Value of exercise capacity and physical activity in the prevention of cardiovascular diseases—brief review of the current literature

A low level of physical activity and decreased exercise capacity are independent risk factors for cardiovascular and all-cause mortality. The assessment of the level of physical activity and its improvement following preventive procedures is methodologically difficult. In population studies, subjective methods, such as questionnaires, activity records and other somewhat imperfect measures (accelerometers, pedometers, and pulse monitors), are used. Direct and especially indirect assessment of physical capacity with exercise tests has become increasingly more accessible and cheap. Both methods have been proved to have high prognostic value. Assessment of physical capacity enables objectification of information on the level and effects of a subjects physical activity acquired via a questionnaire. Taking into account the above-mentioned issues, the role of the assessment of exercise capacity and its improvement is not adequately appreciated. Routine evaluation of exercise capacity has not been included in the current statements on epidemiology and prevention, even in those with an increased Framingham or SCORE risk index in whom low exercise tolerance has been proved to have an unfavorable influence on prognosis. The importance of an increase in the level of physical activity resulting in an improvement in exercise capacity in different population groups should be verified in the near future, but in our opinion there is indirect but strong evidence that actions to improve exercise capacity should become the main goals in the prevention of cardiovascular and all-cause mortality, such as cessation of cigarette smoking, body weight reduction, correction of lipid and carbohydrate metabolism disturbances, and a decrease in blood pressure.     

Evaluation of a profilometrical method for monitoring erosive tooth wear

The in vivo monitoring of erosive wear is difficult because lesions mostly progress relatively slowly and reliable reference points are difficult to obtain. To date, only a few methods for clinical monitoring of erosive loss have been described, which either require extensive equipment or do not provide sufficient sensitivity. The aim of the present study was to evaluate, using study models (epoxy resin material), a procedure that permits the reliable and accurate monitoring of erosive substance loss within acceptable observation periods. The method is the profilometric measurement of erosive tissue loss using acid-resistant markers, which represent both a reference area and a structure for the defined retracing of a given erosive lesion surface. The study model magnified values slightly (2.8%; not significant), the precision was < 4 microm, and the repeatability was good (95% limits of repeatability ranging from -4.7 to 5.2 microm). The estimated detection threshold for erosive loss is 15 microm, which appears to be adequate for monitoring. The method is indicated for special dental care in cases of severe dental erosion (e.g. eating disorders) and for clinical studies.     

Diagnostik und Therapie der Insektengiftallergie

The increasing incidence and the potentially life-threatening reactions to venom stings indicate the necessity for otolaryngologists to have a basic knowledge of the diagnosis and treatment of venom allergy. The diagnosis of insect venom allergy is based on the history, skin prick testing (ideally performed as a titration series), and in vitro analysis of specific IgE antibodies to venoms. An emergency medication kit should be prescribed for the patient in case of future venom stings, comprising an H1-blocking antihistamine, a steroid and an adrenaline pen for self-injection. Subcutaneous allergen-specific immunotherapy (sSIT) is the standard treatment to avoid allergic reactions following venom stings in the future. SIT is indicated following all immediate-type reactions to venom stings; contraindications relate to the general recommendations of allergen-specific immunotherapy. Aqueous as well as alum-adsorbed depot allergen preparations can be used for subcutaneous injections. The important dose-increase phase can be performed using conventional, cluster, rush or ultra-rush schedules. Specific immunotherapy is successful in nearly 90% to 100% of patients after 3-5 years of treatment.     

Testicular microlithiasis: an unreported feature of McCune-Albright syndrome in males

OBJECTIVE: To ascertain the incidence of testicular microlithiasis (TM) in boys with McCune-Albright syndrome (MAS). STUDY DESIGN: Study population consisted of 8 boys with MAS whose medical records were reviewed with emphasis on their past genitourinary histories. All of the boys underwent a clinical and ultrasonographic (US) scanning of the scrotal and inguinal regions. US results in boys with MAS were compared with those obtained in two control populations consisting of 20 healthy subjects and 12 boys with idiopathic and untreated central precocious puberty (CPP). RESULTS: Clinical examination revealed urological abnormalities in no patients, whereas US showed a typical picture of TM in 5 of 8 boys. TM was observed in none of the subjects belonging to control populations (v=15.2 and 11.3, respectively; P <.001). CONCLUSIONS: In a series of 8 boys with MAS we demonstrated a high prevalence (62%) of TM that was associated with neither malignant nor nonmalignant conditions. This finding is unlikely to be only occasional, considering the very low prevalence of TM reported until now in healthy children and young adults and in our results in control populations. TM may be another marker for MAS.     

