Effective Relief Research Articles

Methods of local anesthesia in postoperative anesthesia of oncosurgical operations on the nasopharynx in children

BACKGROUND: Postoperative analgesia should begin even in the operating room, so that at the time of awakening the patient does not experience pain and discomfort. The work is devoted to the problems of postoperative analgesia using local anesthesia techniques in oncosurgery of the nasopharynx in children.
 AIM: The aim of the study to analyze the primary results of the use of local anesthesia methods in postoperative analgesia in pediatric oncosurgery of the nasopharynx.
 MATERIALS AND METHODS: A study was conducted in the immediate postoperative period (16 hours) in ten patients, whose average age was 14 years with ENT surgical pathology. The physical status of the children corresponded to the III class according to the ASA classification. The patients were divided into two equal groups of 5 people: the 1st group included children who, for the purpose of postoperative analgesia at the end of the surgical intervention, underwent conduction anesthesia of the nose from three points according to Weisblat; the 2nd group (comparison group) is represented by patients in whom infraorbital anesthesia was used after surgery. Non-invasive monitoring of systolic and diastolic blood pressure, heart rate was carried out. The oxygen status was monitored by pulse oximetry.
 RESULTS: The data obtained from the analysis of hemodynamic parameters, pain assessment by VAS (Visual Analog Scale) testified to the effectiveness of pain relief in patients in the study groups. The main hemodynamic parameters and pain assessment data for the groups were similar to each other and were within the reference values. There were differences in the duration of postoperative analgesia.
 CONCLUSIONS: The proposed methods of postoperative analgesia make it possible to abandon the use of narcotic drugs, synthetic opioid analgesics, non-steroidal anti-inflammatory drugs, but not excluding analgesics antipyretics. The positive first results of this study provide for the need for a further set of observations, possibly in different clinics due to the relative rarity of oncological pathology of the nasopharynx in childhood.

Effective and Efficient Relief Supply Chain Management: A Case Study of Flood Relief-2022 in Sindh

In the backdrop of recent floods in Pakistan, this study focuses to identify the challenges faced in the aid distribution supply chain and envision best practices from Business Supply Chains for use across the relief projects. The argument is that relevant aspects of business supply chain can be applied for operational efficiency of relief supply chain. Using a mixed method approach, seven organizations based in Karachi were selected using purposive sampling method and data was collected using questionnaire having both open and closed ended questions. The quantitative data was analyzed using Microsoft excel and qualitative data was analyzed by thematic analysis. The findings of the study show that all the stakeholders agreed that coordination and collaboration in relief work can increase the effectiveness. The main challenges faced by them were inadequate financial resources, accessing the affected areas, duplication of the relief operation in same areas, as some of the areas got the attention of all relief actors while others got missed at a given time. The research suggests that by adapting CPFR model, Collaborative Planning, Forecasting and Replenishment in the supply chain approach, combined effort and practices can increase the efficiency and effectiveness of relief work.

Therapeutic potential of allosteric modulators for the treatment of gastrointestinal motility disorders.

Gastrointestinal motility is tightly regulated by the enteric nervous system (ENS). Disruption of coordinated enteric nervous system activity can result in dysmotility. Pharmacological treatment options for dysmotility include targeting of G protein-coupled receptors (GPCRs) expressed by neurons of the enteric nervous system. Current GPCR-targeting drugs for motility disorders bind to the highly conserved endogenous ligand-binding site and promote indiscriminate activation or inhibition of the target receptor throughout the body. This can be associated with significant side-effect liability and a loss of physiological tone. Allosteric modulators of GPCRs bind to a distinct site from the endogenous ligand, which is typically less conserved across multiple receptor subtypes and can modulate endogenous ligand signalling. Allosteric modulation of GPCRs that are important for enteric nervous system function may provide effective relief from motility disorders while limiting side-effects. This review will focus on how allosteric modulators of GPCRs may influence gastrointestinal motility, using 5-hydroxytryptamine (5-HT), acetylcholine (ACh) and opioid receptors as examples. LINKED ARTICLES: This article is part of a themed issue Therapeutic Targeting of G Protein-Coupled Receptors: hot topics from the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists 2021 Virtual Annual Scientific Meeting. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v181.14/issuetoc.

