Der Schmerz
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The care of severely ill patients, whether in hospital, in residential homes or in their own homes, should be characterized by humanity and dictated by efforts to make life worth living for the person concerned. Preservation of the quality of life should be paramount if the doctor can no longer effect a cure. ⋯ Close contact with members of the family and with friends and neighbours is particularly important in this phase of life. A sick person's quality of life is what the legislator had in mind when domiciliary care was given priority over residential care at the time of the legal changes to reform the health care system.
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A study was conduced in 100 migraine patients and 100 control subjects who did not suffer from headaches to test Dung's hypothesis that the number of painful spinal processes in the throacic spine can be used as a quantitative measure of the degree of pain in the patient concerned. The results show significant differences in the frequency of painful spinal processes between the two study groups. This supports Dung's hypotheses. As it is easy to determine the presence of painful spinal processes the frequency of this phenomenon, the reasons for it and its significance should be the sujbects of further examination.
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The oral administration of strong opioids like morphine is a very effective treatment in cancer pain. However, these analgesics are rarely prescribed for patients suffering from severe "non-malignant" pain. We examined the effects of oral opioids (morphine sulphate tablets, buprenorphine and levomethadone) given to patients with intractable rheumatic pain, which were refractory to other therapeutic measures. ⋯ No drug abuse, dependence or tolerance were observed. Strong opioids are not analgesics of first choice in patients with rheumatic disease, but an opioid medication should be considered-as well as in patients with intractable pain caused by another disease-when alternative therapeutic measures have failed. The principles of opioid medication in rheumatic pain are similar to those in patients with cancer pain.