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For families of chronically ill children with a high level of psychosocial stress, it is necessary to involve child and adolescent psychiatric or psychosomatic specialists directly in the pediatric treatment process. For this purpose, a family consultation was set up in the Heidelberg University Pediatrics as part of a model project, which deals with these families in an interdisciplinary and systemic way. It shows that the implementation of the consultation works despite a high organizational effort and is regularly used. The first evaluation results confirm the already described high levels of psychosocial stress in the affected families. They indicate a positive assessment of the consultation and a desire for a permanent offer. First follow-up results indicate a significant decrease in treatment-related concerns, uncertainty and a reduction in treatment-related problems. The lack of a viable funding model poses a challenge for long-term implementation., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Objective: Millions of people are fleeing the war in Ukraine. Stressors associated with flight can have a massive impact on mental health. The aim of the present study was to perform a low-threshold screening for mental distress symptoms among Ukrainian refugees in an initial reception center in Baden-Württemberg., Methods: At the initial reception center in Heidelberg Ukrainian refugees were interviewed about psychological distress during consultations with medical care providers, using four screening questionnaires (PC-PTSD-5, PHQ-9, GAD-7, stress thermometer) in Ukrainian or Russian language, and further sociodemographic data and data about the refugees' background were collected., Results: More than 90% of the N = 36 respondents reported that they had experienced war, 55.6% reached the cut-off score for post-traumatic stress disorder. One fourth of the participants reached cut-off scores for depression and more than 30% for generalized anxiety disorder. The majority of respondents had relatives living in embattled cities, and in over 36% close relatives were currently deployed in war. In the group comparison there was no significant correlation of symptom burden with the family background situation., Discussion: In line with the existing literature, many of the participants showed signs of mental distress. Potentially affected persons can be identified using low-threshold screening questionnaires. Adequate care for mentally stressed refugees according to their needs should be established to facilitate integration., Conclusion: Due to the known high prevalence of mental distress, refugees should be screened for mental distress symptoms at a low-threshold level to identify affected individuals. The psychosocial situation of Ukrainian refugees should be considered at an early stage in medical care., (Copyright © 2023. Published by Elsevier GmbH.)

Objective: The VISION intervention is a manualized short-term treatment for people with somatic symptom disorder, integrated into the primary care and delivered by psychotherapists via video consultations. As an innovative technology-based approach, the intervention was most recently piloted in a randomized feasibility trial. During the qualitative accompanying study presented here, the intervention was evaluated and optimised from the user perspective of patients who participated in the feasibility study., Methods: We interviewed a total of N=10 patients included in the intervention group in three semi structured focus group discussions focusing on how they (1) assess the intervention in terms of acceptance and individual benefit and (2) which adjustments are necessary from the user perspective for further optimization of the intervention. We performed a qualitative content analysis using MAXQDA Plus 2022., Results: Respondents reported initial reservations on their part regarding care via video consultation. After a brief period of habituation, the intervention was universally accepted. Main suggestions for improvement included a stronger focus on supporting patients find follow-up psychotherapy (if indicated) more flexible settings (e. g., location of video consultation), and a stronger integration of treatment into primary care., Discussion and Conclusion: The study provides systematically elaborated comprehensive findings on participants' practical experiences with the intervention. The model is appropriate for treating people with somatic symptom disorder. Before implementation, important suggestions for improvement should be thoroughly considered with continued patient and public involvement., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Objectives: In Germany, the office-based psychosomatic medicine with focus on acute care offers psychosomatic treatment besides primary care by general practitioners and regular psychotherapy. The aim of this study is to determine specific characteristics of these innovative office-based practices. Methods: In a qualitative cross-sectional study, twelve board-certified specialists in psychosomatic medicine, practicing office-based psychosomatic medicine were surveyed by means of semi-structured telephone-interviews. After transcription and coding in MAXQDA 2020, a content analysis was conducted. Results: The innovative practice model was characterized by high numbers of initial contacts in walk-in or pre-planned consultation hours. Besides regular psychotherapy long-term and low-threshold treatment was offered. Physician assistants organised the workflow and administrative tasks. For settlement the EBM-number psychosomatic interview or short-term treatment was used. Focusses were set on somatopsychic and socio-medical treatment and consultant support. Psychotherapy often was realised in form of group sessions by integrating behavioural and psychodynamic psychotherapy. Discussion: The innovative psychosomatic practice model with focus on acute care shows an independent profile. A treatment based on medical understanding of complex somatic disease processes can be provided to somatopsychic patients. Future studies should compare this practice model to psychosomatic practices receiving a treatment by guideline psychotherapy. Conclusions: In Germany, the practices of psychosomatic medicine with a focus on acute care closes an increasing gap in psychosomatic care and augments treatment possibilities, especially for elderly and multimorbid patients.

