8,283 research outputs found
[Assessment of musculoskeletal pain]
No full textThe rationale for a successful treatment of musculoskeletal pain is an adequate initial assessment. Standardized questionnaires, modern imaging modalities such as computed tomography, magnetic resonance imaging and musculoskeletal ultrasound or electrophysiology have enriched our armamentarium in the last decades. Pain inducing pathologies can often be identified and treated in a targeted way due to these procedures. But none of these techniques allows an adequate judgment of the acquired findings. Supplementary tests have to be indicated and interpreted in the context of the patient's entire history and the clinical findings. These two remain to be the cornerstones of the assessment of painful musculoskeletal disorders
Nocardia cyriacigeorgici: Erstbeschreibung als invasive Infektion
No full textBACKGROUND
Diagnostic laboratories increasingly offer bacterial identification to the species level. The 17 nocardia species known to date differ in their clinical presentation, antibiotic resistance patterns and geographic distribution. The discovery of a new species with pathogenicity for humans calls for the characterization of its clinical and epidemiological properties.
PATIENTS AND METHODS
Nocardia isolated from multifocal brain abscesses of an immunocompromised patient were further identified by the analysis of their cellular fatty acids and sequencing of the 16S ribosomal DNA. Quantitative antibiotic resistance testing was performed with E-tests.
RESULTS
The 16S ribosomal DNA analysis showed a 99 % homology to Nocardia cyriacigeorgici. This is the first report of this species as an invasive human pathogen. N. cyriacigeorgici was found susceptible for meropenem, amikacin, ceftriaxon and cotrimoxazole. The combination of surgical drainage and antibiotic treatment for 13 months was curative.
CONCLUSIONS
N. cyriacigeorgici has the potential to cause invasive infections at least in immunocompromised patients. Comparing clinical and in vitro characteristics with N. asteroides, the main causative agent of nocardial infections in Europe, we found no clinically relevant differences
High-resolution ultrasound confirms reduced synovial hyperplasia following rituximab treatment in rheumatoid arthritis
No full textOBJECTIVE: To assess the response of RA patients to rituximab (RTX) treatment using a sensitive imaging technique for synovitis. METHODS: Twenty-three RA patients were treated with two 1000-mg infusions of the B-cell depleting antibody, RTX, in an observational protocol. Clinical response was assessed by the European League Against Rheumatism (EULAR) response criteria. High-resolution grey-scale and colour-coded power Doppler (PD) ultrasonography was performed at baseline and 6 months after RTX. The second to fifth MCP and PIP joints were bilaterally examined with joints in a neutral 0 position from a palmar view and scored from 0 to 3. RESULTS: Median disease activity score (DAS28) improved from 5.03 to 3.56 (P = 0.001), which corresponded to a EULAR moderate response in 11 of 23 patients and a EULAR good response in another 6 patients. Improved control of disease activity by RTX was also indicated by tapering of median daily corticosteroid doses from 10 to 5 mg, without flare ups. Mean grey-scale scores correlated with the swollen joint count at baseline (r = 0.484, P = 0.022) and month 6 (r = 0.519, P = 0.011). Mean grey-scale scores improved upon RTX from a 0.90 median (range 0.13-1.87) to 0.75 (range 0.19-1.50, P = 0.023). Frequency of PD positive joints was low (6.1%) at baseline and did not significantly change following RTX treatment. CONCLUSIONS: High-resolution grey-scale ultrasonography (US) examination confirmed reduced synovial hyperplasia, but the applied PD method displayed no significant changes. Therefore, only grey-scale US is recommended in follow-up examinations after RTX treatment
Musikstädte as real and imaginary soundscapes: urban musical images as literary motifs in twentieth-century German modernism
No full textPhDThis study examines German literary images of musical life as part of the wider sound identity of the modern German city at the turn of the twentieth century. Focussing on a forty-year period from 1890 to 1930, synonymous with the emergence of the modern German metropolis as an aesthetic object, the project assesses, compares and contrasts how musical life in the Musikstädte was perceived and portrayed by writers in an increasingly noisy urban environment. How does urban musical life influence and condition city writings? What are the differences and similarities between the writings on various musical cities? Can an urban textual sound identity be derived from these differences and similarities? The approach employed to answer these questions is a new, cross-disciplinary one to urban sound in literature, moving beyond reading the key sounds of the urban soundscape using urban musicology, sensorial anthropology and cultural poetics towards a literary contextualisation of the urban aural experience.