Ultrasound-guided pulsed radiofrequency of cervical nerve root for cervical radicular pain: a prospective randomized controlled trial

Pulsed radiofrequency (PRF) on cervical dorsal root ganglion (DRG) for pain management in cervical radicular pain is mainly performed via a transforaminal approach under fluoroscopic guidance. Ultrasound-guidance periradicular cervical nerve root intervention raises concern about the neuromodulatory effect. This study aims to evaluate the effectiveness and duration of pain relief between PRF treatment and steroid injection on the cervical nerve roots. To evaluate the efficacy of pulsed radiofrequency for cervical radicular pain. A prospective, double-blinded, randomized controlled clinical trial PATIENT SAMPLE: Patients who underwent ultrasound-guided periradicular cervical nerve root PRF or steroid injection from January 2020 to May 2021 at King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand. The primary outcome was the pain score at 3 months postprocedure. The secondary outcomes were the duration of pain relief of at least 50%, pain scores at other time points after pain intervention, the amount of rescue pain medications, procedural time, and complications. Forty-two patients who presented with chronic cervical radicular pain were prospectively randomized into the PRF and steroid groups. Patients in the PRF group received PRF treatment at 42°C for 4 minutes, followed by the injection of 2% lidocaine 1.5 mL and dexamethasone 10 mg to the targeted cervical nerve root. The steroid group received the same injectate. Patients and pain assessors were blinded. The numerical rating scale (NRS) and the Neck Disability Index (NDI) questionnaires were used for pain intensity and neck functional assessment before and after the procedure. Pain reduction was recorded up to a 9-month follow-up. Data analysis was obtained from 20 and 21 patients receiving PRF and steroid treatment, respectively. At 3-month postprocedure, there were 70% of patients in the PRF group reported 50% pain reduction compared with 23.8% of patients in the steroid group (p<.01). Moreover, patients in the PRF group had significantly less pain (NRS 2.8±2.7) compared with patients in the steroid group (NRS 5.5±2.6) (p=.01). The neck disability index demonstrated significant improvement at 3 and 6 months (p<.01) after PRF treatment compared with steroid injection alone. The duration, in which pain relief was at least 50%, was significantly longer in patients who received PRF treatment (6.0±4.1 months) compared with those in the steroid group (2.3±2.1 months) (p<.01). Ultrasound-guided periradicular cervical nerve root PRF exhibited a neuromodulatory effect and was considered effective for patients with cervical radicular pain. It provided a longer duration of pain relief and improvement of neck function for up to 6 months.

The effectiveness of using “Painmetrica” software for the diagnosis and selection of treatment for chronic pain syndrome in degenerative diseases of the spine

Objective. To evaluate the effectiveness of using the “Painmetrica” software for the diagnosis and selection of treatment for pain in degenerative diseases of the spine. Materials and methods. Software “Painmetrica” was developed for the diagnosis and selection of treatment for pain in degenerative diseases of the spine. Through a bidirectional nonrandomized controlled trial, its effectiveness was evaluated using telephone interviews with 42 patients. For comparison, a telephone interview was conducted with 47 patients for whom the Panimetrica program had not been used in the treatment.Results. The effectiveness of using “Painmetrica” software for the diagnosis and selection of treatment for patients with back pain was demonstrated. In the main group, the decrease in pain syndrome tended to differ due to an increase in the number of patients in whom pain was relieved by more than 50% and completely disappeared (p = 0,09 according to the two-tailed Fisher’s exact test). Patients treated with Painmetrica algorithms experienced sleep recovery due to a decrease in pain: changes persisted in 12 cases (28,6%), while in the comparison group, sleep changes remained in 24 patients (51,1%) (p=0,05 according to two-tailed Fisher’s exact test). Against the background of effective pain relief in patients who used Painmetrica, there was a decrease in the use of non-steroidal anti-inflammatory drugs (NSAIDs) (17 patients (40,5%) of the main group versus 36 patients (76,6%) of the control group, p = 0,001 according to the twotailed Fisher’s exact test ). At the same time, only 8 patients (19.1%) in the main group and 30 patients (63.8%) in the comparison group (p &lt; 0.001 according to Fisher’s two-sided exact test) indicated the need to consult a neurologist.Conclusion. The effectiveness of the use of “Painmetrica” software for the diagnosis and selection of treatment of patients with degenerative diseases of the spine on an outpatient basis in relation to the need for patients to use nonsteroidal anti-inflammatory drugs, the need for additional consultation of a neurologist, as well as effective relief of sleep disorders caused by pain were demonstrated.

