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Avraham S, Khaslavsky S, Kashetsky N, Starkey SY, Zaslavsky K, Lam JM, Mukovozov I. Therapie der okulären Rosazea: Eine systematische Literatur-Übersicht: Treatment of ocular rosacea: a systematic review. J Dtsch Dermatol Ges 2024; 22:167-176. [PMID: 38361192 DOI: 10.1111/ddg.15290_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 09/28/2023] [Indexed: 02/17/2024]
Abstract
ZusammenfassungDie Rosazea ist eine häufige chronische Hauterkrankung, die sich hauptsächlich im mittleren Bereich des Gesichtes manifestiert. Die okulären Manifestationen der Rosazea wurden bisher nur unzureichend untersucht und bereits die Schätzungen der Prävalenz schwanken erheblich zwischen 6% und 72% der Gesamtpopulation aller Rosazea‐Patienten. Zu den Behandlungsmöglichkeiten der okuläre Rosazea gehören die Lidhygiene, topisch anwendbare antimikrobielle Substanzen, topisch oder oral verabreichte Antibiotika und Vitamin‐A‐Derivate, Cisclosporin‐haltige Emulsionen speziell für das Auge und IPL‐Behandlungen (intense pulsed light). Direkte Vergleiche zwischen den verschiedenen Therapieoptionen fehlen jedoch. Ziel dieser Literatur‐Übersicht ist es, die Wirksamkeit und Nebenwirkungen der verschiedenen Behandlungsmöglichkeiten der okulären Rosazea zu vergleichen. Dazu wurden systematische Datenbankrecherchen in Cochrane, MEDLINE und Embase durchgeführt. Titel, Abstrakt, Volltext und Daten wurden jeweils doppelt durchgesehen. Insgesamt erfüllten 66 Artikel mit einer kumulierten Patientenzahl von 1275 Patienten die Einschlusskriterien. Zu den wirksamsten Behandlungsoptionen zählten topisch anwendbare antimikrobielle Substanzen und die orale Gabe von Antibiotika. Damit konnte bei 91% (n = 82/90) bzw. 89% (n = 525/580) der Patienten ein vollständiges oder partielles Ansprechen erzielt werden. Es folgten die IPL‐Behandlung (89%, n = 97/109 partielles Ansprechen), die Ciclosporin‐Augen‐Emulsion (87% n = 40/46) und die Lidhygiene (65%, n = 67/105). Kombinationsbehandlungen führten in 90% der Fälle (n = 69/77) zu einem vollständigen bzw. partiellen Ansprechen. Diese Ergebnisse deuten darauf hin, dass eine topische Therapie mit antimikrobiellen Substanzen, Antibiotika per os, IPL und Ciclosporin‐haltige Emulsionen die effektivsten Einzelmaßnahmen zur Behandlung der okulären Rosazea darstellen.
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Affiliation(s)
| | | | - Nadia Kashetsky
- Medizinische Fakultät, Memorial University of Newfoundland, St. John's, NL, Kanada
| | - Samantha Y Starkey
- Medizinische Fakultät, Universität British Columbia, Vancouver, BC, Kanada
| | - Kirill Zaslavsky
- Abteilung Ophthalmologie und Wissenschaft des Sehens, Universität Toronto, Toronto, ON, Kanada
| | - Joseph M Lam
- Abteilung Dermatologie und Wissenschaft der Haut, Universität British Columbia, Vancouver, BC, Kanada
- Kinderkrankenhaus British Columbia, Vancouver, BC, Kanada
| | - Ilya Mukovozov
- Abteilung Dermatologie und Wissenschaft der Haut, Universität British Columbia, Vancouver, BC, Kanada
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2
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Zeng J. The I Ching as a Potential Jungian Application: History and Practice. J Anal Psychol 2023; 68:913-932. [PMID: 37782002 DOI: 10.1111/1468-5922.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/24/2023] [Indexed: 10/03/2023]
Abstract
Swiss psychiatrist Carl Jung had a lifelong interest in the I Ching after discovering it in 1919. Jung's interest in the I Ching is arguably more practical than purely theoretical or intellectual, and references to I Ching divination appear frequently in his various publications, seminars, letters and clinical practice records. After a few observations on the history of the study of the I Ching in China, the author categorizes Jung's three uses of the I Ching as physical use (to preview future potentials of outer reality), psychological use (to reveal one's psychological state), and psychical approach (to engage with the divine through ""["shen", spiritual agencies]). Finally, the author discusses the current Jungian engagement by demonstrating clinical cases in contemporary times. Some Jungian analysts practise I Ching divination to obtain insights into the physical and psychological state of therapeutic relationships and for personal development. This paper is a historical and critical engagement of the Jungian practice of I Ching divination.
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Heppt MV, Leiter U. Das kutane Plattenepithelkarzinom: Aktueller Stand, Perspektiven und offene Fragen. J Dtsch Dermatol Ges 2023; 21:421-425. [PMID: 37070515 DOI: 10.1111/ddg.15052_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/10/2023] [Indexed: 04/19/2023]
Affiliation(s)
- Markus V Heppt
- Hautklinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
- Comprehensive Cancer Center Europäische Metropolregion Erlangen-Nürnberg (CCC ER-EMN), Erlangen
| | - Ulrike Leiter
- Universitäts-Hautklinik, Eberhard-Karls-Universität Tübingen
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Pohl D, Vavricka S, Fox M, Madisch A, Studerus D, Wiesel P, Heinrich H, Linas I, Schoepfer A, Schwizer A, Wildi S. [Frequent Gastro-Intestinal Disorders: Management of Functional Dyspepsia and Irritable Bowel Syndrome in Clinical Practice]. Praxis (Bern 1994) 2023; 112:304-316. [PMID: 37042398 DOI: 10.1024/1661-8157/a003988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Frequent Gastro-Intestinal Disorders: Management of Functional Dyspepsia and Irritable Bowel Syndrome in Clinical Practice Abstract: Functional dyspepsia (FD) and irritable bowel syndrome (IBS), two common gastrointestinal entities with overlapping symptoms, should be diagnosed according to Rome IV criteria. This includes one or more of the following symptoms: in FD, postprandial fullness, early satiation, epigastric pain or burning; in IBS, recurrent abdominal pain associated with defecation, change in frequency of stool or form of stool. To exclude structural diseases, attention should be paid to alarm symptoms. As far as treatment is concerned, a stepwise scheme proves to be effective for both diseases. Step 1: doctor-patient discussion with explanation of diagnosis and prognosis as well as clarification of therapy goals; lifestyle adaptations; use of phytotherapeutics; step 2: symptom-oriented medication: for FD, PPIs or prokinetics; for IBS, antispasmodics, secretagogues, laxatives, bile acid sequestrants, antidiarrheals, antibiotics, probiotics; step 3: visceral analgesics (antidepressants).
