Der Schmerz
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Chronic pain is a frequent and disabling health problem in children and adolescents and is associated with high health care utilization and costs. ⋯ An effective multimodal pain therapy may reduce health care costs in children and adolescents. Further economic studies are needed to evaluate long-term effects of pain therapy for children and adolescents with chronic pain in a controlled design.
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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.
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National and international surveys have shown that the quality of pain therapy in hospitals shows deficits, especially in the nonoperative disciplines. ⋯ In addition to the perioperative modules of QUIPS, QUIKS (quality improvement in conservative pain management), an instrument for quality assurance of pain treatment in patients in nonoperative disciplines, is now available.