Der Schmerz
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The implementation of the cross-sectional subject of palliative care (Q13) at medical faculties in Germany is heterogeneous. In faculties without a chair for palliative medicine, other solutions are needed. ⋯ With the new teaching concept, medical students feel well prepared for the treatment of terminally ill and dying patients. The combination of different learning formats with an interdisciplinary and cross-sectoral focus promotes education with a practical orientation.
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Historical Article
[Pain asymbolia-discovered around 1930 by Paul F. Schilder, almost forgotten today?]
Paul Ferdinand Schilder was born in Vienna in 1886 and died in New York in 1940. Today he is remembered particularly as a psychoanalyst and a psychotherapist. His research in neuroscience, however, was also both comprehensive and innovative. ⋯ His publications on the condition are characterized by meticulousness, progressive thinking and critical reflection. He nosologically assigned pain asymbolia to the group of agnosias and integrated it into the concept of body image, which was a central issue in his entire scientific work. This article additionally addresses the question of whether Schilder's assumptions are still valid today and what consequences might arise from this.
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Epidermolysis bullosa (EB) is a rare genetic disease that soon becomes apparent after a child's birth. Mechanical stress in particular causes painful skin-blistering that potentially leads to numerous complications. Dressing materials fulfill important functions for children with EB: they help protect the skin, but create problems at the same time. ⋯ With their action-oriented expertise, parents can avoid additional skin damage caused during dressing changes. Here, the focus is on technical skills that lead to more comfort for the affected child and help parents to meet the challenge of dressing changes. Regarding the child's development, parents are continually confronted with new challenges and must adapt their old, or develop new, strategies.
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Complex regional pain syndrome (CRPS) is a disease of the limbs composed of various disorders and defined by the cardinal symptom of pain. So-called exergames with a combination of physical activity and fun are increasingly being offered as part of treatment. Exergame therapy could also provide CRPS patients with repetitive training, reward and motivation. ⋯ In this study the use of exergames proved to be a suitable tool for rehabilitation of the hand in adult CRPS patients. Whether exergames represent an effective rehabilitation strategy should be examined by means of functional and activity-related target criteria in a representative sample in a randomized controlled study.
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Calcitonin gene-related peptide (CGRP) is released from trigeminal afferents during migraine and cluster headache attacks and can be detected in the jugular plasma. Infusion of CGRP can induce headache attacks in migraine and cluster patients. Inhibition of the CGRP signal system is therapeutic in migraine and cluster headache. ⋯ Peripheral inhibition of the CGRP system reduces these actions. Outside the trigeminovascular system, CGRP is important for maintaining the perfusion of organs in critical situations, promotes growth and repair functions and is an immunomodulatory factor. These actions should be considered when the CGRP system is suppressed for a long time.