ISSN:0749-8047    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The mixed headache syndrome is characterized by a combination of two headache types-migraine and muscle contraction-occurring in the same individual. Although both entities have been studied extensively as separate conditions, little research has been done on the mixed headache syndrome and its pathogenesis. Current data include analgesic and ergot dependency, as well as depression, as a contributor to its development. Treatment of the mixed headache patient requires a multidisciplinary approach. Nonpharmacologic therapies that are important in this treatment include lifestyle modification, biofeedback, psychologic intervention, dietary management, stress reduction, and sleep regulation. Analgesics and ergot medications must be strictly regulated to avoid dependency, as well as rebound headaches, due to caffeine-containing analgesics or ergotamine preparations. Abortive therapy consists of muscle relaxants and nonnarcotic analgesics. Prophylactic therapy is essential in the management of the mixed headache patient. Antidepressants including tricyclics and monoamine oxidase inhibitors (MAOIs) have demonstrated efficacy for many of these patients. In addition, specific pharmacologic therapy of migraine with β-blockers, calcium channel antagonists, and nonsteroidal antiinflammatory agents (NSAIDs) may be needed. Close monitoring and careful adjustment of these agents requires frequent office visits, thus enhancing a continuity of care that is fundamental in the management of the mixed headache patients.

ISSN:0749-8047    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Forty patients, having had a hysterectomy, evaluated the quality of pain relief with self-administered sublingual buprenorphine. Every morning, the patients received 12 sublingual tablets and were instructed to take 2 tablets every 6 h with an increase to 3 if they experienced insufficient pain relief. Thirty-six patients (90%) were pain free or had good pain relief. All patients and nurses found the self-administration principle satisfactory. The nurses found all the patients able to manage self-administration in the early postoperative period. Thirty-five patients wanted the same treatment at a future occasion. Self-administered sublingual buprenorphine seems to be promising for postoperative pain relief.

ISSN:0749-8047    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The aim of this work was to evaluate in a double-blind controlled study the effect of a pure muscle relaxant drug (dantrolene sodium) in the symptomatic treatment of uncomplicated acute low back pain in 20 patients. The one capsule daily dosage (25 mg) was given for 4 days. Patients treated with dantrolene sodium obtained an improvement of muscle contracture (p < 0.001 versus placebo). VAS pain measurement, and pain behavior (both p < 0.001 versus placebo). The electromyogram (EMG) parameters (i.e., the antalgic reflex motor unit firing) improved in the treated group (p < 0.01 versus placebo). Data show the possibility of treating uncomplicated acute low back pain with a pure muscle relaxant. Some basic physiopathological aspects of low back pain are also discussed.

ISSN:0749-8047    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

SummaryThe ability to dependably measure clinical signs and symptoms is a minimum requirement for arriving at rational diagnoses and treatment plans for any health problem. This report examines interexaminer reliability as it applies to the measurement of signs and symptoms of temporomandibular disorders (TMDs). Interexaminer reliability is defined as the degree of consistency among examiners when making observations of the same clinical variable. Review of available data and results from our own studies lead us to the following conclusion regarding the dependable assessment of clinical signs and symptoms of TMDs. Training of examiners emerges clearly as a crucial consideration to even approximate dependable assessment of TMD signs and symptoms. Certain signs and symptoms associated with TMDs appear to be more consistent than others, less susceptible to spontaneous change over time, and probably less susceptible to being influenced by the clinical examination procedure itself. By marked contrast, other groups of TMD signs and symptoms appear less reliable, either because they change spontaneously over time, as we believe is the case with temporomandibular joint sounds, or because the examination procedures themselves may cause changes, as may be the case with repeated muscle palpations. These findings have clear clinical relevance. Experienced and competent clinicians who specialize in treatment of TMDs but who are not extensively trained in standardized methods of examination and diagnosis may easily disagree on the evaluation of a patient. Clinicians and researches should work together to develop examination procedures, measurement scales, and clinical criteria that can serve as a common basis from which to assess reliability and report clinical findings.

ISSN:0749-8047    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The purpose of this descriptive correlational study was to determine what relationships exist among patients' perceptions of their chronic pain situation and their coping responses. A convenience sample of 34 pain clinic subjects had nonmalignant pain of at least 3-month duration. Coping responses as measured by a perceived coping rating had a significant correlation with (a) pain intensity, (b) depression, and (c) family functioning dissatisfaction. Coping responses related to changes in daily activities/relationships had a highly significant relationship with (a) depression and (b) family functioning dissatisfaction. No significant relationship existed between pain intensity and (a) changes in daily activities/relationships, or (b) family functioning dissatisfaction. Depression had a significant correlation with (a) pain intensity and (b) pain intensity, and (c) family functioning dissatisfaction. Individuals who perceived themselves as not coping well were in pain and depressed, both of which are amenable to some degree to nursing intervention.

ISSN:0749-8047    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

This article has a throrough literature review on the question of quality assurance with emphasis on cost containment. The paper contains a brief historical perspetive: the definition of quality assurance; and methods and problems facing different health care entities, including pain clinics. Solutions are presented to help ensure quality in health care, and conclusions and recommendations are stated.

ISSN:0749-8047    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Fibromyalgia syndrome (FS) is a painful soft-tissue disorder that has not been adequately characterized by electrodiagnosis. An electrodiagnostic examination was performed on 55 patients who fulfilled specific criteria for primary and secondary FS. Of the 41 patients with primary FS, no electrodiagnostic abnormalities involving the peripheral nervous system or musculature were detected.

ISSN:0749-8047    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Twelve patients with acute zoster infections and severe pain in the affected dermatomes were treated with intravenous acyclovir for 5 days. The most striking effect was a rapid decrease of pain within the first 24 h of treatment. Severe pain in acute zoster is considered an indication for acyclovir therapy.

ISSN:0749-8047    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A controlled study was performed in 13 patients (six controls and seven who received intrathecal Midazolam) undergoing upper abdominal operations to establish whether intrathecal Midazolam provided peroperative analgesia or influenced the adrenocortical and hyperglycaemic response to surgery. All patients were given a standardised general anaesthetic. Heart rate, blood pressure, and enflurane and diamorphine requirements were recorded peroperatively. The patients who received intrathecal Midazolam required significantly less enflurane (p < 0.01) and diamorphine (p = 0.0006), but the normal stress response was unaltered. It was concluded that intrathecal Midazolam provides a significant degree of peroperative analgesia, but does not affect the pathways involved in the stress response.

ISSN:0749-8047    

出版商:OVID    

年代:1988

数据来源: OVID