A study on the location of emergency supplies reserve center in Guangxi for tropical cyclone disasters

On average, Guangxi experiences 2 severe tropical cyclone disasters yearly. A large number of disaster victims need governments at all levels to raise enough emergency supplies to carry out effective relief. However, there is no proper reserve center for tropical cyclone disaster storage and collection of emergency supplies in Guangxi, so it is urgent to choose a suitable location to build the Guangxi tropical cyclone disaster emergency supplies reserve center. The data of 16 severe tropical cyclone disasters and rescues in Guangxi from 2014 to 2021 were collected. An optimal location model of the emergency supplies reserve center for tropical cyclone disasters in Guangxi was established using the improved center of gravity method based on GIS. After four iterations of calculation, the longitude and latitude coordinate S5(108.64, 21.98) were used as a suitable site to construct the Guangxi Tropical Cyclone Disaster Emergency Supplies Reserve Center to ensure the fastest and lowest cost delivery of emergency supplies to the disaster areas in Guangxi. According to the map of Tiandi, the actual place corresponding to this coordinate is near Liuwu Village next to Qinzhou East Railway Station, Qinnan District, Qinzhou, Guangxi. This location coordinate S5 can provide a reference for the Guangxi Zhuang Autonomous Region government to select a suitable address to construct the Guangxi Tropical Cyclone Disaster Emergency Supplies Reserve Center. The improved center of gravity location model based on GIS can also provide a reference for other provinces or cities to carry out emergency supplies reserve center locations.

Does Digital Rubbing Massage-Pain Relief (DRM Pain Relief) Affect Breast Cancer Patients' Pain, Comfort, and Quality of Life?

The incidence of breast cancer in Indonesia is the highest among types of cancer in women, with an estimated pain prevalence of 40%-89%. More than 50% of cancer patients suffer from pain that has not been resolved. Cancer pain's impact will affect the comfort level and quality of life. The purpose of this study was to analyze the effectiveness of DRM Pain Relief on the degree of pain, comfort, and quality of life among breast cancer patients. The research was a true experimental study with pre-test and post-test designs with a control group. The population was all breast cancer patients attending hospitals in Semarang and Pekalongan Districts. The research subjects were 64 respondents who met the inclusion and exclusion criteria. Respondents were selected randomly and divided into two groups, namely 32 in the treatment group (DRM Pain Relief application) and 32 in the control group (only received drugs as conventional therapy in the hospital). Data were analyzed using a multivariate test. The application of DRM Pain Relief was effective in reducing the degree of pain (p < .001), and effectively increasing comfort (p < .001), as well as improving the quality of life of breast cancer patients in the components of improvement in symptom status, functional status, and global quality of life with p-value <.001, .003, < .001, respectively. The DRM Pain Relief effectively reduces the degree of pain, increases comfort, and improves the quality of life of breast cancer patients.

