Läkartidningen
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A pathophysiological mechanism named "nociceptive sensory sensitisation" is introduced to explain part of the fibromyalgia pain syndrome as well as several local or regional long standing pain conditions like epicondylitis, chronic low back pain, whiplash associated disorder, temporomandibular pain disorder and trochanteritis. The article is based on a vast rheumatological clinical experience on patients presenting with local or wide-spread pain, and on literature studies. ⋯ Sensory sensitisation should be considered as a pathophysiological reaction originating from tissues and organs exposed to "external" overload or trauma, either physical, chemical or biochemical. The sensitisation process is usually facilitated by "internal" psychological distress.
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Biography Historical Article
[Lars Hertervig and Edvard Munch. Two Norwegian artists balancing between sanity and madness].
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Randomized Controlled Trial Comparative Study Clinical Trial
[Home care for elderly cancer patients. More intensive follow-up and home services reduce the need of specialist care].
The effects of intensified primary health care were examined in the "Support-Care-Rehabilitation" project conducted in Uppsala county 1993-1997. Intensified primary health care was one part of an individual support intervention and comprised extended information about patients from the specialist clinics, and education and supervision in cancer care for GPs and home care nurses. The aim was to improve the ability of general practitioners and home care nurses to monitor and support cancer patients. ⋯ About 90% of intensified primary health care patients reported such contacts, compared to 26% of control patients. The number of days of hospitalization at the specialist clinics for elderly patients (> or = 70 yr.) randomized to the intervention group were 393 less than for elderly controls three months after diagnosis. The conclusion is that intensified primary health care constitutes a cost-effective strategy for enhancing co-operation between home care, primary health care and specialist clinics.