Schmerz最新文献

{"title":"[N-Check: nerve check to document chemotherapy-induced peripheral neuropathy (CIPN) in incurable cancer].","authors":"Annabell Syben, Sascha Weber, Iris Appelmann, Roman Rolke","doi":"10.1007/s00482-024-00828-8","DOIUrl":"https://doi.org/10.1007/s00482-024-00828-8","url":null,"abstract":"<p><p>Chemotherapy-induced polyneuropathy (CIPN) encompasses a spectrum of symptoms ranging from hypoesthesia with impaired gait, stance and fine motor skills to painful dysesthesia and allodynia and significantly impairs the quality of life of those affected. In the present pilot study, quantitative sensory testing (QST) was used to investigate CIPN as a common adverse effect of cytostatic drugs in patients with incurable cancer. The QST is a standardized examination procedure that is not yet routinely used in cancer patients. It is used to examine thermal and mechanical perception and pain thresholds to record the subjectively experienced pain phenotype. In the N‑Check pilot project, the QST was used before and after tumor-specific, potentially CIPN-inducing treatment and the data collected was compared in a pre-post analysis. In addition, the specific effects of CIPN on the health-related quality of life of patients treated primarily with a palliative intention were recorded using the Functional Assessment for Cancer Therapy-General (FACT-G) questionnaire. Overall, the patients showed significant heat hypoalgesia after chemotherapy as a sign of damage to small nerve fibers. In addition, there were signs of deterioration of the quality of life. The feasibility of QST in patients with incurable cancer and palliative, neurotoxic chemotherapy was demonstrated in this pilot study.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Avoidance-endurance fast screen : AEFS validation with one- and two-level response scaling in healthy subjects].","authors":"Sonja V Baumermann, Christina Titze, Monika I Hasenbring","doi":"10.1007/s00482-024-00836-8","DOIUrl":"https://doi.org/10.1007/s00482-024-00836-8","url":null,"abstract":"<p><strong>Background and objectives: </strong>Chronic pain affects an enormous number of patients in Germany. Therefore, early detection is important using easy, quick and reasonable screening methods. The avoidance-endurance fast screen is currently available in two different versions: one asking for pain-related behaviour in light and severe pain and the other assessing overall severe pain-related behaviour. In this study we aim to examine the agreement between both scales and for the first time describe the role of protective psychological features such as resilience and self-compassion in this model.</p><p><strong>Materials and methods: </strong>Epidemiological cross-sectional study (n = 278) of a healthy cohort occasionally experiencing pain (< 3 months). The analysis was done using standard descriptive statistics, correlations (Spearman's rho) and deductive statistics (t-tests and one-factor ANOVA with post hoc Bonferroni correction) and effect sizes (Cohen's d). Matching of the instruments was calculated with Cohen's kappa.</p><p><strong>Results: </strong>The results showed a moderate agreement for the two versions. A validity check of the subgroups resulted in comparable findings. The one-level version scored higher in terms of pain persistence which caused subgroup changes from adaptive to eustress-endurance responses and from fear-avoidance to distress-endurance responses. The distress-endurance subgroup had significantly lower values of the trait self-compassion.</p><p><strong>Conclusions: </strong>Based on the results of this study, the quality of agreement between the two AEFS versions is considered strong. Without the comparison between mild and strong pain, endurance behaviour was reported more often. According to these findings, overestimation of pain persistence behaviour using the one-level version might result. Therefore, future studies should re-evaluate the cut-offs. As reported in previous studies, protective psychological features showed the highest scores in the eustress-endurance subgroup.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Influence of health care crises on the treatment of cancer pain: a presentation using the example of the COVID-19 pandemic from the provider's perspective].","authors":"Frederik Dombrowski, Stefan Wirz, Hannes Hofbauer, Pascal Kowark, Joachim Erlenwein, Ulrike Stamer, Kristin Kieselbach","doi":"10.1007/s00482-024-00826-w","DOIUrl":"https://doi.org/10.1007/s00482-024-00826-w","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic led to significantly restricted access to pain medicine services. Patients with cancer-related pain are considered a vulnerable group in terms of care deficits. A questionnaire among providers providing treatment to this group was used to assess limitations and solutions in this critical situation.