[Trigger finger-pitfalls and differential diagnosis]. / Der schnellende Finger ­ Pitfalls und Differenzialdiagnostik.

The differential diagnosis of a trigger finger presents a clinical challenge. This case depicts a 32-year-old male patient who presented with persistent snapping of the right index finger at the metacarpophalangeal joint without localized tenderness despite previous surgical A1-annular ligament release. CT diagnostics demonstrated a prominent articular tuberosity. The MRI showed no pathological findings. Surgical revision with concomitant excision of the tuberosity restored smooth mobility of the index finger.

Relationship of collagen as the component of the extracellular matrix with the mechanisms of autonomic regulation of the cardiovascular system under simulated conditions of long-term isolation.

The study of proteins - potential markers, associated signal transduction pathways, and their targets - provides a new understanding of the fundamental mechanisms occurring at the level of regulatory processes in the cardiovascular system (CVS), especially in space flight, as well as in model experiments that reproduce its individual effects on the human body. The article presents the results of studies in an experiment with 120-day isolation within the framework of the SIRIUS project in which 6 volunteers aged 28 to 44 years (three men and three women) participated. SIRIUS (Scientific International Research in Unique Terrestrial Station) is the international research project, which studies the issues of biomedical and psychological support of long-term manned space flights. The possible involvement of collagen different types, an extracellular matrix protein, in the mechanisms of autonomic regulation of the CVS was studied. Using chromatic mass spectrometry in urine samples and analysis of heart rate variability, we have established that the extracellular matrix collagen, which is present, in particular, in the structure of the blood vessel wall, are markers associated with the modulating effect of the autonomic nervous system on the regulatory mechanisms of blood circulation. We hypothesized that these proteins may be a biomarker of the autonomic balance in the regulatory mechanisms of the circulatory system. In addition, these proteins can also be markers of the aging process, which increases the risks of developing autonomic dysfunction of the cardiovascular system (dominance of sympathicotonia) and changes in the quality of the tissue of the heart muscle and blood vessels, provoking the development of prenosological conditions and diseases of the cardiovascular system.

High prevalence of missed information related on bone health in orthogeriatric patients with fragility fractures of the pelvis-an institutional register-based analysis.

This is the first study that highlighted the amount of missed information related on bone health in orthogeriatric patients suffering fragility fractures of the pelvis and also evaluated its prevalence and differing etiology in the assessed patients, regarding osteoporosis and/or osteomalacia, based on laboratory and instrumental measurements. This evaluation should become a standardized procedure in the treatment of orthogeriatric patients presenting with a FFP. INTRODUCTION: Fragility fractures of the pelvis (FFP) are common in orthogeriatric patients. Secondary fracture prevention regarding evaluation and treatment of an underlying osteoporosis or osteomalacia is still often neglected. The purpose of this study was to evaluate the amount of missed information related on bone health in older adult FFP patients, the prevalence of vitamin D deficiency in assessed patients, and if fracture type-dependent distribution patterns could be observed. METHODS: A retrospective analysis of prospectively collected data of an institutional register was performed. Patients aged 80 years and older (n = 456) admitted with a FFP from 01/2003 until 12/2019 to a level I trauma center were included. RESULTS: In 456 patients, FFP type II were leading (66.7%). Diagnostics were conducted in 37.1% of the patients regarding measurement of vitamin D levels and 21.7% regarding DXA measurements; vitamin D deficiency was observed in 62.7%, indicators for an underlying osteomalacia in 45.8%, and an osteoporosis in 46.5% of the assessed patients. CONCLUSION: Although FFP are common and will increase, there is still a lack of secondary fracture prevention, starting with information related on bone health. In the assessed patients, a high prevalence of vitamin D deficiency was present, but no significant correlation between vitamin D level and type of fracture was observed. Ongoing education for varying etiology and specific treatment of these fractures is necessary, as surgical treatment was unified, but drug therapy remains different.

[Influence of infrared cold laser radiation emission on free radical processes in various tissues of rats with circulatory cerebral hypoxia].

Influence of infrared cold laser emission (IRCL) on the dynamic equilibrium between lipid peroxidation and tension of the antioxidant defense system in rat's tissues (blood, brain, retina, cornea) was evaluated in animals with circulatory cerebral hypoxia induced by occlusion of the left carotid artery. Tissues of white rats were examined for IRCL effects on hemiluminescence, malonic dialdehyde, SOD and catalase activities on the background of circulatory cerebral hypoxia. Data of the experiment evidenced an antioxidant effect of posthypoxic IRCL therapy as it reduces intensity of the free radical processes in plasma, cerebral tissues and retina. The experiment demonstrated the IRCL ability to modulate LPO, to stiffen the antioxidant defense system in the event of eye diseases originated from circulatory hypoxia of the ocular analyzer.

