HELIOSPHERIC ENERGETIC NEUTRAL HYDROGEN MEASURED WITH ASPERA-3 AND ASPERA-4

We re-analyze the signal of non-planetary energetic neutral atoms (ENAs) in the 0.4-5.0 keV range measured with the Neutral Particle Detector (NPD) of the ASPERA-3 and ASPERA-4 experiments on board the Mars and Venus Express satellites. Due to improved knowledge of sensor characteristics and exclusion of data sets affected by instrument effects, the typical intensity of the ENA signal obtained by ASPERA-3 is an order of magnitude lower than in earlier reports. The ENA intensities measured with ASPERA-3 and ASPERA-4 now agree with each other. In the present analysis, we also correct the ENA signal for Compton-Getting and for ionization loss processes under the assumption of a heliospheric origin. We find spectral shapes and intensities consistent with those measured by the Interstellar Boundary Explorer (IBEX). The principal advantage of ASPERA with respect to the IBEX sensors is the two times better spectral resolution. In this study, we discuss the physical significance of the spectral shapes and their potential variation across the sky. At present, these observations are the only independent test of the heliospheric ENA signal measured with IBEX in this energy range. The ASPERA measurements also allow us to check for a temporal variation of the heliospheric signal as they were obtained between 2003 and 2007, whereas IBEX has been operational since the end of 2008.

Increased bone mineral density at the hypoxia prone site of the juxta-articular metacarpal bone in patients with limited systemic sclerosis: a cross-sectional study

OBJECTIVES Low levels of oxygen has been shown to be involved in the induction of osteogenesis, particularly in bone repair. It is unknown whether hypoxia leads to osteogenesis at the hypoxia prone skeletal sites in limited systemic sclerosis. This study determined the total and trabecular volumetric bone mineral density (vBMD) at the hypoxia prone site of the juxta-articular metacarpal bone. METHODS In this cross-sectional study, female patients with limited systemic sclerosis were included and compared to healthy controls. Peripheral quantitative computed tomography was used to measure cross-sectional area, total vBMD, and trabecular vBMD at the radius, the tibia and the third metacarpal bone. Disease severity was assessed by the modified Rodnan Skin Score. RESULTS Twenty consecutive patients were included in the sclerosis group and 20 in the control group. Mean age was 60 years (range 52-68 years), and mean disease duration was 45 months (range 4-156 months). Age, height, and weight were comparable between the groups. The mean modified Rodnan Skin Score was 1.78 (range 0 to 8). The sclerosis group showed both higher total and trabecular vBMD at the distal metacarpal bone (p=0.05 and 0.04, respectively). vBMD of the tibia and radius did not differ in both groups. CONCLUSIONS vBMD at the juxta-articular metacarpal bone in patients with limited systemic sclerosis is increased, possibly due to an alteration in local bone metabolism and hypoxia induced local osteogenesis.

Primum et super omnium: nihil nocere Operationsindikation im Wandel bei Divertikulitis

Diverticulitis is a common disease in western countries and its incidence is increasing especially among young patients. Colonic diverticulosis, incidentally diagnosed by endoscopy or CT-scanning, has no immediate clinical consequences. Progression to diverticulitis develops in only 4 % of cases. In the last decades management of diverticular disease evolved and expectative treatment and less invasive techniques have gained importance. Elective resection has traditionally been advised after a second episode of diverticulitis or after a first episode if the patient was less than 50 years of age or complicated disease occurred. Recent changes in understanding the natural history of diverticular disease have substantially modified treatment paradigms. Elective resection in case of recurrent diverticular disease should be performed on a individual basis and in cases with complications like intestinal obstruction or fistulas. Primary anastomosis is an option even in emergency surgery due to colonic perforation, while diverting operations are indicated for selected patient groups with a high risk profile. Several prospective studies showed good results for laparoscopic drainage and lavage in the setting of perforated diverticulitis with generalized peritonitis, though this concept needs to be controlled with randomized clinical trials before application into the daily practice. This article should provide a short overview of trends in the surgical treatment of diverticulitis, help to understand the natural history of the disease and thereby explain the currently lower frequency of surgical interventions for diverticulitis.