Cybernetic Principles in Psychophysiology: Their Significance and Conclusions for Palliative Care.

Palliative care is dedicated to terminally ill patients with advanced disease, regardless of diagnosis, under the overarching premise of optimizing quality of life. This narrative review examines the extent to which principles of cybernetics and psychophysiology underlie this approach. Psychophysiology researches the physiological equivalents of psychological states and traits such as activation and individual reactivity, the interoception and the personal characteristics.

Status of inpatient pain therapy using the example of a general and abdominal surgery normal ward - a prospective questionnaire study to review a pain therapy algorithm ("real-world data").

Objectives: The mean pain intensity for inpatient consultations, for example in cancer patients, is known. However, the proportion of necessary consultations in the total volume of patients of a ward or a hospital, the general pain intensity in a surgical ward and the relationship between pain medication, length of stay and therapeutic success are unknown. The aim of the study was to examine surgical patients in a single normal ward subclassified into various groups (-/+ surgery, ICU stay, cancer, consultation for pain therapy etc.

Long-term opioid therapy and mental health comorbidity in patients with chronic pain.

Objectives: Evidence suggests that patients with chronic pain and mental illness are more likely to receive long-term opioid therapy (LTOT) and at higher doses but are also at increased risk of experiencing opioid-related harm. This study investigates LTOT and its relationship to mental illness in the setting of a university-based outpatient pain clinic with liaison psychiatric care.

Methods: Retrospective analysis of patients with chronic pain admitted between 2011 and 2015.

What does low psychological distress mean in patients with no mental disorders and different pains of the musculoskeletal system?

Objectives: The aim of this study is to define the different levels of psychological distress in patients suffering from pain and functional disorders of the musculoskeletal system.

Methods: This investigation was conducted as a retrospective study of 60 patients randomly selected of a German specialized orthopaedic hospital within the year 2016, whose therapeutic approaches are based on a non-surgical orthopaedic multimodal approach of manual therapy. All patients were suffering from pain and functional disorders of the musculoskeletal system.

[Characteristics and prevalence of painful coenesthesia in a pain clinic].

Background: Coenesthesia, a rarely described symptom, is classified as schizophrenia according to ICD-10 and can occur independently of psychiatric diseases as a form of pain. The prevalence in chronic pain disorders is still unknown. The present study investigates the characteristics and psychological comorbidities of painful coenesthesia.

The Incidence of Mental Disorders Increases over Time in Patients with Cancer Pain: Data from a Retrospective Cohort Study.

Background: It is well known that cancer patients more seldom have a psychiatric disorder than noncancer patients with chronic pain. Conversely, earlier studies have suggested that, at the psychiatric level, long-term cancer survivors (LCSs) have more in common with noncancer patients affected by chronic pain.

Materials And Methods: We investigated 89 cancer patients with acute pain (Acute Cancer Pain Patients, ACPPs) treated at a university outpatient chemotherapy department and compared these with 61 LCSs (living >5 yr after the first diagnosis) admitted by general practitioners for the treatment of noncancer pain.

Psychiatric Disorders in Complex Regional Pain Syndrome (CRPS): The Role of the Consultation-Liaison Psychiatrist.

Background: Complex regional pain syndrome (CRPS) is a multifactorial disorder with complex aetiology and pathogenesis. At the outpatient pain clinic of Magdeburg University Hospital, all patients, without exception, are subject to permanent psychiatric care delivered by a consultation-liaison psychiatrist. In CRPS, psychological stabilization and treatment of the neuropathic aspects are equally important.

[Aspects of liaison psychiatry care of patients in a university pain clinic].

Background: Owing to a rise of psychosomatic comorbidities, the treatment of psychological disorders, which may negatively impact prognosis and therapy, is increasingly becoming a focus of attention for pain outpatient clinics.

Aim: This study investigates and discusses the advantages of liaison psychiatric care in a university pain clinic.

Methods: In this retrospective study, we investigated all patients who presented to an anaesthesiologically led pain clinic between January and June 2014.

[Pain therapy in in-patients with cancer. Effects of a manual-based approach as guideline for pain-consulting service at a university hospital].

