IF 1 4区医学

Schmerz Pub Date : 2024-01-09 DOI: 10.1007/s00482-023-00776-9

Judith N Wagner

引用次数: 0

[Opioid withdrawal following refilling of an implantable drug delivery system for intrathecal infusion]. [用于鞘内输注的植入式给药系统重新填充后阿片类药物的戒断]。

IF 1 4区医学

Schmerz Pub Date : 2024-01-04 DOI: 10.1007/s00482-023-00779-6

Marco Reining, Michael Kretzschmar

引用次数: 0

[Use of strongly acting sustained-release opioids in pediatrics : Pitfalls and solutions for morphine and hydromorphone]. [在儿科使用强效缓释阿片类药物：吗啡和氢吗啡酮的陷阱和解决方案]。

IF 1 4区医学

Schmerz Pub Date : 2024-01-03 DOI: 10.1007/s00482-023-00775-w

Franziska Zimbelmann, Sarah Flaute, Melanie Deipenbrock, Elvira Ahlke, Georg Hempel, Margit Baumann-Köhler

{"title":"[Use of strongly acting sustained-release opioids in pediatrics : Pitfalls and solutions for morphine and hydromorphone].","authors":"Franziska Zimbelmann, Sarah Flaute, Melanie Deipenbrock, Elvira Ahlke, Georg Hempel, Margit Baumann-Köhler","doi":"10.1007/s00482-023-00775-w","DOIUrl":"https://doi.org/10.1007/s00482-023-00775-w","url":null,"abstract":"Background: In pediatrics, adequate treatment with potent opioids requires the administration of sustained-release preparations for many patients; however, the dosing and administration of sustained-release morphine and hydromorphone preparations via gastrointestinal tubes confronts providers with a major hurdle, especially as the company Mundipharma GmbH has discontinued the production and distribution of the preparation MST retard granules in 2019, which has been proven for these purposes in pediatrics. The aim of this study was to establish a production technique for available sustained-release opioid preparations, which are particularly suitable for use in the low-dose range required in pediatrics and which can also be administered via gastrointestinal tubes.Method: Low-dose preparations were produced by opening of morphine and hydromorphone capsules and weighing of the sustained-release pellets. To evaluate the partition, an analysis of the drug content via high performance liquid chromatography (HPLC) was conducted. Moreover, the administration via gastrointestinal tubes (charrière, Ch 8-Ch 10) was examined by an ex vivo experiment.Results: The examination showed a practicable method to produce low dosages of sustained-release morphine and hydromorphone. The preparations are in accordance with the test for content uniformity of the European Pharmacopoeia (Ph. Eur.). Furthermore, the pellets were administered to gastrointestinal tubes Ch 8 (morphine) and Ch 10 (hydromorphone) by a syringe application technique and passed the tubes completely.Conclusion: The production technique can be considered as safe and enables the off-label oral application or application via gastrointestinal tubes of sustained-release opioids in pediatrics.","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139088176","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}

引用次数: 0

[Opportunities and risks of advance directives : An appraisal of the practice in Germany after legal regulation in 2009]. [预先指示的机遇与风险：2009 年德国法律规范后的实践评估]。

IF 1 4区医学

Schmerz Pub Date : 2024-01-02 DOI: 10.1007/s00482-023-00771-0

Christoph G Dietrich, Konrad Schoppmeyer

{"title":"[Opportunities and risks of advance directives : An appraisal of the practice in Germany after legal regulation in 2009].","authors":"Christoph G Dietrich, Konrad Schoppmeyer","doi":"10.1007/s00482-023-00771-0","DOIUrl":"https://doi.org/10.1007/s00482-023-00771-0","url":null,"abstract":"Background: Living wills/advance directives (AD) are an important tool for specifying patient wishes regarding medical care in the case of future inability to consent. Since 2009, German legislation defines framework conditions for the creation and validity of such directives in § 1901a BGB.Methods: An extensive literature search in an international and a German-language database was conducted to identify, analyze, and evaluate scientific articles on opportunities, risks, and problems in the creation and implementation of living wills.Results: Between 10 and 40% of patients have an AD. Among the stipulations in the AD, the demand for sufficient pain therapy is very important. However, numerous problems in the preparation and implementation of ADs reduce their value in everyday clinical practice. In particular, unclear conditions of validity, unspecific instructions for action, and lack of availability of the directives prevent practitioners from determining the patient's will. Other fundamental problems include frequent patient ambivalence and clinical ethical dissent. In addition, the framework condition of unlimited coverage set by the law carries the risk that changes of opinion in the course of life or disease are not taken into account.Conclusion: Preparing an AD requires a high level of information, consultation, and time, as well as regular review or adjustment of its content. These factors are often not considered, thus complicating implementation and reducing the value of living wills. Possible solutions to these problems or alternative concepts for different patient settings are discussed in this review.","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139074974","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}

引用次数: 0

[Holistic treatment of endometriosis]. 【子宫内膜异位症的整体治疗】。

IF 1 4区医学

Schmerz Pub Date : 2023-12-01 Epub Date: 2023-08-25 DOI: 10.1007/s00482-023-00747-0

