Der ?untere Bauchmuskel“Eine EMG gestützte Untersuchung verschiedener Bauchmuskulaturübungen Eine EMG gestützte Untersuchung verschiedener Bauchmuskulaturübungen

Für eine korrekte Haltung kommt dem Bauchmuskel eine entscheidende Rolle zu. In dieser Arbeit werden 4 verschiedene übungen mittels EMG untersucht. Neben der Intensit?t kommt auch der Ausführung (gestreckte oder im Knie gebeugte Beine) eine wichtige Rolle zu. übungen mit gestreckten Beinen erm?glichen ein koordinatives Training des unteren Anteils des Bauchmuskels. In Hinsicht auf die Intensit?t konnte kein Unterschied zwischen den einzelnen Anteilen gefunden werden.     

Serielle Ganzk?rperk?ltetherapie im Criostream bei entzündlich-rheumatischen Erkrankungen

BACKGROUND AND PURPOSE: Local as well as whole-body cryotherapy is used to relieve pain and inflammation in rheumatic diseases. In comparison with a chamber-based whole-body cryotherapy, the novel criostream whole-body therapy (single-person cabin with cold air cooled by liquid nitrogen) as an innovative technique offers not only a rapid therapeutic effect but also a considerable reduction in costs. The aim of this study was to compare the effect of whole-body cryotherapy in the criostream on pain reduction, disease activity and pro-inflammatory cytokines (tumor necrosis factor-[TNF-]alpha and interleukin-[IL-]1), and improvement in functional scores. PATIENTS AND METHODS: Ten patients with different active inflammatory rheumatic diseases (four patients with rheumatoid arthritis, three patients with ankylosing spondylitis, and three patients with psoriatic arthritis/spondylitis) underwent nine sessions of whole-body cryotherapy in 5 days for a short time period (at first 90 s, with step-up in each application to 2.5 min total time). RESULTS: Pain and disease activity scores decreased significantly, and, subsequently, also the functional scores showed a significant amelioration. Furthermore, there was a significant reduction in TNF-alpha (p < 0.01) and IL-1 (p < 0.05). Side effects were reported only after the first application in two cases (headache and sensation of cold). CONCLUSION: The criostream offers an elegant and, from the patient's point of view, attractive therapeutic agent in the multimodal treatment concept for inflammatory rheumatic diseases.     

Ist Kiefergelenkknacken ein Risikofaktor für Schmerzen im Kiefergelenk?

AIMS: To investigate the association between TMJ clicking and pain in the affected TMJ. PATIENTS AND METHODS: In this study a total of 454 consecutive patients seeking treatment for their pain in the region of the temporomandibular joint (TMJ) or the masticatory muscles were recruited. Patients were examined using the German version of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMJ-G). Clicking in the clinical examination was considered the potential risk factor (exposure). The outcome was pain in the TMJ. To characterize the exposure-outcome association, a relative risk was calculated using a stratified analysis (Mantel-Haenszel method). RESULT: The relative risk of developing pain in the TMJ due to joint clicking was 0.9 (95% confidence interval: 0.8-1.1). Thus, no association between clinical TMJ clicking and pain in the affected TMJ could be found. CONCLUSION: Based on these results, TMJ clicking requires no treatment to prevent pain in the affected TMJ.     

?Rücken-Coach“

Question

Back pain is a challenge for case management but is a health insurance fund (HIF) that identifies high risk patients and includes them in a back pain assessment and a multimodal program cost-effective?

Methods

Case managers of a HIF contacted selected patients and requested information on pain and current perspectives. Patients in the intervention group were offered a multimodal assessment and, if applicable, a multimodal treatment program. Control group patients received verbal or written (back book) information. Cost data were evaluated with respect to the interview data 1 year prior and 1 year afterwards.

Findings

Of the 800 insured persons contacted 621 were nationwide, 88 were regional controls and 91 were intervention patients. Inability to work was still rising in all groups but less in the intervention group versus both control groups. Drugs, hospital as well as cure/adjuvant costs were less for intervention patients than in both control groups. The investment for the program was thus more than refinanced.

Interpretation

Case management was well accepted but the intervention was in need of training for case managers and the specific diagnostic and treatment option regionally.

Funding

The HIF was responsible for the study investment and project partners shared the training of the HIF regional case managers.     

Langzeitbetreuung junger Erwachsener nach Krebserkrankung im Kindesalter – Wohin führt der Weg?

METHODS: Between January 1990 and November 2006, 65 consecutive childhood cancer survivors entered a prospective follow-up study to evaluate the frequency and severity of tumor- and/or therapy-related long-term sequelae. Their median age at diagnosis was 9.7 years, median actual age is 25.1 years, and median duration of follow-up is 14.8 years. RESULTS: Nine patients (13.9%) were completely free from late effects, whereas 31/65 patients (47.6%) had only minimal late effects without need of medical support and 25/65 patients (38.5%) had severe late effects requiring long-term medical care. The most frequent late effects were endocrine deficits, musculosceletal problems, neurologic problems, chronic hepatitis and hearing loss. Currently, a network of local adult care providers is being established in order to enable a smooth and competent referral from pediatric hemato-oncology to adult medicine. CONCLUSIONS: Two thirds of former childhood cancer patients are able to return to everyday life without any impairment. However, one third is suffering from considerable morbidity requiring long-term medical care. Transition models from pediatric hemato-oncology to adult health care providers are urgently needed.     

Das Verhalten der Kalium- und Natriumkonzentrationen im Herzmuskel der Katze nach Aconitin und Digitoxin sowie bei „Strophanthinüberempfindlichkeit“

Research in Experimental Medicine - Nach Aconitingabe kommt es an Katzenherzen zu einem intracellulären Anstieg der Kalium- und Natriumkonzentration. Auch nach einer nicht toxischen...     

Leitlinie ?Diagnostik und Therapie des Morbus Crohn“ – Kurzfassung für Internisten und Haus?rzte

Zusammenfassung   Die Leitlinie „Diagnostik und Therapie des Morbus Crohn“ ist das Ergebnis einer evidenzbasierten Konsensuskonferenz, die von der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten zusammen mit dem Kompetenznetz Chronisch entzündliche Darmerkrankungen ausgerichtet wurde. Hier sollen die für die praktische Arbeit von Internisten und Haus?rzten wesentlichen Empfehlungen zusammengetragen werden. W?hrend die initiale Diagnostik wegen der apparativen Untersuchungen die Zusammenarbeit mit einem endoskopierenden Kollegen erfordert, kann der unkomplizierte Schub in der haus?rzlichen Praxis zumeist mit Steroiden erfolgreich behandelt werden. Für die Langzeittherapie sind Steroide aber ungeeignet. Hier sollte rechtzeitig eine Therapie mit Immunsuppressiva in Zusammenarbeit mit einem Gastroenterologen erfolgen. Bei notwendigen Operationen, der Therapie von Fisteln, psychosomatischen Aspekten und extraintestinalen Manifestationen ist die Zusammenarbeit mit Fach?rzten verschiedener anderer Disziplinen notwendig.