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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Anaesthesist 46 (1997), S. 516-527 
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Rehabilitation chronischer Schmerzpatienten ; Organisation von Schmerzambulanzen ; Interdisziplinäre Schmerztherapie ; Schmerztherapie in Deutschland ; Rehabilitation von Rückenschmerzen ; Key words Comprehensive rehabilitation programs ; Rehabilitation of chronic pain syndromes ; Back pain rehabilitation ; Clinical and social factors of chronic pain patients ; Pain treatment in Germany
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract There is still a significant lack of treatment and rehabilitation facilities for chronic pain patients in Germany today. Most of all the treatment of low back pain and widespread pain syndromes or panalgesia is time consuming and complicated. The main problem of anaesthesiological pain clinics is the increase of these complex pain syndromes in the last years. The definition of chronic pain is a contiuous noxious input modulated and compounded by the prolonged or recurrent nature of chronic state and further complicated by a multitude of economic and psychosocial factors. It is now clear that no one discipline or mode will suffice. Only a multidisciplinary and intensive approache will prevail, as discussed in this article. Unfortunately these multidisciplinary pain units are nearly not existing in Gemany just as little as control of the effectiveness of pain treatment.
    Notes: Zusammenfassung Die Versorgungslage von Patienten mit chronischen Schmerzen in Deutschland ist augenblicklich immer noch durch das Fehlen entsprechender qualifizierter schmerztherapeutischer Einrichtungen und Rehabilitationsmaßnahmen gekennzeichnet. Besonders aufwendig sind dabei Patienten mit chronischen Rückenschmerzen sowie multilokuläre Schmerzbilder und Panalgesien. Eines der Hauptprobleme an den anästhesiologisch geleiteten Ambulanzen ist die Zunahme dieser schwer chronifizierten Schmerzbilder in den letzten Jahren. Durch ein komplexes Ineinandergreifen verschiedener somatischer medizinischer Bereiche sowie psychologischer und sozialer Faktoren ist hier eine erfolgreiche Behandlung nur in enger simultaner interdisziplinärer Zusammenarbeit möglich. Viele Autoren haben in qualitativen Reviews und Metaanalysen die generelle Wirksamkeit multidisziplinärer, meist verhaltenstherapeutisch orientierter Konzepte beschrieben. Monodisziplinäre Vorgehensweisen ohne Verhaltensänderung der Patienten bleiben dagegen in der Regel wirkungslos. Trotzdem haben diese Erkenntnisse bisher keinen Eingang in das deutsche Gesundheitssystem gefunden. Ein multifaktorielles Störungsmodell, in dem biologische und psychologische Aspekte integriert sind, wird bei uns nur von wenigen Experten vertreten und das dichotome Krankheitsmodell (medizinische vs. psychologische Ursachen) dominiert in Wissenschaft und Praxis immer noch. Darüber hinaus fehlen Kontrolle und Überprüfung der Effizienz und damit auch die Rechtfertigung vieler schmerztherapeutischer Maßnahmen und Tätigkeiten im hiesigen Gesundheitssystem.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Der Anaesthesist 46 (1997), S. 428-429 
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Transdermales Fentanyl ; Nebenwirkungen ; Atemdepression ; Opioidintoxikation ; Nicht-Tumorschmerz ; Key words Transdermal fentanyl ; Adverse reactions ; Depression of ventilation ; Opioid intoxication ; Non-cancer pain
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract A 22-year-old male suffering from neuropathic pain in his right leg had sufficient analgesia with oral tilidin 300 mg per day. Nevertheless, the general practitioner decided to change the therapy to transdermal fentanyl. Having cut a fentanyl patch (50 µg/h) into pieces, he applied one-fourth of the patch; 60 min later the patient developed signs of opioid intoxication, including heavy sedation, nausea and respiratory depression. After the patch was removed another 60 min later, the patient made a complete recovery. The risks following inappropriate application of transdermal fentanyl are discussed.
