Journal articles: 'Receiving relief'

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Penne, R. B. "Pain Relief in Patients Receiving Periocular Botulinum Toxin A." Yearbook of Ophthalmology 2009 (January 2009): 159–60. http://dx.doi.org/10.1016/s0084-392x(09)79058-6.

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Harrison, Andrew R., Jonathan P. Erickson, Jill S. Anderson, and Michael S. Lee. "Pain Relief in Patients Receiving Periocular Botulinum Toxin A." Ophthalmic Plastic & Reconstructive Surgery 24, no. 2 (March 2008): 113–16. http://dx.doi.org/10.1097/iop.0b013e31816386e1.

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DYSON, RICHARD. "The extent and nature of pauperism in five Oxfordshire parishes, 1786–1832." Continuity and Change 28, no. 3 (November 27, 2013): 421–49. http://dx.doi.org/10.1017/s0268416013000374.

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This article examines the nature of pauperism in the south and east of England during the time of the Old Poor Law by using census material from five predominately rural parishes in Oxfordshire between 1786 and 1832. The proportion of people receiving poor relief was calculated for each parish, together with the types of people receiving such relief. While pauperism was significant in some parishes, others had relatively low levels of people receiving relief, and groups of poor hit by traditional life-cycle poverty were still common. Previous notions of widespread pauperism in the south and east during this period may thus need to be revised, with greater acknowledgement of the influence of local factors.

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AHMED, SAJJAD, RAHEEL AZHAR KHAN, TASSADAQ KHURSHID, Muhammad Boota, Muhammad Ishaque, and Syed Hafiz Majid Waseem. "POST OPERATIVE ANALGESIA FOLLOWING OPEN CHOLECYSTECTOMY." Professional Medical Journal 18, no. 03 (September 10, 2011): 411–17. http://dx.doi.org/10.29309/tpmj/2011.18.03.2358.

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Introduction: Pain following surgery is a universal phenomenon; it is often underestimated and undertreated. Epidural analgesia is considered to be the best method of pain relief after subcostal cholecystectomy. Epidural is effective technique that offers comparable analgesia and better side effect profile. Design: Quasi Experimental study. Period: Jan2010 to June 2010. Setting: Military Hospital Rawalpindi. Material and methods: This is a prospective, randomized control trial. The main objective of this study was to compare the number of rescue doses for postperative pain relief, after subcostal cholecystectomy under epidural anesthesia, in patients receiving continuous epidural infusion of bupivacain 0.125% with those receiving intermittent boluses. Thoracic epidural catheter was placed for post operative pain relief. Patients were divided into two equal groups. Patient receiving continuous epidural anaesthesia were placed in group A and those receiving intermittent doses were included in group B. Sampling technique: Purposive (non probability) sampling. Result: Patient who received intermittent boluses (group B) required less rescue doses of nalbuphine as compared to the patients who received continuous infusion of 0.125 bupivacain. Conclusions: Intermittent boluses of 0.125% bupivacain are considered a better method of postoperative pain relief than continuous infusion of 0.125 % bupivacain.

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Kwon, Young-Bae, Ji-Hoon Kim, Jung-Hee Yoon, Jae-Dong Lee, Ho-Jae Han, Woung-Chon Mar, Alvin J. Beitz, and Jang-Hern Lee. "The Analgesic Efficacy of Bee Venom Acupuncture for Knee Osteoarthritis: A Comparative Study with Needle Acupuncture." American Journal of Chinese Medicine 29, no. 02 (January 2001): 187–99. http://dx.doi.org/10.1142/s0192415x01000228.

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The aim of this investigation was to determine whether been venom (BV) administered directly into an acupoint was a clinically effective and safe method for relieving the pain of patients with knee osteoarthritis (OA) as compared to traditional needle acupuncture. We evaluated the efficacy of BV acupuncture using both pain relief scores and computerized infrared thermography (IRT) following 4 weeks of BV acupuncture treatment. We observed that a significantly higher proportion of subjects receiving BV acupuncture reported substantial pain relief as compared with those receiving traditional needle acupuncture therapy. Furthermore, the IRT score was significantly improved and paralleled the level of pain relief.

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Frederick, John, and Chris Goddard. "Sweet and Sour Charity: Experiences of Receiving Emergency Relief in Australia." Australian Social Work 61, no. 3 (September 2008): 269–84. http://dx.doi.org/10.1080/03124070802229763.

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Klapper, JA, and S. O’Connor. "Rizatriptan Wafer–Sublingual vs. Placebo at the Onset of Acute Migraine." Cephalalgia 20, no. 6 (July 2000): 585–88. http://dx.doi.org/10.1046/j.1468-2982.2000.00079.x.

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Rizatriptan wafer is a 5HT1B/1D agonist for use in the acute treatment of migraine. It is a freeze-fried formulation, approved for oral administration, which dissolves on the tongue and is swallowed with saliva. In this study the efficacy of sublingually administered rizatriptan 10-mg wafer was evaluated in a randomized, double-blind, placebo-controlled, out-patient study involving 39 migraineurs. Patients were instructed to treat a migraine at the onset of pain in order to evaluate time of onset of pain relief and pain relief at 1 h. The average time to onset of relief was 25 min for patients treated with rizatriptan wafer and 27 min for patients treated with placebo. At 1 h, 50% of the patients receiving rizatriptan wafer and 50% of the patients receiving placebo experienced significant relief. Implications and potential reasons for a high placebo response are discussed.

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Boyer, George R. "“Work for their prime, the workhouse for their age”: Old Age Pauperism in Victorian England." Social Science History 40, no. 1 (2016): 3–32. http://dx.doi.org/10.1017/ssh.2015.79.

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This paper examines the extent of local government support for the elderly, in the form of poor relief, in Victorian England. It presents newly constructed estimates of old age pauperism rates for each of England's ten registration divisions from 1861 to 1908, the year the Old Age Pension Act was adopted. My estimates show that the share of persons aged 65 and older receiving government assistance in the nineteenth century was far larger than most contemporaries, and many historians, believe. The share receiving poor relief declined after 1871, largely as a result of changes in relief administration, but on the eve of the adoption of the Old Age Pension Act more than one in five persons over 65 was in receipt of public assistance. In sum, government support for the elderly is not a post-welfare state phenomenon. Old age pauperism rates differed substantially across registration divisions and in general were higher in southern than in northern England. I present evidence that much of the north-south differential was due to differences in wage rates and employment opportunities and differences in the administration of poor relief, although differences in welfare customs might have played a role.

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Makkar, Jeetinder Kaur. "Effect of Different Volumes on Pain Relief in Patient Receiving Fluoroscopic Guided Interlaminar Lumbar Epidural Steroid Injection." January 2018 1, no. 21;1 (May 15, 2018): 243–49. http://dx.doi.org/10.36076/ppj.2018.3.243.

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Background: Epidural steroids injections (ESI) are frequently used to treat lumbar radicular pain. Although different volume have been used for interlaminar ESI in adults, there is no controlled trial comparing the effect of different volumes on pain relief for the same dose of steroid . Objective: To compare the effect of increase in volume of epidural drug on pain relief in lumbar ESI . Study design: Randomized double blind trial Settings: Pain OR of a tertiary care centre Methods: Sixty patients were randomly allocated to 1 of 3 groups: Group A (4 mL), Group B (6 mL), and Group C (8 mL). Pain was evaluated using visual analog scale (VAS) and improvement in disability using modified Oswestry Disability Questionnaire scores (MODQS) at 2, 4, 8, 12, and 24 weeks. Patients having less than 50% pain relief from baseline received an additional epidural injection of the same volume with a maximum of 3 injections at least 15 days apart. The primary objective of the study was incidence of patients attaining more than 50% pain relief at 6 months. Secondary outcome included MODQS and pattern of spread of iodinated contrast on fluoroscopy. Results: At the end of 6 months, there was no significant difference in the effective pain relief between the 3 groups (Group A-16/22 (72.7%), Group B-15/20 (75%), Group C-13/18 (72.2%); P = 0.98, chi- square test). All groups demonstrated a significant reduction in mean VAS scores. There was no significant intergroup difference in VAS sores and MODQS at all the time intervals. The pattern of contrast spread did not differ between the 3 groups. Limitation: Not a placebo controlled trial Conclusions: An increase in volume of the injectate from 4 mL to 8 mL did not increase the efficacy of interlaminar ESI. Key words: Epidural steroid, volume, low back pain, interlaminar:

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Flythe, Jennifer E., Tandrea Hilliard, Graciela Castillo, Kourtney Ikeler, Jazmine Orazi, Emaad Abdel-Rahman, Amy Barton Pai, et al. "Symptom Prioritization among Adults Receiving In-Center Hemodialysis." Clinical Journal of the American Society of Nephrology 13, no. 5 (March 20, 2018): 735–45. http://dx.doi.org/10.2215/cjn.10850917.

