bluuebunny/crossref_metadata_2025 huggingface dataset:
Facilitation of fracture repair using low-intensity pulsed ultrasound
Authors: Wong W. T. , Bennell K. L. , McMeeken J. M. , Wark J. D. , Warden S. J.
Published: March 2018

A recent application of ultrasound (US) therapy is to bone fractures. In two randomized controlled trials in humans, specific dosed US accelerated fresh tibial and radial fracture repair by 38%. When applied to delayed- and non-unions the same dosed US resulted in union in over 80% of cases. Similar US may augment fracture repair in veterinary practice. This paper reviews US dosages applied during fracture repair and their effect on bone healing. It concludes by discussing the clinical and practical implications of these findings to veterinary practice and the need for further research into this electrotherapeutic modality.

Low-intensity pulsed ultrasound has been shown to facilitate fresh fracture repair, reduce the incidence of delayed-union and initiate healing of fractures displaying delayedand non-union. This paper discusses these findings and their implications to veterinary practice.
Effect of intramedullary pin size on reducing bone plate strain
Authors: Ferry K. , Fawcett A. , Gentry D. , Hyman W. , Geller S. , Slater M. , Hulse D.
Published: March 2018

The degrees of plate strain, coupled with various diameters of intramedullary pins, is reported. In addition, the fatigue life and stiffness of the plate/pin construct was determined.
Extraction resistance of 2.7 mm medio-lateral-placed cortical screws compared with 2.7 mm and 3.5 mm cranio-caudal-placed cortical screws in canine cadaver radii
Authors: Rochat M. C. , Brusewitz G. H. , Payton M. E. , Linn L. L.
Published: March 2018

Medial placement of a 2.7 mm dynamic compression plate (DCP) has been proposed as an alternative to cranial placement of a 3.5 DCP for the treatment of mid-diaphyseal to metaphyseal radial fractures in dogs (13, 17). The purpose of this study was to compare the extraction strength of 2.7 mm screws placed in a medio-lateral (ML) plane with both 2.7 mm and 3.5 mm screws placed in a cranio-caudal (CC) plane in canine cadaver radii.

Comparisons between these three screw orientations were evaluated by placing six screws (in vitro) in each of 16 paired radii and then conducting a standard extraction test (also known as a pull-out test). One radius of each pair received 2.7 mm ML screws (n = 48), the opposite radius received either 2.7mm CC or 3.5 mm CC screws (n = 24 each). Extraction strength was compared by screw position within a bone and between planes of placement within matched pairs.

Screw position within a bone did not have a significant effect on strength comparisons. The number six (most distal) screw was consistently and significantly weaker than the other screws without regard to plane of placement. Medio-lateral screws were significantly stronger than both 2.7 mm and 3.5 mm screws placed in a cranio-caudal plane. Medial placement of a 2.7 mm dynamic compression plate (DCP) is a viable alternative to cranial placement of a 3.5 DCP for treatment of mid-diaphyseal to distal radial fractures in dogs, with regard to screw purchase and holding strength.

A comparison of extraction strength of 2.7 mm screws placed in a medio-lateral (ML) plane was made with both mm and 3.5 mm screws placed in a cranio-caudal (CC) plane in canine cadaver radii. Medio-lateral screws were significantly stronger than both mm and 3.5 mm screws placed in a cranio-caudal plane. With regard to screw purchase and holding strength, medial placement of a 2.7 mm dynamic compression plate (DCP) is a viable alternative to cranial placement of a 3.5 DCP for treatment of mid-diaphyseal to distal radial fractures in dogs.
Fragmented palmar metacarpophalangeal sesamoids in dogs: a long-term evaluation
Authors: Koblik P. D. , Whitehair J. G. , Kass P. H. , Bradley C. , Mathews K. G.
Published: March 2018

Long-term clinical and radiographicresponse to surgical and conservativemanagement of 22 dogs with fragmentedsesamoids was evaluated. Mean follow-up was 3.6 years (range = 3 monthsto 11.0 years).

Initial (retrospective) and follow-up(prospective) radiographs of the affectedpalmar sesamoids and associatedmetacarpophalangeal joints were evaluatedusing a graded scoring system. A lameness evaluation and physicalexamination were performed at followupin a blinded manner. In addition,owners were asked to complete a questionnaireregarding their pet’s thoraciclimb lameness.

There was not any difference betweengroups (sesamoidectomy, conservativemanagement, incidental finding)in age at onset, duration of lamenessprior to therapy, body weight at treatment, time to follow-up, number ofaffected joints, nor owner perceptionsof whether they thought the lamenessimproved, resolved, or recurred, andwhether or not they were pleased withthe outcome.

Sesamoid fragmentation treated bysesamoidectomy resulted in significantlygreater progression of radiographicchanges that were consistentwith degenerative joint disease.

Chronic lameness resolved or improvedto the point of owner satisfactionwith conservative therapy in most cases. Continued lameness, or recurrent,although improved lameness associatedwith heavy activity, occurred followingsurgical extirpation of the affectedsesamoids in many cases. Given thesefindings, a more conservative approachto the treatment of chronic lamenessassociated with sesamoid fragmentationmay be warranted.

