Instantaneous Relief Research Articles

Headache Due to Spontaneous Intracranial Hypotension Treated with Cervical Epidural Blood Patch

Abstract Spontaneous intracranial hypotension (SIH) is caused by spinal leakage of cerebrospinal fluid and it is characterized by an orthostatic headache without a history of trauma or dural puncture. Epidural blood patches have been regarded as the mainstay of therapy for SIH, often providing instantaneous relief of symptoms in 90% of cases regardless of the site of the leak. We present a rare case report of an epidural leak treated with a cervical epidural blood patch.

Instant Pain Relief and ROM By Soft Glides

Effectiveness of Soft Tissue gliding in bringing about Instant spike of Mobility and Instantaneous relief in pain during Shoulder Abduction Movement: A Promising Case Study.

AB170. SOH23ABS_238. Epidural blood patch for spontaneous intracranial hypotension (case report)

Background: Spontaneous intracranial hypotension (SIH) is caused by spinal leakage of cerebrospinal fluid (CSF) and it is characterized by an orthostatic headache without a history of trauma or dural puncture. SIH may lead to serious complications such as subdural haematoma (SDH), may lead to neurological deficits and can even be life-threatening. Lumbar epidural blood patching (EBP) has been regarded as the mainstay of therapy for SIH, often providing instantaneous relief of symptoms in 90% of cases regardless of the site of the leak. There is no conclusive evidence regarding the specific time from the onset of symptoms after which the epidural blood patch should not be tried. This report presents a case of SIH that was successful with lumbar EBP after 6 weeks of symptom onset.

Recovering the instantaneous images of underwater objects distorted by surface waves

ABSTRACT Method for recovering the single instantaneous images of underwater objects distorted by surface waves is presented. This method consists of a combination of two independent parts. In the first part, the algorithm for the determination of an instantaneous relief of waved sea surface from sunglints characteristics has been developed. The instantaneous relief is presented as a sum of harmonics with unknown amplitudes, wavenumbers and phases. To find those unknowns, a system of nonlinear equations that includes the parameters of sunglints, such as the coordinates of glints and their sizes, was derived. The number of unknowns depends on a number of harmonics in a sum, approximating the instantaneous surface relief. In the second part, the algorithm for recovering of the instantaneous image of an underwater object distorted by surface waves is developed. The correctness of the method is tested by a natural experiment.

Intracranial Air Embolism after Inferior Alveolar Nerve Block: A Case Report.

IntroductionThe number of nontraumatic dental pain emergency department (ED) visits continues to substantially rise in frequency every year. While there are several methods for treating dental pain, an inferior alveolar nerve block (IANB) is a non-narcotic alternative that provides instantaneous relief of severe pain.Case ReportA 59-year-old male presented to the ED from a dentist’s office for evaluation of a right-sided headache with an associated episode of palpitations and near syncope that developed while receiving an inferior alveolar nerve block. Computed tomography of the patient’s head revealed multiple small foci of air in the right temporalis muscle and in the intracranial venous drainage system. Given the patient’s history of dental procedure, the intravascular introduction of air and local anesthetic was suspected.ConclusionInferior alveolar nerve block procedures can have complications, including hematoma formation, trismus, facial palsy, needle breakage, and in this case, intravascular injection and cerebral air embolism. To perform a successful IANB, it is critical for providers to be familiar with anatomical landmarks and to consistently perform aspiration to confirm that needle placement is not intravascular.

Predictors of instantaneous relief from spinal manipulation for non-specific low back pain: a delphi study

