Sturzfrei dank Pilates? : Auswirkungen von Pilatesübungen auf das Sturzrisiko geriatrischer Patienten/Patientinnen gemessen am Timed up and go Test

Darstellung des Themas: Die Gesundheitskosten weltweit steigen durch Sturzverletzungen der älter werdenden Gesellschaft kontinuierlich an. Es zeigt sich eine Notwendigkeit diese Kosten durch gezielte Sturzprophylaxen zu senken. Pilates eignet sich durch die sanften, präzisen Übungen besonders gut für ältere Erwachsene. Die Kräftigung der tiefliegenden Muskulatur steht im Zusammenhang mit Gleichgewicht und Stürzen bei Senioren/Seniorinnen. Ziel: Anhand dieser Arbeit sollen die Auswirkungen von Pilatesübungen auf das Sturzrisiko geriatrischer Patienten/Patientinnen anhand des Timed up and go Test geprüft werden. Methode: Mit vorab definierten Ein- und Ausschlusskriterien wurden sechs Studien zum Thema Pilates und Timed up and go Test mittels einer systematischen Literaturrecherche auf Medline, Pedro und Amed erworben. Mit Hilfe des AICA-Formulars und der Pedro-Skala wurde eine Bewertung der Studien vorgenommen. Relevante Ergebnisse: Signifikante TUG-Ergebnisse nach einer sechs- bis zwölfwöchigen Pilatesintervention zeigten sich bei vier von sechs Studien. Schlussfolgerung: Ein regelmässiges Pilatestraining hat tendenziell einen positiven Effekt auf das Sturzrisiko geriatrischer Patienten/Patientinnen. Es zeigte sich jedoch, dass Pilates kein geschützter Begriff ist und die unterrichteten Übungen von klassischen Pilatesübungen oftmals abweichen. Beeinflussende Faktoren für den Trainingserfolg sind insbesondere das Alter der Probanden/Probandinnen und deren Allgemeinzustand.Background: Throughout the world health costs are increasing steadily due to fall injuries of an ageing society. There is a need to reduce these costs with targeted prevention of falls. Pilates in particular qualifies through its gentle and precise motions as an ideal exercise for older adults. The strengthening of the low lying muscle parts stands in relation to balance and the falling of the elderly. Purpose: In this study the effects of pilates exercises will be examined on geriatric patients’ fall risk with the aid of the Timed up and go Test (TUG). Methods: With a systematic research of literature on platforms such as Medline, Pedro and Amed, six studies on the subject of pilates and the Timed up and go Test were selected on the basis of predefined criteria of inclusion and exclusion. With the aid of the AICA-form and the Pedro-scale, an analysis of the studies was performed. Results: After a six to twelve week pilates intervention, four out of six studies showed significant results. Conclusion: Consistent pilates training tends to have a positive effect on the fall risk of geriatric patients. However, it appears that pilates is not a protected term and the taught exercises often deviate from classical pilates exercises. Influencing factors for training success are the study participants’ age and general condition

Kann Akupunkt-Meridian-Massage (AMM) kurzfristig Einfluss auf Herzfrequenz, Herzfrequenzvariabilität und Blutdruck nehmen?

