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Der Schmerz 6건

  1. [해외논문]   [Caffeine plus analgesics-a significant combination.].  

    Fox, J M
    Der Schmerz v.2 no.4 ,pp. 183 - 197 , 1988 , 0932-433x ,

    초록

    Since the ban of phenacetin and barbiturates in analgesics, caffeine as a constituent of analgesics has recently more often been blamed for promoting the abuse of analgesics. The available relevant literature was reviewed to perform a benefit/risk analysis. The results were as follows. The capability of caffeine to potentiate analgesia was demonstrated in controlled clinical trials involving approximately 12000 patients. This effect does not mean that there is a stronger analgesic effect, but that the addition of caffeine allows to reduce the dose of analgesics significantly, while maintaining the same analgesic efficacy. A minimum single dose of 50 mg caffeine is required to achieve this potentiation. Furthermore, it was demonstrated in controlled clinical trials in about 2000 patients that the maximum analgesic effect is achieved after 30-45 min with caffeine-containing analgesics, but only after 60-90 min with monotherapy. This must be regarded as a great advantage in terms of cumulative toxicity, because additional or higher doses due to insufficienttimeliness of efficacy are thus avoided. Thus, the analgesic benefit of caffeine as a constituant of analgesic drugs can no longer be denied, even though some studies leave room for criticism. (It should be added that this beneficial effect was investigated only for acute treatment with acetylsalicylic acid plus caffeine or with paracetamol plus caffeine). Toxicity studies with combination drugs indicate that there are no risks beyond the known risks of the individual components. On the contrary, the studies suggest that there is a tendency towards underadditivity; with an equal analgesic efficacy, therefore, the toxicological risk of an analgesic plus caffeine tends to be lower than with the respective analgesic alone. With respect to the frequently postulated promotion of analgesic abuse by caffeine, the results of this review are best summarized by citing the statement of the Federal Drug Review Committee "Neurology/Psychiatry" at the Bundesgesundheitsamt (BGA): "There is no evidence showing that a possible potential for dependence in the case of analgesics, such as acetylsalicylic acid or paracetamol, is increased by caffeine. Even though this could be assumed in theory, based on the available data there is no proof of an additional abuse potential for caffeine in combination with analgesics" [11]. The question of whether combination analgesics containing caffeine ought to be sold only on prescription might better be answered in the negative; in Germany, the percentage of self-medication (i.e., without consulting the doctor) in the consumption of prescription analgesics reaches up to 40% (1). Furthermore one could even argue that by introducing prescription schedule for analgesics containing caffeine a higher consumption of analgesic substance might be induced (to achieve an analgesic efficacy equal to that of combination drugs). This however might cause a higher and unpredictable risk (e.g., gastrointestinal bleeding) with proper use in exchange for of a reduction in the predictable risk with misuse or abuse. This would raise major ethical and legal issues. Minimizing one special risk does not automatically reduce the overall risk.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  2. [해외논문]   [The psychological aspect of cancer pain.].  

    Aulbert, E
    Der Schmerz v.2 no.4 ,pp. 198 - 204 , 1988 , 0932-433x ,

    초록

    The perception and expression of pain are primarily psychological phenomena and are not directly correlated with the intensity of the nociceptive stimulus. They are often influenced by earlier experiences of pain, and also by current expectations and fears. The cancer patient interprets pain as a sign of the continued existence and of the progression of the malignant disease: if the pain can be controlled the patient will take this as an indication that the underlying disease can be cured. Inappropriately treated pain, on the other hand, can initiate a vicious circle leading to really excruciating pain and functional destabilization of the patient. Conversely, the personality and the psychological condition of the patient can have a profound effect on how pain is experienced. Fear, for example, is known to exacerbate pain, and fear is often due to a less than ideal doctor-patient relationship, e.g. one in which the patient does not receive adequate information about the disease. Pain can be interpreted as a message that has to be understood before an adequate therapeutic response is possible. For desperate patients who are socially isolated after a long period of illness, pain may be the only way of communicating their unhappiness to other people and of feeling alive at all. Patients with intractable pain are sometimes given placebo therapy, particularly if the pain is interpreted as "only" psychogenic in character or if traditional methods of treatment have failed. Confrontation with terminally ill patients is an especially difficult and frustrating experience for health professionals. The fact that the disease cannot be cured and that a patient is in constant pain reminds the physician of the limitations of curative medicine. This can trigger defense mechanisms in the physician, which may in turn cause insecurity and fear in the patient. In the course of treatment for pain, cancer patients derive most psychological support from the emotional empathy of the therapist, whose availability for the patient is the most important means of preventing the patient's with-drawal into depression. If cancer pain is accompanied by an emotional, psychic and vegetative imbalance, psychotropic drugs are beneficial. In particular, antidepressants and neuroleptics have become an important component of the treatment of chronic pain in cancer patients. Due consideration of the emotional and motivational status of the patient will make it possible to choose between the different effect profiles of these drugs. However, the use of psychotropic drugs should complement, and cannot replace, empathic care from the physician.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  3. [해외논문]   [The correspondence between pain stimulus and pain sensation.].  

