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Natalya Maltseva Elena Borzova Daria Fomina Mojca Bizjak Dorothea Terhorst-Molawi Mitja Košnik Kanokvalai Kulthanan Raisa Meshkova Simon Francis Thomsen Marcus Maurer the COLD-CE Steering Committee 《Allergy》2021,76(4):1077-1094
Cold urticaria (ColdU) is a common form of chronic inducible urticaria characterized by the development of wheals, angioedema or both in response to cold exposure. Recent research and guideline updates have advanced our understanding and management of ColdU. Today, its pathophysiology is thought to involve the cold-induced formation of autoallergens and IgE to these autoallergens, which provoke a release of proinflammatory mediators from skin mast cells. The classification of ColdU includes typical and atypical subtypes. We know that cold-induced wheals usually develop on rewarming and resolve within an hour and that anaphylaxis can occur. The diagnosis relies on the patient's history and cold stimulation testing. Additional diagnostic work-up, including a search for underlying infections, should only be done if indicated by the patient's history. The management of ColdU includes cold avoidance, the regular use of nonsedating antihistamines and the off-label use of omalizumab. However, many questions regarding ColdU remain unanswered. Here, we review what is known about ColdU, and we present important unanswered questions on the epidemiology, underlying pathomechanisms, clinical heterogeneity and treatment outcomes. Our aim is to guide future efforts that will close these knowledge gaps and advance the management of ColdU. 相似文献
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《Best Practice & Research: Clinical Rheumatology》2020,34(1):101489
Systemic sclerosis is a severe immune-mediated rheumatic disease by virtue of its clinical impact and mortality. There are a number of other sclerosing skin diseases that should be considered in the differential diagnosis and these are important because they may require specialist investigation and management. In addition, long-term follow up of the different conditions should reflect the risk of associated complications and anticipated duration of therapy. This article reviews the clinical features of potential mimics of scleroderma (systemic sclerosis) including localised forms of scleroderma (morphoea) and other conditions that lead to skin thickening and connective tissue fibrosis or scarring. 相似文献
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目的探讨普瑞巴林对带状疱疹后遗神经痛的有效性与安全性。方法选择带状疱疹后遗神经痛患者72例并随机分为两组各36例。观察组采用普瑞巴林治疗,对照组采用加巴喷丁治疗,观察比较两组的疗效及不良反应。结果治疗4周后,观察组总有效率为83.33%,显著高于对照组(P<0.05);两组的VAS评分均比治疗前降低,但观察组降低更显著(P<0.01);两组均无严重不良反应发生。结论普瑞巴林治疗带状疱疹后遗神经痛安全有效,能显著改善患者的VAS评分,无严重不良反应。 相似文献
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This article reviews the use of conventional disease-modifying antirheumatic drugs (DMARDs) in the treatment of early rheumatoid arthritis (RA). The Finnish early RA cohorts are used as examples of how early and active treatment strategies have improved over time with increasing variety of available DMARDs. Therapy goals of early RA include remission to prevent severe long-term outcomes of RA. Remission can be achieved in a third of patients with early RA using a combination of conventional DMARDs, including methotrexate, sulfasalazine, hydroxychloroquine, and prednisolone. Of patients with early RA, 20% to 30% do not improve enough with conventional treatments and should be identified at early phases to consider institution of biologic agents. 相似文献
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Orsolya Balogh Valentin Brodszky László Gulácsi Emese Herédi Krisztina Herszényi Hajnalka Jókai Sarolta Kárpáti Petra Baji Éva Remenyik Andrea Szegedi Péter Holló 《The European journal of health economics》2014,15(1):101-109
Background
Despite the widespread availability of biological drugs in psoriasis, there is a shortage of disease burden studies.Objectives
To assess the cost-of-illness and quality of life of patients with moderate to severe psoriasis in Hungary.Methods
Consecutive patients with Psoriasis Area and Severity Index (PASI) > 10 and Dermatology Life Quality Index (DLQI) > 10, or treated with traditional systemic (TST) or biological systemic treatment (BST) were included. Demographic data, clinical characteristics, psoriasis related medication, health care utilizations and employment status in the previous 12 months were recorded. Costing was performed from the societal perspective applying the human capital approach. Quality of life was assessed using DLQI and EQ-5D measures.Results
Two-hundred patients were involved (females 32 %) with a mean age of 51 (SD 13) years, 103 (52 %) patients were on BST. Mean PASI, DLQI and EQ-5D scores were 8 (SD 10), 6 (SD 7) and 0.69 (SD 0.3), respectively. The mean total cost was €9,254/patient/year (SD 8,502) with direct costs accounting for 86 %. The main cost driver was BST (mean €7,339/patient/year). Total costs differed significantly across treatment subgroups, mean (SD): no systemic therapy €2,186 (4,165), TST €2,388 (4,106) and BST €15,790 (6,016) (p < 0,001). Patients with BST had better PASI and DLQI scores (p < 0.01) than the other two subgroups.Conclusions
Patients with biological treatment have a significantly better quality of life and higher total costs than patients with or without traditional systemic treatment. Our study is the largest in Europe and the first in the CEE region that provides cost-of-illness data in psoriasis involving patients with BST.58.
职业倦怠是指在以人为服务对象的职业领域中,个体的一种情感耗竭、人格解体和个人成就感降低的症状。由于护士是一种典型的以人为服务对象的职业,因此,护士是职业倦怠的高发人群,也一直是职业倦怠研究中重点关注的职业人群之一,医护人员发生职业倦怠机会高,尤其以护士更为突出,影响护士职业倦怠主要相关因素有年龄、护龄、婚姻、工作之余的家务劳动、学历、职称、劳动关系、收入、工作量、工作岗位和轮班等因素,由于护理模式向整体护理的转变,以患者为中心,护理角色职能发生质的改变,对护士提出了更高的要求,加重护士职业倦怠的发生。作者就护理职业倦怠的概念及内涵、危害、原因、职业倦怠现状及预防,同时指出干预医护人员职业倦怠的不同影响因素探索有效的方法。 相似文献
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Aleksandra Lesiak Marcin Zakrzewski Karolina Przyby?owska Micha? Rogowski-Tylman Anna Wozniacka Joanna Narbutt 《Archives of Medical Science》2014,10(6):1239-1243