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Affiliation(s)
- Daniel Pohl
- Klinik für Gastroenterologie und Hepatologie, Universitätsspital Zürich, Schweiz
| | | | - Mark Fox
- Zentrum für Integrative Gastroenterologie, Klinik Arlesheim, Schweiz
| | | | | | - Paul Wiesel
- Gastro-entérologie, Centre Médical d'Epalinges, Epalinges, Schweiz
| | | | - Ioannis Linas
- Gastroenterologische Gruppenpraxis, Hirslanden Campus Bern, Schweiz
| | - Alain Schoepfer
- Service de gastro-entérologie et hépatologie, Centre hospitalier universitaire vaudois CHUV, Lausanne, Schweiz
| | - Alexandra Schwizer
- Klinik für Gastroenterologie und Hepatologie, Kantonsspital St. Gallen, St. Gallen, Schweiz
| | - Stephan Wildi
- Klinik für Gastroenterologie und Hepatologie, Kantonsspital St. Gallen, St. Gallen, Schweiz
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Treudler R, Simon JC. Entwicklungen und Perspektiven in der Allergologie. J Dtsch Dermatol Ges 2023; 21:399-404. [PMID: 37070519 DOI: 10.1111/ddg.15034_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/02/2023] [Indexed: 04/19/2023]
Affiliation(s)
- Regina Treudler
- Klinik für Dermatologie, Venerologie und Allergogogie, Medizinische Fakultät der Universität Leipzig
- Leipziger interdisziplinäres Centrum für Allergologie (LICA), Leipzig
| | - Jan-Christoph Simon
- Klinik für Dermatologie, Venerologie und Allergogogie, Medizinische Fakultät der Universität Leipzig
- Leipziger interdisziplinäres Centrum für Allergologie (LICA), Leipzig
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6
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Badini M, Georgitsogiannakos N, Angelella J, Wu MA. [Angioedema without Urticaria: Medical History and Findings]. Praxis (Bern 1994) 2023; 112:223-225. [PMID: 36919321 DOI: 10.1024/1661-8157/a003995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Angioedema without Urticaria: Medical History and Findings Abstract. Abstracts: We present the case of a woman with repeated attacks of angioedema without wheals. Given that there was no benefit from systemic steroid and antihistamines therapy, we interpretated the clinical picture as bradykinin- (and not histamine-) induced. Owing to the late onset and a negative family history, we suspected a case of angioedema due to acquired C1-INH deficiency. This hypothesis was later confirmed by specific hematological tests. We therefore started a specific prophylaxis and therapy in case of acute attacks.
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Bornstein MM, Navarini AA, Schriber M, Baumhoer D. [Not Available]. Swiss Dent J 2022; 132:706-707. [PMID: 36200758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Michael M Bornstein
- Klinik für Oral Health & Medicine, Universitäres Zentrum für Zahnmedizin Basel UZB, Universität Basel, Schweiz
| | - Alexander A Navarini
- Dermatologische Poliklinik, Universitätsspital Basel, Universität Basel, Schweiz
| | - Martina Schriber
- Klinik für Oral Health & Medicine, Universitäres Zentrum für Zahnmedizin Basel UZB, Universität Basel, Schweiz
| | - Daniel Baumhoer
- Knochentumor-Referenzzentrum und DÖSAK, Referenzregister am Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Universität Basel, Schweiz
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Schriber M, Lanzer M, Gander T, Bornstein MM. [Not Available]. Swiss Dent J 2022; 132:512-513. [PMID: 35791733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Martina Schriber
- Oro-faziales Diagnostikzentrum Weinbergstrasse, Zürich, Schweiz
- Klinik für Oral Health & Medicine, Universitäres Zentrum für Zahnmedizin Basel (UZB), Universität Basel, Basel, Schweiz
| | - Martin Lanzer
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsspital Zürich, Zürich, Schweiz
| | - Thomas Gander
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsspital Zürich, Zürich, Schweiz
| | - Michael M Bornstein
- Klinik für Oral Health & Medicine, Universitäres Zentrum für Zahnmedizin Basel (UZB), Universität Basel, Basel, Schweiz
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Bomberg H, Lorenzana D, Schlickeiser J, Dünki A, Farshad M, Eichenberger U. [Noninvasive Treatments for Acute and Chronic Back Pain]. Praxis (Bern 1994) 2022; 111:797-813. [PMID: 36285410 DOI: 10.1024/1661-8157/a003858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Noninvasive Treatments for Acute and Chronic Back Pain Abstract. The therapy of back pain - especially the medication with opioids - can be challenging for the treating physician. Specific back pain can often be diagnosed by imaging and successfully treated by surgery or medication. In contrast, nonspecific back pain can be worsened by inappropriate imaging, questionable surgical indications and uncontrolled drug use. For the therapy of nonspecific back pain, maintaining daily activity and exercise therapy is central. Opioids are effective drugs for short-term use. However, long-term use often leads to opioid-induced hyperalgesia and hormonal dysfunction with decreased quality of life and libido. Furthermore, opioids can lead to abuse and addiction. After an ineffective treatment with non-opioids, opioids may be given for a limited time period (if possible shorter than four weeks) according to international guidelines.
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Affiliation(s)
- Hagen Bomberg
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich, Schweiz
- Diese Autoren haben gleichermassen zu dieser Arbeit beigetragen und teilen sich die Erstautorschaft
| | - David Lorenzana
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich, Schweiz
- Diese Autoren haben gleichermassen zu dieser Arbeit beigetragen und teilen sich die Erstautorschaft
| | - Jannis Schlickeiser
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich, Schweiz
| | - Alexandro Dünki
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich, Schweiz
| | | | - Urs Eichenberger
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich, Schweiz
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Abstract
Treatment-Emergent Central Sleep Apnea - Detection and Treatment Abstract. In treatment-emergent central sleep apnea (TECSA), affected patients with obstructive sleep apnea newly develop central sleep apnea (AHI central ≥5/h) under therapy with positive pressure ventilation which cannot be explained by other causes. The pathophysiology of TECSA is incompletely understood. PaCO2 and the associated apnea threshold seem to play a central role. The incidence of TECSA varies (1.8-20%), and in about 2/3 of cases it is self-limiting in the course of the therapy. If persistence or new onset occurs later in the course of positive pressure therapy, a further evaluation (e.g., echocardiography, neurologic examination, medication history) is indicated. Effective treatment options include a change in ventilation therapy (adaptive servoventilation or bilevel ventilation with back-up frequency) or additional nocturnal oxygen supplementation; these options should be decided case by case.
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Affiliation(s)
- Tabea Hutter
- Universitätsklinik für Pneumologie, Inselspital, Universitätsspital Bern, Universität Bern, Bern, Schweiz
| | - Christian Horvath
- Universitätsklinik für Pneumologie, Inselspital, Universitätsspital Bern, Universität Bern, Bern, Schweiz
- Sleep Research Laboratories of the University Health Network Toronto Rehabilitation Institute (KITE) and Toronto General Hospital and Department of Medicine of the University of Toronto, Toronto, Kanada
| | | | - Anne-Kathrin Brill
- Universitätsklinik für Pneumologie, Inselspital, Universitätsspital Bern, Universität Bern, Bern, Schweiz
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11
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Berres-Wehrle F, Mukkadam K, Baumhoer D, Bornstein MM. [Not Available]. Swiss Dent J 2021; 131:924-925. [PMID: 34753283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Frauke Berres-Wehrle
- Klinik für Oral Health & Medicine, Universitäres Zentrum für Zahnmedizin Basel UZB, Universität Basel
| | - Khaled Mukkadam
- Klinik für Oralchirurgie, Universitäres Zentrum für Zahnmedizin Basel UZB, Universität Basel
| | - Daniel Baumhoer
- Knochentumor-Referenzzentrum und DÖSAK, Referenzregister am Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Universität Basel
| | - Michael M Bornstein
- Klinik für Oral Health & Medicine, Universitäres Zentrum für Zahnmedizin Basel UZB, Universität Basel
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Ding M, Dong X, Sun YL, Sokolowska M, Akdis M, van de Veen W, Azkur AK, Azkur D, Akdis CA, Gao YD. Recent advances and developments in COVID-19 in the context of allergic diseases. Clin Transl Allergy 2021; 11:e12065. [PMID: 34582102 PMCID: PMC8646609 DOI: 10.1002/clt2.12065] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Since the first reports of coronavirus disease 2019 (COVID-19) in Wuhan, China, in December 2019, there have been 198 million confirmed cases worldwide as of August 2021. The scientific community has joined efforts to gain knowledge of the newly emerged virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the immunopathological mechanisms leading to COVID-19, and its significance for patients with allergies and asthma. METHODS Based on the current literature, recent advances and developments in COVID-19 in the context of allergic diseases were reviewed. RESULTS AND CONCLUSIONS In this review, we discuss the prevalence of COVID-19 in subjects with asthma, attacks of hereditary angioedema, and other allergic diseases during COVID-19. Underlying mechanisms suggest a protective role of allergy in COVID-19, involving eosinophilia, SARS-CoV-2 receptors expression, interferon responses, and other immunological events, but further studies are needed to fully understand those associations. There has been significant progress in disease evaluation and management of COVID-19, and allergy care should continue during the COVID-19 pandemic. The European Academy of Allergy & Clinical Immunology (EAACI) launched a series of statements and position papers providing recommendations on the organization of the allergy clinic, handling of allergen immunotherapy, asthma, drug hypersensitivity, allergic rhinitis, and other allergic diseases. Treatment of allergies using biologics during the COVID-19 pandemic has also been discussed. Allergic reactions to the COVID-19 vaccines, including severe anaphylaxis, have been reported. Vaccination is a prophylactic strategy that can lead to a significant reduction in the mortality and morbidity associated with SARS-CoV-2 infection, and in this review, we discuss the proposed culprit components causing rare adverse reactions and recommendations to mitigate the risk of anaphylactic events during the administration of the vaccines.
