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 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This article discusses the current and potential use of paradoxical interventions in behavioral medicine. Paradoxical interventions are considered to be of two types: intra-individual and interpersonal. Treatment indications differ for the two types of interventions. Intraindividual paradoxical interventions have been successful in the treatment of insomnia, psychogenic urinary retention and constipation. Interpersonal paradoxical interventions have been subjected to less empirical research, but have been useful in the treatment of anorexia nervosa and in family based interventions where medical patients maladaptively cope with their rehabilitation. Paradoxical procedures are also used in the treatment of sexual dysfunction and may be of value in pain management. Further possible applications as well as limitations of paradoxical interventions in behavioral medicine are discussed.
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PMID:Paradoxical interventions in behavioral medicine. 649 Sep 30

Pain occurs frequently in patients with cancer and, if uncontrolled, may lead to depression, deep anxiety, insomnia, and progressive mental and physical deterioration. Pain can be effectively relieved in the majority of cases by balanced use of pharmacologic agents and other treatment modalities, including surgery, chemotherapy, and radiation therapy. A thorough evaluation of the patient's complaints and an accurate diagnosis of the causes and mechanism of pain are mandatory for the formulation of an effective and individualized treatment plan. Continuing emotional support is essential to the relief of suffering in patient and family.
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PMID:Pain syndromes associated with cancer. Achieving effective relief. 669 19

Plasma concentrations of diazepam and its major active metabolite nordiazepam were measured in 108 neurosurgical patients taking diazepam in doses of 5 to 40 mg/day for periods from one month to 16 years. Diazepam was used for relief of pain or muscle spasm, or anxiety and sleeplessness associated with these two symptoms, and was considered to be beneficial by 83% of the patients, although use of other drugs confounded this evaluation. Concentrations of total diazepam-nordiazepam ranged from 0 to 2,584 ng/mL, with nordiazepam being the predominant metabolite. "Low" concentrations (less than 250 ng/mL) were found in 35 of the 108 patients, with 19 having concentrations lower than 100 ng/mL. "High" concentrations (greater than 900 ng/mL) were found in 20 patients and did not occur more frequently than in other studies of long-term diazepam ingestion. Even with long-term use, diazepam seemed to retain its efficacy and did not lead to any clear-cut abuse.
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PMID:Long-term use of diazepam. 679 75

Encouraged by the good results obtained using acupuncture anaesthesia, we started therapeutic acupuncture in our institute of anaesthesiology four years ago. In the meantime acupuncture is as important a therapeutic method in our out-patients department as are therapeutic local anaesthesia, transcutaneous electrical nerve stimulation and biofeedback. The results in 520 patients who have been treated with acupuncture for different diseases are reported. The success of treatment, the number of sessions and the recurrence-rate within one and a half years are discussed for the different diseases. Acupuncture treatment was regarded successful when 1, the patient had no complaints at all without medication, and 2, when there was significant improvement (no long term medication, only mild complaints with unusual strain, which were responsive to minimal medication). Thus treatment in cephalgia was successful in 83% with no recurrences (NR) in 84%. In cervical pain syndromes the respective percentages were 80% (NR = 74%) in constipation 80% (NR = 72%), sinusitis 86% (NR = 100%), insomnia 100% (NR = 100%). Good results, albeit with high recurrence rate were achieved in cases of trigeminal neuralgia in 90% (NR = 23%), colitis ulcerosa in 100% (NR = 0%), in bronchial asthma 70% (NR = 50%) and in tumour pain 61% (NR = 0%). Treatment in patients suffering from parathymic conditions were unsatisfactory and results in cases of tinnitus were negative.
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PMID:[Acupuncture therapy in the outpatients-department of the University Clinic Heidelberg (author's transl)]. 697 22

Carprofen is a new non-steroidal compound with analgesic, anti-inflammatory and anti-pyretic properties. Eighty patients with different types of extra-articular inflammatory processes such as periarthritis humero-scapularis, tendinitis, bursitis, etc., were studied by means of two double-blind protocol designs comparing carprofen 150 and 300 mg daily, either as a b.i.d. or a t.i.d. administration, for two weeks. The criteria to determine the therapeutic properties of the compound was based on the improvement of spontaneous pain, pain with movement and functional limitation. Evolution of symptoms showed that either 150 or 300 mg carprofen administered as a b.i.d. schedule, were equally effective (chi 2 test between groups was not significant). According to a t.i.d. schedule results were better with 300 mg. General tolerance was excellent and only 15% of the patients receiving 300 mg complained of side-effects, such as nausea, mild dermatitis, acidity and insomnia. In conclusion, carprofen 150 or 300 mg has a good therapeutical activity in extra-articular inflammatory processes, employing either a b.i.d. or a t.i.d. schedule.
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PMID:Experience with carprofen in extra-articular inflammatory processes. 698 66

