Verwendungsraten von Prothesen der unteren Extremität in Deutschland und der Schweiz: Ein Vergleich der Jahre 2005-2008

Zusammenfassung: Hintergrund: In den USA hat die Verwendung der totalen Hüftprothese innerhalb der letzten Dekade stark zugenommen. Es ist jedoch nicht bekannt, ob sich dieser Trend auf andere Länder übertragen lässt. Ziel dieser Untersuchung war daher der detaillierte Vergleich der Verwendungsraten von Hüft-, Knie- und OSG-Prothesen in der BRD und der Schweiz im Zeitraum 2005-2008 und ein Sekundärvergleich mit den USA. Patienten und Methoden: Aus Daten der beiden statistischen Bundesämter wurden die Einwohnerzahl, Geschlechts- und Altersverteilung sowie die Anzahl von Primär- und Revisionseingriffen ermittelt. Aus diesen Kennzahlen konnte die Anzahl von Primär-, Revisions- und Gesamteingriffen, der Revisionslast, von Primär- und Revisionsraten pro 100.000 Einwohner und Jahr sowie geschlechts- und altersspezifische Primär- und Revisionsraten berechnet werden. Ein im Vergleich dazu reduzierter Datensatz aus den USA stammt direkt vom Autor der entsprechenden Auswertungen. Ergebnisse: In Deutschland, der Schweiz und den USA stieg die Anzahl der Voll- und Teilhüftprothesenimplantationen pro 100.000 Personen von 235,8, 238,2 und 116,8 im Jahr 2005 auf 254,7, 262,7 und 127,3 an. Für Voll- und Teilknieprothesen lagen die Raten bei 156,3, 140,1 und 178,2 Implantationen in 2005 und 188,3, 176,8 und 213,6 in 2008. Die Revisionslast für Hüftprothesen lag in der BRD in 2005 mit 13,6% um 3,6% höher als in der Schweiz und betrug 11,2% in den USA. In 2008 lag sie mit 15,1% um 4,6% höher als in der Schweiz und betrug wiederum 11,2% in den USA. Für Knieprothesen lag die Last in der BRD in 2005 bei 11,1% und damit 3,5% höher als in der Schweiz; in den USA betrug sie 7,4%. In 2008 lag sie bei 12,8% und somit 4,2% höher als in der Schweiz und betrug 8,9% in den USA. In allen 3 Ländern lag die Revisionslast für Knieprothesen stets unter derjenigen für Hüftprothesen. Schlussfolgerung: In allen 3 Ländern stiegen die Primärraten für Hüft- und Knieprothesen an, diejenigen für Knieprothesen stärker. Die Revisionslasten lagen in 2008 für beide Prothesentypen in der BRD am höchsten. In der Schweiz gab es eine vorübergehende Senkung der Revisionslasten und erst ab 2007 wieder einen Anstieg. Die Verwendungsrate von Hüftprothesen pro 100.000 Einwohner lag in den USA stark unter den Raten der BRD und der Schweiz, für Knieprothesen lag sie leicht darübe

We don't know what you did last summer. On the importance of transparent reporting of reaction time data pre-processing

In behavioral, cognitive, and social sciences, reaction time measures are an important source of information. However, analyses on reaction time data are affected by researchers' analytical choices and the order in which these choices are applied. The results of a systematic literature review, presented in this paper, revealed that the justification for and order in which analytical choices are conducted are rarely reported, leading to difficulty in reproducing results and interpreting mixed findings. To address this methodological shortcoming, we created a checklist on reporting reaction time pre-processing to make these decisions more explicit, improve transparency, and thus, promote best practices within the field. The importance of the pre-processing checklist was additionally supported by an expert consensus survey and a multiverse analysis. Consequently, we appeal for maximal transparency on all methods applied and offer a checklist to improve replicability and reproducibility of studies that use reaction time measures

Femoroacetabular impingement and classification of the cam deformity: the reference interval in normal hips

