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Introduction
There are no valid data available for Germany on the prevalence of migraine using the new diagnostic and classification criteria of the International Headache Society (IHS).Sample and methods
Therefore, a survey on migraine prevalence was carried out on a representative sample of 2000 residents aged 16 to 69 years of the states of the former West Germany. The questionnaire incorporated the new criteria of the IHS and the diagnosis of migraine was based on the corresponding classification.Results
Some 23.4% of the sample suffered from headaches, and 3.6% were identified as having migraine according to the IHS classification. The prevalence of migraine was 5.3% in women and 1.7% in men. The highest prevalence of 5.7% was found in the group aged 40–49 years. By extending the 4–72 h IHS attack duration criterion to 2–72 h, the migraine prevalence increased from 3.6% to 4.4%.Discussion
For methodological reasons our study may underestimate the true prevalence of migraine in Germany. Taking our rather “conservative” figures into account, our study reveals, however, that there are more than 2 million migraine sufferers in Germany between 16 and 69 years of age. 相似文献2.
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Background
The aim of this study was to examine the validity and reliability of clinical stability tests for upper cervical instability.Methods
A search of the literature was performed in the databases PubMed, CINAHL, and the Cochrane Library. The quality of the studies was assessed using the quality appraisal tool for studies of reliability (QAREL) checklist and the diagnostic study appraisal worksheet of the Centre for Evidence-Based Medicine (CEBM). For the analysis of the contents, comparison criteria that describe the validity and reliability of the stability tests were established.Results
The Sharp-Purser test is especially valid for rheumatoid arthritis in the recognition of upper cervical instabilities. An atlas-dens interval (ADI) >?4 mm is also appropriate for exclusion of upper cervical instabilities. The passive intervertebral movement (PIM) tests also seem to be valid and reliable for the diagnosis of upper cervical instabilities in patients with whiplash injuries. The upper cervical flexion test is the only test that provides reliable results in patients with Down’s syndrome. The clunk test and the anteroposterior laxity test are not suitable for the diagnosis of upper cervical instabilities.Conclusion
The Sharp-Purser and PIM tests appear to be suitable for the diagnosis of upper cervical instabilities. 相似文献4.
Background
Pain, restriction of mobility and cognitive impairment are often present in old age and intensify each other.Objectives
Is there a relationship between mobility, pain, cognitive capacity, diagnoses and number of prescribed medication for residents of nursing homes?Methods
Subgroup analysis of the baseline data from an intervention study for optimization of the medication safety of 120 nursing home residents.Results
Pain was presumed in 77.8% of the residents. Persons with cognitive impairment were more frequently affected. The results of the observational and self-reported pain assessment in cognitively impaired patients did not agree for two-thirds of the cases. A correlation between prevalence of pain, pain intensity and mobility could only be shown for persons without cognitive impairment. Half of the persons were unable to walk; 80% of the residents with analgesics as a permanent medication were more restricted in their mobility.Conclusions
Cognitive impairment is associated with pain and reduced mobility, whereby self-rated pain did not concur with the observational pain assessment for two-thirds of the residents with cognitive impairment. This illustrates the difficulty of observational pain assessment.5.
Groák Béla 《Zeitschrift für die gesamte experimentelle Medizin einschliesslich experimenteller Chirurgie》1936,97(1):823-825
Research in Experimental Medicine - 相似文献
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K. Limbrecht-Ecklundt P. Werner H. C. Traue A. Al-Hamadi S. Walter 《Schmerz (Berlin, Germany)》2016,30(3):248-256
Background
The monitoring of facial expressions to assess pain intensity provides a way to determine the need for pain medication in patients who are not able to do so verbally.Objectives
In this study two methods for facial expression analysis – Facial Action Coding System (FACS) and electromyography (EMG) of the zygomaticus muscle and corrugator supercilii – were compared to verify the possibility of using EMG for pain monitoring.Material and methods
Eighty-seven subjects received painful heat stimuli via a thermode on the right forearm in two identical experimental sequences – with and without EMG recording.Results
With FACS, pain threshold and pain tolerance could be distinguished reliably. Multiple regression analyses indicated that some facial expressions had a predictive value. Correlations between FACS and pain intensity and EMG and pain intensity were high, indicating a closer relationship for EMG and increasing pain intensity. For EMG and FACS, a low correlation was observed, whereas EMG correlates much better with pain intensity.Conclusions
Results show that the facial expression analysis based on FACS represents a credible method to detect pain. Because of the expenditure of time and personal costs, FACS cannot be used properly until automatic systems work accurately. The use of EMG seems to be helpful in the meantime to enable continuous pain monitoring for patients with acute post-operative pain.9.
