Der Schmerz
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Review Comparative Study
[Serotonin receptor 1A-modulated dephosphorylation of glycine receptor α3: a new molecular mechanism of breathing control for compensation of opioid-induced respiratory depression without loss of analgesia].
To control the breathing rhythm the medullary respiratory network generates periodic salvo activities for inspiration, post-inspiration and expiration. These are under permanent modulatory control by serotonergic neurons of the raphe which governs the degree of phosphorylation of the inhibitory glycine receptor α3. ⋯ Our physiological investigations show that this 5-HTR(1A)-GlyRα3 modulation allows treatment of respiratory depression due to opioids without affecting the desired analgesic effects of opioids. The molecular mechanism presented here opens new pharmacological possibilities to treat opioid-induced respiratory depression and respiratory disorders due to disturbed inhibitory synaptic transmission, such as hyperekplexia.
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The effect of interdisciplinary multimodal therapy of chronic back pain is well documented. With elapsing time changing diagnostic focuses, therapeutic strategies and objectives have to be considered. ⋯ The requirement of a rational causal therapy in chronic back pain still remains but the focal points shift to the consideration of somatic, psychological and social disposing and supporting factors. The aim of this paper is to reflect the necessary orthopedic expertise in the context of the pathomechanics of chronic back pain and the interdisciplinary teamwork.
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There is evidence on the importance of fear avoidance beliefs (FAB) as prognostic risk factors in elderly patients suffering from chronic low back pain (CLBP). However, so far there is no validated German instrument for measuring FAB in elderly CLBP patients. The aim of the study presented was to evaluate the psychometric properties of the Catastrophizing Avoidance Scale D-65+ (CAS-D-65+) within a population of elderly patients with CLBP. ⋯ As shown in this study the CAS-D-65+ is a reliable and a valid instrument for the assessment of FAB in older patients with CLBP.
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Comparative Study
[Back pain and social status among the working population: what is the association? Results from a German general population survey].
Little empirical evidence is available on differential associations between social status indicators and back pain in Germany. This study therefore systematically evaluated associations between different indicators of social status and back pain. ⋯ Back pain cannot generally be regarded as a symptom of a low social status. However, social inequality is of major importance regarding the prediction of severe back problems. A better understanding of mediating factors is essential for the prevention and therapy.
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The empirical findings on risk factors for a favorable/unfavorable outcome upraised via pain intensity, disability and functional capacity after empirically well-evaluated multimodal treatment are inconsistent. The objective of this study was to analyze the relevance of psychosocial and pain-related variables for therapeutic outcome in an unselected sample of patients with chronic non-specific back pain (CBP). ⋯ The calculated regressions showed only a moderate ability to predict or explain the outcomes pain intensity, disability and functional capacity. However, depression and body mass index (BMI) were significantly related to pain-related therapeutic outcome.