In den letzten Jahren hat das Interesse an alternativen Methoden zur Erhaltung von Gesundheit, zum Teil in Kombination mit der Schulmedizin, unaufhörlich zugenommen. Immer öfter ist die Rede von der Traditionellen Chinesischen Medizin, die als solche Alternative gilt. Die TCM beinhaltet viele Facetten und die Akupunkt-Meridian-Massage (AMM) ist eine von ihnen. Die Arbeit befasst sich nun damit, inwieweit Akupunkt-Meridian-Massage kurzfristig Einfluss auf das kardiovaskuläre System als Ausdruck des sympathovagalen Gleichgewichtes nehmen kann. Verglichen werden hierfür die Parameter der ProbandInnen unter Einfluss von Akupunkt-Meridian-Massage sowie Placebo-Massage. Zur Ermittlung der Werte finden die Polar S810 und ein Blutdruckgerät von Hartmann Tensoval Anwendung. Es gilt herauszufinden, ob sich Akupunkt-Meridian-Massage auf die Parameter auswirkt und sich eventuelle Unterschiede zur Placebo-Massage eruieren lassen. Die Resultate sprechen einerseits für eine erhöhte parasympathische, andererseits für eine gestiegene sympathische Aktivität. Im AMM-Versuch verzeichnen die ProbandInnen zum Schluss eine niedrigere Herzfrequenz. Dies scheint im ersten Moment positiv zu sein, doch handelt es sich hierbei nur um zirka zwei Schläge verglichen zum Ausgangswert, während die Herzfrequenz im Placebo-Versuch um 1,97 S/min (gemessen mit Polar S810) steigt. Somit differiert das Endergebnis um zirka 4 Schläge in der Minute. Eventuelle Vergleichszahlen ohne jegliche (Schein-) Beeinflussung der Werte wären hier interessant. Über eine Wirkung von AMM auf den Blutdruck lassen sich keinerlei Aussagen treffen. Als signifikant gilt bloß der diastolische Blutdruck, der im Placebo-Versuch ansteigt. Rückschlüsse auf den AMM-Versuch können deshalb nicht gezogen werden, obwohl in diesem Fall eine geringere Erhöhung der Werte, verglichen zum Ausgangswert, vorliegt (systolischer Blutdruck = AMM: Anstieg um 1,08 mmHg vs Placebo: Anstieg um 2,55 mmHg; diastolischer Blutdruck = AMM: Anstieg um 2,14 mmHg vs Placebo: Anstieg um 3,03 mmHg). Die Erhöhung beträgt somit mit Placebo-Versuch um zirka 1 mmHg mehr. Also ein (nicht signifikantes) Ergebnis, das theoretisch keine wesentlichen Unterschiede erkennen lässt. In Bezug auf die Herzfrequenzvariabilität steigen sowohl Parameter des parasympathischen (pNN50, HF, RMSSD) sowie des sympathischen Systems (LF, VLF) an. Im Fall der LF registriert die Polar S810 im AMM-Versuch höhere Werte als während des Placebo-Tests, doch gilt dies ebenso für die HF. Ansonsten verhalten sich die Werte sehr ähnlich. Die Resultate LF/HF sind nicht signifikant und lassen daher auch keine näheren Analysen zu. Die VLF unterliegt starken Schwankungen und ist wahrscheinlich in diesem Zusammenhang kaum aussagekräftig. Als Ausdruck der parasympathischen Aktivität wird unter anderem pNN50 angesehen. Dieser Wert erhöht sich zwar tendenziell um ca. 3% im AMM-Versuch, von einem signifikanten Resultat kann jedoch nicht gesprochen werden. (Im nicht signifikanten Placebo-Test steigt pNN50 um ca. 2% bis zum Ende der Untersuchung). Für RMSSD gilt eine signifikante Erhöhung im AMM-Versuch. Einen ähnlichen nicht signifikanten Verlauf nimmt der Wert im Placebo-Test. Dabei steigt der Wert im AMM-Versuch vom Ausgangswert bis zur zweiten Nachmessung um 16,5 ms an während sich dieser im gleichen Zeitraum im Placebo-Test bloß um 8,8 ms (n.s.) erhöht. Des Weiteren fällt RMSSD im Placebo-Versuch bis zur letzten Messung unter die zu Beginn erhobenen Daten. Im AMM-Test ist ebenso ein Abfall bis zur letzten Messung ersichtlich, doch bleiben die Werte trotzdem erhöht (um 9,24 ms). Von einem Effekt der Akupunktmassage kann demnach nur bedingt gesprochen werden. Vor allem die Problematik der ProbandInnenrekrutierung gleicht mitunter einem wesentlichen Hindernis und gilt gleichzeitig als größte Aufgabe. Der spezielle Mechanismus einer Akupunktur oder AMM beziehungsweise deren Effekt auf das kardiovaskuläre System bleibt somit nach wie vor unklar und benötigt weitere Untersuchungen

Characterization of the CD14⁺⁺CD16⁺ Monocyte Population in Human Bone Marrow

Numerous studies have divided blood monocytes according to their expression of the surface markers CD14 and CD16 into following subsets: classical CD14(++)CD16(-), intermediate CD14(++)CD16(+) and nonclassical CD14(+)CD16(++) monocytes. These subsets differ in phenotype and function and are further correlated to cardiovascular disease, inflammation and cancer. However, the CD14/CD16 nature of resident monocytes in human bone marrow remains largely unknown. In the present study, we identified a major population of CD14(++)CD16(+) monocytes by using cryopreserved bone marrow mononuclear cells from healthy donors. These cells express essential monocyte-related antigens and chemokine receptors such as CD11a, CD18, CD44, HLA-DR, Ccr2, Ccr5, Cx3cr1, Cxcr2 and Cxcr4. Notably, the expression of Ccr2 was inducible during culture. Furthermore, sorted CD14(++)CD16(+) bone marrow cells show typical macrophage morphology, phagocytic activity, angiogenic features and generation of intracellular oxygen species. Side-by-side comparison of the chemokine receptor profile with unpaired blood samples also demonstrated that these rather premature medullar monocytes mainly match the phenotype of intermediate and partially of (non) classical monocytes. Together, human monocytes obviously acquire their definitive CD14/CD16 signature in the bloodstream and the medullar monocytes probably transform into CD14(++)CD16(-) and CD14(+)CD16(++) subsets which appear enriched in the periphery

