Der Schmerz
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Randomized Controlled Trial
[The impact of catastrophizing on the effect of depression on pain and functional ability : A longitudinal mediator analysis].
While the association between pain and depression is well proven, little is known about the mechanisms influencing this relationship. The cognitive distortion of catastrophizing plays a significant role in several concepts of both diseases. ⋯ Catastrophizing mediates the relationship between depression and pain as well as functional capacity; therefore, the reduction of catastrophizing thoughts and attitudes should be a focus in rehabilitation programs.
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The assessment of pain as a part of adequate pain management is an integral part of the clinical routine. Much research has been carried out concerning use, relevance and validity of different assessment scales; however, patients' perspective of pain assessment has not yet been studied in Germany. The aim of the present study was to collate patients' experiences regarding pain assessment based on the numeric rating scale (NRS). ⋯ The survey results indicate that the validity of the measurement and therefore the indicated therapy is influenced by subjective concepts. Patients themselves suggested alternatives for detecting the quality of pain. The data should be replicated in larger samples and also take possible influences on the perception of the assessment into account.
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Comparative Study
[Preoperative, neuropathic component in patients with back pain].
The objectification of pain is essential for evaluation, treatment plan and follow-up; therefore, it is necessary to find reliable clinical parameters. ⋯ The painDETECT questionnaire was shown to be a very suitable instrument for evaluating the neuropathic pain component in patients with dorsalgia. This could be very useful in planning further therapy.
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Review
[Dipyrone (metamizole) : Considerations on monitoring for early detection of agranulocytosis].
Dipyrone (metamizole) is a non-opioid analgesic commonly used in Germany, which can, in very rare cases, cause life-threatening agranulocytosis. The prescribing information calls for regular monitoring of the differential blood count in cases of long-term treatment. However, there is uncertainty about how this testing should be handled in practice. ⋯ Providing patients and medical staff with better information about early symptoms of agranulocytosis could be a sensible way to prevent complications. Any suspicion of agranulocytosis should immediately lead to a differential blood count and to the withdrawal of all drugs possibly associated with agranulocytosis. Patients should be monitored and treated according to the severity of their symptoms.