Comparison Chart of Lyme Disease and Co-Infections Symptoms

Total Page:16

File Type:pdf, Size:1020Kb

Comparison Chart of Lyme Disease and Co-Infections Symptoms Comparison Chart of Lyme Disease and Co-infections Symptoms Back to Starts Temperat Cognitiv Dental Digestiv Ear Eyes Head- Circulat coInfections with ure e Disturba e Disturba Disturban Neck ory "Onset Disturban Disturba nces Disturba nces ces Disturba Disturba " ces nces nces nces nces Borreliosis -rash 9 Listed 43 Listed 5 Listed 23 Listed 5 listed 25 listed 33 listed 16 listed (sometime Symptoms Symptoms Symptoms Symptoms Symptoms Symptoms Symptoms Symptoms Lyme -feels **Neuroborell -Difficulty **- -Sound -Light - -infection - s) chewing - disturbances inflammation Disease unregulated iosis: sensitivity sensitivity Headaches, -Flu-like pain in with -Can not -ear -Pain, -stiff neck - of -short term stand hot or teeth tongue, the heart More memory problems pressure confusion cold -chronic chewing, valves, lining symptom -pain from -drooping lids, -fluid in temperatures. loss gingivitis - of the heart s here swallowing, head -Sharp -Poor receding sound etc. - extra My Lyme and esophagus, decisions - -ringing in -Sudden pains coinfections -Body gums Stomach, beats temperature poor -thinning blurred "foggy" abdomen, ear -Numbness -Stroke now below 37C ( planning - vision. Double impulsivenes enamel -Decreased -tender permanently bowels, vision. -Heart rate 98.6°F) -Painful hearing in areas - gone!! s intestines, one or both - Increased -blood -Ice cold body gums/jaw neuralgia's -poor liver - ears. - pressure parts and floaters Reluctance Plugged disturbances judgment - red face patches to go to -Floating and more -loss of ears. -Light Copyright © Do -Unexplained school/work black specs headedness, sudden over- ability for /going out to -Ears not copy without popping - "Spots" wooziness, heating complex eat because feeling off written before eyes permission. throughout of bouts of -Brain fog diarrhea. -Looking balance body. -Difficulty through -Twitching of -Unexplained with multi- waviness/wigg facial lyness, - muscles chills tasking. ,sensation of -Unexplained -Problems redness. sweats/fevers/ sharp facial with letter or -Pressure in pain, crawly feeling very number eyes feeling. hot. reversals -Unexplained -Dry eyes fevers -Drooping of eyelids More . -Sharp, -Bleeding Anaplasmo -Flu like symptoms . knife-like, easily sis rash (rare) here behind the eyes type of -heart headache. -Gradual, More Dental -Loss of -Eye **heart Babesiosis -chills -Headache nonspecifi symptoms problems, appetite - . problems problems Babesia -High Fevers here TMJ -Neck c Nausea -bloodshot - intermittent stiffness -Rash problems --Abdominal eyes -sore Tachycardia occasional -drenching -Sudden pain -weight -Sore throat eyes -Congestive night pain within or cough loss -sensitivity to each tooth heart failure sweats -diarrhea light -pallor or -band -malaise entire jaw -enlarged -Many, many -Brain fog pressure more around the -low grade bones liver -jaundice fever -swollen heart -low blood spleen -lower belly pressure fat More Bartonellosis -Flu-like -prolonged - More -Numerous -pain from **Many eye -sharp -Thickened same day Inflammation symptoms GI track sound from blood -vein fevers disorders frontal or here brain as bite of brain disorders top of head swelling -hot flashes inflammation -vision loss Bartonella -rash -Inflammed -poor - headaches -cold -eye intravascular extremities spinal cord appetite infections -brain fog List of Bartonella -memory disease -gastritis loss -broken Infections -Red eyes -dizziness -lower veins - abdominal -intense -Loss of jaw here unexplained type of pain pressure bone -anorexia - -Vision loss, >infections bruises, gastrointesti blurred vision, of the brain -spider veins light nal lesions >edocarditis -weight sensitivity, - pulse -eye gain. -polyps -Liver infections in/around -Pain behind major