Med Klin
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Successful pharmacologic treatment of cancer pain is founded upon careful assessment and measurement of pain before and during therapy. Strong opioids should be used timely in accordance to the WHO 3-step analgesic ladder. The oral route should always be favored. ⋯ In case of changement of route of administration the relative potency ratio of oral morphine to parenteral morphine is about 3:1. The coadministration of nonopioids is essential for the relief of cancer pain in many cases. Adjuvant drugs may provide pain relief in specific types of pain (e.g. neuropathic pain).
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T CELL RESPONSE: T lymphocytes play a key role in the coordination of the immune response. T helper cells contribute primarily by means of cytokine release, whereas cytotoxic T cells eliminate cells bearing antigens recognized as foreign. Through its T cell receptor each T cell can recognize a specific peptide antigen, which is presented in the context of the major histocompatibility complex (MHC) to T helper cells by specialized antigen-presenting cells or to cytotoxic T cells by nearly all body cells. Upon contact with its specific antigen, the T cell receptor transduces an activation signal into the T cell, leading to proliferation, cytokine production, or efficient cytotoxicity.
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Comparative Study
[Value of the Hannover Intensive Score (HIS) in internal medicine intensive care].
Scoring systems are important tools for quality control and stratification of study populations in intensive care medicine. The study aims to systematically evaluate predictive ability and severity classification ability of the combined physiologic-therapeutic Hannover Intensiv Score (HIS). Such data are not existing regarding medical intensive care medicine. ⋯ The Hannover Intensiv Score as a model of a combined physiologic-therapeutic scoring system was successfully validated concerning hospital outcome prediction and severity of disease classification in a large medical ICU population. Thus, for these applications it can be used in similar German ICUs. A main argument for applying the system is the employment of a fairly small set of easily accessible parameters.
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Cloning of the ob-gene and characterization of its gene product leptin has led to the identification of a satiety factor, which signals the amount of peripheral fat stores to the central nervous system and regulates further feeding behaviour, thus playing a central role in the regulation of body weight. Soon after cloning of the ob-gene, a leptin-binding receptor has been identified in the central nervous system as well as in various peripheral organs. A feedback loop between peripheral fat stores and leptin receptors in the central nervous system appears to play an important role in normal body weight regulation. ⋯ Moreover, leptin may play a role in manifestation of insulin resistance and type II diabetes. Since the identification of leptin, a vast number of studies have been conducted to assess the molecular mechanisms and signal transduction pathways that are involved in the development and manifestation of obesity. From the large body of data generated to date, novel concepts of the regulation of energy balance and target strategies to control human obesity should soon be forthcoming.
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A prospective longitudinal study was performed from 1989 to 1996 in order to check the effectiveness of prophylactic measures in Germany. ⋯ The iodine supply has been improved. However, the declared targets have not yet been met. The findings show that effective goitre prophylaxis can still be achieved while maintaining the voluntary principle.