Non-drug Therapy Research Articles

Complementary and Alternative Medicine to Treat Fibromyalgia Symptoms. A Systematic Review.

This study aims to investigate the current evidence for the use of complementary and alternative medicine (CAM) in fibromyalgia (FM). A systematic review was conducted searching for PubMed, Scopus, CINAHL, PsycInfo, and Web of Science databases. Randomized controlled trials published up to December 2023 in peer-reviewed journals were included. Methodological quality was assessed by the Quality Assessment of Controlled Intervention Studies tool. A total of 216 articles were identified and 15 constituted the final sample. The type of CAM most used was traditional Chinese medicine (60%), and the most common instrument used was the Fibromyalgia Impact Questionnaire (60%). Our review was grouped into four themes based on the origin of the therapies: 1) Traditional Chinese Medicine; 2) Japanese natural harmonization (eg, Reiki); 3) Ayurvedic Medicine; and 4) Other non-drug therapies. Our systematic review showed that there is a wide range of CAMs used to treat FM. Most of the clinical trials have shown significant results for the effectiveness of these interventions in both physical and mental health outcomes of FM as compared to control groups. However, the heterogeneity of the interventions and outcomes warrants further studies on this topic.

The Effect of Bangun-Bangun Leaf Juice on Hemoglobin Levels for Postpartum Mother in The Working Area of Puskesmas Talun Kenas

During the puerperium, anemia can occurs in mothers who had lower than nor-mal hemoblobin levels. This condition could caused iron loss, onterfere with the lactatio process, anda cause the uterus to fail to contract because not enough blood enters oxygen to the uterus. The strongest factor causing post partum ane-mia was blood loss during delivery, both moderate and large. Events that cause the mother to lose moderate to large amounts of blood, nameli interventions dur-ing labor such as episiotomy, delivery using a vacuum; third or fourth degree perineal laceration; and caesarean section. The provision of non-drug therapy that can be given to increase hemoglobin levels was to provide iron containing nutrients. The research aim to determine the effect of bangun-bangun leaf juice on hemoglobin levels for postpartum mother in the Working area of Puskesmas Talun Kenas. This research was a type of quantitative research that is quasi-experiment. The population of this study is all postpartummothers in the work area of Puskesmas Talun Kenas. The samples obtained were 25 people with accidental sampling technique. The statistical test used was the paired sample t test, with a 95% confidence level (? = 0,05). The results of this study indicate that there is an effect of bangun-bangun leaf juice on hemoglobin levels in postpartum mothersin the working area of Puskesmas Talun Kenas (p vaue 0,000). So it was expected that the health center could informed the mother about the benefits of bangun-bangun leaf juice in increasing maternal hemoglobin levels during the postpartum period which can informed during antenatal care visits or during home visits for postpartum mother.

K-WISC-V Processing Speed Index Analysis to Verify the Effectiveness of ADHD Symptom Improvement Using Pediatric Digital Content

The most common treatment approach for children diagnosed with attention deficit hyperactivity disorder (ADHD) involves drug therapy; however, persuading parents and motivating children in the early stages of treatment is challenging. Consequently, there is a growing interest among parents of children with ADHD in non-drug therapies. Moreover, recent advancements in information and communication technology have increased the accessibility of digital treatments for ADHD and non-drug therapy content. However, some challenges persist in confirming specific and objective effects. In this retrospective study, we developed game-type digital therapy content for children aged 6–16 years and monitored improvements in ADHD symptoms using the K-WISC-V subtest processing speed index. The analysis revealed that the rate of change in the sum of converted scores on the 14th day was 0.64% lower in the experimental group compared with the control group; however, on the 28th day, the rate of change increased by 6.93%. This suggests that the supplementary use of Neuroworld DTx therapy proved effective for visual enhancement. Furthermore, improvements were observed in visual discrimination, short-term memory, and motor cooperation abilities. Consequently, game-based digital content is an effective adjunctive therapy for children dealing with ADHD.

Effectiveness of Yijinjing on cognitive and motor functions in patients with Parkinson's disease: study protocol for a randomized controlled trial.