Objective: Due to pre-, peri-, and post-migration stress factors, the prevalence of mental illnesses among refugees is higher than in the average population. To survey the prevalence of symptoms of posttraumatic stress disorder, depression and anxiety disorder among refugees who have been living in Germany for a longer period of time in a low threshold manner, a study with short questionnaires in temporary accommodations in the Rhine-Neckar region was conducted., Methods: To determine the prevalence of psychological stress symptoms, all adult refugees in 7 temporary accommodations in the Rhine-Neckar region were approached. If they agreed to participate and spoke one of the 7 available languages, psychological stress was assessed using PC-PTSD-5 and PHQ-4 (n=106)., Results: On average, the participants experienced 3.18 (SD 2.48) traumatic events. 47.2% showed symptoms of posttraumatic stress disorder, 37.7% of depression and 29.2% of anxiety disorder. Neither gender nor age was significantly related to certain traumatic events or the diagnoses mentioned., Discussion: This study shows a high prevalence of traumatization and psychological distress among refugees that have been living in Germany for several months or years. However, both the identification of affected persons and mental health care is associated with numerous challenges., Conclusion: Even after a longer stay in Germany, the prevalence of psychological distress is significantly higher in both genders and across all age groups compared to the general population. There is a great need to identify mentally ill refugees systematically and to close existing gaps in mental health care., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht.

Treatment clusters and personnel assessment in psychosomatic medicine and psychotherapy - results of a feasibility study of the platform model Objectives: In accordance with the legal requirements of the PsychVVG, it is necessary to develop criteria for inpatient and day-care psychosomatic psychotherapeutic care, which can be used to determine the appropriate staffing for different treatment areas and different care structures. For psychosomatic medicine and psychotherapy a model with four treatment clusters was developed, which is oriented on the one hand to the psychotherapeutic intensity and on the other hand to the medical expenditure. Method: In three consecutive rounds with up to 30 experts, representative selected from the three institution types university hospital, departmental psychosomatic medicine and specialized clinic, the minute values per patient required for a treatment according to the guidelines were determined using the Delphi method. Newly developed activity profiles for the six occupational groups were used, which allow the recording of all patient- and setting-related activities. Results: With the results of the feasibility study, an instrument has been developed for the first time to determine the requirements of staffing in psychosomatic medicine. Convergent minute values could be formulated for three of the four treatment clusters. Conclusions: The provision of care in psychosomatic medicine and psychotherapy is complex, so that a limitation to four treatment areas is only possible if significantly more generous equivalence rules are applied between the professional groups than those laid down in the PPP Directive.

Due to the pandemic caused by the coronavirus disease 2019 (COVID-19) and the resulting constraints on personal (i.e. face to face) treatment, video consultations have recently gained a major role in the delivery of healthcare services; however, until now, most psychotherapists have little experience with conducting video consultations, not least because of poor possibilities for reimbursement from the statutory health insurance. This article provides (1) an overview of the effectiveness of psychotherapy interventions delivered via video consultations for depression and anxiety disorders, (2) recommendations for setting up and conducting these consultations and (3) first experiences of psychotherapists from a German feasibility study and from the provision in routine care in hospital during the COVID-19 pandemic., (© The Author(s) 2020.)

