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1.
Phys Rev Lett ; 126(8): 083201, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33709766

RESUMO

We investigate the differential ionization probability of chiral molecules in the strong-field regime as a function of the helicity of the incident light. To this end, we analyze the fourfold ionization of bromochlorofluoromethane (CHBrClF) with subsequent fragmentation into four charged fragments and different dissociation channels of the singly ionized methyloxirane. By resolving for the molecular orientation, we show that the photoion circular dichroism signal strength is increased by 2 orders of magnitude.

2.
Support Care Cancer ; 28(10): 4667-4675, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31955277

RESUMO

PURPOSE: Patients with advanced cancer often receive suboptimal end-of-life (EOL) care. Particularly males with advanced cancer are more likely to receive EOL care that is more aggressive, even if death is imminent. Critical factors determining EOL care are EOL conversations or advance care planning. However, information about gender-related factors influencing EOL conversations is lacking. Therefore, the current study investigates gender differences concerning the content, the desired time point, and the mode of initiation of EOL conversations in cancer patients. METHODS: In a cross-sectional study, 186 female and male cancer patients were asked about their preferences for EOL discussions using a semi-structured interview, focusing on (a) the importance of six different topics (medical and nursing care, organizational, emotional, social, and spiritual/religious aspects), (b) the desired time point, and (c) the mode of discussion initiation. RESULTS: The importance of EOL topics differs significantly regarding issue (p = 0.002, η2 = 0.02) and gender (p < 0.001, η2 = 0.11). Males wish to avoid the engagement in discussions about death and dying particularly if they are anxious about their end-of-life period. They wish to be addressed regarding the "hard facts" nursing and medical care only. In contrast, females prefer to speak more about "soft facts" and to be addressed about each EOL topic. Independent of gender, the majority of patients prefer to talk rather late: when the disease is getting worse (58%), at the end of their therapy, or when loosing self-sufficiency (27.5%). CONCLUSION: The tendency of patients to talk late about EOL issues increases the risk of delayed or missed EOL conversations, which may be due to a knowledge gap regarding the possibility of disease-associated incapability. Furthermore, there are significant gender differences influencing the access to EOL conversations. Therefore, for daily clinical routine, we suggest an early two-step, gender-sensitive approach to end-of-life conversations.


Assuntos
Planejamento Antecipado de Cuidados/normas , Neoplasias/psicologia , Assistência Terminal/psicologia , Estudos Transversais , Feminino , Identidade de Gênero , Humanos , Masculino
3.
J Phys Chem B ; 124(8): 1557-1570, 2020 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-31967826

RESUMO

We present a quantitative description of the proton spin-lattice relaxation rate R1(T,ω) of glycerol including temperatures from 191 to 360 K and a frequency range 10 kHz < ω/2π < 20 MHz covered by the field-cycling technique. The analysis encompasses the data compiled by Noack and co-workers in 1971, so far, the most complete data set (10 kHz > ω/2π < 117 MHz). Applying frequency-temperature superposition, master curves are constructed extending over 15 decades in frequency/time. They are described by contributions reflecting translational and rotational dynamics mediated by inter- and intramolecular relaxation pathways. The rotational part of the spectral density/susceptibility shows high similarity with those reported by dielectric spectroscopy or photon correlation spectroscopy (PCS). In addition to a Cole-Davidson-like peak, a high-frequency "excess wing" has to be accounted for. Quantitative agreement with the PCS susceptibility is found which probes the same order of the rotational correlation function. The translational contribution is reproduced by applying the force-free hard sphere model, describing diffusion of dipolarly coupled spin systems. Rotational and translational time constants are compared to those from other techniques. Our approach is paradigmatic for the analysis of spin relaxation in glass-forming liquids. It also solves long-standing deficiencies regarding the analyses of deuteron relaxation. Moreover, the case of glycerol is special as its large separation of translation and rotation dynamics, probably because of its hydrogen bond network, is not found in nonassociated liquids.

