Der Schmerz
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Physical, sexual and emotional abuse in childhood and adolescence is considered to play a role in the etiology and generalization of chronic pain in adulthood. However, it remains unclear whether abuse is specifically associated with different dimensions of nonspecific chronic low back pain (CLBP) and if these associations are mediated by psychological symptoms. ⋯ The influence of childhood abuse on CLBP is different for specific pain dimensions; therefore, CLBP should be faced as a complex construct that comprises different dimensions. Childhood abuse is suggested as a risk factor for spreading pain in CLBP persons; therefore, CLBP patients reporting additional pain locations might benefit from diagnostic and therapeutic interventions specific for childhood abuse experiences.
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Controlled Clinical Trial
[Symptom control and place of death in palliative cancer patients in primary care : Results of the controlled PAMINO evaluation study.]
The care of patients at the end of life focuses on preservation of the quality of life, symptom control and fulfillment of the preferred place of death. Only few care and outcome-related data for primary palliative care in Germany are available; therefore, the objective was to examine the quality of life, symptom control and place of death of patients with palliative treatment by general practitioners (GP). ⋯ Stable emotional functioning, good symptom control in cancer patients at the end of life and the high rate of dying at home as preferred suggest that GPs with specific training can ensure high-quality general palliative care.
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The aim of the study was to compare the opioid piritramide (7.5 mg/ml) which is commonly used in Germany (equipotential 5 mg morphine) to oxycodone (10 mg/ml) when given for patient-controlled intravenous analgesia (PCIA) in surgical disciplines, such as general surgery, orthopedic surgery, trauma surgery and gynecological surgery. Typical side effects of the respective opioids and safety of the procedures were compared. Oxycodone is available both as parenteral and oral formulations. ⋯ The direct comparison of piritramide and oxycodone showed advantages for oxycodone in terms of typical opioid side effects. The effectiveness of analgesia was comparable in both groups.
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Quantitative sensory testing (QST) is a standardized and formalized set of clinical sensitivity tests based on subjective (psychophysical) methods, which depends on the cooperation of the subject being investigated. Calibrated stimuli are used to measure the perception and pain thresholds, which provide information on the presence of sensory plus or minus signs. The QST equipment presented mimics natural thermal or mechanical stimuli. ⋯ The majority of QST parameters are normally distributed only after logarithmic transformation (i.e. secondary normalization). With QST a complete somatosensory profile can be obtained within 1 h. The QST is a suitable method for characterizing the function of the somatosensory system in clinical trials and also in clinical practice as a diagnostic procedure.