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Affiliation(s)
- Mei Ding
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
| | - Xiang Dong
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
| | - Yuan-Li Sun
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Willem van de Veen
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Ahmet Kursat Azkur
- Department of Virology, Faculty of Veterinary Medicine, University of Kirikkale, Kirikkale, Turkey
| | - Dilek Azkur
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of Kirikkale, Kirikkale, Turkey
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Ya-Dong Gao
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
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Schick M. [CME/Answers: Traumatized Refugees in Family Practice - A Quick Reference Guide]. Praxis (Bern 1994) 2021; 110:717-719. [PMID: 34583538 DOI: 10.1024/1661-8157/a003722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
CME/Answers: Traumatized Refugees in Family Practice - A Quick Reference Guide Abstract. Traumatic experiences, flight and life in exile do not constitute an illness per se, but are associated with an increased risk of mental illness. In view of the lack of specialized treatment units, the general practitioner's office often remains the only place of treatment for traumatized refugees. Particularly challenging is the combination of complex complaints, multidimensional psychosocial stress factors and difficult treatment conditions which face managerial and organizational limitations in the dense daily practice routine. In this article, recommendations for working with this heterogeneous group of patients are discussed.
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Affiliation(s)
- Matthis Schick
- Ambulatorium für Folter- und Kriegsopfer, Klinik für Konsiliarpsychiatrie und Psychosomatik, Universitätsspital Zürich, Zürich
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14
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Schick M. [CME: Traumatized Refugees in Family Practice - A Quick Reference Guide]. Praxis (Bern 1994) 2021; 110:681-688. [PMID: 34521270 DOI: 10.1024/1661-8157/a003721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
CME: Traumatized Refugees in Family Practice - A Quick Reference Guide Abstract. Traumatic experiences, flight and life in exile do not constitute an illness per se, but are associated with an increased risk of mental illness. In view of the lack of specialized treatment units, the general practitioner's office often remains the only place of treatment for traumatized refugees. Particularly challenging is the combination of complex complaints, multidimensional psychosocial stress factors and difficult treatment conditions which face managerial and organizational limitations in the dense daily practice routine. In this article, recommendations for working with this heterogeneous group of patients are discussed.
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Affiliation(s)
- Matthis Schick
- Ambulatorium für Folter- und Kriegsopfer, Klinik für Konsiliarpsychiatrie und Psychosomatik, Universitätsspital Zürich, Zürich
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Tosic L, Voglis S, Bellut D, Sprengel K, Regli L, Stienen MN. [Acute Traumatic Central Cord Syndrome: Etiology, Pathophysiology, Clinical Manifestation, and Treatment]. Praxis (Bern 1994) 2021; 110:324-335. [PMID: 33906439 DOI: 10.1024/1661-8157/a003659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Acute Traumatic Central Cord Syndrome: Etiology, Pathophysiology, Clinical Manifestation, and Treatment Abstract. The acute traumatic central cord syndrome (ATCCS) represents an injury to the spinal cord with disproportionately greater motor impairment of the upper than the lower extremities, with bladder dysfunction and with varying degrees of sensory loss below the level of the respective lesion. The mechanism of ATCCS is most commonly a traumatic hyperextension injury of the cervical spine at the base of an underlying spondylosis and spinal stenosis. The mean age is 53 years, and segments C4 to Th1 are most frequently affected. In addition to medical history and clinical examination, the definitive diagnosis is made by magnetic resonance imaging, where T2-hyperintense lesions are typically observed in the affected spinal cord segment. Surgical decompression (and fusion) of the respective segment is recommended to prevent repetitive trauma to the spinal cord and to stop progression of clinical symptoms. Patients with diagnosed ATCCS and who are treated adequately usually have a good prognosis.
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Affiliation(s)
- Lazar Tosic
- Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich
- Klinisches Neurozentrum, Universität Zürich, Zürich
- Interdisziplinäres Wirbelsäulenzentrum, Universitätsspital Zürich, Zürich
| | - Stefanos Voglis
- Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich
- Klinisches Neurozentrum, Universität Zürich, Zürich
- Interdisziplinäres Wirbelsäulenzentrum, Universitätsspital Zürich, Zürich
| | - David Bellut
- Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich
- Klinisches Neurozentrum, Universität Zürich, Zürich
- Interdisziplinäres Wirbelsäulenzentrum, Universitätsspital Zürich, Zürich
| | - Kai Sprengel
- Interdisziplinäres Wirbelsäulenzentrum, Universitätsspital Zürich, Zürich
- Klinik für Traumatologie, Universitätsspital Zürich, Zürich
| | - Luca Regli
- Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich
- Klinisches Neurozentrum, Universität Zürich, Zürich
- Interdisziplinäres Wirbelsäulenzentrum, Universitätsspital Zürich, Zürich
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Rau M, Köppel-Fürer K, Knechtle B. [Doctor, Do You Know Red Yeast Rice?]. Praxis (Bern 1994) 2021; 110:207-220. [PMID: 33726520 DOI: 10.1024/1661-8157/a003617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Doctor, Do You Know Red Yeast Rice? Abstract. We present cases of patients with high total cholesterol who wanted to use an alternative therapy for lowering cholesterol. An improvement in the lipid profile was found in all patients, and all tolerated the product made from red rice yeast very well. No side effects were observed. The patients who take red fermented rice consciously choose an alternative agent in the field of phytotherapy because they already have to take several conventional medicines and are no longer willing to use an additional drug of this kind. Another reason is that they no longer want to put up with the side effects they suffered from when using a common lipid-lowering drug.
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Affiliation(s)
- Monika Rau
- Medbase St. Gallen am Vadianplatz, St. Gallen
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Stienen MN, Sprengel K, Butsch R, Achermann Y, Wolfensberger A, Regli L, Bellut D. [Tuberculous Spondylitis - Diagnosis and Management]. Praxis (Bern 1994) 2020; 109:775-787. [PMID: 32752962 DOI: 10.1024/1661-8157/a003518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Tuberculous Spondylitis - Diagnosis and Management Abstract. Despite a decreasing incidence of tuberculosis (TB) over the last decades in Switzerland, the frequency of newly diagnosed tuberculous spondylitis has remained stable. It occurs most frequently in old, immunocompromised persons and/or persons who have moved to Switzerland from TB endemic areas. It is a chronic manifestation of TB, which is characterized by 'cold abscesses', neurological deficits and kyphotic spinal deformity. Tuberculous spondylitis is often diagnosed with a delay, which can lead to higher morbidity and treatment complexity. Antibiotic therapy is essential in tuberculous spondylitis. Surgical interventions aim to obtain samples, decompress nervous structures, obtain pain control and, if necessary, deformity correction/stabilization. This paper provides an overview of the modern diagnostic and therapeutic management of tuberculous spondylitis in Switzerland.
