[Identification and clinical use of the Metabolic Syndrome]. / Wird das Metabolische Syndrom in der Klinik erkannt und die Diagnose aktiv verwendet?

The Metabolic Syndrome is characterised by the following components: atherogenic dyslipidemia, elevated blood pressure, elevated glucose and abdominal obesity. 22% of 415 patients of an outpatient clinic in internal medicine fulfilled the criteria of a Metabolic Syndrome. The most common components were abdominal obesity, elevated blood pressure and elevated triglyceride. Only one in five treating physicians diagnosed a Metabolic Syndrome. Our data show that the concept of the Metabolic Syndrome has limited utility in clinical practice.

Sequence and classification of FdPV2, a papillomavirus isolated from feline Bowenoid in situ carcinomas.

Bowenoid in situ squamous cell carcinoma (BISC) is a rare feline skin disorder, which has been described as often associated with papillomavirus infection. It is clinically characterized by solitary or multiple hyperkeratotic plaques affecting older cats. Papillomavirus (PV) sequences amplified from feline viral plaques, and BISC lesions seldom correspond to FdPV1. The goal of the present study was to investigate three cases of BISC and to carry out initial genomic analysis of the associated viral DNA. Samples of skin biopsies taken from three BISC cats were histologically characterized. DNA was extracted and rolling-circle amplification was performed on the skin samples. Restriction enzyme analysis of the amplified DNA revealed the presence of a putative unknown PV. The whole genome was subsequently sequenced and cloned. Alignments with previously described feline PV sequences were carried out and phylogenetic trees were generated. The circular 7,899 base pair sequence of Felis domesticus PV type 2 (FdPV2) contains a typical noncoding region and characteristic open reading frames (ORF) for six putative viral proteins. Phylogenetic analysis based on the nucleotide alignment of L1 genes or the amino acid alignment of E1 proteins of FdPV2 and 52 other PV types indicates that FdPV2 might represent a new genus.

[Muscle pain. De Quervain throiditis]. / Muskelschmerzen. Thyreoiditis de Quervain.

A 62-year-old female patient presents with myalgia, dysphagia and daytime fatigue. Clinical examination is normal. Laboratory results show a hyperthyroidism and an increased erythrocyte sedimentation rate. Clinical presentation, an ultrasound and further examinations suggest a thyroiditis de Quervain. A treatment with NSAR is started. After eight weeks the thyroid hormones return to normal and the patient is asymptomatic.

[Low-fat and light-products--old hat?]. / Low fat und Light-Produkte--Schnee von gestern?

In contrast to the undefined term "light" energy-reduced food is defined by the Swiss law that the energy-content has to be reduced by 30%, and energy-poor corresponds to a reduction of at least 50%, respectively. This must not be achieved by a reduction in protein content. Energy- and fat-reduced products are widely used; especially the use of low-fat dairy products is recommended by US guidelines as part of a healthy lifestyle pattern. There is evidence that such a lifestyle can positively influence the course and incidence of several chronic diseases like type 2 diabetes, arterial hypertension and atherosclerotic complications. However, the consumption of light products alone has not been shown to be associated with health benefits, in particular not with reduced body weight.

A comparative study of satellite and ground-based phenology.

Long time series of ground-based plant phenology, as well as more than two decades of satellite-derived phenological metrics, are currently available to assess the impacts of climate variability and trends on terrestrial vegetation. Traditional plant phenology provides very accurate information on individual plant species, but with limited spatial coverage. Satellite phenology allows monitoring of terrestrial vegetation on a global scale and provides an integrative view at the landscape level. Linking the strengths of both methodologies has high potential value for climate impact studies. We compared a multispecies index from ground-observed spring phases with two types (maximum slope and threshold approach) of satellite-derived start-of-season (SOS) metrics. We focus on Switzerland from 1982 to 2001 and show that temporal and spatial variability of the multispecies index correspond well with the satellite-derived metrics. All phenological metrics correlate with temperature anomalies as expected. The slope approach proved to deviate strongly from the temporal development of the ground observations as well as from the threshold-defined SOS satellite measure. The slope spring indicator is considered to indicate a different stage in vegetation development and is therefore less suited as a SOS parameter for comparative studies in relation to ground-observed phenology. Satellite-derived metrics are, however, very susceptible to snow cover, and it is suggested that this snow cover should be better accounted for by the use of newer satellite sensors.

