The incidence of complex regional pain syndrome: a population-based study.

The complex regional pain syndrome (CRPS) is a painful disorder that can occur in an extremity after any type of injury, or even spontaneously. Data on the incidence of CRPS are scarce and mostly hospital based. Therefore the size of the problem and its burden on health care and society are unknown.

Multiplex bead array assay for detection of 25 soluble cytokines in blister fluid of patients with complex regional pain syndrome type 1.

Inflammatory processes are known to be involved at least in the early phase of complex regional pain syndrome type 1 (CRPS1). Blister fluid obtained from the involved extremities displayed increased amounts of proinflammatory cytokines IL-6 and TNFalpha compared with the noninvolved extremities. The aim of this paper is to investigate the involvement of mediators by measurement of several other cytokines using new detection techniques that enable multiple cytokine measurement in small samples.

Intermediate stage complex regional pain syndrome type 1 is unrelated to proinflammatory cytokines.

The aim of this paper is to determine the involvement of tumour necrosis factor-alpha (TNF-alpha) and interleukin (IL)-6 in intermediate CRPS 1 as locally formed mediators of inflammation. In this study, 25 patients with proven CRPS 1 (Bruehl criteria) were included. All patients participated in one of our earlier studies during the acute stage of their disease.

Mast cells are involved in inflammatory reactions during Complex Regional Pain Syndrome type 1.

Background: The Complex Regional Pain Syndrome type 1 (CRPS1) is a complication of surgery or trauma but spontaneous development is also described. Although the pathogenesis remains debatable, afferent, efferent and central nervous system mechanisms are proposed. Recently we showed involvement of the proinflammatory cytokines IL-6 and TNFalpha which is direct evidence for an inflammatory process.

Computer-assisted skin videothermography is a highly sensitive quality tool in the diagnosis and monitoring of complex regional pain syndrome type I.

The use of thermography in the diagnosis and evaluation of complex regional pain syndrome type 1 (CRPS1) is based on the presence of temperature asymmetries between the involved area of the extremity and the corresponding area of the uninvolved extremity. The interpretation of thermographic images is, however, subjective and not validated for routine use. The objective of the present study was to develop a sensitive, specific and reproducible arithmetical model as the result of computer-assisted infrared thermography in patients with early stage CRPS1 in one hand.

Anti-inflammatory actions of acupuncture.

Acupuncture has a beneficial effect when treating many diseases and painful conditions, and therefore is thought to be useful as a complementary therapy or to replace generally accepted pharmacological intervention. The attributive effect of acupuncture has been investigated in inflammatory diseases, including asthma, rhinitis, inflammatory bowel disease, rheumatoid arthritis, epicondylitis, complex regional pain syndrome type 1 and vasculitis. Large randomised trials demonstrating the immediate and sustained effect of acupuncture are missing.

Evidence for local inflammation in complex regional pain syndrome type 1.

Background: The pathophysiology of complex regional pain syndrome type 1 (CRPS 1) is still a matter of debate. Peripheral afferent, efferent and central mechanisms are supposed. Based on clinical signs and symptoms (e.

Neuroimmune alterations in the complex regional pain syndrome.

This review focuses on some clinical aspects of the complex regional pain syndrome, such as oedema, local temperature changes and chronic pain, as a result of supposed neurogenic inflammation. Involvement of the immune system could imply the subsequent release of neuropeptides, pro-inflammatory cytokines and eicosanoids, which in turn leads to a complex cross-talk of primary and secondary generated mediators of inflammation. The development and application of drugs that act through selective receptor antagonism or enzymatic synthesis inhibition to prevent further stimulation of this cascade that could inevitably lead to chronicity of this disease are extensively discussed.

The development of a dementia process within the family context: the case of Alice.

Qualitative analysis was used to analyse a diary written over a period of two years by the sister of a dementia patient. The analysis is directed at the question of how a patient and a social network respond to each other during the dementia process. The diary highlights features in the development of the dementia process which receive scant attention in empirical studies: changes in the interaction process between patient and social network; a patient's residual capacities; a caregiver's perceived rewards of caregiving.

