Der Schmerz
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In order to characterize the pain care situation in Germany, a health technology assessment (HTA) was carried out on behalf of the German Institute for Medical Documentation and Information (DIMDI). ⋯ Further development should strive to increase the provision of pain and palliative care. There is a great need for pain care research in order to concrete the needs.
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Randomized Controlled Trial
[Phantom limb pain. Psychological treatment strategies].
Similar to other pain syndromes phantom limb pain is characterized by learning and memory processes that maintain the pain and increase maladaptive plastic changes of the brain: therefore, psychological interventions that change maladaptive memory processes are useful. In addition to traditional psychological interventions, such as pain management training and biofeedback, more recent developments that involve sensory discrimination training, mirror treatment, graded motor imagery, prosthesis training and training in virtual reality are interesting. These interventions not only reduce phantom limb pain but also reverse the associated maladaptive brain changes.
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Review Comparative Study
[Pharmacological treatment of delirium in palliative care patients. A systematic literature review].
This systematic literature review aims to collect and analyse relevant clinical trials for the drug treatment of delirium in palliative care. The search was conducted including July 2012 in Medline (from 1966) and Embase (from 1974). The search retrieved 448 studies, of which 3 studies could be included in the analysis. ⋯ This literature analysis reflects the positive clinical experience, especially when using haloperidol. To confirm these recommendations, further substantial clinical studies are needed. The English full-text version of this article can be found at SpringerLink (under "Supplemental").
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Review Comparative Study
[Treatment of diarrhea with loperamide in palliative medicine. A systematic review].
Diarrhea is a distressing symptom which limits the quality of life in patients receiving palliative care and is associated with high morbidity and mortality. In patients with AIDS, it is a more common problem than for other entities (e.g., cancer). Loperamide is considered the first choice medication for the symptomatic treatment of diarrhea. ⋯ The identified studies revealed methodical problems. A definite recommendation for administration of loperamide can, therefore, not be derived from this work. The English full-text version of this article is available at SpringerLink (under "Supplemental").
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Cross-sectoral clinical pathways for chronic pain patients in standard and routine care are a major challenge for the German healthcare system. The Algesiologikum group has developed such clinical pathways including an essential infrastructure. ⋯ The range of treatment in the hospitals includes multimodal, invasive and surgical pain therapy. The present report illustrates possibilities and frontiers of the Algesiologikum concept based on all patients treated since 2009.