disorder -Enlarged the eyes organs - MANY -progressive spleen anemia -under right rib pain B. quintana - Relapsing . More liver and . pain behind severe blood Rash(fleeti fevers symptoms spleen the eyes headache infection Trench here enlargement ng) heart valve Fever -Sudden problems high fevers endocarditis . More vomiting . headache Borrilia -Flu-like -chills symptoms . miyamotoi Rash (not -relapsing here often) fever along with flu like symptoms . More - . -Enlarged -Heart Boutonneu -Rash -Meningitis symptoms Gastrointesti blood vessels problems se fever -Flu-like here nal in eyes -Meningism- neck bleeding stiffness, -enlarged intolerance liver - of bright enlarged light, spleen headache - rash -recurrent **Neurobruc More Gastric -ringing in ** Many eye Brucellosis -Tumors Endocarditis fevers - symptoms discomfort - ear -hearing (rare) ellosis problems -Rapid heart Brucella profuse here colitis - /abscesses - Flu-like Inflamed loss -Optic nerve rate sweating - constipation -ischemic night sweats brain causes -nausea - -pain from inflammation - many sound retinal strokes diarrhoea symptoms; detachment -aneurysms, -no appetite -conjunctivitis - -seizure -impaired enlarged liver hepatitis posterior -subdural cognitive uveitis -eyeball hemorrhage C inflammation - -pressure functions anemia purpura, - -memory enlarged maculopapular inside skull loss - spleen -cranial difficulty lesions nerve performing -sudden loss of vision palsies activities of -unusually long daily living headaches -speech -Brucella difficulties meningitis Much More - . - -double vision -Scratchy Clamydia More . inflammation inflammation and decreased sore throat, . Pneumonia symptom of the brain of the vision, eye laryngitis, s here (encephalitis) eardrum infection -temporary paralysis, mainly -confusion in the face. - -acute Persistent psychosis -aseptic progressive meningitis Headache -dry cough -nasal congestion -Sudden high More -light -severe -rare Colorado Flu like- sometimes: fever symptoms . sensitivity pneumonitis (rare) a headache Tick Fever here -Nausea, -myocarditis faint rash 10%: -vomiting meningitis -diarrhea, - or abdominal encephalitis pain - hepatitis. Eastern tick- More . -eye problems headache vasculitis Flu-like symptoms borneRickett rash siosis here prolonged More -upset -bleed Ehrlichiosis flu-like Sharp fever symptoms . - rash stomach easily Ehrlichia here headaches (sometime -nausea, -vasculitis s) -meningitis -loss of -anemia appetite -cough -sore throat -Very -memory More - -light . -abnormal Mycoplasmo night - symptoms gastrointesti . blood similar loss sensitivity sis sweats here to chronic nal pressure -loss of -visual Mycoplasm -intermittent -congestive Lyme fevers concentratio problems disturbances heart failure a's n disease. -nausea see Mycoplasma -floaters - slow Pneumoniae -diarrhea growing -eye pain (Multisyst -bloating emic) (lives within cells) -Flu-like -Altered More severe - Powassan .Fever -vomiting consciousne . symptoms . headach virus shivering ss - anorexia,nau here no rash sea and Confusion - -stiff neck diarrhea agitation tick-borne -Personality -liver encephalitis- abnormalitie changes s Hallucination Children: s Buldging in more soft spot and more Valvular ** Symptoms enlarged damage Coxiella More similar to meningitis - -No rash liver symptoms endocarditis burnetti . those of . encephalitis -Flu-like inflamed here -50%: Q Fever Lyme liver disease. abnormal liver function Rickettsia More - -light sensitive vasculitis -Flu-like headache symptoms . gastrointesti . can lead to recettsii -About a here untreated: Rocky week later nal myocarditis a rash -10%: problems dizziness Mountain develops Spotted -10% will aphasia jaundice congestive produce Fever deafness heart failure stools -meningitis positive for occult blood. STARI -Rash See .See .More .Similar to ..Similar to .Similar to headache ..Similar to Lyme Lyme symptoms lyme lyme lyme stiff