[Subclinical thyroid disease]. / Subklinische Störungen der Schilddrüsenfunktion.

Subclinical thyroid dysfunction is a frequent disorder characterized by abnormal levels of thryotropin (TSH) and normal thyoid hormones. Subclinical hypothyroidism can be associated with unspecific symptoms and dyslipidemia, a substitution is generally recommended if the TSH is > 10 microU/l. With lower TSH-levels, the indication for substitution is individual, depending on other risk factors or diseases like dyslipidemia, smoking, goiter, pregnancy or clinical symptoms. Subclinical hyperthyrodism is a risk factor for atrial fibrillation and reduced bone mass densitiy. A diagnostic and therapeutic approach should be performed individually.

[Effectiveness of therapeutic interventions in obesity]. / Wirksamkeit therapeutischer Interventionen bei Adipositas.

Obesity is a chronic disease resulting from various genetic factors and environmental conditions (nutrition, sedentary life-style, psychological factors). The importance of prevention and therapy of obesity is emerging because of the high prevalence of metabolic complications. The first goal of any therapy must be a stabilisation of weight, followed by a reduction of body weight. Any intervention must be long-acting. Short-acting therapies (diets) result in a regain of body weight in over 90%. The most effective therapy is an integrative concept basing on: change of nutrition by reduction of fat and carbohydrate intake (daily deficit of 500-1000 kcal). psychotherapeutic approach, targeting a long-term change of eating-behaviour and life-style, avoiding guilt feelings. encouraging physical activity. Drugs (Orlistat, Sibutramin) may be helpful in selected cases as a part of a limited treatment, they do not replace changes in lifestyle. Surgical interventions (gastric banding, gastric bypass) can be considered in morbid obesity with the presence of metabolic complications, as they are the most effective way of weight reduction.

[From obesity to diabetes]. / Von der Adipositas zum Diabetes.

The major risk factor for the development of insulin resistance and type 2 diabetes is obesity. A key role is the new understanding of adipocytes as an endocrine system. Adipocytes secrete numerous substances that contribute to peripheral insulin resistance, including adiponectin, resistin, TNF-alpha and interleukin 6. There is also a role of free fatty acids by blocking directly intracellular metabolism of glucose and by their lipotoxicity. The pre-receptor metabolism of cortisol may be enhanced in visceral adipose tissue by activation of 11 beta-hydroxysteroid dehydrogenase type 1. The new class of thiazolidinediones (glitazones), binding to the peroxisome proliferator activated receptor (PPAR-gamma) lowers the levels of resistin and increases adiponectin, resulting in an improvement of glucose homeostasis. However, the first step to avoid insulin resistance should be an attempt to reduce body weight and to increase physical activity. These are successful means to avoid the development of type 2 diabetes from prediabetic states, as shown recently in 3 independent intervention trials.

[Lymphadenopathy]. / Lymphadenopathie.

Lymphadenopathy is a very common problem that affects patients of all ages. Differential diagnosis is extensive, in general lymph nodes that have been present for longer than 1 month and measure more than 1 x 1 cm should be considered for further examinations, including laboratory testing and biopsy for histological and microbiological examinations.

[What is your diagnosis? Iron deficiency anemia due to intestinal blood loss]. / Wie lautet Ihre Diagnose? Eisenmangelanämia infolge intestinalem okkultem Blutverlust.

Iron lack anemia due to chronic blood loss was diagnosed in a 12 year old dog based on typical hematological abnormalities including moderate regenerative anemia (Hct 21%) and microcytosis (MCV 39 fl). Clinical abnormalities included weakness and episodic vomiting. Chronic occult blood loss in adult dogs most commonly occurs in the gastrointestinal tract associated with ulcus or neoplasia. Possible diagnostic steps include radiographs, abdominal ultrasound, gastroduodenoscopy and exploratory laparotomy. In the dog of this report gastric and duodenal adenocarcinomata were found during necropsy confirming the clinical suspicion of a bleeding gastrointestinal malignancy.