bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effekte der Ganzkörper-Elektro-myostimulation auf die Knochendichte eines Hochrisikokollektivs für Osteoporose
Authors: Bebenek M. , von Stengel S. , Kemmler W. 
Published: August 2018

Zusammenfassung
Ziel: Intensives körperliches Training zum Erhalt der Knochendichte kann oder möchte von vielen älteren Menschen nicht durchgeführt werden. Ganzkörper-Elektromyostimulation (WB-EMS) könnte hier eine geeignete Option zur Frakturprophylaxe sein.
Methodik: Inaktive, schlanke und osteopenische Frauen (75 ± 4 Jahre; BMI: 22 ± 1 kg/m2) wurden randomisiert einer WB-EMS- (n = 38) und einer Kontrollgruppe (KG: n = 38) zugeteilt. Die WB-EMS-Gruppe führte über 54 Wochen eine EMS-Applikation (1,5 x 20 min/Woche, 85 Hz) durch. Studienendpunkte waren die Knochendichte (BMD) an der Lendenwirbelsäule (LS) und am Schenkelhals (SH). Es wurde eine Intentionto- Treat (ITT)- und eine Per-Protokoll-Analyse (PPA) durchgeführt.
Ergebnisse: Die ITT-Analyse zeigte für die BMD-LS (WB-EMS: 0,6 ± 2,5 % vs. KG: −0,7 ± 2,5 %, p = 0,050) im Gegensatz zur BMD-SH (−0,3 ± 2,2 % vs. −0,6 ± 2,8 %, p = 0,768) einen “grenzwertig” signifikanten Zwischengruppenunterschied. Die PPA bestätigte dieses Ergebnis (BMD-LS: 0,9 ± 2,1 vs. −0,6 ± 2,5 %, p = 0,015; BMD-SH: 0,1 ± 2,5 % vs. −0,5 ± 2,6%, p = 0,476) mit höherer Effektstärke.
Fazit: Bei älteren Menschen mit Vorbehalten gegen ein intensives Körpertraining kann WB-EMS zumindest als Option zur (vertebralen) Frakturprophylaxe in Betracht gezogen werden.
Klinische Verwendung osteo logischer Biomaterialien
Authors: Maier G. S. , Gelinsky M. , Hose D. , Schnettler R. , Heiß C. 
Published: August 2018

ZusammenfassungIm klinischen Alltag finden sich die unterschiedlichsten Fachdisziplinen der Traumatologie und operativen Orthopädie sowie der Mund-Kiefer-Gesichtschirurgie und Neurochirurgie täglich mit der Frage nach einer möglichst optimalen Deckung bzw. Auffüllung knöcherner Defekte konfrontiert. Trotz einer Fülle kommerziell verfügbarer Knochenersatzmaterialien, die sich derzeit auf dem Weltmarkt befinden, ist die autologe Knochentransplantation (Spongiosaplastik) weiterhin der uneingeschränkte Goldstandard, doch die begrenzte Verfügbarkeit und Entnahmemorbidität/-komplikationen limitieren die klinische Anwendung. Ziel dieser Übersichtsarbeit ist es, die alternativen Ersatzmöglichkeiten in Form von Knochen - ersatzmaterialien für knöcherne Defekte und ihre klinische Anwendung aufzuzeigen.
Bioreaktoren für Knochen-Tissue-Engineering
Authors: Hsu H.-H. , Goepfert C. , Pörtner R. 
Published: August 2018

ZusammenfassungZur medizinischen Behandlung großer Knochendefekte oder Verletzungen werden als Alternative zu etablierten Behandlungs-methoden neue Konzepte des Tissue Engineering (TE) diskutiert. Beim Knochen-TE ist es das Ziel, eine mit Zellen besiedelte drei-dimensionale (3D), biologisch abbaubare Struktur am Ort der Verletzung zu implantieren. Techniken für die organotypische Kultivierung von Knochenzellen in vitro beruhen auf der Kultivierung von Gewebezellen in Bioreaktoren in einem definierten Kultur-medium auf porösen Matrizes (Scaffolds), um ein gewebeähnliches Wachstum in 3D-Strukturen zu ermöglichen. Ein wichtiger Faktor für die erfolgreiche 3D-Kultur ist die Schaffung adäquater Strömungsbedingungen, die wiederum Einfluss auf die biochemischen und biophysikalischen (z. B. mechanische) Reize haben, denen die Zellen ausgesetzt sind. Hier müssen neben Schereffekten auch Stofftransportlimitierungen berücksichtigt werden. Der Beitrag fasst den aktuellen Stand bei der Entwicklung von Bioreaktoren für die Generierung von Knochenersatzmaterialien zusammen.
Osteoklastäre Resorption osteologischer Biomaterialien
Authors: Wu L. , Wojtas N. , Kleinmichel F. , Günter C. I. , Machens H.-G. , Schilling A. F. , Grünherz L. 
Published: August 2018

