The problematic concept of somatoform pain DSM-IV

DSM-IV is the problematic concept of somatoform pain disorder and list the following criteria for pain disorders:

1. Pain in one or more anatomical region (s) are at the forefront of the clinical picture and should justify clinical attention for sufficient severity.
2. The pain causes clinically significant distress or deterioration in social, occupational, or other important areas of functioning.
3. The psychological factors are important for the beginning, severity, exacerbation, or maintenance of the pain.
4. Symptoms or failure is not intentionally produced or feigned.
5. The pain could not be better explained and did not meet the criteria for dyspareunia by affective, anxiety, or psychotic disorders.

Pain disorder according to DSM-IV is characterized by pain, which is the focus of clinical attention and in terms of onset, degree, exacerbation or maintenance significantly related to psychological factors. Psychological factors are important both as a cause, trigger symptoms or maintaining factor. The guidelines present in the clinical diagnosis of ICD-10 mind-body dualism tends to be avoided in the DSM-IV, but implicitly there. Psychological factors are not to be understood as a "decisive causal effect" on pain, which is different from the ICD-10 guidelines where they should be dominant and no organic substrate (not even myogelosis muscle) can be given.

Puerperal Mastitis | BreastPainBlog.blogspot.com

Mastitis

Nonpuerperperale Mastiden

In inflammation of the mammary gland, also called mastitis, usually red and swollen breasts. Putting may issue a purulent discharge; in addition, an abscess may form. For malignant cancer (breast cancer) are typically excluded mammography (X-ray).

Inflammation can have various causes, often with pathogen contamination is present, which is usually above the entrance to the nipple on the milk ducts:

Puerperal mastitis

The puerperal mastitis is an inflammation of the breast, which usually occurs as a result of breastfeeding at 1 to 9% of mothers during childbirth. It is a bacterial infection with staphylococci (Staphylococcus aureus 90%), or Streptococcus, which can be entered through the nipple at first in the milk ducts, and finally in the mammary gland. The main mode of transmission of these bacteria come from the nasopharynx of the mother on the child until the mother's nipple.

Signs of puerperal mastitis, which mostly occur in the first and second week after birth, are fever, chest pain, and redness of the breast. Treatment should be initiated as soon as possible and take place depending on the stage of inflammation. In the early stages of milk production decreases with any medication; mothers should continue breastfeeding while so that the chest is well drained. This can be followed by treatment with antibiotics.

For the prevention of mastitis is still good technique is recommended.

Proper breastfeeding technique involves,

that the nipple and surrounding area cleaned before each application thoroughly with water,

that there have mother and child comfortable while breastfeeding,

that babies around the areola recognized by mouth and sucks vigorously, taking care of the child to freedom of nasal breathing,

that the child during the first 3 days after delivery sucks no more than 5 minutes on each breast (then click the application can be extended to 10 to 15 minutes) and

that children do not fall asleep while breastfeeding and nipple in the mouth, because it can cause minor skin lesions to support infection by pathogens.

To avoid the smallest cracks in the skin, called the gap, the mother must leave the nipples dry air during the postpartum period.

Nonpuerperale Mastiden

When mastitis Nonpuerperal is local inflammation of the breast tissue outside of lactation. You can - such as puerperal mastitis - as a result of bacterial infection (staphylococci or streptococci), which has penetrated into the mammary gland duct, can occur. Often these facilities bacteria find fertile ground in the secretion, which is delivered by the lobules and has accumulated in the milk ducts. This bacterial infection is treated with antibiotics. In rare cases, the nonpuerperal mastitis turn into a chronic stage.

Symptoms are similar to breast cancer (inflammatory breast cancer), and inflammation can cause tumors. Karzinognen presence of tumor must be removed in any case. The diagnosis can be made from tissue samples often simply by removing (biopsy) and examination, giving physicians also indicate whether breast inflammation may be a symptom of other underlying disease present. The Nonpuerperal mastitis can occur as other comorbidities, physical illness is usually chronic. Such as in tuberculosis, syphilis (syphilis), sarcoidosis, fungal infections, actinomycosis or as a result of infection by parasites. The treatment is then carried out in accordance with this underlying disease.