BackgroundThere is some evidence and anecdotal reports that high-velocity low-amplitude (HVLA) spinal manipulation therapy (SMT) for non-specific low back pain (NSLBP) may immediately reduce pain in some patients. The mechanism for such a change remains unclear and the evidence is conflicting. The aim of this study was to seek consensus among a sample of expert manual therapists as to the possible clinical predictors that could help identify patients who are most likely to receive instant relief from NSLBP with SMT intervention.MethodsThirty-seven expert chiropractors and manipulative physiotherapists from around the world were invited to participate in a three round online Delphi questionnaire during the second half of 2018. Participants were provided with a list of 55 potential signs and symptoms as well as offering them the option of suggesting other factors in the first round. The variables were rated using a 4-point Likert likelihood scale and a threshold of 75% agreement was required for any item to progress to the next round.ResultsOf these 37 experts, 19 agreed to participate. Agreement as to the proportion of patients who receive instantaneous relief was minimal (range 10–80%). A total of 62 items were ranked over the 3 rounds, with 18 of these retained following the third round. The highest rated of the 18 was ‘A history including a good response to previous spinal manipulation’.Discussion/conclusionFive categories; patient factors, practitioner factors, signs and symptoms of NSLBP presentation, an instrument of measurement (FABQ), and the presence of cavitation following SMT best describe the overall characteristics of the factors. The 18 factors identified in this study can potentially be used to create an instrument of measurement for further study to predict those patients with NSLBP who will receive instantaneous relief post-SMT.

A Novel Approach to Managing Post Retropubic Vaginal Sling Pain

ObjectiveTo describe a novel technique of using peripheral nerve neuromodulation (PNNM) for the treatment of refractory, mesh-induced chronic pelvic pain. Chronic pelvic pain associated with mesh can be a debilitating complication and there is currently no consensus on treatment. PNNM has been shown to be successful in the treatment of post-traumatic neuralgias but has yet to be studied in mesh complications. Materials and MethodsWe present a case of a 50-year-old woman who had unrelenting pelvic pain after retropubic sling placement. She failed multiple therapies including medications, mesh removal, pelvic floor physical therapy, pudendal neuromodulation, and pelvic floor onabotulinumtoxinA trigger point injections. ResultsThe only treatment that provided temporary relief of this patient's pain was transvaginal trigger point injections along with a right pudendal nerve block using 40 mg triamcinolone and 0.5% ropivacaine. To help define if treatment at the site of her pain would provide relief, a series of blocks were done by advancing a needle retropubically to her area of pain and injecting triamcinolone and 0.5% ropivacaine. This injection, which corresponded to the previous tract of her retropubic sling, provided temporary, but profound, relief. PNNM was then done with placement of the electrode in the retropubic space at the site of her pain. This provided instantaneous relief of almost all of her pain symptoms. Twelve months postoperatively, the patient continued to have >90% improvement in her pain. ConclusionFocused PNNM is a simple procedure and can provide symptomatic relief for refractory postvaginal mesh pain.

Combined kyphoplasty and intraoperative radiotherapy (Kypho-IORT) versus external beam radiotherapy (EBRT) for painful vertebral metastases - a randomized phase III study

BackgroundThe spine is the most frequent location of bone metastases. Local treatment aims at palliation of pain and, given the increased likelihood of long-term cancer survival, at local control. Kyphoplasty and intraoperative radiotherapy (Kypho-IORT) provided instantaneous pain relief in 70% of patients at the first day after the intervention and resulted in local control rates of > 93% at 1 year in a recently conducted phase I/II trial. To assess its clinical value, we designed a phase III trial which tests Kypho-IORT against the most widespread standard-of-care, external beam radiotherapy (EBRT), in patients with painful vertebral metastases.MethodsThis phase III study includes patients ≥50 years of age with up to 4 vertebral metastases and a pain score of at least 3/10 points on the visual/numeric analogy scale (VAS). Patients randomized into the experimental arm (A) will undergo Kypho-IORT (Kyphoplasty plus IORT with 8 Gy prescribed to 13 mm depth). Patients randomized into the control arm (B) will receive EBRT with either 30 Gy in 10 fractions or 8 Gy as a single dose. The primary end point is pain reduction defined as at least − 3 points on the VAS compared to baseline at day 1. Assuming that 40% of patients in the Kypho-IORT arm and 5% of patients in the control arm will achieve this reduction and 20% will drop out, a total of 54 patients will have to be included to reach a power of 0.817 with a two-sided alpha of 0.05. Secondary endpoints are evaluation of the percentage of patients with a pain reduction of at least 3 points at 2 and 6 weeks, local tumor control, frequency of re-intervention, secondary fractures/sintering, complication rates, skin toxicity/wound healing, progression-free survival (PFS), overall survival (OS) and quality of life.DiscussionThis trial will generate level 1 evidence on the clinical value of a one-stop procedure which may provide instantaneous pain relief, long-term control and shortened intervals to further adjuvant (systemic) therapies in patients with spinal metastases.Trial registrationRegistered with ClinicalTrials.gov, number: NCT02773966 (Registration date: 05/16/2016).

