Der Schmerz
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Review Meta Analysis
[Recommendations of the second update of the LONTS guidelines : Long-term opioid therapy for chronic noncancer pain].
The second scheduled update of the German S3 guidelines on long-term opioid therapy for chronic noncancer pain (CNCP), the LONTS (AWMF registration number 145/003), was started in December 2018. ⋯ A responsible administration of opioids requires consideration of possible indications and contraindications as well as regular assessment of efficacy and adverse effects. Opioids remain a treatment option for CNCP if nonpharmacological therapies are not effective and/or other drugs are not effective, are not tolerated or are contraindicated.
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Review Meta Analysis
Efficacy, tolerability and safety of cannabis-based medicines for cancer pain : A systematic review with meta-analysis of randomised controlled trials.
The importance of medical cannabis and cannabis-based medicines for cancer pain management needs to be determined. ⋯ Very low quality evidence suggests that oromucosal nabiximols and THC have no effect on pain, sleep problems and opioid consumption in patients with cancer pain with insufficient pain relief from opioids. The complete manuscript is written in English.
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Review Meta Analysis
[Etiology and pathophysiology of fibromyalgia syndrome : Updated guidelines 2017, overview of systematic review articles and overview of studies on small fiber neuropathy in FMS subgroups].
The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was planned for April 2017. ⋯ Fibromyalgia syndrome is most probably the end result of various pathogenetic factors and pathophysiological mechanisms.
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Review Meta Analysis
[Chronic low back pain and psychological comorbidity : A review].
Back pain is a common, disabling problem in Germany. Previous research has evaluated associations between low back pain (LBP), depression, and fear. ⋯ The results can improve the understanding of the complexity of LBP perception and its therapy. The generalization of the results is limited. To cover the correlation of psychosocial and lifestyle factors and pain perception of LBP, further research is required. To obtain a clearer picture of pain perception in persons with LBP, standardized pain assessment would be beneficial. In addition, we recommend that future studies follow standardized procedures to allow greater comparability.
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Review Meta Analysis
[Recommendations for treatment of fibromyalgia : Where will we stand in 10 years?]
This article elucidates changes in the recommended diagnostics and therapy of fibromyalgia (FM). The recommendations from major internationally recognized guidelines are compared with the newest recommendations of the European League Against Rheumatism (EULAR) that in contrast to the guidelines surprisingly recommend physical exercise after patient education for all FM patients. ⋯ Finally, we try to predict how patients will be treated 10 years from now, for which knowledge from the guidelines and the initial approaches that diagnosed heterogeneity in FM are included. Empirically based questions will drive mechanism-based approaches as opposed to simply reacting to symptoms, in order to meet the challenge of an individual, mechanism-oriented treatment.