    G?bel, H , Heller, O , Nowak, T , Westphal, W
    Der Schmerz v.2 no.4 ,pp. 205 - 211 , 1988 , 0932-433x ,

    초록

    The relationship between painful pressure stimuli and induced pain intensity was examined. For experimental pain stimulation in 26 subjects, randomized local pressure on the middle phalanxes of fingers II-IV was used (pressure area 2.56 mm(2), six different pressure levels, three different pressure times). The induced pain intensity was measured by the category splitting procedure. Our results demonstrate that the pain intensity is proportional to the logarithm of the pressure stimulus. This finding is predicted by Fechner's law. The intraindividual and interindividual deviations are normally distributed. The retest reliability between measurements in the morning and in the evening amount to 0.98. Thus, the procedure can be used to objectify the pain intensity experienced.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  4. [해외논문]   Chronischer Kreuzschmerz—ein operativ therapieresistenter Casus  

    Schick, I. , Wö , rz, R.
    Der Schmerz v.2 no.4 ,pp. 212 - 213 , 1988 , 0932-433x ,

    초록

    The relationship between painful pressure stimuli and induced pain intensity was examined. For experimental pain stimulation in 26 subjects, randomized local pressure on the middle phalanxes of fingers II-IV was used (pressure area 2.56 mm(2), six different pressure levels, three different pressure times). The induced pain intensity was measured by the category splitting procedure. Our results demonstrate that the pain intensity is proportional to the logarithm of the pressure stimulus. This finding is predicted by Fechner's law. The intraindividual and interindividual deviations are normally distributed. The retest reliability between measurements in the morning and in the evening amount to 0.98. Thus, the procedure can be used to objectify the pain intensity experienced.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

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  5. [해외논문]   Chronischer Schmerz: homogenes Syndrom oder heterogene Krankheitsbilder?  

    Trabert, W. , Thoden, U.
    Der Schmerz v.2 no.4 ,pp. 213 - 215 , 1988 , 0932-433x ,

    초록

    The relationship between painful pressure stimuli and induced pain intensity was examined. For experimental pain stimulation in 26 subjects, randomized local pressure on the middle phalanxes of fingers II-IV was used (pressure area 2.56 mm(2), six different pressure levels, three different pressure times). The induced pain intensity was measured by the category splitting procedure. Our results demonstrate that the pain intensity is proportional to the logarithm of the pressure stimulus. This finding is predicted by Fechner's law. The intraindividual and interindividual deviations are normally distributed. The retest reliability between measurements in the morning and in the evening amount to 0.98. Thus, the procedure can be used to objectify the pain intensity experienced.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

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  6. [해외논문]   Bericht Uber den „Second International Congress on Cancer Pain”, 14.-17. Juli 1988, New York, USA  

    Seemann, H. , Schug, S. , Zech, D. , Zimmermann, M.
    Der Schmerz v.2 no.4 ,pp. 216 - 224 , 1988 , 0932-433x ,

    초록

    The relationship between painful pressure stimuli and induced pain intensity was examined. For experimental pain stimulation in 26 subjects, randomized local pressure on the middle phalanxes of fingers II-IV was used (pressure area 2.56 mm(2), six different pressure levels, three different pressure times). The induced pain intensity was measured by the category splitting procedure. Our results demonstrate that the pain intensity is proportional to the logarithm of the pressure stimulus. This finding is predicted by Fechner's law. The intraindividual and interindividual deviations are normally distributed. The retest reliability between measurements in the morning and in the evening amount to 0.98. Thus, the procedure can be used to objectify the pain intensity experienced.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

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