Phlebologie an deutschen Hautkliniken: eine Bestandsaufnahme im Auftrag der Deutschen Gesellschaft für Phlebologie

Reich-Schupke S, Alm J, Altmeyer P, et al. Phlebologie an deutschen Hautkliniken: Eine Bestandsaufnahme im Auftrag der Deutschen Gesellschaft für Phlebologie. Hautarzt. 2013;64(9):685-694.Phlebologic diseases have become extremely common and have major socio-economic impact. However, the percentage of dermatologists working in phlebology appears to be decreasing according to the data of the German Society of Phlebology (DGP). To investigate the reasons for this development, we-on behalf of the DGP-sent a questionnaire to 120 German Departments of Dermatology in autumn 2012. In 76 returned questionnaires, the number of physicians with additional fellowship training in phlebology averaged 1.5; the average number of those who fulfill the criteria for training fellows in phlebology was 0.9. In 71.1 % of the departments there was a phlebologist. A special phlebologic outpatient clinic existed in 73.7 % of the departments. Sonography with Doppler (89.5 %) and duplex (86.8 %) was used as the most frequent diagnostic tool. For therapy, compression (94.7 %), sclerotherapy (liquid 78.9 %, foam 63.2 %, catheter 18.4 %), endoluminal thermic procedures (radio wave 28.9 %, laser 17.1 %) and surgery (especially crossectomy and stripping 67.1 %, phlebectomy of tributaries 75 %) were used. The average number of treatments was very heterogenous in the different departments. Phlebology definitely plays an important role in dermatology. Most departments fulfill the formal criteria for the license to conduct advanced training in phlebology. A wide spectrum of phlebological diagnostic and therapeutic procedures is available.Hintergrund Venenleiden sind eine Volkskrankheit und haben eine enorme sozioökonomische Bedeutung. Dennoch scheint der Anteil der phlebologisch tätigen Dermatologen entsprechend den Zahlen der Deutschen Gesellschaft für Phlebologie (DGP) abzunehmen. Methoden Um die Ursachen dieser Entwicklung zu untersuchen, führten wir im Herbst 2012 im Auftrag der DGP eine Befragungsstudie zur Phlebologie an 120 deutschen Hautkliniken durch. Ergebnisse In 76 antwortenden Klinien gab es im Mittel 1,5 Phlebologen und 0,9 Ärzte mit Voraussetzungen zur Weiterbildungsermächtigung Phlebologie. In 71,1 % der Kliniken gab es einen Phlebologen, in 73,7 % eine phlebologische Sprechstunde. Zur Diagnostik wurden besonders die Doppler- (89,5 %) und Duplexsonographie (86,8 %) eingesetzt. In der Therapie führte die Kompressionstherapie (94,7 %), gefolgt von Sklerosierungstherapien (flüssig 78,9 %, Schaum 63,2 %, Katheter 18,4 %), den endoluminalen thermischen Verfahren (Radiowelle 28,9 %, Laser 17,1 %) und den operativen Eingriffen (vor allem Cross- und Saphenektomie 67,1 %, Seitenastexhairese 75 %). Die durchschnittlichen Behandlungszahlen waren sehr heterogen. Schlussfolgerung Die Phlebologie spielt in der Dermatologie weiterhin eine wichtige Rolle. Mehrheitlich sind in den Kliniken die Möglichkeiten zur Weiterbildung Phlebologie gegeben. Es wird ein breites Spektrum an phlebologischen Techniken zur Diagnostik und Therapie angeboten

Effect of the multifunctional cosmetic ingredient sphinganine on hair loss in men and women with diffuse hair reduction

Nicole Gerlach,1,* Matthias Mentel,2,* Tim Köhler,2 Benjamin Tuchscherer,2 Birgit Garbe,1 Jasmina Ülker,1 Hagen Tronnier,1 Ulrike Heinrich,1 Mike Farwick2 1DermaTronnier GmbH & Co. KG, Institute for Experimental Dermatology, Witten/Herdecke University, Witten, 2Evonik Nutrition & Care GmbH, Essen, Germany *These authors contributed equally to this work Abstract: Sphingolipids are well known to promote keratinocyte differentiation and to induce ceramide production. In addition, they show anti-inflammatory and antimicrobial activities. Thus, the aim of this study is to investigate the potential effect of sphinganine on prolonging the hair anagen rate and improving the overall hair quality and scalp health. The inhibitory potential of sphinganine toward 5-α-reductase was studied using an in vitro assay. The stimulation of the antimicrobial peptide HBD2 by sphinganine was measured by real-time polymerase chain reaction and immunostaining. Sphinganine bioavailability was studied ex vivo using a pig skin model. A placebo-controlled, double-blind study was designed to evaluate the efficacy of sphinganine on hair loss and hair/scalp quality in vivo. In vitro results showed that sphinganine is a potent inhibitor of 5-α-reductase type I that prevents the conversion of testosterone to dihydrotestosterone, a key factor of androgenetic male baldness. In vivo results demonstrated efficacy in reducing non-illness-related hair loss among males. In terms of expert rating, all hair quality and scalp parameters improved after application of sphinganine. Improved scalp health might be linked to the observed increase of the antimicrobial peptide HBD2. Thus, sphinganine is well suited as a topical alternative for the improvement of scalp health and hair quality and anti-hair loss application. Keywords: sphinganine, 5-α-reductase inhibition, HBD2, hair loss, anagen rate, TrichoScan&reg

Facial expression recognition and subthalamic nucleus stimulation

Objective: To study the impact of STN stimulation in Parkinson's disease on perception of facial expressions. Results: There was a selective reduction in recognition of angry faces, but not other expressions, during STN stimulation. Conclusions: The findings may have important implications for social adjustment in these patients