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Background and objectivesIndividuals receiving in-center hemodialysis experience a high symptom burden that detrimentally affects their quality of life. There are few evidence-based interventions for symptom relief in this population. To stimulate innovation in symptom management, data on patient symptom prioritization and treatment preferences are needed. We undertook this study to (1) identify patient-prioritized symptoms for the development of symptom relief therapies and (2) elicit preferences for treatments among individuals receiving hemodialysis.Design, setting, participants, & measurementsWe conducted a mixed methods study that included focus groups in Carrboro, North Carolina; Tucson, Arizona; and Seattle, Washington and a nationally distributed online survey. Focus group transcripts were analyzed for patterns, and the highest priority symptoms were determined on the basis of frequency and report severity. We used focus group findings to inform survey items. Focus group and survey results were crossvalidated and synthesized for final symptom prioritization.ResultsThere were 32 participants across three focus groups and 87 survey respondents from 27 states in the United States. The physical symptoms of insomnia, fatigue, muscle cramping, and nausea/vomiting and the mood symptoms of anxiety and depressed mood were reported by participants in all focus groups. Among survey respondents, fatigue (94%), cramping (79%), and body aches (76%) were the most common physical symptoms, and feeling depressed (66%), worried (64%), and frustrated (63%) were the most common mood symptoms. The top-prioritized symptoms were consistent across focus group and survey participants and included the physical symptoms insomnia, fatigue, and cramping and the mood symptoms anxiety, depression, and frustration. Participants indicated that symptom frequency, duration, unpredictability, and social and financial effects factored most heavily into symptom prioritization.ConclusionsPatients prioritized the physical symptoms of insomnia, fatigue, and cramping and the mood symptoms of anxiety, depression, and frustration as the top symptoms for which to find new therapies.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2018_03_20_CJASNPodcast_18_5_F.mp3

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Elhakim, MD, Mokhtar, Hany Abd Elfattah, MD, Dalia Nasr El-Din, MD, Reem El-Kabarity, MD, Azia Atef, MD, and Atef El-Fakey, MD. "Midazolam as an antiemetic in patients receiving epidural morphine for postoperative pain relief." Journal of Opioid Management 5, no. 4 (January 29, 2018): 189. http://dx.doi.org/10.5055/jom.2009.0020.

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Purpose: Epidural morphine has been associated with a significant incidence of postoperative nausea and vomiting (PONV). The authors have evaluated the prophylactic effects of midazolam in preventing nausea and vomiting following epidural morphine for postoperative pain control.Methods: The authors studied 80 women (n = 40 in each group) undergoing total abdominal hysterectomy under epidural anesthesia, in a randomized, double-blind, placebo-controlled study. At the end of the surgery, all patients received epidural morphine 3 mg for postoperative pain. Before morphine injection, the midazolam group received lowdose midazolam infusion (1 mg bolus followed by 1 mg h-1), while the placebo group received IV saline.Results: Patients in the midazolam group reported a lower incidence of total PONV, and a lower frequency of rescue antiemetic request than those in the placebo group (p < 0.05). In addition, midazolam was associated with a reduced incidence of pruritus following epidural morphine (p < 0.05).Conclusion: The authors conclude that low-dose midazolam infusion is effective in the prevention of nausea, vomiting, and pruritus following epidural morphine for postoperative pain control.

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Miller, PharmD, BCPS, BCPPS, FPPAG, Jamie L., Kimberly Ernst, MD, MSMI, FAAP, Stephen B. Neely, MPH, Katy Stephens, BS, Philip Barker, Grant H. Skrepnek, PhD, RPh, and Peter N. Johnson, PharmD, BCPS, BCPPS, FPPAG, FCCM. "Low-dose versus high-dose methadone for the management of neonatal abstinence syndrome." Journal of Opioid Management 15, no. 2 (March 1, 2019): 159–67. http://dx.doi.org/10.5055/jom.2019.0497.

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Objectives: The primary objective was to compare median time to symptom relief (time from methadone initiation until two consecutive modified Finnegan [neonatal abstinence syndrome, NAS] scores 8) between neonates receiving low-dose (≤0.275 mg/kg/day) versus high-dose (0.275 mg/kg/day) methadone. Secondary objectives included assessment of factors associated with symptom relief. Design: Retrospective cross-sectional study.Setting: Ninety-nine bed neonatal intensive care unit within a tertiary-care academic hospital.Participants: Seventy-two neonates who received methadone for NAS over a 7.5-year period.Main outcome measures(s): Kaplan-Meier curves with a log-rank test and a stepwise Cox proportional-hazard model were used to analyze outcomes. Results: The median dose for the low-dose (n = 40) and high-dose (n = 32) groups were 0.19 mg/kg/day (interquartile range [IQR], 0.12-0.24) divided every 6-12 hours and 0.4 mg/kg/day (0.3-0.44) divided every 6-8 hours, respectively. The median time to symptom relief was higher in the low-dose versus high-dose groups, 9.3 (5.8-24.6) versus 6.0 (5.4-12.5) hours, respectively (p = 0.014). Low-dose males had a longer time to symptom resolution than other groups (p = 0.008). Female premature neonates (37 weeks gestation) had a shorter time to symptom relief than term neonates [adjusted hazard ratio = 2.96 (1.02-8.62)]. The median total duration of methadone was shorter but not statistically significant between high- versus low-dose groups, 17.5 (IQR: 11.0-25.0) versus 21.0 days (IQR: 10.0-28.0), respectively (p = 0.483).Conclusions: Neonates receiving high-dose methadone had a significantly shorter time to symptom relief. Differences in sex were noted in response to therapy with low-dose males having a longer time to symptom relief and premature neonates a shorter time to symptom relief.

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Thompson, JA, MB Jennings, and W. Hodge. "Orthotic therapy in the management of osteoarthritis." Journal of the American Podiatric Medical Association 82, no. 3 (March 1, 1992): 136–39. http://dx.doi.org/10.7547/87507315-82-3-136.

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The authors evaluate the use of orthoses as a primary therapeutic means in the long-term management of patients with osteoarthritis of the foot and ankle. A comparison of the amount of pain relief experienced by 64 subjects (mean age 63 years) with different treatment regimens for osteoarthritis was made to determine the role orthoses played in helping to reduce or eliminate pain. One hundred percent of the subjects wearing orthoses only for relief of pain had a statistically significant longer period of pain relief than those on nonsteroidal anti-inflammatory drugs. Fifty-five percent of the subjects using orthoses and nonsteroidal anti-inflammatory drug therapy also had a statistically significant longer period of pain relief than those receiving nonsteroidal anti-inflammatory drug therapy only.

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Argoff, MD, Charles, Paul Arnstein, RN, PhD, FAAN, Steven Stanos, DO, Cynthia Y. Robinson, PhD, Bradley S. Galer, MD, Errol Gould, PhD, and Arnold Gammaitoni, PharmD. "Relationship between change in pain intensity and functional outcomes in patients with chronic pain receiving twice daily extended-release hydrocodone bitartrate." Journal of Opioid Management 11, no. 5 (September 1, 2015): 417. http://dx.doi.org/10.5055/jom.2015.0291.

