Bei dieser Patientin wurde klinisch und laborchemisch bei typischen Elektrolytstörungen sowie tiefem Morgen-Kortisol und erhöhtem Adrenokortikotropem Hormon eine chronische primäre ...Nebenniereninsuffizienz diagnostiziert, der bei positivem Antikörpernachweis eine Autoimmunadrenalitis zugrundelag. Die zusätzliche primäre Hypothyreose (bei positiven Thyreoperoxidase-Antikörper, anti-TPO-Ak) und die Sprue sprachen für ein polyglanduläres Autoimmunsyndrom (PAS) Typ 2. Die Behandlung mit Hydrokortison, später zusätzlich mit einem Mineralokortikoid und Thyroxin zeigte eine rasche Regredienz der Beschwerden. Bei Patienten mit Morbus Addison ist ein Screening für andere endokrinologische Erkrankungen erforderlich.
In this patient with tiredness, hyperpigmentation, weight loss, nausea and vomiting, chronic primary adrenal insufficiency (M. Addison) was diagnosed based on the clinical features, the typical electrolyte abnormalities and the reduced morning cortisol together with increased adrenocorticotropic hormone. The detection of autoantibodies against adrenal tissue and 21-hydroxylase revealed an autoimmune adrenalitis as the cause. The additional primary hypothyroidism (with positive thyreoperoxidaseantibodies, anti-TPO-antibodies) and the coeliac disease argued for a polyglandular autoimmune syndrome type 2. Treatment with hydrocortisone and with mineralocorticoid and thyroxine later on showed a rapid improvement of clinical symptoms. In patients with Morbus Addison, a screening for associated endocrine disorders is warranted.
In this patient with tiredness, hyperpigmentation, weight loss, nausea and vomiting, chronic primary adrenal insufficiency (M. Addison) was diagnosed based on the clinical features, the typical ...electrolyte abnormalities and the reduced morning cortisol together with increased adrenocorticotropic hormone. The detection of autoantibodies against adrenal tissue and 21-hydroxylase revealed an auto-immune adrenalitis as the cause. The additional primary hypothyroidism (with positive thyreoperoxidase-anti-bodies, anti-TPO-antibodies) and the coeliac disease argued for a polyglandular autoimmune syndrome type 2. Treatment with hydrocortisone and with mineralocorticoid and thyroxine later on showed a rapid improvement of clinical symptoms. In patients with Morbus Addison, a screening for associated endocrine disorders is warranted.
The development, planning, implementation, and integration of a nonprescription medication (self-care) experience into an existing community advanced pharmacy practice experience (APPE) at the ...University of Arkansas for Medical Sciences College of Pharmacy is described. The APPE will provide enhanced self-care education and skill development for students in response to the new Accreditation Council for Pharmacy Education Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree, which will take effect in July 2007. A description of the Advanced Community Pharmacy Over-The-Counter APPE is provided along with insights gleaned from the faculty involved.
Infants and toddlers are at high risk of neglect and maltreatment, as they are especially dependent on the care and the safeguard of their parents. Child protection can only succeed if early and ...preventive support for families at risk and their infants is provided. The project "A good start to life" helps to promote parental sensitive behaviour and care giving competence of parents in precarious life settings and in high risk situations and is aimed to prevent child neglect and abuse at an early age. A relevant prerequisite for child protection is interdisciplinary networking between the involved systems. The main focus of the project is the establishment of collaboration and network structures between the infant and youth welfare system and the health-care system and their services in eight communities in four states in Germany by using so-called round tables as communication platforms. Preliminary results of the round tables are reported in this article together with the results of the evaluation process.
The development, planning, implementation, and integration of a nonprescription medication (self-care) experience into an existing community advanced pharmacy practice experience (APPE) at the ...University of Arkansas for Medical Sciences College of Pharmacy is described. The APPE will provide enhanced self-care education and skill development for students in response to the new Accreditation Council for Pharmacy Education Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree, which will take effect in July 2007. A description of the Advanced Community Pharmacy Over-The-Counter APPE is provided along with insights gleaned from the faculty involved. PUBLICATION ABSTRACT
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