4.
Nat Commun ; 10(1): 5592, 2019 12 06.
Artigo em Inglês | MEDLINE | ID: mdl-31811135

RESUMO

In Paris in 2015, the global community agreed to limit global warming to well below 2 [Formula: see text]C, aiming at even 1.5 [Formula: see text]C. It is still uncertain whether these targets are sufficient to preserve marine ecosystems and prevent a severe alteration of marine biogeochemical cycles. Here, we show that stringent mitigation strategies consistent with the 1.5 [Formula: see text]C scenario could, indeed, provoke a critical difference for the ocean's carbon cycle and calcium carbonate saturation states. Favorable conditions for calcifying organisms like tropical corals and polar pteropods, both of major importance for large ecosystems, can only be maintained if CO[Formula: see text] emissions fall rapidly between 2025 and 2050, potentially requiring an early deployment of CO[Formula: see text] removal techniques in addition to drastic emissions reduction. Furthermore, this outcome can only be achieved if the terrestrial biosphere remains a carbon sink during the entire 21st century.

5.
Int J Cosmet Sci ; 41(5): 472-478, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31339574

RESUMO

OBJECTIVE: To confirm the robustness and validity of an automatic scoring system, algorithm-based, that grades the severity of nine facial signs through "selfies" smartphones pictures taken by European Caucasian women through dermatological assessments. METHODS: 157 Caucasian women from three countries (France, Germany, Spain), of different ages (20-75 years), took one "selfie" image by the frontal camera of their smartphones whereas local dermatologists photographed them with the back camera of the same smartphone. The same nine facial signs of these subjects were initially graded by these local dermatologists, using referential Skin Aging Atlases. All 314 "selfies" images were then further automatically analyzed by the algorithm. The severity of facial signs (wrinkles, pigmentation, ptosis, skin folds etc.) were statistically compared to the assessments made by the three dermatologists, taken as ground truth. RESULTS: Highly significant coefficients of correlation (P < 0.001) were found in the three cohorts between the grades provided by the system and those from dermatologists in live. The back camera - of a better resolution than the frontal one - seems affording slightly more significant correlations. However, although significantly correlated, the signs of vascular disorders and cheek skin pores present some disparities that are likely linked to the technical diversity of smartphones or self-shootings, leading to lower coefficients of correlations. CONCLUSION: This automatic scoring system offers a promising approach in the harmonization of Dermatological assessments of skin facial signs and their changes with age or the follow up of anti-aging treatments.


Assuntos
Dermatologistas , Face , Pele , Adulto , Idoso , Automação , Estudos de Coortes , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Pessoa de Meia-Idade , Smartphone , Adulto Jovem
6.
Rev Sci Instrum ; 90(2): 026103, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30831751

RESUMO

A hybrid pressure cell was fabricated from commercially available copper-beryllium and custom-made Ni-Cr-Al Russian alloy, tailored for usage as a reaction vessel supplying a volume of about 400 mm3. In order to directly (in situ) monitor pressure and chemical reactions within the chamber, a large diamond window suitable for spectroscopic sample analysis was implemented. The performance of the hybrid cell was validated from high-pressure neutron-diffraction measurements on carbon dioxide.

7.
J Cosmet Laser Ther ; 21(2): 71-75, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29764244

RESUMO

INTRODUCTION: Fractionated radiofrequency (RF) tissue tightening is an alternative method to fractionated laser treatment of skin wrinkling, laxity and acne scars, with reduced risk of scarring or persistent pigmentation. The aim of this study was to evaluate and quantify the wound healing process after RF treatment. MATERIALS AND METHODS: 12 patients were treated with a 64-pin fractional bipolar RF device with 60 mJ/pin applied energy. Confocal laser scanning microscopy (CLSM) examination was performed on day 1, day 2, day 7 and day 14 after treatment. Clinical wound healing process was measured and expressed as a percentage. RESULTS: All patients developed erythema, mild edema and crusts at the treated areas. Two weeks after treatment clinical symptoms resolved. During ablation patients reported moderate pain. Directly after ablation microscopic ablation zones could be detected in CLSM. Measurement of MAZ at epidermis, dermo-epidermal junction and papilary dermis showed a constant diameter until two weeks after treatment. Re-epithelization of the MAZ could be detected already 1 week after treatment. However, 2 weeks after ablation the honeycomb pattern of the epidermis was not yet completely restored. DISCUSSION: Bipolar fractionated RF treatment demonstrates clinically a rapid wound healing response. The subepidermal remodelling process still ongoing after 14 days, showing new granulation tissue. Therefore, treatment intervals of at least 14 days should be recommended to allow completion of the remodelling process.