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Objective: Evaluate levels of pain relief achieved in patients with chronic pain treated with hydrocodone-extended release (HC-ER) up to 48 weeks and show that these levels were associated with secondary functional and global outcomes.Design: Post hoc analyses were based on a previously reported study that started with an open-label conversion/titration phase for ≤ 6 weeks followed by an open-label 48-week treatment phase.Setting: Private practice and institutional pain centers.Participants: Three hundred ninety-one opioid-experienced subjects with moderate to severe pain for ≥3 months.Interventions: Individualized doses (20-300 mg) of extended-release hydrocodone every 12 hours.Main outcome: Almost 60 percent (232/391) of subjects achieved moderate or substantial levels of pain relief (≥30 percent reduction in pain score) during the study.Results: Subjects who achieved moderate or substantial pain relief demonstrated significant (p < 0.001) improvements in Oswestry Disability Inventory (ODI), all pain interference outcomes, and Subject Global Assessment of Medication. Subjects with substantial pain relief had decreases in ODI, Hospital Anxiety and Depression Scale (HADS) anxiety, and HADS depression scores of −13.4 ± 14.92, −1.9 ± 3.37, and −1.7 ± 3.26, respectively. The five most commonly reported treatment-emergent adverse events were constipation (12.5 percent), back pain (11.1 percent), nausea (9.9 percent), vomiting (9.7 percent), and arthralgia (7.8 percent) and are consistent with opioid therapy.Conclusions: Moderate or substantial levels of pain relief were associated with the greatest functional improvements in patients treated with HC-ER. These results may help define success of opioid therapy and determine if it should be continued or an alternative treatment should be tried.

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Chowdhury, Anupananda, Dipika Choudhury, Upasana Majumdar, and Trina Sen. "Effectiveness of pre-emptive thoracic epidural analgesia for acute post thoracotomy pain relief: a randomised blinded study." International Journal of Research in Medical Sciences 7, no. 10 (September 25, 2019): 3636. http://dx.doi.org/10.18203/2320-6012.ijrms20194196.

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Background: Thoracotomy is one of the most damaging surgical insults on respiratory mechanics and management of post-thoracotomy pain is a challenge. This study was conducted to compare intensity of postoperative pain, measured by VAS, in patients receiving Pre-emptive TEA compared to patients receiving epidural analgesia during surgical closure.Method: Group A comprised of patients receiving Pre-emptive TEA with 0.1%Ropivacaine and 2 μg/ml fentanyl, 20 minutes before incision. Group B comprised of patients receiving the same drug, during surgical closure.Results: Demographic profile was comparable between both groups. Both groups offered good analgesia, but pre-emptive group took an upper hand upto4th postoperative hour (p<0.05), both at rest and coughing. Beyond 4thhour, analgesic efficacy of both groups was comparable.Conclusion: Pre-emptive technique offered better analgesia over the postoperative technique up to 4th postoperative hour, both at rest and coughing.

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Wright, Julie M., Stephen D. Price, and William A. Watson. "Nsaid Use and Efficacy in the Emergency Department: Single Doses of Oral Ibuprofen versus Intramuscular Ketorolac." Annals of Pharmacotherapy 28, no. 3 (March 1994): 309–12. http://dx.doi.org/10.1177/106002809402800301.

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OBJECTIVE: To compare the clinical efficacy of single doses of intramuscular ketorolac and oral ibuprofen in the emergency department (ED) treatment of acute pain. DESIGN: A retrospective analysis of data collected during a prospective survey of pain management efficacy. The design was noninterventional, and therapy was selected by the treating physician independent of the trial. SETTING: Urban teaching hospital adult patient emergency department. PARTICIPANTS: A convenience sample of ED patients in acute pain. INTERVENTIONS: Patients received ibuprofen 800 mg po (n=95), or ketorolac 60 mg im (n=30) as a single dose. Therapy was selected by the treating physician and was not influenced by the study. RF.8ULTS: Data collected were a 100-mm visual analog pain scale at patient arrival and discharge, verbal description of pain relief, patient demographics, pain management data, and discharge diagnosis. Baseline pain intensity was higher in patients receiving ketorolac (77 mm median) than in those receiving ibuprofen (65 mm, p=0.02). Pain relief was similar (p=0.29) with either treatment when assessed by visual analog scale or patient definition of pain relief. CONCLUSIONS: A single dose of either nonsteroidal antiinflammatory drug produced similar pain relief in the general ED population during clinical treatment of pain. Ketorolac should not necessarily be considered a more effective analgesic than ibuprofen in these commonly used doses.

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Friedman, Deborah I. "Novel Intranasal Delivery of Sumatriptan as a Route to Rapid and Sustained Relief in the Acute Treatment of Migraine." US Neurology 12, no. 02 (2016): 84. http://dx.doi.org/10.17925/usn.2016.12.02.84.

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Migraine remains a common debilitating condition that exerts a high social and economic burden worldwide. Despite the widespread availability of various medications for migraine, many patients are dissatisfied with their treatment. Rapid and effective treatment at an early stage in an attack is vital in migraine to prevent central sensitization leading to attacks that are difficult to treat. Most migraineurs prefer oral medications but this is not always the most rapid or efficient route into the bloodstream. Intranasal administration of migraine treatment provides a rapid, convenient and reliable alternative to oral and other routes. AVP-825 is an intranasal medication delivery system approved by the US Food and Drug Administration in January 2016 as ONZETRA™ Xsail™ (sumatriptan nasal powder [Avanir Pharmaceuticals, Aliso Viejo, CA]) for the acute treatment of migraine with or without aura in adults. AVP-825 contains low dose sumatriptan powder and takes advantage of some unique aspects of the nasal anatomy to confer rapid pain relief in the acute treatment of migraine. In two Phase III trials, AVP-825 was well tolerated and showed significantly faster migraine pain relief and relief from other symptoms including photophobia, phonophobia, and nausea than placebo or oral sumatriptan. This benefit was achieved with substantially lower drug exposure than oral sumatriptan. Additional analyses of data from the Phase III trials show that significantly more patients with migraine receiving AVP-825 reported clinically meaningful relief, sustained relief, pain freedom, lower migraine-related disability and more consistent relief across multiple attacks than those receiving oral sumatriptan. The rapid and sustained action of AVP-825 and its convenience creates the potential for this unique treatment to reduce the burden of migraine in many patients.

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Turner, P. G. "THE NEW FUNDAMENTAL NORM OF RECOVERY FOR LOSSES TO EXPRESS TRUSTS." Cambridge Law Journal 74, no. 2 (July 2015): 188–91. http://dx.doi.org/10.1017/s000819731500046x.

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THE principles for recovering monetary relief for losses to express trusts have recently been uncertain, especially in “commercial” situations. Where trustees undertook to hold money on trust for a lender and to advance the money to a borrower after receiving security documents, the trustees no doubt breach the trust by advancing the money without first receiving the security documents. However, since Target Holdings v Redferns [1996] A.C. 421, it has been uncertain what measure of relief the lender-beneficiary can recover – and especially whether the measure differs according to (1) whether the form of relief claimed is a general accounting or “equitable compensation” for only particular defaults or (2) whether the circumstances are “commercial”. Under the accounting doctrines as traditionally applied, trustees unable to vouch for trust assets they earlier received could not reduce their liability by showing that part or all of the loss would have been suffered even had they performed the trust correctly. The trustees were responsible for the misapplied sum regardless of causal enquiries. But, in Target, the House of Lords – emphasizing the commercial nature of the case – denied a lender-beneficiary's claim to recover the full sum wrongly disbursed by trustees. The significance of the case has been contested. Did Target change a fundamental norm of monetary relief for losses suffered through breach of trust – a norm applicable regardless of whether the form of relief claimed is a general accounting or equitable compensation for only particular defaults? Did Target instead leave the traditional accounting doctrines untouched, and create a new remedy of equitable compensation for breach of trust? Or did Target establish a “commercial” exception to traditional principles of trustee accountability, an exception limiting the quantum of relief? Indeed, was Target decided per incuriam?

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Dey, Saugat. "Comparing neuromodulation modalities involving the suprascapular nerve in chronic refractory shoulder pain: retrospective case series and literature review." Clinics in Shoulder and Elbow 24, no. 1 (March 1, 2021): 36–41. http://dx.doi.org/10.5397/cise.2021.00038.

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Chronic shoulder pain not relieved by either conservative or surgical management is referred to as chronic refractory shoulder pain. This is a retrospective case series where chronic refractory shoulder pain patients were treated either with peripheral nerve stimulation (PNS) or with pulsed radiofrequency (p-RF) therapy to the suprascapular nerve. Both patients receiving PNS reported 100% pain relief for the first month. At the 3- and 6-month follow-ups, one patient continued to experience 100% relief while the other reported 90% relief. One patient undergoing p-RF experienced about 90% pain relief at both 1- and 3-month intervals and 0% relief at the 6-month interval. The other patient with p-RF experienced 33% relief at 1-month and 0% relief thereafter. No patient reported any complications. The results of previous randomized controlled trials evaluating the efficacy of p-RF administered to the suprascapular nerve were mixed, and there is a lack of published studies on PNS effects. Neuromodulation of the suprascapular nerve can be effective for chronic refractory shoulder pain patients. Larger scale randomized controlled trials comparing PNS and p-RF are needed to better understand their respective therapeutic capacity.