Sylvia Mechsner

{"title":"[Holistic treatment of endometriosis].","authors":"Sylvia Mechsner","doi":"10.1007/s00482-023-00747-0","DOIUrl":"10.1007/s00482-023-00747-0","url":null,"abstract":"Background: The pain phenomena caused by endometriosis are manifold. In addition to nociceptive pain there is also a nociplastic reaction with central sensitization. Atypical symptoms, such as acyclic lower abdominal pain, radiating pain, nonspecific bladder and intestinal complaints or even depression increasingly occur in addition to the classical cyclic complaints, such as severe dysmenorrhea, cyclic lower abdominal pain, dyspareunia, dysuria and dyschezia. Due to the diffuse range of symptoms, affected patients often consult not just gynecologists but also specialists from other disciplines (internal medicine, gastroenterology, orthopedics, pain therapy, psychology etc.).Objective: The complexity of endometriosis is presented. The resulting approaches to multimodal interdisciplinary holistic treatment are described.Results: Interdisciplinary concepts should be involved in the optimal treatment of endometriosis patients along with hormonal and surgical treatment, mostly under the supervision of a gynecologist and pain management, dietary changes, psychological support and physiotherapeutic management should also be included. This article provides an overview of possible treatment strategies for chronic symptomatic endometriosis.Conclusion: Based on multimodal treatment strategies and regarding the complex pathophysiological alterations of this disease, the complex complaints that significantly impair the quality of life of endometriosis patients can be greatly improved.","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"437-447"},"PeriodicalIF":1.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10427998","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}

引用次数: 0

[Electrotherapeutical stellate ganglion block on a patient with complex regional pain syndrome of the upper limb]. 电疗星状神经节阻滞治疗上肢复杂局部疼痛综合征1例。

IF 1 4区医学

Schmerz Pub Date : 2023-12-01 Epub Date: 2022-12-02 DOI: 10.1007/s00482-022-00682-6

Alexander Ranker, Elke Behr-Eggers

引用次数: 1

[Complementary and supplementary procedures in the treatment of headache]. 【治疗头痛的补充和补充程序】。

IF 1 4区医学

Schmerz Pub Date : 2023-12-01 Epub Date: 2023-07-11 DOI: 10.1007/s00482-023-00738-1

Charly Gaul, Laura Zaranek, Gudrun Goßrau

引用次数: 0

[Yoga as an intervention for chronic pain]. [瑜伽对慢性疼痛的干预]。

IF 1 4区医学

Schmerz Pub Date : 2023-12-01 Epub Date: 2023-06-28 DOI: 10.1007/s00482-023-00733-6

Dennis Anheyer, Holger Cramer

引用次数: 0

[Concept for integrative pain treatment of osteoarthritis of the knee based on the evidence for conservative and complementary therapies]. [基于保守疗法和补充疗法证据的膝关节骨关节炎疼痛综合治疗概念]。

IF 1 4区医学

Schmerz Pub Date : 2023-12-01 Epub Date: 2023-07-28 DOI: 10.1007/s00482-023-00739-0

Dominik Irnich, Petra Bäumler

{"title":"[Concept for integrative pain treatment of osteoarthritis of the knee based on the evidence for conservative and complementary therapies].","authors":"Dominik Irnich, Petra Bäumler","doi":"10.1007/s00482-023-00739-0","DOIUrl":"10.1007/s00482-023-00739-0","url":null,"abstract":"Background: Osteoarthritis of the knee (gonarthritis) represents a medical challenge.Research question: What is the evidence with respect to approaches of complementary medicine and their integration into multimodal pain management concepts?Material and methods: Qualitative nonsystematic literature search on the epidemiology and pathophysiology as well as informative clinical trials, meta-analyses and clinical guidelines about conservative treatment including complementary therapy for gonarthritis.Results: Osteoarthritis of the knee is a frequent condition with biopsychosocial risks factors for chronification. The German S2k clinical guideline (k = consensus-based, not based on scientific systematic literature searches) published by the Association of the Scientific Medical Societies in Germany (AWMF) in 2017 has not yet been updated. The current guidelines of the American College of Rheumatology (ACR) date from 2020. Both guidelines recommend exercise therapy, weight reduction, short-term analgesics, topical therapy, intra-articular corticoid injections and acupuncture with variable strengths. Furthermore, transcutaneous electrical nerve stimulation (TENS), laser and other electrophysical therapies, shock waves, traction treatment, ergotherapy, comfrey poultices and mudpacks can also be used. Current research supports the benefits of tai chi/qigong and medicinal leaches.Conclusion: Complementary treatment approaches, such as acupuncture, tai chi/qigong, topical naturopathic self-treatment and leeches (with limitations) can, in addition to behavioral changes, exercise therapy and short-term pharmacological treatment, be important evidence-based components of integrative pain management concepts, e.g. in terms of an interdisciplinary multimodal pain treatment (IMPT). Besides pain reduction and functional improvement they promote the internal control conviction through the possibility of self-treatment and self-exercise.","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"413-425"},"PeriodicalIF":1.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9886696","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}

引用次数: 0

[Migraine and mitochondrial diseases : Energy deficit in the brain]. [偏头痛和线粒体疾病：大脑能量不足]。

IF 1 4区医学

Schmerz Pub Date : 2023-12-01 Epub Date: 2023-11-03 DOI: 10.1007/s00482-023-00764-z

Lucia Hämmerl, Torsten Kraya

引用次数: 0

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