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Wwollina U.,Academic Teaching Hospital | Goldman A.,Clinica Goldman
Clinical, Cosmetic and Investigational Dermatology | Year: 2015

Acne is a common inflammatory disease. Scarring is an unwanted end point of acne. Both atrophic and hypertrophic scar types occur. Soft-tissue augmentation aims to improve atrophic scars. In this review, we will focus on the use of dermal fillers for acne scar improvement. Therefore, various filler types are characterized, and available data on their use in acne scar improvement are analyzed. © 2015 Wollina and Goldman. Source

Rhomberg W.,Academic Teaching Hospital
International Journal of Cancer Research and Prevention | Year: 2012

Background. About 70% of patients with incurable cancer will eventually succumb to distant metastasis. Therefore, the development of therapies against metastasis is of considerable interest. In the past, clinical research on the dynamics of metastasis was difficult to perform, but now the advent of modern imaging techniques has made it relatively easy to obtain follow-ups. In contrast, extensive preclinical research was done yielding interesting results. Methods. The paper describes previous and present results of clinical investigations achieved by drugs whose modes of action are related to an inhibition of the metastatic cascade. The state of antimetastatic clinical research is briefly summarized in the following areas: Clinically useful drugs with antimetastatic activity in preclinical experiments but not or not fully examined in the clinic (e.g. prostacyclines, pentoxifylline, anticoagulants, megestrol acetate); successful studies with antimetastatic drugs whose results were ignored or forgotten (e.g., D-galactose, Avemar®); and drugs that only recently showed antimetastatic activity in the clinic (e.g., bisphosphonates, razoxane, and razoxane combined with vindesine). Results. Randomized studies have shown a reduction of liver metastases and survival advantages in gastric and colon cancer following perioperative infusions of D-galactose by blocking liver lectines. Avemar®, a wheat germ extract, likewise showed convincing antimetastatic activity. These studies, however, did not get the interest of the medical community. Bisphosphonates are able to suppress skeletal metastases in breast cancer patients; further research is ongoing. Razoxane, a bis-dioxopiperazine derivative, proved to be highly anti-metastatic in animal models. In the clinic, it showed a metastasis inhibition in colorectal cancer. The addition of vindesine, a semi-synthetic vinca alkaloid, to razoxane led to an unexpected appearance of anti-metastatic efficacy in a study of 59 soft tissue sarcomas. This key study is further outlined by a synopsis. Finally, antimetastatic efficacy and increased radiosensitivity was seen in a multicenter study on angiosarcomas with vindesine and razoxane. Conclusions. In contrast to extensive preclinical antimetastasis research, the potential and importance of this reasearch is as yet not fully recognized in the clinic. Multimodal antimetastatic treatment (AMT) trials sometimes require patience because of treatment durations of months but intensive AMTs offer the potential of cure even in advanced stages of a disease. The fact that no form of antimetastatic treatment is uniformly accepted or routinely used in the clinic inspite of anti-metastatic research over more than 50 years - that makes you think. © Nova Science Publishers, Inc. Source

Wiedermann C.J.,Academic Teaching Hospital | Lehner G.F.,Innsbruck Medical University | Joannidis M.,Innsbruck Medical University
Current Opinion in Critical Care | Year: 2012

PURPOSE OF REVIEW: End-of-life care and communication deficits are important sources of conflicts within ICU teams and with patients or families. This narrative review describes recent studies on how to improve palliative care and surrogate decision-making in ICUs and compares the results with previously published literature on this topic. RECENT FINDINGS: Awareness and use of end-of-life recommendations is still low. Education about end-of-life is beneficial for end-of-life decisions. Residency and nurses training programmes start to integrate palliative care education in critical care. Integration of palliative care consults is recommended and probably cost-effective. Projects that promote direct contact of care team members with patients/families may be more likely to improve care than educational interventions for caregivers only. The family's response to critical illness includes adverse psychological outcome ('postintensive care syndrome-family'). Information brochures and structured communication protocols are likely to improve engagement of family members in surrogate decision-making; however, validation of outcome effects of their use is needed. SUMMARY: Optimizing palliative care and communication skills is the current challenge in ICU end-of-life care. Intervention strategies should be interdisciplinary, multiprofessional and family-centred in order to quickly reach these goals. Copyright © 2012 Lippincott Williams & Wilkins. Source

Pollatos O.,University of Potsdam | Herbert B.M.,University Hospital of Tuebingen | Wankner S.,Ludwig Maximilians University of Munich | Dietel A.,Academic Teaching Hospital | And 3 more authors.
Journal of Psychosomatic Research | Year: 2011

Objectives: Somatoform disorders are characterized by the presence of multiple somatic symptoms. While the accuracy of perceiving bodily signal (interoceptive awareness) is only sparely investigated in somatoform disorders, recent research has associated autonomic imbalance with cognitive and emotional difficulties in stress-related diseases. This study aimed to investigate how sympathovagal reactivity interacts with performance in recognizing emotions in faces (facial recognition task). Methods: Using a facial recognition and appraisal task, skin conductance levels (SCLs), heart rate (HR) and heart rate variability (HRV) were assessed in 26 somatoform patients and compared to healthy controls. Interoceptive awareness was assessed by a heartbeat detection task. Results: We found evidence for a sympathovagal imbalance in somatoform disorders characterized by low parasympathetic reactivity during emotional tasks and increased sympathetic activation during baseline. Somatoform patients exhibited a reduced recognition performance for neutral and sad emotional expressions only. Possible confounding variables such as alexithymia, anxiety or depression were taken into account. Interoceptive awareness was reduced in somatoform patients. Conclusions: Our data demonstrate an imbalance in sympathovagal activation in somatoform disorders associated with decreased parasympathetic activation. This might account for difficulties in processing of sad and neutral facial expressions in somatoform patients which might be a pathogenic mechanism for increased everyday vulnerability. © 2011 Elsevier Inc. Source

Verma S.B.,Nirvana Skin Clinic | Wollina U.,Academic Teaching Hospital
Indian Journal of Dermatology | Year: 2014

Two cases of infantile perianal pyramidal protrusions (IPPP), one pyramidal in shape and one leaf shaped, are being described by us. Both were notable for coexisting hemangiomas in the close vicinity. To the best of our knowledge we are reporting these two variants of IPPP with the associated neighboring hemangiomas for the first time in Indian dermatologic literature. We suggest that this presentation may be a part of one of the syndromes that comprise anorectal malformations with hemangiomas like PELVIS syndrome and others mentioned in the table. Source

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