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Düsseldorf, Germany

Karger A.,Universitatsklinikum Dusseldorf
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz | Year: 2014

Depression is one of the most prevalent and debilitating diseases. In recent years there has been increased awareness of sex- and gender-specific issues in depression. This narrative review presents and discusses differences in prevalence, symptom profile, age at onset and course, comorbidity, biological and psychosocial factors, the impact of sexual stereotyping, help-seeking, emotion regulation and doctor-patient communication. Typically, women are diagnosed with depression twice as often as men, and their disease follows a more chronic course. Comorbid anxiety is more prevalent in women, whereas comorbid alcohol abuse is a major concern in men. Sucide rates for men are between three and five times higher compared with women. Although there are different symptom profiles in men and women, it is difficult to define a gender-specific symptom profile. Socially mediated gender roles have a significant impact on psychosocial factors associated with risk, sickness behavior and coping strategies. In general, too little attention has been paid to the definition and handling of depression and the gender-related requirements it makes on the healthcare system. © 2014 Springer-Verlag Berlin Heidelberg. Source

Neuroendocrine neoplasms (NEN) appear morphologically homogeneous, however biologically and clinically they are a very heterogeneous tumor group. The spectrum of NEN ranges from incidentally detected high differentiated tumors with benign behavior to poor differentiated clinically high aggressive tumors associated with a worse prognosis. NEN may occur in every organ, but are most common in the lung and the gastroenteropancreatic system (GEP). In order to unify and improve the diagnosis and therapy of GEPNEN, the European Neuroendocrine Tumor Society (ENETS) developed guidelines for the diagnosis and clinical management of NEN during the last 6 years. In consideration of these guidelines the TNM classification of the Union for International Cancer Control (UICC) was introduced in 2009. Only 1 year later the new GEP-NEN classification of the World Health Organisation (WHO) was presented. This review summarizes the new classifications and the morphological diagnosis of GEP-NEN. Based on these classifications an optimal prognostic stratification of GEP-NEN is possible, which is the base for their risk stratification, their imaging and treatment and allows a comparison of large tumor collectives. © 2013. Source

Lobnig B.M.,Universitatsklinikum Dusseldorf
Diabetologe | Year: 2011

Secondary forms of diabetes result from diseases which modify the function and structure of the liver and pancreas, such as pancreatitis, pancreatectomy and liver cirrhosis or from diseases of the endocrine system associated with increased levels of hormones counterregulatory to insulin, such as Cushing's disease, Cushing syndrome, acromegaly and pheochromocytoma. They may also result from metabolic diseases, such as hemochromatosis and cystic fibrosis or from pharmacological interventions, in particular the administration of glucocorticoids and to a lesser degree from other pharmaceuticals such as immunomodulators. Secondary diabetes may be associated with special characteristics, such as glucagon deficiency, impairment of nocturnal or fasting hepatic glucose output, impairment of peripheral glucose metabolism and deterioration of the circadian patterns of insulin sensitivity. For these reasons therapy of secondary diabetes may require other therapeutic strategies than those for classical diabetes and may demand deviations from the clinical care guidelines for type 1 and type 2 diabetes. In contrast to primary forms of diabetes high quality clinical trials and evidence-based guidelines are not available for secondary forms of diabetes. © 2011 Springer-Verlag. Source

Hufeland M.,Universitatsklinikum Dusseldorf
Journal of Pediatric Orthopaedics | Year: 2014

The trichorhinophalangeal syndrome is a rare genetic syndrome with characteristic craniofacial and skeletal abnormalities including hip pathology in variable manifestation. We describe hip involvement with Perthes-like changes and a novel mutation of the TRPSI gene in a family with 4 affected individuals. This case series underlines the clinical significance of rare genetic disorders such as TRPS that among other differential diagnoses should be kept in mind when children present with Perthes-like changes of the hip joint. © 2014 by Lippincott Williams & Wilkins Source

Marker-Hermann E.,Klinik Innere Medizin IV Rheumatologie Klinische Immunologie Nephrologie | Fischer-Betz R.,Universitatsklinikum Dusseldorf
Current Opinion in Obstetrics and Gynecology | Year: 2010

Purpose Of Review: This review discusses how inflammatory rheumatic diseases [rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus (SLE)] of the mother can influence the course of pregnancy and the development of the fetus. Antirheumatic drug therapy of the mother and strategies to prevent fetal complications namely in SLE must be considered with care. Recent Findings: The current literature is presented discussing hypotheses about the immunologic mechanisms leading to amelioration or exacerbation of the rheumatic symptoms in rheumatoid arthritis and ankylosing spondylitis during pregnancy. In SLE, several recent studies have been published concerning fetal complications in the antiphospholipid syndrome and in Ro/SSA-positive and La/SSB-positive mothers and how to diagnose, treat, or prevent these. Summary: Today, women with inflammatory rheumatic diseases are normally fertile and can be encouraged to become pregnant, when there is a stable and quiescent phase of the disease. This is in particular important for patients with SLE, although pregnancy outcome in SLE has improved over the last decades. Pregnancy in SLE is still a high-risk period during the disease course with the highest risk in women with active lupus nephritis. In contrast, women with rheumatoid arthritis develop amelioration of the rheumatic symptoms during the course of pregnancy in most cases; female ankylosing spondylitis patients are likely to show unaltered or aggravated symptoms of back pain and impaired function. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source

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