The literary motifs of the symphony, the gramophone and urban noise are put under the spotlight through the analysis of a wide range of modernist works by authors who have a special relationship with music. At the centre of this analysis are the Kaffeehausliteratur authors Hermann Bahr, Alfred Polgar and Peter Altenberg, the then Munich-based author Thomas Mann and the lesser known René Schickele. The analysis of these particular works is framed in the music-geographical context of the Musikstadt and literary underpinnings of this topos, ranging from Ingeborg Bachmann to Hans Mayer and, once again, Thomas Mann. In analysing these texts, the methodological approach devised by Strohm, who identifies the blending of a range of urban sounds as a definition of urban space and identity, is applied. His ideas combine historical literary
analysis, musical history and urban sociology. They are rarely used in the analysis of the auditory environment.Arts and Humanities Research Council
Westfield TrustWestfield Trust Studentship
Arts and Humanities Reseach Council (AHRC
Rudolf Otto filosofo della religione
No full textLo straordinario successo del Sacro (1917), che ha reso celebre Rudolf Otto, ha provocato, per contraccolpo, la diffusione di una figura stilizzata dell’autore, impoverita dall’oblio toccato al resto della sua produzione e da letture parziali e semplificative. Una ricostruzione genetica del modo in cui Otto impone la nozione di «heilig» nel lessico tedesco specializzato, muovendo da Lutero e opponendo al neokantismo una lettura friesiana del trascendentale, fa emergere la qualità filosofica di una teoria del religioso che rivela convergenze insospettate con la fenomenologia husserliana. The extraordinary success of The Holy (1917) made Rudolf Otto famous, but it also contributed to propagate a simplified figure of the author. The rest of his work was condemned to oblivion, which caused misleading interpretations of The Holy itself. A genetic reconstruction of the way in which Otto established the term «heilig» in the technical German proves to be fruitful. When considering his interpretation of Luther and his Fries-based opposition to a neoKantian approach to the concept of «transcendental», the philosophical relevance of Otto’s theory of religion can be fully recognized, as well as unsuspected links to Husserlian phenomenology
Persistence of ultrasound synovitis in patients with rheumatoid arthritis fulfilling the DAS28 and/or the new ACR/EULAR RA remission definitions: results of an observational cohort study.
No full textOBJECTIVE
The primary aim of the study was to evaluate whether rheumatoid arthritis (RA) patients considered to be in remission according to clinical criteria sets still had persisting ultrasound (US) synovitis. We further intended to evaluate the capacity of our US score to discriminate between the patients with a clinically active disease versus those in remission.
METHODS
This is an observational study nested within the Swiss Clinical Quality Management in Rheumatic Diseases (SCQM) rheumatoid arthritis cohort. A validated US score (SONAR score) based on a semi-quantitative B-mode and Doppler (PwD) score as part of the regular clinical workup by rheumatologists in different clinical settings was used. To define clinically relevant synovitis, the same score was applied to 38 healthy controls and the 90st percentile was used as cut-off for 'relevant' synovitis.
RESULTS
Three hundred and seven patients had at least one US examination and concomitant clinical information on disease activity. More than a third of patients in both DAS28 and ACR/EULAR remission showed significant gray scale synovitis (P=0.01 and 0.0002, respectively) and PwD activity (P=0.005 and 0.0005, respectively) when compared to controls. The capacity of US to discriminate between the two clinical remission groups and patients with active disease was only moderate.
CONCLUSION
This observational study confirms that many patients considered to be in clinical remission according the DAS and the ACR/EULAR definitions still have residual synovitis on US. The prognostic significance of US synovitis and the exact place of US in patients reaching clinical remission need to be further evaluated
Hans David Blum Collection.
