Search

Copyright of Colo-Proctology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: With the help of specialized outpatient palliative care teams (German abbreviation: SAPV), seriously ill and dying patients in Germany can be adequately cared for in their home environment until the end of their lives; however, there are no uniform standards or guidelines for well-executed pain management right now., Objective: This approach serves as basic research in the field of public health research. This is intended to present which methods (use of different professional groups, use of pain medications, alternative medical treatment etc.) the individual SAPV teams use for pain management. From this it can be deduced which procedures can be considered particularly effective., Material and Methods: This cross-sectional study was conducted in May 2021. All German SAPV teams (n = 307) listed on the homepage of the German Association for Palliative Medicine (DGP) were contacted by post and invited to participate. A total of 175 teams (57%) responded to the request and were included in the evaluation. A descriptive data analysis was performed., Results: Pain management in the German outpatient care of palliative patients is based on several components. All common pain medications are used, but primarily metamizole (99.4%) as a non-opioid analgesic, morphine (98.3%) from the opiate series and pregabalin (96.6%) as a co-analgesic are mainly prescribed. If pain therapy fails, 22.5% of the SAPV teams perform palliative sedation for symptom control on a regular basis., Conclusion: This cross-sectional study is the first of its kind to provide a general overview of the treatment options for pain management in German outpatient palliative care. In comparison with international studies, the question arises as to whether uniform therapy schemes and a reduction in the medication available in the individual SAPV teams could lead to an improvement in patient care., (© 2023. The Author(s).)

Introduction: Physical therapy (PT) and occupational therapy (OT) as supportive forms of treatment in palliative care, together with other treatment measures, can create participation for seriously ill patients in the form of a life that is as autonomous as possible until the end of life. However, specially trained staff are needed for the care of palliative patients in order to do justice to the clients' special life situation. In Germany, no corresponding survey on the subject has so far been conducted. So it is unclear to what extent PT and OT are offered in palliative care structures in this country, which tasks are assigned to the respective professional groups, and what the level of knowledge is that caregivers have about treatment options., Aim: Compilation of an overview of the provision, need and use of PT and OT in the various areas of palliative care in Germany. If there is a lack of provision, the reasons for this will be identified., Methods: In this cross-sectional survey, a self-designed 9-item questionnaire was sent out to a total of 260 hospices, 323 palliative care units and 304 specialized outpatient palliative care services (SOPC) listed on the homepage of the German Society for Palliative Medicine (DGP). The respondents' answers were analysed using a purely descriptive approach., Results: The response rate was 439 (49.5%). A total of 434 questionnaires (49%) were included in the analysis. A heterogeneous distribution of PT and OT offers between outpatient, inpatient, and hospice palliative care can be seen, with the outpatient area showing a significantly fewer offerings. 29% of the SOPC teams can offer neither PT nor OT. This is mostly due to a shortage of skilled workers or a lack of funding opportunities. The different areas of responsibility of physiotherapists and occupational therapists are known to the majority of respondents (hospice 87%, palliative care unit 83%, SOPC 81%) and are also reflected in the distribution of tasks between the two professional groups. Especially palliative care units and SOPC teams state that they would like to offer more PT and OT (palliative care units 42% more PT and 58% more OT; SOPC 65% more PT and 50% more OT)., Discussion: This cross-sectional survey is the first of its kind to provide an overview of the PT and OT offerings in the different sectors of German palliative care. In a comparison of the two forms of therapy, occupational therapists are used less frequently than physiotherapists. An international comparison of the study situation also shows that the use of OT in palliative care, in particular, has not yet been implemented satisfactorily. Outside Germany, the main reasons for this are a shortage of specialists and a lack of knowledge about the tasks of OT., Conclusion: PT and OT are frequently used treatment options in all areas of German palliative care. In order to better classify structural problems in care, further differentiated surveys should be conducted. Furthermore, a better knowledge base should be created through research and information activities of both professional groups in palliative care., (Copyright © 2022. Published by Elsevier GmbH.)