Parkinson's disease (PD) is a common neurodegenerative disorder that affects motor and non-motor functions, significantly reducing patients' quality of life. No effective drug-based treatments are known to solve this problem. Non-drug therapies such as Yijinjing exercise have shown potential in improving cognitive and motor functions in PD patients. However, solid evidence must still be provided to support their clinical efficacy. This study aims to evaluate the clinical efficacy of Yijinjing exercise interventions in PD patients and explore the underlying mechanisms between the cognitive and motor functions in PD. This is a single-center randomized controlled trial in which 96 eligible PD patients will be randomly assigned to receive either Yijinjing exercise group or brisk walking group or control group in a ratio of 1:1:1. Interventions (Yijinjing exercise or brisk walking training, 40 min per session) will be provided in 3 sessions per week (Monday, Wednesday, Friday) for 12 weeks, with a total of 36 sessions. After the treatment, there will be a 1-month follow-up period. The primary outcomes will be measured using the Montreal Cognitive Assessment (MoCA) and the Unified Parkinson's Disease Rating Scale motor section (UPDRS-III). Secondary outcomes include balance function, executive function, walking function, sleep quality, and quality of life. Additionally, the prefrontal cerebral and sensorimotor cortex blood oxygen signal level will be collected to explore the underlying mechanisms. All outcomes will be assessed at baseline, at the end of 12 weeks of treatment and after an additional 1-month follow-up period. The results of the study protocol will provide high-quality evidence for the potential of intervention measures based on the Yijinjing exercise to improve the cognitive and activity levels of Parkinson's disease patients. We envision the Yijinjing exercise as a non-pharmacological family activity that can provide a new and more effective method for the treatment of Parkinson's disease patients or those at risk. This study was approved by the Ethics Committee of the Second Rehabilitation Hospital of Shanghai (2020-05-01). The trial has been registered in the China Clinical Trials Registry (ChiCTR2200055636).

Vulvovaginal atrophy: current methods of diagnosis and treatment

Aim. To review modern methods of diagnosis and treatment of vulvovaginal atrophy (VVA), which is one of the manifestations of genitourinary syndrome of menopause in periand postmenopausal women.Materials and methods. A review of domestic and foreign literature on the prevalence and modern methods of diagnosis and treatment of VVA was carried out.Results. Unlike vasomotor symptoms, VVA progresses with age, causing a significant impairment in women’s quality of life. Symptoms usually begin to bother perimenopausal patients, but their frequency and severity increase significantly in postmenopausal women. Diagnosis of VVA can present some difficulties, as many women perceive their condition as a natural manifestation of aging and do not seek medical care. Currently, drug and non-drug therapies for VVA have been proposed, each of which has its own characteristics, indications, and contraindications. However, the safety and effectiveness of some of them have not been fully proven.Conclusion. VVA is common in periand postmenopausal women. Modern aspects of the diagnosis and treatment of this pathology can significantly improve the quality of life of patients with VVA symptoms. However, further research is needed to confirm safety of the proposed treatment methods, and search for new techniques is required.

СРАВНИТЕЛЬНАЯ ОЦЕНКА ЭФФЕКТИВНОСТИ ВОЗДЕЙСТВИЯ ИСКУССТВЕННОГО МИКРОКЛИМАТА У ПОДРОСТКОВ С БОЛЕЗНЯМИ ОРГАНОВ ДЫХАНИЯ В САНАТОРНЫХ УСЛОВИЯХ

Based on the selected, criteria-based risk phenotypes for chronic lung diseases (CBL), 177 adolescents, 11-17 years old (11.94±0.8 years), during the three-week observational observation, two phenotypic groups (2.3), during their stay in the sanatorium, were prescribed an equivalent set of non-drug therapy, with various additions, halo-therapy (GLT) or speleo therapy (SLT). The dynamics were analyzed, with a comparison of a set of diagnostic indicators, at the beginning and at the end of the course of sanatorium treatment: variability of PSV per week, OFV1, FVC, OFV1/FVC, MOS75-50-25, lung age, electronic auscultation, symptoms (cough, shortness of breath, sputum separation), CO., No., assessment of the quality of life (QOL) according to the SF-10 questionnaire. For phenotype 2 (moderate risk of CBL), there was a better dynamics, weekly variability of PSV, increase in PSV in % of due, severity of respiratory acoustic noise, - when using GLT; at the same time, in the gender decomposition, there was a more pronounced positive dynamics, in boys, in terms of growth of OFV-l, FZHEL-l, OFV1/FZhEL-% and OFV1/FZhEL-% , MOS 25-75-l and MOS50-% of due, -, against the background of GLT. For phenotype 3 (high risk of CKD), less pronounced clinical and functional dynamics were noted. According to QOL, for phenotypes 2 and 3, when supplementing the course of sanatorium treatment with SPT or GLT, both in physical and socio-mental components, both in girls and boys, it was positive. For phenotype 2, QOL improved, with the use of GLT, at p<0.05: according to the parameters of general health, according to the component of physical well-being, it was more noticeable in young men. For phenotype 3, a reliable QOL dynamics was established, according to the dynamics of general health and the social component. In general, young men of phenotypes 2 and 3 reacted better to the additional effects of GLT compared with SPT, which was confirmed by reliable positive dynamics of functional indicators and QOL.