Assuntos
Terapia por Radiofrequência , Envelhecimento da Pele/efeitos da radiação , Cicatrização/efeitos da radiação , Adulto , Técnicas Cosméticas/efeitos adversos , Eritema/etiologia , Feminino , Humanos , Masculino , Microscopia Confocal , Dor/etiologia , Ondas de Rádio/efeitos adversos , Cicatrização/fisiologia
8.
J Chem Phys ; 149(4): 044902, 2018 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-30068172

RESUMO

Viscoelastic response in terms of the complex shear modulus G*(ω) of the linear polymers poly(ethylene-alt-propylene), poly(isoprene), and poly(butadiene) is studied for molar masses (M) from 3k up to 1000k and over a wide temperature range starting from the glass transition temperature Tg (174 K-373 K). Master curves G'(ωτα) and G″(ωτα) are constructed for the polymer-specific relaxation. Segmental relaxation occurring close to Tg is independently addressed by single spectra. Altogether, viscoelastic response is effectively studied over 14 decades in frequency. The structural relaxation time τα used for scaling is taken from dielectric spectra. We suggest a derivative method for identifying the different power-law regimes and their exponents along G″(ωτα) ∝ ωε″. The exponent ε″ = ε″(ωτα) ≡ d ln G″(ωτα)/d ln(ωτα) reveals more details compared to conventional analyses and displays high similarity among the polymers. Within a simple scaling model, the original tube-reptation model is extended to include contour length fluctuations (CLFs). The model reproduces all signatures of the quantitative theory by Likhtman and McLeish. The characteristic times and power-law exponents are rediscovered in ε″(ωτα). The high-frequency flank of the terminal relaxation closely follows the prediction for CLF (ε″ = -0.25), i.e., G″(ω) ∝ ω-0.21±0.02. At lower frequencies, a second regime with lower exponent ε″ is observed signaling the crossover to coherent reptation. Application of the full Likhtman-McLeish calculation provides a quantitative interpolation of ε″(ωτα) at frequencies below those of the Rouse regime. The derivative method also allows identifying the entanglement time τe. However, as the exponent in the Rouse regime (ωτe > 1) varies along εeRouse = 0.66 ± 0.04 (off the Rouse prediction εRouse = 0.5) and that at ωτe < 1 is similar, only a weak manifestation of the crossover at τe is found at highest M. Yet, calculating τe/τα= (M/Mo)2, we find good agreement among the polymers when discussing ε″(ωτe). The terminal relaxation time τt is directly read off from ε″(ωτα). Plotting τt/τe as a function of Z = M/Me, we find universal behavior as predicted by the TR model. The M dependence crosses over from an exponent significantly larger than 3.0 at intermediate M to an exponent approaching 3.0 at highest M in agreement with previous reports. The frequency of the minimum in G″(ωτα) scales as τmin ∝ M1.0±0.1. An M-independent frequency marks the crossover to glassy relaxation at the highest frequencies. Independent of the amplitude of G″(ω), which may be related to sample-to-sample differences, the derivative method is a versatile tool to provide a detailed phenomenological analysis of the viscoelastic response of complex liquids.

9.
Br J Dermatol ; 179(2): 478-485, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29569229

RESUMO

BACKGROUND: Early detection is a key factor in improving survival from melanoma. Today, the clinical diagnosis of cutaneous melanoma is based mostly on visual inspection and dermoscopy. Preclinical studies in freshly excised or paraffin-embedded tissue have shown that the melanin fluorescence spectra after stepwise two-photon excitation, a process termed dermatofluoroscopy, differ between cutaneous melanoma and melanocytic naevi. However, confirmation from a larger prospective clinical study is lacking. OBJECTIVES: The primary end point of this study was to determine the diagnostic accuracy of dermatofluoroscopy in melanoma detection. Secondary end points included the collection of data for improving the computer algorithm that classifies skin lesions based on melanin fluorescence and the assessment of safety aspects. METHODS: This was a prospective, blinded, multicentre clinical study in patients with pigmented skin lesions (PSLs) indicated for excision either to rule out or to confirm cutaneous melanoma. All included lesions underwent dermoscopy and dermatofluoroscopy in vivo before lesions were excised and subjected to histopathological examination. RESULTS: In total, 369 patients and 476 PSLs were included in the final analysis. In 101 of 476 lesions (21·2%) histopathology revealed melanoma. The observed sensitivity of dermatofluoroscopy was 89·1% (90 of 101 melanomas identified), with an observed specificity of 44·8%. The positive and negative predictive values were 30·3% and 93·9%, respectively. No adverse events occurred. CONCLUSIONS: Dermatofluoroscopy is a safe and accurate diagnostic method to aid physicians in diagnosing cutaneous melanoma. Limitations arise from largely amelanotic or regressing lesions lacking sufficient melanin fluorescence.


