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As with dentoalveolar infections, the inmate may be triaged and stabilized by MLPs or physicians and seen by the dentist at dental sick call. The system must be designed to allow for inmates to be seen within 24 hours for stabilization of their pain and an evaluation of its source. Pain associated with denture irritation can be stabilized by leaving the denture out until the inmate may be seen by a dentist. Level two is primarily associated with the dental daily sick call or other requests for urgent care. Inmates with intermittent or constant pain, an inability to eat, and other dental symptoms that cause discomfort should have access to assessment and the initiation of treatment within 24 hours by a dentist, physician, or appropriately trained MLP. Examples of Level 2 care are toothaches, infections, and pain of apparent maxillofacial origin. Level 3 is disease control or routine care. The acute problems have been stabilized in Levels 1 and 2. Inmates who enter this level require a comprehensive treatment plan. When an inmate progresses to Level 3, he should be free from infection; and pain that interferes with normal daily activities. 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"clause", "offset": [8360, 8373]}, {"key": "information-which", "type": "clause", "offset": [8465, 8482]}, {"key": "based-on", "type": "clause", "offset": [8486, 8494]}, {"key": "the-facts", "type": "clause", "offset": [8502, 8511]}, {"key": "pertaining-to", "type": "definition", "offset": [8512, 8525]}, {"key": "state-of", "type": "definition", "offset": [8555, 8563]}, {"key": "medical-knowledge", "type": "clause", "offset": [8564, 8581]}, {"key": "before-signing", "type": "clause", "offset": [8685, 8699]}, {"key": "the-standard", "type": "clause", "offset": [8796, 8808]}, {"key": "basis-of", "type": "clause", "offset": [8874, 8882]}, {"key": "an-individual", "type": "clause", "offset": [8912, 8925]}, {"key": "subject-to-change", "type": "clause", "offset": [8939, 8956]}], "samples": [{"hash": "ccPQONAaW6Z", "uri": "/contracts/ccPQONAaW6Z#pain", "label": "Safety With Injectables", "score": 25.7941463339, "published": true}], "size": 1, "snippet": "Discomfort associated with DC injections is normal and usually of a short duration. It is possible to have a fainting episode (vasovagal) from discomfort or anxiety about the injections. Procedural discomfort is managed with oral pain medicine, local anesthesia injections before DC is injected, and over the counter analgesics. Complications (adverse events) Potential complications attributable to the injection of DC for fat reduction in the chin and jawline are: Damage to Marginal Mandibular Nerve - DC injections in the area of the marginal mandibular nerve, which is located in the vicinity of the jaw bone can occur. This would produce diminished motion in the corner of the mouth. According to data from the research on DC, this is a rare complication and generally resolves over time. Difficulty to swallow - Difficulty to swallow has been reported in a few patients that have undergone DC injections. Typically, this resolves. Individuals who have a history of swallowing difficulties may not be suitable for DC injections. Infection - Although infection following injection of DC is unusual, bacterial, fungal, and viral infections can occur. Should any type of skin infection occur, additional treatment including antibiotics may be necessary. Damage to deeper structures - Deeper structures such as nerves, salivary glands, and the neck muscles may be damaged during the course of injection. Injury to deeper structures may be temporary or permanent. Temporary numbness can occur in the area where DC is injected. Skin Necrosis - It is very unusual to experience death of skin and deeper soft tissues after DC injections. Skin necrosis can produce unacceptable scarring. Should this rare complication occur, additional treatments, or surgery may be necessary. Granulomas and Fat Necrosis - Painful masses in the skin and deeper tissues after a DC injection are extremely rare. Should these occur, additional treatments including antibiotics or surgery may be necessary. These may produce scarring within the skin and deeper structures. Allergic Reactions and Hypersensitivity - As with all injectable products, allergic reactions