Robotic-assisted simple prostatectomy: long-term, trifecta- and pentafecta-based analysis of functional outcomes

Background: Robotic-assisted simple prostatectomy (RASP) proved to be a sound and effective procedure for bladder outlet obstructive symptoms relief. Routinely, the transvesical (Freyer) or transcapsular (Millin) techniques are performed. A novel approach of near-infrared fluorescence imaging (NIFI)-guided urethra-sparing robot-assisted prostatectomy (Madigan) was recently introduced. Objectives: The aim of our study was to evaluate the long-term functional outcomes between the Millin, Freyer, and Madigan RASP. Design: This is a single-center, retrospective evaluation of a prospectively maintained Institutional Review Board–approved database. Methods: Data from patients who have undergone RASP in our center were prospectively collected. Demographics, prostate size, and preoperative flowmetry parameters were assessed. Questionnaires such as International Index of Erectile Function (IIEF), and International Consultation on Incontinence Questionnaire (ICIQ), International prostatic symptoms score (IPSS) with its quality of life (QoL) score, Male Sexual Health Questionnaire (MSHQ), Overactive bladder questionnaire (OABQ) were administered to every patient preoperatively and during follow-up. We tested composite outcomes (trifecta) defined as a combination of postoperative Q-max &gt;15 ml/s, IPSS score &lt; 8, and absence of complications. We also tested a pentafecta which keeps in account the persistence of antegrade ejaculation (MSHQ &gt; 0) and the erectile function maintenance (∆IEEF &lt; 6). Results: Median follow-up was 36 months. Millin, Madigan, and Freyer procedures were performed in 37 (51%), 18 (25%), and 17 (24%) cases, respectively. Trifecta was achieved in 43 (60%) patients. Preoperative ICIQ, postoperative IPSS, postoperative OABQ, and QoL were significantly different between groups (all p &lt; 0.02). Pentafecta was achieved by 14 (20%) patients. The pentafecta group showed a statistically significant advantage in terms of postoperative IPSS and MSHQ ( p &lt; 0.01). Conclusion: RASP provides an effective and durable relief of obstructive symptoms at long-term follow-up, regardless of the technique, achieving the trifecta in the majority of the patients. The Madigan technique is significantly related to the pentafecta achievement.

Popularity-Based Data Placement With Load Balancing in Edge Computing

In recent years, edge computing has become an increasingly popular computing paradigm to enable real-time data processing and mobile intelligence. Edge computing allows computing at the edge of the network, where data is generated and distributed at the nearby edge servers to reduce the data access latency and improve data processing efficiency. One of the key challenges in data-intensive edge computing is how to place the data at the edge clouds effectively such that the access latency to the data is minimized. In this paper, we study such a data placement problem in edge computing while different data items have diverse popularity. We propose a popularity based placement method which maps both data items and edge servers to a virtual plane and places or retrieves data based on its virtual coordinate in the plane. We then further propose additional placement strategies to handle load balancing among edge servers via either offloading or data duplication. Simulation results show that our proposed strategies efficiently reduce the average path length of data access and the load-balancing strategies indeed provide an effective relief of storage pressures at certain overloaded servers.

Progress in the treatment of lupus nephritis with Chinese medicine

By examining the recent domestic and international literature, we provide a breakdown of Chinese medicine in the treatment of lupus nephritis in recent years. It summarizes the etiology and pathogenesis of the disease, the historical theoretical sources of TCM evidence-based treatment and the composition of prescriptions and medicines, elaborates on TCM stage-based treatment, and outlines various TCM characteristic treatment methods including internal herbal tonics, acupuncture, medicinal baths, tui-na and enemas.The results showed that the above-mentioned TCM treatment methods not only have precise clinical efficacy, but also can appropriately reduce the frequency of hormone use, thus alleviating the physical harm caused by the related side effects, with considerable safety and effective relief of patients' pain.

Ethical path for human rights protection in the digital society

In the digital age, digital survival has become an important part of the basic way of life, and produced a series of digital situation related human rights protection requirements, including equal use of digital technology without discrimination, from the use of digital technology, from the use of digital technology manipulation of people, as well as the personal digital information and property autonomy, etc. In the face of increasingly professional and strong control of digital technology, the digital age of human rights protection not only need the government to establish regulation digital technology development and application of laws and regulations, establish professional relief agencies to regulate data companies and online social platform, provide effective relief to help digital vulnerable groups, and requires the development and use of digital technology and network social platform to strengthen self-discipline, and establish everyone must abide by the digital technology application ethics.

