Arthroskopie bei Hüftdysplasie

Zusammenfassung: Die kausale Behandlung der Hüftdysplasie besteht in einer Pfannenreorientierungsosteotomie, deren Resultate stark von den intraartikulären Schäden abhängen. Entscheidender prognostischer Faktor ist der Knorpelstatus, jedoch können Rupturen des Labrum acetabulare und des Lig.capitis femoris auch für Symptome verantwortlich sein. In diesem Zusammenhang bietet die Hüftarthroskopie ein wertvolles Instrument zur präzisen Diagnose und Behandlung dieser Läsionen. Bislang gibt es jedoch noch keine Resultate, die ein solches Vorgehen unterstütze

Arthroskopische Hüftchirurgie: Psoastenotomie und Eingriffe an der Gelenkkapsel

Zusammenfassung: Psoasassoziierte Schmerzen und eine schmerzhaft springende Psoassehne werden konservativ behandelt. Bei persistierenden Schmerzen kann eine Tenotomie indiziert sein. Das arthroskopische Verfahren im Rahmen der Hüftarthroskopie des peripheren Kompartiments ermöglicht eine minimalinvasive, selektive Tenotomie der Psoassehne auf Gelenkniveau mit deutlich reduzierter Komplikationsrate. Im Gegensatz zum extraartikulären, endoskopischen Verfahren ist keine weitere Portalanlage notwendig, zudem können intraartikuläre Pathologien ausgeschossen oder direkt behandelt werden. Die arthroskopische Psoastenotomie bei 9Patienten zeigte nach durchschnittlich 9Monaten postoperativ gute Ergebnisse ohne Rezidiv, subjektive Beugeschwäche oder Komplikationen. Instabilität und primäre Kapsulitis sind wahrscheinlich seltene, aber zu beachtende Hüftpathologien. Sekundäre Bewegungseinschränkungen sind häufige Folgen chronischer Hüfterkrankungen. Zur arthroskopischen Kapselplikatur, Kapselshrinking und Kapselrelease mit oder ohne Narkosemobilisierung liegen bisher nur wenige Erfahrungen vor. Die ersten Ergebnisse erscheinen ähnlich vielversprechend wie am Schultergelenk. Kapsulotomie und Kapselresektion sind bereits feste Bestandteile der arthroskopischen Behandlung der sekundären Bewegungseinschränkung verschiedener Hüfterkrankunge

Optical Properties of Graphene Nanoflakes: Shape Matters

In recent years there has been significant debate on whether the edge type of graphene nanoflakes (GNF) or graphene quantum dots (GQD) are relevant for their electronic structure, thermal stability and optical properties. Using computer simulations, we have proven that there is a fundamental difference in the calculated absorption spectra between samples of the same shape, similar size but different edge type, namely, armchair or zigzag edges. These can be explained by the presence of electronic structures near the Fermi level which are localized on the edges. These features are also evident from the dependence of band gap on the GNF size, which shows three very distinct trends for different shapes and edge geometries.Comment: 8 pages, 9 figures. Submitted to The Journal of Chemical Physic

Trajectories of Functional Health and Its Associations With Information Processing Speed and Subjective Well-Being: The Role of Age Versus Time to Death

Functional health declines with advancing age, which is supposedly the consequence of both normal, “primary aging” as well as of mortality-related, “tertiary aging” processes. To better understand the independent effects of both processes, we investigated how age and time to death relate to changes in functional health over up to 12 years. Additionally, adopting the disablement process model for an end-of-life perspective, we investigated if both age and time to death moderate associations of information processing speed and subjective well-being with functional health. Data from the German Ageing Survey were used. Our sample consisted of 578 participants who had died between 2002 and 2016 (mean age at death: 76.59 years, range 45–95 years). Information processing speed was measured by the Digit Symbol Substitution Test. The well-being indicators assessed were positive affect and depressive symptoms. Based on longitudinal multilevel regression models, we found that functional health significantly decreased over time in study. Approaching death was a stronger predictor of functional health decline than was chronological age. Regarding moderation effects, controlling for gender, education, and multimorbidity, individuals closer to death at baseline revealed stronger associations of both depressive symptoms and information processing speed with baseline functional health, whereas these associations were not moderated by chronological age. Our findings suggest that change in functional health is more strongly affected by time to death than by chronological age. Moreover, there may be a growing importance of cognitive resources and well-being for functional health with advanced “tertiary aging,” but not with progression of “primary aging.

Effect of the Carbohydrate Composition of feed Concentratates on Methane Emission from dairy Cows and Their Slurry

Dietary carbohydrate effects on methane emission from cows and their slurry were measured on an individual animal basis. Twelve dairy cows were fed three of six diets each (n = 6 per diet) of a forage-to-concentrate ratio of 1:1 (dry matter basis), and designed to cover the cows' requirements. The forages consisted of maize and grass silage, and hay. Variations were exclusively accomplished in the concentrates which were either rich in lignified or non-lignified fiber, pectin, fructan, sugar or starch. To measure methane emission, cows were placed into open-circuit respiration chambers and slurry was stored for 14 weeks in 60-L barrels with slurry being intermittently connected to this system. The enteric and slurry organic matter digestibility and degradation was highest when offering Jerusalem artichoke tubers rich in fructan, while acid-detergent fiber digestibility and degradation were highest in cows and slurries with the soybean hulls diet rich in non-lignified fiber. Multiple regression analysis, based on nutrients either offered or digested, suggested that, when carbohydrate variation is done in concentrate, sugar enhances enteric methanogenesis. The methane emission from the slurry accounted for 16.0 to 21.9% of total system methane emission. Despite a high individual variation, the methane emission from the slurry showed a trend toward lower values, when the dietwas characterized by lignified fiber, a diet where enteric methane release also had been lowest. The study disproved the assumption that a lower enteric methanogenesis, associated with a higher excretion of fiber, will inevitably lead to compensatory increases in methane emission during slurry storag