Fosfosal or 2-phosphonoxybenzoic acid is a new analgesic drug, whose analgesic activity and side effects have been determined in a double blind clinical study in comparison with placebo. The study has been done with 60 outpatients, of both sexes, which suffered musculoskeletal and arthritic pains. Patients were treated with fosfosal or placebo for eight days. The daily dose of fosfosal was 1 gram three times a day, once every 6-8 hours. The results obtained show that fosfosal has a clear analgesic activity, statistically significant versus placebo in all the parameters that were measured: pain severity, activity impairment and insomnia. The overall evaluation of the group of patients treated with fosfosal showed a marked improvement with a difference statistically significant with respect to the control group treated with placebo (p less than 0.001). The distribution of results in the fosfosal treated group was as follows: poor, 1; regular, 8; good, 10 and excellent, 6. The distribution in the placebo group was as follows: poor, 15; regular, 3; good, 2 and excellent, 0. The marked analgesic activity, the absence of side effects and the excellent gastric tolerance suggest that fosfosal is a promising new analgesic drug useful for the treatment of painful syndromes of several etiologies.
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PMID:[Comparative double-blind study of the analgesic activity of fosfosal (UR-1521) in patients with musculoskeletal and articular pain (author's transl)]. 701 70

In the case of psychosomatic disease, it seems that every Oriental drug produces the same effect. Similar to other symptomatic therapies, treatment of Zheng with an Oriental drug results in improvement of psychosomatic disease. Thus, patients differ between Chaikojialonglotsuboleitang and Guizhifulingwan. Principle indications are neither sleeplessness nor irritation, but pressure pain and resistance in the right upper abdomen in the former drug and pressure pain and resistance in the left lower abdomen in the latter. Treatment with the drug according to this procedure consequently results in recovery from the disease. This is the reason why we call it a radical therapy, not a symptomatic one. As the Oriental drug produces extremely favorable effects in psychosomatic disease and often cures it radically, we believe that this therapy should be applied as a first choice among the drug therapies available.
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PMID:Oriental drugs and herbs (crude drug) for psychosomatic diseases. 705 26

Patients with chronic psychogenic pain appear to suffer from a specific depressive type of disease, with somatized pain as the prime expression of a concealed mental agony (pain-prone disorder). This view is supported by clinical, premorbid, and psychodynamic findings, as well as by the presence of biological markers including a family history of affective disorders and response to antidepressants. Additional biological markers of depression include shortened rapid eye movement (REM) latency in sleep and nonsuppression in the dexamethasone suppression test (DST). The study of both markers in 20 consecutive pain-prone patients with insomnia showed clearly abnormal REM latency and/or DST nonsuppression in one half of the otherwise homogeneous group. There was high correlation between DST cortisol level and REM latency. both biological markers tend to predict response to antidepressants. The findings confirm that the pain-prone disorder can be viewed as a variant of depressive disease.
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PMID:Biological markers for depression in chronic pain. 708 2

Polygraphic recordings of the sleep of patients complaining of insomnia has led to recognition of specific patterns of disturbed sleep corresponding to different etiologies of insomnia. This study presents results of polygraphic recordings of the sleep of 26 patients with chronic pain for which no physical cause can be found. All 26 also complained of insomnia. Sleep parameters of this group were compared with those to two other groups also complaining of insomnia: 12 patients whose disturbed sleep was judged secondary to psychiatric disorder, and 16 patients with the subjective complaint of insomnia in whom no objective evidence of sleep disturbance could be demonstrated. The three groups differed significantly in terms of their sleep parameters. The pain patients slept less than the subjective insomnia patients. The sleep disturbance of the psychiatric patients was more severe than that of the chronic patients. Several chronic pain patients showed evidence of nocturnal myoclonus; several also showed alpha rhythm intrusions into their sleeping electroencephalograms. The study verifies that chronic pain patients do experience significant sleep disturbance and raises several questions concerning relationships among chronic pain, sleep disturbance, and psychiatric illness, particularly depression.
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PMID:Disturbed sleep in patients complaining of chronic pain. 708 3

This open study evaluated the safety, tolerance and efficacy of multiple oral doses of butorphanol tartrate as long-term therapy for moderate to severe pain of various aetiologies. Twenty patients were given doses ranging from four to twelve 4 mg tablets per day for a period of 3 to 201 days (median 87 days). Median pain relief over the entire study was rated as good, very good or excellent in eleven patients (55%) and poor to fair in the remaining nine patients (45%). Global assessments were as follows: good to very good--twelve patients; poor to fair--eight patients. Ten of the twenty patients treated reported side-effects (sedation, light-headedness, dizziness, insomnia and headache) ranging from mild to severe. No drug-related abnormalities with respect to blood pressure, body-weight or laboratory data were evident.
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PMID:An open evaluation of oral butorphanol as long-term therapy in out-patients suffering from moderate to severe chronic pain. 722 22


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