Long-term clinical and radiographic response to surgical and conservative management of 22 dogs with fragmented sesamoids was evaluated. Mean follow-up was 3.6 years. Sesamoid fragmentation treated by sesamoidectomy resulted in significantly greater progression of radiographic changes that were consistent with degenerative joint disease. Chronic lameness resolved or improved to the point of owner satisfaction with conservative therapy in most cases. Continued or recurrent lameness was common following sesamoidectomy. Conservative therapy should be attempted prior to sesamoidectomy for dogs with chronic lameness associated with palmar metacarpophalangeal sesamoid fragmentation.
Plasma and synovial concentrations of carprofen in dogs with chronic osteoarthritis
Authors: Schneider T. A. , Budsberg S. C.
Published: March 2018

The objective of this study was to measure the synovial and plasma concentration of carprofen in normal and osteoarthritic stifle joints throughout a 12-hour period. Eight healthy male mixed breed hound dogs with chronic right stifle osteoarthritis (OA) secondary to right cruciate ligament transection, were used. Each dog was treated with carprofen (2mg/kg every 12 hours) for 14 days at four different time periods. Prior to treatment, each dog had baseline data collected that included two force plate evaluations (seven days apart), synovial fluid, and plasma collections. Plasma samples were collected at three hours post drug administration on days two, four, six, eight, 10, and 12. On days #7 and 14 plasma, serum, bilateral stifle synovial fluid and ground reaction forces (GRFs) were collected at three, six, nine, or 12 hours post-medication, depending upon the test protocol. Vertical and cranio-caudal ground reaction forces were recorded at each time period. Plasma concentrations measured at three hours remained constant over each testing protocol. There were not any differences between the plasma carprofen concentrations at three, nine, or 12 hours between days #7 or 14. A significant difference was not found in the carprofen synovial concentrations between left and right stifles at any time. Significant increases in vertical impulse data were found at six hours post-treatment, for all of the collection periods on days three, seven and 14. During the study, there was not any indication that carprofen had a ‘preference’ for the OA stifle as opposed to the normal stifle. Carprofen administration increased the total force transmitted through the abnormal limb.

Carprofen concentrations in the plasma and synovial fluid and ground reaction forces were measured in dogs with single stifle osteoarthritis at three, six, nine and 12 hours following dosing at 2 mg/kg every 12 hours. Carprofen did not have a ‘preference’ for the OA stifle as opposed to the normal stifle. Carprofen administration increased the total force transmitted through the abnormal limb.
The surgical treatment of talocrural luxation in nine cats
Authors: Ehrismann G. , Schmökel H. G.
Published: March 2018

The surgical treatment of talocrural luxation in nine cats was evaluated. Stabilisation of the joint was achieved by internal fixation of fractures and ligament replacement. A splint provided external support in eight cats and an external fixator was used in one. The support remained in place for three to seven weeks in five cats (group #1) but is was removed after ten days in four (group #2) and physiotherapy applied to the leg. Using a scoring system the repairs were assessed at 5-30 months, when cats in group #2 had better function and less DJD than those in group #1. Early mobilisation and weight-bearing may have favourably influenced this result.

The treatment of talocrural luxations in cats is reported. Early physiotherapy and mobilisation appeared to benefit the outcome.
The equine nuchal ligament 2: passive dynamic energy exchange in locomotion
Authors: Bertram J. E. A. , Gellman K. S.
Published: March 2018

Head and neck movements in horses are characteristic at each gait, implying that the oscillation patterns are an intrinsic part of locomotion. In this study, we examined the head and neck movements of Standardbred horses exercising on a treadmill, and calculated the mechanical work performed by the head and neck segments at the walk, trot and canter. The position of the head and neck relative to the trunk was used to calculate the elastic strain energy stored in the nuchal ligament during the head movements of locomotion. These data allowed us to estimate the proportion of oscillatory work that is contributed by passive components of the equine neck. Elastic strain energy stored in the nuchal ligament contributes 55% of the work of moving the head and neck at the walk, and 33% and 31% respectively at the trot and canter. By substituting passive nuchal ligament work for active muscular work, the horse is able to reduce its metabolic cost of locomotion.
Polyarthritis following vaccination in four dogs
Authors: Garner M. , Lübke S. , Schmidt M. F. G. , Bennett D. , Brunnberg L. , Kohn B.
Published: March 2018

The purpose of this study was to describe four dogs that developed polyarthritis (PA) shortly after vaccination.

Between 1996–1999, 27 dogs were admitted to the Clinic for Small Animals, University of Berlin with clinical signs of PA. Based on the history, clinical findings, results of routine laboratory tests, radiography and ultrasonography, synovial fluid analysis, serum titers for rheumatoid factors, infectious disease and immunological serum titers nine dogs were diagnosed with idiopathic PA type I and 14 dogs with other forms of polyarthritis. Vaccine-associated PA (VAPA) was suspected in four dogs of different breeds (1.3–2.4 years old) which showed a sudden onset of lameness with several painful and swollen joints three – 15 days (mean 11) after vaccination. Synovial fluid analysis revealed nucleated cell counts ranging from 4,000-72,000/μl (mean 30,000) with 30–90% (mean 80) neutrophils. Treatment consisted of NSAIDs and doxycycline. The VAPA dogs quickly recovered in one to two days, three had not experienced a recurrent arthritic episode, one dog developed arthritic signs 12 days after revaccination. An accurate vaccination history is important on all dogs presenting with PA. In accordance with anecdotal reports the signs of disease in VAPA can spontaneously resolve.
Elbow dysplasia in a Basset Hound
Authors: Volk S. W. , Keith D. G. , McLear R. C. , Smith G. K. , Kapatkin A. S.
Published: March 2018