Mental health conditions represent a significant burden to the individual as well as the society. Within the health care system, the general practitioner is the first and, in most cases, the only provider. Timely referral of patients to specialized care is often difficult due to several barriers, particularly in rural areas. These barriers comprise long waiting times, the rising prevalence of psychosomatic and somatopsychic comorbidity, immobility in the elderly and stigmatisation related to mental health conditions. Following the Integrated Health Care approach, diagnosis and therapy of mental health conditions by psychotherapists directly within the general practice constitute an effective care model. We present a care model that is based on a telemental treatment approach for depression and anxiety disorders. Central is the piloting of psychotherapeutic video consultations in the general practice. The following article provides an overview of the care model and provides results concerning the intent to adopt the model in office-based psychotherapists., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Staffing level: Survey among psychosomatic-psychotherapeutic institutions in Germany Objectives: To establish the first nationwide hospital survey to assess the level of staffing for inpatient and daycare treatment in psychosomatic hospitals and specialist departments in Germany., Methods: Using a standardized written hospital survey from the Deutsches Krankenhausinstitut (DKI), we invited a total of 218 psychosomatic-psychotherapeutic hospitals and specialist departments to participate. The participation rate of the institutions was 35%., Results: In the overall sample, one psychotherapist (physician/clinical psychologist) was responsible for treating a median of 3.9 beds/patients (interquartile range 3.1-5.1) and one nurse a median of 2.9 beds/patients (interquartile range 2.3-3.9). There were significant differences for the nurse-patient ratio depending on the organizational size of the institution. To ensure quality treatment, professional experts saw increased staffing needs of about 12-17% across both professions. For the professional groups of specialist therapists and social workers, broad variances were observed for the therapist-patient ratio in the overall sample., Conclusions: The study provides an important and relevant data basis for the further discussion to determine mandatory minimal staffing levels in German psychosomatic-psychotherapeutic institutions.

Background: Although seldom diagnosed, post-traumatic stress disorder (PTSD) has a high prevalence in primary and tertiary care. In a consecutive cross-sectional study, the prevalence of traumatic experiences and the severity of post-traumatic symptoms as well as specific characteristics of traumatized patients in the context of the dermatological treatment were examined., Patients and Methods: Standardized questionnaires for assessing general psychopathology (Brief Symptom Inventory, BSI), coping with dermatological diseases (Adjustment to Chronic Skin Diseases Questionnaire, MHF) and diagnosis of trauma (Essen Trauma-Inventory, ETI) were used in 221 patients with different skin diseases., Results: In total, 85.1 % of the patients reported at least one potentially traumatic event in their lives, whereby psychometrically in 8.6 % of the cases the diagnostic criteria for a PTSD were met. Patients with suspected PTSD were more impacted by psychopathology, had more problems in coping with their skin diseases and attributed mental stress as having a greater influence on their skin disease than nontraumatized patients or traumatized patients without suspected PTSD. In addition, cumulative traumatization also leads to increased trauma symptomatology and greater difficulties in coping with skin diseases., Conclusion: The results emphasize the impact of a comorbid PTSD on a patient's ability to cope with skin diseases and underline the need for the inclusion of the differential diagnosis PTSD in dermatological treatment settings.

The aim of this study was the validation of a short disease-specific questionnaire (ELI, Essen Quality of Life Index for Eating Disorders) to measure the health-related quality of life in patients with eating disorders. A total of 182 currently ill and former eating disordered patients and 87 healthy controls completed the ELI questionnaire as well as other reliable and valid instruments (EDQOL, SF-12, EDI-2, FKB-20, SEED, BSI, IIP-D and SOC-13). In addition, 46 eating disorder patients completed the same questionnaires at the end of therapy. The ELI proved to have a high internal consistency of α=0.96. As expected, one main factor was found with a high declaration of variance of 71.25%. There is also evidence for very good construct validity and good sensitivity for change. Therefore, the ELI is an economic, reliable and valid instrument that assesses disease-specific health-related quality of life of individuals with eating disorders. The questionnaire can be recommended for research as well as clinical care contexts., (© Georg Thieme Verlag KG Stuttgart · New York.)

Mealtime support is a cornerstone of eating disorders (ED) inpatient and day-care treatment but has received only little attention in research so far and no valid recommendations are available for this type of intervention. Thus, the aim of the present study was to gather a comprehensive picture of how mealtime support is currently practiced in Germany. In a nationwide survey, 97 staff members from 66 ED centers across Germany completed a survey-form that covered 4 broad topics: (a) setting, (b) general conditions, (c) specific interventions, and (d) treatment providers' perspective. For the most part, mealtime support is delivered by nurses. Two thirds of the centers provide at least one therapeutically supported meal per day. Most centers offer their patients a kitchen and/or a guided cooking group. Patient eating behavior and amount of food eaten is documented by three quarters of staff members. Most staff members offer some kind of role modeling by eating their own meals at the same table. Food exposure is provided by a minority. Whereas two thirds use sanctions when patients did not achieve their eating goals, only one third use positive reinforcement when patients achieved their goals. Less than one half offer some kind of post-meal support. The results provide important insights into the current practice of mealtime support and will thus inform future studies that examine the efficacy of different types and interventions of mealtime support., (© Georg Thieme Verlag KG Stuttgart · New York.)