</p><p><strong>Materials and methods: </strong>The online survey, developed by the 'Tumour Pain Working Group' of the German Pain Society using the Delphi method, included questions on site structure, pandemic-related care problems, and burdens experienced by those treating patients. It was distributed several times via the mailing lists of the German Pain Society and the 'Palliative Medicine Working Group' of the German Society of Anaesthesiology and Intensive Care Medicine.</p><p><strong>Results: </strong>In all, 175 fully completed questionnaires were analysed. Over 75% of participants reported pandemic-related staff shortages and closures of pain medicine facilities, with 32% of facilities temporarily not treating elective pain patients and 13% not treating any emergencies. Care was hampered by numerous logistical problems such as very frequent pandemic-related cancellations by patients or in the transmission of prescriptions. Alternative forms of consultation by telephone or telemedicine, rarely used before the pandemic, were reported by 79 and 31% of respondents respectively, but deficiencies were noted. In addition, 52.1% of respondents complained of severe and 26.8% of moderate psychological stress due to the pandemic, and 74.1% evaluated working conditions as moderately to severely difficult. Medical training was still possible for 86% through format changes.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic revealed numerous deficits in the care of patients with cancer-related pain, as well as burdens on healthcare providers. The development of new concepts could help to ensure better care in future crisis situations.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wir gestalten Zukunft : Abstracts des Deutschen Schmerzkongresses 2024: 16.–19. Oktober 2024 im CC Rosengarten, Mannheim.","authors":"","doi":"10.1007/s00482-024-00827-9","DOIUrl":"10.1007/s00482-024-00827-9","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"1-92"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Conservative combination therapy of sciatica due to lumbar disc herniation with mechanical physiotherapy (McKenzie), gabapentin, and transforaminal epidural injections].","authors":"Manuela Jäntsch-Rieckert, Oliver Rommel, Verena Kästner, Lotte Maercklin-Rommel, Georg Jäger","doi":"10.1007/s00482-024-00824-y","DOIUrl":"https://doi.org/10.1007/s00482-024-00824-y","url":null,"abstract":"<p><strong>Background: </strong>Treatment of sciatica due to lumbar disc herniation can be surgical or conservative. Conservative management has been described to be effective in 90% of patients; however, in most studies no consistent treatment concept was used.</p><p><strong>Objectives: </strong>In the present study, we evaluated the effect of a combined nonsurgical management (McKenzie physiotherapy, gabapentin, and periradicular injections) in 40 patients during a 10-day inpatient treatment.</p><p><strong>Methods: </strong>In addition to the neuro-orthopedic examination, pain severity at rest and after walking were assessed. The Oswestry pain disability scale, the pain severity scale, and the painDETECT scale were examined to assess neuropathic pain components. The duration of incapacity for work and the requirement of a later surgery were recorded. Examinations were performed on the day of admission, on days 3, 6, 10, and 84, 3 months after discharge.</p><p><strong>Results: </strong>During conservative treatment, a continuous reduction of pain and an improvement of the straight leg raise test as well as finger-to-floor distance could be documented. As the three treatment options were introduced with a time delay, it could be demonstrated that all significantly contributed to the improvement. All treatments were tolerated without side-effects and persistent improvement after 12 weeks. On admission, 32% of patients revealed a neuropathic pain component which decreased to 7% at the follow-up. A total of 28 patients showed impaired muscle strength on admission, which decreased to 7 patients on follow-up. Electromyography revealed pathological results in 70% of patients examined. A significant improvement of quality of life (Oswestry Disability Index [ODI]) could be observed and the patients returned to work after 5.8 weeks. Only 3/40 patients required surgical management due to persistent pain.</p><p><strong>Conclusion: </strong>The combined nonsurgical operative treatment program is effective and well tolerated.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Tetrahydrocannabinol (THC) in patients with fibromyalgia syndrome (FMS) : A retrospective study of changes in pain, psychometric variables, and analgesic consumption during inpatient interdisciplinary multimodal pain therapy (IMPT)].","authors":"Horst Bettstetter, Arne Schäfer","doi":"10.1007/s00482-023-00727-4","DOIUrl":"10.1007/s00482-023-00727-4","url":null,"abstract":"<p><strong>Background: </strong>Since March 1, 2017, medical cannabis (MC) can be prescribed nationwide in Germany. To date, there have been a number of qualitatively different studies on the effectiveness of MC in fibromyalgia syndrome (FMS).