Neuroendocrinol Lett
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Neuroendocrinol Lett · Jan 2013
Case ReportsFear of pain and movement in a patient with musculoskeletal chronic pain.
Pain-related fear may pose a serious barrier in the management of patients with chronic musculoskeletal pain, resulting in severe functional impairment in many cases. The paper describes the cognitive-behavioural therapy of a patient with a specific phobia (fear of pain and movement). The principal objective of the therapy was to educate the patient in strategies and skills to manage his fear and to verify the effect of the therapy. ⋯ Group multimodal therapy of pain was provided by an interdisciplinary team of health care providers, specialising in pain management (psychotherapist, doctors and physiotherapists). The programme was based on operant therapy principles and included pacing and graded exercising and walking, relaxation, group education about ergonomics, and fear and pain relapse prevention. Reduction in the fear of pain and movement was achieved, and social bonds and physical and social activities improved after the psychotherapy, while the results were stable for two years.
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Neuroendocrinol Lett · Jan 2013
Comparative Study Clinical TrialCore needle biopsy of thyroid nodules - evaluation of diagnostic utility and pain experience.
A crucial problem in the non-operative diagnosis of thyroid nodules is the significant amount of non-diagnostic biopsies. This is a challenge for practicing endocrinologists especially when the results of the repeated biopsies remain non-diagnostic. The lack of a concrete preoperative diagnosis may result in unnecessary thyroidectomies in patients. Alternatively, it may also lead to the delayed diagnosis of cancer. One method of biopsy specimen acquisition that could potentially increase the diagnostic accuracy of thyroid biopsies is the application of core-needles. The aim of the study was to compare the diagnostic value and patient tolerability of core-needle aspiration biopsies (CNAB) with fine-needle aspiration biopsies (FNAB). ⋯ CNAB did not prove to be superior to FNAB. Despite the larger needle gauge used during core-needle biopsies, the patients' tolerability was comparable to conventional fine-needle biopsies.
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Neuroendocrinol Lett · Jan 2013
Randomized Controlled TrialRelationship of ketamine's antidepressant and psychotomimetic effects in unipolar depression.
Ketamine and other NMDA (N-methyl-D-aspartate) antagonists produce fast-acting antidepressant-like effects, although the underlying mechanism is unclear. Furthermore, high affinity NMDA antagonists such as ketamine are associated with psychotomimetic effects. To date the link between the antidepressant and psychotomimetic effects of ketamine has not been explored. We examined the relationship between the antidepressant and psychotomimetic effects of a single ketamine infusion in subjects diagnosed with major depressive disorder. ⋯ The substantial relationship between ketamine's antidepressant and psychotomimetic effects was found. This relationship could be mediated by the initial steps of ketamine's action, trough NMDA receptors, shared by both ketamine's clinical effects.
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Neuroendocrinol Lett · Jan 2013
Randomized Controlled Trial"Mesodiencephalic" modulation in the treatment of diabetic neuropathy.
Aim of the study was to verify the efficacy of "mesodiencephalic" modulation (MDM), as named by the commercial promoters, in reducing symptoms accompanying painful diabetic neuropathy and in improving mental health. ⋯ The study did not demonstrate any positive effect of MDM on painful diabetic neuropathy compared to placebo, relative to pain or mental state evaluations. The study emphasizes the need of using placebo-controlled studies, especially when testing a new analgesic drug or a method for pain modulation.
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Neuroendocrinol Lett · Jan 2013
Comparative Study Clinical TrialThe comparison of general anaesthesia using the bispectral analysis (BIS) and spinal anaesthesia in terms of the one-day health care for haemorrhoid surgery using the HAL-RAR method.
The gradual advancement of one-day surgery and conjoint ambulatory anaesthesia results from possibilities to execute mini-invasive surgeries. Such surgeries offer great benefits to the patient due to faster reconvalescence and less pain as well as faster return to normal life. The HAL-RAR method for haemorrhoid surgery, introduced as early as in 1995 by Dr. Morigan in Japan. ⋯ BIS is a processed EEG parameter measuring the hypnotic effect of hypnotics and sedatives in brain. BIS helps to reduce the use of anaesthetics during anaesthesia. Our results are promising and we continue in the study, monitoring also other possible parameters.