MMW Fortschritte der Medizin
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Rigorous and appropriate pain therapy is a major element in palliative medicine, and affords the patient the possibility of being better able to organize the remaining time left to him. Every person has a legal right to, receive appropriate treatment for his/her pain, which in advanced disease states, is a multidimensional condition. ⋯ Nevertheless, the simple expression of solidarity with the terminally-ill patient, as is reflected by the provision of sympathetic attention, has in itself a positive impact on pain. By offering comprehensive and nationwide palliative care that is oriented to the needs of the terminal patient, society helps to provide a culture of the dying, and thus also of the living, that reflects humanistic principles.
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Sleep disorders could be the symptoms of organic or non-organic conditions. The diagnostics comprises a detailed medical history of the patient complemented by a sleep diary, as well as organic medical and psychological/psychiatric examinations. ⋯ Nondrug strategies include sleep hygiene, stimulus control, sleep restriction and cognitive techniques. For sleep disturbances due to a psychological or organic disease, the primary condition must be treated.
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The diagnosis of restless legs syndrome is made on the basis of the clinical symptoms and, if applicable, complemented with a polysomnography. This is followed by neurophysiological examinations and laboratory diagnostics and permits a differentiation between idiopathic and secondary RLS. ⋯ An idiopathic RLS is treated with drugs. Primarily, L-dopa/benserazide and dopaminergic agonists are used, but opioids and anticonvulsants are also successful.