Medication Overuse in Chronic Pain.

Chronic pain is usually managed by various pharmacotherapies after exhausting the conservative modalities such as over-the-counter choices. The goal of this review is to investigate current state of opioids and non-opioid medication overuse that includes NSAIDs, skeletal muscle relaxants, antidepressants, membrane stabilization agents, and benzodiazepine. How to minimize medication overuse and achieve better outcome in chronic pain management? Although antidepressants and membrane stabilization agents contribute to the crucial components for neuromodulation, opioids were frequently designated as a rescue remedy in chronic pain since adjunct analgesics usually do not provide instantaneous relief. The updated CDC guideline for prescribing opioids has gained widespread attention via media exposure. Both patients and prescribers are alerted to respond to the opioid epidemic and numerous complications. However, there has been overuse of non-opioid adjunct analgesics that caused significant adverse effects in addition to concurrent opioid consumption. It is a common practice to extrapolate the WHO three-step analgesic ladder for cancer pain to apply in non-cancer pain that emphasizes solely on pharmacologic therapy which may result in overuse and escalation of opioids in non-cancer pain. There has been promising progress in non-pharmacologic therapies such as biofeedback, complementary, and alternative medicine to facilitate pain control instead of dependency on pharmacologic therapies. This review article presents the current state of medication overuse in chronic pain and proposes precaution to balance the risk and benefit ratio. It may serve as a premier for future study on clinical pathway for comprehensive chronic pain management and reduce medication overuse.

The Effects of Boredom on Helping and Help-Seeking Behaviors among Team Members

Individuals experience task-focused boredom in the case of understimulation where they perceive their ability to exceed task demands and find the task meaningless, and self-focused boredom in the case of overstimulation where they perceive task demands to exceed their ability and feel fatigued. As social beings, individuals seek stimulation from their immediate social environment when they are bored because social interactions are engaging, and facilitate the instantaneous relief of boredom. To shed light on how employees deal with workplace boredom, I use the social support resource theory to develop a theoretical model explaining how task-focused boredom and self-focused boredom drive helping and help-seeking behaviors respectively in a team context. Specifically, task-focused boredom predicts the availability of cognitive resources positively and results in offering help to teammates, while self-focused boredom predicts the availability of cognitive resources negatively and leads to help-seeking from teammates, among individuals with high team identification but not among individuals with low team identification. My model provides a novel perspective for thinking about how task-focused boredom and self-focused boredom function as antecedents to impact interpersonal dynamics in the team context. This clarifies and paints a more complete picture of the role of boredom in the organizational context. I also discuss the theoretical and practical implications of my model.

A comparative analysis between Nd:YAG and CO2lasers for their sealing ability of dentinal tubules with and without fluoride varnish: An in vitro study

Background: Application of laser energy onto exposed dentinal tubules provides instantaneous relief from dentin hypersensitivity. The aim of the present study was to compare between CO 2 and Nd:YAG laser irradiation for their sealing ability on human dentinal tubules when treated with and without fluoride varnish, using Scanning Electron Microscopy. Materials and Methods: Twenty extracted human intact third molar teeth were selected. A total of six samples were obtained from each tooth. One hundred and twenty dentin samples from 20 teeth were then divided into six groups with 20 samples in each group. These slabs were treated with 17% ethylenediaminetetraacetic acid (EDTA) for 5 min and with 5% NaOCl for the next 2 min for removal of the smear layer. Each of the samples from a single tooth was then subjected to six different treatment protocols according to the groups given below.Group 1 (n = 20) : CO 2 laserGroup 2 (n = 20) : Nd:YAG laserGroup 3 (n = 20) : Varnished with fluoride and lased with CO 2 laserGroup 4 (n = 20) : Varnished with fluoride and lased with Nd:YAG laserGroup 5 (n = 20) : Varnished with fluorideGroup 6 (n = 20) (control) : Not subjected to lasing and fluoride applicationAll samples were examined under scanning electron microscope. Results were subjected to statistical analysis using one-way analysis of variance (ANOVA) and the multiple comparisons among groups were carried out by Student's t-test. Results: Compared to conventional fluoridation or laser irradiation, in the treatment of dentin hypersensitivity, CO 2 lasers in combination with fluoride varnish appear to show better efficacy than either treatment modality alone.