A Basset Hound with elbow dysplasias (ununited anconeal process and elbow incongruity in the left elbow, fragmented medial coronoid process and elbow incongruity in the right elbow) was followed by serial radiography, computer tomographic (CT) scan and arthroscopy at eight,11,13,16 and 19 months of age. Radiographs were insensitive to progressive changes in the elbow dysplastic joints. CT and arthroscopy were both highly sensitive to subtle and severe changes occurring in the elbow joint over the times examined. Further studies evaluating the effect of multiple arthroscopic examinations itself on joints as well as age that CT will be sensitive to the earliest changes in the elbow joint need to be investigated. Hopefully, these studies will help evaluate early surgical interventions and help to eliminate elbow dysplasia in breeding dogs.
Isolating the effects of equine hoof shape measurements on capsule strain with finite element analysis
Authors: McClinchey H. L. , Jofriet J. C. , Thomason J. J.
Published: March 2018

The shape of the equine hoof capsule affects how weightbearing forces are resisted by the capsule and are transmitted to deeper structures within the hoof. Our aim was to isolate the effects of several measurements describing hoof shape on strains and stresses in the hoof capsule. Multiple finite-element models are constructed with toe angles in the range 42° to 58°, heel angles from 34° to 50°, toe lengths of 8.5 to11.5 cm, and medial and lateral angles from 68° to 83°. Strain at the toe is inversely related to toe angle, and not strongly affected by heel angle; it increases with toe length distally on the toe, but decreases near the coronary border. Varying medial and lateral angles show that more upright walls have less strain at the quarters. This study demonstrates the effectiveness of finite element methods in complementing in vitro and in vivo studies of hoof mechanics.
Lumbar intervertebral disc replacement using bioabsorbable self-reinforced poly-L-lactide full-threaded screws, or cylindrical implants of polylactide polymers, bioactive glass and Polyactive™
Authors: Ylinen P. , Tulamo R.-M. , Kellomäki M. , Türmälä P. , Rokkanen P. , Palmgren T.
Published: March 2018

Intervertebral disc surgery leads to changes in the segmental anatomy and mobility, and subsequently to degenerative changes in the lumbar spine. Artificial intervertebral disc implants sufficient to replace the human lumbar intervertebral disc have been developed and the requirements for these defined. This is to our knowledge the first study on bioabsorbable intervertebral disc replacement implants. SR-PLLA screws, previously used in orthopaedic internal fixations, and cylindrical implants, specifially developed for this experimental preliminary study, were used to replace lumbar intervertebral discs of growing pigs. After a 15-week follow-up period, the radiological and histological changes in the intervertebral spaces were analyzed. The cylindrical implants were able to prevent narrowing of discectomied spaces, and tissue regeneration in the intervertebral space was induced and occured simultaneously with degradation of the implant.
Nuklearmedizinische Diagnostik in der Neuroonkologie
Authors: Weckesser M.s , Pauleit D. , Steiger H.-J. , Langen K.-J.
Published: March 2018

Die Beurteilung der Ausdehnung von Hirntumoren, die Abschätzung der Prognose und die Rezidivdiagnostik stellen auch im Zeitalter der Magnetresonanztomographie (MRT) noch wichtige Herausforderungen in der neuroonkologischen Diagnostik dar. Nuklearmedizinische Verfahren unter Verwendung der Positronen-Emissions-Tomographie (PET) und Single Photonen Emissions Tomographie (SPECT) können hier einen wesentli-chen Beitrag leisten. So ermöglichen die PET und SPECT mit radioaktiv markierten Amino-säuren eine optimierte Darstellung der Ausdehnung von zerebralen Gliomen, was bei der Probeentnahme, der Planung einer Operation und einer Bestrahlung hilfreich sein kann. Außerdem können mit verschiedenen Tracern Tumorrezidive von posttherapeutischen Veränderungen besser differenziert werden sowie Hinweise auf den Malignitäts-grad und die Prognose von Hirntumoren gewonnen werden.
Knochenverträglichkeit und Compliance: Knackpunkte der Aromatase-hemmer-Therapie
Authors: Grübler Beate
Published: March 2018

Zur adjuvanten Therapie bei hormonrezeptorpositivem Brustkrebs gehören Aromatasehemmer (AH), die sich offenbar in ihrer Knochenverträglichkeit unterscheiden.
Mechanical effects of high density polyethylene Dynamic Compression Plate hole inserts on bone-plate constructs
Authors: Nunamaker D. M. , Richardson D. W. , Sullivan E. K.
Published: March 2018