No full textThe Hans David Blum Collection documents his research of the history of his family and consists of correspondence, documents, photographs, manuscripts and notes, genealogical tables and trees, and clippings. Additionally there is a small amount of personal materials.Elaine Wolff, August 2005; David Hans Blum, August 2006Hans David Blum was born in 1919 in Breisach am Rhein, Germany. He is the author of a number of books, including Juden in Breisach.Finding aid available onlineRheineck. Müllheimdigitize
[Burgundische Historie]
No full text[Hans Erhart Tüsch]Impressum: Ort und Datum in der Vorlage genannt, Drucker nach ISTCFor the identity of the author (also known as Hans Düsch) and the political slant and the date of the text, see K. Ohly, Gb Jb 1956, p.131Woodcut
Measuring finger joint cartilage by ultrasound as a promising alternative to conventional radiograph imaging
No full textOBJECTIVE: To evaluate the reliability and validity of a novel ultrasound (US) imaging method to measure metacarpophalangeal (MCP) and proximal interphalangeal (PIP) finger joint cartilage. METHODS: We examined 48 patients with rheumatoid arthritis (RA), 18 patients with osteoarthritis (OA), 24 patients with unclassified arthritis of the finger joints, and 34 healthy volunteers. The proximal cartilage layer of MCP and PIP joints for fingers 2-5 was bilaterally visualized from a posterior view, with joints in approximately 90 degrees flexion. Cartilage thickness was measured with integrated tools on static images. External validity was assessed by measuring radiologic joint space width (JSW) and a numeric joint space narrowing (JSN) score in patients with RA. RESULTS: Precise measurement was possible for 97.5% of MCP and 94.2% of PIP joints. Intraclass correlation coefficients for bilateral total joint US scores were 0.844 (95% confidence interval [95% CI] 0.648-0.935) for interobserver comparisons and 0.928 (95% CI 0.826-0.971) for intraobserver comparisons (using different US devices). The US score correlated with JSN for both hands (adjusted R(2) = 0.513, P < 0.001) and JSW of the same finger joints (adjusted R(2) = 0.635, P < 0.001). Reduced cartilage shown by US allowed discrimination of early symptomatic OA versus early RA and healthy joints. In patients with RA, US scores correlated with duration of treatment-resistant, progressive RA. CONCLUSION: The US method of direct visualization and quantification of cartilage in MCP and PIP joints is objective, reliable, valid, and can be useful for diagnostic purposes in patients with arthritis
Sonographic follow-up of patients with carpal tunnel syndrome undergoing surgical or nonsurgical treatment: prospective cohort study
No full textPurpose
To compare changes in the largest cross-sectional area (CSA) of the median nerve in wrists undergoing surgical decompression with changes in wrists undergoing non-surgical treatment of carpal tunnel syndrome (CTS).
Methods
This study was a prospective cohort study in 55 consecutive patients with 78 wrists with established CTS, including 60 wrists treated with surgical decompression and 18 wrists with non-surgical treatment. A sonographic examination was scheduled before and 4 months after initiation of treatment. We compared changes in CSA of the median nerve between wrists with surgical treatment and wrists with non-surgical treatment using linear regression models.
Results
Decreases in CSA of the median nerve were more pronounced in wrists with CTS release than in wrists undergoing nonsurgical treatment (difference in means, 1.0 mm2; 95% confidence interval, 0.3–1.8 mm2). Results were robust to the adjustment for age, gender, and neurological severity at baseline. Among wrists with CTS release, those with postoperative CSA of 10 mm2 or less tended to have better clinical outcomes than those with postoperative CSA of greater than 10 mm2 (p=.055). Postoperative sonographic workup in the 3 patients with unfavorable outcome or recurrence identified likely causes for treatment failure in 2 patients.
Conclusions
In this observational study, surgical decompression was associated with a greater decrease in median nerve CSA than was nonsurgical treatment. Smaller postoperative CSAs may be associated with better clinical outcomes. Additional randomized trials are necessary to determine the optimal treatment strategy in different subgroups of patients with CTS.
Type of study/level of evidence
Therapeutic III
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