed when no rise is found. The specific enzyme defect can then be identified by biochemical and histochemical methods.

Tender indurated nodules and plaques are formed in the subcutaneous fat which terminate, after resolution, in atrophy. With the development of new lesions, a febrile reaction occurs with nausea, vomiting and muscular pains. The thighs are mostly involved. The nodules are hard, freely movable, irregular masses. A liquefying type has been described. The treatment is purely symptomatic.

T HE purpose of this report is to bring to the attention of physicians a condition which can be readily overlooked and characterized as a “virus infection,” “influenza” or “grippe,” but in reality is a distinct, self-Iimited but disabling disease. It is a syndrome which is ignored in the standard textbooks of medicine but which can be found in texts on toxicology and industrial hygiene. It is apparently better known to plumbers than to physicians and is called “galvo” by them. However, the disease occurs also among workers in brass foundries, hence is often called brass-founders’ ague and brasiers’ disease. Although it is most commonly caused t)y zinc fumes, it apparently can be caused by other metals and is therefore called metal fume fever. Metal fume fever is an industrial disease produced by the inhalation of zinc oxide fumes when zinc is heated in an oxidizing atmosphere to a temperature near the boiling point, as in smelting, galvanizing, brass-founding, brazing and oxyacetylene welding of galvanized iron. The symptoms are systemic, disabling and resemble those of influenza. It is characterized I))chills, fever, muscular pains, nausea and vomiting, followed by some degree of prostration. Complete recovery occurs in twenty-four to forty-eight hours. Workers exposed to the disease acquire immunity to attacks but, given a period of removal from the environment as occurs following week ends or holidays, susceptitjility returns. l

A typical outbreak of gastro-enteritis was reported. Oct. 23, 1924. The cases were restricted to about 140 persons of 225 eating regularly at the dining room of the women's hall of West Virginia University. Of 193 girl students questioned, 124 were affected with an acute gastro-enteritis, preceded by cramps, chills and fever, and vomiting, and accompanied by muscular pains, diarrhea and prostration. All made a prompt and uneventful recovery. The earliest case reported began at midnight Monday, October 20. Other cases followed rapidly, 109 cases being reported on Tuesday, thirteen on Wednesday, and one mild and atypical case on Thursday. On Wednesday, forty-five girls were prostrated in bed. The peak was between noon and 6 p. m. Tuesday, when thirty-three cases were reported. Subsequent study based on written questionnaires traced the source of trouble beyond reasonable doubt to the Monday noon meal. During the period of a week preceding to

Great confusion has prevailed in the use of the term rheumatism, since it has been applied to all sorts of painful affections of the joints and even to more indefinite muscular pains. Deforming types of arthritis have been included, and such expressions as rheumatoid arthritis have been employed. But for many years it has been recognized that there is one condition in which painful swelling of the joints is variously combined with tonsillitis, chorea, fever, subcutaneous nodules and especially with profound disease of the heart, that stands apart from all the rest and is most commonly known as acute rheumatic fever. I shall speak simply of rheumatism, to refer to this condition, because it seems that the term applies properly to no other. Rheumatism is an infectious disease that occurs in children or in young adults, sometimes with a very acute course, more often progressing slowly with several explosions of

Rat-bite fever is an infectious disease following the bite of a rat, or much more rarely, the bite of some animal having contact with rats (weasel, ferret, cat). There is an incubation period of from one to sixty days, averaging about two weeks. This is followed by one or more febrile attacks, accompanied by a characteristic rash. As a rule there are many of these paroxysms, which tend to recur with remarkable regularity, at intervals of from five to ten days. The duration of the individual attack averages from two to three days. The temperature rises gradually, to attain the maximum on the second day, and falls by crisis, with profuse sweating. Severe muscular pains and dysphagia are often prominent symptoms. In the interval between attacks the patient feels almost well. This is the usual form of the disease. In cases, however, in which there is only one attack, the

During the past three months there has been, and still continues, in Chicago an epidemic of sore throat that is unusually severe and characterized by complications strikingly different from those of other years. That it is generally prevalent throughout the city is attested by numerous physicians. A streptococcus presenting certain peculiar characteristics is found in practically all cases. A number of Cases have terminated fatally. In view of these facts, it is thought wise to make a brief preliminary statement at this time concerning certain clinical and bacteriologic features of the disease. The attack usually begins suddenly with or without a chill. The fever, the muscular pains, the prostration and the constitutional symptoms are out of all proportion to what one would expect from the amount of local involvement. The pulse is relatively slow. The leukocytes are only moderately increased. The throat presents a diffuse redness; there is much secretion

That brucellosis is a disease of protean manifestations was recognized by Hughes 1 in his classic description. Simpson, 2 Gentry, 3 Hardy, 4 Bierring 5 and Woodward 6 have described its varied symptoms more recently. Hamman and Wainwright 7 emphasized the importance of considering brucellosis in cases of unexplained pyrexia. Parsons and Poston 8 recently described four cases of brucellosis in which lymphadenitis was the outstanding feature. One case terminated fatally, and a detailed description of the postmortem observation was given. Every writer on the subject of brucellosis emphasizes the difficulty of diagnosis. In general, brucellosis may be divided into two clinical types, the acute and the chronic. In the acute type the onset may be sudden or gradual; the fever tends to be intermittent or undulating. Chilliness is common; often there are actual rigors with drenching night sweats. Joint and muscular pains, anorexia with loss in weight, splenomegaly and

A 55-year-old woman suffered for 18 months from progressive weakness with articular and muscular pains. Skin lesions typical of dermatomyositis appeared six months before death. A subacute type of diffuse interstitial pneumonitis developed, leading to pulmonary insufficiency in the five months preceding death, and was manifested by progressive cough and dyspnea. Six similar reported cases are reviewed and the association of dermatomyositis with diffuse interstitial pneumonitis is stressed.