This study was conducted in order to investigate the mechanical effects of high density polyethylene screw hole inserts in 4.5 mm Dynamic Compression Plate (DCP) – synthetic bone constructs. A mid-shaft ‘osteotomy’ was created in synthetic bone cylinders. The bisecting ‘osteotomy’ was reduced using six-hole broad DCPs and 4.5 mm cortical bone screws. The screws adjacent to the ‘osteotomy’ were placed using a loadguide. The remaining screws were placed in neutral position. High density polyethylene DCP screw hole inserts were incorporated with each screw in neutral position, in the experimental group. The bone plate constructs were tested in four point cyclical bending with the plates loaded at 2,000 Newtons, for a total of 6,000 cycles. Osteotomy gap was measured at 3,000 and 6,000 cycles. Screw head deflection adjacent to the osteotomy was measured. Kruskal-Wallis non-parametric testing was used for statistical comparisons. There was significantly less gapping at the osteotomy site in the treatment group after 3,000 cycles (0.49 +/- 0.18 mm [control] vs. 0.06 +/- 0.14 mm [treated], P=0.02) and 6,000 cycles (0.6 +/- 0.18 mm [control] vs. 0.1 +/- 0.22 mm [treated], P=0.02). The screws adjacent to the gap were significantly more deformed in the control group than those in the treated constructs (3.63 +/- 1.81 [control] vs. 1.06 +/- 1.55 [treated], P=0.0002). The polyethylene inserts improved the interface between bone plate and screw head, resulting in decreased relative movement of the implant and bone. The polyethylene inserts also resulted in less bending of the loaded screws.
Intraoperative skeletal traction in the dog
Authors: Margini A. , Cappellari F. , Peirone B. , Rovesti G. L.
Published: March 2018

A standard skeletal traction technique was applied to each major segment of the appendicular skeleton of ten fresh dog cadavers. Opposition points and anchorage points for the application of traction were determined for each skeletal segment. Traction was exerted by means of a micrometric traction stand, connected to the limb by bands or a stirrup. Traction was applied to the antebrachium and the tibia through nylon traction bands anchored to the metacarpus and metatarsus, respectively. A traction stirrup applied to the condylar region was used as the anchorage point to load the humerus and femur. Once a peak force of 25 kg weight was achieved, the load was monitored for half an hour to check for any variation. After that, each skeletal segment was osteotomized in the mid-diaphyseal region, and evaluated for any angular malalignment due to a mismatch between the axis of the bone and the applied loading. Any ensuing angular malalignment was successfully corrected by manoeuvres using the traction stand. The technique used in this study to perform intraoperative skeletal traction proved to be reliable and consistent for each segment of the appendicular skeleton.
Medial Congenital Elbow Luxation in a Dog
Authors: Milton J. L. , Hudson J. A. , Pernell R. T. , Finn-Bodner S.T. , Montgomery R. D.
Published: March 2018

Medial congenital elbow luxation was diagnosed bilaterally in an 8-week-old Pomeranian. All previous reports of congenital elbow luxation in the dog have been lateral. Treatment principles used with lateral congenital elbow luxation were successfully utilized. The ability of congenital elbow luxations to be medial further confuses the aetiology.
Successful Treatment of Congenital Shoulder Luxation in a Dog by Closed Pinning
Authors: Read R. A.
Published: March 2018

Congenital shoulder luxation in the dog is commonly associated with deformity of the humeral head and glenoid, making reduction and stabilization difficult. Early diagnosis of congenital luxation of the shoulder in a Papillon made it possible to successfully reduce and stabilize the luxation using a closed pinning technique. One year later the joint was functionally and radiographically normal.
Use of the AO Wire Passer to Aid Placement of Obstetrical Saw Wire for Osteotomy
Authors: Gofton N. , Cockshutt Joanne
Published: March 2018

The AO wire passer can be used as an effective guide for passage of obstetrical saw wire for osteotomy. Use of the wire saw and passer reduces soft tissue trauma by minimizing tissue dissection, and promoting positioning of the saw in close contact with the bone.
A Retrospective Long-Term Evaluation of Ununited Anconeal Process Excision on the Canine Elbow
Authors: Wallace L.J. , Johnston G.R. , Roy R.G.
Published: March 2018

A retrospective study was done to evaluate the long-term clinical radio-graphic effects of ununited anconeal process excision performed in dogs 5 to 12 months of age. Six dogs (seven surgically treated elbows) were evaluated at a mean of 65 months postoperatively for front limb lameness, elbow range of motion, and radiographic evidence of osteoarthritis. Limb use was considered good to excellent in 6 of 7 dogs. Osteo-arthritis, which progressed in all surgically treated elbows, was considered severe in three, moderate in one and mild to moderate in three. Early excision of an ununited anconeal process results in progressive osteoarthritis and a mild decrease in range of motion but good long-term function of the canine elbow joint.

Long-term evaluation of dogs with excision of an ununited anconeal process was performed. Long-term limb use was considered good to excellent in six of seven dogs. Early excision of an ununited anconeal process results in progressive osteoarthritis and a mild decrease in range of motion but good long-term function of the canine elbow joint.
Structural Adaptations to Mechanical Usage. A Proposed “Three-Way Rule” for Bone Modeling
Authors: Frost H. M.
Published: March 2018