Background: Appropriate medication is an important and substantial part in the therapy of tumor-induced pain.

Objective: The objective of this study was to investigate the efficiency of anaesthesiology-based consultant service characterizing the quality of this type of treatment in daily clinical practice of a university hospital, i. e.

[The Risks of Perioperative Addiction to Benzodiazepines in the Elderly: What the Surgeon Needs to Know].

Background: In Germany, more than one million people use benzodiazepines on a regular basis. The majority of them is older than 60 years and take low-dose benzodiazepines for sleep disorders. This does not necessarily induce tolerance, but may result in problems such as falling, seizures or delirium if benzodiazepines are discontinued or taken on a long-term basis.

[The addicted patient in anaesthesia - benzodiazepine dependence].

As a result of the demographic change, the proportions of elderly patients undergoing operations and anesthesia are increasingly important. The consumption of benzodiazepines evidently rises with increasing age. Associated with the increasing consumption in the elderly is the risk of cognitive impairment, delirium, falls and fractures.

[Pain therapy in patients with schizoaffective disorder and cancer].

We report on two patients with schizoaffective psychosis, cancer, and pain. However, it is not possible to make somatic or psychic disturbances alone responsible for the pain. In patients with current schizoaffective disorders, only administration of a combination of psychopharmaceutical and opioid agents is successful.

[Subsyndromal delirium -- experience in psychiatry -- expectations for postoperative management].

The phenomenon of delirium is well known since over 100 years. The anesthesiology has recognized that early detection and therapy results in significant improvement of postoperative clinical state of health of the patients. In the following article it will be discussed that it could be profitable to make a further step: threatening the subsyndromal delirium.

[The successfully treated patients - are they the satisfied ones?].

The current scientific opinion on the success of a therapy is that patients having undergone a successful therapy are satisfied. However, in reality, it is possible that patients with poor living conditions are satisfied (well-being paradox) whereas patients treated successfully are not (dissonance). The higher the psychological distress, the more rare is the assumption that successful therapy is an equivalent of satisfaction.

[The Helsinki Declaration for Patient Safety in Anaesthesiology - Post operative care including pain management].

Primary aspects of post operative care should include decisive and adequate treatment of pain. Accordingly, schemes based on international guidelines and in consensus with other departments of the university hospital were developed. Successful therapy includes resolute action on three levels: Instruction of physicians, including supervision.

[Psychotropic drugs - The special importance of anticonvulsants and neuroleptics in treatment of patients with chronic pain].

Therapy by psychotropic drugs is bound to limited indications, which are partially changing. By an extent literary research in pubmed and Cochrane especially corresponding articles of the past 10 years were proofed. So antidepressants were continually seldom given to nociceptor pain.

[The general importance of antidepressants in treatment of patients with chronic pain].

In recent years it came to a change of paradigm in therapy of chronic pain. Not the one cause is now responsible for a defined pain but a group of factors. According to this pain will be no longer treated with opioids or NSAIDs only but by given psychotropic drugs.

[Atypical neuroleptics in the treatment of atypical facial neuralgia. Two case reports].

The criteria for the diagnosis of the atypical facial neuralgia make it is possible to classify under this neurological diagnosis also psychiatric disorders as conasthetic depression. In two case reports it is told about patients with both diagnosis. Due to this they were treated with an atypical neurolepticum (Olanzapine) to reach three targets: Therapy of the depression, pain i.

[Cenesthesia as a rare differential diagnosis of persistent idiopathic facial pain].

Cenesthesia is portrayed as a rare differential diagnosis to persistent idiopathic facial pain, including the resulting therapy with antipsychotics. In this case report a female patient developed persistent facial pain 2 years after manifestation of a depressive disorder. The symptoms appeared as a bizarre pain phenomenon closely resembling the psychotic phenomenon of cenesthesia (body hallucinations).

Effects of enhanced activity on synaptic transmission in mouse extensor digitorum longus muscle.

1. Transmitter release at neuromuscular junctions of extensor digitorum longus (EDL) muscle in mice was studied after 2-8 month periods of unforced running in wheels. 2.