Assuntos
Dermoscopia/métodos , Detecção Precoce de Câncer/métodos , Melanoma/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Adulto , Idoso , Biópsia , Dermoscopia/efeitos adversos , Dermoscopia/instrumentação , Detecção Precoce de Câncer/efeitos adversos , Detecção Precoce de Câncer/instrumentação , Estudos de Viabilidade , Feminino , Fluoroscopia/efeitos adversos , Fluoroscopia/instrumentação , Fluoroscopia/métodos , Humanos , Melanoma/patologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade , Pele/diagnóstico por imagem , Pele/patologia , Neoplasias Cutâneas/patologia
10.
Forensic Sci Int ; 284: 33-38, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29331681

RESUMO

The measurement of hair cortisol is increasingly used to measure long-term cumulative cortisol levels and investigate its role as an important stress mediator. In this study a comparative statistical analysis of five independent studies (all analyzed in our laboratory) was performed to investigate baseline ranges of cortisol values in hair and evaluate potential influences of sex, age and hair color. Cortisol concentrations in hair of 554 subjects were measured and a comparative statistical analysis was performed. The analysis showed that cortisol levels significantly differ depending on age. The toddler group (7 months (0.6 years) to 3 years) showed significantly higher values (median 10pg/mg, p-value<0.0001, d=0.78) than the adolescent group. The adolescent groups showed significantly lower (p-value<0.0001, d=0.58 and p<0.0001, d=0.13) values (median 2.4pg/mg and 2.8pg/mg) than the adult group (median 5.8pg/mg). Furthermore, in the adult group men showed significantly higher cortisol values than women (p-value<0.05, d=0.17). This effect could not be seen in the adolescent group. Black hair showed higher cortisol concentrations than blond hair (p-value<0.0001, d=1.3). In addition, two rounds of interlaboratory comparisons for hair cortisol samples between four laboratories revealed very consistent results. Our results demonstrate that baseline cortisol levels are generally low in hair thus making a standardized and well-elaborated analytical method indispensable for accurate determination. Age-dependent normative baseline cortisol levels (toddlers, adolescents and adults) are highly recommended based on the comparative analysis comprising five independent studies.


Assuntos
Cabelo/metabolismo , Hidrocortisona/metabolismo , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Cromatografia Líquida , Feminino , Cor de Cabelo , Humanos , Lactente , Masculino , Espectrometria de Massas , Pessoa de Meia-Idade , Fatores Sexuais , Adulto Jovem
12.
Phys Rev Lett ; 119(24): 243202, 2017 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-29286725

RESUMO

The ionization rate of an atom in a strong optical field can be resonantly enhanced by the presence of long-living atomic levels (so-called Freeman resonances). This process is most prominent in the multiphoton ionization regime, meaning that the ionization event takes many optical cycles. Nevertheless, here, we show that these resonances can lead to rapid subcycle-scale plasma buildup at the resonant values of the intensity in the pump pulse. The fast buildup can break the cycle-to-cycle symmetry of the ionization process, resulting in the generation of persistent macroscopic plasma currents which remain after the end of the pulse. This, in turn, gives rise to a broadband radiation of unusual spectral structure, forming a comb from terahertz to visible. This radiation contains fingerprints of the attosecond electron dynamics in Rydberg states during ionization.

