Der Schmerz
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In a survey of German hospitals with obstetric units, data on anaesthesia and analgesia in obstetric pain management were collected. ⋯ EA is the mainstream method of relieving labour pains in almost all German hospitals, but is used significantly more often in hospitals with rather high numbers of yearly deliveries than in hospitals in which there are few deliveries per year.
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A new definition of fibromyalgia syndrome (FMS) based on symptoms and without tender points is discussed from a rheumatological viewpoint. ⋯ The key symptoms of FM are chronic widespread pain, non-restorative sleep and subjective disabilities. The frequency of general and extra-musculoskeletal symptoms underlines that FMS is more than just a "pain disorder".
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Outpatient surgeons were surveyed about the quality of postoperative pain therapy after outpatient interventions. ⋯ This survey shows that the guidelines for acute pain therapy (http://www.awmf.de ) are only partially implemented.
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Review Comparative Study
[A clinical challenge. Pragmatic treatment of migraine and concomitant depression].
The association of migraine and depression has been confirmed in numerous studies and it has been suggested that both diseases influence each other in a bidirectional way. As the conventional antidepressants mostly aggravate a pre-existing depression, treatment of both is a demanding task and should be planned in an interdisciplinary setting with neurologists and psychiatrists experienced in pain management. The pharmacological therapy is mainly based on a modulation of the serotonergic and noradrenergic systems and non-pharmacological treatment is also incorporated. ⋯ A combination of several antidepressants with acute acting antimigraine drugs can provoke potentially threatening side effects, however, these possible side effects should not lead to suboptimal treatment of patients with depression and concomitant migraine. The current data on the antimigraine effects of common antidepressants are reviewed and advice for the preventive treatment of migraine with concomitant depression is given. Additionally, hazardous interactions and preferable drug combinations are listed.
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Review Comparative Study
[Migraine and hormones: what can we be certain of?].
Women suffer from migraine far more frequently than men. This sex difference during the reproductive years is considered to result from additional trigger factors, such as the fluctuating hormones of the menstrual cycle and with the reproductive milestones of women. The role of the female hormones on migraine is illustrated by the phenomenon of menstrual migraine, and the changes in the clinical course of migraine with menarche, pregnancy, menopause and the external application of hormones. In summary, epidemiological, clinical and experimental studies document a substantial influence of female sex hormones on the pathophysiology of migraine headache.