neck lyme -Flu- here symptoms symptoms symptoms disease disease symptoms. like symptoms symptoms neurotoxin during a Tick .More . Paralysis s blood symptoms released here meal cause by tick salivary paralysis glands Tick-borne encephaliti . s Drenching . -conjunctivitis Tickborne Flu-like .More -nausea . -headache no rash sweats symptoms - Relapsing -vomiting -facial palsy -cycles of high here Fever -meningitis Myocarditis fever,f -anorexia -blood -Liver and pressure spleen More -inflamed Francisella -Flu-like -fever -nausea -sore throat symptoms . eyes often . -Rash -exhaustion -mouth Tularencis here -vomiting with a and discharge. sores Tularemia -diarrhea, -rare; -abdominal meningitis pain -intestinal ulceration's -weight loss Note: There may be more or less symptoms depending on the strain of pathogen, an individuals immune seystem, complications, and other infections present in the body. Immune/EndocrineDi Locom Psychia Neurolo Reprod Respirat Severe Skin Urinary sturbances otor tric gic uctive ory Sleep Disturb Disturba Disturb Disturb Disturb Disturba Disturb Disturb ances nces ance ances ances nces ances ances Borelliosis 12 listed 33 listed 22 listed 30 listed 12 listed 6 listed 9 listed 14 listed 5 listed -Immune dysfunction - - - -Testicular -Air hunger -Skin -Bladder -Arthritis -Fatigue Lyme depression Hypersensit pain -non- blotches - problems - Thyroid, Adrenal -Pains of -Menstrual productive -difficulty kidney disease ivity falling or rashes -Spleen all disturbance disturbance -explosive -Abnormal cough staying -tickling -lymphathic system - types in irritability - brain s s. joints, -laboured asleep. on Inflammation anxiety/distr -pelvic pain, waves breathing, -Unable to - tendons, - the skin Neurogenic -Edema ess -twitching - or gasping get into the ligaments, reproductiv bladder -candida(Sugar -rage - unexplaine deep -Nodules e - -Bladder craving,Allergies)
Recommended publications
  • A New Mother with Night Sweats
    MedicineToday PEER REVIEWED CLINICAL CASE REVIEW A new mother with night sweats Commentary by CASE SCENARIO JOHN EDEN MB BS, FRCOG, FRANZCOG, CREI Sally is a 35-year-old woman who presents for her three-monthly contraceptive injection of depot medroxyprogesterone. She mentions in passing that since the birth of her second child, A 35-year-old woman has been experiencing nine months previously, she has been experiencing night sweats three or four times a week. She has no obvious focus of infec- night sweats since the birth of her second tion, no pain and no other systemic symptoms, although she child nine months previously. says she often feels very tired. She also reports that she is still producing some breast milk despite having stopped breastfeed- MedicineToday 2013; 14(4): 67-68 ing six months previously. Sally recalls that about two years ago, before she conceived her second child, she was quite sick with an ‘ovarian infection’ and then an ectopic pregnancy. Sally’s pelvic ultrasound results are normal, as are the results of urine and blood tests, including a full blood count, erythrocyte sedimentation rate, C-reactive protein level, thyroid function and serum prolactin level. Her serum follicle-stimulating hormone and other reproductive hormone levels are in the normal range for the luteal phase of the menstrual cycle. Professor Eden is Associate Professor of Reproductive Endocrinology at the What could be causing Sally’s night sweats? University of New South Wales; Director of the Barbara Gross Research Unit at the Royal Hospital for Women and the University of New South Wales; COMMENTARY Director of the Women’s Health and Research Institute of Australia; and Hot flushes and sweats are not unusual in women who are having Director of the Sydney MenopauseCopyright _LayoutCentre and 1 Medical 17/01/12 Co-Director 1:43 PM of Pagethe 4 regular menstrual cycles, especially during the bleeding phase © ISTOCKPHOTO/LISA VALDER.