Use of optical coherence tomography in myopia

PURPOSE: To measure retinal thickness and retinal nerve fiber layer thickness using optical coherence tomography in patients with myopia. PATIENTS AND METHODS: Thirty patients (13 girls and 17 boys) 14 to 18 years old were included in the study. The control group consisted of 15 patients. Each patient was subjected to routine ophthalmic investigations, which included the assessment of visual acuity for near and distant objects, autorefractometry, measurement of intraocular pressure, biometry, and assessment of the static visual field. The foveal retinal thickness and the peripapillary nerve fiber layer thickness were measured using optical coherence tomography. RESULTS: The mean foveal retinal thickness was 231.0 microm in eyes with low myopia, 218.0 microm in eyes with medium myopia, and 178.0 microm in eyes with high myopia. The mean thickness of the retinal nerve fiber layer was 150.0 microm, 140.0 microm, and 152.0 microm, respectively. Statistically significant differences were revealed between patients with high myopia and the control group. CONCLUSION: Optical coherence tomography can be employed to assess the retinal thickness and thus facilitate the detection of the evolution of alterations in myopia.     

Typ-I-Allergie gegen Schwimmkanüle beim Laryngektomierten

While irritation of the tracheal mucosa is a common finding after laryngectomy, specific hypersensitivity to tracheal tubes or their components is extremely rare and has only been documented as a contact allergy. In this case report, we present type I hypersensitivity to tracheal tube components for the first time. The patient regularly used a special silicone tube for swimming after laryngectomy and complained about increasing tracheal irritation during and after the use of this tube. A standard skin prick test with common aeroallergens and a skin patch test with standard, rubber and adhesive allergens as well as with parts of the silicone tube was performed. Different parts of the tracheal tube were also tested with a scratch test. Total IgE as well as specific IgE for latex allergens was measured. Both skin prick and patch tests were negative. No specific IgE for latex allergens was detected. The scratch test generated strongly positive reactions against native tube material. The positive findings in the skin tests demonstrate specific hypersensitivity to the tracheal tube or its components in terms of a type I hypersensitivity. The causative component remains unclear.     

Coexistence of Addison-Biermer's anaemia with endocrine glands' dysfunctions

Addison-Biermer's anaemia is an autoimmune disease. It may coexist with other auto-aggressive diseases, precede them or join the other existing autoimmune diseases. It most often accompanies the Hashimoto disease but also may coexist polyglandular autoimmune syndrome (PGA). Three types of PGA are distinguished: PGA1--Blizzard's Syndrome, PGA2--Schmidt's Syndrome, and PGA3. The latter, unlike the remaining ones, is characterized by normal function of adrenal glands. Addison-Biermer's anaemia occurrence may be often difficult to diagnose as coexisting illnesses might ouflage its clinical symptoms. The aim of this paper was to analyse patients with different types of PGA with coexisting Addison-Biermer's anaemia. Group of 24 individuals was analysed: 2 women with PGA1, 10 patients with PGA2, 10 patients with PGA3. In 2 remaining ones PGA was not confirmed. Addison-Biermer's anaemia occurred in 7 patients (2 with PGA2 and 5 with PGA3 syndrome). Decreased concentration of vitamin B12 was diagnosed in 3 individuals among 24 examined patients (1 with type 3 and 2 with type 2), as well in 2 patients with unconfirmed PGA. Addison-Biermer's anaemia was not observed in patients with PGA1. We observed that megaloblastic anaemia occurred characteristic schedule depending on appearance of autoimmune diseases: in PGA2--many years after other immunopathies were found, in PGA3--as first auto-aggressive disease. Our analysis suggests the necessity of detailed check-ups on patients with Addison-Biermer's anaemia, as with time they may develop other diseases, especially hypothyroidism and/or PGA failure. On the contrary, in individuals with thyroid gland diseases and PGA syndromes further checkups should be megaloblastic anaemia-sensitive. In both cases it is important to consider substitutive treatment. The possibility of family coexisting both pernicious anaemia and autoimmune endocrinopathies needs diagnostics of members of the patient's family.