Articles: pain.
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Intravenous demand analgesia is introduced as a possible way to optimize the treatment of acute pain. Within certain limits patients are allowed to self-administer small doses of analgesics as often as they need; microprocessors are used to control safe operation and to document individual drug consumption. ⋯ Demand analgesia is described not only as an effective therapeutic concept but also as an interesting tool for pain research (influences on pain perception, comparison of analgesic potencies etc.). It is strongly suggested from the results that treatment of acute pain ought to be more individualized than it is now in routine practice.
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Vestn. Khir. Im. I. I. Grek. · Jan 1984
Comparative Study[Analgesia by electric current in the early postoperative period].
In 295 patients in the early postoperative period anesthesia was performed by means of percutaneous electrostimulation with a new national apparatus Eliman-101. The authors note high efficiency of such analgesia in 63,4% of the patients, satisfactory results were obtained in 32,3%. No sufficient anesthesia was achieved in 13 patients (4,3%). There were no side effects and complications.
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J. Pharmacol. Exp. Ther. · Jan 1984
Comparative StudyIn vivo studies on spinal opiate receptor systems mediating antinociception. II. Pharmacological profiles suggesting a differential association of mu, delta and kappa receptors with visceral chemical and cutaneous thermal stimuli in the rat.
The intrathecal administration of mu (morphine) and delta (D-Ala2-D-Leu5-enkephalin) but not kappa agonists (ethylketocyclazocine, bremazocine and U50488H) or partial agonists (nalbuphine and buprenorphine) produced a dose-dependent inhibition of all cutaneous thermal (hot plate and tail-flick) responses in the rat. In contrast, on visceral chemical tests (writhing), mu and kappa agonists but not delta agonists exerted a powerful suppression of the response. Whereas the ED50 of morphine on the cutaneous thermal tests did not differ from that observed on the visceral chemical test, agents with significant mu and delta activity (metkephamid and beta-endorphin) showed a prominent reduction in activity on the writhing as compared with the hot plate and tail-flick. ⋯ Kappa ligands were selectively resistant to antagonism with naloxone pA2 values for those agonists ranging from 5.9 to 6.6. These observations suggest that there are three discriminable populations of receptors in the spinal cord whose activation results in a selective modulation of the response of the animal to noxious stimuli. In addition, the selective effects of the delta agonists on cutaneous thermal and kappa agonists on visceral chemical suggest a differential coding of spinal afferents through which these stimuli are transmitted.
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The spinal application of opiates is followed by a long-lasting and strong pain relief. This action is based upon the binding of opiates to specific opiate receptors situated in the substantia gelatinosa of the spinal cord. Two possible approaches exist - intrathecally or epidurally. ⋯ The epidural opiate analgesia has proven good results with few side effects in the treatment of postoperative pain, pain of multiple rib fractures and other thoracic trauma or cancer pain. In obstetrics analgesia by spinal opiates was disappointing. Mode of action, possible side effects and the results of epidural opiates are discussed.
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The Journal of pediatrics · Jan 1984
Chlamydia trachomatis: important relationships to race, contraception, lower genital tract infection, and Papanicolaou smear.
Chlamydia trachomatis is a common cause of sexually transmitted disease in adolescent girls. Of 366 adolescent patients screened, 15.3% were found to have chlamydial endocervical infections, with an infection rate of 23.3% in blacks, 14.3% in Hispanics, and 10.3% in whites (P = 0.01, excess for blacks). Of Chlamydia-positive patients, 63.6% had a diagnosis of lower genital tract infection, compared with 35.4% of Chlamydia-negative patients (P = 0.004). ⋯ Inflammatory changes on Papanicolaou smears were associated with chlamydial infection (P = 0.0001). Other variables identified as risk factors for chlamydial infection included both a younger age at first intercourse (P = 0.02) and more years of sexual activity (P = 0.02). Chronologic, menarchal, and gynecologic age, biologic age of the cervix, the number of sexual partners in the last month and during a lifetime, and parity were not found to be associated with recovery of Chlamydia.