[Placebo Effects in Acute Pain Therapy].

Placebo and nocebo effects are currently within the focus of clinical and experimental pain research. Neurophysiological and psychophysiological mechanisms might play an important role. Placebo and nocebo effects might be mediated through the descendent inhibitory pain pathway via endogenous opioids.

[Case Report: Opioid Therapy for Chronic Low Back Pain].

Within this case report we describe and discuss the treatment of a patient with chronic low back pain complaining about severe pain, reduced functionality and symptoms of depression, who was treated with long-term opioids (480 mg morphine equivalents). According to the recommendation of current guidelines we successfully reduced the opioid daily dose and discharged the patient with 28 mg morphine equivalents, improved physical functionality and reduced chronic pain intensity following a specific interdisciplinary pain rehabilitation programme for seniors.

ALPHA glycolytic vasculogenesis better correlates with MRI and CT imaging techniques than the traditional oxygen vasculogenesis theory.

Objective: Traditional vasculogenesis has many contradictions related to treatment and imaging. This occurs because cancer also uses glycolysis, which does not need oxygen or arteries. Glycolytic lactate supports many procancer processes but high levels of it inhibit glycolysis.

Acidic lactate sequentially induced lymphogenesis, phlebogenesis, and arteriogenesis (ALPHA) hypothesis: Lactate-triggered glycolytic vasculogenesis that occurs in normoxia or hypoxia and complements the traditional concept of hypoxia-based vasculogenesis.

Our hypothesis, ALPHA (Acidic Lactate sequentially induced Lymphogenesis, PHlebogenesis, and Arteriogenesis) proposes that lactate triggers vasculogenesis to manage lactate levels and complements the traditional vasculogenesis hypothesis. The teleologic basis for glycolytic vasculogenesis is primariy to produce drainage vessels, initially lymphatics but subsequently veins.