Das Kompressionssyndrom des Nervus ulnaris in der Ellenbogenregion:befundabhängiges Therapiekonzept und Erstbeschreibung einer subperiostalen Neosulcusplastik

Hintergrund: Seit den 1960er Jahre werden die Ergebnisse der anterioren Transposition bzw. der einfachen Dekompression verglichen und diskutiert. Methode: Ein befundorientiertes Konzept wurde bei 173 Patienten nach 6 Jahre ausgewertet: Transposition bei Cubitus valgus, gezielte Dekompression durch Ausschließen oder Beheben von 12 moeglichen Kompressionsursachen. Im Falle der Nervenluxation wurde die Indikation und die Methode der Subperiostalen Neosulcusplastik (SNP) erstmalig beschrieben und in einer Fall-Kontroll Studie ausgewertet. Ergebnisse: 91% zufriedene Patienten. Komplikationen waren selten. Die Ergebnisse der SNP waren in 90% gut, bei der Kontrollgruppe waren es 38% (10 Patienten mit SNP, 8 Kontrolle). Risikogruppen wurden definiert. Fazit: die befundorientierte Methode zeigt im Langzeitverlauf ueberdurchschnittlich gute Ergebnisse. Die 12 Kompressionsursachen sollten jedem Operateur gelaeufig sein. Die SNP sollte im Rahmen prospektiver Studien weiter ausgewertet werden. Background: Since the 1960s the results of the anterior transposition or the simple decompression are compared and discussed. Method: A findings-oriented concept was evaluated with 173 patients with 6 years follow-up: A anterior transposition in cubitus valgus cases, specific decompression by excluding the 12 possible compression causes. For cases of nervous dislocation the indication and the method of the Subperiostal Neosulcusplasty (SNP) was for the first time described and evaluated in a case-control-study. Results: 91% were good. Complications were rare. In the SNP-group (10 Patients) the results were good in 90%, in the control group (8 Patients) there were 38%. High-Risk Patients were defined. Conclusion: The findings-oriented concept shows after 6 years Follow-up exceptionally good results. The 12 compression causes should be familiar to every surgeon. The SNP should be evaluated further within prospective studies

Myélome multiple survenant au cours d’une Fièvre Méditerranéenne Familiale

L'objectif de ce travail est de rapporter une observation particulière de myélome multiple survenant au cours d'une maladie périodique. Il s'agit d'un patient tunisien de 53 ans suivi depuis le jeune âge pour maladie périodique dont le diagnostic était confirmé par l'étude génétique montrant l'homozygotie pour la mutation M694V du gène MEFV, fut admis pour exploration d'une douleur avec tuméfaction fessière droite récente. Les explorations biologiques et radiologiques ont permis de retenir le diagnostic d'un myélome multiple de type IgA à chaînes légères kappa stade III B, associé à une volumineuse localisation plasmocytaire très agressive de l'aile iliaque droite envahissant les structures musculaires avoisinantes. Notre observation, qui à notre connaissance est la deuxième signalant une telle association, se distingue par sa survenue brutale, sa progression rapide et le caractère très agressif de l'hémopathie.Key words: Fièvre méditerranéenne familiale, maladie périodique, myélome multiple, plasmocytome, cance

Primary Plasmacytoma of The Testis with no Evidence of Multiple Myeloma: a New Case Report and Literature Review

Plasmacytomas of the testis are extremely rare tumours, especially when occurring in the absence of a previous or concurrent diagnosis of multiple myeloma. We report a new case of solitary testicular plasmacytoma, with immunohistochemical studies showing monoclonal cytoplasmic production of IgG lambda light chains, in a 51-year-old man who had no evidence of multiple myeloma 3 years after the orchiectomy.Key Words: Testis, plasmacytoma, multiple myelom

Exceptional cause of bowel obstruction: rectal endometriosis mimicking carcinoma of Rectum - A case report

Endometriosis with intestinal serosal involvement is not uncommon in women of childbearing age. However, endometriosis presenting as colon obstruction is rare and occurs in less than 1% of cases. The Lack of pathognomonic signs makes the diagnosis difficult, mostly because the main differential diagnosis is with neoplasm, even during the intervention. Reported here is a case of a 35-year –old woman presenting with bowel obstruction due to rectal endometriosis. The patient presented signs and symptoms of bowel obstruction. Colonoscopy and radiological findings were suggestive of rectal carcinoma. Surgeons performed an anterior resection with right salpingectomy. Histopathology diagnosed bowel endometriosis. This case demonstrates the difficulty of establishing an accurate pre- and intra-operative diagnosis and the ability of intestinal endometriosis to mimic colon cancer

Iatrogenic colorectal Kaposi sarcoma complicating a refractory ulcerative colitis in a human immunodeficiency negative-virus patient

Kaposi sarcoma is a mesenchymal tumor associated to a human herpes virus-8. It often occurs in human immunodeficiency virus-positive subjects. Colorectal localization is rare. We report the case of a colorectal Kaposi sarcoma complicating a refractory ulcerative colitis treated with surgery after the failure of immunomodulator therapy in a human immunodeficiency virus-negative heterosexual man.Key words: Kaposi’s Sarcoma, ulcerative colitis, Human Herpes Virus-8, Infliximab, immunosuppressio

Effects of moderate- vs. high-intensity interval training on physical fitness, enjoyment, and affective valence in overweight/obese female adolescents: a pre-/post-test study

