Articles: patients.
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An outpatient treatment programme for pain control was applied in 25 chronic pain patients in three general medical practices, supervised by a medical psychologist as a group therapist. The patients has been suffering from headaches, migraines, cervical pain, shoulder and arm pain, and low back pain for at least 6 months. A sample of 20 patients with the same disorders served as a control group which waiting for treatment. ⋯ Nonetheless, all the subjects treated showed improvements in their average scores for trait anxiety, depression and symptoms complaints compared with the untreated controls. Our results indicate a long-term improvement in well-being as a result of the treatment. Treatment adherence seems to be the most important factor in the maintenance of long-term reduction of pain intensity.
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The gate control theory resulted in intensified consideration and investigation of psychological factors in the pathogenesis and continuation of chronic pain. This had led to an increasing interest in the efficacy of psychotherapy for such patients. The different forms of psychotherapy (hypnosis, relaxation, behavior therapy, psychodynamically oriented therapy) currently most often applied are reviewed with notes on the methods and the efficacy recorded for each. ⋯ The small numbers of patients evaluated in most of the studies suggest that the population investigated may well not be representative, especially if the difficulty of motivating chronic pain patients to present for psychotherapy is taken into account. In addition, a diagnostic classification of the population investigated is lacking. Conclusions are drawn for the planning of future therapy studies.
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Journal of anesthesia · Mar 1989
Effects of anesthetic and related agents on calcium-induced calcium release from sarcoplasmic reticulum isolated from rabbit skeletal muscle.
We have investigated the effects of anesthetic and related agents on Ca(2+)-induced Ca2+ release (CICR) in heavy sarcoplasmic reticulum isolated from rabbit skeletal muscle. The purpose of this study is to elucidate their possible role as triggering agents in malignant hyperthermia (MH). ⋯ It is unlikely that lidocaine is a potent facilitator of CICR at any concentrations. We conclude that procaine, lidocaine, non-depolarizing muscle relaxants and opiate can be used safely for MH susceptible patients and that ketamine and succinylcholine are not recommended.
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Journal of anesthesia · Mar 1989
A new closed-system using partially frozen injectate for thermodilution cardiac output determinations.
The FI (partially frozen injectate) system, a new closed-system devised by the authors for thermodilution cardiac output determinations, has two major features: 1) it needs no ice-filled receptacle to keep injectate cold because it uses partially frozen injectate, and 2) it can go without monitoring the injectate temperatures during the whole process of cardiac output determinations. The author evaluated the accuracy and reproducibility of cardiac output determinations with the FI system in 10 critically ill patients, as compared with another closed-system (which is commercially available) and the standard open method. ⋯ Even when no monitoring of injectate temperatures was made, the predicated error in the calculated cardiac output resulted as low as 2% with the FI system. The mean cardiac output values were not statistically different between the FI system and the other two systems.
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During the 1960s, it was observed that the tricyclic antidepressant imipramine was effective in the treatment of neuralgia, myalgia, and pain in carcinoma. Similarly, in other studies, clomipramine was also found to have an analgesic effect. The sedative antidepressant amitriptyline has proved effective in migraine prophylaxis, chronic tension headache, and psychogenic musculoskeletal and neuralgic facial pain. ⋯ The remaining tricyclic and the tetracyclic antidepressants have not been sufficiently well evaluated. This is also true of monoamine oxidase inhibitors, of which individual reports to date suggest are probably also effective as analgesics. A scientific investigation into the possible differences in the effectiveness of various antidepressants in specific chronic pain conditions is an important task for the future.