A collection of fundamental structural adaptations is defined for how compacta and spongiosa respond to overloading in compression, tension and flexure, alone and in combinations. Those adaptations underlie most physiological tissue- and organ-level structural adaptations of healthy intact bones to mechanical usage, so explaining them is a major task for models of mechanical determinants of bone architecture. A biomechanical function called the Gamma function is then devised to predict from a structure's net end-loads and the strain history of any given small bone surface domain, whether mechanically induced formation, resorption or neither will occur in that domain. A separate function is devised to predict local rates of modeling from local strain histories. These functions correctly predict varied details of all of the fundamental adaptations and they also suggest new laws for the mechanical control of bone architecture, some of which are presented. The threeway rule is a new way to analyse the mechanical determinants of bone architecture that accounts for bone-biological realities learned after 1960.
Ischio-ilial Pinning for Stabilization of Coxo-femoral Luxations: An Anatomical Study
Authors: Beale B. S. , Dean P. W. , Kearney M. T. , Lewis D. D.
Published: March 2018

Bilateral cranio-dorsal coxo-femoral luxations were created in 20 canine cadavers. After reduction, ischio-ilial pins were placed bilaterally, at one of three insertion sites ventral or ventro-lateral to the ischiatic tuberosity. Stability of the reduction was assessed before and after pin placement. All (20) pins placed in the central position prevented the femoral head from luxating to the cranio-dorsal position, while cranio-dorsal luxations occurred in two of 10 cadavers after medial pin placement and two of 10 cadavers after lateral pin placement. The pelvic region was dissected to assess the relationship of the pin to the regional anatomy. Pins placed at the central position were often in contact with the ischiatic nerve, while pins placed in the medial and lateral positions were not. Pins placed in the central position afford the greatest stability; however, they also have the greatest potential of ischiatic nerve trauma.

The stability, resulting from ischio-ilial pinning, to prevent coxo-femoral luxation was studied in canine cadavers
Diaphyseal Allograft: Eight-year Evaluation in a Dog
Authors: Hoefle W. D. , Wilson J. W.
Published: March 2018

The fate of a 4 cm fresh diaphyseal cortical allograft, placed in the femur of a dog, is documented by microradiogram, microangiogram and correlated histology, eight years after implantation. Transplanted bone remained. The graft had not vascularized, it remained acellular, active resorption was not evident and new bone had been deposited directly on the transplanted bone.
Intermittent Open Mouth Locking in a Persian Cat
Authors: Lewis D. D. , Pechman R. D. , Oakes M. G.
Published: March 2018

Intermittent open mouth locking occurred in a Persian cat as the result of impingement of the left coronoid process of the mandible on the ipsilateral zygomatic arch. The condition was treated successfully by partial zygomatic arch ostectomy.
Kirschner-Ehmer Device Alone to Stabilize Caudal Lumbar Fractures in Small Dogs
Authors: Blackmore Julia , Phillips Lesley
Published: March 2018

A Kirschner-Ehmer device was used to stabilize caudal lumbar fractures/luxations in three dogs weighing 12 kg or less. A through and through Kirschner-Ehmer device maintained alignment during the healing process using the appropriate sized rods and clamps. Postoperative management included strict cage confinement and oral broad spectrum systemic antibiotics for up to two weeks after removal of the Kirschner-Ehmer device. In all three cases, the fractures/luxations were healed within six to eight weeks. The Kirschner-Ehmer device could then be removed with sedation or general anaesthesia.
Mechanical Analysis of the Veterinary Cuttable Plate
Authors: Holmberg D. L. , Fruchter A. M.
Published: March 2018

A laboratory model was chosen to compare the stiffness of various small bone plates during the application of a bending force. Forces were applied to and measured from the plate surface directly. Other compressible materials were not in contact with the supporting or measuring devices. Although we cannot recommend from this experimental model that the stiffest plate would be the best treatment option, we can conclude that: (1) the stiffness of two stacked veterinary cuttable plates was approximately equal to the sum of the stiffness for each plate, (2) screw size did not have an effect on the stiffness of the veterinary cuttable plate in three out of four comparisons, and (3) single and stacked veterinary cuttable plates were stiffer than mini bone plates accepting 1.5 mm and 2.0 mm cortical screws and less stiff than the 2.7 mm dynamic compression plate.
Eye Laceration in a Horse
Authors: Angell J. A.
Published: March 2018

A case study is presented of a Hanoverian filly with a corneo-scleral laceration. The lesion was the result of self-inflicted trauma. Medical treatment was instituted for the first twenty-four hours after the injury. Aggressive surgical treatment was necessary to attempt to save the eye and for the future use of a cosmetic scleral shell.

The owner of the filly decided upon surgical repair of the corneo-scleral laceration and the eventual use of a cosmetic scleral shell. As the filly matures, the shell will need to be enlarged in order to fill the enlarging orbit.
“Wenn ich nur wüsste, wer mir helfen kann”
Authors: Christoph V. , Hille K.
Published: March 2018

Mehr als andere Berufsgruppen in Deutschland leiden Lehrkräfte unter berufsbedingten psychischen Belastungen. Daher stellt sich die Frage, welche Unterstützungssysteme von den Lehrkräften gesehen, genutzt und gewünscht werden. In dieser Studie wurden 153 Lehrer befragt, welche Art der Unterstützung sie bei Problemen, z. B. mit Schülern oder bei fachlichen Fragen, in Anspruch nehmen, in welchen Bereichen und durch welche Instanzen sie sich mehr Unterstützung wünschen, und wie zufrieden sie mit der erhaltenen Unterstützung für ihre Arbeit sind.