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Affiliation(s)
- Martin N Stienen
- Interdisziplinäres Wirbelsäulenzentrum, Universitätsspital Zürich, Universität Zürich
- Klinik für Neurochirurgie, Universitätsspital Zürich, Universität Zürich
- Klinisches Neurozentrum, Universität Zürich
| | - Kai Sprengel
- Interdisziplinäres Wirbelsäulenzentrum, Universitätsspital Zürich, Universität Zürich
- Klinik für Traumatologie, Universitätsspital Zürich, Universität Zürich
| | - Raphael Butsch
- Interdisziplinäres Wirbelsäulenzentrum, Universitätsspital Zürich, Universität Zürich
- Klinik für Rheumatologie, Universitätsspital Zürich, Universität Zürich
| | - Yvonne Achermann
- Klinik für Infektionskrankheiten und Spitalhygiene, Universitätsspital Zürich, Universität Zürich
| | - Aline Wolfensberger
- Klinik für Infektionskrankheiten und Spitalhygiene, Universitätsspital Zürich, Universität Zürich
| | - Luca Regli
- Interdisziplinäres Wirbelsäulenzentrum, Universitätsspital Zürich, Universität Zürich
- Klinik für Neurochirurgie, Universitätsspital Zürich, Universität Zürich
- Klinisches Neurozentrum, Universität Zürich
| | - David Bellut
- Interdisziplinäres Wirbelsäulenzentrum, Universitätsspital Zürich, Universität Zürich
- Klinik für Neurochirurgie, Universitätsspital Zürich, Universität Zürich
- Klinisches Neurozentrum, Universität Zürich
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Paschke K, Holtmann M, Melchers P, Klein M, Schimansky G, Krömer T, Reis O, Wartberg L, Thomasius R. [Media-associated disorders in childhood and adolescence: Evidence paper of the joint addiction commision of the German societies and professional associations of child and adolescent psychiatry and psychotherapy]. Z Kinder Jugendpsychiatr Psychother 2020; 48:303-317. [PMID: 32614281 DOI: 10.1024/1422-4917/a000735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Media-associated disorders in childhood and adolescence: Evidence paper of the joint addiction commision of the German societies and professional associations of child and adolescent psychiatry and psychotherapy Abstract. Media-associated disorders (MAD) describe the problematic use of the internet, certain electronic devices in general as well as digital applications. During childhood and adolescence, digital games and social media are the most commonly used applications. In May 2019, as first MAD "gaming disorder" was included as a clinical diagnosis in the ICD-11. The prevalence of MAD in German children and adolescents is estimated to lie between 3 % and 5 %. In most cases, MAD are accompanied by psychiatric comorbidities. MAD ensue because of dysfunctional learning processes in combination with general and specific risk factors. They are associated with neural changes like those of substance-associated addictions. Diagnostics can be based on validated questionnaires and clinical exploration, though a standardized diagnostic path is not yet common. Treatment depends on the level of severity and generally comprises outpatient, day-clinic, and inpatient therapy approaches with elements from cognitive-behavioral therapy and under parental involvement. Suitable treatments are not yet available in all German regions and have also not been sufficiently evaluated. Moreover, only a few studies exist on the efficacy of prevention measures addressing MAD in children and adolescents. Thus, further research is strongly required.
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Affiliation(s)
- Kerstin Paschke
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters (DZSKJ), Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Martin Holtmann
- vLWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Hamm
| | - Peter Melchers
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Klinikum Oberberg, Kreiskrankenhaus Gummersbach und Klinik Marienheide, Gummersbach
| | | | | | - Thomas Krömer
- Gemeinschaftspraxis für Kinder- und Jugendpsychiatrie, Psychotherapie & Psychosomatik, Hamburg
| | - Olaf Reis
- Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Universität Rostock, Rostock
| | - Lutz Wartberg
- Fakultät für Humanwissenschaften, MSH Medical School Hamburg, Hamburg
| | - Rainer Thomasius
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters (DZSKJ), Universitätsklinikum Hamburg-Eppendorf, Hamburg
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19
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von Arx T, Kissling- Jeger FB, Simone SFM. [Through-and-through cystic lesion: spontaneous healing after needle aspiration and conventional root-canal therapy]. Swiss Dent J 2020; 130:31–35. [PMID: 31904205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Inflammation-related pathologies such as apical periodontitis or radicular cysts are frequent lesions of the jawbones. Typically, a radiolucency is present that is not always distinguishable from other pathologies. A surgical approach would allow for tissue harvesting with further histopathologic processing. However, in the present case report of a cystic and large tunnelling lesion in the anterior maxilla, a conservative treatment with diagnostic needle aspiration and subsequent root-canal therapy was chosen. The long-term follow-up (eight years) including cone-beam computed tomography demonstrates a complete healing of the former bone defect with reestablishment of the vestibular and palatal cortices as well as absence of pain and other clinical symptoms.
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Affiliation(s)
- Thomas von Arx
- Klinik für Oralchirurgie und Stomatologie, Zahnmedizinische Kliniken der Universität Bern
| | - Franziska B Kissling- Jeger
- Privatpraxis, Luzern
- Klinik für Zahnerhaltung, Präventiv- und Kinderzahnmedizin, Zahnmedizinische Kliniken der Universität Bern
| | - Simone F M Simone
- Klinik für Oralchirurgie und Stomatologie, Zahnmedizinische Kliniken der Universität Bern
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Vorburger D, Frauchiger-Heuer H, Dedes KJ. [Rare Forms of Mastitis]. Praxis (Bern 1994) 2020; 109:1055-1062. [PMID: 33050811 DOI: 10.1024/1661-8157/a003509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Rare Forms of Mastitis Abstract. Inflammatory breast diseases caused by bacterial infections represent the main cause for mastitis in breastfeeding and non-breastfeeding women. The clinical appearance and a standardized evaluation can indicate rare inflammatory breast diseases. An underlying comorbidity or the evidence of rare pathogens could be suggestive. However, core needle biopsy is the main step in diagnostics. Malignancy, e.g. an inflammatory breast cancer must consistently be excluded. This mini review outlines a few rare inflammatory breast diseases, their initial presentation, and how to diagnose them accurately.
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21
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Häusermann M. [The Role of Ultrasonography in Family Medicine]. Praxis (Bern 1994) 2020; 109:596-607. [PMID: 32517603 DOI: 10.1024/1661-8157/a003501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Role of Ultrasonography in Family Medicine Abstract. This overview describes the various applications of sonography in family practice. After an outline of the requirements for examiners and equipment, the individual areas of examination are discussed, in part with the most important diagnostic criteria, and illustrated with case studies using images and videos. Readers should be encouraged to make broad use of sonography and to attend regular further training and education courses in this field.
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Gaisl T, Thiel S, Kohler M. [CME: Obstructive Sleep Apnea: A Common Disease]. Praxis (Bern 1994) 2020; 109:207-213. [PMID: 32126916 DOI: 10.1024/1661-8157/a003385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
CME: Obstructive Sleep Apnea: A Common Disease Abstract. Obstructive sleep apnea is a common sleep related breathing disorder with a collapse of the upper respiratory tract, leading to repetitive oxygen desaturations and 'micro arousals'. If the physiological sleep architecture is impaired, patients are at risk for an increased daytime sleepiness and an increased blood pressure. Main risk factors are central obesity, age, male sex, (and snoring). By means of weight loss, alcohol restriction, and continuous nocturnal positive pressure ventilation (CPAP), the obstructive sleep apnea syndrome can be treated, with mandibular advancement devices representing a second-choice therapy.
