Psychosoziale Rehabilitation von Kindern und Jugendlichen mit körperlicher und/oder psychischer Erkrankung

The guidelines regarding medical rehabilitation have changed. When applying for medical rehabilitation, the International Classification of Functioning (ICF) must be used for young adults with somatic and/or psychiatric diseases. The ICF is an appropriate tool to assess the outcome of rehabilitation in children and adolescents. Nowadays the ICF is used in rehabilitation hospitals; in former times the Functional Independence Measure (FIM) was used. The different criteria of the ICF such as personal factors, environmental factors, body function and structure (impairment), activities (limitation) and participation (restriction) are explained. A case report is presented which shows the outcome of rehabilitation according to FIM and ICF in graphic form.     

Notfälle bei extrapyramidalen Erkrankungen

Zusammenfassung Extrapyramidalen Störungen liegen zwar meist chronische Erkrankungen zugrunde, jedoch kommt es unter Umständen auch zum akuten Auftreten oder zu einer dramatischen Verschlechterung bis hin zu lebensbedrohlichen Zuständen. So kann ein Infekt, Medikamentenentzug oder eine Exikkose bei Parkinson-Patienten eine akinetische Krise auslösen. Auch akute, therapieassoziierte Psychosen mit Halluzinationen, Verwirrtheits- und Unruhezuständen können beim Parkinson-Patienten eine Notfallbehandlung erforderlich machen. Akute medikamenteninduzierte Dystonien treten nach einer Latenz von Stunden bis Tagen nach der Therapie mit Neuroleptika auf. Diese Frühdyskinesien können mit i.v.-Gabe von Anticholinergika effektiv behandelt werden. Seltene Folge einer Neuroleptikatherapie ist das maligne neuroleptische Syndrom, das mit Hyperthermie, Rigor und Bewusstseinsveränderungen einhergeht und zur kardiopulmonalen Dekompensation führen kann. Auch hier ist eine rasche Diagnosestellung entscheidend.     

Preselection Thymocytes Are More Sensitive to T Cell Receptor Stimulation Than Mature T Cells

During T cell development, thymocytes which are tolerant to self-peptides but reactive to foreign peptides are selected. The current model for thymocyte selection proposes that self-peptide–major histocompatibility complex (MHC) complexes that bind the T cell receptor with low affinity will promote positive selection while those with high affinity will result in negative selection. Upon thymocyte maturation, such low affinity self-peptide–MHC ligands no longer provoke a response, but foreign peptides can incidentally be high affinity ligands and can therefore stimulate T cells. For this model to work, thymocytes must be more sensitive to ligand than mature T cells. Contrary to this expectation, several groups have shown that thymocytes are less responsive than mature T cells to anti-T cell receptor for antigen (TCR)/CD3 mAb stimulation. Additionally, the lower TCR levels on thymocytes, compared with T cells, would potentially correlate with decreased thymocyte sensitivity. Here we compared preselection thymocytes and mature T cells for early activation events in response to peptide–MHC ligands. Remarkably, the preselection thymocytes were more responsive than mature T cells when stimulated with low affinity peptide variants, while both populations responded equally well to the antigenic peptide. This directly demonstrates the increased sensitivity of thymocytes compared with T cells for TCR engagement by peptide–MHC complexes.     

Crigler-Najjar Syndrom Typ I infolge segmentaler paternaler Isodisomie 2

Ohne Zusammenfassung     

Medikamentöse Kopfschmerztherapie

Ohne Zusammenfassung     

The right to be born

The right to be born embodies several different rights: the right to be conceived, the right to be implanted in the uterus, and the right to live (or not be aborted). The right to be conceived, or the right of parents to reproduce, may depend upon circumstances. Do couples have the right to have children to whom they cannot offer an adequate upbringing? Do couples have the right to have as many children as they wish if in this way they will reduce the amount of food available to other families? Is the right to have children coupled with a responsibility not to have more children than a community, a country or the world can support? Fertilisation occurs in the fallopian tube, but only about 30% of fertilised ova normally become successfully implanted in the uterus. Fertilisation can also be achieved in a test tube and the resultant embryo then implanted in the mother's uterus to grow into a "test tube baby". Is it ethical to allow the use of donor sperm or ova, a surrogate mother, experimentation on embryos, and what should be done with "spare" embryos? The British Unborn Child (Protection) Bill 1986 prohibits anyone from possessing a fertilised embryo unless it is for the purpose of enabling a specific women to have a child. The right to live and not be aborted may involve a conflict of interests between a mother and her unborn child. A mother may claim absolute rights over her own body, including the right to have an abortion if she desires.(ABSTRACT TRUNCATED AT 250 WORDS)