Nur jeder Fünfte der befragten Lehrer ist zufrieden mit der Unterstützung, die er erhält. Die meisten Lehrer fühlen sich allein gelassen. Am ehesten werden Kollegen und Literatur zu Rate gezogen. Als wünschenswert wurden z. B. mehr Coaching und Supervision, die Unterstützung durch Fachkräfte anderer Berufszweige, z. B. Schulpsychologen oder-sozialarbeiter, sowie relevante und qualitativ hochwertige Fortbildungen genannt, die in Form einer systematischen Unterstützung psychischen Belastungen entgegenwirken können.
S3-Leitlinien Demenzen
Authors: Hausner L. , Frölich L.
Published: March 2018

Die Therapie der Demenzen umfasst eine pharmakologische Behandlung und psychosoziale Interventionen für Patienten und Angehörige im Kontext eines symptom- und schweregradabhängigen Gesamtbehandlungsplans. Primäres Ziel ist die Behandlung der Kernsymptomatik kognitive Störungen, ADL-Defizite und, falls notwendig, Therapie der psychischen und Verhaltenssymptome. Evidenzbasiert ist die stadiumabhängige Behandlung der AD mit AChE-I und Memantin. Die höchste verträgliche Dosis sollte angestrebt werden sowie eine kontinuierliche Langzeittherapie. Es ist gerechtfertigt, eine gemischte Demenz wie eine AD zu behandeln. Die Behandlung der VD mit einem AChE-I oder Memantin ist eine Off-label-Behandlung ohne vollständig überzeugenden Wirksamkeitsbeleg. Es gibt keine Evidenz zur Behandlung kognitiver Symptome oder Verhaltenssymptome bei Patienten mit FTD oder LKD. Für die antidementive Behandlung der PD ist Rivastigmin wirksam und zugelassen.
Rationale Epilepsiebehandlung bei tuberöser Sklerose
Authors: Wiemer-Kruel A. , Bast T.
Published: March 2018

Die tuberöse Sklerose (tuberous sclerosis complex, TSC) ist eine Systemerkrankung aufgrund eines Defekts der Tumorsuppressorgene TSC1 (Hamartin) und TSC2 (Tuberin) und der damit verbundenen reduzierten Hemmung des mTOR-Stoffwechsel (mammilian target of rapamycin). Etwa 85% der Patienten leiden an einer Epilepsie, die meist im ersten Lebensjahr und nicht selten als WestSyndrom beginnt und häufig pharmakorefraktär verläuft. Mindestens 60% der Patienten entwickeln kognitive Defizite, Verhaltensstörungen und/oder einen Autismus. Ein früher Epilepsiebeginn korreliert mit diesen Entwicklungsstörungen. Vigabatrin ist bei Säuglingen die Therapie der ersten Wahl. Bei älteren Patienten gibt es keine sicheren Hinweise auf eine höhere Wirksamkeit gegenüber anderen Standardantiepileptika. Die Therapie erfolgt syndromspezifisch nach den Leitlinien. Nach Versagen von zwei Standardtherapien sollte eine prächirurgische Epilepsiediagnostik an einem erfahrenen Zentrum erfolgen, auch bei multiplen Läsionen oder (scheinbar) generalisierten Anfällen. Patienten mit TSC sprechen sehr gut auf ketogene Diäten an. Auch die Vagusnervstimulation zeigt bemerkenswerte Effekte. Erste Berichte legen einen antiepileptischen Effekt von mTOR-Inhibitoren bei TSC nahe.
A Theoretical Appraisal of the Dependence of Respiratory Sinus Arrhythmia on Gradual Vagal Blockade
Authors: Pyetan E. , Akselrod S.
Published: March 2018

Motivation:
The high frequency (HF) indices of heart rate variability (HRV), which reflect the magnitude of respiratory sinus arrhythmia (RSA), have been repeatedly used as measures of cardiac vagal tone. Recent studies, however, have shown experimentally that variations in these indices do not necessarily reflect proportional changes in cardiac parasympathetic outflow.

Objective:
The goal of this study was to obtain a physiological-based theoretical evaluation of the relationship between RSA and cardiac vagal tone, which will help explain conflicting experimental results previously published.

Methods:
We derived a theoretical model for heart rate (HR) response to gradual vagal blockade. The model implements the integral-pulse-frequency-modulation (IPFM) approach to sinoatrial (SA) node physiology. The level of vagal blockade was simulated by the addition of a cardio-selective muscarinic antagonist.

Results and Conclusion:
The derivations of the model lead to a closed set of equations, from which the dependence of the HF indices on the level of vagal blockade is deduced. It is shown that several aspects of the physiological condition may have a substantial effect on this relationship: the level of baseline vagal activity, the relationship between vagal tone and the fluctuations in its traffic, the level of sympathetic activity, etc… Hence, changes in the HF indices of HRV provide a plausible assessment of the changes in cardiac vagal tone only under a specific range of physiological conditions.
Nonlinear Dynamics of Respiratory Patterns during Maturation
Authors: Sekine M. , Moodie K. L. , Akay M.
Published: March 2018

Objectives:
In this paper, we quantify the fractal scaling characteristics of phrenic neurograms during eupnea in piglets, the output of the respiratory neural network that accompany maturation We also attempt to investigate whether the fractal properties are altered with maturation.