척추 수술 실패 증후군에 대한 수기요법의 효과

Objectives This study aimed to assess the efficacy and safety of manual therapy in patients with failed back surgery syndrome (FBSS). Methods We searched eight electronic databases from October 2022 and only selected randomized controlled trials (RCTs) reporting outcomes for manual therapy in FBSS patients. Included studies were analyzed qualitatively. Results A total of twelve RCTs were included and three studies were meta-analyzed. Manual therapy combined with exercise demonstrated more favorable outcomes in terms of pain reduction compared to exercise therapy only (P&lt;0.01). Some studies reported that manual therapy resulted in low efficacy, while some studies reported that specific manual techniques have a significant effect in pain relief. We, therefore, conclude that several studies have a high risk of bias. Conclusions Findings suggest that manual therapy is a safe and non-invasive, promising option for managing FBSS. However, manual therapy is not the best option in all circumstances; thus, this should be selectively applied by a well-trained practitioner. Further studies such as well-designed, risk-controlled RCTs are required to gain stronger evidence.

Does Ultrasound Guidance Provide Pain Relief During Intrauterine Contraceptive Device Insertion? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

To evaluate ultrasound guidance effect in pain relief during intrauterine device (IUD) insertion. Four different databases were searched from inception till June 2022. We selected randomized controlled trials (RCTs) that compared transabdominal ultrasound guidance versus traditional non-guided IUD insertion among women undergoing IUD placement for contraception. We used Revman software during performing our meta-analysis. Our primary outcome was the pain score during IUD insertion as evaluated by the Visual Analog Scale (VAS). Our secondary outcomes were the procedure insertion time, satisfaction, and incidences of complications and misplaced IUDs. Seven RCTs were retrieved with a total number of 1267 patients. There was a significant reduction in the VAS pain score during IUD insertion among the ultrasound-guided group (MD=-1.91, 95% CI [-3.08, -0.73], P=.001). The procedure insertion time was significantly shorter within the ultrasound guidance group compared with the control group (MD=-1.35, 95% CI [-1.81, -0.88], P < .001). Moreover, more women were significantly satisfied with the procedure among the ultrasound-guided group (P < .001). In addition, ultrasound-guided IUD insertion was linked to significant decline in incidences of complications and misplaced IUDs. Ultrasound guidance can be used as a modified technique during IUD insertion as it decreases pain, procedure time, and rates of complications and misplaced IUDs with better patient satisfaction.

Кросс-региональный анализ настроений пользователей сетевых сообществ ВКонтакте «Типичный Краснодар» и «Типичный Кемерово»

This research tested a complex analytical method based on semantic modeling of discursive fields and network analysis that can be applied to networked linguistic data. The copyright software package Monitoring and Analysis of Social Networks, Internet Communities, and Users provided automatic data processing to restore the semantic core of the discursive fields generated by Typical Krasnodar and Typical Kemerovo online communities in 2021–2022. The analysis was visualized as social graphs and semantic core models. It identified a number of sensitive topics that generated a lot of feedback. The method also proved efficient in predicting cultural and socio-political trends. The complex methodology provided rapid identification of amplified discursive activity, conditions for social unrest, and bifurcation points for destructive social practices. The results may contribute to effective information management and social strain relief in the regions through discursive control of online communication.

Topical cyclosporine versus allergen specific immunotherapy in perennial allergic conjunctivitis.