ZusammenfassungKnochen ist ein lebendiges dynamisches Gewebe, das ständigem zellulär vermitteltem Umbau unterliegt. Dieser physiologische Prozess führt dazu, dass nach Implantation von Knochenersatz-Biomaterialien die Knochenzellen beginnen, mit dem Implantat zu interagieren und sowohl das Material als auch den umgebenden Knochen zu verändern. Dieser Prozess ist für die Lebensdauer des Implantates und damit für den klinischen Erfolg von besonderer Bedeutung. In diesem Artikel geben wir einen Überblick über die aktuellen Entwicklungen in diesem Zusammenhang. Es werden insbesondere die physiologische Notwendigkeit des Remodelings, die Resorption von Biomaterialien, die Aktivierung von Osteoklasten durch Materialpartikel sowie die Effekte der medikamentösen Regulierung des osteoklastären Knochenabbaus betrachtet.
Therapeutic options in male osteoporosis
Authors: Farahmand P. , Ringe J. D. 
Published: August 2018

SummaryOsteoporosis in men is increasingly recognized as an important public health problem but affected patients are still under-diagnosed and -treated. As in women the diagnostic and therapeutic strategy has to be adapted to the individual case. In the practical management it is very important to detect possible causes of secondary osteoporosis, to explain the possibilities of basic therapy counteracting individual risk factors and communicate that osteoporosis is a chronic disease and adherence to a long-term treatment is crucial. In established severe osteoporosis a careful analgesic therapy is important to avoid further bone loss related to immobility. In elderly men with increased risk of falling insufficient Vitamin D supply or impaired activation of Vitamin D due to renal insufficiency must be taken into consideration. Specific medications available today for the treatment of male osteoporosis comprise among antiresorptive drugs the bis phosphonates alendronate, risedronate and zoledronic acid. Denosumab, the first biological therapy is approved for men with androgen deprivation therapy for prostate cancer. An important advantage of this potent antiresorptive drug is the increased adherence due to the comfortable application by sixmonthly subcutaneous injections. Study results from the 2-year multi-center randomized controlled ADAMO-Study will very soon allow the use of denosumab in all types of male osteoporosis. Teriparatide, the 34 N-terminal amino acid sequence of parathyroid hormone was approved for men with osteoporosis as an anabolic agent based on proven efficacy by different studies. Among drugs with other modes of action the D-hormone pro-drug alfacalcidol can be used in men alone or in combination with the advantage of pleiotropic effects on calcium absorption, parathyroids, bone and muscle. Recently also Strontium-ranelate was approved for male patients with the limitation to exclude men with clinical relevant cardiovascular risk factors. In general the possibilities to treat male osteoporosis have considerably improved during recent years. Today there is a choice of a spectrum of drugs from mild to strong potency with different modes of action on bone turnover to design strategies for individual male patients.
The influence of gonadal hormones on skeletal health in men
Authors: Kraenzlin M. E. , Meier C. 
Published: August 2018

SummaryOsteoporosis in men has only recently begun to receive more attention despite it being estimated that about one third of all osteoporotic fractures occur in men and that the residual lifetime fracture risk in a man aged 60 years may be as high as 30 %. Accrual of bone mass and age-related bone loss in aging healthy men are multifactorial processes involving hormonal, environmental, and genetic factors. This review will summarise the effects of gonadal steroids on bone turnover and bone mass in both, men with over hypogonadism and healthy elderly men with age-related androgen deficiency.
Effekt eines körperlichen Trainings auf die Knochendichte bei Männern
Authors: Shojaa M. , von Stengel S. , Kemmler W. 
Published: August 2018