The technical progress of brain imaging methods in recent years have decisively contributed to a better understanding of the neurobiological underpinnings of eating disorders. However, the identification and detection of underlying neurocircuits is complicated by the aetiological heterogeneity of clinically and psychopathologically defined eating disorder phenotypes. It is against this background that renowned scientists advocate that neurocircuit function should be the starting point for the upward investigation of behavioural responses and the downward research of constitutional genetic and molecular biological factors. According to this theory, psychobiological research of disturbed eating behaviour will follow to a greater extent a transdiagnostic and dimensional approach, and will be based on well characterized neurocircuits in the future. Furthermore, the latest findings in brain research will allow to investigate directly the interaction between neurocircuit function and energy metabolism in eating disorders. The typical onset of anorexia nervosa and bulimia nervosa in puberty suggest that age related biological and psychosocial alterations in this phase of life serve as a trigger for the beginning of the disease. Therefore, a greater integration of the developmental perspective as well as (epi-) genetic aspects in psychobiological research will be of great scientific interest in the future., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background and Objective: Considering the prolonged life-expectancies and the resulting demands that are placed on cancer patients and their relatives, the importance of specific counseling and support services including psycho-oncology, social services, nutritional, and exercise counseling has profoundly increased. The main focus of the current study was to evaluate the multidisciplinary health care needs of emotionally distressed cancer patients whoe were treated in a Comprehensive Cancer Center. METHODS AND STUDYGROUP: 831 out-patients were evaluated with regard to their psychological distress level and their multidisciplinary health care needs for specialist services of psycho-oncology, social services, nutritional, and exercise counseling using a tablet-PC assisted screening questionnaire. Separate analyses were completed for patients with and without psychological distress., Results: One third of the screened patients showed clinically relevant psychological distress. Health care needs for all specialist services were significantly greater among these patients compared to patients without psychological distress (all p-values < 0.005). The higher needs were foremost presented by the number of needed specialist services (p < 0.001): two thirds of the psychologically distressed patients demonstrated, besides the need for a psycho-oncological service, a need for two or three further specialist services, whereas among patients without psychological distress more than 70% showed a need for at most one specialist service., Conclusion: Multidisciplinary health care needs of psychologically distressed cancer patients should be systematically addressed in a Comprehensive Cancer Center, and patients should be offered a coordinated and integrated health care program., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Up to 50 % of all cancer patients require psychosocial support during the course of their disease. However, only a proportion of these patients make use of the existing services. This is partly because patients are unaware that psychosocial support services are available to them. We investigated whether systematically providing printed information concerning psychosocial support can increase the knowledge and usage of these services, as well as health-related self-efficacy., Materials and Methods: In a controlled trial, 108 breast cancer patients were assigned alternately to either an intervention- or a control group. At two predefined time points before and during radiotherapy, patients in the intervention group received correspondence informing them about psychosocial services (psycho-oncology, clinical social work and the Cancer Information Service).The control group received no systematic information. Using a standardized questionnaire, all patients were subsequently questioned about their knowledge of psychosocial support services, their perceived self-efficacy and their use of psychosocial support services., Results: We found that systematic provision of information had a positive effect on the knowledge of psychosocial support services (p = 0.042; d = 0.45) and self-efficacy (p = 0.047; d = 0.42). However, no increase in the actual usage of these services was observed (p = 0.661; d = 0.10)., Conclusion: The systematic provision of information in the form of written correspondence can easily be implemented into clinical routine and is an effective way to increase cancer patients' knowledge of psychosocial support services. Furthermore, providing information about the services had a positive impact on patients' perceived self-efficacy. However, simply making this information available did not increase the usage of psychosocial support services.

Fitting multilevel models to diary data allows the analysis of development trends, group differences, and breakpoints in time trends. The aim of this study is the application of multilevel modelling to determine time trends in the diary data of a group of obese patients with and without binge eating disorder (BED). Throughout the course of a four-month multi-modal intervention program, the patients answered questions daily on handheld computers about their eating behaviour as well as their psychological and physical states. Multilevel analysis of the diary data shows that initially the trend of the eating behaviour over time decreases but increases towards the end of the therapy. Results of the application of a relatively new method to identify break points in linear trends indicate that the 85 (th) day of the therapy is a break point in the trend over time of the eating behaviour. Significant differences in the development of the eating behaviour over time were found for the subgroups of patients with and without BED.