Research progress of non-drug therapy for post-stroke patients with cognitive impairment

Research progress of non-drug therapy for post-stroke patients with cognitive impairment

Unmet needs of drugs for irritable bowel syndrome and inflammatory bowel diseases: interest of vagus nerve stimulation and hypnosis.

The gut and the brain communicate bidirectionally through the autonomic nervous system. The vagus nerve is a key component of this gut-brain axis, and has numerous properties such as anti-inflammatory, antinociceptive, anti-depressive effects. A perturbation of this gut-brain communication is involved in the pathogeny of functional digestive disorders, such as irritable bowel syndrome, and inflammatory bowel diseases. Stress plays a role in the pathogeny of these diseases, which are biopsychosocial models. There are presently unmet needs of pharmacological treatments of these chronic debilitating diseases. Treatments are not devoid of side effects, cost-effective, do not cure the diseases, can lose effects over time, thus explaining the poor satisfaction of patients, their lack of compliance, and their interest for non-drug therapies. The gut-brain axis can be targeted for therapeutic purposes in irritable bowel syndrome and inflammatory bowel disease through non-drug therapies, such as hypnosis and vagus nerve stimulation, opening up possibilities for responding to patient expectations.

The adapted physical activity teacher, a professional helping people to live better with Parkinson's disease

Recognized by numerous scientific studies as an effective non-drug therapy for the treatment of most chronic illnesses, physical activity is booming. Many players are currently sharing the market. Among these professionals is the adapted physical activity teacher. Theyhave a university degree in adapted physical activity and health. They propose motorized teaching situations using adapted physical activities, whether sporting or artistic, under technical, material, regulatory and motivational conditions that are appropriate to the situation and to the safety of the participant. The aim is rehabilitation, education, prevention and/or social integration.

Application of Non-drug Therapy in Breast Cancer

Application of Non-drug Therapy in Breast Cancer

Effects of the Prolong Life With Nine Turn-Method Qigong on Fatigue, Insomnia, Anxiety, and Gastrointestinal Disorders in Patients With Chronic Fatigue Syndrome: Protocol for a Randomized Controlled Trial.

Chronic fatigue syndrome (CFS) is a debilitating multisystem disorder that can lead to various pathophysiological abnormalities and symptoms, including insomnia, gastrointestinal disorders, and anxiety. Due to the side effects of currently available drugs, there is a growing need for safe and effective nondrug therapies. The Prolong Life With Nine Turn (PLWNT) Qigong method is a system of mind-body exercise with restorative benefits that can alleviate the clinical symptoms of CFS and impart a significant inhibitory effect. Various studies have proven the treatment efficacy of PLWNT; however, the impact on insomnia, gastrointestinal disorders, and anxiety in patients with CFS has not yet beeninvestigated. This study aims to evaluate the efficacy and safety of the PLWNT method in terms of its effects on fatigue, insomnia, anxiety, and gastrointestinal symptoms in patients with CFS. We will conduct a randomized, analyst-blinded, parallel-controlled trial with a 12-week intervention and 8-week follow-up. A total of 208 patients of age 20-60 years will be recruited. The patients will be randomly divided into a PLWNT Qigong exercise group (PLWNT Group) and a control group treated with cognitive behavioral therapy at a ratio of 1:1. Participants from the treatment groups will be taught by a highly qualified professor at the Shanghai University of Traditional Chinese Medicine once a week and will be supervised via web during the remaining 6 days at home, over 12 consecutive weeks. The primary outcome will be the Multidimensional Fatigue Inventory 20, while the secondary outcomes include the Pittsburgh Sleep Quality Index, Gastrointestinal Symptom Rating Scale, Hospital Anxiety and Depression Scale, functional magnetic resonance imaging, gut microbiota, and peripheral blood. The study was approved by the ethics committee of Shanghai Municipal Hospital of Traditional Chinese Medicine in March 2022 (Ethics Approval Number 2022SHL-KY-05). Recruitment started in July 2022. The intervention is scheduled to be completed in December 2024, and data collection will be completed by the end of January 2025. Over the 3-year recruitment period, 208 participants will be recruited. Data management is still in progress; therefore, data analysis has yet to be performed. This randomized trial will evaluate the effectiveness of the PLWNT method in relieving fatigue, insomnia, anxiety, and gastrointestinal symptoms in patients with CFS. If proven effective, it will provide a promising alternative intervention for patients with CFS. China Clinical Trials Registry ChiCTR2200061229; https://www.chictr.org.cn/showproj.html?proj=162803. PRR1-10.2196/53347.

