Articles: treatment.
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A short survey about the different methods available for producing postoperative analgesia is given, the goal being to make it clear to the clinician that there are quite a number of techniques to be used although the everyday clinical practice often sticks to simple and not too effective methods of pain treatment following surgery. Initially presenting short informations about the neurophysiology of pain and the pathogenesis and causes of postoperative pain two main groups of producing analgesia are then discussed. Thefirst group deals with the systemic use of analgesics be it nonnarcotic analgesic antipyretics or narcotic analgesics (opioids). ⋯ They present clear advantages over the local anesthetic methods as there are the long lasting analgesia and the selective blockade of pain not touching motor and sympathetic nerve fibers. A delayed respiratory depression however might be a serious danger showing an incidence of 0,3% in the epidural and some 10% in the subarachnoid route. Aiming to inform the clinician once again about the vast field of possibilities available to make the postoperative course painfree it is hoped that this important task in the postoperative period will be handled with more consequence and effectivity in the future.
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AH 25086 B is a selective agonist of the newly determined 5-HT(1) receptors, which are sited mainly in the intracranial section of the carotid artery. According to experimental studies, the effect of AH 25086 B is decidedly more highly selective than that of ergotamine; the blood flow through the arteriovenous anastomoses of the internal carotid artery is clearly reduced, while the blood flow through the capillaries supplying the brain is increased. With AH 25086 B administered in an infusion rapid abolition of migraine attacks already in progress proved possible. ⋯ On average it took 31 min (range 10-60 min) for the headache to be relieved, regardless of the duration of migraine symptoms before the start of treatment. This was not a controlled study, but the results (14 very good, 6 good or satisfactory, in 21 attacks treated) were better than could have been expected by chance. Tolerance of the preparation was good, all side-effects being transitory and mild; with dosages up to 1.6 mug kg(-1) min(-1) no changes were seen in heart rate or blood pressure.
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As a result of changing public attitudes non-orthodox methods of pain therapy have become widely accepted within everyday health care. The view that non-orthodox methods, even if not overly successful are at least harmless is widely held. ⋯ Patients should be questioned about the use of alternative methods of treatment and physicians should be aware of unwanted effects of acupuncture, cell therapy, Ajurvedic medicines and herbal therapies. In addition, they should know that some drugs sold as herbal products with "no side-effects" are enriched with e.g. phenylbutazone and/or corticoids, for example.
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The majority (72 percent) of U. S. residency programs in obstetrics and gynecology include first-trimester abortion techniques in their training. Programs affiliated with public hospitals or with private non-Catholic institutions are the most likely to provide such training, while Catholic-affiliated training programs and those at military hospitals are the least likely to do so. ⋯ Nine percent of programs report that all residents participate in first-trimester abortion training, and another 56 percent report that at least half of their residents do so. The participation rate is linked to the expectations of the program: Approximately 88 percent of programs that routinely incorporate abortion techniques in their training report that from one-half to all their residents participate, compared with about 55 percent of programs that offer the training as an option. Approximately 82 percent of programs teach abortion techniques up to at least 20 weeks' gestation.(ABSTRACT TRUNCATED AT 250 WORDS)