Grenzzoneninfarkte mit symptomatischer Epilepsie

Bei sechs Patienten mit seriell auftretenden epileptischen Anfällen im Rahmen eines frischen Hirninfarktes werden periodisch auftretende einseitige Spitzenentladungen im EEG beschrieben. Bei vier Kranken ließen sich computer-tomographisch Infarktbezirke im Grenzzonenbereich zwischen dem Versorgungsgebiet von mittlerer und hinterer Hirnarterie nachweisen. Dopplersonographische und angiographische Befunde sprachen bei fünf Patienten für eine embolische Genese der Infarzierung. Unter einer vorübergehenden antikonvulsiven Therapie bildeten sich die epileptischen Anfälle und die EEG-Veränderungen innerhalb von Stunden zurück. Eine Dauertherapie war im Gegensatz zu entsprechenden EEG-Veränderungen bei Großhirninfarkten anderer Lokalisation in keinem Fall erforderlich

Changing Perspectives on Disability and Technology: Events, Trends and Personal Choices

In this chapter, eight (past-)presidents of the Association for the Advancement of Assistive Technology in Europe (AAATE) reflect on their personal engagement with the technology and disability field. The result is a patchwork of personal contributions, reflecting aspects of the contemporary history of Assistive Technology in its broadest sense, relevant for our collective memory and for those attracted to this field for their professional career.In diesem Kapitel reflektieren acht (ehemalige) Vorsitzende der Association for the Advancement of Assistive Technology in Europe (AAATE) über ihr persönliches Engagement im Bereich Technologie und Behinderung. Das Ergebnis ist ein Sammelsurium persönlicher Beiträge, die Aspekte der gegenwärtigen Geschichte der Assistiven Technologien im weitesten Sinne widerspiegeln, die für unser kollegiales Gedächtnis und für diejenigen relevant sind, die sich in ihrer beruflichen Laufbahn für diesen Bereich interessieren

Dosing Characteristics of Recombinant Human Luteinizing Hormone or Human Menopausal Gonadotrophin-Derived LH Activity in Patients Undergoing Ovarian Stimulation: A German Fertility Database Study

Objectives: The aim of the study was to evaluate dosing of recombinant human luteinizing hormone (r-hLH) or human menopausal gonadotrophin (hMG)-derived medications with LH activity in ovarian stimulation (OS) cycles for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Design: A non-interventional study was performed to analyse data from the German RecDate database (January 2007-December 2011). Participants/Materials, Setting, Methods: Starting/total r-hLH/hMG dose, OS duration/cycle number, r-hLH/hMG initiation day (first day of administration), and population/cycle characteristics were assessed in women (& GE;18 years) undergoing OS for IVF/ICSI using r-hLH or hMG-derived medications (excluding corifollitropin alfa, clomiphene citrate, letrozole, mini/micro-dose human chorionic gonadotrophin, and urofollitropin alone). Data were summarized descriptively. Results: 67,858 identified cycles utilized medications containing r-hLH (10,749), hMG (56,432), or both (677). Mean (standard deviation) OS duration with r-hLH and hMG was 10.1 (4.43) and 9.8 (6.16) days, respectively. Median (25th-75th percentile) r-hLH starting dose (75.0 [75.0-150.0] IU) was consistent across patients regardless of age, infertility diagnosis, or gonadotrophin-releasing hormone (GnRH) protocol. Median (25th-75th percentile) hMG-derived LH activity starting dose was 225.0 (150.0-300.0) IU, regardless of GnRH protocol, but was lower in women aged <35 years and those with ovulation disorders/polycystic ovary syndrome. Median (25th-75th percentile) total dose for r-hLH (750.0 [337.5-1,125.0] IU) and hMG-derived LH activity (1,575.0 [750.0-2,625.0] IU) varied according to patients' age, infertility diagnosis, cycle number, and r-hLH/hMG initiation day. GnRH antagonist use resulted in a numerically higher median total hMG-derived LH activity dose than GnRH agonist use. Limitations: The data used in this study were taken from electronic medical records relating to a specific timeframe (2007-2011) and therefore may not accurately reflect current clinical practice; however, it is likely that the differences between the two compounds would be maintained. Additionally, secondary data sources may suffer from uniformity and quality issues. Conclusions: The standard of care for OS cycles is described with respect to IVF/ICSI treatment including an LH component in Germany during the specified timeframe

Effectiveness and safety of opicapone in Parkinson’s disease patients with motor fluctuations: the OPTIPARK open-label study

Background The efficacy and safety of opicapone, a once-daily catechol-O-methyltransferase inhibitor, have been established in two large randomized, placebo-controlled, multinational pivotal trials. Still, clinical evidence from routine practice is needed to complement the data from the pivotal trials. Methods OPTIPARK (NCT02847442) was a prospective, open-label, single-arm trial conducted in Germany and the UK under clinical practice conditions. Patients with Parkinson’s disease and motor fluctuations were treated with opicapone 50 mg for 3 (Germany) or 6 (UK) months in addition to their current levodopa and other antiparkinsonian treatments. The primary endpoint was the Clinician’s Global Impression of Change (CGI-C) after 3 months. Secondary assessments included Patient Global Impressions of Change (PGI-C), the Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Questionnaire (PDQ-8), and the Non-Motor Symptoms Scale (NMSS). Safety assessments included evaluation of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs). Results Of the 506 patients enrolled, 495 (97.8%) took at least one dose of opicapone. Of these, 393 (79.4%) patients completed 3 months of treatment. Overall, 71.3 and 76.9% of patients experienced any improvement on CGI-C and PGI-C after 3 months, respectively (full analysis set). At 6 months, for UK subgroup only (n = 95), 85.3% of patients were judged by investigators as improved since commencing treatment. UPDRS scores at 3 months showed statistically significant improvements in activities of daily living during OFF (mean ± SD change from baseline: − 3.0 ± 4.6, p < 0.0001) and motor scores during ON (− 4.6 ± 8.1, p < 0.0001). The mean ± SD improvements of − 3.4 ± 12.8 points for PDQ-8 and -6.8 ± 19.7 points for NMSS were statistically significant versus baseline (both p < 0.0001). Most of TEAEs (94.8% of events) were of mild or moderate intensity. TEAEs considered to be at least possibly related to opicapone were reported for 45.1% of patients, with dyskinesia (11.5%) and dry mouth (6.5%) being the most frequently reported. Serious TEAEs considered at least possibly related to opicapone were reported for 1.4% of patients. Conclusions Opicapone 50 mg was effective and generally well-tolerated in PD patients with motor fluctuations treated in clinical practice. Trial registration Registered in July 2016 at clinicaltrials.gov (NCT02847442)

Die Hedge-Effizienz des Bobl-Futures für Jumbo-Pfandbriefe

German 'Pfandbriefe', issued by German Mortgage Banks and backed by loans to the public sector or first mortgages, inhabit a huge volume of outstanding issues which contrasts sharply with a lack of adequate hedging instruments. The invention of a 'Pfandbrief' Future will attract new investors to this important segment of the German bond market and further enhance liquidity. Our research focusses on the hedging performance of a simulated Future contract. In a quantitative study we investigate first how well an already existing Future on mid-term German government bonds (socalled 'Bundesobligationen') is suited for hedging 'Pfandbrief' portfolios. The exact specification of a Future contract on German Pfandbriefe is still a matter of discussion between experts which has forced us to make judicious assumptions about its design. This enables us to simulate Future prices and compare its hedging quality for 'Pfandbriefe' with that of the Future on 'Bundesobligationen'. Simulation results which indicate a superior hedging performance of the new Future contract may provide a crucial argument in favour of launching the new product