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Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

Different ways to stabilize a sternal fracture are described in literature. Respecting different mechanisms of trauma such as the direct impact to the ...

University Hospital Erlangen

Decreases in sex hormone levels with menopause may bring about a number of consequences in women's general health and sexual well-being, especially when levels decline suddenly and prematurely, as in surgical menopause. In addition to the well-established role of estrogens in preserving the biological basis of sexual response, there is emerging evidence that androgens are significant independent determinants affecting sexual desire, activity and satisfaction, as well as mood, energy and other components of women's health. Hypoactive sexual desire disorder (HSDD), a persistent absence of sexual fantasies or thoughts and/or desire for and receptivity to sexual activity that causes personal distress, is experienced by some postmenopausal women. Even though conventional hormone therapy with estrogens or estrogens and progestogens may be effective for vaginal atrophy, increasing vaginal lubrication and reducing dyspareunia, it has not been shown to consistently increase sexual desire or activity and many women with sexual dysfunction remain unresponsive. Several recent, large, phase III studies have shown that the addition of transdermal testosterone to conventional hormone therapy can be helpful in surgically menopausal women presenting with HSDD. After 24 weeks of treatment in these studies, testosterone-treated women experienced significantly greater increases in satisfying sexual activity and sexual desire, and greater decreases in distress, than placebo-treated women. Accurate clinical assessment and individualized management of sexual symptoms are fundamentally important for all menopausal women with HSDD or other sexual problems.

Hypoactive sexual desire disorder in postmenopausal women.

To develop a screening tool to allow a postmenopausal woman to determine whether to seek evaluation for hypoactive sexual desire disorder (HSDD).

Development and validation of a new screening tool for hypoactive sexual desire disorder: The Brief Profile of Female Sexual Function (B-PFSF).

Transdermal testosterone patch (TTP) treatment produced statistically significant improvements in a satisfying sexual activity (SSA), sexual desire, and personal distress in postmenopausal women suffering from hypoactive sexual desire disorder (HSDD), but clinical significance of these changes was not determined.

Clinically relevant changes in sexual desire, satisfying sexual activity and personal distress as measured by the profile of female sexual function, sexual activity log, and personal distress scale in postmenopausal women with hypoactive sexual desire disorder.

For essential oils, several biological effects such as antibacterial, anti-inflammatory, expectorant, and blood-circulation-enhancing properties have been described. The method of application depends on the pathophysiology, the desired outcome, safety, and toxicity data. For treating respiratory symptoms and nervous disorders, inhalation may be the best means of application, whereas topical application is the best way for treating skin diseases. For dermal application, percutaneous absorption of essential oil and oil components is of great interest. Essential oils are complex mixtures of different volatile substances. So, the question is raised whether all components of a complex composed essential oil are equivalent with respect to their human skin permeation. By means of artificial mixtures of different essential oil ingredients, we investigated the cooperative effect of monoterpenes and phenylpropanoids on the permeation through heat-separated human skin epidermis in static Franz-Diffusion Cells. Limonene showed an enhancing effect on the permeation of citronellol and eugenol. Both alpha-pinene and myrcene increased the apparent permeability ( P(app)) value of phenylethanol. beta-Pinene had an enhancing effect on the permeation behaviour of methyleugenol but not of geraniol. The investigations clearly show that cooperative effects of single essential oil components may influence percutaneous essential oil absorption.

Cooperative interaction of monoterpenes and phenylpropanoids on the in vitro human skin permeation of complex composed essential oils.

Rose oil is the essential oil extracted from the petals of the damask rose. It is an ingredient of cosmetic as well as health care products and it is used in folk medicine and in aromatherapy. It is well known that essential oils are able to permeate the skin whereas the lipophilic properties of the compounds as well as the application site have an influence on their permeation behaviour. In this paper, we investigated the influence of the application site on the permeation of rose oil.

Variation of in vitro human skin permeation of rose oil between different application sites.

BACKGROUND: The impact of herpes zoster (HZ) and post-herpetic neuralgia (PHN) on patients' quality of life (QoL) is currently poorly documented. SUBJECTS AND METHODS: Telephone interviews in Germany identified patients ≥50 years old with painful HZ diagnosed during the previous 5 years. Bespoke questions evaluated previous HZ episodes. RESULTS: Of 11,009 respondents, 280 met the screening criteria, and 32 (11%) developed PHN. PHN was associated with significantly worse outcomes than HZ (all P < 0.05). Mean pain scores associated with PHN and HZ, respectively, were 7.1 and 6.2 (average) and 8.2 and 7.0 (worst). Many patients with PHN (91%) and HZ (73%) experienced problems with daily activities, including work, studies, housework, family and leisure activities. Mean pain interference scores in patients with PHN versus HZ were highest for sleep (6.5 versus 4.9), normal work (6.1 versus 4.4) and mood (5.9 versus 4.4). Most employed interviewees with PHN (70%) and HZ (64%) stopped work during the disease. Pain and QoL outcomes were not significantly different between all patients versus those diagnosed during the previous 12 months or between patients aged 50-59 years versus ≥60 years. CONCLUSIONS: HZ causes substantial pain, which seriously interferes with many aspects of daily life, particularly in patients with PHN.

Sonja Schmitt

Orthopedic and Trauma Surgery

University Hospital Erlangen

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling