Der Schmerz
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Amalgam, which has long been used as a restorative material, has recently become the target of more and more criticism. An assessment of amalgam requires consideration of different aspects of toxicology, allergology, electrochemistry, psychology, and dentistry. ⋯ Almost all preventive or therapeutic dental treatment can have adverse effects, and an attempt to eliminate all risks could well eliminate established methods in dentistry as well. This paper presents the ramifications of an amalgam ban, which is being called for by various groups, in some detail.
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In the first stage of labor, pain is caused by distension of the cervix and low uterine segments in combination with isometric contraction of the uterus. Pain in the second stage of labor is dominated by tissue damage in the pelvis and perineum. Labor pain is due to an activation of nociceptors partly resulting from ischemia. ⋯ An increase in plasma catecholamines and glucocorticoids influences uterine contractions. The amount of beta-endorphin released from the pituitary and placenta into the blood is relatively high but obviously not sufficient to depress pain effectively. Adequate nerve block and epidural anesthesia, as well as measures to relieve anxiety, will help markedly to reduce the risks associated with labor pain.