Nihon rinsho. Japanese journal of clinical medicine
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Dysmenorrhea is commonly observed in women and it reduces their quality of life. Most of dysmenorrhea is based on the disease of endometriosis, uterine myoma, uterine anomalies etc. and some cases are functional. ⋯ There are many different factors for dysmenorrhea in endometriosis, which is the commonest disease with dysmenorrhea, and we have to perform various therapies for pain. Therefore, we discuss in this paper the control for the functional dysmenorrhea and the pain in endometriosis.
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Neuropathic pain results from injury to neural structures within the peripheral or central nervous systems. Such injury promotes spontaneous and ectopic firing of nerves as well as reorganization of the nervous system. Neuropathic pain persists chronically. ⋯ This hypersensitivity is manifest as hyperalgesia and allodynia. Complex regional pain syndrome, CRPS is a category of neuropathic pain and is further divided into type I(reflex sympathetic dystrophy: RSD) and type II(causalgia). CRPS is characterized by localized autonomic dysregulation in the affected area with vasomotor and/or sudomotor changes, edema, colour difference, sweating abnormality, and atrophy.
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Morphine is clinically superior in relieving severe pain such as cancer pain. However, considering misplaced fears of the dangers of dependence potential and abuse liability, doctors have hesitated to treat patients with morphine. ⋯ The present study was then designed to investigate the rewarding effects induced by morphine under chronic pain by inflammatory and neuropathic pain in rodents. Furthermore, we also investigated whether any biological changes to interfere with the effects of morphine could be seen under chronic pain.
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Depression in cancer patients is common and occurs throughout the course of cancer illness. We review diagnosing, treatment and palliative care issues as well as epidemiology and etiology of major depression in cancer patients. The prevalence of major depression in cancer patients was reported to range from 6 to 42%. ⋯ To avoid under-diagnosing depression in cancer patient, it should include not only psychological symptoms, but also physical symptoms. The treatment includes patient education, counseling, behavioral techniques and antidepressant medications. In palliative care setting, life review interview would be effective for depression.
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Pharmacology, clinical efficacy and tolerability of serotonin noradrenaline reuptake inhibitors(SNRIs) are overviewed. They include milnacipran, venlafaxine, duloxetine, MCI-225 and nefazodone, however, only milnacipran is currently used in Japan. ⋯ SNRIs are well tolerated in general and safer than TCAs. SNRIs can be considered to be first-line antidepressant drugs.