Methods:
The phrenic neurogram in piglets was recorded from the C5 phrenic nerve during eupnea at four postnatal ages; the 3-6 days, the 7-14 days, 15-21 days and the 26-31 days age groups and analyzed using the maximum likelihood estimator (MLE).

Results:
Our results suggest that the mean fractal measures over a recording of five consecutive breaths during eupnea for each piglet in each group were higher during the first 6 days and slightly decreased for the 7-14 days and significantly decreased for the 15-21 days and significantly increased for subsequent maturation (the 26-31 days old group).

Conclusions:
We suggest that there is a significant alteration in the fractal organization in piglet respiratory patterns during maturation and a decrease in the fractal value is unique to the15-21 days old group.
Integration of Web-based and PC-based Clinical Research Databases
Authors: Sun K. , Charpentier P. , Nadkarni P. M. , Brandt C. A.
Published: March 2018

We have created a Web-based repository or data library of information about measurement instruments used in studies of multi-factorial geriatric health conditions (the Geriatrics Research Instrument Library – GRIL) based upon existing features of two separate clinical study data management systems. GRIL allows browsing, searching, and selecting measurement instruments based upon criteria such as keywords and areas of applicability. Measurement instruments selected can be printed and/or included in an automatically generated standalone microcomputer database application, which can be downloaded by investigators for use in data collection and data management.

Methods:
Integration of database applications requires the creation of a common semantic model, and mapping from each system to this model. Various database schema conflicts at the table and attribute level must be identified and resolved prior to integration. Using a conflict taxonomy and a mapping schema facilitates this process.

Results:
Critical conflicts at the table level that required resolution included name and relationship differences.

Conclusions:
A major benefit of integration efforts is the sharing of features and cross-fertilization of applications created for similar purposes in different operating environments. Integration of applications mandates some degree of metadata model unification.
Privacy Protection for HealthGrid Applications
Authors: Claerhout B. , De Moor G. J. E.
Published: March 2018

Objectives:
This contribution aims at introducing the problem of privacy protection in e-Health and at describing a number of existing privacy enhancing techniques (PETs). The recognition that privacy constitutes a fundamental right is gradually entering public awareness. Because healthcare-related data are susceptible to being abused for many obvious reasons, public apprehension about privacy has focused on medical data. Public authorities have become convinced of the need to enforce privacy protection and make considerable efforts for promoting through privacy protection legislation the deployment of PETs.

Methods:
Based on the study of the specific features of Grid technology, ways in which PET services could be integrated in the HealthGrid are being analyzed. Grid technology aims at removing barriers between local and remote resources. The privacy and legal issues raised by the HealthGrid are caused by the transparent interchange and processing of sensitive medical information. PET technology has already proven its usefulness for privacy protection in health-related marketing and research data collection.

Results:
While this paper does not describe market-ready solutions for privacy protection in the HealthGrid, it puts forward several cases in which the Grid may benefit from PETs.

Conclusion:
Early integration of privacy protection services into the HealthGrid can lead to a synergy that is beneficial for the development of the HealthGrid itself.
The Grid as a Healthcare Provision Tool
Authors: Blanquer I. , Hernández V.
Published: March 2018

Objectives:
This paper presents a survey on HealthGrid technologies, describing the current status of Grid and eHealth and analyzing them in the medium-term future. The objective is to analyze the key points, barriers and driving forces for the take-up of HealthGrids.

Methods:
The article considers the procedures from other Grid disciplines such as high energy physics or biomolecular engineering and discusses the differences with respect to healthcare. It analyzes the status of the basic technology, the needs of the eHealth environment and the successes of current projects in health and other relevant disciplines.

Results:
Information and communication technology (ICT) in healthcare is a promising area for the use of the Grid. There are many driving forces that are fostering the application of the secure, pervasive, ubiquitous and transparent access to information and computing resources that Grid technologies can provide. However, there are many barriers that must be solved. Many technical problems that arise in eHealth (standardization of data, federation of databases, content-based knowledge extraction, and management of personal data …) can be solved with Grid technologies.

Conclusions:
The article presents the development of successful and demonstrative applications as the key for the take-up of HealthGrids, where short-term future medical applications will surely be biocomputing-oriented, and the future of Grid technologies on medical imaging seems promising. Finally, exploitation of HealthGrid is analyzed considering the curve of the adoption of ICT solutions and the definition of business models, which are far more complex than in other e-business technologies such ASP.
Large Medical Datasets on the Grid
Authors: de Alfonso C. , Hernández V. , Blanquer I.
Published: March 2018

Objective:
This paper shows the use of the emerging Grid technology for gathering underused resources that are distributed among a corporate network. The work of these resources is coordinated for facing tasks which are not affordable by the individual usage of each of them.

Methods:
This paper shows an application for the projection, using Volume Rendering techniques, of huge medical volumes obtained from CTs and RMIs, adapted to Grid computing.

Results:
As a result the article shows the feasibility of the creation of an application based up on Grid technology, which solves problems that cannot be addressed by using common techniques. As an example, the article describes the projection of a huge medical dataset, which exceeds the resources of most common PCs, carried out by taking profit of idle CPU cycles from the computers of an organization.