Background
Decisive for initiation of growth-dependent orthodontic treatment is the growth potential of a patient within the next 2 years. In order to determine the average growth potential of a child or adolescent at the time of examination, the growth curves of the World Health Organization (WHO) are used. These encompass the non-individualized growth rates. There is a growth peak in puberty and an even higher growth potential in the early infant development period.Methods
This study was concerned with the use of a body size-related individual measure in the calculation of the growth rate. This involved analyzing the growth curves of children with respect to the growth rate at different points in time. The age-related growth rates were compared not in absolute values but in relation to body size.Results
Using the same basic data, the early infant growth potential seems to be greater and the growth peak in puberty seems to be lower when the growth rate is relatively applied. In young girls the growth peak in puberty disappears almost completely. Recommendations to initiate therapy during the growth maximum in puberty for the greatest possible efficiency, therefore lose in importance. The specialist societies recommend the earliest possible time point for therapy when dysfunctions are present. The correction of oral dysfunction is more easily possible when carried out as early as possible. The earliest possible point in time is defined exclusively according to the mental capacity of the children for therapy. In this way greater success can be achieved with smaller therapeutic measures. 相似文献10.
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Manual medicine should concentrate more on the early recognition of the causes of damage resulting in pain due to false posture or overloading of the musculoskeletal system during occupational activities or activities of daily living. Increased muscle tension or deviations in movement patterns result in structural alterations. This leads to pain and this in turn leads to alterations in motor function. Both cases are described as dysfunctions or disorders in movement control, which can possibly be detected in the initial stages by preliminary and targeted manual examinations. Under these aspects a preventive manual medicine check-up for runners was developed, which is presented in this article and which can possibly be used as an exemplary model for other target groups. 相似文献
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Background
There are no data available on the prevalence of disabling abdominal pain and menstrual cramp in adults in Germany.Methods
Abdominal pain and menstrual cramp, additional somatic symptoms and depressive symptoms were assessed by the Patient Health Questionnaires (PHQ) 15 and 9 in persons ≥?14 years from a sample representative of the general German population. The association of disabling abdominal and menstrual cramp with demographic and clinical variables was tested by logistic regression analyses.Results
A total of 2524 out of 4064 (62.1?%) contacted persons participated in the study. Of the participants 11.9?% reported suffering from slight abdominal pain and 0.9?% reported suffering from severe abdominal pain within the last 4 weeks. Female gender with an odds ratio (OR) of 2.23 (95?% confidence interval CI 1.67–2.98, p?<?0.001), younger age (OR 0.97, 95?% CI 0.96–0.98, p?<?0.001), physical symptom burden PHQ 15 (OR 1.33, 95?% CI 1.26–1.40, p?<?0.0001) and depression PHQ 9 (OR 1.13, 95?% CI 1.08–1.77, p?<?0.0001) were predictive for abdominal pain. Of the women aged 14–55 years 19.8?% reported to be slightly troubled by menstrual cramp and 3.9?% reported suffering from severe menstrual cramp within the last 4 weeks. Menstrual cramps were predicted by younger age (OR 0.96, 95?% CI 0.94–0.97, p?<?0.001), somatic symptom burden PHQ 15 (OR 1.24, 1.12–1.36, p?<?0.0001) and depression PHQ 9 (OR 1.08, 95?% CI 1.01–1.15, p?<?0.0001).Conclusion
Persons in the general German population frequently reported slightly disabling abdominal pain and menstrual cramp; however, severely disabling abdominal pain and menstrual cramp were rarely reported. Abdominal pain and menstrual cramps were associated with additional somatic complaints and depression. 相似文献14.
