Roentgenological signs in the skeleton of uremic children

The roentgenological signs encountered in the skeleton of uremic children, some treated by hemodialysis and others untreated, are described and related to histological studies. There is a discrepancy in behaviour between cortical and cancellous bone. Under the influence of parathormone cortical bone is eroded from the periosteal, endosteal and Haversian system surfaces. In contrast, cancellous bone is dense (osteosclerosis). The epiphyseal growth plate is narrow in end-stage renal failure; the histological equivalent of the radiolucent area in the growing zone is primary spongiosa consisting of undermineralised woven bone devoid of chondroid.     

Plantare Fasziitis und Strahlentherapie

Zusammenfassung Patienten mit plantarer Fasziitis und refraktären Schmerzen werden beim Versagen anderer Therapieformen einer niedrig dosierten Radiotherapie (RT) zugeführt. Für diese fehlten bisher entsprechende evidenzbasierte und strahlenbiologische Untersuchungen. 2001 wurde deshalb von der German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD) eine deutschlandweite Patterns-of-care-Studie mittels standardisiertem Fragebogen durchgeführt. Insgesamt 136 Einrichtungen behandelten 3621 Patienten/Jahr mit chronischen oder therapierefraktären Schmerzen. Die mediane Gesamtbestrahlungsdosis betrug 6 Gy (mediane Einzeldosis: 1 Gy). 76 Institutionen berichteten Daten ihrer klinischen Evaluation von insgesamt 7947 Patienten. Eine Schmerzbesserung für mindestens 3 Monate wurde in 70%, eine anhaltende Schmerzbesserung in 65% berichtet. Radiogene akute oder chronische Nebenwirkungen traten nicht auf. Die strahlenbiologischen Untersuchungen zeigten einen signifikanten Anstieg der Granulozytenfunktion bei 1,5 Gy und einen signifikanten Abfall bei 3,5 und 4,0 Gy. Dies könnte den lokal entzündungshemmenden Effekt niedrig dosierter Strahlentherapie erklären. Sie bietet beim schmerzhaften therapierefraktären Fersenbeinsporn eine ausgezeichnete Alternative für Patienten mit Kontraindikationen gegen eine Langzeitbehandlung mit Steroiden oder NSAID.     

Could flies explain the elusive epidemiology of campylobacteriosis?

Background  

Unlike salmonellosis with well-known routes of transmission, the epidemiology of campylobacteriosis is still largely unclear. Known risk factors such as ingestion of contaminated food and water, direct contact with infected animals and outdoor swimming could at most only explain half the recorded cases.     

Symptome,Risikofaktoren und Ätiologie von transitorisch ischämischer Attacke und Schlaganfall

BACKGROUND: It is unclear whether clinical signs and symptoms differ in the presentation of transient ischemic attack (TIA) and stroke, apart from temporal dynamics. METHODS: Signs and symptoms of patients diagnosed with TIA or stroke were prospectively collected and compared by means of an age-adjusted logistic regression analysis. Risk factors, prehospital medication, and diagnostic workup were obtained from the charts. RESULTS: Four hundred five patients diagnosed with stroke (68+/-12 years old, 45% female) and 143 diagnosed with TIA (64+/-14 years old, 48% female) were included. Signs and symptoms of patients with TIA were less often "classic" such as paresis (48% vs 71%, P<0.001) or sensory loss (38% vs 48%, P=0.03). The etiology of TIA was more often classified as "undetermined" (57% vs 46%, P<0.05). CONCLUSIONS: Transient ischemic attack needs special attention and intensive diagnostic workup, because it bears a considerable risk of death and disability but presents less often with classic signs and symptoms and its etiology often remains undetermined.     

Combined modality treatment for locally advanced non-small cell lung cancer: preoperative chemoradiation does not result in a poorer quality of life

The German Lung Cancer Cooperative Group (GLCCG) is assessing the impact of chemoradiation in addition to chemotherapy in the neoadjuvant treatment of stage III NSCLC. After three cycles of cisplatin/etoposide patients receive either hyperfractionated radiotherapy (RT) with concurrent carboplatin/vindesine and then surgery (arm A) versus surgery and then conventional RT (arm B). Quality of life (QL) was assessed throughout therapy using the EORTC QLQ-C30 and EORTC QLQ-LC 13. Of 126 eligible patients, 54 completed treatment. For patients in both treatment arms physical functioning decreased, whereas dyspnoea, fatigue and pain increased from beginning to the end of treatment. For self-assessed QL no statistically significant effect was found in or between the two treatment arms. The combined modality approach with preoperative radio/chemotherapy proves to be feasible in treating locally advanced NSCLC patients without decreasing their subjective QL.