Dermatologie (Heidelberg, Germany)最新文献

The orf virus is one of the parapoxviruses. It occurs worldwide and its natural reservoir are sheep and goats. Infections in humans can occur through direct or indirect contact with affected animals. The infectious ulcerations usually heal spontaneously after a few weeks in immunocompetent patients. An infection must be reported to the responsible professional association if the exposure occurs in the occupational environment, for example in farmers.

Background: Global climate and environmental changes impose a significant impact on human health by increasing prevalences of chronic and acute skin diseases. Climate-associated environmental changes can also trigger or intensify mental illnesses independently of a skin disease.

Aim: Discussion of the effects of the climate and environmental changes on dermatological diseases applying the biopsychosocial model.

Materials and methods: A selective literature search in the PubMed database and other sources was conducted.

Results: The biopsychosocial model considers complex interactions between biological, psychological, and social factors. In view of the consequences of climate and environmental changes, an extension of the model is proposed for the first time in order to address new challenges. The modified presentation supports the understanding of the dynamics and underscores that in dermatological care not only direct health effects of climate and environmental changes have to be dealt with, but also with an increasing number of mental illnesses, which in turn are to be regarded as direct and indirect health effects.

Conclusion: Coping with the predicted increase in the burden of disease and the decline in the available labor force associated with demographic change poses a major challenge. In order to maintain the functionality of the healthcare system, the prompt implementation of resource-efficient, sustainable measures in all areas of society is essential. The integrative consideration of dermatological and psychological complaints in the context of climate and environmental changes requires the adaptation of content for the education, training, and continuing education of specialists.

Background: Analyses of patient evaluations and barriers to the implementation of teledermatology procedures are still rare. The aim of this study was to determine whether administrative processes have an influence on the patient evaluation of telephone and video consultations.

Methods: With the help of a patient survey, assessments of the processes and organisation surrounding the outpatient appointment were asked. These were then compared to the assessment of whether the telephone or video consultation is an alternative to on-site consultation.

Results: In all, 1538 patients took part in the survey. Significant correlations were found between the evaluation of the telephone or video consultation and the distance between the place of residence and the outpatient clinic, whether the patient had already been seen several times or for the first time, as well as the evaluation of the waiting time for the appointment, the organisation before the appointment and the waiting time in the outpatient clinic.

Conclusions: The study shows that even after the Coronavirus pandemic, telephone and video consultations remain an important tool for patients to contact their physician. However, patients' perceptions of the processes around the outpatient appointment have an influence on their willingness to participate in a digital consultation.

Background: Sampling refers to the free supply of small product samples. In this process, the packaging can be disproportionate to the contents leading to raw material consumption and, in the case of poor recyclability, environmental pollution.

Objective: In this article, calculations regarding the ratio between packaging and product weight for commonly used types of packaging (sachet, tube, jar) of dermatological product samples are presented. The usefulness of sampling is discussed considering environmental and economic criteria.

Material and methods: A total of 43 dermatological product samples from different manufacturers were manually weighed and classified. Packaging was disassembled into its structural components. The proportional weights or the weight of the bottle/tube body were calculated with database values for the respective material in terms of greenhouse gas equivalents (CO2eq) and freshwater consumption. Subsequently, a total sum for the impact of each packaging was formed. Only the material and manufacturing process were considered because there were no valid data available for transport, utilization, and end of life (EoL) impacts.

Results: The smallest and lightest product sample (1.24 g) generated ca. 15 g CO2eq and approximately 700 ml of freshwater consumption. The largest and heaviest product sample (37 g) generated 53 g CO2eq and 5.78 l of freshwater consumption. Assuming an annual distribution of 10 million units of the 43 product samples examined here, ca. 8000 t of CO2eq are produced by the packaging alone. Additionally, 880,000,000 l of water are used and approximately 2300 t of packaging waste are generated.

Discussion: Sampling shows an unfavorable ratio between CO2eq/water consumption and utility, especially in comparison to larger units of packaging. Millions of product samples are distributed annually in doctor's practices, hospitals and pharmacies, particularly in dermatology. The practice of sampling should be questioned both ecologically and economically.

Background: The European Union and the German federal government have initiated a climate protection program with guidelines and laws that, for the first time, hold the healthcare sector accountable. The legal provisions have far-reaching implications for hospitals. This article presents the specific provisions to be observed and the best practices for implementing the necessary measures.

Objective: This study aims to provide a concise overview of the legal provisions to be observed in the healthcare sector and to highlight support services for implementation.

Materials and methods: Selective internet research on legal provisions for the healthcare sector and guidance on approach.

Results: The EU Corporate Sustainability Reporting Directive (CSRD) with taxonomy came into force on January 5, 2023. The Climate Protection Act, which was amended in April 2024, the Energy Efficiency Act (EnEfG), which came into force in January 2024, and the Supply Chain Sustainability Obligations Act (LKSG) are the most important German legal frameworks to be observed. The EU regulations and the German government's laws pose new challenges for hospitals, but are also an opportunity to tackle the necessary measures to reduce greenhouse gas equivalents in a structured manner.

Conclusion: Achieving climate neutrality by 2045 is in everyone's interest and can only succeed if all sectors contribute. The healthcare sector has not yet been held accountable, despite its significant contribution of approximately 5% to national greenhouse gas emissions. The legal provisions now trigger a necessary transformation but also pose challenges in day-to-day operations, requiring support services.

Herpes zoster (HZ) is a common disease caused by reactivation of varicella zoster virus. Diagnosis is usually based on the typical clinical presentation. Standard treatment includes antiviral, topical and analgesic therapies. As a complication, postherpetic neuralgia (PHN) can result from acute HZ infection, particularly in older and/or immunocompromised people. This can seriously impair the quality of life of those affected and requires adequate analgesia. In addition to the genesis, clinical presentation and treatment recommendations for HZ and PHN, this article also deals in particular with the vaccination prophylaxis recommended by the standing vaccination commission of the Robert Koch Institute (STIKO).