ABSTRACT
Cleidocervical muscles (CCM) or levator claviculae muscles in humans can be found as supernumerary unilaterally or bilaterally on the neck attached proximally to the clavicle and distally to the transverse process of cervical vertebrae at various levels. Altogether 20 case reports from year 1994 till present including 25 subjects related to CCM were found and analysed where parameters such as cervical insertion level, clavicular insertion at the middle vs. lateral third, unilateral vs. bilateral presence of the muscle, study type, reported gender of the subjects were extracted. Our literature survey shows that the prevalence of CCM in male and female was equally presented in radiological studies whereas almost 3-fold higher prevalence of males was found in cadaver reports. Since body donor system worldwide is male dominant, a 1:1 proportion of male and female in radiological studies could show more reality-based distribution of this muscle. Nevertheless, the presentation of this muscle was found in over 90% of the case reports unilaterally with higher left sided dominance. Even though the attachment points of CCM varied from case to case, the proximal attachment was found slightly more frequent on the middle third of the clavicle whereas the distal insertion was present more often on the superior cervical vertebrae than the lower ones. With prevalence of CCM in the population around 2.0-2.5%, the clinical, radiological and surgical relevance of this variation has to be highlighted to avoid potential misleading diagnostics in the neck.
Subject(s)
Neck Muscles , Neck , Humans , Male , Female , Clavicle , Cervical Vertebrae/diagnostic imaging , CadaverABSTRACT
Dermatologic-psychosomatic rehabilitation is indicated when a patient has both cutaneous and psychological disease, as well as when psychosocial factors have a negative influence on the course of disease or coping mechanisms. The goals of multimodal dermatologic and psychotherapeutic treatment are increased empowerment and self-action, as well as acceptance of disability. Requirements for admission are given with regard to ICF. The course of rehabilitation is explained and the most important therapeutic tools are presented.
Subject(s)
Dermatology/trends , Psychophysiologic Disorders/psychology , Psychophysiologic Disorders/rehabilitation , Rehabilitation/trends , Skin Diseases/psychology , Skin Diseases/rehabilitation , Germany , Humans , Skin Diseases/complicationsABSTRACT
Guidelines for dermatological rehabilitation are based on the International Classification of Functioning, Disabilities and Health (ICF), which includes context factors such as physical environment, socioeconomic conditions, and the personal situation of the patient. Guidelines give specific recommendations for personal conditions of rehabilitation, staff, equipment, process of treatment, and evaluation. They assist doctors, patients, and public institutions in orientation and decision making. The latest publications are a joint summary obtained from experts, with substantial participation of the social insurance agencies, and demonstrate the growing importance of guidelines which are the result of a compromise between the conflicting interests of medical progress on the one hand and economic restrictions on the other. Consequences for allocation of financial resources in the health system are discussed.
Subject(s)
Dermatology/standards , International Classification of Diseases , Practice Guidelines as Topic/standards , Practice Patterns, Physicians'/standards , Rehabilitation/standards , Skin Diseases/diagnosis , Skin Diseases/rehabilitation , Dermatology/methods , Disabled Persons/classification , Disabled Persons/rehabilitation , Germany , Humans , Internationality , Rehabilitation/methods , Severity of Illness Index , Skin Diseases/classification , World Health OrganizationABSTRACT
Dermatological rehabilitation treatment can take different forms: climato-therapy, baths, phototherapy and psychosomatic treatments. Which of these treatments is of most benefit to any one patient depends on his or her illness. Accordingly, a psychosomatic approach to dermatological illness is indicated mainly when a psychological disorder and a dermatological disease coincide. In addition, dermatoses with psychological triggers or overlays, and also depression, pre-existing emotional disorders and special motivation for psychotherapy should be considered for psychosomatic treatment. Finally, patients who are having trouble accepting or confronting malignant skin tumours may also benefit.
