HIV-assoziierte Malignome

Kaposi's sarcoma (KS), Non-Hodgkin's lymphma (NHL) and invasive cervical cancer are considered AIDS-defining malignancies. The incidence of Kaposi's sarcoma has recently been increased as a secondary manifestation of AIDS. The pathogenesis is not completely understood. Human herpesvirus 8 could be identified as an infectious cofactor. Therapeutic strategies should be based on prognostic factors and tailored to the patient's individual situation. Local treatments widely used are cryotherapy or radiotherapy. Systemic therapies such as interferon-alpha. or single and multiagent chemotherapy are also well established. Based on their high response rates and favorable toxicity profile, liposome-encapsulated anthracyclines may be considered first-line therapy for advanced AIDS-related KS. HIV-associated NHL may increase in frequency as HIV-infected individuals survive longer with improved antiretroviral therapy. There is no advantage for intensive as compared with standard or less intensive chemotherapeutic regimens of the CHOP type. Complete remissions can be achieved in approximately 50% of the patients, but the recurrence rate is high. The therapeutic strategy should include an optimal supportive care and antiretroviral treatment because chemotherapy significantly increases the risk of opportunistic infection. In urban populations at risk, cervical cancer is a common AIDS-related malignancy in women. Patients with cervical carcinoma usually have a more aggressive and more advanced disease. Various malignant diseases, such as Hodgkin's lymphoma, anal cancer or seminoma in patients with AIDS occur at higher frequency in HIV infection

Equisetum x ascendens LUBIENSKI & BENNERT (subg. Hippochaete, Equisetaceae), a new horsetail taxon for the flora of North Rhine-Westphalia

Die triploide Schachtelhalm-Hybride E. x ascendens wird als neue Sippe für die Flora Nordrhein-Westfalens vorgestellt. Es werden Aspekte ihrer Biologie und Nomenklatur diskutiert sowie Bestimmungsmerkmale angegeben, welche eine Abgrenzung von E. hyemale, E. x moorei und E. ramosissimum erlauben. Die nordrheinwestfälischen Vorkommen der Hybride werden beschrieben, standortökologisch bewertet und in den Kontext der\ud allgemeinen Verbreitung in Mitteleuropa gestellt. Darüber hinaus werden Verbreitung und Ökologie aller in NRW bekannten Sippen der Untergattung Hippochaete charakterisiert und verglichen. Für alle Arten und Hybriden werden aktuelle Verbreitungskarten für dieses Bundesland präsentiert.The triploid horsetail hybrid E. x ascendens is reported as being a member of the flora of North Rhine-Westphalia (NRW), Germany. Aspects of its biology and nomenclature are discussed, and diagnostic features given allowing for separating it from E. hyemale, E. x moorei, and E. ramosissimum. The North Rhine-Westphalian habitats of the hybrid are described and ecologically characterized with reference to its general distribution in Central Europe. Additionally, distributional and ecological patterns of all known members of subgenus Hippochaete in NRW are discussed. For all species and hybrids updated distribution maps are presented for this state

Nutzen statt Produkte kaufen: Verbreitung und Effekte neuer Produkt-Dienstleistungs-Konzepte im deutschen Verarbeitenden Gewerbe

--

Equivalent Mid-Term Results of Open vs Endoscopic Gluteal Tendon Tear Repair Using Suture Anchors in Forty-Five Patients.