    [Show full text]
  • Clinical Data Mining Reveals Analgesic Effects of Lapatinib in Cancer Patients
    www.nature.com/scientificreports OPEN Clinical data mining reveals analgesic efects of lapatinib in cancer patients Shuo Zhou1,2, Fang Zheng1,2* & Chang‑Guo Zhan1,2* Microsomal prostaglandin E2 synthase 1 (mPGES‑1) is recognized as a promising target for a next generation of anti‑infammatory drugs that are not expected to have the side efects of currently available anti‑infammatory drugs. Lapatinib, an FDA‑approved drug for cancer treatment, has recently been identifed as an mPGES‑1 inhibitor. But the efcacy of lapatinib as an analgesic remains to be evaluated. In the present clinical data mining (CDM) study, we have collected and analyzed all lapatinib‑related clinical data retrieved from clinicaltrials.gov. Our CDM utilized a meta‑analysis protocol, but the clinical data analyzed were not limited to the primary and secondary outcomes of clinical trials, unlike conventional meta‑analyses. All the pain‑related data were used to determine the numbers and odd ratios (ORs) of various forms of pain in cancer patients with lapatinib treatment. The ORs, 95% confdence intervals, and P values for the diferences in pain were calculated and the heterogeneous data across the trials were evaluated. For all forms of pain analyzed, the patients received lapatinib treatment have a reduced occurrence (OR 0.79; CI 0.70–0.89; P = 0.0002 for the overall efect). According to our CDM results, available clinical data for 12,765 patients enrolled in 20 randomized clinical trials indicate that lapatinib therapy is associated with a signifcant reduction in various forms of pain, including musculoskeletal pain, bone pain, headache, arthralgia, and pain in extremity, in cancer patients.
    [Show full text]
  • Approach to Polyarthritis for the Primary Care Physician
    24 Osteopathic Family Physician (2018) 24 - 31 Osteopathic Family Physician | Volume 10, No. 5 | September / October, 2018 REVIEW ARTICLE Approach to Polyarthritis for the Primary Care Physician Arielle Freilich, DO, PGY2 & Helaine Larsen, DO Good Samaritan Hospital Medical Center, West Islip, New York KEYWORDS: Complaints of joint pain are commonly seen in clinical practice. Primary care physicians are frequently the frst practitioners to work up these complaints. Polyarthritis can be seen in a multitude of diseases. It Polyarthritis can be a challenging diagnostic process. In this article, we review the approach to diagnosing polyarthritis Synovitis joint pain in the primary care setting. Starting with history and physical, we outline the defning characteristics of various causes of arthralgia. We discuss the use of certain laboratory studies including Joint Pain sedimentation rate, antinuclear antibody, and rheumatoid factor. Aspiration of synovial fuid is often required for diagnosis, and we discuss the interpretation of possible results. Primary care physicians can Rheumatic Disease initiate the evaluation of polyarthralgia, and this article outlines a diagnostic approach. Rheumatology INTRODUCTION PATIENT HISTORY Polyarticular joint pain is a common complaint seen Although laboratory studies can shed much light on a possible diagnosis, a in primary care practices. The diferential diagnosis detailed history and physical examination remain crucial in the evaluation is extensive, thus making the diagnostic process of polyarticular symptoms. The vast diferential for polyarticular pain can difcult. A comprehensive history and physical exam be greatly narrowed using a thorough history. can help point towards the more likely etiology of the complaint. The physician must frst ensure that there are no symptoms pointing towards a more serious Emergencies diagnosis, which may require urgent management or During the initial evaluation, the physician must frst exclude any life- referral.