    Notes: Zusammenfassung Ein 22jähriger Patient, der an einem neuropathischen Schmerz im rechten Bein leidet, ist mit einer oralen Tilidin-Medikation von 300 mg/die zufriedenstellend analgetisch eingestellt. Der Hausarzt möchte ihn dennoch auf transdermales Fentanyl umstellen und appliziert ihm 1/4 eines zuvor zerschnittenen Fentanylpflasters (50 µg/h). Bereits 60 min später entwickelt der Patient Zeichen einer Opioidintoxikation mit Schläfrigkeit, Übelkeit und Atemdepression. Weitere 60 min später wird das Pflaster entfernt; der Zwischenfall bleibt für den Patienten folgenlos. Es wird auf die Risiken eines unsachgemäßen Umgangs mit transdermalen Fentanylpräparaten hingewiesen.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    The journal of membrane biology 144 (1995), S. 49-58 
    ISSN: 1432-1424
    Keywords: Signal transduction ; Lysophospholipids ; Plasma membrane receptor ; Phospholipase C-activation ; Calcium influx ; Calcium entry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology
    Notes: Abstract We tested lysophosphatidic acid (LPA), known to induce inositol phosphate generation and calcium signals as well as rearrangements of the cytoskeleton and mitogenic responses in fibroblasts, for its ability to activate phospholipase C in an exocrine cell system, the salt-secreting cells from the avian nasal salt gland. LPA (〉10 nmol/l) caused the generation of inositol phosphates from membrane-bound phosphatidylinositides. The resulting calcium signals resembled those generated upon activation of muscarinic receptors, the physiological stimulus triggering salt secretion in these cells. However, close examination of the LPA-mediated calcium signals revealed that the initial calcium spike induced by high concentrations of LPA (〉10 μmol/l) may contain a component that is not dependent upon generation of inositol (1,4,5)-trisphosphate (Ins(1,4,5)P3) and may result from calcium influx from the extracellular medium induced by LPA in a direct manner. Low concentrations of LPA (〈10 μmol/l), however, induce inositol phosphate generation, Ins(1,4,5)P3-mediated release of calcium from intracellular pools and calcium entry. These effects seem to be mediated by a specific plasma membrane receptor and a G protein transducing the signal to phospholipase C in a pertussis-toxin-insensitive manner. Signaling pathways of the muscarinic receptor and the putative LPA-receptor seem to merge at the G-protein level as indicated by the fact that carbachol and LPA trigger hydrolysis of the same pool of phosphatidylinositol (4,5)-bisphosphate (PIP2) and mobilize calcium from the same intracellular stores.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Applied physics 23 (1980), S. 341-344 
    ISSN: 1432-0630
    Keywords: 42.55
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics , Physics
    Notes: Abstract An N2-laser of 19 ns pulse-duration and an energy of 30 mJ has been developed and examined. A dc preionization, a grooved electrode and a partial electrical screening of the discharge tube permit reproducible single-shot operation and yield a homogeneous beam.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    USA/Oxford, UK : Blackwell Science Ltd
    Cephalalgia 9 (1989), S. 0 
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: After many years of unsuccessful conservative treatment 16 patients suffering from hemicrania are relieved of their pain or are improved by operative treatment. Hemicranial attacks or permanent hemicrania is found to be caused by upper cervical nerve root compression. Vascular compression of C2 (n = 9) or scar tissue surrounding C2 (n = 1) or C3 (n = 1) is the pathology identified in cases of cervicogenic headache or “cluster headache-like” headache. Compression attributable to tumor, prolapsed disc, or spondylotic changes is found to be a cause of permanent headache. Only in those patients with permanent headache are radiological or electrophysiological findings helpful for diagnosis. In patients with hemicranial attacks and compression of nerve root C2 (n = 10) or C3 (n = 1), only vasoactive tests (provoking or relieving pain) or local anaesthesia prove to be helpful in diagnosing and localizing the origin of pain. The operation involves freeing the nerve roots from vascular compression. In two patients the C2 ganglion is resected. Thirteen patients subsequently become pain free. In three patients, hemicrania improves. Four of the 16 patients experience a recurrence of pain after the decompressive operation. After additional thermorhizotomy two patients have no further complaints and one patient has improved. One patient can tolerate his pain with occasional analgesics. The problem of referred pain into the fronto-ocular region is discussed.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Biochimica et Biophysica Acta (BBA)/Gene Structure and Expression 783 (1984), S. 67-73 
    ISSN: 0167-4781
    Keywords: (O. hookeri) ; Chloroplast biogenesis ; Posttranscriptional control ; Ribulosebisphosphate carboxylase / oxygenase ; Transcription ; Translation
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology , Medicine , Physics
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Physics Letters A 95 (1983), S. 365-368 
    ISSN: 0375-9601
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Physics
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Journal of Quantitative Spectroscopy and Radiative Transfer 37 (1987), S. 211-218 
    ISSN: 0022-4073
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Physics
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Advances in Space Research 9 (1989), S. 47-51 
    ISSN: 0273-1177
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics , Physics
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Optics Communications 53 (1985), S. 229-234 
    ISSN: 0030-4018
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Physics
    Type of Medium: Electronic Resource
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