Enhancing the Development and Growth of Infant Cerebral Palsy Rats Using Selective Spinal Manipulations.

Cerebral palsy (CP) is a refractory pediatric disease with a high prevalence, high disability rate, and difficult treatment. A variety of treatments are currently used for CP. The treatment involves drug and non-drug therapy. Traditional Chinese medicine external therapy is a very distinctive treatment method in non-drug therapy. As one of the external therapies of traditional Chinese medicine, massage is used in treating cerebral palsy and has good efficacy, small side effects, and strong operability. As a part of TCM external therapy, selective spinal manipulation can effectively promote the growth and development of infant rats with cerebral palsy.The operation was mainly divided into four steps: first, the rubbing method was applied to the spine and both sides of the spine for 1 min. The pressing and kneading method was applied to the spine for 5 min, and the muscles on both sides of the spine for 5 min. Second, pressing and kneading the sensitive local acupoints in the spine for 2 min were performed. Thirdly, the affected limb was treated by twisting method for 1 min. Fourth, the rubbing method was applied to a midline from the forehead to the back of the brain for 1 min. This study aimed to use selective spinal manipulation to treat infant rats with cerebral palsy. The weight, Rotarod test, Foot-fault score, and growth hormone of infant rats with cerebral palsy were detected to understand the effect of selective spinal manipulation on the growth and development of infant rats with cerebral palsy. The results showed that it can promote weight gain, improve balance ability and motor function, promote growth and development of infant cerebral palsy rats, promote growth hormone secretion, and increase the temperature of sensitive parts of the back.

Applications of functional near-infrared spectroscopy in non-drug therapy of traditional Chinese medicine: a review

Non-drug therapies of traditional Chinese medicine (TCM), including acupuncture, massage, tai chi chuan, and Baduanjin, have emerged as widespread interventions for the treatment of various diseases in clinical practice. In recent years, preliminary studies on the mechanisms of non-drug therapies of TCM have been mostly based on functional near-infrared spectroscopy (fNIRS) technology. FNIRS is an innovative, non-invasive tool to monitor hemodynamic changes in the cerebral cortex. Our review included clinical research conducted over the last 10 years, establishing fNIRS as a reliable and stable neuroimaging technique. This review explores new applications of this technology in the field of neuroscience. First, we summarize the working principles of fNIRS. We then present preventive research on the use of fNIRS in healthy individuals and therapeutic research on patients undergoing non-drug therapies of TCM. Finally, we emphasize the potential for encouraging future advancements in fNIRS studies to establish a theoretical framework for research in related fields.

An Individual Rehabilitation and/or Habilitation Program for Children with Disabilities (IPRH)