13.
J Chem Phys ; 146(22): 224901, 2017 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-29166039

RESUMO

Segmental dynamics of a highly entangled melt of linear polyethylene-alt-propylene with a molecular weight of 200 kDa was studied with a novel proton nuclear magnetic resonance (NMR) approach based upon 1H → 2H isotope dilution as applied to a solid-echo build-up function ISE(t), which is constructed from the NMR spin echo signals arising from the Hahn echo (HE) and two variations of the solid-echo pulse sequence. The isotope dilution enables the separation of inter- and intramolecular contributions to this function and allows one to extract the segmental mean-squared displacements in the millisecond time range, which is hardly accessible by other experimental methods. The proposed technique in combination with time-temperature superposition yields information about segmental translation in polyethylene-alt-propylene over 6 decades in time from 10-6 s up to 1 s. The time dependence of the mean-squared displacement obtained in this time range clearly shows three regimes of power law with exponents, which are in good agreement with the tube-reptation model predictions for the Rouse model, incoherent reptation and coherent reptation regimes. The results at short times coincide with the fast-field cycling relaxometry and neutron spin echo data, yet, significantly extending the probed time range. Furthermore, the obtained data are verified as well by the use of the dipolar-correlation effect on the Hahn echo, which was developed before by the co-authors. At the same time, the amplitude ratio of the intermolecular part of the proton dynamic dipole-dipole correlation function over the intramolecular part obtained from the experimental data is not in agreement with the predictions of the tube-reptation model for the regimes of incoherent and coherent reptation.

14.
Radiat Prot Dosimetry ; 177(1-2): 16-20, 2017 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-28981795

RESUMO

Compared to the intended EU reference level of 300 Bq m-3 for indoor radon concentrations, the contribution of building materials appears to be low. Considering the recommended limit of 100 Bq m-3 by WHO, their contribution is supposed to be relevant, especially at low air exchange rates. This study as part of a two-part research project investigated the suitability of direct low level 222Rn measurement under simulated indoor conditions with commercial radon monitors and dynamically operated emission test chambers. Active measuring devices based on ionisation or scintillation chambers with 1-σ uncertainties below 8.6% at 20 Bq m-3 were found to be best suitable for a practical test procedure for the determination of radon exhalation rates of building materials. For the measurement of such low concentrations, the knowledge of the accurate device background level is essential.


Assuntos
Poluentes Radioativos do Ar/análise , Poluição do Ar em Ambientes Fechados/análise , Monitoramento de Radiação/instrumentação , Radônio/análise , Materiais de Construção , Desenho de Equipamento , Umidade , Temperatura , Compostos Orgânicos Voláteis
15.
Phys Chem Chem Phys ; 19(34): 23357-23361, 2017 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-28825734

RESUMO

The growth of two-dimensional materials into three-dimensional geometries holds the promise for high performance hybrid materials and novel architectures. The synthesis of such structures, however, proceeds in fundamentally different flow regimes compared to conventional CVD where pressure differences and wall collisions are neglected. We here demonstrate the remarkable stability of graphene growth under varying fluid dynamic flow regimes. We investigate the growth process across different flow conditions using confined growth in refractory pores. Analysis of the growth rate reveals a transport-limited process which allows experimental determination of the gas diffusion coefficient. The diffusion coefficient was found to be constant for large pore dimension but scales with pore dimension as the pore size decreases below the mean free path providing clear evidence for previously predicted Knudsen molecular-flow conditions for atomic confinement. Surprisingly, changes to the flow conditions by two orders of magnitude do not cause qualitative changes of the graphene growth process. This unique behavior was attributed to rarefied flow conditions by scaling analysis and an analytical relation between growth rate and constriction could be extracted that proves accurate throughout the investigated conditions. Our results demonstrate a fundamentally different growth process compared to traditional CVD processes that is akin to atomic layer deposition and highlight the feasibility of high-quality 2D-material growth on 3D morphologies with ultra-high aspect ratios.

16.
J Magn Reson ; 277: 79-85, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28258024

RESUMO

Field-Cycling (FC) NMR experiments were carried out at 1H Larmor frequencies down to about 3Hz. This could be achieved by fast switching a high polarizing magnetic field down to a low evolution field which is tilted with respect to the polarization field. Then, the low frequency Larmor precession of the nuclear spin magnetization about this evolution field is registered by means of FIDs in a high detection field. The crucial technical point of the experiment is the stabilization of the evolution field, which is achieved by compensating for temporal magnetic field fluctuations of all three spatial components. The paper reports on some other basic low field experiments such as the simultaneous measurement of the Larmor frequency and the spin-lattice relaxation time in such small fields as well as the irradiation of oscillating transversal magnetic field pulses at very low frequencies as a novel method for field calibration in low field FC NMR. The potential of low field FC is exemplified by the 1H relaxation dispersion of water at frequencies below about 2kHz stemming from the slow proton exchange process.

