Der Schmerz
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Review Meta Analysis
[Recommendations for treatment of fibromyalgia : Where will we stand in 10 years?]
This article elucidates changes in the recommended diagnostics and therapy of fibromyalgia (FM). The recommendations from major internationally recognized guidelines are compared with the newest recommendations of the European League Against Rheumatism (EULAR) that in contrast to the guidelines surprisingly recommend physical exercise after patient education for all FM patients. ⋯ Finally, we try to predict how patients will be treated 10 years from now, for which knowledge from the guidelines and the initial approaches that diagnosed heterogeneity in FM are included. Empirically based questions will drive mechanism-based approaches as opposed to simply reacting to symptoms, in order to meet the challenge of an individual, mechanism-oriented treatment.
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Randomized Controlled Trial
[Treatment of fibromyalgia syndrome with gamma-hydroxybutyrate : A randomized controlled study].
The etiology of fibromyalgia syndrome is not yet fully understood. Current hypotheses suggest a potential role of gamma-hydroxybutyrate (GHB) in influencing endocrinological abnormalities in patients with fibromyalgia. ⋯ Administration of low dose GHB did not yield clinical improvements in female outpatients with fibromyalgia. General improvement in the course of treatment may have resulted from operant behavioral pain therapy. Future studies on GHB should control hypothetical risk factors for identification of non-responders.
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Randomized Controlled Trial
[The impact of catastrophizing on the effect of depression on pain and functional ability : A longitudinal mediator analysis].
While the association between pain and depression is well proven, little is known about the mechanisms influencing this relationship. The cognitive distortion of catastrophizing plays a significant role in several concepts of both diseases. ⋯ Catastrophizing mediates the relationship between depression and pain as well as functional capacity; therefore, the reduction of catastrophizing thoughts and attitudes should be a focus in rehabilitation programs.
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The wrist and hand form a highly complex organ that is of great importance in almost all daily activities. The hand serves as a tool and an organ of sense. ⋯ Almost all structures of the hand are easily accessible for clinical examination, i. e. inspection, palpation and clinical tests, including dynamic testing. Diagnostic imaging completes the examination procedure.
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Multicenter Study
[Experience in measuring the quality of treatment in interventional pain therapy : The Activity Index on a touchscreen PC].
There is a growing interest in patient-related outcome measurement. In this field questionnaires on touch screens are becoming more common. This study was designed to identify problems in usability and feasibility of a web-based questionnaire. ⋯ This web-based questionnaire is the first of its kind to be evaluated in everyday practice of interventional pain therapy for lumbar back pain. The vast majority of the patients were able to efficiently complete the questionnaire. The questionnaire was highly acceptable to patients, nurses and doctors. We found some usability problems but mainly in the older age group.