Conclusions:
Grid technology is emerging as a new framework which allows gathering and coordinating resources distributed among a network (LAN or WAN), for addressing problems which cannot be solved through the single use of any of these resources. Medical Imaging is a clear application area for this technology.
A Multi-resolution Approach for Content-based Image Retrieval on the Grid
Authors: Tweed T. , Miguet S. , Hassan K.
Published: March 2018

Objectives:
Hospitals and medical centers are producing more and more data that need to be processed. Those data are confidential, heterogeneous, and limited to the geographic site where they have been produced. Unless properly anonymized, they cannot be distributed on wide area networks.

Methods:
Grid technologies allow the globalization of storage and processing resources, and enable large-scale experimentations on distributed data. They constitute a promising tool to treat the different data and analyze the knowledge they contain, while offering secured access and high-performance computing capacities to the different users. Our aim is to evaluate the possibilities of grid technologies for handling medical data.

Results and Conclusions:
In this paper, we focus on a breast cancer diagnosis assistance tool, based on distributed and incremental knowledge construction and a content-based image retrieval system. We analyze the different scenarios of uses of such a tool. We further propose an algorithm that indexes mammographic images for content-based query purposes. This algorithm is tested on images of different resolutions in order to reduce the indexation time and we analyze its performance with experiments on the grid.
The GENIUS Web Portal
Authors: Andronico G. , Falzone A. , Lo Re G. , Pulvirenti A. , Rodolico A. , Barbera R.
Published: March 2018

Objective:
The development of computational Grids is making huge amounts of computing power and data storage available for a lot of scientific applications.

At this stage of development, the use of the Grid is mainly based on Command Line Interface (CLI) tools that are not very friendly and can be considered an obstacle to the use of these powerful tools. The objective of this paper is to present a solution to this problem.

Methods:
To ease the access of new users to the grid the GENIUS (Grid Enabled web eNvironment for site Independent User job Submission) grid portal has been jointly developed by INFN and NICE within the context of both the Italian INFN Grid and the European DataGrid Projects. Here we devote particular care to the description of job creation and submission and the services for transparent access to user’s data and applications.

Results:
Using GENIUS, the obstacle of complicated CLI can be overtaken and simple web interfaces can be built for specific user communities and applications. Here we show examples in the field of bio-medical applications.

Conclusions:
The use of Grid can be made easy with the use of Grid portals such as GENIUS.
GPCALMA: a Grid-based Tool for Mammographic Screening
Authors: Bagnasco S. , Bottigli U. , Cheran S. C. , Delogu P. , Fantacci M. E. , Fauci F. , Forni G. , Lauria A. , Lopez Torres E. , Magro R. , Masala G. L. , Oliva P. , Palmiero R. , Ramello L. , Raso G. , Retico A. , Sitta M. , Stumbo S. , Tangaro S. , Zanon E. , Cerello P.
Published: March 2018

Objectives:
The next generation of high energy physics (HEP) experiments requires a GRID approach to a distributed computing system: the key concept is the Virtual Organisation (VO), a group of distributed users with a common goal and the will to share their resources.

Methods:
A similar approach, applied to a group of hospitals that joined the GPCALMA project (Grid Platform for Computer Assisted Library for MAmmography), will allow common screening programs for early diagnosis of breast and, in the future, lung cancer. The application code makes use of neural networks for the image analysis and is useful in improving the radiologists' diagnostic performance. GRID services allow remote image analysis and interactive online diagnosis, with a potential for a relevant reduction of the delays presently associated with screening programs.

Results and Conclusions:
A prototype of the system, based on AliEn GRID Services [1], is already available, with a central server running common services [2] and several clients connecting to it. Mammograms can be acquired in any location; the related informatio required to select and access them at any time is stored in a common service called Data Catalogue, which can be queried by any client. Thanks to the PROOF facility [3], the result of a query can be used as input for analy-sis algorithms, which are executed on the nodes where the input images are stored,. The selected approach avoids data transfers for all the images with a negative diagnosis and allows an almost real time diagnosis for the set of images with high cancer probability.
Health Risk Appraisal Using Internet Technology
Authors: Yoshida K. , Suka M.
Published: March 2018

Objective:
To develop a Web-based Health Risk Appraisal (HRA) system as a tool for health education based on personal health examination data.

Methods:
A Japanese health examination database was analyzed to develop models for HRA, which were designed to predict each of ten laboratory values in a year with and without lifestyle modifications. The HRA models were embedded into a server.

Results:
The Web-based HRA system has been introduced into a Japanese health care association having 37 branch centers. Following a health examination, an individual health education program using the Web-based HRA system is provided to a given client at each branch center or at a client’s office. A measured laboratory value and corresponding predicted laboratory values in a year with and without lifestyle modifications are displayed on the screen in forms of both numerical values and graphs. A trained nurse or another health care provider operates the system and explains the HRA result.

Conclusion:
The Web-based HRA system will be a practical tool for individual health education following health examination.
Evaluating Personal Health Care and Health Promotion Web Sites
Authors: Collen A. , Lang J. R.
Published: March 2018

Objective:
An exemplary sample of web sites relevant to personal health care and health promotion was chosen and evaluated.

Methods:
Both quantitative and qualitative data were converged to assess and rank the sites on nine attributes.

Results:
The sites provided a definitive range of value and variety of presentations, health care and health promotion information, and services covering the virtual choices currently available to users of the Internet.

Conclusion:
Discussion focused on methodological approaches and issues of web site evaluation serving the public interest, health care, and health promotion.