BACKGROUND AND PURPOSE: Most patients with femoroacetabular impingement (FAI) have a cam deformity, which may be quantified by measuring the alpha angle and anterior offset ratio (AOR). Knowledge of what constitutes a "normal" alpha angle and AOR is limited. We defined the reference intervals of these measurements from normal hips in the general population. PATIENTS AND METHODS: 157 individuals from the general population were reviewed clinically and radiographically. 74 individuals with clinical evidence of hip disease or radiographic evidence of osteoarthritis (OA) were excluded, leaving a study group of 83 individuals (mean age 46 (22-69) years, 44 females) with normal hips. The alpha angles and AORs were measured from cross-table lateral radiographs taken in 15 degrees internal rotation. A validation study consisting of a cadaver study and a measurement reliability study was also performed. RESULTS: The mean alpha angle was 48 degrees in men and 47 degrees in women. The mean AOR was 0.19, the same in men and women. Thus, sexes were combined to derive 95% confidence intervals for the population mean alpha angle (46-49 degrees ) and AOR (0.18-0.20). The 95% reference interval for the alpha angle was 32-62 degrees degrees, and for the AOR it was 0.14-0.24. The validation study confirmed that these measurements were resistant to a reasonable degree of variation in positioning and that the repeatability and reproducibility of the measurements was good. INTERPRETATION: These reference intervals indicate that clinically and radiographically normal hips may have alpha angles and AORs that have previously been considered "abnormal". The thresholds provided by this study will aid classification of individuals involved in longitudinal studies of FAI and OA, and may be of use to the practicing clinician in evaluating the young adult with hip pain

In situ production of titanium dioxide nanoparticles in molten salt phase for thermal energy storage and heat-transfer fluid applications

In this study, TiO2 nanoparticles (average particle size 16 nm) were successfully produced in molten salt phase and were showed to significantly enhance the specific heat capacity of a binary eutectic mixture of sodium and potassium nitrate (60/40) by 5.4 % at 390 °C and 7.5 % at 445 °C for 3.0 wt% of precursors used. The objective of this research was to develop a cost-effective alternate method of production which is potentially scalable, as current techniques utilized are not economically viable for large quantities. Enhancing the specific heat capacity of molten salt would promote more competitive pricing for electricity production by concentrating solar power plant. Here, a simple precursor (TiOSO4) was added to a binary eutectic mixture of potassium and sodium nitrate, heated to 450 °C, and cooled to witness the production of nanoparticles

CD4+ T Cell Effects on CD8+ T Cell Location Defined Using Bioluminescence

T lymphocytes of the CD8+ class are critical in delivering cytotoxic function and in controlling viral and intracellular infections. These cells are “helped” by T lymphocytes of the CD4+ class, which facilitate their activation, clonal expansion, full differentiation and the persistence of memory. In this study we investigated the impact of CD4+ T cells on the location of CD8+ T cells, using antibody-mediated CD4+ T cell depletion and imaging the antigen-driven redistribution of bioluminescent CD8+ T cells in living mice. We documented that CD4+ T cells influence the biodistribution of CD8+ T cells, favoring their localization to abdominal lymph nodes. Flow cytometric analysis revealed that this was associated with an increase in the expression of specific integrins. The presence of CD4+ T cells at the time of initial CD8+ T cell activation also influences their biodistribution in the memory phase. Based on these results, we propose the model that one of the functions of CD4+ T cell “help” is to program the homing potential of CD8+ T cells

Lack of the purinergic receptor P2X7 results in resistance to contact hypersensitivity

Engagement of P2X7 on mouse dendritic cells, presumably by ATP released in response to contact allergen, is needed for IL-1β production and the sensitization phase of contact hypersensitivity

M tuberculosis in the adjuvant modulates time of appearance of CNS-specific effector T cells in the spleen through a polymorphic site of TLR2

DC deliver information regulating trafficking of effector T cells along T-cell priming. However, the role of pathogen-derived motives in the regulation of movement of T cells has not been studied. We hereinafter report that amount of M tuberculosis in the adjuvant modulates relocation of PLP139-151 specific T cells. In the presence of a low dose of M tuberculosis in the adjuvant, T cells (detected by CDR3 BV-BJ spectratyping, the so-called "immunoscope") mostly reach the spleen by day 28 after immunization ("late relocation") in the SJL strain, whereas T cells reach the spleen by d 14 with a high dose of M tuberculosis ("early relocation"). The C57Bl/6 background confers a dominant "early relocation" phenotype to F1 (SJL 7C57Bl/6) mice, allowing early relocation of T cells in the presence of low dose M tuberculosis. A single non-synonymous polymorphism of TLR2 is responsible for "early/late" relocation phenotype. Egress of T lymphocytes is regulated by TLR2 expressed on T cells. Thus, pathogens engaging TLR2 on T cells regulate directly T-cell trafficking, and polymorphisms of TLR2 condition T-cell trafficking upon a limiting concentration of ligand