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Holdcroft, Anita, Mervyn Maze, Caroline Doré, Susan Tebbs, and Simon Thompson. "A Multicenter Dose-escalation Study of the Analgesic and Adverse Effects of an Oral Cannabis Extract (Cannador) for Postoperative Pain Management." Anesthesiology 104, no. 5 (May 1, 2006): 1040–46. http://dx.doi.org/10.1097/00000542-200605000-00021.

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Background Cannabinoids have dose-related antinociceptive effects in animals. This clinical study aimed to investigate whether a single oral dose of cannabis plant extract (Cannador; Institute for Clinical Research, IKF, Berlin, Germany) could provide pain relief with minimal side effects for postoperative pain. Methods Patients (aged 18-75 yr) were recruited and consented before surgery if patient-controlled analgesia was planned for provision of postoperative pain relief. Each patient received a single dose of 5, 10, or 15 mg Cannador if he or she had at least moderate pain after stopping patient-controlled analgesia. Starting with 5 mg, dose escalation was based on the number of patients requesting rescue analgesia and adverse effects. Pain relief, pain intensity, and side effects were recorded over 6 h and analyzed using tests for trend with dose. Results Rescue analgesia was requested by all 11 patients (100%) receiving 5 mg, 15 of 30 patient (50%) receiving 10 mg, and 6 of 24 patients (25%) receiving 15 mg Cannador (log rank test for trend in time to rescue analgesia with dose P < 0.001). There were also significant trends across the escalating dose groups for decreasing pain intensity at rest (P = 0.01), increasing sedation (P = 0.03), and more adverse events (P = 0.002). The number needed to treat to prevent one rescue analgesia request for the 10-mg and 15-mg doses, relative to 5 mg, were 2.0 (95% confidence interval, 1.5-3.1) and 1.3 (95% confidence interval, 1.1-1.7), respectively. The study was terminated because of a serious vasovagal adverse event in a patient receiving 15 mg. Conclusion These significant dose-related improvements in rescue analgesia requirements in the 10 mg and 15 mg groups provide a number needed to treat that is equivalent to many routinely used analgesics without frequent adverse effects.

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Vikström, Marie-Christine (Lotta). "Vulnerability among paupers: Determinants of individuals receiving poor relief in nineteenth-century northern Sweden." History of the Family 11, no. 4 (January 2006): 223–39. http://dx.doi.org/10.1016/j.hisfam.2006.12.004.

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King, Nancy J. "Non-Capital Habeas Cases after Appellate Review: An Empirical Analysis." Federal Sentencing Reporter 24, no. 4 (April 1, 2012): 308–20. http://dx.doi.org/10.1525/fsr.2012.24.4.308.

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In 2007, researchers from the National Center for State Courts and Vanderbilt University Law School reported the findings from a study of litigation in 2384 randomly selected, non-capital habeas cases, approximately 6.5% of the non-capital habeas cases commenced in federal district courts in 2003 and 2004 by state prisoners. In this article, I update that report, including the cases that were pending when the 2007 report was prepared, following the study cases into the federal courts of appeals, and back into the state courts. Even after appellate review of denials and dismissals, the percentage of non-capital petitioners receiving federal habeas relief remains less than the 1% rate reported prior to AEDPA. Descriptive findings include appeals and requests to file successive petitions by circuit, and rulings on certificates of appealability by circuit. Detailed information regarding each case receiving relief in federal court is also included.

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Huang, Ying, Xihan Li, Tong Zhu, Jian Lin, and Gaojian Tao. "Efficacy and Safety of Ropivacaine Addition to Intrathecal Morphine for Pain Management in Intractable Cancer." Mediators of Inflammation 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/439014.

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Objective. Although intrathecal drug infusion has been commonly adopted for terminal cancer pain relief, its adverse effects have made many clinicians reluctant to employ it for intractable cancer pain. The objective of this study is to compare the efficacy and security of an intrathecal continuous infusion of morphine and ropivacaine versus intrathecal morphine alone for cancer pain.Methods. Thirty-six cancer patients received either a continuous morphine (n=19) or morphine and ropivacaine (n=17) infusion using an intrathecal catheter through a subcutaneous port. Numerical Rating Scale (NRS) scores and the Barthel Index were analyzed. Adverse effects and complications on postoperative days 1, 3, 7, and 15 were also analyzed.Results. All patients experienced pain relief. Compared to those who received morphine alone, patients receiving morphine and ropivacaine had significantly lower postoperative morphine requirements and higher Barthel Index scores on the 15th postsurgical day (P<0.05). Patients receiving morphine and ropivacaine had lower NRS scores than patients receiving morphine alone on postoperative days 1, 3, 7, and 15 (P<0.05). Negative postsurgical effects were similar in both groups.Conclusions. Morphine and ropivacaine administration through intrathecal access ports is efficacious and safe and significantly improves quality of life.

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Zemskov, Vladimir M., Konstantin N. Pronko, Dmitrii A. Ionkin, Alexei V. Chzhao, Maria N. Kozlova, Alexander A. Barsukov, Nadezhda S. Shishkina, Valentina S. Demidova, Andrei M. Zemskov, and Amiran Sh Revishvili. "Immune Status of Pancreatic Cancer Patients Receiving Cryosurgery." Medical Sciences 7, no. 6 (June 22, 2019): 73. http://dx.doi.org/10.3390/medsci7060073.

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Cryosurgery used on patients with unresectable pancreatic cancer improved their quality of life, but mainly because of the pain relief. In postoperative patients, multifaceted changes in immunity were found, and the state of the immune system prior to surgery often was a decisive factor to indicate whether further disorders in the postoperative period would develop, or by contrast, it would boost its recovery. Some patients receiving cryosurgery showed immune system imbalance and activation, and of antitumor immunity in particular. It has been suggested that the advisability of immunotropic therapy for specific treatment algorithms should be predicted or the therapy should be suspended at some pathologic stage, and this has been immunologically confirmed. Cryosurgery should be considered as a reasonable alternative to the existing types of surgery for pancreatic cancer or as an essential component of multimodal therapy, consisting of topical cryosurgery, chemotherapy, and immunotropic therapy, to boost antitumor immunity and to discontinue cytoreductive therapy due to its toxic effects.

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Niconchuk, Jonathan A., and Michael G. Richardson. "Complete relief of CRPS-associated pain during magnesium infusion in a patient with postpartum preeclampsia." Regional Anesthesia & Pain Medicine 44, no. 4 (January 11, 2019): 521–23. http://dx.doi.org/10.1136/rapm-2018-100142.

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A pregnant patient with chronic regional pain syndrome (CRPS) and indwelling spinal cord stimulator presented with twin gestation for induction of preterm labor due to preeclampsia. Intravenous magnesium was initiated and a lumbar epidural catheter was placed uneventfully for labor analgesia. The patient reported complete relief of her CRPS-associated pain during and for 24 hours after delivery, while receiving intravenous magnesium, with her pain symptoms returning shortly after discontinuing magnesium. To our knowledge, there are no case reports that describe CRPS-associated pain relief while on peripartum magnesium therapy.

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Louie, Laura, Nopporn Pathanapornpandh, Unchalee Pultajuk, Robert Kaplan, Ian Hodgson, Lawrence Maund, and Heather Greenlee. "The Mae on Project: Using Acupuncture for Symptom Relief and Improved Quality of Life for People Living with Hiv and Aids in Rural Thailand." Acupuncture in Medicine 28, no. 1 (March 2010): 37–41. http://dx.doi.org/10.1136/aim.2008.000299.

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Acupuncture in combination with antiretroviral therapies is a potentially useful treatment for HIV-related symptom relief in resource-poor settings. Traditional Chinese medicine has a long history of being used to enhance immune function. In the setting of HIV, Chinese traditional medicine allows for symptom treatment without adding extra medications to a complex drug regime. This paper provides details of a project at Mae On Hospital in rural northern Thailand where allopathic/conventional treatments are used in tandem with acupuncture. A preliminary evaluation of the project suggests that an integrated approach to symptom relief is viewed positively by respondents receiving acupuncture, though further studies are required to confirm the association between acupuncture and symptom relief. The project also demonstrates the feasibility of developing a cost-effective acupuncture programme using local healthcare staff.

