Ausgleich posttraumatischer Beinverkürzungen mit einem motorisierten intramedullären Nagel

Zusammenfassung: Hintergrund: Während der Kindheit können Frakturen zu einer signifikanten Beinlängendifferenz (BLD) führen. Die herkömmliche Methode, Beinlängendifferenzen und Fehlstellungen zu korrigieren, ist die Kallotasis mit Anlage eines Fixateur externe. Patienten und Methoden: Zwischen 2006 und 2008 wurden 11Patienten mit posttraumatischer BLD (2,4-4,3cm) mit einem vollimplantierbaren motorisierten Distraktionsmarknagel (Fitbone®) behandelt und deren Befunde ausgewertet. Hospitalisationszeit, Erreichen der Korrekturlänge, Rehabilitationszeit sowie Komplikationen wurden erfasst. Ergebnisse: In 5 Fällen wurden neben der erfolgreichen Beinverlängerung auch Korrekturen in mindestens einer weiteren Ebene durchgeführt. Bei einem durchschnittlichen Distraktionsindex von 1,03mm/Tag (0,6-1,2mm/Tag), betrug der mittlere Konsolidierungsindex 40Tage/cm. Der stationäre Aufenthalt dauerte im Mittel 9,8 (8-20Tage). Knochen- und Weichteilinfektionen sowie andere, v.a. fixateurassoziierte Komplikationen wurden nicht beobachtet. Funktionell wurden exzellente Ergebnisse erreicht. Der präoperative Bewegungsumfang konnte bei allen Patienten wiederhergestellt werden, in 3 Fällen wurde er verbessert. Schlussfolgerung: Der Fitbone®-Distraktionsmarknagel ist eine adäquate Alternative zu herkömmlichen Konzepten und reduziert typische fixateurassoziierte Komplikatione

Response to the letter by Udo Bonnet

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153273/1/nmo13715_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153273/2/nmo13715.pd

Genome-wide association study for 13 udder traits from linear type classification in cattle

Udder conformation traits are known to correlate with the incidence of clinical mastitis and the length of productive life. The results of a genome-wide association study based on imputed high-density genotypes of 1,637 -Brown Swiss sires and de-regressed breeding values for 13 udder traits are presented here. For seven traits significant signals could be observed in five regions on BTA3, BTA5, BTA6, BTA17, and BTA25. For fore udder length and teats diameter significant SNPs were found in a known region around 90 Mb on BTA6. For the trait rear udder height significant SNPs are positioned in the coding region of the SNX29gene. Several significant SNPs around 62 Mb on BTA17 are associated with the traits rear udder width, frontteat placement and rear teat placement. The function of potential candidate genes and the influence of substructure will be addressed as next steps

Results of an Indo-Swiss programme for qualification and testing of a 300-kW IISc-Dasag gasifier

The paper describes the performance and operational experience in India on a high efficiency, low tar, woody biomass gasifier developed at Indian Institute of Science, Bangalore. This development is also of interest to Switzerland, which has a substantial potential of biomass energy. The test scheme included measurements on tar and particulates and the effluents along with necessary measurements for the mass and energy balance. The results indicate a low tar level to meet the engine specifications and the effluents issuing out of the system could be treated using simpler techniques, as the levels are low

DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS (DISH) OF THE ELBOW: A CAUSE OF ELBOW PAIN? A CONTROLLED STUDY

Elbow pain is a common complaint and elbow hyperostosis a frequent radiological condition. However, little is known about the association between the clinical and radiological findings. To evaluate the relationship between spinal and extraspinal hyperostotic features and the clinical relevance of elbow hyperostosis we have performed the first controlled, double-blinded study of 85 hospitalized probands, 33 with and 52 without thoracospinal hyperostosis on lateral chest X-ray. Elbow and shoulder hyperostosis were graded on bilateral standard radiographs. Elbow pain was assessed by an interviewer using a standardized questionnaire and extraskeletal causes of elbow pain were recorded. The prevalence of elbow hyperostosis was increased in cases with thoracospinal hyperostosis compared to controls (82% versus 58%, X2 = 5.32, P<0.025, n = 85, odds ratio (OR) 3.30 (95% Cl 1.16-9.35)). Similarly, the prevalence of elbow hyperostosis was increased in cases with shoulder hyperostosis compared to controls (83% versus 60%, x2 = 4.51, P<0.05, n = 84, OR = 3.20 (95% CI 1.06-9.66)), emphasizing the multifocal nature of hyperostotic features. Elbow pain was only slightly more prevalent in cases with elbow hyperostosis compared to controls (21% versus l3%, x2 = 0.75, NS, OR = 1.84 (95% CI 0.46-7.44)). We conclude that elbow hyperostosis is a radiological finding of doubtful clinical relevanc

The linear multiplet and ectoplasm

In the framework of the superconformal tensor calculus for 4D N=2 supergravity, locally supersymmetric actions are often constructed using the linear multiplet. We provide a superform formulation for the linear multiplet and derive the corresponding action functional using the ectoplasm method (also known as the superform approach to the construction of supersymmetric invariants). We propose a new locally supersymmetric action which makes use of a deformed linear multiplet. The novel feature of this multiplet is that it corresponds to the case of a gauged central charge using a one-form potential not annihilated by the central charge (unlike the standard N=2 vector multiplet). Such a gauge one-form can be chosen to describe a variant nonlinear vector-tensor multiplet. As a byproduct of our construction, we also find a variant realization of the tensor multiplet in supergravity where one of the auxiliaries is replaced by the field strength of a gauge three-form.Comment: 31 pages; v3: minor corrections and typos fixed, version to appear in JHE

Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions

Cyclic vomiting syndrome (CVS) is characterized by severe episodic emesis in adults and children. Cannabinoid hyperemesis syndrome is an increasingly recognized CVS‐like illness that has been associated with chronic cannabis use. There are significant gaps in our understanding of the pathophysiology, clinical features, comorbidities, and effective management options of CVS. Recommendations for treating CVS are based on limited clinical data, as no placebo‐controlled, randomized trials have yet been conducted. Diseases associated with CVS, including migraine, mitochondrial disorders, autonomic dysfunction, and psychiatric comorbidities, provide clues about pathophysiologic mechanisms and suggest potential therapies. We review our current understanding of CVS and propose future research directions with the aim of developing effective therapy. Establishing a multicenter, standardized registry of CVS patients could drive research on multiple fronts including developing CVS‐specific outcome measures to broaden our understanding of clinical profiles, to serve as treatment end points in clinical trials, and to provide a platform for patient recruitment for randomized clinical trials. Such a robust database would also facilitate conduct of research that aims to determine the underlying pathophysiological mechanisms and genetic basis for CVS, as well as identifying potential biomarkers for the disorder. Soliciting government and industry support is crucial to establishing the necessary infrastructure and achieving these goals. Patient advocacy groups such as the Cyclic Vomiting Syndrome Association (CVSA), which partner with clinicians and researchers to disseminate new information, to promote ongoing interactions between patients, their families, clinicians, investigators, to support ongoing CVS research and education, must be an integral part of this endeavor.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149751/1/nmo13607.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149751/2/nmo13607_am.pd

Guidelines on management of cyclic vomiting syndrome in adults by the American Neurogastroenterology and Motility Society and the Cyclic Vomiting Syndrome Association

The increasing recognition of cyclic vomiting syndrome (CVS) in adults prompted the development of these evidence‐based guidelines on the management of CVS in adults, which was sponsored by the American Neurogastroenterology and Motility Society (ANMS) and the Cyclic Vomiting Syndrome Association (CVSA). GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework was used and a professional librarian performed the literature search. The expert committee included the President of the CVSA who brought a patient perspective into the deliberations. The committee makes recommendations for the prophylaxis of CVS, treatment of acute attacks, diagnosis, and overall management of CVS. The committee strongly  recommends that adults with moderate‐to‐severe CVS receive a tricyclic antidepressant (TCA), such as amitriptyline, as a first‐line prophylactic medication and receive topiramate or aprepitant as alternate prophylactic medications. Zonisamide or levetiracetam and mitochondrial supplements (Coenzyme Q10, L‐carnitine, and riboflavin) are conditionally recommended as alternate prophylactic medications, either alone or concurrently with other prophylactic medications. For acute attacks, the committee conditionally recommends using serotonin antagonists, such as ondansetron, and/or triptans, such as sumatriptan or aprepitant to abort symptoms. Emergency department treatment is best achieved with the use of an individualized treatment protocol and shared with the care team (example provided). The committee recommended screening and treatment for comorbid conditions such as anxiety, depression, migraine headache, autonomic dysfunction, sleep disorders, and substance use with referral to appropriate allied health services as indicated. Techniques like meditation, relaxation, and biofeedback may be offered as complementary therapy to improve overall well‐being and patient care outcomes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149730/1/nmo13604.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149730/2/nmo13604_am.pd

Constitutive basal and stimulated human small bowel contractility is enhanced in obesity

Small bowel contractility may be more prominent in obese subjects, such that there is enhanced nutrient absorption and hunger stimulation. However, there is little evidence to support this. This study examined in vitro small bowel contractility in obese patients versus non-obese patients

Management of cyclic vomiting syndrome in adults: Evidence review

BackgroundThis evidence review was conducted to inform the accompanying clinical practice guideline on the management of cyclic vomiting syndrome (CVS) in adults.MethodsWe followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and focused on interventions aimed at prophylactic management and abortive treatment of adults with CVS. Specifically, this evidence review addresses the following clinical questions: (a) Should the following pharmacologic agents be used for prophylaxis of CVS: amitriptyline, topiramate, aprepitant, zonisamide/levetiracetam, or mitochondrial supplements? (b) Should the following pharmacologic agents be used for abortive treatment: triptans or aprepitant?ResultsWe found very low‐quality evidence to support the use of the following agents for prophylactic and abortive treatment of CVS: amitriptyline, topiramate, aprepitant, zonisamide/levetiracetam, and mitochondrial supplements. We have moderate certainty of evidence for the use of triptans as abortive therapy. We found limited evidence to support the use of ondansetron and the treatment of co‐morbid conditions and complementary therapies.ConclusionsThis evidence review helps inform the accompanying guideline for the management of adults with CVS which is aimed at helping clinicians, patients, and policymakers, and should improve patient outcomes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149694/1/nmo13605.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149694/2/nmo13605_am.pd