may occur. Allergic reactions may require additional treatment. It is unknown if DC is associated with serious systemic anaphylactic allergic reactions. Accidental Intra-arterial injection - One of the risks with using this product is unintentional injection into a blood vessel. The chances of this happening are very small and may not be of consequence, as DC has been given intravenously to treat medical conditions. Under / Over Correction - The injection of DC to fullness in the chin and jawline may not produce the desired outcome. The amount of correction may be inadequate or excessive. It may not be possible to control the process of injection of DC due to factors attributable to each patient\u2019s situation. If under correction occurs, you may be advised to consider additional injections of DC. Over correction may require additional treatment. Additional Advisories Advisories for patients considering DC injections: Off-label usage of DC- DC, is labeled for specific use in the reduction of fat deposits of the chin and jawline. The use of DC for other conditions and disorders would be considered \u201coff- label\u201d usage by your physician. FDA defines off label use as, \u201cUse for indication, dosage form, dose regimen, population or other use parameter not mentioned in the approved labeling.\u201d The FDA recognizes that off label use of drugs by prescribers is often appropriate and may receive endorsement from published literature. DC may be used according to a physician\u2019s practice to treat other conditions. Unsatisfactory Result - DC injections alone may not produce an outcome that meets your expectations for improvement in fullness of the chin and jawline. There is the possibility of a poor or inadequate response. Additional injections may be necessary. Surgical procedures or other treatments may be recommended. Unknown Risks - There is the possibility that additional risks and complications attributable to the use of DC injections may be discovered. Migration of DC - DC may migrate from its original injection site and produce changes in adjacent tissue or other unintended effects. Drug and Local Anesthetic Reactions - There is the possibility that a systemic reaction could occur from either the topical or local anesthetic or epinephrine used for sensory nerve block anesthesia when DC injections are performed. This would include the possibility of light-headedness, rapid heartbeat (tachycardia), and fainting. Medical treatment of these conditions may be necessary. Combination of Procedures - In some situations, off-label neurotoxin injections or other types of treatments may be used in addition to DC in order to specifically treat areas of the chin and jawline or to enhance the outcome from DC therapy. The effect of other forms of external skin treatments (laser and HIFU therapies, on tissue that has been treated with DC is unknown. The effect of DC injections into tissue that has been formerly treated with other types of treatments (laser, liposuction) is unknown. Pregnancy and Nursing Mothers - Animal reproduction studies have not been performed to determine if DC could produce fetal harm. It is not known if DC or its breakdown products can be excreted in human milk. It is not recommended that pregnant women or nursing mothers receive DC treatments. Drug Interactions - It is not known if DC reacts with other drugs within the body. Long-Term Effects - DC injections should not be considered as a permanent treatment for fullness in the chin and neck region. Over time, wrinkles or soft tissue looseness may appear. Subsequent alterations in face and neck appearance may occur as the result of aging, weight loss of gain, sun exposure, or other circumstances not related to DC injections. Future surgery or other treatments may be necessary. DC injections do not arrest the aging process or produce permanent tightening of the skin or improvement in wrinkles of the chin and jawline. Health Insurance Most health insurance companies exclude coverage for cosmetic surgical procedures and treatments or any complications that might occur from the same. Health insurance companies may not pay for DC injections used to treat medical conditions. Please carefully review your health insurance subscriber information pamphlet. Additional Treatment Necessary There are many variable conditions