Comparison of fresh and ensiled white and red clover added to ryegrass on energy and protein utilization of lactating cows

Two respiratory chamber experiments were conducted with dairy cows to compare metabolizable energy and protein utilization when feeding white or red clover with ryegrass. In experiment 1, fresh ryegrass was mixed with fresh white (WF) or red clover (RF) (60/40, on dry matter (DM) basis). Experiment 2 involved similar mixed diets in ensiled form (WS and RS, respectively), and two ryegrass silage diets, without (GS) or with supplementary maize gluten (GS+). Barley was supplemented according to requirements for milk production. Voluntary forage DM intake remained unaffected in experiment 1 and was higher (P<0·01) in experiment 2 for WS than for GS and GS+(128 v. 98 and 106 g/kg M0·75). Within experiments, no treatment effects occurred for apparent nutrient digestibilities, milk yield, and composition. Protein utilization (milk-N/N-intake) was numerically lower on all clover-based diets (0·24 to 0·25) versus GS (0·29). With added maize gluten (GS+), protein utilization decreased to 0·23, indicating that ryegrass silage (plus barley) alone provided sufficient metabolizable protein. Consequently, higher (P<0·01) urinary energy losses occurred in GS+ compared with GS, despite similar metabolizable energy intakes, and a trend for the highest plasma urea levels was found for GS+ cows (7·59 mmol/l; P<0·1). Overall, this study illustrates that the white and red clovers investigated were equivalent in energy and protein supply, also in comparison to the ryegrass. It remains open whether these forage legumes, when supplemented to a moderate-protein ryegrass, would have contributed to metabolizable protein supply or would have merely increased metabolic nitrogen loa

Effect of Red and White Clover Added to a Rye Grass-Based Diet on Intake, Fibre Digestion and Methane Release of Dairy Cows

Forage legumes like white and red clover are widely grown in association with grass, with the intention to improve the quality of grass-based diets. However little is known about the effect of either white or red clover added to a grass-based diet on methane release, and existing studies are not conclusive. The objective of this study, applying the respiratory chamber technique, was to determine the effect of red and white clover added to a rye grass-based diet on intake, fibre digestion and methane release of dairy cows

Direct magnetic resonance arthrography of the knee: utility of axial traction

The purpose of this study was to determine the impact of axial traction during acquisition of direct magnetic resonance (MR) arthrography examination of the knee in terms of joint space width and amount of contrast material between the cartilage surfaces. Direct knee MR arthrography was performed in 11 patients on a 3-T MR imaging unit using a T1-weighted isotropic gradient echo sequence in a coronal plane with and without axial traction of 15kg. Joint space widths were measured at the level of the medial and the lateral femorotibial joint with and without traction. The amount of contrast material in the medial and lateral femorotibial joint was assessed independently by two musculoskeletal radiologists in a semiquantitative manner using three grades (‘absence of surface visualization, ‘partial surface visualization or ‘complete surface visualization'). With traction, joint space width increased significantly at the lateral femorotibial compartment (mean = 0.55mm, p = 0.0105) and at the medial femorotibial compartment (mean = 0.4mm, p = 0.0124). There was a trend towards an increased amount of contrast material in the femorotibial compartment with axial traction. Direct MR arthrography of the knee with axial traction showed a slight and significant increase of the width of the femorotibial compartment with a trend towards more contrast material between the articular cartilage surface

Wireless capsule endoscopy for the detection of small bowel diseases in HIV-1-infected patients

<p>Abstract</p> <p>Background and Aims</p> <p>In HIV-infected patients, manifestations of the disease are common in the gastrointestinal tract. The objective of our study was to evaluate the diagnostic yield of the Given^®Video Capsule System (Given Imaging, Yoqneam, Israel) in these patients.</p> <p>Methods</p> <p>After exclusion of GI-tract stenosis by anamnestic exploration, 49 patients were included into the study. Stratification: Group A (n = 19): HIV-positive, CD₄cell count < 200/μl, gastrointestinal symptoms present. Group B: HIV-positive, CD₄< 200/μl, without gastrointestinal symptoms (n = 19 Group) C: healthy volunteers (n = 11).</p> <p>Results</p> <p>In group A there was a total of 30 pathological findings, 15 of which with therapeutic implications. In group B, there was a total of 22 pathological findings, 5 relevant for therapy. In group C there was a total of 13 pathological findings, 3 with therapeutic relevance. In 89% (group A) vs. 26% (group B), pathological findings were detected distal the ligament of Treitz (p = 0.001). All capsules were recovered without complications after 12 to 96 h from the stool.</p> <p>Conclusion</p> <p>Wireless capsule endoscopy of the small intestine should be considered for HIV-infected patients with marked immunosuppression and gastrointestinal symptoms.</p

How did individuals in the second half of life experience the Covid-19 Crisis? Perceived threat of the Covid-19 Crisis and subjective influence on a possible infection with Covid-19

This chapter examines the extent to which people in the second half of life felt threatened by the COVID-19 pandemic, whether there were differences between middle-aged and older individuals, and the role of self-rated health. This chapter also addresses how people perceived their influence on contracting COVID-19