Showing papers in "Mmw-fortschritte Der Medizin in 2008"

Early detection of breast cancer

Abstract: It is recommended that women of all ages, and regardless of whether they attend mammographic screening, are aware of how their breasts normally look and feel and report any new or unusual changes promptly to their general practitioner. No one method for women to use when checking their breasts is recommended over another. It is recommended to reduce the risk of death due to breast cancer that women aged 50–74 years attend the BreastScreen Australia Program for free two-yearly screening mammograms having considered the benefits and downsides. Mammographic screening is not recommended for women younger than 40 years of age. Women aged 40–49 years and 75 years and over are eligible to receive free screening mammograms through the BreastScreen Australia Program but they do not receive an invitation to attend. In deciding whether to attend for screening mammography, women in these age groups should balance the potential benefits and downsides for them. For women of all ages who are at increased risk† of developing breast cancer it is recommended that an individualised surveillance program be developed in consultation with the woman’s general practitioner and/or specialist.

[Analgesic and muscle tonus normalizing effect of flupirtine retard in chronic back pain. Results of a standardized therapeutic evaluation applying objective methods for measuring pain pressure threshold, pain pressure tolerance and muscle tension].

Abstract: BACKGROUND Chronic back pain is mainly caused by painful tension in the back muscles Thus, analgesics with muscle tone decreasing effects that apparently normalize increased muscle tonus through specific modes of action without disturbing normal muscular movement are an important therapeutic option Flupirtine retard (Katadolon S long) has provided such an option since 2006 OBJECTIVES To impartially evaluate the muscle tonus normalizing effects of flupirtine retard by applying specific, objective test methods in patients with chronic musculoskeletal pain under routine practice conditions METHODS Prospective standardized evaluation of a treatment with flupirtine retard in 30 patients with continuous chronic, therapy refractory back pain Measurement of general pain intensity, pain pressure threshold and pain pressure tolerance for trigger-point related pain and muscle tension in the affected back muscles before and during flupirtine retard treatment were performed in a standardized manner RESULTS In comparison to the reproducible, constant initial values, the two-week treatment with flupirtine retard led to a significant improvement in all measured muscle-specific indicators: pain pressure threshold (+48%), pain pressure tolerance (+27%) and depth of penetration in the muscle (+18%) (all values p < 0001) These were also correlated with a clinically observable and statistically significant pain relief from an initial level of 70 +/- 13 to 30 +/- 14 CONCLUSION Flupirtine retard was shown to be a useful, effective and very tolerable therapeutic option for patients with chronic back pain The improvement of muscle disturbances which are responsible for the pain in addition to pain relief was shown firstly by objective measure methods

Juckreiz, Schmerzen, fleckige Herde

Abstract: Schmerzen, Entzundungen und Miktionsprobleme sind nur einige der Beschwerden, die einen Lichen sclerosus et atrophicus begleiten. Die fruhe Diagnose lohnt sich. Durch rechtzeitige Beschneidung konnen sich bei Mannern die Hautveranderungen zuruckbilden. Zudem haben verschiedene Topika sowie Lichttherapien ihre Wirksamkeit gezeigt.

Pilze auf dem Genitale

Abstract: Candida-Infektionen sind vor allem in Korper regionen mit feuchtwarmem Milieu eine haufige Plage. Klinisch sind sie leicht zu erkennen, in der Pilzkultur schnell nachweisbar und therapeutisch meist gut zuganglich. Langer kann sich die Behandlung hinziehen, wenn Haut, Nagel oder Haare von Dermatophyten befallen sind. Unsere Autoren zeigen Ihnen hier einige typische Falle.

[Treatment of chronic osteoarthritis pain: effectivity and safety of a 7 day matrix patch with a low dose buprenorphine].

Abstract: Patients with osteoarthritis often suffer from chronic pain. If pain treatment with NSAIDS and coxibes is no longer indicated, a constant and user friendly opioid analgesia can be achieved with a low dose buprenorphine patch being applicated using an interval of 7 days. The use of this matrix patch was evaluated in a multicenter observational study on 4263 patients in clinical practice. During treatment a significant decrease of mean pain intensity on a 11-point scale could be observed from 6.9 points before using the patch to 2.9 points at the end of observation. Further effects were a decrease of additional analgetic medication and an improvement of aspects of life quality, e.g. mobility and quality of sleep. Only in 4.5% of the patients adverse effects were observed, reflecting the expected range of adverse effects of opioids. Thus it could be demonstrated that the use of the transdermal patch is an effective, user friendly and safe way of chronic pain relief for osteoarthritis patients.

[Importance of a fixed combination of AT1-receptor blockade and hydrochlorothiazide for blood pressure lowering in cardiac risk patients. A postmarketing surveillance study with candesartan/HCTZ].

Abstract: BACKGROUND The treatment of arterial hypertension in Germany is, compared to international control rates, not adequate. In particular patients having additional cardiac risk factors like diabetes mellitus, dyslipidemia, increased waist circumference as well as concomitant diseases like myocardial infarction, heart- as well as kidney failure would benefit from an effective antihypertensive therapy. Aim of the present study was therefore to investigate in more detail blood pressure control in patients receiving a fixed combination of 16 mg Candesartan and 12.5 mg hydrochlorothiazide (HCTZ). METHODS The present studywas performed as a non-interventional observational study. Included were patients with previously uncontrolled hypertension with at least one further risk factor. Primary variable was the blood pressure reduction over a time period of 8 weeks; secondary variables were the achievement of blood pressure targets and the tolerability of Candesartan/HCTZ. RESULTS Between August 2006 and February 2007 3,787 patients in 893 physicians' offices in Germany were included. Patients were 62.2 +/- 11.3 years old, 48.1% were female, 97.5% had at least one additional risk factor, 29.8% a cardiovascular event. The risk to die from cardiovascular disease within the next 10 years was 7.4% according to the SCORE Score. By prescribing patients a fixed combination of 16 mg Candesartan/12.5 mg HCTZ a mean blood pressure reduction of -27.2/-13.4 mmHg was achieved (p < 0.001), pulse pressure was reduced by 13.8 mmHg (p <0.001) - both compared to previous therapy. A mean of 83.1% of patients achieved the guideline defined blood pressure targets (140/90 mmHg), 42.9% of patients even 130/80 mmHg. Serious adverse events were extremely rare (0.5%; hypertensive crisis, transitory ischemic attack). CONCLUSION Prescribing patients with previously uncontrolled hypertension a combination of 16 mg Candesartan/12.5 mg HCTZ was tolerable and effective for blood pressure reduction in patients with arterial hypertension and additional risk factors like diabetes mellitus, dyslipidemia and the metabolic syndrome.