in addition to risk and potential complications that may influence the long-term result of DC injections. Even though risks and complications occur infrequently, the risks cited are the ones that are particularly associated with DC injections. Other complications and risks can occur but are even more uncommon. Should complications occur, additional surgery or other treatments may be necessary. You are advised to seek medical care should complications or adverse events occur after tissue filler treatments. Although good results are expected, there is no guarantee or warranty expressed or implied, on the results that may be obtained with the use of DC injections. The practice of medicine and surgery is not an exact science. Financial Responsibilities This treatment provides a defined amount of DC for the treatment of fullness under the chin and jawline due to fat deposits. If additional interim injections of DC are needed in order to maintain or improve results, you will be responsible for these costs in addition to the cost of this treatment session. It is unlikely that DC injections to treat cosmetic problems would be covered by your health insurance. Additional costs of medical treatment would be your responsibility should complications develop from DC injections. You would also be responsible for additional forms of treatments or surgery recommended to improve the appearance of fullness under the chin and jawline. Disclaimer Informed-consent documents are used to communicate information about the proposed treatment of a disease or condition along with disclosure of risks and alternative forms of treatment(s). The informed-consent process attempts to define principles of risk disclosure that should generally meet the needs of most patients in most circumstances. However, informed consent documents should not be considered all-inclusive in defining other methods of care and risks encountered. Your physician may provide you with additional or different information which is based on all of the facts pertaining to your particular case and the state of medical knowledge. It is important that you read the above information carefully and have all of your questions answered before signing the consent on the next page. Informed-consent documents are not intended to define or serve as the standard of medical care. Standards of medical care are determined on the basis of all of the facts involved in an individual case and are subject to change as scientific knowledge and technology advance and as practice patterns evolve.", "hash": "67c16ba41ddad9921721485b1106eacb", "id": 4}, {"snippet_links": [], "samples": [{"hash": "8w5SDj4c8l2", "uri": "/contracts/8w5SDj4c8l2#pain", "label": "Doctoral Thesis", "score": 31.6060002711, "published": true}], "size": 1, "snippet": "Published online 2003. doi:10.1016/S0304-3959(02)00484-0", "hash": "c9cc7944918fd1d1744726ab1df44613", "id": 5}, {"snippet_links": [{"key": "the-national", "type": "clause", "offset": [159, 171]}, {"key": "chronic-pain", "type": "definition", "offset": [213, 225]}, {"key": "in-the-united-states", "type": "clause", "offset": [401, 421]}, {"key": "heart-disease", "type": "clause", "offset": [519, 532]}, {"key": "march-2019", "type": "clause", "offset": [593, 603]}, {"key": "terms-of", "type": "definition", "offset": [647, 655]}, {"key": "rehabilitation-expenditures", "type": "definition", "offset": [677, 704]}, {"key": "according-to", "type": "definition", "offset": [843, 855]}, {"key": "health-problem", "type": "definition", "offset": [944, 958]}, {"key": "development-of", "type": "clause", "offset": [1108, 1122]}, {"key": "the-fda", "type": "clause", "offset": [1214, 1221]}, {"key": "treatment-of-pain", "type": "definition", "offset": [1230, 1247]}, {"key": "an-extended", "type": "clause", "offset": [1291, 1302]}, {"key": "product-candidate", "type": "definition", "offset": [1439, 1456]}, {"key": "treatment-options", "type": "clause", "offset": [1505, 1522]}, {"key": "research-study", "type": "definition", "offset": [1590, 1604]}, {"key": "stanford-university", "type": "definition", "offset": [1608, 1627]}, {"key": "at-risk", "type": "definition", "offset": [1668, 1675]}, {"key": "at-the-source", "type": "definition", "offset": [1713, 1726]}, {"key": "treatment-alternatives", "type": "clause", "offset": [1788, 