Articles: treatment.
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Neuroadenolysis of the pituitary (NALP) is an efficient measure for treatment of severe pain in patients with bony metastases. It is especially recommended for primary carcinomas of the breast or prostate. The procedure, transsphenoidal puncture of the pituitary under radiographic control and instillation of up to 2 ml 95% alcohol, is simple. ⋯ The following results are significant (P<0.05): (1) LH: poststimulation values are extremely suppressed; (2) FSH: basal values decrease; (3) ACTH: basal values decrease after the 6th day. The antalgic effect of NALP is independent of its hormonal consequences. NALP produces hormonal suppressions of various degrees, and is not a "chemical hypophysectomy".
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The American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the Nurses Association of the American College of Obstetricians and Gynecologists, and the National Medical Association recently released guidelines aimed at protecting the privacy of adolescent patients. The organizations stated that, in many cases, young people will not confide in health professionals if the young people feel that these discussions will be reported to their parents. Ultimately, the organizations said, health risks to adolescents are so impelling that legal barriers and deference to parental involvement should not stand in the way of needed health care. ⋯ However, the statute is silent in regard to medical treatment involving prescription contraceptives. By negative inference, the statute would preclude a minor on her own from making a decision about abortion. This article examines Texas statutes dealing with consent for medical treatment for minors and discusses US Supreme Court decisions on a minor's rights to abortions and contraceptives.
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Eight hundred and forty male patients attending sexually transmitted disease (STD) clinic for urethritis were investigated. Out of them, 31.6% had gonococcal urethritis, 16.1% suffered from nongonococcal urethritis due to Ureaplasma urealyticum and in 12.6%, both the organisms were present. ⋯ Gonorrhoeae were resistant to penicillin, all the strains were sensitive to spectinomycin; while all Ureaplasma strains were sensitive to tetracyclines. As the treatment differs for these two organisms, it is necessary to identify the correct etiological agent.
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In the past the view has often been expressed that children are less sensitive to pain than adults as a result of the assumption that their nervous system is not as well developed. According to this theory, newborns were not supposed to feel pain at all, and for this reason minor surgery was often performed with inadequate anesthesia. Evidence in the more recent literature and the regular choice of "pain in children" as a topic for congresses exemplify the more and more widespread belief that children of all ages can feel pain and, relative to their developmental stage, suffer accordingly. ⋯ As cognition develops further, the patient's own concept of health and sickness changes, as does the ability to express feelings of pain. In the pathogenesis of pain in children, the dominant types are nociceptor pain (e.g., as a result of trauma or infection) and pain resulting from malfunction (e.g., physical malposition, migraine), whereas nervous pain occurs less frequently. Pediatricians should pay particular attention to the treatment of acute and chronic pain in children.
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The first type of facial pain is of vascular origin. Cluster headache is described as well as its subgroups and carotidodynia. Two organic lesions of the arterial wall can also cause facial pain: dissection of the internal carotid artery and giant cell arteritis. ⋯ Also, local lesions in the cranial nerves can cause facial pain, as well as organic processes of the upper cervical spine and of the occipitocervical transition. The characteristics of facial pain due to eye or ENT and dental lesions are described. So called atypical facial pain occurs quite frequently and mostly affects middle-aged women.