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Ramsey,, Anthony R. "The Concept of Yearning to be Recognized: Caring for Women Who Suffer from Migraine." International Journal of Human Caring 12, no. 4 (June 2008): 26–31. http://dx.doi.org/10.20467/1091-5710.12.4.26.

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Women seeking pain relief for migraine headache from local healthcare agencies may have difficulty receiving adequate treatment. The purpose of this article is to present the concept of yearning to be recognized in relation to caring for women seeking pain relief from migraine headache. Computerized databases were searched using the key words migraine, women, nurse, suffering, communication, and acknowledgement. A synthesized definition of the concept was created and a gap in the literature was identified regarding the nursing care of patients who experience migraine headache. Acase study presenting one woman’s story, which informs the concept, will be described.

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Norman, Cheryl, and Linda Maynard. "Buccal opioids for breakthrough pain in children with life-limiting conditions receiving end-of-life care." International Journal of Palliative Nursing 25, no. 10 (October 2, 2019): 472–79. http://dx.doi.org/10.12968/ijpn.2019.25.10.472.

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Background: Many palliative care health settings that care for children and young people (CYP) at the end of life use the buccal mucosa as a route of drug administration to manage the sudden onset of symptoms, such as seizures, agitation and dyspnoea, and for breakthrough pain management. The buccal route is a minimally invasive method that delivers fast symptom relief and is useful for those with swallowing impairment or reduced enteral absorption. Aim: This paper reports on a small retrospective study involving 26 CYP who received end-of-life care between January and December 2017 to review the advantages and disadvantages of using buccal opioids for breakthrough pain relief with a focus on diamorphine as the preferred opioid. Method: A retrospective case note review. Findings: This paper shares the clinical practice experiences from one UK organisation of care for CYP at the end of their lives and contributes to the growing body of pharmacological evidence. Conclusion: Buccal opioids, specifically buccal diamorphine, are an effective strategy to treat breakthrough pain or dyspnoea in CYP.

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Bounes, Vincent, Caroline Barniol, Vincent Minville, Charles-Henri Houze-Cerfon, and Jean Louis Ducassé. "Predictors of pain relief and adverse events in patients receiving opioids in a prehospital setting." American Journal of Emergency Medicine 29, no. 5 (June 2011): 512–17. http://dx.doi.org/10.1016/j.ajem.2009.12.005.

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Thapa, Deepak. "Pain Relief Following Shoulder Arthroscopy In Patients Receiving Preoperative Stellate Ganglion Block – Some More Facts !" Pain Physician 5;18, no. 5;9 (September 14, 2015): E935—E936. http://dx.doi.org/10.36076/ppj.2015/18/e935.

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Hakanson, E., M. Bengtsson, H. Rutberg, and A. M. Ulrick. "Epidural Morphine by the Thoracic or Lumbar Routes in Cholecystectomy. Effect on Postoperative Pain and Respiratory Variables." Anaesthesia and Intensive Care 17, no. 2 (May 1989): 166–69. http://dx.doi.org/10.1177/0310057x8901700207.

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Thirty-seven women undergoing elective cholecystectomy were randomised into two groups, receiving either lumbar epidural morphine (group L) or epidural morphine via the thoracic route (group T). The effect on pain relief was assessed by a visual analogue scale and included both resting pain and ‘provoked’ pain. Respiratory parameters (PEF, FEVI and FVC) were also studied. The patients were investigated preoperatively, and 4, 6, 12 and 24 hours after the start of surgery. No significant difference was observed between the groups concerning pain relief or respiratory performance. We conclude that after cholecystectomy lumbar epidural morphine is as effective as thoracic epidural morphine in relieving postoperative pain.

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Vercauteren, Marcel P., Lieve Van Den Bergh, Sri L. Kartawiadi, Koen Van Boxem, and Vincent L. H. Hoffmann. "Addition of Bupivacaine to Sufentanil in Patient-Controlled Epidural Analgesia After Lower Limb Surgery in Young Adults." Regional Anesthesia & Pain Medicine 23, no. 2 (March 1998): 182–88. http://dx.doi.org/10.1136/rapm-00115550-199823020-00012.

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Background and ObjectivesThe usefulness of adding bupivacaine to an opioid administered by the epidural route is controversial. This study examines both the quality of pain relief and side effects, in particular urinary retention, during patient-controlled epidural analgesia (PCEA) with sufentanil alone or in combination with two different concentrations of bupivacaine.MethodsIn a double-blind randomized study, 60 healthy young adults undergoing open knee or ankle surgery with combined spinal-epidural anesthesia received postoperative analgesia via PCEA with sufentanil alone or with 0.06% or 0.12% bupivacaine. In addition to pain scores at rest and during mobilization, bladder function was evaluated. Strict criteria were respected in scoring the occurrence of problems suggestive of urinary retention. The 24-hour analgesic consumption and the incidence of other side effects were also recorded.ResultsPatients receiving bupivacaine had better pain relief than those receiving only the opioid, but this difference was more pronounced when measuring dynamic pain scores. The consumption of sufentanil was significantly higher in the group receiving the opioid alone than in the group receiving 0.06% bupivacaine. The bupivacaine dose requirements were twice as high with the 0.12% concentration. Bladder problems occurred significantly more frequently in patients treated with the highest bupivacaine concentration. Motor impairment was not a major problem.ConclusionsA 0.06% bupivacaine-sufentanil combination offered the best results in terms of analgesic quality and lower side effects, mainly micturition problems, which may be explained by the higher consumption of local anesthetic at the higher bupivacaine concentration. Analgesic quality could not be improved by increasing the bupivacaine concentration.

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Nicholson, James P., Sharon A. Basile, and James D. Cury. "Massive Theophylline Dosing in a Heavy Smoker Receiving Both Phenytoin and Phenobarbital." Annals of Pharmacotherapy 26, no. 3 (March 1992): 334–36. http://dx.doi.org/10.1177/106002809202600304.

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OBJECTIVE: To report unusually high theophylline dosing requirements in a smoker receiving concomitant therapy with phenytoin and phenobarbital. DESIGN: Single case report. SETTING: 517-bed, university teaching hospital. PATIENT: 29-year-old woman with newly diagnosed asthma, heavy smoking history, and a seizure disorder. RESULTS: The additive influence of smoking, phenytoin, and phenobarbital greatly increased the theophylline dosing requirements. Doses of up to 4 g/d (59 mg/kg/d) were required to achieve adequate symptomatic relief of her asthma as well as to provide therapeutic serum theophylline concentrations. CONCLUSIONS: Multiple polymorphisms may additively influence theophylline metabolism and exceptionally large theophylline doses may be required in some patients who smoke and are comedicated with phenytoin and phenobarbital.

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Xavier, Adhin Antony, Raga Chandana, Aleem Sarwar, C. K. Dhanapal, and S. Sudarshan. "A Comparative Study of Thrombolytics Used for The Treatment of STEMI in a South Indian Tertiary Care Hospital." Research in Pharmacy and Health Sciences 2, no. 3 (August 15, 2016): 160–62. http://dx.doi.org/10.32463/rphs.2016.v02i03.32.

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Background: ST segment elevated myocardial infarction is the most common cause of mortality and morbidity in worldwide; it occurs when thrombus formation results in complete occlusion of major epicardial vessel, thrombolytics was the first choice of treatment for STEMI along with other supporting therapies. Objective: To compare safety and efficacy of thrombolytics Streptokinase, Tenecteplase and Reteplase for the treatment of STEMI. Methodology: This is a prospective observational study conducted for a period of 6 months (November 2014 to May 2015) in RMMCH, Chidambaram. A total of 90 cases were collected. Study consist of three groups, group-1 (receiving streptokinase), group-2 (receiving Reteplase) and group 3 (receiving tenecteplase). Relevant data was obtained from case sheets before and after lysis and analyzed. Result: The study identified all three fibrinolytic drugs to be efficacious in causing > 50% resolution in ST segment, symptoms relief. Safety parameters were found to be fair in Reteplase group where no side effect was observed. Hypotension and cardiovascular arrest was observed in Streptokinase and Tenecteplase respectively. Efficacy was found to be high in Reteplase group with 93% of STEMI resolution and 93% of symptomatic relief where 83 % and 90% in tenecteplase and 83% and 86% in streptokinase groups. One death was reported in streptokinase and tenecteplase group respectively. Conclusion: Reteplase was found to be most safest and efficacious drug followed by tenecteplase and streptokinase.

