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Die vorliegende überarbeitete Leitlinie zum Lipödem wurde unter der Federführung der Deutschen Gesellschaft für Phlebologie (DGP) erstellt und finanziert. Die Inhalte beruhen auf einer systematischen Literaturrecherche und dem Konsens von acht medizinischen Fachgesellschaften und Berufsverbänden. Die Leitlinie beinhaltet Empfehlungen zu Diagnostik und Therapie des Lipödems. Die Diagnose ist dabei auf der Basis von Anamnese und klinischem Befund zu stellen. Charakteristisch ist eine umschriebene, symmetrisch lokalisierte Vermehrung des Unterhautfettgewebes an den Extremitäten mit deutlicher Disproportion zum Stamm. Zusätzlich finden sich Ödeme, Hämatomneigung und eine gesteigerte Schmerzhaftigkeit der betroffenen Körperabschnitte. Weitere apparative Untersuchungen sind bisher besonderen Fragestellungen vorbehalten. Die Erkrankung ist chronisch progredient mit individuell unterschiedlichem und nicht vorhersehbarem Verlauf. Die Therapie besteht aus vier Säulen, die individuell kombiniert und an das aktuelle Beschwerdebild angepasst werden sollten: komplexe physikalische Entstauungstherapie (manuelle Lymphdrainage, Kompressionstherapie, Bewegungstherapie, Hautpflege), Liposuktion und plastisch-chirurgische Interventionen, Ernährung und körperliche Aktivität sowie ggf. additive Psychotherapie. Operative Maßnahmen sind insbesondere dann angezeigt, wenn trotz konsequent durchgeführter konservativer Therapie noch Beschwerden bestehen bzw. eine Progredienz des Befundes und/oder der Beschwerden auftritt. Eine begleitend zum Lipödem bestehende morbide Adipositas sollte vor einer Liposuktion therapeutisch angegangen werden.
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http://dx.doi.org/10.1111/ddg.13036_g | DOI Listing |
Nucleic Acids Res
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Leibniz Institute of Plant Genetics and Crop Plant Research (IPK) OT Gatersleben, Corrensstr 3, 06466 Seeland, Germany.
In eukaryotes, accurate chromosome segregation during cell division relies on the centromeric histone H3 variant, CENH3. Our previous work identified KINETOCHORE NULL2 (αKNL2) as a plant CENH3 assembly factor, which contains a centromere-targeting motif, CENPC-k, analogous to the CENPC motif found in CENP-C. We also demonstrated that αKNL2 can bind DNA in vitro in a sequence-independent manner, without the involvement of its CENPC-k motif.
View Article and Find Full Text PDFAntonie Van Leeuwenhoek
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GIPhy - Genome Informatics and Phylogenetics, Biological Resource Center of Institut Pasteur, Institut Pasteur, Université de Paris, 75015, Paris, France.
A Gram-staining-positive, aerobic bacterium, designated strain JJ-181, was isolated from the root surface of soybean. Based on the 16S rRNA gene sequence similarities, strain JJ-181 was grouped into the genus Cohnella, most closely related to Cohnella hashimotonis F6_2S_P_1 (98.85%) and C.
View Article and Find Full Text PDFInt J Biometeorol
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Institute for Lung Research, German Center for Lung Research (DZL), Universities of Giessen and Marburg Lung Centre, Philipps-Universität Marburg, Marburg, Germany.
Community-acquired pneumonia (CAP) is a major global health concern as it is a leading cause of morbidity, mortality and economic burden to the health care systems. In Germany, more than 15,000 people die every year from CAP. Climate change is altering weather patterns, and it may influence the probability and severity of CAP.
View Article and Find Full Text PDFWater Res
December 2024
Faculty of Engineering, Institute of Environmental and Process Engineering, RheinMain University of Applied Sciences, Wiesbaden, Germany.
Although the paper industry processes polymeric materials and discharges large amounts of wastewater, no research on microplastics in the wastewater from paper mills has been published to date. This study is the first to investigate this issue. The wastewater treatment plants of twelve representatively selected German paper mills were investigated using an analysis protocol based on µ-Raman spectroscopy.
View Article and Find Full Text PDFPhilos Trans A Math Phys Eng Sci
December 2024
Max-Planck-Institut für die Physik des Lichts, Staudtstraße 2, Erlangen 91058, Germany.
Quantum entanglement describes superposition states in multi-dimensional systems-at least two partite-which cannot be factorized and are thus non-separable. Non-separable states also exist in classical theories involving vector spaces. In both cases, it is possible to violate a Bell-like inequality.
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