The National Lung Screening Trial (NLST) could demonstrate, for the first time, in a prospective randomized trial, that low-dose CT screening (LD-CT) may decrease lung cancer mortality. At the moment, it is unclear how these results will be applicable to Austria. Specifically, the definition of the population at an increased risk for lung cancer and management of the high rate of false-positive results are problematic. As a consequence, lung cancer screening in Austria is recommended following the guidelines of the Austrian Society of Radiology and the Austrian Society of Pneumology. The recommendations suggest that only individuals with a significantly increased risk for lung cancer should be screened (age > 55 years, 30 pack-years, active or former smokers since < 15 years). The screened individuals must be informed about the high probability of false-positive screening results and the necessity for additional follow-up examinations or invasive examinations. The screened individuals must be informed that a CT screening may not prevent them from developing an inoperable lung cancer. In addition, CT screening examinations should be performed with a low-dose CT technique for at least three years at yearly intervals. In view of the high probability of false-positive findings, the evaluation of detected pulmonary nodules should be performed according to an already established standardized protocol.

Cellulomonas spp. are often believed to be of low virulence. There are only a few reports of human infections. We report the first case of endocarditis caused by Cellulomonas in an intravenous drug abuser. The diagnosis of infective endocarditis (IE) in this case was definite using the Duke criteria. The course of the disease was complicated with a heart failure and possible mycotic aneurysm in the left leg. After the end of antimicrobial therapy aortic valve replacement was done because of severe heart failure.

Breast cancer is the most common type of cancer among women worldwide. Several epidemiological studies have shown an inverse relationship between the risk of breast cancer and physical activity levels, whereas exercise training has been recognized as a significant means in the rehabilitation process of breast cancer survivors. The relative risk reduction of breast cancer for women who engaged in moderate to vigorous physical activity for 3-5 days peek week ranged between 20-40 %. Furthermore, several studies demonstrated a 24-67 % reduction in the risk of total deaths and 50-53 % reduction in the risk of breast cancer deaths in women who are physically active after breast cancer diagnosis compared with sedentary women. Breast cancer survivors should be encouraged to participate in rehabilitation programs in order to obtain numerous physiological and psychological benefits. These include reductions in fatigue and improvements in immune function, physical functioning, body composition, and quality of life. Based on recent scientific evidence, a complete rehabilitation program for patients with breast cancer should combine both strength and aerobic exercise in order to maximize the expected benefits.

A prospective observational study of parenteral selenium supplementation started in January 2008 which included 72 septic patients with APACHE II scores ranging from 19 to 40 after admission.Patients were divided into two major groups: one with a continual infusion of sodium selenite at 750 µg/24 h for 6 days and a placebo group followed by subgroups according to the presence or absence of surgical procedure. Routine biochemical and hematological para-meters were determined continuously. Sequential Organ Failure Assessment (SOFA) scores were calculated in two-day intervals.Patients who died had a higher Acute Physiology and Chronic Health Evaluation (APACHE) II score, lower albumin on the 3rd days of therapy and higher C-reactive protein (CRP) on the 6th days of therapy. Statistically, there was no significant difference in the comparison of CRP, fibrinogen, albumin, plasma proteins, or neutrophil to lymphocyte counts during the 6 days in all subgroups. There was a significant difference in the comparison of leukocytes on the 6th day of therapy. Glutathione peroxidase and glutathione reductase activity was increased in selenium subgroups with negative correlation in placebo subgroups during the therapy. A downward trend in SOD activity, more appreciable in selenium groups, seemed to be a reflection of lower superoxide radical production. This is biased more as a result of GPx activity restoration, preventing further peroxidation of organic substrates and cyclic formation of other radicals, than actual attenuation of their production.Selenium substitution increased selenium dependent antioxidant enzyme activity and, in comparing mortality in groups, we found a 16.7 % decrease in mortality in favor of supplementation with selenium.

OBJECTIVE:

This study investigated the relationship of plasma antioxidants to airway inflammation and systemic oxidative stress in children suffering from atopic asthma with consideration of the intake of nutritional supplements. SUBJECTS AND RESEARCH

METHODS:

A total of 35 asthmatic children (AG) and 21 healthy controls (CG) participated in this study. Plasma levels of vitamins A and E, β-carotene, coenzyme Q10 and malondialdehyde (MDA) were analyzed with high-performance liquid chromatography (HPLC); the total antioxidant capacity (TAC) was measured photometrically, and selenium was determined by atomic absorption spectroscopy (AAS). The volume of fractionated exhaled nitric oxide (FeNO) was measured with the NIOX nitric oxide monitoring system.