Anorexia nervosa differs distinctly from other psychogenic eating disorders. Well known for the past 300 years, anorexia occurs consistently and is one of the most serious illnesses to be found for a certain age group. Three-quarters of the patients are healed or improve their condition long-term; one-quarter has a chronic course frequently including somatic complications and death. Because of the long healing process as well as the extensive chronification and complication rate, an individual treatment plan should be set up at the beginning of therapy to allow for a long-term structure of the course of therapy. Depending on the severity, phase and co-morbidity, inpatient and ambulant therapies are indicated. Depending on the duration of therapy, adequate weight (BMI > 15 kg/m2), good motivation, and lack of complications, an ambulant therapy is justified. Inpatient treatment is multimodal corresponding to the multifactorial etiology of anorexia nervosa. Weight gain is an important primary goal of therapy and a prerequisite for a conflict oriented, ambulant psychotherapy to be carried on after inpatient treatment. Ambivalent psychotherapy motivation and the necessity of symptom orientation demand technical modification both for inpatient as well as ambulant psychotherapy.

In 1994 binge eating disorder (BED) was included into the DSM-IV as provisional diagnostic category requiring further study. The prevalence in the general population is 2%; BED is 1.5 times more common in women than men. Up to 30% of participants in weight loss programs meet criteria for BED. As opposed to patients with bulimia nervosa (BN), restraint or restrictive eating is not a necessary antecedent in the development of BED. Eating-related as well as general psychopathology is significantly more common in obese patients with BED compared to obese patients without BED. In treating obese patients with BED there are several potential goals of treatment, including cessation of binge eating and improvement of eating-related psychopathology (e.g. concerns about weight and shape), weight loss or prevention of further weight gain, improvement of physical health, and reduction of psychiatric co-morbidity. Contrary to expectations weight loss programs do not appear to worsen the eating disorder and successful treatment of binge eating does not automatically promote weight loss. Controlled treatment studies could demonstrate that psychotherapeutic approaches and drug treatment are successful in reducing binge eating episodes in patients with BED. Remission rates are generally high (e.g., 50% and more with CBT) and the overall prognosis is better than for patients with BN. Patients who achieve complete abstinence from binge eating lose more weight compared to patients who remain symptomatic; however the degree of weight loss after CBT targeting binge eating is modest and does not meet with the expectations of the patients. The long-term treatment success of drug treatment remains unclear. It is currently discussed if BED represents a truly distinct diagnostic entity.

Aim: The aim of the present study was to evaluate to what extent the orthostatic dysregulation of FMS patients can be attributed primarily to reduced baroreceptor-mediated activation of the sympathetic nervous system and whether a hyporeactive sympathetic nervous system can also be confirmed for mental stress., Patients and Methods: A total of 28 patients with primary FMS were examined and compared with 15 healthy subjects. Diagnostic investigations of the autonomic nervous system were based on measuring HRV in frequency range and assessing spontaneous baroreflex sensitivity (sBRS) under mental stress and passive orthostatism., Results: Both under orthostatic and mental stress FMS patients exhibited reduced activation of the sympathetic nervous system as measured by the spectral power of HRV in the low-frequency range and the mean arterial blood pressure or heart rate. The present study provided no indications for dysregulation of sBRS., Conclusion: The results obtained confirm the hypothesis of a hyporeactive stress system in FMS patients for both peripherally and centrally mediated stimulation of the sympathetic nervous system.

Pharmacological approaches for the treatment of cardioinhibitory vasovagal syncope are controversially discussed in the literature. In acute treatment of neurocardiogenic syncope, anticholinergics (atropine) are used effectively. Randomised and placebo-controlled clinical trials evaluating the preventive significance of anticholinergic agents in the therapy of cardioinhibitory vasovagal syncope are still missing. We report the case of an 18-year-old male patient with recurrent convulsive, cardioinhibitory neurocardiogenic syncope. Vasovagal syncope occurred predominantly as centrally induced syncope triggered by negative emotions such as fear or by seeing blood. Under resting conditions, the patient revealed increased parasympathetic tone with nocturnal bradycardia of 38 beats/min. In the course of head-up tilt table testing a cardioinhibitory syncope with an asystolic pause of 10 seconds occurred without any prodromes after 10 minutes of upright positioning. In order to inhibit parasympathetic tone, medication with ipratropiumbromide was initiated. Time-variant analysis of heart rate variability (autoregressive model) during head-up tilt table testing showed under the medication with ipratropiumbromide a vagal mediated cardioinhibition to 56 beats/min, but no further sinus arrest. Throughout clinical follow-up of 6 months the patient remained syncope-free under the medication. The usefulness of ipratropiumbromide in inhibiting vagal mediated cardioinhibition will be discussed referring to the case report and to studies evaluating anticholinergic agents in the treatment of neurocardiogenic syncope.