Is the breast best for children with a family history of atopy? The relation between way of feeding and early childhood morbidity.

Background: Previous studies reported that breast-feeding protects children against a variety of diseases, but these studies were generally conducted on "high-risk" or hospitalized children. This paper describes the results of our study on the effects of breast-feeding on rate of illness in normal children with a family history of atopy.

Methods: A historic cohort approach of 794 children with a family history of atopy was used to assess the effects of breast-feeding on illness rates.

Infusion of propofol versus midazolam for sedation in the intensive care unit following coronary artery surgery.

The use and the hemodynamic effects of propofol and midazolam were studied during titrated continuous infusions to deep sedation (sedation level 5: asleep, sluggish response to light glabellar tap or loud auditory stimulus) following coronary artery surgery. The drugs were compared in 30 ventilated patients in an open randomized study. The duration of infusion was approximately 570 minutes in both groups.

Morbidity in early childhood: family patterns in relation to sex, birth order, and social class.

Background And Objectives: This study investigated family patterns of morbidity in early childhood related to different degrees of severity of morbidity, sex, birth-order position, and social class.

Methods: The study was performed using data collected by the Continuous Morbidity Registration Project of the Department of Family Practice of the Nÿmegen University in the Netherlands. All recorded morbidity and a number of sociodemographic data (sex, birth order, and social class) were available.

Morbidity from childhood to adulthood. The medical life history of 103 patients.

The aim of the study was to investigate the relationship between presented morbidity in consecutive periods of time in the first 35 years of life. Data were collected in a large rural general practice from 1946 to 1990 and covered 103 persons born between 1946 and 1959 in a general practice in the east of The Netherlands. Morbidity scores were calculated for all registered diagnoses in 5-year periods.

Morbidity in early childhood: differences between girls and boys under 10 years old.

The aim of the study was to investigate the differences in presented morbidity and use of health services among boys and girls in early childhood. The study was performed using data collected by the continuous morbidity registration project of the department of general practice at Nijmegen University. All recorded morbidity, referrals to specialists and admissions to hospitals were recorded by the registration project.

Morbidity in early childhood, sex differences, birth order and social class.

Study Objective: The aim of the study was to investigate the relationship between morbidity in early childhood and gender, birth order, and social class.

Design: The study used data collected in the Nijmegen Continuous Morbidity Registration. All presented morbidity and a number of personal data were available.

Relationship between the working styles of general practitioners and the health status of their patients.

The aim of this study was to relate the working style of general practitioners to the health status of a sample of their patients. From a large regional sick fund forming part of the national health insurance system in the Netherlands a stratified sample was taken of general practitioners with at least 1000 patients on their list, taking into account the degree or urbanization of the area in which they practised and their annual referral rates to specialists. These 75 general practitioners were observed for two days in their surgeries by trained doctors and rated according to criteria defined beforehand.

The relationship between breast-feeding and early childhood morbidity in a general population.

This study investigated the relationship between breast-feeding and early childhood morbidity. Data on morbidity had been recorded in the Continuous Morbidity Registration of the Department of Family Medicine of the University of Nijmegen, the Netherlands, since 1967. Information on early childhood feeding was collected retrospectively by questionnaires mailed to the parents of all the children; the response rate was 94%.

Handling of confidentiality in general practice: a survey among general practitioners in The Netherlands.

This paper describes the results of a study of the handling of confidentiality by general practitioners. A sample of 272 general practitioners in the eastern part of the Netherlands was interviewed. The general practitioners were presented with 10 cases involving confidentiality and were asked what course of action they would pursue.

Effect of bereavement on the health of the remaining family members.

This investigation focuses on the effect of the death of a family member on the number and type of diagnosed illnesses of the remaining members. The data on mortality and morbidity were obtained from a continuous morbidity register. A total of 225 cases of death were selected, involving 313 family members.

Longitudinal studies of family units.

In this paper the transmission of illness and illness behaviour from grandparents to their children and grandchildren is discussed. Maternal grandmothers are found to have most influence. Some prediction of the frequency of new periods of illness among the grandchildren was possible by making use of the number of nervous disorders of the grandparents for which medical help was requested.