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Zhang, Peijun, Zhiqiang Yu, Meili Zhai, Jian Cui, and Jianbo Wang. "Effect and Safety of Remifentanil Patient-Controlled Analgesia Compared with Epidural Analgesia in Labor: An Updated Meta-Analysis of Randomized Controlled Trials." Gynecologic and Obstetric Investigation 86, no. 3 (2021): 231–38. http://dx.doi.org/10.1159/000515531.

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Purpose: The study was aimed to systematically assess the effect and safety of remifentanil patient-controlled analgesia (rPCA) versus epidural analgesia (EA) during labor. Methods: Eligible trials were retrieved from PubMed, EMBASE, ScienceDirect, and Cochrane Library before April 2020. The primary outcomes were patient satisfaction with pain relief and average visual analog scale (VAS) pain scores during labor; the secondary outcomes were rate of spontaneous delivery, oxygen desaturation, maternal hyperthermia, and neonatal Apgar scores <7 at 1 and 5 min. Results: Eleven studies involving 3,039 parturients were included. We found that parturients receiving rPCA were similarly satisfied with pain relief compared to those receiving EA (standardized mean difference: −0.19; 95% confidence interval [CI]: −0.57, 0.18), though had significantly higher VAS pain scores during labor (weighted mean difference: 1.41; 95% CI: 0.32, 2.50). The rate of spontaneous delivery was comparable. rPCA increased the risk of maternal oxygen desaturation (risk ratio [RR]:3.23, 95% CI: 1.98, 5.30). There was no statistical significance regarding hyperthermia (RR: 0.49, 95% CI: 0.24, 1.01). No significant difference was found for neonatal Apgar scores <7 at 1 and 5 min. Conclusion: rPCA could be an optional alternative for pain relief to EA without worsening maternal satisfaction with pain relief, delivery modes, or neonatal morbidity. However, rPCA was associated with higher pain intensity during labor and higher incidence of maternal oxygen desaturation. The routine use of rPCA in labor must be armed with close respiratory monitoring. Continued well-designed studies are required to provide more robust evidence.

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Açmaz, Gökhan, Hüseyin Aksoy, Nil Özoğlu, Ülkü Aksoy, and Evrim Albayrak. "Effect of Paracetamol, Dexketoprofen Trometamol, Lidocaine Spray, and Paracervical Block Application for Pain Relief during Suction Termination of First-Trimester Pregnancy." BioMed Research International 2013 (2013): 1–5. http://dx.doi.org/10.1155/2013/869275.

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The aim of the study was to investigate the analgesic efficacy of preoperative oral dexketoprofen trometamol, intravenous paracetamol, lidocaine spray, and paracervical block with ultracaine on curettage procedure. A total of 111 subjects with the request of pregnancy termination between 5 and 7 weeks of gestation were included in the study. The first group (control group) consisted of 20 participants without medication. The second group consisted of 25 participants receiving 2 puffs of lidocaine sprays on cervical mucosa. The third group consisted of 20 participants receiving oral 25 mg dexketoprofen trometamol. The fourth group consisted of 23 participants receiving 1000 mg intravenous paracetamol and the fifth group consisted of 23 participants receiving paracervical block with ultracaine. Paracervical block reduced pain score significantly in both intraoperative and postoperative periods. All analgesic procedures were significantly effective for reducing pain in postoperative period. Paracervical block may be the best method for reducing pain scores in intraoperative and postoperative periods during curettage procedure. All analgesic procedures such as lidocaine, paracetamol, ultracaine, and paracervical block with ultracaine can be used for reducing pain score in postoperative period. This trial is registered withNCT01947205.

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Wu, Aihua, and Gordon B. Drummond. "Sleep Arousal after Lower Abdominal Surgery and Relation to Recovery from Respiratory Obstruction." Anesthesiology 99, no. 6 (December 1, 2003): 1295–302. http://dx.doi.org/10.1097/00000542-200312000-00010.

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Background Hypoxemic episodes occur during sleep after abdominal surgery, possibly caused by airway obstruction. The authors found arousals from sleep more often than respiratory disturbances, so they related changes in sleep state (short arousals from sleep and longer periods of wakening) to the sudden increase in respiratory flow that indicates relief from complete or partial respiratory obstruction. Methods Sleep state and nasal flow were studied in 16 patients receiving patient-controlled morphine and oxygen by facemask on the night after routine gynecologic surgery. Traces were analyzed separately for sleep events and for sudden increases in respiratory flow. The authors noted sleep events (arousals from sleep and transition from sleep to wake) that occurred within 12 s of relief of obstruction. Results Sleep quality was poor, with only stage 2 sleep in most patients. Median sleep duration was 70% of the study period, with 15 arousals and 6 awakenings per hour of sleep. Only 30% of arousals and awakenings were associated with relief of obstruction. Relief of obstruction also occurred without arousal from sleep, with a median frequency of 38 (30-62) in each night. Relief of obstruction was more frequently associated with arousal from sleep after benzodiazepine premedication (33% vs. 28%; P = 0.012), but this allocation was not randomized. Conclusions Arousals from sleep are frequent after abdominal surgery and mostly not related to respiratory disturbance. Relief of respiratory obstruction can occur during sleep without sleep arousal and during wakefulness.

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Moudi, Sussan, Novin Nikbakhsh, MohsenVakili Sadeghi, Elham Ramzani, Ali Bijani, Roya Yousefi, Marjan Moudi, and Hemmat Gholinia. "Efficacy of olanzapine in symptom relief and quality of life in gastric cancer patients receiving chemotherapy." Journal of Research in Medical Sciences 21, no. 1 (2016): 88. http://dx.doi.org/10.4103/1735-1995.192504.

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Mercadante, Sebastiano, Marco Maltoni, Domenico Russo, Claudio Adile, Patrizia Ferrera, Romina Rossi, Marta Rosati, and Alessandra Casuccio. "The Prevalence and Characteristics of Breakthrough Cancer Pain in Patients Receiving Low Doses of Opioids for Background Pain." Cancers 13, no. 5 (March 2, 2021): 1058. http://dx.doi.org/10.3390/cancers13051058.

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The aim of this study was to assess the prevalence and characteristics of breakthrough cancer pain (BTcP) in patients receiving low doses of opioids for background pain. A consecutive sample of advanced cancer patients receiving less than 60 mg/day of oral morphine equivalent (OME) was selected. Epidemiological data, background pain intensity, and current analgesic therapy were recorded. The presence of BTcP was diagnosed according to a standard algorithm. The number of BTcP episodes, intensity of BTcP, its predictability and triggers, onset duration, interference with daily activities, BTcP medications, satisfaction with BTcP medication, and time to meaningful pain relief were collected. A total of 126 patients were screened. The mean intensity of background pain was 2.71 (1.57), and the mean OME was 28.5 mg/day (SD15.8). BTP episodes were recorded in 88 patients (69.8%). The mean number/day of BTP episodes was 4.1 (SD 7.1, range 1–30). In a significant percentage of patients, BTcP was both predictable and unpredictable (23%). The BTcP onset was less than 20 min in the majority of patients. The mean duration of untreated episodes was 47.5 (SD 47.6) minutes. The mean time to meaningful pain relief after taking a BTcP medication was >20 min in 44.5% of patients. The efficacy of BTcP medication was not considered good in more than 63% of patients. Gender (females) (OR = 4.16) and lower Karnofsky (OR = 0.92) were independently associated with BTcP. A higher number of BTcP episodes/day was associated with gender (females) (p = 0.036), short duration of BTcP (p = 0.005), poorer efficacy of BTcP medication (none or mild) (p = 0.001), and late meaningful pain relief (p = 0.024). The poor efficacy of BTcP medication was independently associated with a higher number of episodes/day (OR = 0.22). In patients who were receiving low doses of opioids, BTcP prevalence was 69.8%. Many patients did not achieve a sufficient level of satisfaction with BTcP medications, particularly with oral morphine. Data also suggest that better optimization of background analgesia, though apparently acceptable, may limit the number of BTcP episodes.

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Costa, Anderson Bessa Da, Larissa Moreira, Daniel Ciampi De Andrade, Adriano Veloso, and Nivio Ziviani. "Predicting the Evolution of Pain Relief." ACM Transactions on Computing for Healthcare 2, no. 4 (October 31, 2021): 1–28. http://dx.doi.org/10.1145/3466781.

