Constrictive Pain Research Articles

Acil Serviste Sekonder Tip Baş Ağrı Tanılı Hastalarda Ağrı Karakteri ile Radyolojik Görüntüleme Bulgularının Karşılaştırılmalı Olarak Değerlendirilmesi; Prospektif Analiz

Objective: Secondary type headache is observed at a rate of 4-5% in the emergency department. In this prospecitve study, it was aimed to evaluate the results of patients with secondary headache, such as consultation, hospitalization, and discharge decision in correlation with radiological imaging findings.
 
 Material and Methods: This is a single-center, prospective and methodological study. According to International Headache Society criteria, sociodemographic characteristics, emergency department examination findings of a total of 200 patients with secondary headache were recorded.
 
 Results: Fifty percent of the patients had throbbing pain, 29.5% had constrictive pain, and the rate of pathological findings on CT was significantly higher in patients with squeezing pain (p=0.019). The hospitalization rate was significantly higher in the patients for whom consultation was requested, and 69.0% of the patients who were admitted to the hospital had constrictive pain (p

Primary bone tumors and tumor like lesions of the ulna

ObjectiveThe aim of this study was to discuss the diagnosis and surgical management and their results according to stage of primary bone tumors at ulna and to share our experience on this exceptional location for bone tumors. MethodsWe have retrospectively reviewed our clinics database and identified 23 cases (14 males and 9 females, mean age was 28.9 (range 4–77)) with primary bone tumors and tumor like lesion involvement of ulna. The patients were evaluated according to complaints, type and grade of tumor, treatment, recurrence and functional status. ResultsThe most common first referral complaint was constrictive pain in 52.1% of the cases, benign tumors and tumor like lesions of the bone constituted 73.9% whereas malignant bone tumors were 26.1%, 39.1% of the lesions were located in distal end of ulna and the mean follow up was 33.8 months (range 8–172 months). Local recurrence has unexpectedly occurred in 3 benign lesions (13.1%). ConclusionBenign bone lesions tend to involve distal and proximal ends, malign bone lesions involve diaphysis mostly. Both benign and malignant diaphyseal lesions of the ulna have better postoperative results regarding the lesions at both ends of ulna. One should also take care of recurrences even after a decade from the primary surgery. Level of evidenceLevel IV, Therapeutic study

Prinzmetal Angina in Major Hemophilia a Patient: A Case Report

Introduction: Prinzmetal anginais a special type ofacute coronary syndrome ST+ wich correspond to a transient occlusion of a coronary vessel secondary to spasm. This type of acute coronary syndrome is very rare and is characterized by the presence of signs of myocardial ischemia on electrocardiogram but coronary angiography and coroscaner are frequently normals. Its management in hemophilia patients is difficult because of the use of anticoagulant and antiplatelet drugs wich increase bleeding risk. We report the case of a major hemophilia A patient which presented Prinzmetal angina.Observation: It is a 64 years old patient, hemophilia A major, chronic smoking (40 pack-year), not diabetic, not hypertensive, which had a retro sternal constrictive pain radiating to the shoulders. At admission he was consciousness. No breath in cardiac auscultation. The electrocardiography showed a heart rate at 61bpm, the axis of the heart was normal. ST-segment elevation was noticed in DIII and AVF: ischemia in the cardiac lower area. Echocardiography was normal. The coroscaner was normal. The troponin I level was at 0.03 µg/L (Normal: 0-0.1µg/L). This patient had a variant Prinzmetal angina. Treatement: Diltiazem Hydrochloride 60 mg 1 tablet / 8 hours. Acetylsalicylic acid 160 mg IV and Clopidogrel 300 mg IV the first day; relay with acetylsalicylic acid 100 mg and clopidogrel 75 mg per day. Transfusion of factor VIII at the dose of 40UI / Kg. Simvastatin 20 mg 1 tablet per day. Perindopril 5 mg 1 tablet the day. The evolution was favorable.Discussion and conclusion: Coronary syndromes are not frequent in morocco hemophilia patients. Their management is complex and involves the presence of an hematologist. DisclosuresNo relevant conflicts of interest to declare.