Ghosts, Meaning, and Faith: After-Death Communications in Bereavement Narratives

After-death communications (ADCs) are reported encounters with a deceased loved one, a contemporary type of ghost experience heralded as therapeutic in coping with bereavement. Pertinent literature generally illustrates the healing power of ADCs with brief, self-contained episodes. The functions of ADCs over the course of grief need exploration. To that end, this article analyzes 20 published book-length autobiographical stories of bereavement in which authors report ADCs. Two functional patterns are identified—instantaneous relief from painful grief symptoms and reinforcement of a consoling religious worldview. The second dynamic links ADCs to meaning-making and religious coping within Christian and Spiritualist frameworks.

Metastasen eines malignen Melanoms als ausgedehnte Raumforderung in der Trachea

We report the case of a 71-year-old man, who was transferred to our clinic with rapidly increasing dyspnea. On examination by flexible bronchoscopy the trachea was found to be almost completely obstructed by metastatic masses of a malignant melanoma. After endoscopic removal of the obstruction, we inserted a covered nitinol stent which led to instantaneous relief of symptoms. Chemotherapy and local radiotherapy were instituted. During the next 9 months there were no signs of recurrence of the tumour in regular pneumological control exams.

Metastasen eines malignen Melanoms als ausgedehnte Raumforderung in der Trachea

We report the case of a 71-year-old man, who was transferred to our clinic with rapidly increasing dyspnea. On examination by flexible bronchoscopy the trachea was found to be almost completely obstructed by metastatic masses of a malignant melanoma. After endoscopic removal of the obstruction, we inserted a covered nitinol stent which led to instantaneous relief of symptoms. Chemotherapy and local radiotherapy were instituted. During the next 9 months there were no signs of recurrence of the tumour in regular pneumological control exams.

New insights into the mechanism of postseismic stress relaxation exemplified by the 23 June 2001 Mw = 8.4 earthquake in southern Peru

The 2001 Mw = 8.4 southern Peru subduction earthquake marked the beginning of a transient postseismic surface motion in direction of the coseismic displacement at the permanent GPS station Arequipa. In general this motion is assigned to afterslip. Our hypothesis is that the observed transient signal can be explained by stress relaxation processes in the overriding plate. We use a 2D finite element model incorporating non‐linear viscoelastic Maxwell rheology. Our model results indicate that coseismically induced stresses are relieved by viscoelastic stress relaxation in the lower crust. The trenchward directed creep motion is transferred to the upper crust due to elastic coupling leading there to an instantaneous relief of elastic stresses. In contrast to the existing conceptual models for stress relaxation, which incorporate shear stresses, we conclude that tensional elastic stresses throughout the crust and upper mantle are the main driving forces for the transient GPS signal.

Sickle-cell anemia crisis: report of seven patients treated with Priscoline

Painful crisis is the most common cause of recurrent morbidity in sickle cell disease (SCD), accounting for approximately 90% of SCD-related admissions. Current management emphasizes prophylaxis by avoiding precipitating factors (cold, stress, infection, altitude, etc), maintenance of fluid balance, and the use of hydroxyurea in severely affected persons. During crisis, analgesia is achieved by using oral and parenteral nonsteroidal anti-inflammatory drugs and opioids.1 In the December 1953 issue of The Journal, Smith et al at Kings County Hospital in Brooklyn, New York, reported on the use of tolazoline (Priscoline, Novartis) an α-adrenergic blocking agent, in seven children with SCD who presented with moderate to severe pain. Their rationale for using this vasodilator agent was based on its previous success in treating moderate to severe pain associated with poliomyelitis. The children in this study ranged in age from 3 to 11 years. Only two had previously been diagnosed with SCD. In the first case, a 5-year-old presented with severe pain in both knees. “Following intravenous administration of the drug, there was almost instantaneous relief from the pain in the extremities.” Significant improvement of the pain was achieved in all 7 patients, and they concluded that although the drug was more effective in visceral pain compared with bone and joint pain, “Priscoline definitely shortened the period of disability in the patients treated.” They postulated that the drug helped reverse the vascular component of the crisis.