17.
Science ; 355(6332): 1392-1395, 2017 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-28325842

RESUMO

The Rosetta spacecraft spent ~2 years orbiting comet 67P/Churyumov-Gerasimenko, most of it at distances that allowed surface characterization and monitoring at submeter scales. From December 2014 to June 2016, numerous localized changes were observed, which we attribute to cometary-specific weathering, erosion, and transient events driven by exposure to sunlight and other processes. While the localized changes suggest compositional or physical heterogeneity, their scale has not resulted in substantial alterations to the comet's landscape. This suggests that most of the major landforms were created early in the comet's current orbital configuration. They may even date from earlier if the comet had a larger volatile inventory, particularly of CO or CO2 ices, or contained amorphous ice, which could have triggered activity at greater distances from the Sun.

18.
Philos Mag Lett ; 97(11): 450-458, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29643740

RESUMO

A combined study of neutron diffraction and difference dilatometry on submicrocrystalline Ni prepared by high pressure torsion aims at studying the anisotropic behaviour during dilatometry and its relation to internal stress and structural anisotropy. Macroscopic stresses were undetectable in the dilatometer samples. Along with specific tests such as post cold-rolling, this shows that an observed anisotropic length change upon annealing is not caused by internal stress, but can be explained by the inherent microstructure, i.e. the anisotropic annealing of relaxed vacancies at grain boundaries of shape-anisotropic crystallites.

19.
Science ; 354(6319): 1566-1570, 2016 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-27856849

RESUMO

The Rosetta spacecraft has investigated comet 67P/Churyumov-Gerasimenko from large heliocentric distances to its perihelion passage and beyond. We trace the seasonal and diurnal evolution of the colors of the 67P nucleus, finding changes driven by sublimation and recondensation of water ice. The whole nucleus became relatively bluer near perihelion, as increasing activity removed the surface dust, implying that water ice is widespread underneath the surface. We identified large (1500 square meters) ice-rich patches appearing and then vanishing in about 10 days, indicating small-scale heterogeneities on the nucleus. Thin frosts sublimating in a few minutes are observed close to receding shadows, and rapid variations in color are seen on extended areas close to the terminator. These cyclic processes are widespread and lead to continuously, slightly varying surface properties.

20.
J Dtsch Dermatol Ges ; 14 Suppl 6: 17-28, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27869373

RESUMO

Obwohl bislang für die Rosazea keine kurative Therapie besteht, können verschiedene Optionen zur Behandlung der Symptome und zur Vorbeugung von Exazerbationen empfohlen werden. Neben Selbsthilfemaßnahme wie der Vermeidung von Triggerfaktoren und einer geeigneten Hautpflege sollte das Rosazea-Management bei Patienten mit erythematöser und leichter bis schwerer papulopustulöser Rosazea die Anwendung topischer Präparate als First-Line-Therapie umfassen. Da Überlappungen der charakteristischen Rosazea-Symptome im klinischen Alltag die Regel sind, sollte die medikamentöse Therapie auf die individuellen Symptome zugeschnitten werden; auch eine Kombinationstherapie kann erforderlich sein. Zu den für die Behandlung der Hauptsymptome der Rosazea zugelassenen Wirkstoffen gehören Brimonidin gegen das Erythem sowie Ivermectin, Metronidazol oder Azelainsäure gegen entzündliche Läsionen. Ihre Wirksamkeit wurde in zahlreichen validen, gut kontrollierten Studien belegt. Darüber hinaus existieren verschiedene nicht zugelassene topische Behandlungsmöglichkeiten, deren Wirksamkeit und Sicherheit noch in größeren, kontrollierten Studien zu untersuchen ist.


Assuntos
Anti-Inflamatórios/administração & dosagem , Dermatoses Faciais/diagnóstico , Dermatoses Faciais/tratamento farmacológico , Fatores Imunológicos/administração & dosagem , Rosácea/diagnóstico , Rosácea/tratamento farmacológico , Administração Cutânea , Administração Tópica , Fármacos Dermatológicos/administração & dosagem , Medicina Baseada em Evidências , Alemanha , Humanos , Assistência Centrada no Paciente/métodos , Avaliação de Sintomas/métodos , Resultado do Tratamento
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