Der Schmerz
-
The philosophical discussion of the phenomenon of pain can help to increase the understanding of human beings in pain and to accompany them in such an experience. Pain affects a human being who has a body. The "I" of this human being cannot escape into painlessness. ⋯ The pain shows how the experience of being in a body is connected to the experience of having an identity. Pain reduces the ability to act and narrows the possibility to interact with others; it affects the manner how the human is still or no longer able to address himself to others. In the reduction of his existence a human being experiences a basic condition of his existence: He is vulnerable.
-
Anesthesiology departments were often integrated into the primary formation of palliative activities in Germany. The aim of this study was to present the current integration of anesthesiology departments into palliative care activities in Germany. ⋯ Until 2005 many university palliative care activities had their origins in cancer pain services. These were often integrated into anesthesiology departments. Currently, anesthesiology departments work as an integrative part of palliative medicine. However, it appears from the present results that there is a domination of internal medicine (especially hematology and oncology) in palliative activities in German hospitals. This allows the focus of palliative activities to be formed by subjective specialist interests. Such a state seems to be reduced by the integration of anesthesiology departments because of their neutrality with respect to faculty-specific medical interests. Advantages or disadvantages of these circumstances are not considered by the present investigation.
-
Randomized Controlled Trial Multicenter Study
[Botulinum toxin type A in the prophylactic treatment of chronic migraine].
Since the second edition of the International classification of headache disorders (ICDH-II 2004), chronic migraine has been listed amongst migraine complications. Compared to episodic migraine the prevalence of chronic migraine is low, its impact, however, significant. Until recently no prophylactic drug had been approved for chronic migraine prophylaxis. ⋯ Thus, for the first time a prophylactic drug against chronic migraine is available which is both effective and well tolerated. Botox® has been licensed in England for the prophylaxis of headaches in adults with chronic migraine in 2010. Approval for its use in Germany has been applied for.
-
Besides the responses to nociceptive stimuli other neural function modes of the brain are necessary to obtain a comprehensive understanding of pain processing in humans. During a resting state without extrinsic stimulation the human brain generates spontaneous low frequency fluctuations of neural activity. This intrinsic activity does not reflect random background noise but is highly organized in several networks. Based on the findings of recent functional imaging studies, the role of these resting state networks in acute and chronic pain is discussed.