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Zusammenfassung Der Migräneschwindel (MiS) gehört zu den häufigsten Ursachen von episodischem Schwindel und findet unter Neurootologen und Migränespezialisten zunehmend Beachtung. Die Diagnosefindung wird häufig durch die Heterogenität seiner klinischen Präsentation bzgl. Art des Schwindels, Dauer und Beziehung zu Kopfschmerzen und anderen migränösen Symptomen erschwert. Attackenbefunde lassen vermuten, dass verschiedene pathophysiologische Mechanismen involviert sein können. Die Therapie des MiS kann sich bislang nur auf Fallbeobachtungen stützen. Gegenwärtig wird der MiS nicht in der Klassifikation der International Headache Society abgebildet, es werden daher Diagnosekriterien vorgeschlagen. 相似文献
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Background
Primary capsular stiffness (PCS) is a common shoulder disease without identifiable etiology or associated pathology. The stage-adapted multimodal treatment of PCS is challenging and still requires optimization.Objectives
The newest, evidence-based perceptions related to PCS with recommendation of clinically relevant diagnostic and therapeutic guidelines are summarized.Materials and methods
Relevant, new findings regarding the etiology and diagnosis of PCS from the last 10 years were summarized. A 2012 treatment algorithm for PCS was updated and expanded with the most current knowledge.Results
The subacromial space is involved in inflammatory processes in the initial phase of PCS. Identification of advanced glycation end products help with understanding the fibrotic changes. Elevated serum lipid levels are associated with PCS but their exact role remains unclear. Distension of the bursa in the superior subscapularis recess is a “new” suggestive MRI sign of the pathology. Combined intraarticular and subacromial corticosteroid injections seem favorable over intraarticular-only injections. Hospital-based exercise class is more effective regarding the functional outcomes of PCS than individual physiotherapy or home exercise. Additional passive stretching of the capsule in the pain-free frozen and thawing states is beneficial. After failure of nonoperative treatment of at least 6 months, arthroscopic arthrolysis is recommended.Conclusions
Several publications in the literature over the past few years have contributed to an improved understanding and better treatment of PCS.18.
Background
Chronic pain is characterized by a complex interaction of somatic, mental and social factors. Assessing these factors in patients with chronic pain is vital during the diagnostic work-up and when making a structured treatment plan. Interdisciplinary pain assessment (ISA) is the most promising method to deal with these challenges. This article presents our experience in performing pain assessments in the hospital setting and also illustrates the characteristic features of chronic pain patients undergoing such assessments.Methods
This study reviews and evaluates patient data from 2704 ISAs performed at the Interdisciplinary Pain Centre of the Zentralklinik Bad Berka, Germany, between 2008 and 2015.Results
The majority of our ISA patients are severely handicapped and show distinct signs of chronic disease. A large proportion of patients is either unable to work or receiving benefits (invalidity pension or retirement pension). In addition, patients reported long disease durations and high emotional distress. Treatment recommendations were based on the patients’ individual clinical presentations and examination results. More than half of the patients required multimodal pain management, while adjustments or therapeutic withdrawal of pain medications, in particular of opioids, were indicated in many patients.Discussion
Our study shows that ISA enables fast, high-quality diagnostic assessments of chronic pain while taking the biopsychosocial model of pain in particular into account. In addition, ISA is not biased with regard to outcome results and recommends the further treatment that appears best for the individual patient. ISA leads not only to inpatient treatment, but also to treatment in other therapeutic settings and, as such, is not merely a door-opener to multimodal pain therapy.19.
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