[The social dimension of tuberculosis in the City of Munich]. / Die soziale Dimension der Tuberkulose in der Stadt München.

Germany is a low-incidence country for tuberculosis, but there is no time for complacency. With an annual incidence of 10 per 100,000 population the City of Munich counts twice as many cases of tuberculosis compared to the national average. Reasons for the concentration of tuberculosis in big cities include the high proportion of migrants from countries with high prevalence of tuberculosis and from socioeconomically disadvantaged populations. Munich's population is growing fast and is expected to exceed 1.5 million in the near future. Migrants looking for employment now come predominantly from Romania, Bulgaria and Poland. The proportion of foreign born patients with tuberculosis increased over the last ten years from 49 to 80 %. Asylum seekers and migrants need special attention from the public tuberculosis services. The proportion of tuberculosis patients with social problems increased from 37 to 55 % over the last 6 years. Demands for medical and social support have increased and the case management is increasingly complex. In 2011 the ambulatory treatment of 6 immigrants was supervised by the public health services in Munich. Increasingly, uninsured patients from southeastern states of the European Union need medical treatment. In Europe the overall number of tuberculosis cases is decreasing. The proportion of multidrug-resistant (MDR) tuberculosis in Eastern Europe is alarming. 15 of worldwide 27 countries with the highest MDR load are located in the European Region. In Munich the number of MDR cases is still low at 1-4 cases each year. But duration, cost and side effects of therapy are strong barriers to treatment success. All patients have the right to get adequate diagnostic work-up and effective treatment no matter in which country they reside. To realize this request with cross-border control and care, is a big challenge to the public health service in a global perspective.

Ultrasound imaging-guided noninvasive ultrasound thrombolysis: preclinical results.

BACKGROUND: Catheter-based therapeutic ultrasound thrombolysis was recently shown to be effective and safe. The purpose of this work was to study the safety and efficacy of external high-intensity focused ultrasound thrombolysis guided by ultrasound imaging in experimental settings. METHODS AND RESULTS: A therapeutic transducer was constructed from an acoustic lens and integrated with an ultrasound imaging transducer. In vitro clots were inserted into bovine arterial segments and sonicated under real-time ultrasound imaging guidance in a water tank. With pulsed-wave (PW) ultrasound, the total sonication time correlated with thrombolysis efficiency (r(2)=0.7666). A thrombolysis efficiency of 91% was achieved with optimal PW parameters (1:25 duty cycle, 200-micros pulse length) at an intensity (I(spta)) of >35+/-5 W/cm(2). Ultrasound imaging during sonication showed the cavitation field as a spherical cloud of echo-dense material. Within <2 minutes, the vessel lumen evidenced neither residual clot nor damage to the arterial wall. On serial filtration, 93+/-1% of the lysed clot became subcapillary in size (<8 microm). In vitro safety studies, however, showed arterial damage when an I(spta) of 45 W/cm(2) was used for periods of >/=300 seconds. CONCLUSIONS: External high-intensity focused ultrasound thrombolysis using optimal PW parameters for periods of

Facial and scalp burns from hair activator products.

Review of 1,008 admissions over the past two years to the Detroit Medical Center Burn Unit revealed 227 patients with facial or scalp burns. Of these, 12 patients sustained burns directly as a result of accidentally igniting a hair activator product called "Jheri-Curl." Eleven patients sustained superficial partial-thickness burns and were adequately treated with Dermaide. One had deeper burns requiring split-thickness skin grafting.

An extension of the concept of inertial frame and of Lorentz transformation.

It is shown how particular kinds of fractional-linear (or projective) transformations generalize the notion of inertial frame in that they ensure that free-particle motion goes over into free-particle motion. A ten-parameter group of such transformations is produced which generalize Lorentz transformations, and which involve besides c (velocity of light) a new fundamental length b; they encompass the ordinary Lorentz group in the limit that b becomes infinite. These extended Lorentz transformations are most simply understood as a type of rotation in the space of homogeneous coordinates, a rotation that unifies 3-space rotations, frame-shifts to moving frames, and space- as well as time-translations. The structure of the invariant differential line element and of the wave operator that generalize those of special relativity are discussed, and implications for the possible revision of usual physical statements are pointed out.