Schweizerische Rundschau für Medizin Praxis = Revue suisse de médecine Praxis
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Several distinct patterns of rheumatic manifestations can be seen throughout the course of Lyme borreliosis: intermittent and migratory musculoskeletal pain without objective findings, intermittent arthritis, chronic erosive arthritis, and joint deformities under affected skin in acrodermatitis chronica atrophicans. Commonly, Lyme arthritis is a late disease manifestation. A clinical history of extra-articular disease manifestations is the most reliable key to Lyme arthritis. ⋯ Otherwise, Lyme arthritis will be frequently over-diagnosed. Lyme arthritis can be cured with antibiotics. However, treatment failures occur with any of the hitherto recommended regimens.
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Advances in the technology of infusion pumps and ports have opened a new spectrum of indications. The choice of the device is dependent on the specific indication. ⋯ As demonstrated in several studies, ports can be safely used for chronic pain treatment. However, as with the use of infusion pumps, the indications for use must be evaluated carefully and especially-trained staff is a prerequisite for success.
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Schweiz. Rundsch. Med. Prax. · Mar 1993
[Chronic tumor pain and opiates: a survey of prescription practice among physicians of German-speaking Switzerland].
Motivated by clinical experience that opioids are still not administered adequately in cancer pain, a survey about their use involving 1200 physicians of the German-speaking part of Switzerland was conducted. The results confirm that a part of the treating physicians uses opioids not rationally, but that the majority follows established guidelines in the treatment of cancer pain. The results are compared and discussed with the current literature on the management of cancer pain.
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Schweiz. Rundsch. Med. Prax. · Mar 1993
Review[Pain assessment and documentation in patients with tumors: theory and reality].
Each tumor patient with pain is not only entitled to a careful diagnostic workup and to effective treatment of his pain syndrome, but also to a clear and useful documentation of the course of his pain(s). This documentation ('pain evolution chart') should at least include the main location(s) of the treated pain and the varying pain intensity during the course of the day as well as at night. A respective pain documentation instrument, the St. ⋯ The 'pain evolution chart' should be a regular part of the patient's hospital chart, as it forces the patient and his care-givers to cope more constructively with the present pain syndrome. The (well instructed) patient himself is responsible for an accurate and realistic pain documentation. Such longitudinal 'pain evolution charts' are not only useful for clinical oncology practice but also for clinical pain and analgesic research.
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Pain as a psychophysical experience and in particular its treatment have always been--and are particularly nowadays--an essential problem in medicine. Beyond that pain has a multitude of connections to human existence. The phenomenon of pain appears in almost all areas of art (painting, sculpture, music and poetry), philosophy and the religions. ⋯ Both belong together in an inseparable act of passive acceptance and active creative experience. Whereas the phenomenon of pain has earlier been seen in its alternative respective components such as physical or spiritual, it is in modern times, following the holistic perception of medicine, regarded as complementary. This complementary view is also the basis for the various forms of combined pain-treatment in use today.