Bilateral Sensory Changes and High Burden of Disease in Patients With Chronic Pain and Unilateral Nondermatomal Somatosensory Deficits: A Quantitative Sensory Testing and Clinical Study.

Objectives: Widespread sensory deficits resembling hemihypoesthesia occur in 20% to 40% of chronic pain patients on the side of pain, independent of pain etiology, and have been termed nondermatomal sensory deficits (NDSDs). Sensory profiles have rarely been investigated in NDSDs.

Materials And Methods: Quantitative sensory testing according to the protocol of the German Research Network on Neuropathic Pain (DFNS) was performed in the face, hand, and foot of the painful body side and in contralateral regions in chronic pain patients.

Functional Characterization of At-Level Hypersensitivity in Patients With Spinal Cord Injury.

Unlabelled: At-level and above-level hypersensitivity was assessed in patients with chronic complete thoracic spinal cord injury (SCI). Patients were classified using somatosensory mapping (brush, cold, pinprick) and assigned into 2 groups (ie, patients with at-level hypersensitivity [SCIHs, n = 8] and without at-level hypersensitivity [SCINHs, n = 7]). Gender and age-matched healthy subjects served as controls.

Short lasting transient effects of a capsaicin 8% patch on nociceptor activation in humans.

Background: At high concentration, the TRPV-1 agonist capsaicin de-sensitizes nociceptors and reduces the intra-epidermal nerve density.

Methods: We investigated the effects of a 5 × 10 cm capsaicin 8% patch on C- and A-delta-nociceptor activation in ten healthy subjects before and at days 1-3-7-21 after patch application. Thermal thresholds, infrared thulium-YAG laser-evoked potentials (LEP) and heat pain (numeric rating scale, NRS, 0-10), electrically induced pain (10 pulses, 1.

Nondermatomal somatosensory deficits in chronic pain are associated with cerebral grey matter changes.

Objectives: Widespread sensory deficits occur in 20-40% of chronic pain patients on the side of pain, independent of pain aetiology, and are known as nondermatomal sensory deficits (NDSDs). NDSDs can occur in absence of central or peripheral nervous system lesions. We hypothesised that NDSDs were associated with cerebral grey matter changes in the sensory system and in pain processing regions, detectable with voxel-based morphometry.

Tetrahydrocannabinol (Delta 9-THC) Treatment in Chronic Central Neuropathic Pain and Fibromyalgia Patients: Results of a Multicenter Survey.

Central neuropathic pain is difficult to treat, but delta 9-Tetrahydrocannabinol (delta 9-THC) may be a promising therapeutic agent. We administered in 172 patients on average 7.5 mg delta 9-THC over 7 months.

[Implementation of an electronic patient record. Experience in an interdisciplinary pain clinic].

A complex electronic patient record was implemented in an interdisciplinary pain clinic. The goal was to create a tool that would allow structured access to the entries made by all specialty groups and permit data analysis for statistical and scientific purposes by means of integrated, coded fields. An electronic workflow was developed to facilitate the processing of documents.

Pulsed radiofrequency treatment of the lumbar medial branch for facet pain: a retrospective analysis.

Background: The use of pulsed radiofrequency (PRF) for treatment of the medial branch is controversial.

Study Design: A retrospective study of the results of PRF treatment of the medial branch in 48 patients with chronic low back pain was carried out. Patients who did not respond were offered treatment with conventional radiofrequency heat lesions.

[Autologous transfusion--from enthusiasm to reason: clinical practice based on scientific knowledge].

This symposium (Nottwil/Lucerne, Switzerland, January 20./21. 2006,) gives you the latest review / clinical results / experimental data on autologous transfusion: Routine leucodepletion of preoperative autologous deposit, immunological perspectives, special processing of bacterially contaminated autologous blood, pro and con concerning autologous blood supply as a reasonable alternative, autologous platelet gel, the Austrian benchmark study on RBC-transfusion.

Hypervolemic hemodilution: an alternative to acute normovolemic hemodilution? A mathematical analysis.

Background: Hypervolemic hemodilution has been proposed as an alternative to normovolemic hemodilution to reduce homologous blood transfusions. So far, convincing data supporting this concept are unknown.