In the course of a year the prevalence of psychiatric comorbidity as well as the effect of psychiatric comorbidity on the length of stay on two internal medical wards we investigated. When examined by separate methods, the prevalence of psychiatric comorbidity reached 36 % (ICD-10 diagnosis) in a sample of 511 medical inpatients of a university hospital. The study shows that patients with psychiatric comorbidity have a significantly longer length of stay - up to 8.2 days compared with inpatients with mere internal diagnosis. This association was not influenced by the length and the severity of the illness. The findings lead to the conclusion that psychiatric comorbidity is a central contributor to one of the most important factors of medical costs - the length of stay.

63 transcutaneous measurements of oxygen pressure and 36 series of infrared thermograms in 9 hypoxic wounds showed that topical administration of tetrachlorine decaoxide (TCDO) results in increased oxygen supply of the wound. This effect is associated with improvement of the skin temperature and decrease of the pathological temperature difference between the wound and the surrounding tissue. TCDO can induce physiological wound healing, since it improves the mechanisms of the immune defence system, wound cleansing, granulation, and epithelialization in slow-healing wounds.

If the skin is not cooled, dermabrasion induces local hyperthermia of 36 to 41 degrees C. This temperature goes down again after one minute and is not considered the cause of postoperative hypertrophic scarring. Yet, cooling of the skin during dermabrasion is generally recommended. In small as well as in large excoriated areas, high speed dermabrasion causes a temperature decrease (delta T) of about 2 to 3 degrees C due to the evaporation of exudate. If we assume that the vascular capillary plexus in the stratum papillare is seriously damaged, the subsequent reparation of the upper skin layers must be clinically and thermographically interpreted as wound healing (latent and proliferative period). The exothermic reaction of the early phase of wound healing is superimposed by the cooling effect due to exudation. The covering of the skin defect with the fine-meshed polyvinyl alcohol hydrogel polyester netfoil, Cutinova, seems to have a favorable influence on the wound healing process, if the covering is regularly changed every one or to days. This may be due to the temperature increase caused by the prevention of the evaporation of the exudate. Measurements of sensitivity (to pressure, temperature, and pain) showed that the cutaneous sensation almost completely recovered after about 15 days.

The publications on the physiology of the free full thickness skin autograft are reported with special reference to the newer ones as a synopsis of literature. Emphasis is placed upon the interesting findings on plastic surgery and especially upon the operative treatment of alopecia.

A simple, easy and effective wound closure following dermabrasion was carried out by fixation of Transite over the Epidermal-cutaneous defect and Allevyn over this Mesh-Graft-Like biologic dressing. Transite shows very little adherence to the wound surface. It is not damaging the wound at removal. The dressing removal is painless.

In a prospective clinical study we have investigated the relevant non-compliance variables with 96 patients affected by onychomycosis, who underwent a combined treatment of nail abrasion and application of a topical antifungal. The patients' non-compliance amounted to 24% of the complete group examined. Significantly this occurred more frequently with men (31.6%) than with women (12.8%), and also more frequently with older women than younger women. It occurred with 42% of the male and female pensioners and with 43% of the students. Furthermore, the group of non-compliance patients, in addition to their onychomycosis, frequently exhibited other illnesses requiring treatment in greater degree than the compliant patients. Additional rising variables, e.g. in the seriousness of the clinical outbreaks on the nails and the number of mycotic nails, did not contribute to an explanation of the differences in compliance behavior of the patients. By careful observation of the compliance factors in relation to specific illnesses, a more favorable set of conditions should be achieved in future for the improvement of patient behavior.

Clinical application of thermovision in dermatology is a non-contact, sterile, and absolutely harmless method and offers a variety of diagnostic and therapeutical possibilities regarding the detection of irregularities in the temperature distribution of the skin. Thermovision provides us with information about the extent of dermatoses or tumors, metastases, as well as the response to therapy. Another important medical application of thermovision is dynamic testing in dermato-surgery. This technique is fundamental with regard to diagnosis, management planning, differential diagnosis, monitoring of therapeutical effects, and as a very sensitive detector of recurrence. We are going to demonstrate the applications mentioned above on the basis of a few examples.