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Affiliation(s)
- Thomas Gaisl
- Klinik für Pneumologie, Universitätsspital Zürich, Zürich
| | - Sira Thiel
- Klinik für Pneumologie, Universitätsspital Zürich, Zürich
| | - Malcolm Kohler
- Klinik für Pneumologie, Universitätsspital Zürich, Zürich
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23
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Krause A, Aries PM, Berger S, Fiehn C, Kellner H, Lorenz HM, Meier L, Müller GA, Müller-Ladner U, Schwarting A, Tony HP, Peters MA, Wendler J. Rituximab in routine care of severe active rheumatoid arthritis : A prospective, non-interventional study in Germany. Z Rheumatol 2019; 78:881-888. [PMID: 30276727 DOI: 10.1007/s00393-018-0552-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To assess safety, effectiveness and onset of effect of rituximab (RTX) in routine clinical treatment of severe, active rheumatoid arthritis (RA). METHODS Prospective, multi-centre, non-interventional study in rheumatological outpatient clinics or private practices in Germany. RTX-naïve adult patients were to receive RTX according to marketing authorisation and at their physician's discretion. Also according to their physician's discretion, patients could receive a second cycle of RTX (re-treatment = treatment continuation). Major outcome was the change in Disease Activity Score based on 28-joints count and erythrocyte sedimentation rate (DAS28-ESR) over 24 weeks and during 6 months of re-treatment. RESULTS Overall, 1653 patients received at least one cycle RTX; 99.2% of these had received disease-modifying antirheumatic drugs (DMARD) pre-treatment and 75.5% anti-tumor necrosis factor(TNF)‑α pre-treatment. After a mean interval of 8.0 months, 820 patients received RTX re-treatment. Mean DAS28-ESR decreased from 5.3 at baseline to 3.8 after 24 weeks (-1.5 [95% confidence interval, CI: -1.6; -1.4]), and from 4.1 at start of cycle 2 to 3.5 at study end (change from baseline: -1.8 [95% CI: -2.0; -1.7]). Improvements in DAS28-ESR and Health Assessment Questionnaire (HAQ) score occurred mainly during the first 12 weeks of RTX treatment, with further DAS28-ESR improvement until week 24 or month 6 of re-treatment. Improvements in DAS28-ESR and EULAR responses were more pronounced in seropositive patients. RF was a predictor of DAS28-ESR change to study end. Safety analysis showed the established profile of RTX. CONCLUSION RTX was safe and effective in a real-life setting with rapid and sustained improvement in RA signs and symptoms.
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Affiliation(s)
- A Krause
- Abteilung Rheumatologie und Klinische Immunologie, Klinik für Innere Medizin, Immanuel Krankenhaus, Königstraße 63, 14109, Berlin, Germany.
| | - P M Aries
- Rheumatologie im Struenseehaus, Hamburg, Germany
| | - S Berger
- Private Practice, Naunhof, Germany
| | - C Fiehn
- Praxis für Rheumatologie und klinische Immunologie, Baden-Baden, Germany
| | - H Kellner
- Private Practice and Division of Rheumatology, KH Neuwittelsbach, Munich, Germany
| | - H-M Lorenz
- Division of Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | - L Meier
- RheumaPraxis, Hofheim, Germany
| | - G A Müller
- Department of Nephrology and Rheumatology, University Hospital Göttingen, Göttingen, Germany
| | - U Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Kerckhoff Hospital GmbH, Bad Nauheim, Germany
| | - A Schwarting
- First Department of Medicine, University Hospital, Johannes Gutenberg-University, Mainz, Germany
| | - H-P Tony
- Division of Clinical Immunology/Rheumatology, Department of Internal Medicine II, University of Würzburg, Würzburg, Germany
| | - M A Peters
- Medical Management Rheumatology, Roche Pharma AG, Grenzach-Wyhlen, Germany
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Bornstein MM, Claude A, Meier T, Tinguely M. [Peripheral giant-cell granuloma in peri-implant tissues]. Swiss Dent J 2018; 128:980-981. [PMID: 30525321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Michael M. Bornstein
- Klinik für Oralchirurgie und Stomatologie, Zahnmedizinische Kliniken der Universität Bern
- Oro-faziales Diagnostikzentrum Weinbergstrasse, Zürich
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Abstract
Therapy of insomnia and nightmares in childhood and adolescence Abstract. Sleep problems and sleep disorders have a high prevalence in childhood and adolescence. Normally, such conditions persist and often become chronic. Daytime impairments are widespread with concentration deficits, mental problems, and also a higher suicide risk. Therefore, early and effective interventions are necessary. As symptoms change with age, therapy should be adjusted accordingly. Various strategies for infants and toddlers, schoolchildren, and adolescents will be named. In addition, evidence of these therapy strategies will be shown. All in all, more randomized controlled studies addressing children and adolescents are needed. Furthermore, studies with children and adolescents suffering from comorbid disorders or mental disorders and sleep problems should be conducted.
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Affiliation(s)
- Angelika A Schlarb
- 1 Abteilung für Psychologie, Fakultät für Psychologie und Sportwissenschaft, Bielefeld
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Kühlewindt T. [CME: Rabies Update: Symptoms, Diagnostics and Therapy]. Praxis (Bern 1994) 2018; 107:564-570. [PMID: 29788857 DOI: 10.1024/1661-8157/a002968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Rabies is one of the oldest known infectious diseases and certainly one of the most feared because of its impressive course. Despite continuous improvement in medical treatment, the disease continues to be almost always fatal after onset of symptoms. Due to urbanization, rabies has lately somewhat disappeared from the public focus in Central Europe. Because of the remaining high number of fatal cases due to rabies infection worldwide and the persistent risk of contagion on holiday or within Switzerland, e.g. due to illegal import of infected animals, the disease is becoming a frequent topic in the media again.
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Affiliation(s)
- Tobias Kühlewindt
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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Abstract
INTRODUCTION In this study we compared the outcomes of dogs with incompletely-excised grade-2 mast cell tumors (incompletely- excised grade-2 MCTs) either adjuvantly treated or not. Dogs with a grade-2 mast cell tumour (MCT) excised either incompletely or with narrow (.
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Affiliation(s)
- S Vincenti
- VRCC Veterinary Referrals, Laindon, United Kingdom
| | - F Findji
- VRCC Veterinary Referrals, Laindon, United Kingdom
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Abstract
INTRODUCTION Eating and rumination behaviour in 22 cows with traumatic reticuloperitonitis was recorded after the start of treatment. Based on the results of clinical, ultrasonographic and radiographic examinations, the cows were divided into two groups: Group A consisted of 12 cows without an intramural or perforating foreign body and group B had 10 cows with an intramural or perforating foreign body. Cows of group A received amoxicillin, flunixin meglumine and a NaCl-glucose infusion, and cows of group B received the same treatment accompanied by foreign body removal via ruminotomy. All cows were fitted with a horse halter equipped with a pressure sensor integrated into the noseband, and eating and rumination activities were recorded continuously for 7 days. Additional 24-hour- recording periods occurred on days 14 and 30. Results obtained previously from 300 healthy cows were used for comparison. Median daily eating time in group A was 168 minutes (reference interval 211 to 319 min) on day 1 and increased to within the reference interval by day 3. Eating time on day 14 was 290 minutes and significantly longer than on day 1. Eating time was 294 minutes on day 30. Eating time in group B was comparable, and the patterns of normalisation for the number of chewing cycles related to eating, rumination time, the number of regurgitated cuds per day and the number of chewing cycles per cud were similar to that of group A: all variables were significantly reduced on day 1 and normalised within 3 to 5 days. The findings showed that eating and rumination are reduced in cows with traumatic reticuloperitonitis and that successful treatment results in rapid normalisation. Monitoring eating and rumination behaviour using a pressure sensor integrated into a halter allows objective clinical assessment of cows recovering from traumatic reticuloperitonitis.
