RESUMEN
BACKGROUND: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Asunto(s)
Dermatología/estadística & datos numéricos , Departamentos de Hospitales/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Enfermedades Cutáneas Vasculares/diagnóstico , Enfermedades Cutáneas Vasculares/terapia , Insuficiencia Venosa/diagnóstico , Insuficiencia Venosa/terapia , Alemania/epidemiología , Humanos , Competencia Profesional/estadística & datos numéricos , Enfermedades Cutáneas Vasculares/epidemiología , Encuestas y Cuestionarios , Insuficiencia Venosa/epidemiologíaRESUMEN
Fixed-ratio food-reinforced responding in rats was studied alone and with concurrent shock avoidance or with concurrent response-independent shocks matched to those that occurred in the avoidance condition. Under each condition, fixed-ratio size was increased over successive daily sessions. Fixed-ratio response rate generally passed through a maximum as a function of fixed-ratio size. Decreased fixed-ratio responding at values beyond the maximum occurred when (1) the time to complete a fixed ratio approximated the response-shock interval of the avoidance schedule, (2) the shock rate increased, and/or (3) the ratio requirements were so high that ratio strain occurred. Avoidance rates decreased slightly as fixed-ratio size increased.
RESUMEN
A series of arylsulfonamido-substituted omega-phenyl-omega-(3-pyridyl)alkenoic acids were synthesized and evaluated in vitro for their ability to act as both a thromboxane A2 receptor antagonist (TRA) and thromboxane synthase inhibitor (TSI). Variations of alkenoic acid chain length, olefin geometry, substituent effect on the benzenesulfonamido group, and conformational flexibility of the substituted arylsulfonamido group were examined. Among the various substituents, iodo-substitution gave the most potent compound. Conformational flexibility between the arylsulfonamido group and the phenyl ring attached to the alkenoic acid side chain significantly enhanced the dual activities. The compound (E)-21c was identified as the most potent TRA/TSI (TRA: Kd = 53 nM; TSI: IC50 = 23 nM) in the series studied. The compounds 9c and 10c have indicated that these series of compounds are orally active and are specific TSIs as exhibited by the so-called 'shunt' effect on prostacyclin synthesis in vitro.