The complete and reliable documentation of endoscopic findings make up the crucial foundation for the treatment of patients with inflammatory bowel diseases such as Crohn´s disease and ulcerative colitis. These findings are, on the one hand, a prerequisite for therapeutic decisions and, on the other hand, important as a tool for assessing the response to ongoing treatments. Endoscopic reports should, therefore, be recorded according to standardized criteria to ensure that the findings of different endoscopists can be adequately compared and that changes in the course of the disease can be traced back. In consideration of these necessities, fifteen members of the Imaging Working Group of the German Kompetenznetz Darmerkrankungen have created a position paper proposing a structure and specifications for the documentation of endoscopic exams. In addition to the formal report structure, the recommendations address a large number of attributes of acute and chronic inflammatory alterations as well as endoscopically detectable complications, which are explained in detail and illustrated using exemplary images. In addition, more frequently used endoscopic activity indices are presented and their use in everyday clinical practice is discussed., Competing Interests: CS erhielt Beratungshonorare von AbbVie, Biogen, Ewopharma, Janssen-Cilag, MSD Sharp & Dohme, Pfizer und Takeda, AbbVie, Berlin Chemie, Biogen, Ewopharma, Dr. Falk, Janssen-Cilag, med update, Merckle, MSD Sharp & Dohme, Norgine, Novartis, Pfizer, Shire, Shield Therapeutics und Takeda sowie Forschungsunterstützung von AbbVie, Olympus und Pentax. OB erhielt Beratungshonorare von AbbVie, AMGEN, Hexal, Immundiagnostik, Dr. Falk Pharma, FERRING Arzneimittel, Janssen-Cilag, MSD Sharp & Dohme, Shield Therapeutics, Takeda Pharma, Tillotts Pharma sowie Referentenhonorare von AbbVie, Astellas Pharma, Biogen, Bristol-Myers Squibb, Dr. Falk Pharma, FERRING Arzneimittel, Janssen-Cilag, MSD Sharp & Dohme, Pfizer Pharma, Takeda Pharma. DCB hat keine Interessenkonflikte angegeben. MG erhielt Berater- bzw. Vortragshonorare von Janssen, Falk, MSD, Galapagos, AbbVie und Takeda. OD hat keine Interessenkonflikte angegeben. TK erhielt Beratungs- und Vortragshonorare von AbbVie, Allmiral, Arena Pharmaceuticals, Celgene/BMS, Celltrion, Ferring, Falk, Gilead Sciences, Galapagos, Janssen, Medtronic, Mundipharma, MSD, Pfizer, Shire, Sterna Biologicals, Takeda, Tillotts Pharma, JL hat folgende Verbindungen zu Unternehmen offenzulegen (Forschungsunterstützung: Vortragshonorar Berater/Gutachtertätigkeit) Medizinverlage Stuttgart; Celgene GmbH, Falk Foundation, Ferring Arzneimittel GmbH; Repha GmbH biologische Arzneimittel, Steigerwald Arzneimittelwerke GmbH, Sanofi, Dr. Willmar Schwabe; TechLab. JMa erhielt Beraterhonorar von AbbVie, Janssen-Cilag, Pharmacosmos und Takeda sowie Referentenhonorar und Reisekostenerstattungen von AbbVie, Cellgene, Falk Foundation, Ferring, Fujifilm, Janssen-Cilag, MSD, Pfizer und Takeda. WM erhielt Beratungshonorare von AbbVie, Amgen, Hexal, Janssen, MSD, Pfizer, Synformulas, Takeda, Vortragshonorare und Reiseunterstützung von AbbVie, alanta health service, Almirall, Aptalis, biogen, Falk, Gilead, Janssen, Pfizer, MSD, Takeda, Tillots, Vifor, Honorare für Studien von AbbVie, Janssen, MSD, Pfizer, Takeda. Er gibt Tätigkeiten in öffentlich-rechtlichen Gremien an als Mitglied der Vertreterversammlung der Landesärztekammer Saarland, der Beratungskommission der Prüfungsstelle für das Saarland, des beratenden Fachausschusses Fachärzte der KV Saarland, des Landesausschusses der Ärzte und Krankenkassen sowie des erweiterten Landesausschusses Saarland. Er ist abhängig beschäftigt im Konzern der alanta health group GmbH, Hamburg, und hält Aktien der Firmen AbbVie und Gilead. JMu macht folgende Angaben: Kooperationsvertrag mit Pentax, Vortragstätigkeiten für Pentax und Olympus, Vortragstätigkeiten für Helios Deutschland. MR erhielt Vortragshonorare von AbbVie, Janssen-Cilag und Ovesco. Der Arbeitgeber von AS erhielt Honorare für Vortrags- oder Beratungstätigkeit von AbbVie, Biogen, Cellgene, Falk Foundation, Pfizer, Janssen-Cilag, MSD, Pfizer und Takeda. TK erhielt Beratungshonorare von AbbVie, Arena, Biogen, BMS, Celgene, Celltrion, Hospira, Mundipharma, Dr. Falk Pharma GmbH, Gilead, Janssen, MSD Sharp & Dome GmbH, Novartis, Roche, Takeda Pharma GmbH und UCB sowie Referentenhonorare von AbbVie, Dr. Falk Pharma GmbH, Ferring Arzneimittel GmbH, MSD Sharp & Dome GmbH, Pfizer, Roche, Takeda Pharma GmbH und UCB. DW gibt Vortrags- und/oder Beratertätigkeiten für die Firmen AbbVie, Takeda, Janssen, MSD, Ferring, Celgene, Pharmacosmos, Celltrion, Tillotts Pharma und Falk Pharma an. RA hat folgende Verbindungen zu Unternehmen offenzulegen (Beratendes Gremium oder Komitee; Referententätigkeit; Beratungstätigkeit; Forschungsförderung): AbbVie, Amgen, Arena Pharmaceuticals, Biogen, Boehringer Ingelheim, Cellgene, Celltrion Healthcare, Dr. Falk Pharma, Ferring, Galapagos, Gilead, InDex Pharmaceuticals, Janssen-Cilag, Kliniksa Pharmaceuticals, MSD Sharp & Dohme, Novartis, Pandion Therapeutics, Pfizer, Roche Pharma, Samsung Bioepsis, Takeda Pharma, Tillotts Pharma AG., (Thieme. All rights reserved.)

Chronic inflammatory bowel diseases are mainly represented by Crohn's disease and ulcerative colitis. Current epidemiological data indicate a rise in incidence over the last five decades in the Western world. Consequently resulting not only in the reconsideration of the pathogenesis of inflammatory bowel diseases but furthermore emphasizing the need for a curative approach. With this review we aim to provide a concise overview on pathogenesis, diagnostics as well as therapy with a particular focus on medical strategies after ileocecal resection in Crohn's disease. In the end the near future with regard to therapeutic strategies to be introduced into daily clinical work will be described., (© Georg Thieme Verlag KG Stuttgart · New York.)