Die Überdosis Sex gegen Angst und Depression

Abstract: Die meisten Menschen versuchen, ihre psychischen Probleme mit Gesprachen, Entspannung oder Medikamenten in den Griff zu bekommen. Einige greifen zum Alkohol. Wieder andere verfangen sich in sexuellen Exzessen verschiedenster Art, die sie jedoch immer weiter in die Isolation treiben. Fur sie ist Sexualitat eine Art „psychisches Analgetikum“ mit Suchtcharakter.

Wie Sie die Informationsflut sinnvoll nutzen

Abstract: Die Flut der medizinischen Fachpublikationen ist fur den im Praxisalltag eingespannten Hausarzt kaum zu bewaltigen. Wollte man sich durch entsprechende Lekture nur zu einem einzigen Fachgebiet wie Diabetes oder Hochdruck auf dem aktuellen Stand halten, musste man taglich bis zu zehn Fachartikel lesen. Systematische Ubersichten konnen die Arbeit wesentlich erleichtern. Unser Beitrag gibt Ihnen Tipps zur Internetrecherche und zeigt, wie Sie die gewonnenen Informationen fur die Praxis nutzen.

Rückenschmerzen: Leitlinien der medikamentösen Therapie

Abstract: Gegen Ruckenschmerz werden meistens nichtsteroidale Antirheumatika verschrieben. Doch die sind auf Dauer problematisch, und zudem gibt es fur viele Patienten bessere Alternativen: Beispielsweise Flupirtin1, Lokalanasthetika oder Antidepressiva. Und wenn sonst nichts hilft, sollten Sie auch keine Hemmungen vor Opioidanalgetika kennen — denn andernfalls handeln Sie dem Patienten einen chronifizierten und kaum noch behandelbaren Schmerz ein.

Modern treatment of erectile dysfunction

Abstract: Greifen Sie in Ihren Patientengesprachen regelmasig das Thema Sexualitat auf? Das sollten Sie; nicht nur, weil eine erektile Dysfunktion die Lebensqualitat des Patienten erheblich beeintrachtigt, sondern auch, weil eine solche Storung z. B. auf eine generalisierte Gefaserkrankung oder auch auf ein psychisches Problem hinweisen kann. Therapeutisch steht heute ein ganzes Arsenal an Masnahmen zur Verfugung. Lesen Sie, wozu Sie im Einzelfall raten konnen.

Post marketing surveillance study with an analgesic (transdermal buprenorphine patch) in patients with moderate to severe chronic pain

Abstract: Aim To obtain information on the efficacy, tolerability and safetyofa transdermal buprenorphine patch (Transtec PRO) in patients with moderate to severe chronic pain. In addition it should be evaluated to what extent the two fixed patch change days per weekare simplifyingthe therapy. Methods In this prospective multi-center post marketing surveillance study patients with chronic cancer and non-cancer pain were treated with transdermal buprenorphine for up to eight weeks. The evaluation included pain intensity, the dosage of the applied analgesics and additional therapies, the renal function (by serum creatinine) and adverse events. Results 3654 patients were treated for a mean of 50.4 days. Using the NRS-11 the mean pain intensity decreased from 6.3 at the time when patients were switched to the transdermal buprenorphine patch to 2.6 at the last treatment evaluation. The matrix patch was safe and well tolerated also in patients with advanced renal insufficiency. Adverse events were reported in 6.7% of the patients. 89.3% of the physicians quoted to prefer transdermal buprenorphine with the two fixed patch change days per week compared to the pre-treatment. Conclusion The buprenorphine-containing matrix patch was effective and well tolerated in patients with moderate to severe chronic cancer and noncancer pain. From the physicians view the two fixed patch change days per week facilitate the guidance of therapy. In patients with advanced renal insufficiency a dose adjustment is not necessary.

Wer braucht als Erster Hilfe

Abstract: Ein Massenanfall von Verletzten (MANV), z. B. nach einem groseren Unfall oder terroristischen Anschlag, stellt sowohl fur die medizinische als auch die organisatorische Einsatzleitung eine besondere Herausforderung dar. Von essenzieller Bedeutung ist, unter den Verletzten moglichst schnell diejenigen zu identifizieren, die eine akut lebensbedrohliche Verletzung erlitten haben. Sie mussen sofort behandelt oder schnell abtransportiert werden.

Weit mehr als nur Schmerztherapie

Abstract: „Palliativmedizin dient der Verbesserung der Lebensqualitat von Patienten und ihren Angehorigen, die mit einer lebensbedrohlichen Erkrankung konfrontiert sind. Dies geschieht durch Vorbeugung und Linderung von Leiden mittels fruhzeitiger Erkennung, hoch qualifizierter Beurteilung und Behandlung von Schmerzen und anderen Problemen physischer, psychosozialer und spiritueller Natur“ (WHO 2002 [1]).