[Medical aspects of objectifying torture sequels]. / Medizinische Aspekte der Objektivierung von Folterfolgen.

Migration, civil wars and other conflicts in various regions of the world have led to a drastic increase in the number of displaced persons and refugees. Associated with this development is an increase in the number of torture victims seeking asylum. This means that the medical personnel is increasingly confronted with the evaluation and therapy of torture victims. The methods of verification of sequels of torture are of utmost importance in the work-up of treatment centres for survivors of torture. Since each organ can be affected by torture, a multidisciplinary cooperation is mandatory for the examination of torture victims. In this paper we shall discuss some aspects concerning the diagnosis of injuries caused by torture which are essential for interviewing and examining torture victims in order to objectify sequels of torture.

Effect of rocaltrol on bone mass in patients with pulmonary disease treated with corticosteroids.

The aim of this study was to evaluate the effect of calcitriol on bone mass in patients with corticosteroid induced osteoporosis. Thirty-seven patients (26 females, 11 males, mean age 66.4 years) with pulmonary disease under long-term treatment with corticosteroids (5-10 mg prednisolone daily) and osteopenia/osteoporosis verified by dual-energy x-ray absorptiometry (DEXA) measurement were enrolled into the study. Rocaltrol was prescribed to 30/37 of the patients, the rest of the patients (6 females, 1 male) served as controls. In the treatment group, there was a slight increase of bone mass in the hip and lumbar vertebrae (L1-L4), whereas the control group showed a decrease of bone mass (change rate of bone mass in patients +0.8% and +1.0%, respectively, vs. -1.9% and -0.3%, respectively, in the control group). The preliminary results of our study suggest a beneficial role for the treatment of corticosteroid induced osteoporosis with Rocaltrol, which is well-tolerated by patients and cost-efficient in patient management.

Proximal extent of pelvic vein thrombosis and its association with pulmonary embolism.

OBJECTIVE: Conventional methods such as duplex ultrasound scanning do not provide accurate information about proximal extension of pelvic vein thrombosis. We evaluated proximal extent of thrombus toward pelvic veins with magnetic resonance imaging in patients with suspected deep vein thrombosis (DVT) proximal to the inguinal ligament on the basis of duplex ultrasound scans. In addition, frequency of pulmonary embolism (PE) and early (4 weeks) clinical outcome were evaluated. METHODS: Two hundred twelve patients with acute symptomatic DVT proximal to the inguinal ligament, diagnosed at duplex ultrasound scanning, were enrolled in this prospective study. All patients underwent magnetic resonance imaging of the abdominal and pelvic veins, as well as lung scintigraphy to detect the presence of pulmonary embolism. RESULTS: In 24 of 212 patients (11%), thrombus was restricted to the femoral vein. The thrombus extended into iliac veins in 142 patients (67%) and into the inferior vena cava in 46 patients (22%). The frequency of PE was not associated with the most proximal extension of thrombus (P =.61). No patients died as a consequence of thromboembolic events. CONCLUSIONS: Extension of DVT into the inferior vena cava occurs relatively frequently. In our patients this finding was not associated with higher risk for PE compared with DVT of the femoral or iliac veins.