Symptom control in the long-term with less side effects is important in perennial allergic conjunctivitis, since would improve quality of life. This study aimed to assess the clinical efficacies of topical cyclosporin A and subcutaneous allergen immunotherapy (SCIT) in terms of sign control in perennial allergic conjunctivitis. This retrospective study included 20 adult patients with perennial allergic conjunctivitis and confirmed sensitization to house dust mites with skin prick test. Patients were assigned to either topical cyclosporine A treatment or SCIT. The participants were followed for 6months, and signs scores were recorded at 1, 3 and 6months. Overall, both cyclosporine and immunotherapy groups showed significant improvements in papillary reaction (p = 0.011 and 0.003, respectively), limbal involvement (p = 0.031 and 0.001), and conjunctival hyperemia (p = 0.001 and p < 0.001) scores during the 6-month follow-up. However, only cyclosporine group showed a significant improvement in corneal involvement scores (p = 0.015) during the study period. When scores at different time points were compared, significant improvement in conjunctival hyperemia was evident at 6months in both groups when compared to baseline (cyclosporine group, 0.7 ± 0.68 vs. 2.4 ± 0.84, 70.8% decrease, p = 0.01; immunotherapy group, 0.3 ± 0.48 vs. 2.3 ± 0.95, 87.0% decrease, p = 0.004), whereas for limbal involvement such an improvement was only evident in the immunotherapy group (0.1 ± 0.32 vs. 1.3 ± 0.95, 92.3% decrease, p = 0.01). Allergen immunotherapy and cyclosporin A treatment may provide effective sign relief in perennial allergic conjunctivitis. It may represent an encouraging treatment option particularly for cases with perennial allergic conjunctivitis refractive to other treatments and positive skin prick test to a specific allergen (house dust in the present study). Long-term relief by SCIT would reduce the side effects of polypharmacotherapy. Larger studies with longer follow-up are warranted to confirm our findings.

The Implementation of Paycheck Protection Program on the Recovery of Restaurant Industry in COVID-19

The epidemic has had a significant negative impact on many industries that rely on foot traffic for profit, with the restaurant industry being the most representative. The government also implemented different levels of lockdowns and subsidies at the beginning of the outbreak to control the spread of the epidemic while subsidizing the affected companies. This paper analyzes the extent to which the Paycheck Protection Program (PPP) under the Coronavirus Aid, Relief, and Economic Security Act (CARESA) for small companies helped the restaurant industry. Even with the limitations of incomplete information on small companies, the results indicate that the first round of the PPP loans helped the restaurant industry's transaction rate, but many restaurants decided to lay off employees because they did not receive follow-up subsidies. Therefore, it is inferred that the help of the PPP is phased, bringing significant boost effect immediately but not sustaining long-term economic recovery. This analysis also provides the basis for a more effective and applicable emergency relief program in the future.

Study on key outcome indexes in treatment of migraine with acupuncture and moxibustion

To identify the key outcome indexes in treatment of migraine with acupuncture and moxibustion. Using literature research, questionnaire survey and consensus conference, the key outcome indexes in treatment of migraine with acupuncture and moxibustion were screened and prioritized. The critical outcome indexes for the treatment in attack stage of migraine included 6 effectiveness outcome indexes (headache intensity, headache duration, headache relieve time, effectiveness and level of headache relief within 2 h, headache-related quality of life, level of headache relief within 24 h) and 1 safety outcome index (incidence of serious adverse reactions). The critical outcome indexes for prophylactic treatment included 6 effectiveness outcome indexes (headache day, headache frequency, headache intensity, effective rate, headache-related quality of life, health-related quality of life) and 1 safety outcome index (incidence of serious adverse reactions). In terms of the attack stage treatment and prophylactic treatment with acupuncture and moxibustion, the outcome indexes are different, among which, those can directly reflect the conditions of migraine should be optioned in priority. To assess the effectiveness of attack stage, the headache intensity is preferred, using the visual analogue scale (VAS) score, and the preferred time is 2 hours after treatment. Regarding the effectiveness of prophylactic treatment, the headache day, headache frequency and headache intensity should be firstly considered in the assessment, in which, the preferred time for assessment is 12 weeks into treatment, while, the best time for follow-up should be 12 weeks after treatment completion. When the quality of life is considered, the migraine-specific quality of life questionnaire (MSQ) is the top option. For either the attack stage treatment or the prophylactic treatment, the high attention should be laid on the outcome indexes for safety and medical economics evaluation.

Efficacy of Tailor-Made Notched Music Training Versus Tinnitus Retraining Therapy in Adults With Chronic Subjective Tinnitus: A Randomized Controlled Clinical Trial.