Efficient and Practical Transfer Hydrogenation of Ketones Catalyzed by a Simple Bidentate Mn−NHC Complex

Catalytic reductions of carbonyl‐containing compounds are highly important for the safe, sustainable, and economical production of alcohols. Herein, we report on the efficient transfer hydrogenation of ketones catalyzed by a highly potent Mn(I)−NHC complex. Mn−NHC 1 is practical at metal concentrations as low as 75 ppm, thus approaching loadings more conventionally reserved for noble metal based systems. With these low Mn concentrations, catalyst deactivation is found to be highly temperature dependent and becomes especially prominent at increased reaction temperature. Ultimately, understanding of deactivation pathways could help close the activity/stability‐gap with Ru and Ir catalysts towards the practical implementation of sustainable earth‐abundant Mn‐complexes

A transação penal na lei n.° 9.099/95 : uma análise sob a perspectiva da instrumentalidade garantista do processo penal

Orientador: Jacinto Nelson de Miranda CoutinhoMonografia (graduação) - Universidade Federal do Paraná, Setor de Ciências Jurídicas, Curso de Graduação em DireitoA presente monografia analisa transação penal na Lei n.º 9.099/95, tomando como paradigma a instrumentalidade garantista do processo penal, como meio para que a aplicação desta figura se harmonize à sistemática processual adotada pela Constituição da República. O trabalho se divide em três capítulos. O primeiro apresenta, detalhadamente, a transação penal, segundo diferentes posições doutrinárias e sua visão pelos tribunais superiores, bem como seu conceito, tomando-a, quanto à sua natureza jurídica, como um direito subjetivo do imputado. A análise segue identificando a iniciativa para o oferecimento do instituto, e os requisitos estabelecidos em lei, os quais são analisados e problematizados individualmente. Estabelece-se o momento processual apropriado para que se estenda ao imputado o acesso ao instituto, no qual se reconhece o efetivo exercício de ação penal. Abordam-se os efeitos correspondentes, e se problematizam as hipóteses de descumprimento da proposta, contrapondo-se a posição jurisprudencial ao estabelecido pela Lei n.º 9.099/95, bem como à contraposição ao sistema de garantias estabelecido constitucionalmente. No segundo capítulo, apresenta-se o sistema garantista processual preconizado pela Constituição da República. Esclarece-se a importância do monopólio estatal da pena e do processo, a instrumentalidade deste em relação àquela, e apresenta esta instrumentalidade como garantia à um processo penal justo, o qual, não raras as vezes, é negado na maneira como se aplica o instituto da transação penal nos Juizados Especiais Criminais, o qual se encontra subvertido a ideais mercadológicos, prejudiciais à concreção das garantias fundamentais constitucionais. O terceiro capítulo traz um cotejo final, evidenciando os pontos mais nebulosos verificados na pesquisa. Assevera a necessidade de se fundamentar a proposta, pelo Ministério Público como forma de obediência às regras do jogo, e, neste sentido, a necessidade, por parte dos Magistrados, em homologarem, de imediato, a proposta aceita pelo noticiado, a fim de cumprir plenamente o estabelecido pela lei e pela Constituição. Ainda se busca desmistificar a visão da transação penal como forma de humanização da pena, bem como sua incompatibilidade com o sistema processual penal acusatório. Conclui-se que a transação penal, para ser exercida em conformidade à Constituição da República, devem ser observadas as regras do jogo, procedendo-se com sua fundamentação pelo Ministério Público, seguida pelo devido controle pelo Magistrado, o qual deve, de imediato, homologar o acordo, a fim de não obstar o acesso a outros direitos e garantias constitucionai

Phosphinine Selenide: Noncovalent Interactions with Organoiodines and Elemental Iodine, and Reactivity towards Potassium Cyanide

A co-crystalline adduct consisting of a phosphinine selenide and an organohalide was obtained by slow evaporation of the solvent from a mixture of 2,6-bis(trimethylsilyl)phosphinine selenide and 1,4-diiodotetrafluorobenzene (1,4-TFDIB). The crystallographic characterization of the product shows π-π stacking, F⋅⋅⋅H hydrogen bonding between 1,4-TFDIB and the phosphinine selenide, as well as F⋅⋅⋅F interactions between 1,4-TFDIB molecules. Moreover, the phosphorus heterocycle could be crystallized with diiodine to form a 1 : 1 adduct. The d(I−I) distance in this compound is 2.8475(3) Å, which is shorter than the corresponding one in triphenylphosphine selenide diiodide, reflecting the weaker net-donor power of the phosphinine selenide towards diiodine. The phosphinine selenide could also be used as a selenium transfer reagent to generate KSeCN from KCN

Healthcare employment as a risk factor for functional neurological disorder: A case-control study.