Introduction: The individual program of rehabilitation and (or) habilitation of children with disabilities (IPRH) is mandatory for execution by the relevant state authorities, local self-government bodies, as well as organizations regardless of organizational-legal forms and forms of ownership. Objective: To conduct a pilot analysis of the implementation of the IPRH contingent of patients of children with disabilities in an urban children’s clinic. Patients and methods: There were 366 reports on the implementation of measures provided for by an IPRH for a disabled person (disabled child) of 222 disabled. The organization of the study was in the nature of a continuous sample. The criterion for the inclusion of patients in it was the passage of an IPRH in a disabled child within a specified time frame. The following techniques were used: grouping, absolute and relative values, average values, detailing, and generalization. The threshold error probability for statistically significant differences was set at a level of 0.05. Results: The structure of the results of the control of the performance of IPRH in 222 disabled children according to the classes of diseases that caused the onset of disability (ICD) was as follows 1) G00-G99 - 35.47 ± 3.13%; 2) Q00-Q99 - 23.50 ± 2.77%; 3) 11.11 ± 2.05%; 4) C00-D48 - 10.25 ± 1.98%; 5) H60-H95 - 7.26 ± 1.67%; 6) M00-M99 - 2.99 ± 1.11%; 7-8) H00-H59 and P00-P96 - 2.14 ± 0.95%; 9-10) K00-K93 and S00-T98 - 1.29 ± 0.74% each; 11-12) I00-I99 and N00-N99 - 0.85 ± 0.60% each; 13-14) J00-J99 and L00-L99 - 0.43 ± 0.42% each. Conclusion: 1. In the structure of IPRH in 222 disabled children, according to the classes of diseases that caused disability (ICD), the following prevailed: 1) VI Diseases of the nervous system G00-G99 – 35.47%; 2) XVII Congenital anomalies, chromosomal disorders Q00-Q99 - 23.50%; 3) IV Diseases of the endocrine system, nutritional disorders, and metabolic disorders E00-E90 – 11.11%; 4) II Neoplasms C00-D48 - 10.25%; 5) VIII Diseases of the ear and mastoid process H60-H95 - 7.26%; 6) XIII Diseases of the musculoskeletal system and connective tissue M00-M99 - 2.99%; 7-8) VIII Diseases of the ear and mastoid process H60-H95 and VII Diseases of the eye and its adnexa H00-H59 - 2.14% each. 2. The effectiveness of medical rehabilitation of disabled children was as follows: 1) Improvement - 23.26%; 2) Stabilization - 74.88%; 3) Deterioration - 1.86%. Dynamic observation was carried out on 94.26% of disabled children, drug therapy - 77.32%, non-drug therapy - 66.93%, and other types of medical rehabilitation were received by 14.48% of patients. Reconstructive operations were performed on 11.26% of disabled children. 3. Prosthetics and orthotics were performed on 38.74% of disabled children. 32.43% of disabled children in need received sanatorium treatment, and 30.18% are currently in line to receive a voucher. For various reasons, 24.32% refused this type of rehabilitation; 3.60% of patients had contraindications at the time the voucher was provided. 4. The obtained research results become the initial everyday statistical tool for objectifying the process of rehabilitation of patients and determining the strength and means of a medical institution to monitor and successfully implement an individual rehabilitation/habilitation program for a disabled person

Brisk Walking Untuk Menurunkan Kadar Glukosa Darah Pada Pasien Diabetes Mellitus Tipe 2: A Literature Review

Background: One of the non-communicable diseases (NCDs) that has received a lot of attention is Diabetes Mellitus. Diabetes management is divided into two ways. The first way is with non-drug therapy (non-pharmacological) and second with drug therapy. Drug therapy in the form of oral hypoglycemic drugs or insulin. Non-pharmacological methods with food planning and physical exercise. The type of light physical exercise recommended for patients with type II diabetes mellitus is walking and brisk walking. Objective: To determine the effect of brisk walking to reduce blood glucose levels in patients with type 2 diabetes mellitus. Methods: This review uses the literature review method. Searches were conducted in PubMed, Garuda, and Google Scholar. The search strategy used keywords with "brisk walking", "physical exercise", "glycemic control", "diabetes mellitus, type II",. Results: Seven articles were reviewed in this literature review. Six articles discussed brisk walking, one article discussed the difference in glycemic control in low - high intensity interval training with endurance training. The overall results of this review show that doing physical activity brisk walking has an effect in reducing blood glucose levels, reducing blood glucose levels by 49.75 mg/dL. Physical activity sessions can be done for 3 - 7 sessions per week with a duration of 15 - 60 minutes. Conclusion: The effect of brisk walking is proven to reduce blood glucose levels in patients with type 2 diabetes mellitus.

Dynamics of the course of Duchenne muscular dystrophy in patients taking ataluren and concomitant drug and non-drug therapy

Background. Duchenne muscular dystrophy is a hereditary, X-linked, progressive, disabling disease. One of the possible pathogenetic methods for treating this disease is the drug ataluren, which acts at the stage of protein translation in the ribosome and makes it possible to read information from mRNA, despite the presence of a premature stop codon in it, and, as a result, synthesize the dystrophin protein.Aim. To evaluate the dynamics of the course of Duchenne muscular dystrophy in patients receiving appropriate drug and non-drug therapy and patients receiving pathogenetic therapy with ataluren.Materials and methods. We examined 38 patients with genetically confirmed Duchenne muscular dystrophy. Of these, 11 patients with a genetically confirmed nonsense mutation receiving pathogenetic therapy with ataluren and 27 patients in the comparison group with other mutations in the dystrophin gene. 6‑minute walk test and timed function tests was done at baseline and during follow-up. Ataluren side effects were assessed.Results. Statistically significant positive dynamics were revealed during follow-up at 12 month when assessing the distance of a 6‑minute walk test and tests for getting up from the floor and running 10 meters in groups taking ataluren and receiving standard drug therapy with the initial initiation of a course of regular physical exercise. The control group was characterized by negative dynamics in speed tests.Conclusion. Thus, when taking ataluren in the standard recommended dosage, patients with Duchenne muscular dystrophy with a nonsense mutation shows a decrease in the rate of disease progression and an improvement in speed and endurance. The initial prescription of regular non-weightbearing aerobic exercise on the early ambulatory stage is also characterized by an increase in motor skills.