[Effect of krypton-containing gas mixture on Japanese quail embryo development].

Investigated were effects of gas mixture with up to 3.0 kgs/cm2 of krypton on the embryonic development of domesticated Japanese quail (Coturnix coturnix japonica dom.). Results demonstrated absence of a serious krypton effect on Japanese quail embryos. Development of embryos proceeded in due course; morphometrically the experimental embryos were essentially similar to controls. It should be noted that despite exposure to acute hypoxic hypoxia during the initial 12 hours of development in the krypton-containing gas mixture, viability of quail embryos was high enough which can be ascribed to the krypton protective action. Besides, an additional experiment showed that krypton partial pressure of 5-5.5 kgs/cm2 produces the narcotic effect on adult Japanese quails.

[Effects of xenon and krypton-containing breathing mixtures on clinical and biochemical blood indices in animals].

Effects of 24-hr breathing air mixtures containing xenon (XBM) and krypton (KBM) were compared in terms of hormonal status, and blood biochemical indices and morphology in laboratory animals. Some changes observed in blood and hormone indices could be a nonspecific adaptive response. Hence, we should elicit whether these effects are quickly reversible or long. For several indices krypton was a more favorable factor than xenon. However, some of its effects invite to delve into effects of different krypton concentrations on organism.

[The use of warm heliox mixtures in rehabilitation after submaximal physical loads during production activity].

Thirty essentially healthy male gas-rescuers 21 to 53 years of age were treated with warm hellox following scheduled physically demanding repairs in open compressed air respiratory systems. Results of the actual test showed that a single heliox treatment makes for positive changes in the respiration and some psychophysiological parameters. The test allowed refinement of the warm hellox procedure of preventing extreme cooling, fatigue of and cardiovascular problems in gas-rescuers using respiratory systems at work place.

[Cytogenetic impacts of air-argon environment on epitheliocytes of the mice cornea].

The purpose was to look into the effects of 24-hr. exposure in a normoxic air-argon environment (AAE) on the epitheliocyte proliferative system, i.e. chromosomal aberrations dynamics and cornea proliferative activity, in laboratory mice. Argon was found to significantly decrease the percentage of spontaneous mutations in cells and, probably, to induce reversible inhibition of cell division. Subsequent experiments may not only disclose the still unknown properties and advantages of argon but also shed light on cell mechanisms triggered by the noble gases in general.

Quality of medical care delivered to Medicare beneficiaries: A profile at state and national levels.

CONTEXT: Despite condition-specific and managed care-specific reports, no systematic program has been developed for monitoring the quality of medical care provided to Medicare beneficiaries. OBJECTIVE: To create a monitoring system for a range of measures of clinical performance that supports quality improvement and provides repeated, reliable estimates at the national and state levels for fee-for-service (FFS) Medicare beneficiaries. DESIGN, SETTING, AND PARTICIPANTS: National study of repeated, cross-sectional observational data collected in 1997-1999 on all Medicare FFS beneficiaries or on a representative sample of beneficiaries with a particular condition. Data were collected using medical record abstraction for inpatient care, analysis of Medicare claims for some ambulatory services, and surveys for immunization rates. Separate samples were drawn for each topic for each state. MAIN OUTCOME MEASURES: Beneficiary patients' receipt of 24 process-of-care measures related to primary prevention, secondary prevention, or treatment of 6 medical conditions (acute myocardial infarction, breast cancer, diabetes mellitus, heart failure, pneumonia, and stroke) for which there is strong scientific evidence and professional consensus that the process of care either directly improves outcomes or is a necessary step in a chain of care that does so. RESULTS: Across all states for all measures, the percentage of patients receiving appropriate care in the median state ranged from a high of 95% (avoidance of sublingual nifedipine for patients with acute stroke) to a low of 11% (patients with pneumonia screened for pneumococcal immunization status before discharge). The median performance on an indicator is 69% (patients discharged with heart failure diagnosis who received angiotensin-converting enzyme inhibitors; diabetic patients having an eye examination in the last 2 years). Some states (particularly less populous states and those in the Northeast) consistently ranked high in relative performance while others (particularly more populous states and those in the Southeast) consistently ranked low. CONCLUSIONS: It is possible to assemble information on a diverse set of clinical performance measures that represent performance on the range of services in a health insurance program. These findings indicate substantial opportunities to improve the care delivered to Medicare beneficiaries and urgently invite a partnership among practitioners, hospitals, health plans, and purchasers to achieve that improvement. JAMA. 2000;284:1670-1676.