1810]}, {"key": "the-properties", "type": "definition", "offset": [1873, 1887]}, {"key": "strategic-decision", "type": "definition", "offset": [1916, 1934]}, {"key": "associated-with", "type": "definition", "offset": [1962, 1977]}, {"key": "general-term", "type": "definition", "offset": [2062, 2074]}, {"key": "common-cause", "type": "definition", "offset": [2457, 2469]}, {"key": "all-risk", "type": "definition", "offset": [2589, 2597]}, {"key": "reduction-in", "type": "definition", "offset": [2736, 2748]}, {"key": "rate-of", "type": "clause", "offset": [2883, 2890]}, {"key": "and-exercise", "type": "clause", "offset": [3368, 3380]}, {"key": "patient-complaints", "type": "clause", "offset": [3616, 3634]}, {"key": "other-risk-factors", "type": "clause", "offset": [3732, 3750]}, {"key": "blood-pressure", "type": "definition", "offset": [3837, 3851]}], "samples": [{"hash": "hbt619o5j1u", "uri": "/contracts/hbt619o5j1u#pain", "label": "At the Market Offering Agreement", "score": 35.0762640755, "published": true}], "size": 1, "snippet": "Pain is a protective reaction that alerts the body to the presence of actual or potential tissue damage so that necessary corrective responses can be mounted. The National Institutes of Health (the \u201cNIH\u201d) defines chronic pain as pain that persists beyond the normal healing time of an injury or that persists longer than three months. It is estimated that chronic pain affects 100 million individuals in the United States and over 1.5 billion people worldwide; thus, more people suffer from chronic pain than diabetes, heart disease, and cancer combined (\u2587\u2587\u2587\u2587\u2587 Therapeutic Categories Outlook, March 2019). Chronic pain exacts a tremendous cost in terms of direct treatment and rehabilitation expenditures, lost worker productivity, prevalent addiction to opioid-based drugs, and emotional and financial burden for patients and their families. According to an Institute of Medicine of the National Academies report, pain is a significant public health problem in the United States that costs society between $560 billion and $635 billion annually. Despite the magnitude of the pain problem, innovation in the development of therapeutic solutions has been largely absent. Since 2010, there have been 20 approvals by the FDA for the treatment of pain, of which 12 were opioid variants, one was an extended-release generic corticosteroid, five were variants of aspirin, and two were variants of other existing drugs. We are developing a novel product candidate designed to overcome the limitations of current treatment options for patients with PAD who suffer from chronic pain. According to a research study by Stanford University, more than 24% of patients with PAD are at risk of high opioid use. By treating pain at the source and presenting patients and physicians with better and safer treatment alternatives, we expect to minimize opioids at the prescription pad. Given the properties of JAN101, we have made the strategic decision to focus initially on pain associated with PAD by treating the underlying cause of PAD. Peripheral artery disease (\u201cPAD\u201d) is a general term for conditions in which arterial blood flow to the limbs is partially blocked. When there is less blood present in the extremities relative to demand, muscle pain and fatigue result, especially in the calf, which is also known as \u201cintermittent claudication.\u201d In many patients, pain and fatigue are relieved through rest. Roughly half of patients with PAD are asymptomatic. The most common cause of PAD / intermittent claudication is atherosclerosis. Diabetes, chronic kidney disease, hypertension, and smoking are all risk factors that can increase the likelihood of PAD. In atherosclerosis, fat deposits (plaques) build up along arterial walls, resulting in a reduction in blood flow in the legs. This same process can cause strokes if the arteries leading up to the brain are affected. Because of the high rate of asymptomatic patients, prevalence figures vary widely. Some estimate that up to 200 million people worldwide have PAD, ranging from asymptomatic disease to severe. Prevalence increases as a function of patient age, rising sharply after the age of 60. Thus, in countries with an aging population, it is expected that the prevalence of PAD will only increase. There is also a strong ethnic and