Compound 48/80 Suppresses Monocytic Tissue Factor-Initiated Extrinsic Blood Coagulation Induced by Bacterial Endotoxin

Background. Hypercoagulability is one of the commonly exhibited endotoxemia septic symptoms; it could contribute to the manifestation of disseminated intravascular coagulation presenting threats to cardiovascular functions. The underlying mechanism, however, remains largely complex and unknown.Objectives. We herein determine whether bacterial endotoxin (LPS) upregulates the activities of clotting factors in plasma, contributing to extrinsic hypercoagulation. Compound 48/80 (48/80) is also tested for its ability to suppress hypercoagulation.Methods. In an in vitro infection model, we exposed whole blood to LPS (Escherichia coli 0111:B04; 100 ng/ml) for 2 h. Thrombin time (TT), prothrombin time (PT), and the activities of clotting factors ( FVII, FIX, FX ) in plasma contributing to the extrinsic coagulation were determined. Peripheral blood monocytes were isolated from Histoplaque 1077 gradient centrifugation, and the procoagulant activity was determined by a single-stage clotting assay on a Fibrometer.Results. LPS drastically activated monocytic procoagulant activity which was defined as tissue factor (TF) activity, whereas LPS had no effect on TT, PT, and the activities of clotting factors in plasma. 48/80 not only instantaneously offset LPS-induced monocytic TF activation, but also significantly inhibited PT including the activities of clotting factors (FVII, FIX, and FX) in plasma, whereas TT remained unaffected.Conclusions. Monocytic TF activation was solely responsible for the extrinsic hypercoagulation in response to LPS. 48/80 effectively suppressed LPS-induced monocyticTF-initiated extrinsic coagulation at multiple sites, possibly presenting a new therapy for an instantaneous relief of hypercoagulation under septic conditions.

Glycyrrhizin gel as a vehicle for idoxuridine--I. Clinical investigations.

The therapeutic efficacy of a new formulation that incorporates 0.2% IDU in glycyrrhizin gel has been tested on patients who suffer from herpes of the lips and nose. The preparation was significantly more effective than a commercial 0.5% IDU ointment. It reduced the healing time and produced an almost instantaneous relief from pain. The higher efficacy of the new preparation may be ascribed to the reported anti-inflammatory and antiviral activities of glycyrrhizin together with an enhanced permeation of the IDU through the skin.

Some thoughts about opiopeptins, peptides with opiate-like activity

When the announcement was made late in 1975, that two closely related pentapeptides (enkephalins) with opiate-like activity had been isolated from porcine brain, there was much excitement. For the biologists not particularly interested in opiates, the finding meant that there were new fields to plow because the novel substances in all probability must be associated with unknown neurons with important physiologic functions. To the pharma- cologists, however, especially those who had been engaged in opiate research, this was tremendously uplifting. I recall saying to myself: Even without any facts, it was not too difficult for me to rationalize and formulate a plausible hypothesis involving the newly discovered peptides to explain heroin addiction. Persons finding it difficult to cope with the stresses of today's competitive society must have a deficiency of enkephalin. Instinctively, they crave heroin to remedy this aberration, and taking the replacement drug, gain instantaneous relief. However, this alleviation can only be temporary because repeated administration of the narcotic turns off the synthesis of the native opioid ligand and this results in further depletion of an already reduced supply. A compensatory mechanism must then develop to certain biochemical processes ordinarily inhibited by enkephalin. As they become increasingly suppressed by repeated high doses of the exogenous substitute a counter-adaptive response results in the inhibited sites developing suprasensitivity, and when the heroin is discontinued, the suprasensitive processes became manifest by an overshoot rebound or the withdrawal syndrome. Thus, now that the endogenous ligand is known it should not be too difficult to determine its physiologic role and sort out the processes it regulates. This knowledge should pave the way to explain acute opiate effects as well as tolerance and physical dependence. Seven years later I am somewhat less ebullient but still full of hope and optimism. Since the isolation of the enkephalins several more peptides with greater potency have been identified and the literature on peptides with

Management of intractable pain by neural therapy.

A total of 51 patients suffering pain of many years duration were treated by procaine-caffeine injections Into scar tissue remote from the site of the pain. In 39 cases, there was an Instantaneous relief.