Therapeutische Umschau. Revue thérapeutique
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Palliative Care is an approach that improves quality of life of patients in complex situations with life-threatening illness. The relief of suffering is important. In this meaning palliative care has a lot to do with symptomatic therapy, because we can't treat the underlying illness. ⋯ We have only one evidence-based pharmacological treatment of dyspnoea, that's morphine. The decision whether to give or not nutrition to a patient with advanced cancer or advanced dementia seems to be a difficult one. But if we have a look into the literature it's much easier to decied, because there is almost no advantage for the patient if we nourish him.
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Polymyalgia rheumatica and Fibromyalgia are probably not distinct clinical entities. Rather polymyalgia rheumatica is the common denomiator of a large spectrum of different diseases. ⋯ Similarly, fibromyalgia is one manifestation of chronic pain syndromes of undetermined etiology. In addition, fibromyalgia can often not be delineated clearely from functional disorders, including depression.
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Medication overuse headache (MOH) occurs in about 1% of the general population. A marked increase of its prevalence has to be expected in the future, since more and more adolescents are subject to medication overuse. The revised International Classification of Headache Disorders contains detailed diagnostic criteria for headache due to particular groups of substances. ⋯ Long-term treatment for headache is ineffective during medication overuse. Relapse rate is variable depending on the substance overused, and may be considerable. Therefore, prophylaxis in patients with migraine or chronic tension type headache who do not yet suffer from MOH, is essential.