Der Schmerz
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Multicenter Study Observational Study
[Management of chronic pain using extended release tilidine : Quality of life and implication of comedication on tilidine metabolism].
The synthetic opioid tilidine is often used in chronic pain treatment. However, the activation via metabolism in patients with concomitant medication and reduced liver or kidney function is not thoroughly investigated. We therefore studied pain treatment efficacy, health-related quality of live and the metabolism of tilidine in patients with chronic pain. ⋯ Pain treatment using tilidine resulted in variable nortilidine concentrations which are obviously not strongly influenced by comedication or reduced liver or kidney function. Only a few side effects were observed with almost no opioid-induced constipation.
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In the treatment of difficult chronic pain conditions, cognitive-perceptive approaches offer an alternative to conventional therapies. Especially phantom limb pain and complex regional pain syndrome (CRPS) are frequently treated with these promising modalities. This article provides an overview of the most important cognitive-perceptive therapies and the research results concerning their clinical efficacy. In addition, we discuss their neurobiological foundation and clinical perspectives.
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Interdisciplinary pain therapy is nowadays the state of the art for the treatment of chronic unspecific back pain. The aim of this article is to present the retrospective analysis of the data from a 1-week intensive outpatient multimodal interdisciplinary pain therapy group program for treatment of patients with chronic unspecific back pain. ⋯ Interestingly, the results showed a significant improvement of almost all evaluated parameters even after a period of 12 months (unfortunately only data for 41 patients were available). In our opinion this improvement is due to the special constellation of the presented program, which with 1 week is relatively short but very intensive with 34 h of treatment. In addition, the program is integrated into a long-term multimodal outpatient treatment, a concept in which the multimodal treatment is individually continued after the 1‑week program. On the other hand, the results especially after 12 months have to be interpreted particularly in this context.
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Besides pharmacological and interventional possibilities nonpharmacological options, deriving from behavioural approaches may be helpful in the treatment of migraine. Already consulting a patient reduces frequency of attacks. Relaxation (especially progressive muscle relaxation), endurance sports, and biofeedback as well as cognitive behavioural therapy are effective in treatment of migraine. The combination of these treatment options also with pharmacological treatment increase the positive effects.
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The aim of this study is to investigate the effects of kinesiophobia on emotion recognition and left/right judgement. ⋯ The results show that kinesiophobic patients have altered recognition of emotions, problems in left/right judgement, and show signs of alexithymia.