Wiener medizinische Wochenschrift
-
Wien Med Wochenschr · May 2006
Case Reports[Is it possible to avoid pathological grief if relatives of patients with palliative diseases are supported?].
The transition from normal to pathological grief is smooth. If it is almost impossible to define normal grief with all the existing descriptions of grief phases and systematic models, then it is all the more difficult to define pathological or complicated grief, especially as the existence of remaining grief, or remaining grief that rises to the surface again through memories, are considered normal processes of grief. ⋯ The response to grief in this case report seems to be pathological or complicated because the process involved in grieving has been replaced by a kind of emotional stagnation, marked by aggression and a feeling of guilt. The family-centred therapeutic approach, taking in the whole family and aimed at discovering potential risk factors for the relatives and the strain they are under, as well as a recognition of the next-of-kin as "secondary patients" have an important role to play in the avoidance of pathological grief.
-
Wien Med Wochenschr · May 2006
Case Reports[Intravenous S-+-ketamine for treatment of visceral pain in the final phase].
Ketamine is a hypnotic pharmacon with high analgesic potency. Ketamine is an agent blocking NMDA-receptors and involves opioid receptors, the voltage-gated sodium-channel, cholinergic receptors and the monoaminergic descending inhibitory pathways. Besides its influence in chronification of pain, NMDA-R is crucial in induction and maintainance of visceral pain, attentional perceptual processes and emotional valuation of pain. ⋯ In the presence of chronic pain states the effect ought to be more marked. There is evidence that the probability of psychotomimetic side effects does not exceed 10%. The rate of side effects can further be minimized through careful titration and prophylaxis (or treatment) with Diazepam 1 mg i.v.
-
Psycho-oncology -- as the diction suggests -- is a multidisciplinary sub-specialty of oncology concerned with the emotional responses of patients at all stages of the disease, their families and staff. Psycho-oncology does not assume the responsibility of cancer cure but attends to the psychological, social and behavioural variables that influence cancer prevention, risk and survival. ⋯ Cancer-related fatigue, for example, disturbs patients' quality of life more often than pain. However, all too often doctors fail to pay enough attention to this unknown symptom.
-
Wien Med Wochenschr · May 2005
[Perioperative pain management at the department of orthopaedic surgery of the Vienna Medical School].
Surgical treatment in the skeleton region and its adjacent tissue causes severe pain, demonstrated by the high demand of anaesthetics in the early postoperative phase. In order to offer adequate and individually adapted pain management, the orthopaedic department is working closely with the departments of anaesthesiology and intensive care medicine of the Vienna Medical University at the Vienna's General Hospital. ⋯ The surgical spectrum of the orthopaedic department consists of general orthopaedic, paediatric-orthopaedic-, sport- and rheuma-orthopaedic, tumour and spine interventions. The purpose of this review is to describe the cooperation between orthopaedic surgeons and anaesthetists at the Vienna Medical University.