Der Schmerz
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The neuropeptide calcitonin gene-related peptide (CGRP) is known to play a major role in the pathogenesis of pain syndromes, in particular migraine pain; however, its implication in inflammatory processes is not well known. The CGRP receptor antagonist BIBN4096BS was shown to reduce migraine pain and trigeminal neuronal activity. An analgesic action of this compound can also be found in rats with induced acute inflammation by injection of complete Freund's adjuvant (CFA) in one hindpaw. ⋯ In vivo electrophysiological studies performed in rats injected with CFA using recordings of wide dynamic range neurons in deep dorsal horn layers of the lumbar spinal cord, confirmed a reduction of neuronal activity after systemic drug administration. The same considerable amount of reduction occurred after topical administration onto the paw with resulting systemic plasma concentrations in the low nanomolar range. Spinal administration of BIBN4096BS did not modify the neuronal activity in the CFA model which suggests that peripheral blockade of CGRP receptors by BIBN4096BS significantly alleviates inflammatory pain.
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Post-traumatic stress disorder (PTSD) is one of the most relevant disorders of patients with chronic pain, but is often underdiagnosed. This also applies to expert testimony. ⋯ This forms the basis for a differentiated expert testimony in the different fields of law (e.g., criminal law, statutory or private accident insurance or social security benefits), in which different requirements must be taken into consideration by the expert. The recognition of malingering is described at length, which plays a major role in PTSD expert testimony in all fields of law.
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Multicenter Study Comparative Study
[Social desirability in pain therapy : Response behavior of various professional groups on the implementation of multi-professional pain management.]
Research on the quality of pain management is often based on self-reported data pertaining to internal regulations provided by employees. However, data examining the correctness of the information given are rare. The project "Pain-Free Hospital" facilitated such an analysis and compared the answers provided by staff members with currently existing regulations. ⋯ Therapy plans and pain management-related regulations are known in hospitals after a systematic training. Data suggest that hospitals without regulations show a trend towards social desirability.