28-jähriger Patient mit erfolgreich behandelter dilatativer Kardiomyopathie

Zusammenfassung: Ein 28-jähriger Patient wurde mit dekompensierter Herzinsuffizienz notfallmäßig zugewiesen. In der Vorgeschichte bestand ein hypogonadotroper Hypogonadismus. Echokardiographisch fand sich eine dilatative Kardiomyopathie. Ein erhöhtes Serumferritin und eine Eisenüberladung in der Leberbiopsie ließen eine hereditäre Hämochromatose vermuten. Die kardiale Beteiligung konnte mittels Magnetresonanztomographie nachgewiesen werden. Genetische Abklärungen ergaben eine homozygote Mutation für G320V und bewiesen eine juvenile Hämochromatose. Eine Aderlasstherapie führte innerhalb eines Jahres zur Normalisierung des Eisenstatus und der kardialen Pumpfunktio

Measuring Optical Properties On Rough And Liquid Metal Surfaces

For understanding and optimizing laser processing of metals and alloys the optical properties, especially the absorption of the work piece in function of the temperature up to the liquid phase have to be known [1]. There are several approaches to extend the Drude-Model [2] for optical properties of metal to temperature dependence [3, 4, 5]. However, a verification of these models is difficult due to the lack of sufficient experimental data. Even though measuring optical properties with ellipsometry is well established, such measurements on metals and alloys at elevated temperatures up to the liquid state are very challenging. To collect the optical properties of different metals and alloys like Al, Ti, Ag, Cu and steel in the solid and liquid state a custom-made high-temperature ellipsometer was used. The instrument is also used to investigate the influence of curved and rough surfaces which may occur due to the heating of the samples during the ellipsometric measurements

Direct Interactions in Relativistic Statistical Mechanics

Directly interacting particles are considered in the multitime formalism of predictive relativistic mechanics. When the equations of motion leave a phase-space volume invariant, it turns out that the phase average of any first integral, covariantly defined as a flux across a $7n$-dimensional surface, is conserved. The Hamiltonian case is discussed, a class of simple models is exhibited, and a tentative definition of equilibrium is proposed.Comment: Plain Tex file, 26 page

The Swiss Systemic lupus erythematosus Cohort Study (SSCS) - cross-sectional analysis of clinical characteristics and treatments across different medical disciplines in Switzerland.

OBJECTIVES: To describe disease characteristics and treatment modalities in a multidisciplinary cohort of systemic lupus erythematosus (SLE) patients in Switzerland. METHODS: Cross-sectional analysis of 255 patients included in the Swiss SLE Cohort and coming from centres specialised in Clinical Immunology, Internal Medicine, Nephrology and Rheumatology. Clinical data were collected with a standardised form. Disease activity was assessed using the Safety of Estrogens in Lupus Erythematosus National Assessment-SLE Disease Activity Index (SELENA-SLEDAI), an integer physician's global assessment score (PGA) ranging from 0 (inactive) to 3 (very active disease) and the erythrocyte sedimentation rate (ESR). The relationship between SLE treatment and activity was assessed by propensity score methods using a mixed-effect logistic regression with a random effect on the contributing centre. RESULTS: Of the 255 patients, 82% were women and 82% were of European ancestry. The mean age at enrolment was 44.8 years and the median SLE duration was 5.2 years. Patients from Rheumatology had a significantly later disease onset. Renal disease was reported in 44% of patients. PGA showed active disease in 49% of patients, median SLEDAI was 4 and median ESR was 14 millimetre/first hour. Prescription rates of anti-malarial drugs ranged from 3% by nephrologists to 76% by rheumatologists. Patients regularly using anti-malarial drugs had significantly lower SELENA-SLEDAI scores and ESR values. CONCLUSION: In our cohort, patients in Rheumatology had a significantly later SLE onset than those in Nephrology. Anti-malarial drugs were mostly prescribed by rheumatologists and internists and less frequently by nephrologists, and appeared to be associated with less active SLE

Open and hidden agendas of "asymptomatic" patients who request check-up exams

BACKGROUND: Current guidelines for a check-up recommend routine screening not triggered by specific symptoms for some known risk factors and diseases in the general population. Patients' perceptions and expectations regarding a check-up exam may differ from these principles. However, quantitative and qualitative data about the discrepancy between patient- and provider expectations for this type of clinic consultation is lacking. METHODS: For a year, we prospectively enrolled 66 patients who explicitly requested a "check-up" at our medical outpatient division. All patients actively denied upon prompting having any symptoms or specific health concerns at the time they made their appointment. All consultations were videotaped and analysed for information about spontaneously mentioned symptoms and reasons for the clinic consultation ("open agendas") and for cues to hidden patient agendas using the Roter interaction analysis system (RIAS). RESULTS: All patients initially declared to be asymptomatic but this was ultimately the case in only 7 out of 66 patients. The remaining 59 patients spontaneously mentioned a mean of 4.2 ± 3.3 symptoms during their first consultation. In 23 patients a total of 31 hidden agendas were revealed. The primary categories for hidden agendas were health concerns, psychosocial concerns and the patient's concept of disease. CONCLUSIONS: The majority of patients requesting a general check-up tend to be motivated by specific symptoms and health concerns and are not "asymptomatic" patients who primarily come for preventive issues. Furthermore, physicians must be alert for possible hidden agendas, as one in three patients have one or more hidden reasons for requesting a check-up