RESULTS:

The plasma antioxidants vitamins A and E, selenium, and coenzyme Q10 but not β-carotene were significantly (p < 0.05) lower in asthmatics than in controls. Further, asthmatic children had significantly reduced plasma concentrations of TAC (p < 0.01), significantly enhanced levels of MDA (p < 0.001), and exhaled a significantly (p < 0.001) higher mean volume of FENO than healthy children. Regular intake of supplements had a significant positive influence on plasma vitamin E (p < 0.01), selenium (p < 0.01), TAC (p < 0.05), MDA (p < 0.01), and FENO (p < 0.01) in asthmatics but not in controls. Additionally, significant negative associations of vitamin E and MDA (AG: p < 0.01; CG: p < 0.05), and vitamin E and FENO (AG: p < 0.05; CG: p > 0.05) were identified.

CONCLUSION:

These results indicate that nutritional supplements beneficially modulate plasma antioxidants and thus might have a positive influence on systemic redox balance and subsequently, pulmonary inflammation in asthmatic children.

BACKGROUND:

Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are common causes of nephrotic syndrome in children and adults. However, frequent relapses, steroid dependence, steroid resistance, and side effects of immunosuppressive therapy remain a therapeutic challenge. Rituximab (RTX) has evolved as an efficacious alternative in childhood MCD/FSGS. We report the effect of RTX in 5 adult patients with multirelapsing/steroid-dependent nephrotic syndrome due to MCD or FSGS.

RESULTS:

All five patients treated with RTX achieved sustained complete remission and additional immunosuppression was withdrawn. One patient had a relapse after 23 months, which was successfully treated with a further series of RTX infusion without reinitiation of steroid therapy. Serious adverse events related to RTX therapy were not observed in our patients.

CONCLUSIONS:

Our results indicate that RTX is effective and cessation of additional immunosuppressants could be achieved in all patients reported in this study. RTX may be an effective alternative therapy in adult patients with multirelapsing/steroid-dependent nephrotic syndrome due to MCD or FSGS.

Neuro-Behçet's disease (NBD) is a rare clinical entity. There are no reports about cortical atrophy in NBD. We report a patient with NBD exhibiting only cortical and cerebellar atrophy without any lesions. A 38-year-old male was hospitalized due to gait disorder. He had experienced forgetfulness, irritability, sexual and behavioral dyscontrol, and incontinence for 5 years. Magnetic resonance imaging (MRI) showed cortical and cerebellar atrophy, but there were no lesions. In the differential diagnosis of NBD, physicians should take into account the presence of both brainstem and cerebellar and cortical atrophy even in the absence of typical lesions for NBD, particularly in the presence of cognitive dysfunctions.

AIM:

The aim of this study was to demonstrate that the presence of atypical perinuclear antineutrophil cytoplasmic antibodies (pANCA) in indeterminate colitis (IC) patients and the potential role of pANCA for predicting the patients either with ulcerative colitis (UC) or Crohn's disease (CD) for UC and CD.

MATERIAL AND METHODS:

Outpatients and inpatients from the hospital were retrospectively enrolled between April 2008 and December 2010. A total of 25 IC patients enrolled in the present study. Subsequently, 25 randomly selected serum samples were tested for pANCA in our laboratory. Determination of pANCA was performed by enzyme linked immunosorbent assay.

RESULTS:

Minimum follow-up was 12 months. The mean duration of disease was 20.52 months. The diagnosis was changed to UC in 13, to CD in 5 patients. The remaining 7 patients are still classified with IC, with mean disease duration of 21.29 months. Duration of disease differs statistically when comparing pANCA positive versus pANCA negative. A positive correlation was found between IC and disease location in our study.

CONCLUSION:

Patients with an initial diagnosis of IC who have positive serology are given a definitive diagnosis of UC or CD, respectively, more often than patients with negative serology.

Median arcuate ligament syndrome (MALS), also known as celiac artery compression syndrome, is a rare cause of abdominal discomfort, postprandial pain and weight loss. Doppler ultrasonography (USG), computed tomography (CT), magnetic resonance imaging (MRI), and selective catheter angiography can be used to identify this abnormality. Classically, the "fish hook" appearance is seen on sagittal images. In our case, mild stenosis (20 %) was seen at the origin of the celiac artery without typical "fish hook" appearance. Higher degree stenosis (55 %) was demonstrated on axial images. We are presenting a rare case of a MALS caused by prominent crura.