racial component to PAD prevalence, which may be due to cultural differences in diet and exercise, along with genetic differences. Some suggest a prevalence of eight to 12 million in the United States alone, with roughly one-third experiencing pain when walking, which improves upon resting. The diagnosis of PAD usually begins with patient complaints of pain in the extremities. If the patient is already being treated or monitored for diabetes or other risk factors, then the physician will check for a weak or absent pulse in the extremity. Decreased blood pressure, poor wound healing, and whooshing sounds (via stethoscope) in the legs are also tell-tale signs of PAD / intermittent claudication. Angiograms, electrocardiograms, and ultrasounds can also be used to image and confirm the diagnosis.", "hash": "714e86d1b0263cfd8b5e98deadc4a87a", "id": 6}, {"snippet_links": [{"key": "that-\u2587", "type": "clause", "offset": [92, 98]}, {"key": "please-read", "type": "clause", "offset": [204, 215]}, {"key": "package-insert", "type": "definition", "offset": [220, 234]}, {"key": "when-taken", "type": "clause", "offset": [267, 277]}], "samples": [{"hash": "7aoKOZOavIP", "uri": "/contracts/7aoKOZOavIP#pain", "label": "Patient Agreement and Informed Consent for Oral Surgery", "score": 22.3415468857, "published": true}], "size": 1, "snippet": "Usually peaks in the first 2 days following surgery and can be controlled by the medication that \u2587\u2587. \u2587\u2587\u2587\u2587\u2587 recommends (e.g. Advil/Motrin [ibuprofen]) or prescribes. They may be taken to relieve the pain (please read the package insert for dosages). These medications when taken on an empty stomach can cause stomach upset, nausea, etc. Please try to take your pain medication with food or fluids.", "hash": "641ea5cae5fe3455f82c0b33b80d324d", "id": 7}, {"snippet_links": [{"key": "the-criteria", "type": "clause", "offset": [43, 55]}], "samples": [{"hash": "8gpkzCvbfn4", "uri": "/contracts/8gpkzCvbfn4#pain", "label": "Research & Development and License Agreement (Spectrx Inc)", "score": 18.0, "published": true}], "size": 1, "snippet": "If [*] differ from conditions in [*], then the criteria for the [*].", "hash": "ca61bca075ecd9f7e759a70c8e90f626", "id": 8}, {"snippet_links": [{"key": "the-international-association", "type": "definition", "offset": [0, 29]}, {"key": "the-study", "type": "definition", "offset": [34, 43]}, {"key": "associated-with", "type": "definition", "offset": [123, 138]}, {"key": "nature-of", "type": "clause", "offset": [278, 287]}, {"key": "the-central", "type": "clause", "offset": [325, 336]}, {"key": "state-of", "type": "definition", "offset": [492, 500]}, {"key": "an-individual", "type": "clause", "offset": [501, 514]}, {"key": "chronic-pain", "type": "definition", "offset": [857, 869]}, {"key": "lack-of", "type": "clause", "offset": [1157, 1164]}, {"key": "employment-issues", "type": "clause", "offset": [1288, 1305]}, {"key": "substantial-burden", "type": "definition", "offset": [1321, 1339]}, {"key": "healthcare-system", "type": "definition", "offset": [1347, 1364]}, {"key": "in-general", "type": "clause", "offset": [1423, 1433]}, {"key": "according-to", "type": "definition", "offset": [1548, 1560]}, {"key": "quality-of-life", "type": "clause", "offset": [1614, 1629]}, {"key": "negative-impact", "type": "definition", "offset": [1675, 1690]}, {"key": "job-loss", "type": "definition", "offset": [1726, 1734]}, {"key": "responsible-for", "type": "clause", "offset": [1956, 1971]}, {"key": "emergency-department", "type": "definition", "offset": [2006, 2026]}, {"key": "from-work", "type": "clause", "offset": [2050, 2059]}], "samples": [{"hash": "c0HUiHaqlfN", "uri": "/contracts/c0HUiHaqlfN#pain", "label": "End User License Agreement", "score": 31.0365548502, "published": true}], "size": 1, "snippet": "The International Association for the Study of Pain (IASP) defines pain as \u201can unpleasant sensory and emotional experience associated with actual and potential tissue damage\u201d (Derbyshire, 1999). Research has illustrated that there is a significant degree of subjectivity to the nature of pain experience, which includes both the central and the peripheral nervous systems, influenced by multiple pain-modulating factors such as past painful experience, cognitive components and the emotional state of an individual (\u2587\u2587\u2587\u2587\u2587\u2587\u2587, 2013). There is also enormous variability among individual\u2019s pain experiences (\u2587\u2587\u2587\u2587\u2587\u2587 et al., 2012b). Pain is activated through special receptors called nociceptors, which recognize actual or potential tissue damage (Hall and \u2587\u2587\u2587\u2587\u2587\u2587, 2011). Pain that lasts and or recurs for more than three months or beyond the time of recovery is chronic pain (Merskey and \u2587\u2587\u2587\u2587\u2587\u2587, 1994a). In chronic pain conditions, physiochemical changes occur within the neural pathways, making them hypersensitive to pain stimuli and the signals are repeatedly triggered. (\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587, 2000). Persistent pain impacts all domains of life, such as disturbed sleep, lack of concentration, mood disorders and feeling fatigued, frustrated, and anxious. The stress and depression generate family and employment issues resulting in a substantial burden on the healthcare system (Turk and Okifuji, 2002). The prevalence of chronic pain, in general, is 43% in the UK; this equates to approximately just under 28 million of the UK population (\u2587\u2587\u2587\u2587\u2587 et al., 2016). According to a Canadian 2007/2008 pain survey, there is a reduced quality of life in more than 50% of individuals with pain, a negative impact on relationships of almost 29% and job loss or taking up less responsibilities for more than 50% of chronic pain patients (\u2587\u2587\u2587\u2587\u2587\u2587, 2011). Chronic pain conditions, in general, produce a significant degree of disability (Breivik et al., 2013) in the sufferer and are responsible for 21% of visits to the accident and emergency department and 25% of absenteeism from work annually (\u2587\u2587\u2587\u2587\u2587\u2587\u2587 and \u2587\u2587\u2587\u2587\u2587\u2587\u2587, 2012).", "hash": "ff8c7de3becdccd735c20d36a574f89d", "id": 9}, {"snippet_links": [], "samples": [{"hash": "kAuOvpIxv3X", "uri": "/contracts/kAuOvpIxv3X#pain", "label": "Medicinal Cannabis Treatment Agreement", "score": 22.8470171512, "published": true}], "size": 1, "snippet": "Author manuscript; available in PMC 2016 December 01. Author Manuscript Published in final edited form as:", "hash": "ecec3f73eafe03f85db14c97422ffdb7", "id": 10}], "next_curs": "Ck0SR2oVc35sYXdpbnNpZGVyY29udHJhY3RzcikLEhZDbGF1c2VTbmlwcGV0R3JvdXBfdjU2Ig1wYWluIzAwMDAwMDBhDKIBAmVuGAAgAA==", "clause": {"title": "Pain", "children": [], "size": 22, "parents": [["quality-of-life-in-rheumatoid-arthritis", "QUALITY OF LIFE IN RHEUMATOID ARTHRITIS"], ["the-right-time", "The Right Time"], ["attorneys-fees", "Attorneys' Fees"]], "id": "pain", "related": [["therapies", "Therapies", "Therapies"], ["virus-management", "Virus Management", "Virus Management"], ["psychological-services", "PSYCHOLOGICAL SERVICES", "PSYCHOLOGICAL SERVICES"], ["influenza-vaccine", "Influenza Vaccine", "Influenza Vaccine"], ["medication", "Medication", "Medication"]], "related_snippets": [], "updated": "2025-07-07T16:38:45+00:00", "also_ask": ["How can 'Pain' clauses be strategically leveraged in negotiations to incentivize performance?", "What essential elements must be included in a 'Pain' clause to ensure clarity and enforceability?", "What are the most common legal risks or pitfalls associated with poorly drafted 'Pain' clauses?", "How do courts typically interpret and enforce 'Pain' clauses compared to liquidated damages provisions?", "What industry or jurisdictional differences exist in the treatment of 'Pain' clauses?"], "drafting_tip": "Define 'pain' precisely to avoid ambiguity; specify measurement criteria to ensure enforceability; clarify remedies for pain to provide certainty for both parties.", "explanation": "The \"Pain\" clause typically defines additional compensation or incentives provided to a contractor or service provider when certain challenging or unfavorable conditions arise during a project. This clause outlines specific scenarios\u2014such as accelerated schedules, difficult working environments, or unexpected obstacles\u2014where the contractor may be entitled to extra payment or benefits. Its core practical function is to fairly allocate risk and motivate performance by compensating parties for enduring hardships beyond the original contract scope."}, "json": true, "cursor": ""}}