Materials And Methods: We therefore present a mathematical model calculating the efficacy of hypervolemic, normovolemic, and "no" hemodilution.

[Cost analysis of autologous transfusion methods--a study of 5,017 patients].

Purpose: Cost analysis of autologous blood conservation measures compared to corresponding homologous blood products.

Methods: This study is based on data from 5,017 patients undergoing major bone and joint surgery in 1993 and participating preoperatively in autologous blood donation (ABD) (with hemoseparation (HS) into autologous packed red blood cells (APRBC) and autologous fresh-frozen-plasma (AFFP)), autologous plasmapheresis (APPH) for harvesting AFFP as well as intra-/postoperative blood salvage with mechanically processed autologous transfusion (MAT).

Results: Total costs for 3,110 ABD with HS amount to DM 517,586.

[Erythropoietin therapy during frequent autologous blood donations. Dose-finding study].

Avoidance of homologous blood products and patients' demand for preoperative autologous blood donation programs are increasing. As many of these patients are older, with a compromised cardiovascular system and a slow response of the erythropoietic system when anemia occurs, the feasibility and benefit of autologous blood donation is often limited. Augmentation of preoperative blood donation by therapy with recombinant human erythropoietin (rHuEPO) has been described in animal models and in patients.

[Cryopreservation of erythrocytes using hydroxyethyl starch: in vivo results of an autologous retransfusion model in humans].

The cryopreservation of human red blood cells (RBC) can be greatly beneficial in certain situations such as for rare blood groups, problems due to multiple antibodies, and as an interim aid during temporary shortages. Additionally, cryopreserved erythrocytes may be useful in cases of civil or military disasters. Frozen/thawed autologous RBC are of particular interest as a supplement to liquid storage for elective operations (e.

[The present possibilities for routine use of blood-saving measures from the anesthesiologic point of view--theoretical basis and clinical practice. I. Potential risks of homologous transfusion; normovolemic hemodilution].

This paper, which is the first part of four, deals with the potential risks of homologous blood transfusion as well as with normovolemic hemodilution, an autologous transfusion method, which is easily to be applied and not expensive. Although the various methods of autologous transfusion are well known for many years the public discussion on the "AIDS-topic" has led to a growing interest in blood-saving measures. However, in contrast to the so-called "AIDS-topic" the potential risks of a transfusion-transmitted hepatitis as well as the immunologic effects of homologous blood are of much greater importance.

[The present possibilities for routine use of blood-saving measures from the anesthesiologic point of view--theoretical bases and clinical practice. III. Autologous blood donation, autologous donation criteria and organizational measures].

This third part of a review on "Autologous Transfusion" deals with preoperative autologous blood donation, with supplemental pharmaco-therapy, with election criteria of the patient as well as with the organizational measures to be taken into account if an intensive autologous predeposit programme is routinely applied. Donation of an autologous predeposit aims at supplying the patient with autologous blood and autologous plasma, respectively, according to the expected blood loss and in order to reduce the need for homologous transfusion. Important aspects, which have to be considered if applying a routine autologous donation programme refer both to the election criteria of the patient and to the organizational programme and measures to be considered.

[The present possibilities for routine use of blood-saving measures from the anesthesiologic point of view--theoretical basis and clinical practice. II: Perioperative retransfusion of acute blood loss; plasmapheresis].

Intra- and postoperative blood-salvage with consecutive retransfusion represent an established part within the "Concept of Autologous Transfusion (CAT)". According to the processing technique of the blood salvaged there exist two different systems: Autologous Transfusion System II (ATS II) and Autologous Transfusion System III (ATS III). By using ATS II blood (with or without anticoagulation) is collected within a collecting reservoir after having passed a rough-filter-system.

[Monitoring in hemodilution].

Normovolaemic haemodilution is an established part within the 'Concept of Autologous Transfusion'. According to the mechanisms to compensate for the dilution-induced anaemia, monitoring of haemodilution has to consider (1) maintenance of normovolaemia; (2) stability of the cardio-vascular system and of a normal pulmonary function; (3) an adequate myocardial oxygen supply. (1) Normovolaemia: Under routine clinical conditions normovolaemia is controlled by close monitoring of fluid balance (considering surgical blood loss, diuresis, and insensible perspiration).