Der Schmerz
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Review
[Chronic migraine and headache by medication overuse. Evolution and revision of classification].
The first International classification of headache disorders (ICHD-I) described migraine as a recurring headache disorder manifesting in attacks lasting 4-72 h. The headache frequency was not considered in these first diagnostic criteria of migraine. Thus, a chronic migraine with at least 15 migraine days per month was only included in the ICHD-II in 2004. ⋯ The term transformed migraine describes the transformation of an episodic migraine into a chronic one, whether medication overuse had been present or not. Up till now a widely accepted definition of chronic migraine and medication overuse headache has not been established due to different views. An overview of the evolution of the diagnostic criteria for both headache disorders in recent years is provided.
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Anesthesiology departments were often integrated into the primary formation of palliative activities in Germany. The aim of this study was to present the current integration of anesthesiology departments into palliative care activities in Germany. ⋯ Until 2005 many university palliative care activities had their origins in cancer pain services. These were often integrated into anesthesiology departments. Currently, anesthesiology departments work as an integrative part of palliative medicine. However, it appears from the present results that there is a domination of internal medicine (especially hematology and oncology) in palliative activities in German hospitals. This allows the focus of palliative activities to be formed by subjective specialist interests. Such a state seems to be reduced by the integration of anesthesiology departments because of their neutrality with respect to faculty-specific medical interests. Advantages or disadvantages of these circumstances are not considered by the present investigation.
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Multicenter Study Comparative Study Controlled Clinical Trial
[Evaluation of the "initiative pain-free clinic" for quality improvement in postoperative pain management. A prospective controlled study].
Demonstration of improved postoperative pain management by implementation of the S3 guidelines on treatment of acute perioperative and posttraumatic pain, by the integrated quality management concept "quality management acute pain" of the TÜV Rheinland or by participation in the benchmark project "Quality improvement in postoperative pain management" (QUIPS). ⋯ The main objective of the certification concept quality management acute pain as a tool for the successful implementation of the S3 guidelines on treatment of acute perioperative and posttraumatic pain, led to a significant improvement in patient outcome. Participation in QUIPS is an ideal supplement to TÜV Rheinland certification and can be recommended as a benchmarking tool to evaluate outcome.
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Pain in the legs belongs to the five most frequent regional pain symptoms. Restless legs syndrome (RLS) presents a particular differential diagnosis for pain in the legs, which is characterized by a nocturnal urge to move the legs often associated with painful sensations in the legs. ⋯ In this overview, the diagnosis and therapy of RLS as well as aspects of pain therapy of the disorder are presented. In addition, the differential diagnoses for exclusion of other specific causes of nocturnal pain in the legs are discussed.
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Comparative Study
[The German version of parents' postoperative pain measure (PPPM-D). Validation on children 2-12 years old].
Parents become increasingly more responsible for the postoperative pain management of their children. Useful and valid pain assessments for parents may improve pain measurement. The aim of this study was to evaluate a German version of the parents' postoperative pain measure (PPPM-D). ⋯ The results of this study provide evidence of the reliability, validity and high acceptance of the PPPM-D as an assessment tool of postoperative pain among children aged 2 through to 12 years of age after orthopedic or trauma surgery.