BackgroundLittle is known about the relative efficacy of open (OGR) vs endoscopic (EGR) gluteal tendon repair of gluteal tendon tears in minimizing pain and restoring function. Our aim is to compare these 2 surgical techniques and quantify their impact on clinical outcomes.MethodsAll patients undergoing gluteal tendon tear repair at our institution between 2015 and 2018 were retrospectively reviewed. Pain scores, limp, hip abduction strength, and the use of analgesics were recorded preoperatively and at last follow-up. The Hip disability and Osteoarthritis Outcome Score Junior and Harris Hip Score Section1 were obtained at last follow-up. Fatty degeneration was quantified using the Goutallier-Fuchs Classification (GFC). Statistical analysis was conducted using one-way analysis of variance and t-tests.ResultsForty-five patients (mean age 66, 87% females) met inclusion criteria. Average follow-up was 20.3 months. None of the 10 patients (22%) undergoing EGR had prior surgery. Of 35 patients (78%) undergoing OGR, 12 (27%) had prior hip replacement (75% via lateral approach). The OGRs had more patients with GFC ≥2 (50% vs 11%, P = .02) and used more anchors (P = .03). Both groups showed statistical improvement (P ≤ .01) for all outcomes measured. GFC >2 was independently associated with a worst limp and Harris Hip Score Section 1 score (P = .05). EGR had a statistically higher opioid use reduction (P < .05) than OGR. Other comparisons between EGR and OGR did not reach statistical significance.ConclusionIn this series, open vs endoscopic operative approach did not impact clinical outcomes. More complex tears were treated open and with more anchors. Fatty degeneration adversely impacted outcomes. Although further evaluation of the efficacy of EGR in complex tears is indicated, both approaches can be used successfully

Injury pattern due to falls from hunting stands

Hunting is a historically constructed cultural act and continues to be a passion and a popular recreational pastime worldwide. Along with a high population density in Europe and a large volume of hunters hunting injuries such as falls from hunting stands continue to occur regularly and are a significant cause of morbidity among hunters. The purpose of this study was to review typical injury patterns after falls from hunting stands in Germany between 2000–2009 using the German agricultural statutory accident insurance database and to compare these findings to other causes of hunting accidents. The most common injury pattern after falls from hunting stands in Germany in the period of 2000–2009 are closed fractures. However, data collection is incomplete. Thus a more precise data collection would help to be able to better analyze accident mechanisms in order to be able to prevent further accidents

The double-transforaminal lumbar interbody fusion: an innovative one-stage surgical technique for posterior kyphosis correction

Posttraumatic deformities after vertebral fractures are challenging for orthopedic surgeons in the non-operative and operative field. Especially osteoporotic fractures may cause a hyperkyphosis resulting in segmental or global sagittal imbalance and chronic back pain. Different vertebral osteotomies are potent to restore sagittal profile but show a very high perioperative risk including neurological and soft tissue complications. In addition, some of these extensive operations require a two-step procedure including posterior and anterior approaches. Therefore, these established techniques may be contraindicated in elderly or multimorbide patients suffering from concomitant diseases. The authors describe the double transforaminal lumbar interbody fusion (TLIF) osteotomy (DTO) as an innovative one-stage and low-invasive surgical technique to correct a fixed posttraumatic kyphosis in the thoracolumbar junction. The procedure includes posterior release (laminectomy, facettectomy, nucleotomy) combined with two expandable TLIF implants (sandwich technique) and posterior instrumentation and is illustrated by a case of a multimorbide 78-year old female

Safety of autologous bone marrow aspiration concentrate transplantation: initial experiences in 101 patients

The clinical application of cellular based therapies with ex vivo cultivation for the treatment of diseases of the musculoskeletal system has until now been limited. In particular, the advanced laboratory and technical effort necessary, regulatory issues as well as high costs are major obstacles. On the other hand, newly developed cell therapy systems permit intra-operative enrichment and application of mesenchymal and progenitor stem cells from bone marrow aspirate concentrate (BMAC) in one single operative session. The objective of the present clinical surveillance study was to evaluate new bone formation after the application of BMAC as well as to record any possible therapy-specific complication

The Orthopaedic forum 2011 Austrian-Swiss-German traveling fellowship tour summary

From January 31st to March 11th 2011 four traveling fellows representing the German speaking associated orthopaedic societies visited different academic orthopaedic centers in the U.K., Canada and the USA