    [Show full text]
  • Review of Systems – Return Visit Have You Had Any Problems Related to the Following Symptoms in the Past Month? Circle Yes Or No
    REVIEW OF SYSTEMS – RETURN VISIT HAVE YOU HAD ANY PROBLEMS RELATED TO THE FOLLOWING SYMPTOMS IN THE PAST MONTH? CIRCLE YES OR NO Today’s Date: ______________ Name: _______________________________ Date of Birth: __________________ GENERAL GENITOURINARY Fatigue Y N Blood in Urine Y N Fever / Chills Y N Menstrual Irregularity Y N Night Sweats Y N Painful Menstrual Cycle Y N Weight Gain Y N Vaginal Discharge Y N Weight Loss Y N Vaginal Dryness Y N EYES Vaginal Itching Y N Vision Changes Y N Painful Sex Y N EAR, NOSE, & THROAT SKIN Hearing Loss Y N Hair Loss Y N Runny Nose Y N New Skin Lesions Y N Ringing in Ears Y N Rash Y N Sinus Problem Y N Pigmentation Change Y N Sore Throat Y N NEUROLOGIC BREAST Headache Y N Breast Lump Y N Muscular Weakness Y N Tenderness Y N Tingling or Numbness Y N Nipple Discharge Y N Memory Difficulties Y N CARDIOVASCULAR MUSCULOSKELETAL Chest Pain Y N Back Pain Y N Swelling in Legs Y N Limitation of Motion Y N Palpitations Y N Joint Pain Y N Fainting Y N Muscle Pain Y N Irregular Heart Beat Y N ENDOCRINE RESPIRATORY Cold Intolerance Y N Cough Y N Heat Intolerance Y N Shortness of Breath Y N Excessive Thirst Y N Post Nasal Drip Y N Excessive Amount of Urine Y N Wheezing Y N PSYCHOLOGY GASTROINTESTINAL Difficulty Sleeping Y N Abdominal Pain Y N Depression Y N Constipation Y N Anxiety Y N Diarrhea Y N Suicidal Thoughts Y N Hemorrhoids Y N HEMATOLOGIC / LYMPHATIC Nausea Y N Easy Bruising Y N Vomiting Y N Easy Bleeding Y N GENITOURINARY Swollen Lymph Glands Y N Burning with Urination Y N ALLERGY / IMMUNOLOGY Urinary
    [Show full text]
  • Pathological Cause of Low Back Pain in a Patient Seen Through Direct Margaret M
    Pathological Cause of Low Back Pain in a Patient Seen through Direct Margaret M. Gebhardt PT, DPT, OCS Access in a Physical Therapy Clinic: A Case Report Staff Physical Therapist, Motion Stability, LLC, and Adjunct Clinical Faculty, Mercer University, Atlanta, GA ABSTRACT cal therapists primarily treat patients that sporadic.9 Deyo and Diehl6 found that the Background and Purpose: A 66-year- fall into the mechanical LBP category, but 4 clinical findings with the highest positive old male presented directly to a physical need to be aware that although infrequent, likelihood ratios for detecting the presence therapy clinic with complaints of low back 7% to 8% of LBP complaints are due to of cancer in LBP were: a previous history of pain (LBP). The purpose of this case report is nonmechanical spinal conditions or visceral cancer, failure to improve with conservative to describe the clinical reasoning that led to disease.5 Malignant neoplasms are the most medical treatment in the past month, an age a medical referral for a patient not respond- common of the nonmechanical spinal con- of at least 50 years or older, and unexplained ing to conservative treatment that ultimately ditions causing LBP, but comprise less than weight loss of more than 4.5 kg in 6 months led to the diagnosis of multiple myeloma. 1% of all total LBP conditions.6 (Table 1).10 In Deyo and Diehl’s6 study, they Methods: Data was collected during the In this era of autonomous practice, analyzed 1975 patients that presented with course of the patient’s treatment in an out- increasing numbers of physical therapists are LBP and found 13 to have cancer.
