We report on a 41-year-old female patient suffering from obesity, binge eating more than twice a week with loss of control, eating rapidly and feeling guilty after eating, dyspnoea and chronic pain in the whole body, especially in her arms, legs and in both ankles. Furthermore, subdued mood, loss of interest and pleasure, fatigue and impaired concentration could be recognized. In the past, weight increase had been observed when corticosteroids were given against exacerbations of sarcoidosis.
In the case of our patient, the beginning of sarcoidosis and increase of weight and pain correlated with augmentation of depression and psychosocial stress. Dysfunctional behavioral features and multiple interactions between diseases could be observed.
We diagnosed obesity, binge eating disorder, major depression, chronic pain disease with somatic and psychical components and sarcoidosis. The patient was treated in a multimodal therapy program including psychotherapy, pharmacotherapy and psychopharmacotherapy, nutritionist advice and therapeutic exercise. A weight loss of 7.9 kg (5.9 %), well-balanced diet, reduction of binge eating and of pain intensity, mood stabilization as well as perception and expression of emotions and coping strategies in chronic diseases were achieved.
Interdisciplinary treatment of patients suffering from psychosomatic, somatic and mental diseases is crucial for a good outcome.
[Show abstract][Hide abstract] ABSTRACT: The main aim of this work is investigating the level of knowledge and diffusion of SOA (Service Oriented Architecture) in the Italian industry. We are also interested to understand what is the trend of SOA (positive or negative?) and what are the methods, technologies and tools really used in the industry. We carried out a personal opinion survey receiving 159 answers by Italian software professionals in two different rounds (2008 and 2011). The data were collected with the help of self-administered Internet questionnaires. The findings suggest that SOA is a relevant phenomenon in the Italian industry, it is well-known (and used enough) and the same is true for its key components (Web services and RESTFul services). On the contrary, orchestration languages and UDDI seem little known and used. Currently, the adoption of SOA is medium with a perceived trend that is more stable than positive (but surely not negative).
Proceedings of 14th IEEE International Symposium on Web Systems Evolution (WSE 2012); 09/2012
[Show abstract][Hide abstract] ABSTRACT: Fatigue is a frequent symptom of patients suffering from sarcoidosis. The origin of fatigue associated with sarcoidosis is unclear. The aim of this study was to assess the impact of affected organs, medication, and comorbidity on fatigue related to sarcoidosis.
In collaboration with the German Sarcoidosis Society, a sample of 1197 subjects, diagnosed with sarcoidosis, were examined. The participants completed a questionnaire that contained the Fatigue Assessment Scale (FAS) and the Multidimensional Fatigue Inventory (MFI).
In this study, muscles, bones and nerves were most strongly associated with fatigue. Patients receiving prednisolone showed heightened fatigue levels, however, the association between the duration of prednisolone therapy and fatigue was weak. The concomitant diseases, pulmonary hypertension and sleep apnoea, showed the greatest impact elevating fatigue (effect sizes d>0.50). In the combined regression analysis, comorbidity was the most important predictor of fatigue.
It is important to consider that multiple clinical factors, especially comorbidities, contribute to the high degrees of fatigue in sarcoidosis.
11/2013; 59(7). DOI:10.4187/respcare.02080
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