Articles: treatment.
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It has been shown that an active metabolite- morphine-6-glucuronide-is formed in man after administration of morphine. In spite of the chemical variation, the glucuronide still possesses high affinity to opioid receptors and the polarity of the glucuronide does obviously not exclude penetration of the blood-brain barrier. ⋯ It can not be excluded at the moment that morphine-6-glucuronide will prove superior to morphine for long term treatment, since the kinetic behaviour excludes sharp undulations of the plasma concentration and probably of the concentration at receptor sites in the brain. It is speculated that this type of pharmacokinetic behaviour will reduce tolerance phenomena and abuse liability.
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Changes in estrogen levels at menarche, menstruation, pregnancy, and menopause may trigger or change the prevalence of migraine. The fall in estrogen that occurs with menstruation is the trigger for menstrual migraine, whereas the sustained high estrogen levels during pregnancy frequently result in headache relief. Estrogen produces changes in prostaglandins, hypothalmic opioids, and prolactin secretion, which may in part account for genesis of headache. The treatment of menstrual migraine and migraine associated with menopause and the use of oral contraceptives is discussed, focusing on standard headache treatment and hormonal manipulation.
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To assess the accuracy of three clinical case definitions for advanced HIV disease: the World Health Organization (WHO) case definition, and the original and revised Caracas case definitions. ⋯ In our study population, case definitions were specific, but only moderately sensitive for advanced HIV disease. Prospective studies should be conducted in diverse geographic regions, using lymphocyte or CD4 cell counts when possible.
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We found that the incidence of post-cesarean puerperal morbidity at Srinagarind Hospital, Khon Kaen University was 5.5 per cent, which is very low compared to other reports. Statistically significant risk factors for post-cesarean puerperal morbidity included having less than 4 antenatal care visits, duration of labour longer than 12 hours and absence of prophylactic antibiotics.
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Acta Anaesthesiol Scand · Feb 1992
Randomized Controlled Trial Clinical TrialEffects of lidocaine aerosol on postoperative pain and wound tenderness following minor gynaecological laparotomy.
Twenty-four female patients undergoing sterilization through a minor lower laparotomy received, in a double-blind, randomized study, either lidocaine spray 200 mg or placebo in the surgical wound. Postoperative pain intensity was evaluated on a verbal and a visual analogue scale and wound tenderness with an algometer. ⋯ Pressure pain thresholds were higher (P less than 0.05) 2 h postoperatively in the lidocaine group, but not 4, 6 and 8 h postoperatively. In conclusion, topically applied lidocaine aerosol in the surgical wound leads to very short and clinically insignificant relief of postoperative pain.