    [Show full text]
  • The IASP Classification of Chronic Pain for ICD-11: Chronic Cancer-Related
    Narrative Review The IASP classification of chronic pain for ICD-11: chronic cancer-related pain Michael I. Bennetta, Stein Kaasab,c,d, Antonia Barkee, Beatrice Korwisie, Winfried Riefe, Rolf-Detlef Treedef,*, The IASP Taskforce for the Classification of Chronic Pain Abstract 10/27/2019 on BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3FlQBFFqx6X+GYXBy6C6D13N3BXo5wGkearAMol2nLQo= by https://journals.lww.com/pain from Downloaded Downloaded Worldwide, the prevalence of cancer is rising and so too is the number of patients who survive their cancer for many years thanks to the therapeutic successes of modern oncology. One of the most frequent and disabling symptoms of cancer is pain. In addition to from the pain caused by the cancer, cancer treatment may also lead to chronic pain. Despite its importance, chronic cancer-related pain https://journals.lww.com/pain is not represented in the current International Classification of Diseases (ICD-10). This article describes the new classification of chronic cancer-related pain for ICD-11. Chronic cancer-related pain is defined as chronic pain caused by the primary cancer itself or metastases (chronic cancer pain) or its treatment (chronic postcancer treatment pain). It should be distinguished from pain caused by comorbid disease. Pain management regimens for terminally ill cancer patients have been elaborated by the World Health Organization and other international bodies. An important clinical challenge is the longer term pain management in cancer patients by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3FlQBFFqx6X+GYXBy6C6D13N3BXo5wGkearAMol2nLQo= and cancer survivors, where chronic pain from cancer, its treatment, and unrelated causes may be concurrent. This article describes how a new classification of chronic cancer-related pain in ICD-11 is intended to help develop more individualized management plans for these patients and to stimulate research into these pain syndromes.
    [Show full text]
  • Download Article
    Advances in Social Science, Education and Humanities Research, volume 356 2nd International Conference on Contemporary Education, Social Sciences and Ecological Studies (CESSES 2019) A New Exploration of the Combined Treatment of Symptoms and Social Work Psychology in Male Sexual Addiction Patients Chengchung Tsai Minyi Li School of Management School of Social Sciences Putian University University of Macau Putian, China Macau, China Abstract—Post-Orgasmic Illness Syndrome (POIS) was progesterone, low cholesterol, low dehydroepiandrosterone, first discovered by Professor Waldinger and Schweitzerl in low cortisol, high prolactin or hypothyroidism. Some cases 2002. After publishing several papers such as "POIS Records encountered by the author team indicate that when the of Emotional, Psychological and Behavioral Changes in Male mother was pregnant in the early years, she or her family had Patients" and "POIS Patients", "Clinical Observation Records smoking habits. Some mothers had long-term use of of Psychological and Behavioral Changes" and "POIS Male contraceptives or were used to eating animal internal organs. Disease Self-reports and Treatment Methods", in this paper, Even some cases were diagnosed as male gynecomastia. the author will cite the views of Chinese medicine practitioners on the treatment of POIS, and hope to provide more practical treatment methods and references for future research. TABLE I. SEVEN GROUPS OF POIS SYMPTOMS FOUND BY WALDINGER AND OTHER MEDICAL TEAMS Keywords—POIS; male; ejaculation; mental state; disorder; Body parts Various local sensations emotion Behavioral symptoms extreme fatigue, exhaustion, palpitations, forgetting words, being too lazy to talk, incoherent, inattention, irritability, I. INTRODUCTION photophobia, depression The main research objects of this paper are journalists, Flu symptoms fever, cold, hot, sweaty, trembling writers and other text workers, as well as creative designers Head symptoms head dizziness, groggy, confused and heavy who take creativity as the selling point as the research object.
    [Show full text]
  • An Unusual Cause of Back Pain in Osteoporosis: Lessons from a Spinal Lesion
    Ann Rheum Dis 1999;58:327–331 327 MASTERCLASS Series editor: John Axford Ann Rheum Dis: first published as 10.1136/ard.58.6.327 on 1 June 1999. Downloaded from An unusual cause of back pain in osteoporosis: lessons from a spinal lesion S Venkatachalam, Elaine Dennison, Madeleine Sampson, Peter Hockey, MIDCawley, Cyrus Cooper Case report A 77 year old woman was admitted with a three month history of worsening back pain, malaise, and anorexia. On direct questioning, she reported that she had suVered from back pain for four years. The thoracolumbar radiograph four years earlier showed T6/7 vertebral collapse, mild scoliosis, and degenerative change of the lumbar spine (fig 1); but other investigations at that time including the eryth- rocyte sedimentation rate (ESR) and protein electophoresis were normal. Bone mineral density then was 0.914 g/cm2 (T score = −2.4) at the lumbar spine, 0.776 g/cm2 (T score = −1.8) at the right femoral neck and 0.738 g/cm2 (T score = −1.7) at the left femoral neck. She was given cyclical etidronate after this vertebral collapse as she had suVered a previous fragility fracture of the left wrist. On admission, she was afebrile, but general examination was remarkable for pallor, dental http://ard.bmj.com/ caries, and cellulitis of the left leg. A pansysto- lic murmur was heard at the cardiac apex on auscultation; there were no other signs of bac- terial endocarditis. She had kyphoscoliosis and there was diVuse tenderness of the thoraco- lumbar spine. Her neurological examination was unremarkable. on September 29, 2021 by guest.
