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S2k Guidelines for the diagnosis and treatment of chronic pruritus – update – short version 下载免费PDF全文
Sonja Ständer Claudia Zeidler Matthias Augustin Gudrun Bayer Andreas E. Kremer Franz J. Legat Peter Maisel Thomas Mettang Martin Metz Alexander Nast Volker Niemeier Ulrike Raap Gudrun Schneider Hartmut F. Ständer Petra Staubach Markus Streit Elke Weisshaar 《Journal der Deutschen Dermatologischen Gesellschaft》2017,15(8):860-872
Associated with a host of different diseases, pruritus is a cardinal symptom that poses an interdisciplinary diagnostic and therapeutic challenge. Over time, that symptom may progress independently of the initial cause, thus losing its function as a warning sign and turning into a clinically relevant disease of its own. In Germany, approximately 13.5 % of the general population are affected by chronic pruritus, with an incidence of 7 %. All forms of chronic pruritus require targeted treatment consisting of (a) diagnosis and management of the underlying disease, (b) dermatological treatment of primary or secondary (for example, dry skin, scratch lesions) symptoms, (c) symptomatic antipruritic treatment, and (d) psychological/psychotherapeutic treatment in case of an underlying or associated psychological or psychosomatic condition. Medical care of patients with chronic pruritus should therefore include an interdisciplinary approach, in particular with respect to diagnosis and therapy of the underlying disease as well as in terms of the management of treatment and adverse events. The objective of the present interdisciplinary guidelines is to define and standardize diagnostic and therapeutic procedures in patients with chronic pruritus. This is a short version of the current S2 guidelines on chronic pruritus. The long version may be found at www.awmf.org . 相似文献
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Sigrun Vehling Claudia Lehmann Karin Oechsle Carsten Bokemeyer Andreas Kr��ll Uwe Koch Anja Mehnert 《Supportive care in cancer》2011,19(4):513-520
Goal of work
While significance of the concept of meaning in understanding adaptation to cancer is widely accepted, it has been little studied, especially in longitudinal data. This study aims to clarify the role of global meaning and meaning-related life attitudes (death acceptance and goal seeking) in predicting different aspects of psychological and existential distress by reference to a specified research model. 相似文献998.
Marianne R. Spalinger Stephanie Kasper Claudia Gottier Silvia Lang Kirstin Atrott Stephan R. Vavricka Sylvie Scharl Tina Raselli Isabelle Frey-Wagner Petrus M. Gutte Markus G. Grütter Hans-Dietmar Beer Emmanuel Contassot Andrew C. Chan Xuezhi Dai David J. Rawlings Florian Mair Burkhard Becher Werner Falk Michael Fried Gerhard Rogler Michael Scharl 《The Journal of clinical investigation》2016,126(11):4388
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Franziska Schmidt Melanie Kny Xiaoxi Zhu Tobias Wollersheim Kathleen Persicke Claudia Langhans Doerte Lodka Christian Kleber Steffen Weber-Carstens Jens Fielitz 《Critical care (London, England)》2014,18(5)
Introduction
ICU-acquired weakness (ICUAW) complicates the disease course of critically ill patients. Inflammation and acute-phase response occur directly within myocytes and contribute to ICUAW. We observed that tripartite motif–containing 62 (TRIM62), an E3 ubiquitin ligase and modifier of inflammation, is increased in the skeletal muscle of ICUAW patients. We investigated the regulation and function of muscular TRIM62 in critical illness.Methods
Twenty-six critically ill patients with Sequential Organ Failure Assessment scores ≥8 underwent two skeletal muscle biopsies from the vastus lateralis at median days 5 and 15 in the ICU. Four patients undergoing elective orthopedic surgery served as controls. TRIM62 expression and protein content were analyzed in these biopsies. The kinetics of Trim62, Atrogin1 and MuRF1 expression were determined in the gastrocnemius/plantaris and tibialis anterior muscles from mouse models of inflammation-, denervation- and starvation-induced muscle atrophy to differentiate between these contributors to ICUAW. Cultured myocytes were used for mechanistic analyses.Results
TRIM62 expression and protein content were increased early and remained elevated in muscles from critically ill patients. In all three animal models, muscular Trim62 expression was early and continuously increased. Trim62 was expressed in myocytes, and its overexpression activated the atrophy-inducing activator protein 1 signal transduction pathway. Knockdown of Trim62 by small interfering RNA inhibited lipopolysaccharide-induced interleukin 6 expression.Conclusions
TRIM62 is activated in the muscles of critically ill patients. It could play a role in the pathogenesis of ICUAW by activating and maintaining inflammation in myocytes.Trial registration
Current Controlled Trials ID: ISRCTN77569430 (registered 13 February 2008)Electronic supplementary material
The online version of this article (doi:10.1186/s13054-014-0545-6) contains supplementary material, which is available to authorized users. 相似文献1000.
Alberto Giannini Guido Miccinesi Edi Prandi Carlotta Buzzoni Claudia Borreani 《Intensive care medicine》2013,39(12):2180-2187