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  • 1
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background The aetiology of morphoea is still unknown. Borrelia burgdorferi as a causative agent of morphoea has been discussed since 1985, but the relationship remains uncertain. Objectives We aimed to find evidence for infection with B. burgdorferi by combined evaluation of different clinical and laboratory data in a group of 54 patients with morphoea. Methods In each patient, an evaluation of the case history was performed with regard to infection with B. burgdorferi, using a standardized questionnaire. Questions focused on previous tick bites and skin changes suspicious for erythema migrans (EM). The case history data of 52 patients were compared with those of 104 matched control subjects and of 25 patients with acrodermatitis chronica atrophicans (ACA). Serological examinations were performed in 53 patients with morphoea. Furthermore, lesional skin was examined for borrelial DNA in 33 patients, using nested polymerase chain reaction (PCR) for the ospA and the borrelial rRNA gene. Results Results of the questionnaire showed no differences between patients with morphoea and matched controls. In contrast, patients with ACA showed a much higher prevalence of tick bites and skin changes suspicious for EM as compared with patients with morphoea. Serological examination was positive in only one patient with morphoea alone and in two additional patients with coexistent ACA. No borrelial DNA was detected by PCR in lesional skin of 33 patients with morphoea. Conclusions No evidence was found for B. burgdorferi infection in patients with morphoea.
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 137 (1997), S. 0 
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Kompressionstherapie ; Dynamische Anpreßdruckmessung ; Mikrodruckmeßsonde ; Compliance ; Key words Compression therapy ; Dynamic pressure measurement ; Piezometric microprobe ; Compliance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The well-documented positive effect of compression stocking therapy on the venous macro- and microhemodynamics of the legs can only be attained if the stockings fit well. In order to determine the effective pressure exerted by compression stockings, we usually deleted in US journals. One can get this out of journal and author’s address have developed a new measuring method based on piezoresistant microprobes and a microprocessor unit. With our 2-mm-thick, 5-mm diameter probe, the pressure between the compression stocking and skin can be measured at any location desired. A temporal resolution of 50 Hz makes it possible to carry out dynamic measurements while the patient is walking or performing exercises on tiptoes. Here we present 4 typical cases out of a total of over 80 which we have evaluated. We have decided empirically that the pressure exerted by a class-2 compression stocking on the skin at the height of the ankles (b-position) should not exceed 70 mm Hg while resting and a peak of 110 mm Hg while exercising on tiptoes. At the middle of the calf (c-position) these values should not exceed 60 mm Hg at rest and 80 mm Hg on tiptoes. The pressure should decrease from the distal to proximal direction in order to produce a drainage gradient. We have found empirically that a pressure gradient of 30–40% from the b to the c measurement is favorable. Too high a proximal pressure or too high a pressure on a part of the lower leg causes pain and swelling. Too low a pressure, on the other hand, does not produce the desired vascular effect and alleviation of symptoms. Although dynamic pressure measurements take about 20–30 minutes per leg, they markedly improve patient compliance with compression therapy.
    Notes: Zusammenfassung Die gut dokumentierte günstige Wirkung der Kompressionstherapie mit Kompressionsstrümpfen auf die venöse Makro- und Mikrohaemodynamik der Beine läßt sich nur mit gut angepaßten Strümpfen erreichen. Um den effektiven Anpreßdruck zu bestimmen, wurde an der Universitäts-Hautklinik Tübingen eine neue Meßmethode, basierend auf piezoresistiven Mikromeßsonden und einer Mikroprozessoreinheit, entwickelt. Der Anpreßdruck zwischen Kompressionsstrumpf und Haut kann mit den 2 mm dicken und 5 mm im Durchmesser großen Sonden an beliebigen Hautarealen gemessen werden. Die zeitliche Auflösung von 50 Hz erlaubt dynamische Messungen beim Gehen oder bei Zehenspitzenständen. Es werden hier 4 typische Fallbeispiele aus bisher über 80 Messungen dargestellt. Empirisch wurde ermittelt, daß der Anpreßdruck eines Strumpfes mit Kompressionsklasse 2 auf die Haut auf Knöchelhöhe (b-Maß) 70 mmHg in Ruhe und 110 mmHg Spitzendruck bei Zehenspitzenständen bzw. 60 mmHg in Ruhe und 80 mmHg bei Zehenständen in Wadenmitte (c-Maß) nicht überschreiten sollte. Der Anpreßdruck soll von distal nach proximal abfallen, um entstauend zu wirken. Empirisch wurden Druckdifferenzen von 30–40% vom b- zum d-Maß als günstig ermittelt. Zu hohe proximale Drucke bzw. zu hohe Drucke an einem Unterschenkelsegment verursachen Schmerzen und Schwellung. Zu niedrige Drucke führen nicht zur Entstauung und gewünschten Beschwerdelinderung. Die Compliance der Patienten hinsichtlich der Kompressionstherapie läßt sich durch eine dynamische Anpreßdruckmessung, die allerdings etwa 20–30 min Zeit pro Bein in Anspruch nimmt, deutlich verbessern.
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