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Affiliation(s)
- U Braun
- Department of Farm Animals, Vetsuisse Faculty, University of Zurich
| | - T Tschoner
- Department of Farm Animals, Vetsuisse Faculty, University of Zurich
| | - M Hässig
- Department of Farm Animals, Vetsuisse Faculty, University of Zurich
| | - K Nuss
- Department of Farm Animals, Vetsuisse Faculty, University of Zurich
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Abstract
Die Necrobiosis lipoidica ist eine seltene granulomatöse Erkrankung von bisher unzureichend geklärter Ätiologie. Häufig stellt die bei Diabetikern gehäuft zu beobachtende und zur Ulzeration neigende Dermatose eine starke Belastung für die Patienten dar. Bezüglich der Therapie existieren aktuell keine deutschen oder europäischen Leitlinien. Gleichzeitig lässt sich unter der aktuellen Standardtherapie, der lokalen oder intraläsionalen Anwendung von Glukokortikoiden, nicht immer ein zufriedenstellendes Ansprechen beobachten. Daher wurde untersucht, ob seit dem Jahr 2000 publizierte Therapiemodalitäten das Therapiespektrum relevant und erfolgversprechend erweitern. Es erfolgte eine Betrachtung aller Arbeiten im oben genannten Zeitraum, bei denen mehr als ein Einzelfallbericht je Therapiemodalität publiziert wurde. Insgesamt wurden in einem systematischen Review die Daten von 16 verschiedenen, seit 2000 publizierten Therapieverfahren in 49 Publikationen analysiert. Im Ergebnis zeigte sich, dass die meisten Erfahrungen bezüglich der topischen PUVA-Therapie, der photodynamischen Therapie (PDT) und der systemischen Therapie mit Fumarsäureestern vorliegen. Allerdings ist auffällig, dass mit steigender Zahl der pro Behandlungsmodalität behandelten Patienten der Anteil der Patienten, bei denen eine Abheilung bzw. eine teilweise Abheilung berichtet wurde, sinkt. Wir interpretieren diese Beobachtung als Publikationsbias. Daher kann für keines der besprochenen Verfahren eine klare Empfehlung als Therapie der zweiten Wahl nach Versagen der lokalen bzw. intraläsionalen Steroidtherapie gegeben werden.
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Affiliation(s)
| | | | - Peter Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
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Rickenbacher P. [New Heart Failure Guidelines: Update for Primary Care]. Praxis (Bern 1994) 2017; 106:297-303. [PMID: 28299996 DOI: 10.1024/1661-8157/a002622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Zusammenfassung. Die Herzinsuffizienz ist definiert als klinisches Syndrom, charakterisiert durch typische Symptome, häufig begleitet von typischen klinischen Befunden in Assoziation mit strukturellen oder funktionellen kardialen Abnormitäten. Unterschieden wird die Herzinsuffizienz mit verminderter, erhaltener und neu «mid-range» Auswurffraktion. Es wird ein neuer Diagnose-Algorithmus basierend auf der klinischen Wahrscheinlichkeit für das Vorliegen einer Herzinsuffizienz bei nicht akutem Beginn vorgestellt. Die etablierte medikamentöse Therapie der Herzinsuffizienz mit verminderter Auswurffraktion umfasst ACE-Hemmer, Betablocker und Mineralokortikoidrezeptor-Antagonisten, ergänzt durch Diuretika bei Vorliegen einer Stauung. Eine neue Therapieoption steht mit dem Angiotensinrezeptor-Neprilysin-Inhibitor Valsartan/Sacubitril zur Verfügung. Neben der medikamentösen Therapie kommt der Device-Therapie, insbesondere der kardialen Resynchronisationstherapie (CRT) eine wichtige Rolle zu. Die entsprechende Indikationsstellung erfolgt durch Kardiologen. Für die Herzinsuffizienz mit erhaltener Auswurffraktion gibt es bisher keine evidenzbasierte Therapie zur Reduktion von Morbidität und Mortalität. Diuretika verbessern Symptome bei Flüssigkeitsretention. Auslösende Faktoren sowie kardiale und nicht-kardiale Komorbiditäten sollen gezielt gesucht und behandelt werden.
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Affiliation(s)
- Peter Rickenbacher
- 1 Abteilung für Kardiologie, Medizinische Universitätsklinik, Kantonsspital Baselland, Bruderholz
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31
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Abstract
Unseen Suffering - Therapy for Traumatized Refugee Children In March 2015 the psychological counselling service (Psychologische Familien- und Lebensberatung) of Caritas Ulm initiated a psychotherapy project for traumatized minor refugees. Besides individual and group therapy, networking and qualification of qualified personnel and volunteers, in autumn 2015 we started offering our services on-site in a large collective accommodation for asylum seekers in Ulm. This was mainly because - in contrast to unaccompanied, mostly adolescent, minor refugees - our services appeared to reach children only by chance. In our opinion this is mostly due to the fact that children's suffering is often far less noticed. This paper describes our first year's project work, followed by reports on the use of psychodrama groups with refugee children and on the therapeutic work in a collective accommodation for asylum seekers.
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Abstract
INTRODUCTION The goal of this study was to investigate whether intravenous infusion of 1000 ml 40% calcium borogluconate combined with the oral adminstration of 500 g sodium phosphate leads to a better cure rate and longer-lasting normocalcaemia and normophosphataemia than standard intravenous treatment with 500 ml calcium borogluconate in cows with parturient paresis. Forty recumbent cows with hypocalcaemia and hypophosphataemia were alternately allocated to group A or B. Cows of both groups were treated intravenously with 500 ml 40% calcium borogluconate, and cows of group B additionally received another 500 ml calcium borogluconate via slow intravenous infusion and 500 g sodium phosphate administered via an orogastric tube. Thirty-two cows stood within 8 hours after the start of treatment and 8 did not; of the 32 cows that stood, 18 belonged to group A and 14 to group B (90% of group A vs. 70% of group B; P = 0.23). Seven cows relapsed; of these and the 8 that did not respond to initial treatment, 10 stood after two standard intravenous treatments. Downer cow syndrome occurred in 5 cows, 3 of which recovered after aggressive therapy. The overall cure rate did not differ significantly between groups A and B. Twelve (60%) cows of group A and 14 (70%) cows of group B were cured after a single treatment and of the remaining 14, 11 were cured after two or more treatments. Two downer cows were euthanized and one other died of heart failure during treatment. Serum calcium concentrations during the first eight hours after the start of treatment were significantly higher in group B than in group A, and oral sodium phosphate caused a significant and lasting increase in inorganic phosphate. More cows of group B than group A were cured after a single treatment (P > 0.05). These findings, although not statistically significant, are promising and should be verified using a larger number of cows.
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Affiliation(s)
- U Braun
- Department for Farm Animals, Vetsuisse Faculty, University of Zurich
| | - D Grob
- Department for Farm Animals, Vetsuisse Faculty, University of Zurich
| | - M Hässig
- Department for Farm Animals, Vetsuisse Faculty, University of Zurich
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Abstract
Zusammenfassung. Gallensteine finden sich bei 10–20 % unserer Bevölkerung, und jährlich werden in der Schweiz gegen 15 000 Cholezystektomien durchgeführt. Grundsätzlich muss zwischen der Cholezystolithiasis (Gallenblasensteine) und der Choledocholithiasis (Gallengangsteine) unterschieden werden. Während der überwiegende Teil der Patienten mit (inzidentellen) Gallenblasensteinen lebenslang keine Beschwerden erleidet, können Gallengangsteine schwerwiegende Komplikationen (z.B. Cholangitis, Pankreatitis) verursachen. Laborchemisch erhöhte Transaminasen und Cholestaseparameter sind bei einer Cholezystolithiasis selten und müssen (bei passender, biliärer Klinik) an eine Choledocholithiasis denken lassen. Bildgebend kommt im Falle von biliären Symptomen primär eine abdominale Sonografie, bei Verdacht auf eine Choledocholithiasis allenfalls zusätzlich eine MRC (Magnetresonanzcholangiografie) oder EUS (Endosonografie) zum Einsatz. Therapie der Wahl bei symptomatischer Cholezystolithiasis sowie nach biliären Komplikationen ist die laparoskopische Cholezystektomie, während Gallengangsteine meist anlässlich einer ERC (endoskopisch retrograde Cholangiografie) mit Papillotomie entfernt werden können.
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Affiliation(s)
- Patrick Aepli
- 1 Gastroenterologie/Hepatologie, Departement Medizin, Luzerner Kantonsspital
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34
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Rudofsky L, Holz-Sapra E. [Not Available]. Praxis (Bern 1994) 2016; 105:867-873. [PMID: 27463271 DOI: 10.1024/1661-8157/a002420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Zusammenfassung. Die Radiotherapie hat einen Stellenwert im Therapiealgorithmus auch bei nicht-malignen, benignen Erkrankungen der Gelenke und des Bindegewebes. Eine grosse Anzahl an degenerativen, entzündlichen, hyperproliferativen und funktionellen Erkrankungen kann mit gutem Erfolg durch eine Bestrahlung behandelt werden. Dabei ist diese Therapieform für den Patienten belastungs- und nebenwirkungsarm.
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35
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Abstract
Although snake bites are rare in Europe, there are a constant number of snake bites in Switzerland. There are two domestic venomous snakes in Switzerland: the aspic viper (Vipera aspis) and the common European adder (Vipera berus). Bites from venomous snakes are caused either by one of the two domestic venomous snakes or by an exotic venomous snake kept in a terrarium. Snake- bites can cause both a local and/or a systemic envenoming. Potentially fatal systemic complications are related to disturbances of the hemostatic- and cardiovascular system as well as the central or peripheral nervous system. Beside a symptomatic therapy the administration of antivenom is the only causal therapy to neutralize the venomous toxins.
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Affiliation(s)
- Andreas Plate
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | | | - Markus Schneemann
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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36
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Abstract
Inflammation is a major mediator of atherosclerosis and plays a pivotal role for both innate and adaptive immunity in the onset and the progression of atherosclerosis. Novel insights into how the adaptive immune system is activated and propagates atherosclerosis elucidate the intricate interplay of different subsets of lymphocytes and their mediators as a central feature of vascular inflammation. The recognition of an inherent anti-inflammatory component of the adaptive immune system mediated by regulatory T (Treg) cells outline a novel concept: the expansion of regulatory T cells to reduce atherosclerosis. Based on a variety of research results, this concept represents a new therapeutic option in patients with atherosclerosis.
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Affiliation(s)
- Roland Klingenberg
- 1 Universitäres Herzzentrum, Klinik für Kardiologie, Universitätsspital Zürich
| | - Christian M Matter
- 1 Universitäres Herzzentrum, Klinik für Kardiologie, Universitätsspital Zürich
| | - Thomas F Lüscher
- 1 Universitäres Herzzentrum, Klinik für Kardiologie, Universitätsspital Zürich
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37
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Niederberger P, Bucher S, Aebi S. [Male Breast Cancer: What is Different?]. Praxis (Bern 1994) 2016; 105:147-151. [PMID: 26837323 DOI: 10.1024/1661-8157/a002250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Male breast cancer is a rare disease. Symptoms and signs resemble breast cancer in women: A palpable mass, enlarged lymph nodes or skin changes (ulceration, secretion, peau d'orange) mandate mammography, ultrasound to assess the regional lymph nodes. The definitive diagnosis is made by biopsy. Men with breast cancer are treated along the same principles as women: resection followed by systemic and radiation therapy. Tamoxifen, not aromatase inhibitors, is the adjuvant therapy of choice for estrogen receptor positive tumors. Therapy of men with metastatic breast cancer follows the same principles as therapy of women.
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Affiliation(s)
| | | | - Stefan Aebi
- 1 Medizinische Onkologie, Luzerner Kantonsspital
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38
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Abstract
Zusammenfassung. Mit der Beschreibung des Typ-A-Verhaltens Ende der 1950er Jahre meinte man, einen psychosozialen Risikofaktor (PSRF) für das erhöhte Herzinfarktrisiko bei gestressten Managern gefunden zu haben. Aufgrund von Metaanalysen musste diese Vorstellung wieder verlassen werden. Heute weiss man, dass gerade Personen mit einem tieferen sozioökonomischen Status ein erhöhtes Infarktrisiko aufweisen und eine feindselige Einstellung gegenüber den Mitmenschen und eine hohe Ärgerbereitschaft die «kardiotoxischen» Komponenten der Typ-A-Persönlichkeit sind. Neben sozialen Faktoren und Persönlichkeitscharakteristika sind negative Emotionen und Erschöpfungszustände als weitere PSRF für kardiovaskuläre Krankheiten identifiziert worden. Genetische, verhaltensrelevante und pathophysiologische Mechanismen erklären diesen Zusammenhang. Die evidenzbasierte psychokardiologische Therapie kann in der psychosomatischen Grundversorgung und der kardialen Rehabilitation erfolgen und bezweckt eine Verbesserung der mentalen Gesundheit, des Funktionsniveaus im Alltag und der Krankheitsprognose.
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Affiliation(s)
- Roland von Känel
- 1 Departement für Psychosomatische Medizin, Klinik Barmelweid, Barmelweid
- 2 Universitätsklinik für Neurologie, Inselspital Bern
- 3 Departement für Klinische Forschung, Universität Bern
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39
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Rosegger P, Schleiffenbaum BE. [Not Available]. Praxis (Bern 1994) 2016; 105:1239-1246. [PMID: 28573954 DOI: 10.1024/1661-8157/a002533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Zusammenfassung. Die Anämie im Alter stellt ein zunehmendes Problem dar, das keinesfalls als normaler Teil des Alterns gesehen werden darf. Zugrundeliegende Krankheiten können in ca. 70–80 % der Fälle gefunden werden, wobei die häufigsten Ursachen ein Eisenmangel, eine chronischen Erkrankung, eine Niereninsuffizienz oder ein Vitamin-B12-/Folat-Mangel sind. Bis zu einem Drittel der Fälle bleiben äthiologisch unklar. Unter diesen finden sich die Patienten mit einer klonalen hämatologischen Erkrankung, die letztlich in einem myelodysplastischen Syndrom (MDS) enden kann. Schon milde Formen der Anämie können, vor allem im Alter, Begleiterkrankungen und die Lebensqualität verschlechtern. Ihre Behandlung reduziert die Morbidität und Mortalität im Alter.
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40
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Abstract
This presentation describes the development of attachment between adopted children and their adoptive parents with a focus on the particular issues seen in international adoptions. The questions of settling in, trauma in the country of origin, and the motivations of the adoptive parents will be discussed. Diagnosis and various psychopathological manifestations will be examined, as will outpatient and inpatient modes of therapy. The treatment of children of various ages will be covered along with the necessity for intensive counseling and psychotherapy for the adoptive parents. This will enable the parents to work through early trauma, which will give them and their adopted child the basis for developing healthy attachment patterns. This in turn will enable the child to mature and integrate into society. Possibilities of prevention are discussed. Many of the approaches discussed here regarding attachment and adoption may be applied to foster children and their foster parents.
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41
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Naegeli B, Franzen O. [Catheter based mitral valve repair for severe mitral regurgitation: patient selection]. Praxis (Bern 1994) 2015; 104:975-980. [PMID: 26331203 DOI: 10.1024/1661-8157/a002114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The catheter-based mitral valve repair is a novel technology for the treatment of severe mitral regurgitation (MR). This technique is suitable for elderly patients with pronounced co-morbidities who are deemed to be high risk for conventional heart surgery. A meaningful reduction of mitral regurgitation leads to improvement of symptoms and quality of life. Studies also demonstrate reverse remodeling of the left ventricle. In heart failure patients with severe MR percutaneous repair reduces re-hospitalization rates>50% in comparison to optimal medical treatment. For degenerative MR conventional surgery is the gold standard, whereas for high surgical risk patients and for severe functional MR percutaneous repair is an alternative.
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42
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Abstract
COPD is not a homogenous disease but consists of at least four different phenotypes: Emphysema, COPD with chronic bronchitis, asthma-COPD overlap syndrome (ACOS), and COPD with recurrent exacerbations. With differentiation, treatment can be designed phenotype-specific. Some modern drugs are not indicated in all phenotypes.
