Southern medical journal
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Allergic rhinitis unresponsive to conservative therapy with antihistamines, decongestants, and environmental control may require the use of corticosteroids for symptomatic relief, even while hyposensitization is being carried out. Such therapy may be given orally, intramuscularly, as a nasal aerosol, or by intraturbinal injection. This discussion deals with the characteristics and appropriate use of each modality.
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An elderly woman who had spinal epidural anesthesia thereafter had headache, anorexia, nausea and vomiting, dehydration, seizures, and cardiovascular collapse. CAT scan revealed air in the posterior fossa, probably caused by intradural injection of air during epidural anesthesia. We propose that this may be an occasional cause of headache or more substantial complications after epidural anesthesia, and suggest that CAT scanning may be helpful in identifying this complication.
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Chronic pain can be treated by combining hypnosis with brief psychotherapy. Hypnosis alone, though useful for acute pain, is seldom effective in relieving chronic pain because it does not address the significant psychologic components in the patient's illness. Treatment using self-hypnosis in conjunction with brief psychotherapy, however, can enable the patient to recognize these components, to change from a passive to an active role in achieving relief, and to modify his attitude toward the pain. This procedure can both reduce suffering and lead the patient to deemphasize pain in his life.