Prinzmetal Angina in Major Hemophilia a Patient: A Case Report

Introduction: Prinzmetal angina is a special type of acute coronary syndrome ST+ wich correspond to a transient occlusion of a coronary vessel secondary to spasm. This type of acute coronary syndrome is very rare and is characterized by the presence of signs of myocardial ischemia on electrocardiogram but coronary angiography and coroscaner are frequently normals. Its management in hemophilia patients is difficult because of the use of anticoagulant and antiplatelet drugs wich increase bleeding risk. We report the case of a major hemophilia A patient which presented Prinzmetal angina. Observation : It is a 64 years old patient, hemophilia A major, chronic smoking (40 pack-year), not diabetic, not hypertensive, which had a retro sternal constrictive pain radiating to the shoulders. At admission he was consciousness. No breath in cardiac auscultation. The electrocardiography showed a heart rate at 61bpm, the axis of the heart was normal. ST-segment elevation was noticed in DIII and AVF : ischemia in the cardiac lower area. Echocardiography was normal. The coroscaner was normal. The troponin I level was at 0.03 µg / L (Normal : 0-0.1µg/L). This patient had a variant Prinzmetal angina. Treatement: Diltiazem Hydrochloride 60 mg 1 tablet / 8 hours. Acetylsalicylic acid 160 mg IV and Clopidogrel 300 mg IV the first day ; relay with acetylsalicylic acid 100 mg and clopidogrel 75 mg per day. Transfusion of factor VIII at the dose of 40UI / Kg. Simvastatin 20 mg 1 tablet per day. Perindopril 5 mg 1 tablet the day. The evolution was favorable. Discussion and conclusion: Coronary syndromes are not frequent in morocco hemophilia patients. Their management is complex and involves the presence of an hematologist.

Tratamento endovascular em paciente portador de coarctação da aorta: relato de caso

Coarctação da aorta constitui um estreitamento de origem congênita na porção inicial da aorta torácica. Tem incidência de 6 a 8% em nascidos vivos. A apresentação clínica é variada. O tratamento de escolha é o cirúrgico. Relatamos um caso de paciente do sexo feminino de 31 anos, com queixa de dor constrictiva na região cervical, dispnéia e claudicação intermitente em membros inferiores, sendo diagnosticada coarctação da aorta associada a estenose aórtica grave, que foi tratada com combinação das técnicas implantação de stent endovascular e angioplastia por balão.

Cefaléia do tipo tensional episódica: avaliação clínica de 50 pacientes

A case series study of 50 consecutive patients with episodic tension type headache (ETTH) was conducted. Clinical aspects, family history and impact on work activities were studied. The casuistry was made up of 40 women and 10 men. The average age was 30 (+/-12) years. Constrictive pain was present in 40 patients (80%). Sickness was the most commonly reported related phenomenon (20%). As expected, bilateral pain predominated; however, unilateral location was also present (10%). Although classically described as a mild pain, we observed that ETTH can come in intense crisis (16%). Family history of tension type headache was positive in 12 patients. The impact on work activities was substantial (14%). Our findings regarding to clinical aspects are in agreement with the literature. It is important to mention that the impact of ETTH on the individual and society should be reconsidered, and is more substantial than has been reported to date.

Baroreflex sensitivity during noxious stimulation in vasovagal reactors to blood donation

Baroreflex sensitivity was assessed at rest and during constrictive pain in healthy males with and without a history of vasovagal reactions to blood donation. Continuous recordings of cardiac inter-beat interval and finger arterial pressure were obtained at rest and during repeated presentations of constrictive thigh-cuff stimulation. Baroreflex sensitivity (in msec/mm Hg) was computed according to the spontaneous sequence analysis method. Results indicated that vasovagal reactors exhibited significantly lower descending baroreflex sensitivity across all periods, and significantly lower ascending baroreflex sensitivity at rest. Baseline differences in ascending baroreflex sensitivity were eliminated during thigh-cuff stimulation, as vasovagal reactors exhibited increases in ascending baroreflex sensitivity while non-reactors exhibited decreases. These findings suggest that susceptibility to vasovagal reactions may be associated with individual differences in baroreflex sensitivity.

Baroreflex sensitivity at rest and during stress in individuals with a history of vasovagal syncope

The baroreflex sensitivity of healthy young adult males who reported some history of vasovagal syncope during emotionally stressful situations (e.g. blood donation) was compared to a control group of individuals who reported no such history. The baroreflex, which induces compensatory bradycardia and vasodilation in response to acute elevations of blood pressure, was examined as a possible mechanism underlying predisposition to vasovagal reactions. Changes in heart rate and vasoconstriction in response to baroreflex stimulation (negative external cervical pressure) at rest and during administration of a mental arithmetic task and a constrictive pain stimulus were assessed. Individuals with a history of vasovagal reactions displayed greater baroreflex sensitivity during the pain stimulus and at rest, but not during mental arithmetic. These findings suggest one mechanism of risk for syncope reactions, particularly in situations involving the experience of pain.