BACKGROUND AND PURPOSE Female gender, younger age and stressful life events are known predisposing factors for functional neurological disorders (FNDs). Employment in a healthcare profession has also been suggested to be a predisposing factor. We set out to conduct a large-scale case-control study to estimate the rate employment in a healthcare profession among people with FND. METHODS We included 200 consecutive patients with a confirmed diagnosis of FND, referred to our clinic at University Hospital Bern Switzerland between October 1, 2016, and August 1, 2019. In addition, we included a control group of 200 patients with a confirmed neurological disorder, matched for age and gender, seen during the same period. The primary endpoint was to compare the prevalence of healthcare professionals between the groups. We also describe the clinical manifestations and concomitant psychiatric diagnoses in the FND cohort. RESULTS Female gender was predominant (70%), and the participants' mean age was 37 years. The proportion of healthcare professionals in the FND patients was 18% (33/186), which was significantly higher than in the control group, in which it was 10.6% (17/189; p = 0.019, 95% confidence interval odds ratio 1.168-4.074). Most healthcare professionals in both cohorts were nurses (21/33 among FND patients, 10/17 among controls). Among FND patients, 140 (70%) had motor symptoms and 65 (32.5%) had a concomitant psychiatric diagnosis. CONCLUSION This case-control study confirmed a higher rate of employment in healthcare professions in patients with FND, suggesting two potential mechanisms of FND: exposure to models/specific knowledge about neurological symptoms or stress-related professional factors. This warrants further studies on underlying mechanisms and prevention

Copper(I) and Gold(I) Complexes of Aminofunctionalized Phosphinines: Synthesis and Structural Characterization

A series of novel 3-N,N-dimethylaminofunctionalized phosphinines were synthesized and structurally characterized. DFT calculations showed that these aromatic phosphorus heterocycles possess stronger π-donor and σ-donor properties compared to the parent phosphinine C5H5P. With CuBr ⋅ SMe2, the corresponding complexes of the type [(phosphinine)2CuBr]2 are formed, which show the classical terminal σ-coordination mode of the phosphorus donor towards the Cu(I) center. Upon reaction with AuCl ⋅ SMe2, mononuclear phosphinine-Au(I)Cl complexes could be obtained and crystallographically characterized. Moreover, the presence of a SiMe3-group and a donor-functionality provide the possibility for post-synthetic ligand modifications. With CuCl ⋅ SMe2 the phosphinine-based hydrochloride salts forms a rare Cu(I) complex with a Cu4Cl4-core, that contains two pairs of differently coordinating phosphinine ligands

Switching between Hydrogenation and Olefin Transposition Catalysis via Silencing NH Cooperativity in Mn(I) Pincer Complexes

While Mn-catalyzed (de)hydrogenation of carbonyl derivatives has been well established, the reactivity of Mn hydrides with olefins remains very rare. Herein, we report a Mn(I) pincer complex that effectively promotes site-controlled transposition of olefins. This reactivity is shown to emerge once the N–H functionality within the Mn/NH bifunctional complex is suppressed by alkylation. While detrimental for carbonyl (de)hydrogenation, such masking of the cooperative N–H functionality allows for the highly efficient conversion of a wide range of allylarenes to higher-value 1-propenybenzenes in near-quantitative yield with excellent stereoselectivities. The reactivity toward a single positional isomerization was also retained for long-chain alkenes, resulting in the highly regioselective formation of 2-alkenes, which are less thermodynamically stable compared to other possible isomerization products. The detailed mechanistic analysis of the reaction between the activated Mn catalyst and olefins points to catalysis operating via a metal–alkyl mechanism─one of the three conventional transposition mechanisms previously unknown in Mn complexes

Au(i)-mediated N2-elimination from triazaphospholes: a one-pot synthesis of novel N2P2-heterocycles

Novel tosyl- and mesitylsulfonyl-substituted triazaphospholes were synthesized and structurally characterized. In an attempt to prepare the corresponding Au(I)-complexes with stoichiometric amounts of AuCl·S(CH3)2, cyclo-1,3-diphospha(III)-2,4-diazane-AuCl-complexes were obtained instead. Our here presented results offer a new strategy for preparing such coordination compounds selectively in a one-pot approach