S3 Guideline Atopic dermatitis: Part1 - General aspects, topical and non-drug therapies, special patient groups.

This S3 guideline was created based on the European S3 guideline, with special consideration of the medical conditions in the German-speaking region and incorporating additions from the previous German-language version. The interdisciplinary guideline commission consisted of representatives from the German Dermatological Society, the Professional Association of German Dermatologists, the Austrian Society of Dermatology and Venereology, the Swiss Society of Dermatology and Venereology, the German Society for Allergology and Clinical Immunology, the German Society for Pediatric and Adolescent Medicine, the Professional Association of Pediatricians and Adolescent Medicine, the Society for Pediatric Allergology and Environmental Medicine, the German Society for Pediatric Rehabilitation and Prevention, the German Society for Psychosomatic Medicine and Medical Psychotherapy, the German Network for Health Services Research, the German Eczema Association and the German Allergy and Asthma Association. This first part of the guideline focuses on the definition and diagnostic aspects of atopic dermatitis (AD), addressing topical therapy as well as non-pharmacological treatment approaches such as UV therapy, psychoeducational therapy, dietary interventions for AD, allergen immunotherapy for AD, and complementary medicine. This part of the guideline also covers specific aspects of AD in children and adolescents, during pregnancy and lactation, and in the context of family planning. Additionally, it addresses occupational aspects of AD and highlights the perspective of the patients. The second part of the guideline, published separately, addresses the systemic therapy of AD.

To explore the mechanism of acupoint application in the treatment of primary dysmenorrhea by 16S rDNA sequencing and metabolomics.

Graphene-based warm uterus acupoint paste (GWUAP) is an emerging non-drug alternative therapy for the treatment of primary dysmenorrhea (PD), but the underlying mechanism is still unclear. SD female rats were randomly divided into control group, model group and treatment group to explore the mechanism of GWUAP in the treatment of PD. Combined with 16S rDNA and fecal metabolomics, the diversity of microbiota and metabolites in each group was comprehensively evaluated. In this study, GWUAP reduced the torsion score of PD model rats, improved the pathological morphology of uterine tissue, reduced the pathological damage score of uterine tissue, and reversed the expression levels of inflammatory factors, pain factors and sex hormones. The 16 S rDNA sequencing of fecal samples showed that the abundance of Lactobacillus in the intestinal flora of the model group decreased and the abundance of Romboutsia increased, while the abundance of Lactobacillus in the intestinal flora of the treatment group increased and the abundance of Romboutsia decreased, which improved the imbalance of flora diversity in PD rats. In addition, 32 metabolites related to therapeutic effects were identified by metabolomics of fecal samples. Moreover, there is a close correlation between fecal microbiota and metabolites. Therefore, the mechanism of GWUAP in the treatment of PD remains to be further studied.

Successful combinations of drug and non-drug therapy for low back pain

Successful combinations of drug and non-drug therapy for low back pain

S3 guideline Atopic dermatitis: Part 2 - Systemic treatment.

The present S3 guideline was created based on the European English-language S3 guideline, with special consideration given to the medical conditions in the German-speaking region, and with additions from the previous German-language version, in accordance with the criteria of the AWMF. This second part of the guideline addresses the systemic therapy of atopic dermatitis (AD). It covers topics such as the indication for systemic therapy in children, adolescents, and adult patients with AD. Furthermore, it addresses all medications approved for AD, such as the biologics dupilumab and tralokinumab, the Janus kinase inhibitors abrocitinib, baricitinib, and upadacitinib, as well as conventional immunosuppressive therapies with systemic glucocorticosteroids and ciclosporin. Additionally, it discusses systemic off-label therapies. The first part of the guideline, published separately, includes the definition and diagnostic aspects of AD, describes topical therapy, non-drug therapy approaches, and addresses aspects related to special patient groups.