    [Show full text]
  • Pain Management & Palliative Care
    Guidelines on Pain Management & Palliative Care A. Paez Borda (chair), F. Charnay-Sonnek, V. Fonteyne, E.G. Papaioannou © European Association of Urology 2013 TABLE OF CONTENTS PAGE 1. INTRODUCTION 6 1.1 The Guideline 6 1.2 Methodology 6 1.3 Publication history 6 1.4 Acknowledgements 6 1.5 Level of evidence and grade of guideline recommendations* 6 1.6 References 7 2. BACKGROUND 7 2.1 Definition of pain 7 2.2 Pain evaluation and measurement 7 2.2.1 Pain evaluation 7 2.2.2 Assessing pain intensity and quality of life (QoL) 8 2.3 References 9 3. CANCER PAIN MANAGEMENT (GENERAL) 10 3.1 Classification of cancer pain 10 3.2 General principles of cancer pain management 10 3.3 Non-pharmacological therapies 11 3.3.1 Surgery 11 3.3.2 Radionuclides 11 3.3.2.1 Clinical background 11 3.3.2.2 Radiopharmaceuticals 11 3.3.3 Radiotherapy for metastatic bone pain 13 3.3.3.1 Clinical background 13 3.3.3.2 Radiotherapy scheme 13 3.3.3.3 Spinal cord compression 13 3.3.3.4 Pathological fractures 14 3.3.3.5 Side effects 14 3.3.4 Psychological and adjunctive therapy 14 3.3.4.1 Psychological therapies 14 3.3.4.2 Adjunctive therapy 14 3.4 Pharmacotherapy 15 3.4.1 Chemotherapy 15 3.4.2 Bisphosphonates 15 3.4.2.1 Mechanisms of action 15 3.4.2.2 Effects and side effects 15 3.4.3 Denosumab 16 3.4.4 Systemic analgesic pharmacotherapy - the analgesic ladder 16 3.4.4.1 Non-opioid analgesics 17 3.4.4.2 Opioid analgesics 17 3.4.5 Treatment of neuropathic pain 21 3.4.5.1 Antidepressants 21 3.4.5.2 Anticonvulsant medication 21 3.4.5.3 Local analgesics 22 3.4.5.4 NMDA receptor antagonists 22 3.4.5.5 Other drug treatments 23 3.4.5.6 Invasive analgesic techniques 23 3.4.6 Breakthrough cancer pain 24 3.5 Quality of life (QoL) 25 3.6 Conclusions 26 3.7 References 26 4.
    [Show full text]
  • PATIENT FACT SHEET Chronic Recurrent Multifocal Osteomyelitis (CRMO)
    PATIENT FACT SHEET Chronic Recurrent Multifocal Osteomyelitis (CRMO) Chronic recurrent multifocal osteomyelitis (CRMO), or thought to be rare, occurring in about 0.4 out of 100,000 chronic nonbacterial osteomyelitis (CNO), is an auto- people per year. As recognition of CRMO is increasing, it inflammatory disorder that causes bone pain due to appears to be more common than that. In fact, CRMO may inflammation in the bones not caused by infection. be nearly as common as bone infections. The average age CONDITION Chronic recurrent multifocal osteomyelitis (CRMO) can that CRMO starts is 9 to 10 years. More girls are affected take months to years to diagnose. CRMO was previously than boys. DESCRIPTION Bone pain is the most common symptom. There is a genetic component. Some families have more than one usually tenderness at the affected site (it hurts to be person with CRMO. pushed on). The pain can cause the person to avoid using CRMO is monitored by following symptoms and imaging the affected body part. Some people with CRMO can studies. MRI is the best way to assess resolution of active develop arthritis (joint swelling). Fatigue is common during bone lesions and/or detect new lesions. active disease. A small fraction of people with CRMO have SIGNS/ SYMPTOMS Treatment of CRMO depends on how severe it is and zoledronic acid). People taking methotrexate and biologic which bones it affects. Treatment usually starts with medications are at a higher risk of infection and should be NSAID medications (ibuprofen, naproxen, meloxicam), evaluated by a doctor if they develop fever or symptoms but some patients need stronger medicines, including of infection.