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Modeling from data usually has two distinct facets: building sound explanatory models or creating powerful predictive models for a system or phenomenon. Most of recent literature does not exploit the relationship between explanation and prediction while learning models from data. Recent algorithms are not taking advantage of the fact that many phenomena are actually defined by diverse sub-populations and local structures, and thus there are many possible predictive models providing contrasting interpretations or competing explanations for the same phenomenon. In this article, we propose to explore a complementary link between explanation and prediction. Our main intuition is that models having their decisions explained by the same factors are likely to perform better predictions for data points within the same local structures. We evaluate our methodology to model the evolution of pain relief in patients suffering from chronic pain under usual guideline-based treatment. The ensembles generated using our framework are compared with all-in-one approaches of robust algorithms to high-dimensional data, such as Random Forests and XGBoost. Chronic pain can be primary or secondary to diseases. Its symptomatology can be classified as nociceptive, nociplastic, or neuropathic, and is generally associated with many different causal structures, challenging typical modeling methodologies. Our data includes 631 patients receiving pain treatment. We considered 338 features providing information about pain sensation, socioeconomic status, and prescribed treatments. Our goal is to predict, using data from the first consultation only, if the patient will be successful in treatment for chronic pain relief. As a result of this work, we were able to build ensembles that are able to consistently improve performance by up to 33% when compared to models trained using all the available features. We also obtained relevant gains in interpretability, with resulting ensembles using only 15% of the total number of features. We show we can effectively generate ensembles from competing explanations, promoting diversity in ensemble learning and leading to significant gains in accuracy by enforcing a stable scenario in which models that are dissimilar in terms of their predictions are also dissimilar in terms of their explanation factors.

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Maharjan, SK, and S. Shrestha. "Intraperitoneal magnesium sulphate plus bupivacaine for pain relief after laparoscopic cholecystectomy." Journal of Kathmandu Medical College 1, no. 1 (December 18, 2012): 21–25. http://dx.doi.org/10.3126/jkmc.v1i1.7251.

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Background: Multimodal analgesia is necessary for management of pain after laparoscopic cholecystectomy. Magnesium sulphate is a new emerging drug for management of acute pain. This study was performed to study the analgesic efficacy of intraperitoneal bupivacaine and bupivacaine plus magnesium sulphate for postoperative pain relief after laparoscopic cholecystectomy. Methods: At the end of laparoscopic cholecystectomy, 60 patients were randomized to one of the following groups: bupivacaine group receiving intraperitoneal instillation of 30 ml of 0.25% bupivacaine and magnesium sulphate group receiving intraperitoneal instillation of 0.25% bupivacaine plus 50 mg/kg magnesium sulphate to total volume of 30 ml. Postoperative pain was evaluated by using visual analogue scale (standard Visual Analogue Scale pain score of 0-10). Time duration of first analgesia demanded was noted and rescue analgesic was given as tramadol 50 mg intravenously and on demand. Pain, Visual Analogue Scale score and total analgesic consumption was recorded for 24 hours and analysed. Results: The patients who were given intraperitoneal bupivacaine plus magnesium sulphate at the end of surgery had better pain relief in first 24 hours, Visual Analogue Scale score of 0-5 compared to sole bupivacaine group who had Visual Analogue Scale score of 3-7. The magnesium sulphate group had longer pain free period of average 5.53±4.33 hours after surgery compared to 3.16±1.59 hours in sole bupivacaine group. Total analgesic consumption in magnesium sulphate group was also less compared to bupivacaine group (125.0±36.5 and 75.0±25.0 in bupivacaine and magnesium sulphate group respectively). All the results show highly significant differences between the groups. Conclusion: The combined instillation of bupivacaine and magnesium sulphate into the peritoneal cavity at the end of laparoscopic surgery renders patients better pain control and less consumption of analgesics in first 24 hours compared to sole bupivacaine group. DOI: http://dx.doi.org/10.3126/jkmc.v1i1.7251 Journal of Kathmandu Medical College, Vol. 1, No. 1, Issue 1, Jul.-Sep., 2012 pp.21-25

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Owen, H., J. C. Currie, and J. L. Plummer. "Variation in the Blood Concentration/Analgesic Response Relationship during Patient-Controlled Analgesia with Alfentanil." Anaesthesia and Intensive Care 19, no. 4 (November 1991): 555–60. http://dx.doi.org/10.1177/0310057x9101900412.

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The effect of supplementing postoperative patient-controlled analgesia (PCA) with a mandatory fixed-rate infusion was studied using alfentanil. Patients were assigned by lottery to receive alfentanil PCA with a bolus of 200 or 300 mcg or alfentanil PCA with a bolus of 100 or 200 mcg plus an infusion of 900 mcg/hr, such that ten patients received each treatment. Seven patients receiving PCA only, compared to two in the groups receiving infusion, were withdrawn due to inadequate pain relief (0.1 > P > 0.05). One patient receiving PCA only was withdrawn because of a low respiratory rate, whereas three patients receiving PCA plus infusion developed respiratory depression. Patients prescribed PCA plus infusion received significantly more alfentanil but did not describe less pain than patients prescribed PCA only. The blood alfentanil concentration immediately prior to demands was significantly higher in the PCA plus infusion groups. These results suggest that during PCA therapy the drug prescription influences the blood concentration associated with satisfactory analgesia.

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Ngo, Federick, and Samantha Astudillo. "California DREAM: The Impact of Financial Aid for Undocumented Community College Students." Educational Researcher 48, no. 1 (September 14, 2018): 5–18. http://dx.doi.org/10.3102/0013189x18800047.

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Ineligibility for state financial aid has traditionally limited undocumented students’ access to higher education. Since 2013, the California Development, Relief, and Education for Alien Minors Act (CA-DREAM) has made state-supported aid available to undocumented college students with demonstrated financial need. We use a difference-in-difference strategy and administrative data to examine the impact of the policy on undocumented community college students’ enrollment behaviors and postsecondary outcomes. The availability of CA-DREAM aid for these students, in the form of enrollment fee waivers, drew in undocumented Hispanic male students, students with lower average incoming high school GPAs, and those who increased their 11th to 12th grade achievement. Receiving DREAM aid significantly increased the average number of units attempted and completed and, in some cases, improved persistence and attainment outcomes. Undocumented students receiving aid achieved at similar levels as U.S. citizen peers receiving aid and better than their undocumented peers not receiving aid.

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Lian, Jayson, Amin Mohamadi, Jimmy J. Chan, Phillip Hanna, David Hemmati, Aron Lechtig, and Ara Nazarian. "Comparative Efficacy and Safety of Nonsurgical Treatment Options for Enthesopathy of the Extensor Carpi Radialis Brevis: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials." American Journal of Sports Medicine 47, no. 12 (October 31, 2018): 3019–29. http://dx.doi.org/10.1177/0363546518801914.

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Background: Numerous treatment options have been proposed for enthesopathy of the extensor carpi radialis brevis (eECRB). Purpose: To (1) compare the efficacy and safety of nonsurgical treatment options for eECRB described in randomized placebo-controlled trials at short-term, midterm, and long-term follow-up and (2) evaluate outcomes in patients receiving placebo. Study Design: Systematic review and meta-analysis. Methods: Following PRISMA guidelines, 4 electronic databases were searched for randomized placebo-controlled trials for eECRB. Studies reporting visual analog scale (VAS) for pain scores and/or grip strength were included. Random- or fixed-effects meta-analysis was employed to compare treatments with at least 2 eligible studies using the standardized mean difference and odds ratio. The study protocol was registered at PROSPERO (ID: CRD42018075009). Results: Thirty-six randomized placebo-controlled trials, evaluating 11 different treatment modalities, with a total of 2746 patients were included. At short-term follow-up, only local corticosteroid injection improved pain; however, it was associated with pain worse than placebo at long-term follow-up. At midterm follow-up, laser therapy and local botulinum toxin injection improved pain. At long-term follow-up, extracorporeal shock wave therapy provided pain relief. With regard to grip strength, only laser therapy showed better outcomes in comparison with placebo. While there was no difference among various treatments in the odds ratio of an adverse event, they all increased adverse events compared with placebo. In placebo-receiving patients, a sharp increase in the percentage of patients reporting mild pain or less was observed from 2% at short-term follow-up to 92% at midterm follow-up. Conclusion: Most patients experienced pain resolution after receiving placebo within 4 weeks of follow-up. At best, all treatments provided only small pain relief while increasing the odds of adverse events. Therefore, if clinicians are inclined to provide a treatment for particular patients, they may consider a pain relief regimen for the first 4 weeks of symptom duration. Patient-specific factors should be considered when deciding on treatment or watchful waiting.

