THERAPEUTISCHE UMSCHAU最新文献

Introduction: Integrative oncology is gaining increasing importance in cancer care. Patients seek additional support that addresses not only physical, but also emotional and spiritual needs. At the same time, studies show positive effects of complementary therapy intervention on quality of life and symptom control. Nevertheless, healthcare professionals often remain uncertain in clinical practice regarding the safety, effectiveness, and communication of such therapies. This article provides an overview of continuing education and training opportunities in the field of integrative oncology in Switzerland, highlights existing gaps, and defines key competencies required for safe and evidence-informed application. Based on international recommendations, practice-relevant learning content, educational formats, and interprofessional teaching strategies are presented. A particular focus is placed on the development of multiprofessional, evidence-based, and practice-oriented educational programs that address various professional groups - from physicians and nurses to complementary therapists. The aim is to promote interprofessional collaboration through structured training and to ensure the safe and effective use of complementary therapies in the oncological setting.

Introduction: Palliative care focuses on the quality of life of people with life-limiting illnesses through bio-psycho-social-spiritual support and multiprofessional collaboration, as early as possible in the disease course and continuing until the end of life. In this context, many patients also seek integrative medical approaches which, with their salutogenetic and multidimensional orientation, align well with the core principles of palliative care. Using anthroposophic medicine and phytotherapy as examples, a spectrum of remedies, external applications, and artistic therapies is presented that can relieve symptoms and strengthen inner resources. A competent indication with careful consideration of benefits and burdens is essential. When applied appropriately, integrative interventions can contribute to providing individualized and comprehensive support for people at the end of life and effectively reinforce the principles of palliative care.

Introduction: In Switzerland, a wide range of integrative oncology (IO) treatments is offered by various medical disciplines. A certificate of competence (SIWF: Swiss Institute for Medical Education, allows to bill from basic incurance) can be obtained for five disciplines: anthroposophic medicine (VAOAS), classical homeopathy (SVHA), phytotherapy (SMGP), TCM/acupuncture (ASA), and clinical hypnosis (SMSH). For Mind Body Medicine a CAS can be obtained (SFMBM). Integrative Nursing is an important therapeutic partner in many medical disciplines, with own established education programmes. These seven core disciplines of IO are based on different concepts and traditions, but they also have, at least in part, commonalities such as a multidimensional view of humanity, a focus on salutogenesis, the strengthening of self-efficacy, and the importance of lifestyle factors and individualised therapy. These core disciplines are offered with varying availability at the centres of the Swiss Network for Integrative Oncology (SNIO: www.integrative-oncology.ch), generally accompanying conventional oncological therapies and close, transparent communication with oncology specialists. The SNIO aims to develop quality criteria, coordinating treatment offers, promote network research, and encourage further training in order to enable coordinated and quality-assured care.

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Introduction: The number of cancer survivors - people who have overcome cancer or are living with the disease - is steadily increasing thanks to improved diagnostics and treatment. Studies indicate that many cancer survivors show good functional and quality of life scores in the long term, but comparisons with reference data show that cancer survivors still experience significant physical, psychological, and social impairments compared to the general population, even years after treatment. Cancer survivorship care focuses on developing care services for this issue, which has not been sufficiently addressed to date. Integrative oncology can offer a substantial contribution in the improvement the situation, particularly in light of the combination of evidence-based complementary therapies with conventional treatments, with the goal of enhancing well-being and quality of life, as well as active self-management (including nutrition and exercise in secondary prevention). Common problems experienced by cancer survivors, such as cancer-related fatigue, sleep disorders associated with cancer, and chemotherapy-induced polyneuropathy, can be reduced and the quality of life (QoL) of cancer survivors improved by integrating IO therapy concepts. Interventions from all core disciplines of IO can be used in many areas of survivorship care in a complementary, collaborative, and transparent manner alongside conventional medical treatments.

Introduction: Integrative oncology (IO) combines conventional cancer medicine with evidence-based complementary procedures, thereby placing special demands on the concept of evidence, research methodology, and the evaluation of care quality. This article highlights key theoretical, methodological, and practical principles. The classic concept of evidence is examined in detail through the three pillars of evidence-based medicine. Complementary research designs such as mixed methods, pragmatic studies, whole-systems approaches, and preference-based designs, are discussed as they offer new perspectives for generating valid and patient-centered evidence. In addition, regulation and practice-oriented quality criteria are presented as well as the current consensus process within the newly founded "Swiss Network for Integrative Oncology" (SNIO), which defines common standards, training structures, and research strategies. These efforts lay the foundation for the ongoing development of the field - toward an IO that is safe, effective, and truly patient-centered.

Introduction: Oral lichen planus (OLP) is a chronic inflammatory, T cell-mediated autoimmune disease of the oral mucosa that primarily affects middle-aged women. A typical clinical feature is a network of white lines (Wickham's striae) on the buccal mucosa. In addition to asymptomatic forms, painful erosive-atrophic variants also occur, which require treatment. Diagnosis is usually clinical, but a biopsy may be needed if the presentation is atypical. In terms of differential diagnosis, drug reactions and contact hypersensitivities must be considered. The exact pathogenesis remains unclear, though immunologic, genetic, and viral factors (especially hepatitis C) are discussed. Topical corticosteroids are the first-line treatment. In therapy-resistant cases, options include tacrolimus, methotrexate (MTX), apremilast, or systemic corticosteroids. Maintaining good oral hygiene, eliminating potential triggers (e. g., amalgam), and tailoring therapy to individual symptoms are essential components of effective management. Due to the risk of malignant transformation to squamous cell carcinoma, regular follow-up is essential.

Introduction: For a long time, advanced melanoma was a difficult-to-treat disease with no effective survival strategies. With the development of checkpoint inhibitors and kinase inhibitors in the 21st century, treatment options have improved considerably. Recent studies indicate that adjuvant therapy with anti-PD1-antibodies significantly improves the recurrence-free survival in stage IIB/C patients without lymph node involvement. However, the challenge is to identify the right patients for long-term treatment, as many could be cured by surgery alone. Neoadjuvant therapy, in which systemic treatment is administered before the surgical removal of the macroscopic lymph node metastases, has proven to be promising. Neoadjuvant approaches, particularly with anti-PD1-antibodies, can significantly reduce the recurrence rate. Additionally, histological analysis of tumor tissue after neoadjuvant therapy could help identify patients who do not require further adjuvant treatment, thereby reducing side effects and costs. However, the implementation of neoadjuvant therapy in clinical practice faces challenges, such as the lack of approval in Switzerland and the need for specialized histopathological assessments. Future research efforts should focus on developing criteria for patient selection and validating the role of histopathological examinations in prognosis. A de-escalation of therapeutic approaches could lead to more patient-centered, resource-efficient medicine.

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Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by pruritus, eczema, and impaired skin barrier. In recent years we have seen significant advances in the treatment of AD, with the introduction of new topical and systemic therapies. In addition to basic therapy and classic topical steroids and calcineurin inhibitors other topical substances and for severe forms systemic biologics and Janus kinase inhibitors are now available. Therapy selection is individualized, level-based considering disease severity, and regarding comorbidities and patient preferences. This article provides an up-to-date overview of evidence-based therapeutic options, discusses their efficacy and safety, and offers an outlook on future developments.