</p><p><strong>Objective: </strong>The aim of the study was to investigate the effectiveness of THC in the course of interdisciplinary multimodal pain therapy (IMPT) on pain and several psychometric variables.</p><p><strong>Materials and methods: </strong>For the study, in the period 2017-2018, all patients in the pain ward of a clinic who were suffering from FMS and were treated in a multimodal interdisciplinary setting were selected based on inclusion criteria. The patients were examined separately according to groups with and without THC about pain intensity, various psychometric parameters and analgesic consumption during the stay.</p><p><strong>Results: </strong>Of the 120 FMS patients included in the study, 62 patients (51.7%) were treated with THC. In the parameters of pain intensity, depression, and quality of life, there was a significant improvement in the entire group during the stay (p < 0.001), which was significantly greater through the use of THC. In five of the seven analgesic groups examined, the dose was reduced or the drug discontinued significantly more often in the patients treated with THC.</p><p><strong>Conclusion: </strong>The results provide indications that THC can be considered as a medical alternative in addition to the substances previously recommended in various guidelines.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"259-266"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11271422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9964589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Benefits and harms of cannabis-based medicines from the viewpoint of patients with chronic pain and their physicians : A cohort study in three pain centers of the German federal state Saarland].","authors":"Claudia Böttge-Wolpers, Patric Bialas, Sven Gottschling, Stephanie Juckenhöfel, Dieter Konietzke, Albrecht Madlinger, Patrick Welsch, Winfried Häuser","doi":"10.1007/s00482-022-00688-0","DOIUrl":"10.1007/s00482-022-00688-0","url":null,"abstract":"<p><strong>Background: </strong>There are no studies available that have simultaneously assessed the benefits and harms of cannabis-based medicines from the viewpoint of patients and their physicians.</p><p><strong>Methods: </strong>All chronic pain patients at three pain centres in the German federal state of Saarland who had received at least one prescription of cannabis-based medicines (CbMs) in the past from the study centre were included in a cross-sectional study from January 1 to December 31, 2021. Patients and their physicians completed a self-developed questionnaire separately.</p><p><strong>Results: </strong>All 187 contacted patients participated in the study. Since the start of CbM therapy, 44.9% of patients reported to be much or very much, 43.3% to be moderately and 8.0% to be slightly improved overall. A total of 2.7% reported no change and 1.1% a moderate deterioration of overall wellbeing. From the patients' point of view, the symptoms most frequently reported to have substantially improved were sleep problems (36.4%), muscle tension (25.1%) and appetite problems (22.1%). The most frequent bothersome side effects were sweating (6.4%), concentration problems (4.2%) and nausea (4.1%). Physicians noted substantial pain relief in 60.7%, improvement of sleep in 65.7% and of mental well-being in 34.3%. A complete cessation of opioids was achieved in 64.7%, of anticonvulsants in 57.9% and of antidepressants in 60% of patients that had received these medications before the start of CbM therapy.</p><p><strong>Conclusions: </strong>CbMs can contribute to a clinically relevant reduction in pain, sleep problems and muscle tension and can improve daily functioning in carefully selected and supervised patients with chronic pain. CbM can contribute to the reduction or complete cessation of other pain medications (antidepressants, anticonvulsants, opioids).</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"241-249"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9116046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ganglionic opioid analgesia (GLOA) with sufentanil?]","authors":"Helmut Gockel, Philipp Stude, Christoph Maier","doi":"10.1007/s00482-024-00816-y","DOIUrl":"10.1007/s00482-024-00816-y","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"282"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Der Schmerz-education and research].","authors":"Hans-Georg Schaible, Lukas Radbruch","doi":"10.1007/s00482-024-00818-w","DOIUrl":"https://doi.org/10.1007/s00482-024-00818-w","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":"38 4","pages":"237-238"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Adaptions of mirror therapy for phantom limb pain with telescoping phenomenon].","authors":"Marina M Finnern, Josepha Zimmer, Herta Flor","doi":"10.1007/s00482-023-00745-2","DOIUrl":"10.1007/s00482-023-00745-2","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"279-281"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11271425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10151518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}