Articles: treatment.
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When treating a cancer patient with severe pain it is not sufficient to treat the cancer and the pain. Effective therapy must adhere to the principles of psychosomatic medicine, i.e., the disease, cancer, isnot treated, but instead a human being who is suffering from this disease, has severe, ongoing pain as a result, and is going to die. Irrespective of the question of whether the patient has been told his diagnosis or not, he will be in an extreme situation psychologically, as he instinctively suspects what is wrong with him. ⋯ If, however, they receive the proper guidance, they will live more consciously and more intensively. In the awareness of imminent death they can experience every day of their life as a gift. Care of terminally ill cancer patients with severe pain thus also must include a guided approach to death.
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We reviewed maternal deaths in the state of Michigan occurring from 1972 through 1984. There were 15 maternal deaths in which anesthesia was considered the primary cause and 4 deaths in which anesthesia was a contributory factor. ⋯ Obesity was a risk factor in 12 patients, in an equal number of patients the risk factor was the emergent nature of the operation, and hypertensive disease was a risk factor in eight. Thirteen of the 15 deaths occurred in black patients.
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Psychological methods for the treatment of chronic pain have been developed within the contextual framework of behavioral medicine during the past few years. Some of these self-control approaches focus on the patient's capacity to cope actively with pain. Standardized self-control training for outpatient group treatment for patients with chronic pain is described. ⋯ Thirty-three patients with chronic back pain were assigned either to one of four treatment groups (n=22) or to a waiting list control group (n=11). After 12 sessions of group treatment, patients showed significant improvement regarding daily ratings of pain intensity and mood and a significant decrease in depression and general physical complaints other than pain; the waiting list patients remained the same. Results showed good maintenance at the half-year follow-up.
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There is no uniform etiology of cancer pain. It is essential to understand the pathogenesis of pain as far as possible before a therapeutic modality can be conceived. The anatomical relation of the painproducing lesion to the site of pain perception should be clear (local, projected and referred pain). ⋯ Due consideration is given to neuroleptics and antidepressive drugs. Information about hormones (corticosteroids, calcitonin a. o.) in cancer pain therapy conclude this survey. Enormous differences of morphine use (Austria: 0.66 kg vs Denmark 16.59 kg per million people per year) indicate that there is a great demand for further professional education in this field.
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Dysmenorrhea, which may be primary or secondary, is the occurrence of painful uterine cramps during menstruation. Until a decade ago, medical and social attitudes toward dysmenorrhea were shrouded with folklore, psychoanalytical profiles, or psychosomatic bases. In secondary dysmenorrhea, there is a visible pelvic lesion to account for the pain, whereas only a biochemical abnormality is responsible for primary dysmenorrhea. ⋯ Primary dysmenorrhea affects 50 percent of postpubescent women and absenteeism among the severe dysmenorrheics has been estimated to cause about 600 million lost working hours or 2 billion dollars annually. Thus, an effective, simple, and safe treatment of primary dysmenorrhea for two to three days during menstruation will not only have a positive economic impact but will also enhance the quality of life. The availability of effective dysmenorrhea therapy with NSAIDs has induced greater expectations of relief by the patient, as well as greater willingness to seek medical help, a more rational approach to patient management by physicians, changes in attitude toward women with primary dysmenorrhea, and the debunking of myths about dysmenorrhea that often have been perpetuated as fact.(ABSTRACT TRUNCATED AT 400 WORDS)