Revised contraindications for the use of non-medical WB-electromyostimulation. Evidence-based German consensus recommendations.

Whole-body electromyostimulation has proven to be a highly effective alternative to conventional resistance-type exercise training. However, due to adverse effects in the past, very extensive contraindications have been put in place for the commercial, non-medical WB-EMS market. Considering recent positive innovations e.g., federal regulation, mandatory trainer education, revised guidelines, and new scientific studies on WB-EMS application, we believe that a careful revision of the very restrictive contraindications on WB-EMS is needed. This applies all the more because many cohorts with limited options for conventional exercise have so far been excluded. During a first meeting of an evidence-based consensus process, stakeholders from various backgrounds (e.g., research, education, application) set the priorities for revising the contraindications. We decided to focus on four categories of absolute contraindications: "Arteriosclerosis, arterial circulation disorders", "Diabetes mellitus" (DM), "Tumor and cancer" (TC), "Neurologic diseases, neuronal disorders, epilepsy". Based on scientific studies, quality criteria, safety aspects and benefit/risk assessment of the category, DM and TC were moved to the relative contraindication catalogue, while arteriosclerosis/arterial circulation disorders and neurologic diseases/neuronal disorders/epilepsy were still considered as absolute contraindications. While missing evidence suggests maintaining the status of neurologic diseases/neuronal disorders as an absolute contraindication, the risk/benefit-ratio does not support the application of WB-EMS in people with arteriosclerosis/arterial circulation diseases. Despite these very cautious modifications, countries with less restrictive structures for non-medical WB-EMS should consider our approach critically before implementing the present revisions. Considering further the largely increased amount of WB-EMS trials we advice regular updates of the present contraindication list.

[Digital subtraction angiography of the lung]. / Digitale Subtraktionsangiographie (DSA) der Lunge.

DSA of the lung entails reduced examination risk and is a simpler procedure than conventional angiography. Out of a total of 55 lung DSA's, 53 (96%) supplied reliable diagnostic information. Suspicion of pulmonary embolism was the most frequent indication. DSA was also successfully employed in therapy control. Since other diseases of the pulmonary vessels can also be diagnosed via DSA, it can largely replace conventional pulmonary angiography. Disadvantages of DSA which must be taken into consideration are the reduced local resolution and limitations imposed by artifacts caused by patients movements.

[Value of ultrasound in screening for liver metastases and liver involvement in malignant systemic disease]. / Die Wertigkeit der Ultraschalluntersuchung beim Screening von Lebermetastasen und von einer Leberbeteiligung bei malignen Systemerkrankungen.

The value of sonography as a primary screening method for the diagnosis of liver metastases or liver involvement by malignant lymphoma has been investigated in 163 patients. The following results were obtained: sensitivity 92%, specificity 80%, accuracy 85%. In 109 patients CT findings were also considered. The high proportion of correct positive and low proportion of low false negative findings makes sonography the method of choice for primary screening. The figures also indicate that if sonography is negative, other diagnostic procedures are unnecessary. If sonography is abnormal, but the findings are not clear, then computed tomography is indicated.