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IVF and CF
The original German question "IVF bei CF" is not relevant for the English archive (financial support; country specific).
17.03.2008
CFRD / frequently decreased BMI in CF / Mitrazapin for off-label use?
Due to the stress reaction of the body of a patient with CF because of a permanent inflammatory reaction underweight is developing frequently in the course of time. Besides the probable increase of respiratory work and the probable decrease of secretion and activity of pancreatic enzymes the reason for that development of underweight is probably mainly the increased cortisole production and the resulting insulin resistance (among others). What would you think about the proposal to try an off-label use of Mitrazapin (e.g. Remergil) in patients over 16 years of age and with a pathologic cortisole level (would say increased level); a drug which is a secure and effective anti-depressive drug with mild and transient side-effects? The most frequently shown side-effect is weight-gain which is caused probably on the one hand by a decrease of the cortisole level and on the other hand by a blockage of the 5-HT2-receptor, which leads to an increase in appetite. The anti-depressive side-effect is not necessarily unwanted. An additional argument for a try of this drug could be a massive impairment of the sleep as a main symptom of a depression. A study about Mitrazapin for the use in anorexia nervosa can be found here: http://edoc.ub.uni-muenchen.de/5458/. In this study the influence of Mitrazapin on the cortisole level in the saliva has been investigated and additionally the weight-gaining effect could be shown impressively (however, probably this effect had also other reasons in the frame of this study). On a website (http://www.sanego.de/Medikament_Mirtazapin) asking systematically for subjective side-effects of drugs 83 comments out of 148 (would say 53%) mention a weight gain. The partly awkward BMI-situations in CF would absolutely justify this procedure in my opinion. Is it not possible to initiate a study on that topic? Yours sincerely,
17.03.2008
Therapeutic equipment
Hello, I have a patient, six years old, who has a very good general condition and is pseudomonas-negative… I would like to prescribe him a trampoline but I do not know if the health insurance is covering the costs. With trampoline I mean this all-weather trampoline for outside that is so fantastic from a therapeutic point of view. Now my question: Can I prescribe this or is this doomed to failure from the beginning? Up to know he has not received any of such therapeutic equipment. "Sport-Thieme" e.g.offers it for the price of 831€. Thank you for your help.
13.03.2008
Hygiene in the office of a physiotherapist
I am treating as a physiotherapist several patients suffering from CF in my office. Since lately, I have a patient with an MRSA (methicillin resistant S. aureus) as well as B. cepacia germ. How are the possibilities to go on treating these patients in the office without "injure" the official hygienic recommendations??
07.03.2008
Standardized CF care
Could you please inform me which medical facilities in Czech Republic are able to provide care for a CF patient at the required standard level? Thank you
15.02.2008
Diagnosis during pregnancy
Hello, My sister is in her 6th month of pregnancy. Since there is CF in our family she underwent an amniocentesis and the child carries both defect genes. When the last ultrasound scan was done everything was ok organically (intestine, etc.). Should my sister go the a CF ambulance before birth and also deliver there? Or is it sufficient to deliver in a hospital with children's hospital and go to an ambulance later? Or depending on what should be make a decision?
15.02.2008
Consultation hours for adults
Hello, I would like to know where special consultation hours for adult CF patients are scheduled in the German speaking region? Many thanks.
15.02.2008
Pseudomonas aeruginosa
How can you avoid Pseudomonas aeruginosa infection? What should be avoided? Sinks and flower vases?
15.02.2008
Specialised centers and organizations
I am a student and am writing my final thesis on the topic of Quality of Life for Adolescents and Adults with CF. I would like to ask whether you can advise me where I can find an overview or more detailed information about all specialised centres and organisations related to CF? I have only found a fraction of this information on the internet. Thank you for your answer, Anna M.
15.02.2008
IV at home
Dear expert team, I hope you can help me. My son needs an IV therapy now and would like/should do it at home because there are rarely beds for CF patients in the hospital in charge. Is there a company in the Vienna [Austria] area offering such therapy? The Fresenius company does not offer it any more. Best regards, Gerda Schmit
15.02.2008
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