Journal of the European Academy of Dermatology and Venereology : JEADV
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J Eur Acad Dermatol Venereol · Oct 2007
Quality of clinical practice guidelines in dermatological oncology.
Clinical practice guidelines are increasingly used. To determine the quality of guidelines the Appraisal of Guidelines and Research and Evaluation (AGREE) instrument was developed and introduced in 2001. The AGREE instrument consists of 23 criteria, grouped in six domains. ⋯ Guidelines in dermatological oncological care are of reasonable quality according to the AGREE instrument. The domains in the AGREE instrument concern especially the methods of development of guidelines. The score according to AGREE can be improved by explicitly mentioning the different items. As clinical guidelines are regarded to be an important instrument to improve quality of care, improvements are needed.
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J Eur Acad Dermatol Venereol · Oct 2007
Generalized and symptom-specific sensitization of chronic itch and pain.
Physicians are frequently confronted with patients reporting severe itch and pain. Particularly in patients suffering from persistent itch and pain, central and peripheral sensitization processes are assumed to be involved in the long-term maintenance and aggravation of the symptoms. The present study explores generalized and symptom-specific sensitization processes in patients suffering from persistent itch and pain. Specifically, it examines whether patients with chronic itch and pain are more sensitive to somatosensory stimuli (generalized sensitization) and simultaneously perceive somatosensory stimuli as a symptom of their main physical complaint, e.g. pain in chronic pain patients (symptom-specific sensitization). ⋯ The present study provides preliminary support that both generalized and symptom-specific sensitization processes play a role in the regulation and processing of somatosensory stimulation of patients with chronic itch and pain.