[The effect of stress-relieving interventions on inflammatory bowel disease: quality assessment of 10 therapeutic studies]

Patient comments and empirical studies suggest an influence of stress on inflammatory bowel diseases (IBD). We performed a quality assessment of previous studies on the effect of stress reduction on IBD in order to formulate recommendations for future studies and to evaluate their potential for improvement.

[Characteristics of patients suffering from chronic pain with depressive symptoms in three different treatment settings]

Only few studies considered demographic and medical characteristics of pain patients with depressive symptoms.

Heart rate variability and biomarkers of systemic inflammation in patients with stable coronary heart disease: findings from the Heart and Soul Study

Chronic low-grade systemic inflammation is a key component in atherogenesis. Decreased heart rate variability (HRV), a strong predictor of cardiovascular events, has been associated with elevations in circulating levels of C-reactive protein (CRP), interleukin (IL)-6, and fibrinogen in apparently healthy individuals. We investigated whether decreased HRV is associated with inflammatory markers in patients with coronary heart disease (CHD).

[Chronic right-sided pain-associated nondermatomal somatosensory deficit following an accident]

We present the case of a 48-year old man who, eight years after an industrial accident, presents with chronic right-sided nondermatomal pain and hypaesthesia to heat and touch. During symmetric peripheral touch functional magnetic resonance imaging revealed hypometabolism in the left thalamus, somatosensory cortex, and anterior cingulate cortex. Pain-associated nondermatomal somatosensory deficits (NDSDs) localizing to one side of the body are a frequent clinical entity, which are often triggered by an accident. The tendency of NDSDs to extend to adjunct ipsilateral body parts and to become chronic points to maladaptive adjustment of pain-processing areas in the central nervous system. Psychological stress prior to or around the triggering event seems an important risk factor for NDSDs.

Multimodal therapy of functional gastrointestinal disorders

A multimodal approach is state-of-the art for effective treatment of functional gastrointestinal disorders (FGD) like irritable bowel syndrome and functional dyspepsia. Based on the now established view that the pathogenesis of FGD is multicausal, evidence-based therapeutic options comprise education about the nature of the disorder, dietary modifications, relaxation techniques, behavioral changes, and pharmacological treatments. These therapies are variously combined depending on the severity of the FGD and the individual needs of the patient. Our overview portrays the options for the therapy of FGD and proposes that these are best provided by an interdisciplinary team of primary care physicians, gastroenterologists, and psychosomatic medicine specialists.

[Pathogenesis of functional gastrointestinal disorders - an interdisciplinary perspective]

Functional gastrointestinal disorders (FGD) are highly prevalent worldwide. Recent research demonstrates that complex and interacting biological and behavioral mechanisms contribute particularly to the pathogenesis of irritable bowel syndrome and functional dyspepsia. Dysregulation of the enteral, neuroenteric, visceral-autonomic, and central nervous systems are important biological contributors, whereas the psychological state of a patient may evidently modulate aspects related to biological stress reactivity and somatic perception both playing a role in the clinical manifestation of FGD. Our overview clearly shows that an interdisciplinary perspective of the pathogenesis of FGD may best serve clinicians and patients.

[Spontaneous dural arterio-venous fistula at the cavernous sinus: detected by decompensation following endoscopic sinus surgery]

Spontaneous dural arterio-venous fistulas can imperceptibly develop over a long time period before they suddenly develop symptoms like bruit, loss of vision, exophthalmos and conjunctival injection. We present the rare case of an occult, para-infectious, dural arterio-venous fistula which became symptomatic after endoscopic sinus surgery. Conjunctival injection and slight exophthalmos developed due to decompensation of venous drainage probably by intraoperative positioning of the patient, positive pressure ventilation and nasal packing.

Polizeigeschosse und ihre Deformation

In den Jahren 2001 bis 2007 ist bei den Polizeien der deutschen Bundesländer und bei den Polizeikorps der Schweiz die so genannte Polizeimunition eingeführt worden. Von dieser mit einem deformierenden Geschoss ausgerüsteten Munition verspricht man sich eine größere Wirksamkeit und wegen der begrenzten Durchschlagsleistung eine geringere Gefährdung unbeteiligter Personen. Bei geringerer Auftreffenergie deformiert sich jedoch das Geschoss weniger, die Wirksamkeit wird kleiner und die Eindringtiefe größer. In der hier vorgestellten Arbeit wurde die Abhängigkeit der Deformation und der Eindringtiefe in ballistische Seife von der Auftreffenergie für alle 4 gegenwärtig vorhandenen Polizeigeschosse untersucht. Bereits bei Schussdistanzen von 25–30 m ist mit einer verminderten Wirksamkeit zu rechnen. Bei einer viel gebrauchten Waffe kann zudem die Mündungsenergie so stark reduziert sein, dass sich bereits bei kurzen Schussdistanzen die Geschosse nicht mehr erwartungsgemäß deformieren.

Longitudinal analysis of quality of life in patients receiving conformal radiation therapy for prostate cancer

To prospectively assess quality of life (QoL) in patients receiving conformal radiation therapy (CRT) for prostate cancer.

[Which clinical symptoms suggest distinct autoantibody measurements?]

The detection of autoantibodies is an important cornerstone in the diagnosis of systemic autoimmune disorders such as autoimmune connectivitides and small vessel vasculitides. Antinuclear antibodies (ANAs ) and antineutrophil cytoplasmic antibodies (c+p-ANCAs) are appropriate diagnostic screening tools for autoimmune connectivitides and small vessel vasculitides. For economic and intellectual/didactic reasons more extensive autoantibody diagnostics should be performed only in particular situations when patients history and clinical exam lead to strong diagnostic suspicion.