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Affiliation(s)
- Thomas Rothe
- Abteilung Innere Medizin, Zürcher Höhenklinik Davos, Davos Clavadel
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43
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Abstract
Cerebral cavernomatous malformations (CCM) are a subgroup of low-pressure cerebral vascular malformation. They have an estimated prevalence of 0,1-4% of the population and account for 8-15% of all cerebral vascular malformations. Depending on their size and localization (supratentorial or infratentorial, brain stem), CCM may present with focal bleedings with or without neurological deficits, as epileptic seizures, or are diagnosed incidentally by MRI performed for unspecific symptoms (e.g. headache, vertigo), especially in younger patients (mostly in 2nd or 3rd decade). The decision-making in patients with CCM can be classified into four categories: surgical or conservative treatment of symptomatic or incidental lesions. The decision regarding the optimal therapy in the individual patient must be made in the knowledge of the natural history (risk for bleeding or epilepsy) on the one hand, and the surgical possibilities (accessibility of the lesion) including their estimated outcome on the other hand. Therefore, careful patient selection and appropriate experience of the centre is warranted in the management of CCM.
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Affiliation(s)
- Martin N Stienen
- Klinik für Neurochirurgie, Kantonsspital St. Gallen, St. Gallen und Service de Neurochirurgie et Faculté de Médicine, Hôpitaux Universitaires de Genève
| | - Philippe Bijlenga
- Service de Neurochirurgie et Faculté de Médicine, Hôpitaux Universitaires de Genève
| | - Karl Schaller
- Service de Neurochirurgie et Faculté de Médicine, Hôpitaux Universitaires de Genève
| | | | - Oliver P Gautschi
- Service de Neurochirurgie et Faculté de Médicine, Hôpitaux Universitaires de Genève
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44
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Buhmann H, Nocito A. [Update on fecal incontinence]. Praxis (Bern 1994) 2014; 103:1313-1321. [PMID: 25351694 DOI: 10.1024/1661-8157/a001831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Fecal incontinence is defined as an accidental loss of stool or the inability to control defecation. There are three subtypes of fecal incontinence: passive incontinence, urge incontinence and soiling. About 8% of the adult population suffer from fecal incontinence, but only 1/3 consults a doctor. Beside the individual handicap, fecal incontinence has a huge socio-economic impact. Causes of fecal incontinence are changes in the quantity or quality of the stool and structural or functional disorders. Diagnostics encompass the medical history, clinical examination including the digital rectal examination, imaging (particularly endoanal ultrasound) as well as functional diagnostics (anal manometry and defecography). Nowadays, the most promising conservative treatment option consists of loperamide and biofeedback therapy. The most successful invasive method is the sacral neuromodulation.
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Affiliation(s)
- Helena Buhmann
- Klinik für Viszeral- und Transplantationschirurgie, Universitätsspital Zürich
| | - Antonio Nocito
- Klinik für Viszeral- und Transplantationschirurgie, Universitätsspital Zürich
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45
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Schärer V, Bruggmann P, Müllhaupt B, Fehr J. [Treatment of hepatitis C - an imminent revolution]. Praxis (Bern 1994) 2014; 103:1123-1131. [PMID: 25228574 DOI: 10.1024/1661-8157/a001782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Treatment of hepatitis C is approaching a revolution. During the last years, many agents have been developed that directly interfere with the viral replication cycle. Therapy of hepatitis C will no longer need Interferon in the future. The new therapies will be shorter, more efficient and with fewer side effects. For patients, the burden of treatment will drop substantially. Even patients are traditionally classified who as "difficult to treat", such as cirrhotic patients, HIV/hepatitis C coinfected patients and patients after liver transplantation will have better chances of cure. For more patients to benefit from the new therapies, identification of infected individuals and diagnostic investigations have to be improved.
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Affiliation(s)
- Verena Schärer
- Klinik für Infektionskrankheiten und Spitalhygiene, Universitätsspital Zürich, Universität Zürich
| | | | - Beat Müllhaupt
- Klinik für Gastroenterologie und Hepatologie, Universitätsspital Zürich, Universität Zürich
| | - Jan Fehr
- Klinik für Infektionskrankheiten und Spitalhygiene, Universitätsspital Zürich, Universität Zürich
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46
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Streit U, Nantke S, Jansen F, Wolf K, Gallasch M, Kohlmann T. [The influence of an improvement of body contact on regulatory disorders in infancy]. Z Kinder Jugendpsychiatr Psychother 2014; 42:301-13. [PMID: 25163993 DOI: 10.1024/1422-4917/a000306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study concerns the influence of an improvement of body contact on regulatory disorders in infancy. Two interventions were examined: 1. parent counseling on the subject of body contact; 2. practical training of body contact in connection with exposure. Both methods were supplemented by a video-based parent training. METHODS 20 infants with regulatory disorder were assigned to each treatment. Body and eye contact were examined by means of video ratings before and after treatment. In addition, we measured the daily amount of crying, sleeping, feeding, being fussy, and quiet play by means of an infant behavior diary. RESULTS Both interventions resulted in an improvement of body contact, though only in the group with practical training was this improvement stable after 3 months. Taking all 40 participating infants together, we found significant improvements for "fussiness," "sleep duration," "awake, quiet or playing," and a marginal significant intervention effect for the duration of crying. Both interventions showed that children who had markedly improved in body contact also improved with regard to the regulation problem. Finally, the practical training of body contact was superior to pure counseling respective to the fussiness of the infants and to their gaze contact. CONCLUSIONS Body contact can be improved through specific therapeutic interventions. Video-based parent training in combination with interventions aiming at an improvement of body contact have a positive effect on the regulation problem.
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Affiliation(s)
| | | | | | - Karina Wolf
- Begabungspsychologische Beratungsstelle der Ludwig-Maximilians-Universität, München
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47
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Huber LC, Isenring BD, Schuurmans MM. [Diagnosis, therapy and prevention of respiratory virus infections in lung transplant recipients]. Praxis (Bern 1994) 2014; 103:453-459. [PMID: 24713381 DOI: 10.1024/1661-8157/a001627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Lung transplant recipients have a life-long profound immunosuppression which makes them prone to respiratory tract infections, in particular viral infections during the winter season. Since the respiratory tract infections may have potentially severe consequences, we recommend early diagnosis and treatment. We obtain nasopharyngeal swabs for viral and bacteriological examination and then treat pre-emptively with antivirals, broad-band antibiotics and often also with intravenous immunoglobulins. Treatment duration is often longer than in immunocompetent patients. As preventive measures we provide vaccination against seasonal influenza and recommend specific daily hygiene measures.
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Affiliation(s)
- Lars C Huber
- Klinik für Pneumologie, Universitätsspital Zürich
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48
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Abstract
The prevalence of a major depressive disorder in patients after myocardial infarction is 20%. Depression is a risk factor for incident coronary heart disease and poor prognosis after myocardial infarction. Poor lifestyle habits and adherence to cardiac therapy as well as metabolic and pathophysiologic changes may partially explain this link. The threatening experience of an acute coronary event and immune and inflammatory changes may be unique features contributing to incident depression after myocardial infarction. While psychotherapy, antidepressants, and physical exercise may alleviate depressive symptoms in patients with coronary heart disease, cardiac rehabilitation additionally reduces mortality risk. Attempts are being undertaken to identify the cardiotoxic characteristics of depression to develop even more effective therapies in the future.
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Affiliation(s)
- Roland von Känel
- Kompetenzbereich für Psychosomatische Medizin, Klinik für Allgemeine Innere Medizin, Universitätsspital, Inselspital, Bern und Departement für Klinische Forschung, Universität Bern
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49
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Abstract
This article highlights some aspects of candidosis which were explored in different models and which yielded relevant information with respect to pathogenesis as well as possibilities of prevention and treatment of candidosis.
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Affiliation(s)
- Esther Segal
- Department of Human Microbiology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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