Deutsche Leitlinie zur Diagnostik und Therapie der zirkumskripten Sklerodermie

Bei der zirkumskripten Sklerodermie handelt es sich um eine heterogene Gruppe von sklerotischen Erkrankungen der Haut mit je nach Subtyp, Schweregrad und Lokalisation möglicher Beteiligung von hautnahen Strukturen wie Fettgewebe, Muskulatur, Gelenke und Knochen. Dies ist eine Aktualisierung der bereits bestehenden deutschen Leitlinie der AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Wissenschaften) mit dem Klassifizierungsgrad S2k. Die Leitlinie gibt einen Überblick zur Definition, Epidemiologie, Klassifikation, Pathogenese, Labordiagnostik, Histopathologie sowie klinischen Scores und apparativen Diagnostik der zirkumskripten Sklerodermie. Des Weiteren erfolgen konsensbasierte Empfehlungen zum Management der zirkumskripten Sklerodermie in Abhängigkeit vom klinischen Subtyp. Die Behandlungsempfehlungen sind in einem Therapiealgorithmus dargestellt. Eine finanzielle Unterstützung zur Erstellung der Leitlinie durch die pharmazeutische Industrie erfolgte nicht. Die Leitlinie ist bis Juli 2019 gültig.     

The use of isothermal heat conduction microcalorimetry to evaluate drug stability in tablets.

Isothermal heat conduction microcalorimetry was used to evaluate chemical stability of a solid drug in tablets. A variety of mixtures were compressed to flat faced tablets of 300 mg weight and 10 mm diameter. The content of drug amounted to 10%. Besides drug containing tablets, also placebo tablets as well as the non compressed mixtures were examined by microcalorimetry at 80 degrees C. The excipient Emcompress exhibited a substantially high exothermic heat flow that was due to a change in crystallinity. For Emcompress containing tablets this interfering signal resulted in such a way that the calorimetric data did not reflect the drug decomposition with sufficient accuracy. In the case of the other preparations the heat flow of the excipients were low, and the calorimetric data did reflect the drug decomposition. The stability increased with increasing content of CaHPO4, respectively, with decreasing content of water. Copyright     

Evidence‐based (S3) Guideline on (anogenital) Lichen sclerosus

Lichen sclerosus (LS) is an inflammatory skin disease that usually involves the anogenital area. All patients with symptoms or signs suspicious of lichen sclerosus should be seen at least once initially by a physician with a special interest in the disease in order to avoid delay in diagnosis, as early treatment may cure the disease in some and reduce or prevent scarring. The diagnosis is made clinically in most cases. Biopsies should only be performed under certain circumstances. The gold standard for treatment remains potent to very potent topical steroids; however, mild and moderate disease in boys and men may be cured by circumcision. Certain triggers should be avoided. http://www.euroderm.org/images/stories/guidelines/2014/S3-Guideline-on-Lichen-sclerosus.pdf http://www.awmf.org/fachgesellschaften/mitgliedsgesellschaften/visitenkarte/fg/deutsche-gesellschaft-fuer-gynaekologie-und-geburtshilfe-dggg.html .     

Diagnostik des Bronchialkarzinoms

Lung cancer is the fourth most common cause of death in Germany. Symptoms are mainly nonspecific and often develop at a late stage. The diagnostic procedure begins with clinical history and examination. X-ray of the thorax is the basis of imaging and is supplemented by a computed tomography (CT) scan of the thorax. A biopsy for histological or cytological evaluation should be performed by the least invasive method, usually bronchoscopy. Supplemented by modern techniques such as narrow-band imaging, endobronchial ultrasound and electromagnetic navigation, bronchoscopy plays an important role in the diagnostic procedure. Positron emission tomography (PET) provides reliable evidence of lung cancer. It can be used for further evaluation of mediastinal lymphadenopathy and also supplements extrathoracical staging. This should cover the most prevalent organs of metastasis, namely the adrenal glands, liver, central nervous system and bones.     

Sexuality and sexual life in women with spinal cord injury: a controlled study.

OBJECTIVE: To describe sexual life in women with spinal cord injury. DESIGN: Controlled cross-sectional, questionnaire. PARTICIPANTS AND METHODS: Women, 18-65 years, treated at spinal cord centres in Sweden, Denmark, Norway, Finland and Iceland. 545 women (57%) completed the questionnaires. The age-matched control group consisted of 507 women. The 104-item Spinal Cord Injury Women Questionnaire, was designed to assess different dimensions of sexuality. RESULTS: 80% of the women with spinal cord injury had engaged in sex after the injury. Reasons for not wanting or not having the courage to be intimate and sexual were physical problems, low sexual desire, low self-esteem and feelings of being unattractive. The motivations of both the women with spinal cord injury and controls to engage in sexual activity were intimacy-based rather than primarily sexual. Being in the right mood both before and during sex to become receptive to sexual stimulation was important. CONCLUSION: For women who are able to overcome the physical restrictions and mental obstacles due to injury, it is possible to regain an active and positive sexual life together with a partner. Sexual information and counselling should be available both during initial rehabilitation and later when the women have returned to their homes.     

Über die Totalexstirpation des karzinomatösen Magens

Ohne Zusammenfassung (Mit 2 Abbildungen.)     

A solid colloidal drug delivery system for the eye: encapsulation of pilocarpin in nanoparticles

The present study was undertaken in order to encapsulate pilocarpin into nanoparticles. Two principally different methods for manufacturing these particles were investigated. Firstly, pilocarpin was dissolved in an aqueous medium in which the polymerization was carried out, and secondly, the polymerizing monomer was kept saturated with the drug solution under acidic conditions resulting in an incorporation into the nanoparticles in an aqueous environment. The amount of pilocarpin that could be incorporated into the nanoparticles was found to be largely influenced by the temperature at which the nanoparticles were produced and by the stabilizers used. At low temperatures, up to 60 per cent of pilocarpin nitrate could be encapsulated into butylcyanoacrylate nanoparticles using emulsion polymerization techniques. Larger amounts of pilocarpin could not be incorporated because of the hydrophilicity of the salts of this drug. The physico-chemical characteristics of the nanoparticles are reported: the particle size and morphology were determined by scanning and transmission electron microscopy and photon correlation spectrometry. The average particle size was about 100 nm. The results obtained in this study show that photon correlation spectrometry is a suitable method for the sizing of nanoparticles.