Der Schmerz
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This review summarizes the various forms of behavioral treatment of migraine which could demonstrate empirical efficacy. The main unimodal kinds of treatment are thermal and electromyography (EMG) biofeedback training and progressive muscle relaxation. The various relaxation techniques do not differ in their efficacy in treating migraine. ⋯ A combination of pharmacological and behavioral treatment can achieve additional success. There is strong evidence for the clinically significant efficacy of all forms of behavioral treatment in childhood and adolescence. There are no signs of differential indications.
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Besides the different forms of odontalgia, myalgias of the masticatory muscles are the most frequent noninfectious complaints in the orofacial region. After summarizing the recommendations set forth by the Interdisciplinary Working Group of Orofacial Pain within the German Chapter of the IASP (German Pain Society), we present the current state of knowledge regarding the etiology, diagnosis, and therapeutic options, based on an extensive literature search. A systematic literature search was carried out in PubMed, the Cochrane Library, and the database of the Deutsche Zahnärztliche Zeitschrift. ⋯ Short- and long-term trials have added more evidence to the fact that different therapeutic measures have similar efficacy. In patients with chronic myalgias of the jaw muscles, involvement of a psychotherapist is crucial. Patient education, oral appliances, physiotherapeutic exercises, and acupuncture are recommended therapeutic measures, while physical therapy, pharmacotherapy, and psychological therapy received a limited recommendation.
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Observational Study
[End of life care in general practice: results of an observational survey with general practitioners].
Little is known about the amount of end of life care provided by general practitioners (GPs) in Germany. Therefore the aim of the HAVEL study is to describe the involvement of GPs in end of life care in more detail. ⋯ General practitioners are highly involved in palliative health care, even for patients who eventually die in hospitals. Differences in patient characteristics and circumstances compared to specialized palliative care should be reflected in curricula for training in palliative care and the definition of a palliative situation.
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In 2013 palliative medicine (PM) will be integrated into the undergraduate curriculum as part of the mandatory education in German medical universities. The aim of this study is to determine the current state of implementation at German medical faculties (MF). ⋯ The implementation of the mandatory training in PM at MFs in Germany is inhomogeneous. Further steps include in particular the development of a competence-based curriculum and assessment.