Chronic subjective tinnitus can have a serious effect on daily life, even causing serious psychological disorders. Currently there are no specific effective solutions or cures. Tailor-made notched music training (TMNMT) is a recently proposed sound therapy that has simpler processes and a higher compliance rate than tinnitus retraining therapy (TRT), a widely used treatment for chronic subjective tinnitus. This study explores the therapeutic effect of TMNMT in comparison to TRT to highlight its clinical value. The study was a randomized controlled, single-blinded clinical trial. One hundred twenty eligible participants were randomly assigned to receive TMNMT (n = 60) or TRT (n = 60) for 3 mo with concurrent follow-up. It should be noted that the duration of sound treatment in TRT was modified to 2 hr per day for better feasibility in practice. The primary outcome was mean change in tinnitus handicap inventory (THI) measured at baseline ( T0 ), 1 mo ( T1 ) and 3 mo ( T2 ) after intervention. Change in visual analog scale (VAS) was measured as a secondary outcome. A comparison of therapeutic effectiveness between TMNMT and TRT was evaluated by repeated measure analysis of variance. One hundred and twelve (93%) of participants took part in the study, of which 64 were men and 48 women. Mean (SD) age was 42.80 (12.91) years. Fifty-eight were allocated to receive TMNMT and 54 to receive TRT. The between-group difference in primary outcome was -6.90 points (95% confidence interval [CI], -13.53 to -0.27) at T1 and -6.17 points (95% CI, -13.04 to 0.71) at T2 . These results closely reached to clinical significance of tinnitus-related effective relief. For the secondary outcome, the mean value in the TMNMT group was 0.83 points (95% CI, 0.12 to 1.54), significantly lower than the mean value of the TRT group. The differences in THI and VAS between the two groups were statistically significant after intervention. Further analysis showed that age and baseline THI and VAS scores were associated with change in THI and VAS scores after interventions. Both TMNMT and TRT were able to alleviate chronic subjective tinnitus effectively after a 3 month intervention. When the two forms of therapy were compared TMNMT appeared to be more effective and consequently potentially superior to TRT for reducing tinnitus loudness and functional and emotional disturbance associated with chronic subjective tinnitus.

EE681 Costs of Treating Acute Hereditary Angioedema (HAE) Attacks With C1 Inhibitors in Five Central and Eastern European Countries

Hereditary angioedema (HAE) is a rare genetic disease caused by the deficiency or dysfunction of C1 esterase inhibitor (C1-INH), and characterized by recurring episodes of severe swelling, which can be life-threatening. Frequency and severity of attacks vary. Replacement C1-INH therapies provide effective relief; however, there is a lack of comparative data on economic outcomes in Central and Eastern European countries (CEE).

A clinical case of the use of a new selective μ1-opioid analgesic Tafalgin in the treatment of chronic cancer pain

In the Russian Federation, tetrapeptide tyrosyl-D-arginyl-phenylalanyl-glycine amide (Tafalgin), a novel analgesic, selective agonist of 1-opioid receptors, was developed and approved in 2022. The article presents the first experience of the successful use of Tafalgin in treating chronic pain in a cancer patient with poor tolerance to traditional opioids (tramadol, tapentadol, morphine). At baseline, pain severity, according to the Neurological Rating Scale (NRS), was 57 points at rest and up to 9 points in motion out of the maximum 10. The combination of 400 mg/day of tramadol with gabapentin and a non-steroidal anti-inflammatory drug was ineffective; 400 mg/day of tapentadol in combination with gabapentin and a non-steroidal anti-inflammatory drug also was ineffective. Morphine tablets 60 mg/day were effective (NRS score of 23), but unrelenting nausea and vomiting were unmanageable and significantly reduced quality of life. Reducing the dose of oral morphine to 20 mg/day mitigated adverse events but reduced the effectiveness of pain relief (resting NRS score of 4 points). Tafalgin 4 mg subcutaneously BID, then TID reduced the pain severity to an average daily NRS score of 1.22 over the first 3 days of treatment with no adverse events. Sleep, appetite, and physical activity improved. The patient received Tafalgin for 84 days, and she gained 5 kg due to improved nutrition during that time. The drug is comparable in efficacy to morphine and is associated with fewer adverse events. A limitation to widespread use is the availability of a formulation for subcutaneous injection only.