Real-Time Sonoelastography of Salivary Glands for Diagnosis and Functional Assessment of Primary Sjögren’s Syndrome

The purpose of this study was to investigate the value of real-time sonoelastography (RTS) of salivary glands for the diagnosis and assessment of glandular damage in primary Sjögren’s syndrome (pSS). After institutional review board approval, 45 pSS patients, 24 sicca patients and 11 healthy controls were investigated prospectively. Questionnaires were completed and Saxon and Schirmer tests and routine blood tests carried out in all patients. All patients underwent B-mode ultrasonography and RTS of parotid and submandibular glands. Abnormal findings were graded from 0 to 48 and from 0 to 16, respectively. Sialoscintigraphy was done according to a routine protocol; scoring ranged from 0 to 12. Statistical analysis comprised receiver operating characteristic curve and multivariate regression analysis. Patients with pSS had higher B-mode (median score = 25 [range: 2–44] vs. 9 [1–20], p < 0.001) and RTS (6.5 [2–13] versus 4 [1–9], p < 0.001) scores than controls with sicca syndrome, yielding areas under the curve of 0.83 and 0.85 (p < 0.05 each), respectively for pSS diagnosis. In cases with an inconclusive B-mode ultrasonography result, RTS (cutoff score: ≥6) led to a sensitive (66.7%) and specific (85.7%) classification of patients and sicca controls. In multivariate regression analysis, RTS (regression coefficient = –0.48, p = 0.005), but not B-mode ultrasonography, reflected impaired salivary gland function according to the Saxon test, whereas none of the subjective measures of dryness or discomfort were related to ultrasonography results. B-mode and RTS results were both associated with sialoscintigraphy scores (regression coefficient = 0.66, p < 0.001, and regression coefficient = 0.55, p = 0.001, respectively). Reproducibility of B-mode ultrasonography and RTS was good, with intra-class correlation coefficients of 0.93 (95% confidence interval: 0.57–0.98) and 0.93 (95% confidence interval: 0.79–0.98), respectively. In summary, RTS might be a useful adjunct to B-mode ultrasonography for diagnosis and assessment of salivary gland impairment in primary Sjögren’s syndrome.     

Rolle der Diabetesberatung im digitalen Zeitalter

Digitization has long since taken hold in the diabetes sector. Digital support including pumps, rtCGM (CGM: continuous glucose monitoring, rtCGM: real time CGM), iscCGM (intermittent scanning CGM), apps as well as measuring devices with pattern recognition and a reminder function has become commonplace in many areas. Training to become a diabetes advisor provides diabetes professionals with appropriate basic knowledge to advise the patient in self-management with technical support. Continuous medical training to empower and support patients in health literacy, data protection and the use of telemedicine is imperative.     

Research on the Release of Dangerous Compounds from the BTEX and PAHs Groups in Industrial Casting Conditions

The assessment of the harmfulness of moulding and core sands is mainly based on investigations of compositions of gases emitted by liquid casting alloys during the mould pouring. The results of investigations of moulding sands obtained under industrial conditions are presented in this paper. A unique research stand was designed and built for this aim. It allowed us to determine emissions of gases at individual stages of casting a mass up to 50 kg. This approach enables simulation of foundry conditions. Moulding sands bound by organic binders (phenol-formaldehyde; furan), inorganic binders and green sand, were subjected to investigations. The composition of gases that evolved during the individual stages, pouring, cooling and knocking out, was tested each time, and the contents of Polycyclic Aromatic Hydrocarbons (PAHs) and benzene, toluene, ethylbenzene, and xylenes (BETX) were analysed. Investigations indicated that the emission of gases from sands with inorganic binders is negligible when compared with the emission of gases from sands with organic binders. The emission of gases from green sand is placed in the middle of the scale. As an example: the sand with furan resin emitted 84 mg of BTEX (in recalculation for 1 kg of sand) while from sands with inorganic binders there was a maximum of 2.2 mg (for 1 kg of sand). In the case of sands with inorganic binders, MI and MC sands indicated comparable and very low emissions of gases from the PAHs group, at the level of 0.018 mg and 0.019 mg for 1 kg of sand, respectively. The higher emission of PAHs from MG sand is the result of its different way of hardening (a binder was of an organic character) than of sands MI and MC.     

Spontaneous Coronary Artery Dissection in a Young Man with a Factor V Leiden Gene Mutation: A Case Report and Review of the Literature

Spontaneous coronary artery dissection is a rare but increasingly recognized cause of acute myocardial ischemia in young adults, especially in women. We report a case of spontaneous coronary dissection in a young healthy man who was also a carrier of the factor V Leiden gene mutation.