    [Show full text]
  • Prostate Cancer and Malignant Bone Pain
    Prostate Cancer and Malignant Bone Pain Prostate cancer is the second most prevalent cancer diagnosis among men worldwide, with an estimated 782,000 new cases in 2007 that will lead to over 253,000 deaths [1]. Diagnosis Most patients worldwide are diagnosed above the age of 65; in developed countries, the mean age of diagnosis is approximately 59 years [7]. Earlier diagnosis is partly due to greater awareness about prostate cancer and increased screening, especially with the use of the prostate-specific antigen (PSA) test. The highest incidence rates are in the United States, while parts of Asia and Africa have the lowest incidence, with a 50-fold difference between the lowest and highest incidence rates. The 5-year survival rates for all stages of prostate cancer vary from 40% to over 90% in developed countries. Men with early-stage or localized prostate cancer have a cure rate ranging from 50% to 85%, depending on certain features of their cancer. Those with low-grade features and comorbidities are considered for active surveillance, while those with more aggressive tumors who are otherwise healthy may choose definitive local treatment. These treatments include prostatectomy (radical retropubic or robotic-assisted prostatectomy), external-beam radiotherapy, and low-dose brachytherapy [5]. Those diagnosed with metastatic disease are usually started on systemic hormonal therapy that leads to medical castration (reduction of testosterone levels) and often causes remission of prostate cancer. Symptoms Patients with early-stage prostate cancer may present with bladder symptoms related to local obstruction of the urinary outflow tract. After primary therapy, patients often report irritable bladder and bowel symptoms, urinary incontinence, and sexual dysfunction.
    [Show full text]
  • Bone Pain in Cancer Patients: Mechanisms and Current Treatment
    International Journal of Molecular Sciences Review Bone Pain in Cancer Patients: Mechanisms and Current Treatment Renata Zaj ˛aczkowska 1,* , Magdalena Kocot-K˛epska 2,* , Wojciech Leppert 3 and Jerzy Wordliczek 1 1 Department of Interdisciplinary Intensive Care, Jagiellonian University Medical College, 31-008 Krakow, Poland; [email protected] 2 Department of Pain Research and Treatment, Jagiellonian University Medical College, 31-008 Krakow, Poland 3 Laboratory of Quality of Life Research, Chair and Department of Palliative Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; [email protected] * Correspondence: [email protected] (R.Z.); [email protected] (M.K.-K.) Received: 10 October 2019; Accepted: 28 November 2019; Published: 30 November 2019 Abstract: The skeletal system is the third most common site for cancer metastases, surpassed only by the lungs and liver. Many tumors, especially those of the breast, prostate, lungs, and kidneys, have a strong predilection to metastasize to bone, which causes pain, hypercalcemia, pathological skeletal fractures, compression of the spinal cord or other nervous structures, decreased mobility, and increased mortality. Metastatic cancer-induced bone pain (CIBP) is a type of chronic pain with unique and complex pathophysiology characterized by nociceptive and neuropathic components. Its treatment should be multimodal (pharmacological and non-pharmacological), including causal anticancer and symptomatic analgesic treatment to improve quality of life (QoL). The aim of this paper is to discuss the mechanisms involved in the occurrence and persistence of cancer-associated bone pain and to review the treatment methods recommended by experts in clinical practice. The final part of the paper reviews experimental therapeutic methods that are currently being studied and that may improve the efficacy of bone pain treatment in cancer patients in the future.
    [Show full text]