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Goldstein, J., CGH Dahlöf, H.-C. Diener, J. Olesen, R. Schellens, JM Senard, D. Simard, and TJ Steiner. "Alniditan in the Acute Treatment of Migraine Attacks." Cephalalgia 16, no. 7 (November 1996): 497–502. http://dx.doi.org/10.1046/j.1468-2982.1996.1607497.x.

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Alniditan is a new 5HT1D receptor agonist, belonging to a different chemical class from sumatriptan and other indole derivatives used or being developed for the treatment of acute migraine. In a multinational double-blind randomized parallel-groups dose-finding trial, alniditan was given subcutaneously in hospital to patients with migraine headache of moderate or severe intensity at doses of 0.8 mg ( n = 44), 1.0 mg ( n = 42), 1.2 mg ( n=46) and 1.4 mg ( n=39). Efficacy, tolerability and safety of each dose were compared with those of placebo ( n =41 ). At 2 h after injection, headache was absent or mild in 83% and 82% of patients receiving alniditan 1.2 and 1.4 mg respectively compared with 39% for placebo (p0.002). Complete relief from headache was achieved in 72% (1.4 mg) Time to onset of relief decreased with increasing alniditan dose, and there was a dose-dependent reduction in headache recurrence rate: 25% of patients receiving 1.4 mg had responded by 15 min and headache recurred within 24 h in only 16% of the patients who initially responded to alniditan 1.4 mg, significantly less than for placebo (p=0.018). Alniditan was superior to placebo in reducing the associated symptoms of nausea, phonophobia and photophobia, and in increasing patients' functional ability. The use of rescue medication was reduced when compared with placebo, and up to 87% of patients said that they would use the drug again if available. No clinically relevant cardiovascular effects were seen, nor consistent changes in clinical laboratory findings. Adverse effects, mainly head pressure, paraesthesia, and hot flushes, were reported by 34% of placebo-treated patients and up to 70% of patients receiving alniditan, but all doses were very well tolerated and no clear relationship with dose was established. Comparison with published findings suggests that alniditan 1.4 mg sc may have advantages over sumatriptan 6 mg sc in providing complete relief from acute migraine headache, and may be associated with fewer headache recurrences within 24h. Both of these suggestions warrant further and larger trials of alniditan in acute migraine.

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Valera Sifontes, Rimary, and Hédison Kiuity Sato. "Relief effects correction on frequency-domain electromagnetic data." GEOPHYSICS 84, no. 1 (January 1, 2019): E1—E11. http://dx.doi.org/10.1190/geo2017-0452.1.

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During a frequency-domain electromagnetic (FDEM) land survey using transmitter-receiver distances of kilometer order, the receiver and transmitter may be at different altitudes. To increase the signal-to-noise ratio, the transmitting coil size must be increased to the order of a hundred meters and its geometry will be determined by the terrain roughness. Therefore, the equivalent magnetic dipole axis may be neither vertical nor normal to the mean plane representing the terrain surface. Considering the perpendicular loop-loop arrangement, these factors modify the expected secondary magnetic field in two ways: (1) A horizontal primary field arises at the receiving coil position as well as (2) the secondary fields induced by the abnormal currents in the subsurface caused by the tilting of the transmitter dipole axis. A correction procedure is proposed to remove these effects on field FDEM data and tested by using simulated FDEM data with two- or three-layered tilted models to represent the earth with a dipping surface and a nonvertically oriented transmitter magnetic dipole representing a large coil laid on rough terrain. The results demonstrate that the proposed correction procedure has a limited effectiveness, but it can be applied to the FDEM data collected on terrain surfaces having small dipping angles. It is observed that maximum values of the transmitter dipole or surficial plane tilt angle should be 2° to ensure error values in the apparent conductivity less than 10%. Even for the said value, in some combinations of geometric and physical parameters, the tilting and dipping angles can be increased to the order of 5°.

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Ito, Hiroshi, Mayumi Ishida, Kumi Itami, Akira Yoshioka, Izumi Sato, Nozomu Uchida, Nobuyuki Onizawa, and Hideki Onishi. "Wernicke encephalopathy in a lung cancer patient receiving home medical care." Palliative and Supportive Care 19, no. 4 (July 23, 2021): 501–3. http://dx.doi.org/10.1017/s1478951521000900.

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AbstractObjectiveCancer patients often want to spend their final days at home, and it is essential that general practitioners have knowledge of and technical skills related to cancer medicine and symptom relief. Recent clinical studies have revealed that Wernicke encephalopathy (WE) is quite common in cancer patients. However, there have been no reports to date on WE in cancer patients undergoing home medical care.MethodsFrom a series of cancer patient undergoing home medical care, we reported a patient with lung cancer who developed WE.ResultsAn 84-year-old female with lung cancer undergoing home medical care developed an impaired mental state and an attention deficit. Her symptoms fulfilled the diagnostic criteria for delirium. WE was suspected as the patient's food intake had fallen from normal a month previously to somewhere between 50% or just a few mouthfuls. This diagnosis was supported by abnormal serum thiamine and the disappearance of delirium after thiamine administration.Significance of the resultsWhen delirium occurs in cancer patients undergoing home treatment, it is necessary to suspect thiamine deficiency as a potential cause, as appropriate diagnosis and treatment can prevent irreversible brain-related sequelae.

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Karnanda, A., and Habibi A. Naufal. "THE COMPARISON BETWEEN TWO METHODS FOR THE RELIEF OF KNEE OSTEOARTHRITIS PAIN USING OXFORD KNEE SCORE (IMPROVEMENT CHANGES AFTER 4 WEEK FOLLOW UP INJECTION) : INTRAARTICULAR AND GENICULAR NERVE BLOCK IN BLAMBANGAN GENERAL DISTRICT HOSPITAL BANYUWANGI." Orthopaedic Journal of Sports Medicine 8, no. 5_suppl5 (May 1, 2020): 2325967120S0006. http://dx.doi.org/10.1177/2325967120s00061.

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Pain is the hallmark symptom of OA. IACI can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with knee OA. Recent study reported successful pain relief by ablation of the three branches of the Genicular nerve [superior lateral (SL), superior medial (SM), and inferior medial (IM). In the ultrasound-guided GNB technique, these three nerves were selected for the same reasons. Previous studies have identified OKS thresholds to aid the clinician in presenting the expected outcome of surgery in a meaningful way to the patient (OKS provides a means of comparing preoperative and post-operative health status).This cross-sectional, respondents were filled OKS questionaire, and they were self-reported a diagnosis of OA at least one knee by a physician, reported more than 3 months of persistent OA pain. These data were collected at the first post-injection (IACI &GNB) and at 4 week followup visit. The analysis was performed by Independent T-test in SPSS version 22. In IACI group the mean of initial OKS was 37,81±6,87 compare to 34,94±6.14 in GNB group. After 4 weeks, it increased to 42±7.14 and 42,84±7,67 respectively. A total of 82 patients were randomized, with patients receiving an injection, 32 receiving IAIC injection and 50 receiving GNB injection. From Independent Samples T Test, GNB injection demonstrated significantly greater pain reductions and greater percent OKS score improvement than IACI up to 4 weeks postinjection. Comparing two methods, there were significant difference between two groups based on OKS: p=0.000

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Iida, Mitue, Akemi Chiba, Yukari Yoshida, Kumiko Shimizu, and Kiyoko Kanda. "Effects of Shiatsu Massage on Relief of Anxiety and Side Effect Symptoms of Patients Receiving Cancer Chemotherapy." KITAKANTO Medical Journal 50, no. 3 (2000): 227–32. http://dx.doi.org/10.2974/kmj.50.227.

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Li, Jingwen, Peng Peng, Qi Mei, Shu Xia, Yijun Tian, Liya Hu, and Yuan Chen. "The impact of UGT2B7 C802T and CYP3A4*1G polymorphisms on pain relief in cancer patients receiving oxycontin." Supportive Care in Cancer 26, no. 8 (March 3, 2018): 2763–67. http://dx.doi.org/10.1007/s00520-018-4130-4.

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Journal articles on the topic 'Receiving relief'

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