A history of concussions is associated with symptoms of common mental disorders in former male professional athletes across a range of sports

Objective: Recent reports suggest that exposure to repetitive concussions in sports is associated with an increased risk of symptoms of distress, anxiety and depression, sleep disturbance or substance abuse/dependence (typically referred as symptoms of common mental disorders[CMD]) and of later development of neurodegenerative disease, in particular chronic traumatic encephalopathy (CTE). The primary aim of this study was to explore the relationship between sports career-related concussions and the subsequent occurrence of symptoms of CMD among former male professional athletes retired from football (soccer), ice hockey and rugby (union). Methods: Cross-sectional analyses were performed on baseline electronic questionnaires from three prospective cohort studies among former male professional athletes retired from football (soccer), ice hockey and rugby (union). The number of confirmed concussions was examined through a single question, while symptoms of distress, anxiety and depression, sleep disturbance and adverse alcohol use were assessed using validated questionnaires. Results: From 1,957 former professional athletes contacted, a total of 576 (29%) completed the questionnaire. Of these, 23% had not incurred a concussion during their career, 34% had two or three, 18% four or five, and 11% six or more concussions. The number of sports career-related concussions was a predictor for all outcome measures (β = 0.072–0.109; P ≤ 0.040). Specifically, former professional athletes who reported a history of four or five concussions were approximately 1.5 times more likely to report symptoms of CMD, rising to a two- to five-fold increase in those reporting a history of six or more sports career-related concussions. Conclusions: These data demonstrate an association between exposure to sports concussion and subsequent risk of symptoms of CMD in former professional athletes across a range of contact sports. Further work to explore the association between sports concussion and symptoms of CMD is required; in the meanwhile, strategies for effective risk reduction and improved management appear indicated

Juvenile sex offenders: mental health and reoffending

Doreleijers, T.A.H. [Promotor]Vermeiren, R.R.J.M. [Promotor]Nauta-Jansen, L.M.C. [Copromotor

Korrekturosteotomie bei lateraler Tibiakopfimpression und Valgusfehlstellung

Zusammenfassung : Operationsziel : Verbesserung der Gelenkkongruenz bei fehlverheilten Frakturen des lateralen Tibiaplateaus, Schmerzreduktion, Vorbeugung einer Arthrose. Indikationen : Valgusfehlstellung der proximalen Tibia und damit verbundene intraartikuläre Impression des Tibiaplateaus Kontraindikationen : Patienten in schlechtem Allgemeinzustand. Hochgradiges Defizit der Kniegelenkfunktion. Patientenalter > 65 Jahre. Chronische Infektion. Weichteilprobleme. Unfähigkeit des Patienten, die Extremität nach der Operation abrollend zu belasten. Operationstechnik : Tangentiale Osteotomie des mittlerer Fibuladrittels. Gerader lateraler oder parapatellarer Zugang zur lateralen proximalen Tibia. Laterale Arthrotomie des Kniegelenks. Proximale keilförmige öffnende ("open wedge‘ Osteotomie der Tibia. Intraartikuläre Korrektur der Impression des lateralen Tibiakondylus durch subchondrales Einstößeln von Spongiosa. Beurteilung der Achsenverhältnisse des Beins. Interposition kortikospongiöser Knochentransplantate zur Stützung der öffnenden Osteotomie. Bei Bedarf interne Fixation. Weiterbehandlung : Kontinuierliche passive Bewegung bis 90° Flexion ab dem 1. postoperativen Tag. Nach Anlage einer stabilisierenden Schiene dürfen die Patienten 8 Wochen abrollend mobilisieren. Nach radiologischer Knochenheilung schrittweiser Aufbau der Belastung. Ergebnisse : Zwischen 1977 und 1998 wurden 23 Patienten operiert. Zwei Fehlschläge waren zu verzeichnen, wovon einer in einer Arthrodese und der andere in einem totalen Gelenkersatz mündete. Nach durchschnittlich 14 Jahren (5-6 Jahre) wurden 21 Patienten nachuntersucht. Zwei Patienten litten unter einer signifikanten Verschlechterung der Arthrose, vier Patienten wiesen eine leicht progrediente Knorpeldegeneration auf, und bei 15 Patienten war das Ausmaß des Gelenkverschleißes unverändert. Durchschnittlich konnten der tibiofemorale Winkel um 8,6° (13-14,4°), die Tibiakopfimpression um 6 mm (4-9 mm) und der Bewegungsumfang um 12° (0-20°) verbessert werden. Pseudarthrosen fanden sich nich

Investigation of the washout effect in a magnetically driven axial blood pump

For a long-term implementation of the magnetically driven CircuLite blood pump system, it is extremely important to be able to ensure a minimum washout flow in order to avoid dangerous stagnation regions in the gap between the impeller and the motor casing as well as near the pivot-axle area at the holes in the impeller's hub. In general, stagnation zones are prone to thrombus formation. Here, the optimal impeller/motor gap width will be determined and the washout flow for different working conditions will be quantitatively calculated. The driving force for this secondary flow is mainly the strong pressure difference between both ends of the gap. Computational fluid dynamics (CFD) and digital particle image velocimetry (DPIV) will be used for this analysis

Efficacy of platelet transfusions

According to current guidelines, patients with thrombocytopenia due to myelosuppression are supported with platelet concentrates in order to prevent and treat bleeding complications using algorithms which include the level of thrombocytopenia as well as varying clinical parameters, e.g. concomitant infection, the use of anticoagulant drugs, specific interventions. In the last three decades, mainly driven by safety issues, several platelet product changes were made with leukoreduction in the eighties of the previous century, plasma reduction and the use of additive solution in the nineties and the use of pathogen reduction in the first decade of this century.This thesis is mainly based on two randomised controlled trials testing the clinical efficacy of the use of additive solutions and pathogen reduction, essentially showing a decreased clinical efficacy as well as a decrease in adverse transfusion events. A bette r understanding of the pathophysiology of bleeding, thrombocytopenia and platelet transfusion refractoriness will lead to improvements in supportive care as well as patient survival, the common goal of all physicians.UBL - phd migration 201