OBJECTIVE The aim of this study was to compare the effects of 12-week moderate-intensity interval training (MIIT) vs. high-intensity interval training (HIIT) on body composition, physical fitness, and psychological valence in overweight/obese (OW/OB) female adolescents. PATIENTS AND METHODS Thirty-eight OW/OB female students were randomized into HIIT (n=13), MIIT (n=13) or control (n=12) groups. The participants underwent a 12-week interval-training program at 100% to 110% and 60% to 75% of maximal aerobic speed for HIIT and MIIT, respectively. The control group kept their usual physical activity without completing the training program. Pre- and post-training measurements were performed to assess body composition, aerobic capacity, and anaerobic performance (using selected tests evaluating speed, jumping ability, and strength). Ratings of perceived exertion and the feeling scale were evaluated every three weeks. Enjoyment was measured at the end of the program. A two-way analysis of variance with repeated measurements was applied to test for "group×time" interactions for body composition, physical fitness, and affective variables. RESULTS Significant "group×time" interactions were detected for aerobic and anaerobic performance, body composition indices, and the feeling scale. HIIT resulted in more noticeable improvements in body composition and physical performance than MIIT, while no significant changes were found in the control group. Throughout the program, the feeling score has progressively increased in the MIIT group but decreased in the HIIT group. Ratings of the perceived exertion have increased in both groups, more noticeably in the HIIT group. At the end of the program, the MIIT group showed a higher enjoyment score. CONCLUSIONS Despite offering better body composition improvement and physical fitness enhancement, HIIT offered lesser enjoyment and affective valence than MIIT in OW/OB female adolescents. MIIT might be an alternative time-efficient protocol for improving health in this population

The feasibility of an exercise intervention in males at risk of oesophageal adenocarcinoma: a randomized controlled trial

Objective: To investigate the feasibility and safety of a 24-week exercise intervention, compared to control, in males with Barrett's oesophagus, and to estimate the effect of the intervention, compared to control, on risk factors associated with oesophageal adenocarcinoma development. Methods: A randomized controlled trial of an exercise intervention (60 minutes moderate-intensity aerobic and resistance exercise five days/week over 24 weeks; one supervised and four unsupervised sessions) versus attention control (45 minutes stretching five days/week over 24 weeks; one supervised and four unsupervised sessions) in inactive, overweight/obese (25.0-34.9 kg/m2) males with Barrett's oesophagus, aged 18-70 years. Primary outcomes were obesity-associated hormones relevant to oesophageal adenocarcinoma risk (circulating concentrations of leptin, adiponectin, interleukin-6, tumour necrosis factor-alpha, C-reactive protein, and insulin resistance HOMA). Secondary outcomes included waist circumference, body composition, fitness, strength and gastro-oesophageal reflux symptoms. Outcomes were measured at baseline and 24-weeks. Intervention effects were analysed using generalised linear models, adjusting for baseline value. Results: Recruitment was difficult in this population with a total of 33 participants recruited (target sample size: n = 80); 97% retention at 24-weeks. Adherence to the exercise protocol was moderate. No serious adverse events were reported. A statistically significant intervention effect (exercise minus control) was observed for waist circumference (-4.5 95%CI -7.5, -1.4 cm; p < 0.01). Effects on primary outcomes were not statistically significant. Conclusion: This small, exploratory trial provides important information to inform future trial development including recruitment rates and estimates of effect sizes on outcomes related to oesophageal adenocarcinoma risk. Future trials should investigate a combined dietary and exercise intervention to achieve greater weight loss in this population and relax inclusion criteria to maximize recruitment. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12609000401257. © 2015 Winzer et al

In middle-aged and old obese patients, training intervention reduces leptin level: A meta-analysis

BACKGROUND: Leptin is one of the major adipokines in obesity that indicates the severity of fat accumulation. It is also an important etiological factor of consequent cardiometabolic and autoimmune disorders. Aging has been demonstrated to aggravate obesity and to induce leptin resistance and hyperleptinemia. Hyperleptinemia, on the other hand, may promote the development of age-related abnormalities. While major weight loss has been demonstrated to ameliorate hyperleptinemia, obese people show a poor tendency to achieve lasting success in this field. The question arises whether training intervention per se is able to reduce the level of this adipokine. OBJECTIVES: We aimed to review the literature on the effects of training intervention on peripheral leptin level in obesity during aging, in order to evaluate the independent efficacy of this method. In the studies that were included in our analysis, changes of adiponectin levels (when present) were also evaluated. DATA SOURCES: 3481 records were identified through searching of PubMed, Embase and Cochrane Library Database. Altogether 19 articles were suitable for analyses. STUDY ELIGIBILITY CRITERIA: Empirical research papers were eligible provided that they reported data of middle-aged or older (above 45 years of age) overweight or obese (body mass index above 25) individuals and included physical training intervention or at least fitness status of groups together with corresponding blood leptin values. STATISTICAL METHODS: We used random effect models in each of the meta-analyses calculating with the DerSimonian and Laird weighting methods. I-squared indicator and Q test were performed to assess heterogeneity. To assess publication bias Egger's test was applied. In case of significant publication bias, the Duval and Tweedie's trim and fill algorithm was used. RESULTS: Training intervention leads to a decrease in leptin level of middle-aged or older, overweight or obese male and female groups, even without major weight loss, indicated by unchanged serum adiponectin levels. Resistance training appears to be more efficient in reducing blood leptin level than aerobic training alone. CONCLUSIONS: Physical training, especially resistance training successfully reduces hyperleptinemia even without diet or major weight loss