ZusammenfassungDie vorliegende Übersichtsarbeit hat das primäre Ziel, Evidenzen für ein körperliches Training mit Endpunkt Knochendichte (BMD) unter Berücksichtigung der “Angemessenheit” der Studienintervention bei Männern zusammenzufassen und idealerweise auf der Basis dieser Daten Empfehlungen für ein optimiertes Körpertraining zu formulieren.Nach Literaturrecherche gemäß PRISMA konnten final acht Untersuchungen identifiziert werden, die unsere Eligibilitätskriterien erfüllten. Alle Untersuchungen waren randomisierte kontrollierte Trainingsstudien (RCT) mit einer Fallzahl von ≥ n = 8/Studienarm, die die BMD bei gesunden Männern 50+ nach mindestens sechs Monaten Interventionsdauer erfassten.Die methodische und interventionsspezifische Qualität variiert zwischen den RCTs sehr deutlich. Zusammenfassend berichten nur drei Studien signifikante Effekte auf die BMD des proximalen Femurs, kein RCT erfasst signifikante Effekte an der LWS.Im vorliegenden Spannungsfeld liegt ein auffälliger Mangel an gut designten “state of the art”-Trainingsstudien vor. Auch Untersuchungen, welche mögliche geschlechtsspezifische Unterschiede in der ossären Adaption auf Körpertraining erfassen, erscheinen unbedingt nötig.
Der Einfluss der Gesamt-Ernährung auf die Knochengesundheit
Authors: Burckhardt P. 
Published: August 2018

ZusammenfassungDie Ernährungs-Forschung im Gebiet der Osteologie hat über Jahrzehnte die Wirkung von verschiedenen Nahrungsmitteln und Nährsubstanzen auf den Knochen aufgezeigt, und dies in allen Altersklassen. Das hat zur Erkenntnis geführt, dass z. Bsp. Milchprodukte, Früchte und Gemüse, genügend Protein und Kalziumreiche Mineralwasser der Knochendichte förderlich sind. Aber davon praktische Ernährungs-Empfehlungen abzuleiten, bleibt schwierig.Nun sind aber in den letzten 15 Jahren zahlreiche Arbeiten – auch gross angelegte epidemiologische Studien - erschienen, welche verschiedene Ernährungs-Profile in Bezug auf die Knochengesundheit untersucht haben. Daraus ging hervor, dass eine Ernährung mit viel Früchten und Gemüsen, fettarmen Milchprodukten und mässig Fleisch die Knochendichte und sogar die Häufigkeit von Hüftfrakturen günstig beeinfllusst. Darunter findet sich auch die Mittelmeerdiät, während die vegetarische, und vor allem die veganische Diät die Gefahr von Osteoporose erhöhen wegen ihres niedrigen Kalzium- und Proteingehaltes.
Light echoes from the plateau in Eta Carinae’s Great Eruption reveal a two-stage shock-powered event
Authors: Smith Nathan , Andrews Jennifer E , Rest Armin , Bianco Federica B , Prieto Jose L , Matheson Tom , James David J , Smith R Chris , Strampelli Giovanni Maria , Zenteno A 
Published: August 2018

ABSTRACT
We present multi-epoch photometry and spectroscopy of a light echo from η Carinae’s 19th century Great Eruption. This echo's light curve shows a steady decline over a decade, sampling the 1850s plateau of the eruption. Spectra show the bulk outflow speed increasing from ∼150 km s−1 at early times, up to ∼600 km s−1 in the plateau. Later phases also develop remarkably broad emission wings indicating mass accelerated to more than  10 000 km s−1. Together with other clues, this provides direct evidence for an explosive ejection. This is accompanied by a transition from a narrow absorption line spectrum to emission lines, often with broad or asymmetric P Cygni profiles. These changes imply that the pre-1845 luminosity spikes are distinct from the 1850s plateau. The key reason for this change may be that shock interaction with circumstellar material (CSM) dominates the plateau. The spectral evolution of η Car closely resembles that of the decade-long eruption of UGC 2773-OT, which had clear signatures of shock interaction. We propose a two-stage scenario for η Car’s eruption: (1) a slow outflow in the decades before the eruption, probably driven by binary interaction that produced a dense equatorial outflow, followed by (2) explosive energy injection that drove CSM interaction, powering the plateau and sweeping slower CSM into a fast shell that became the Homunculus. We discuss how this sequence could arise from a stellar merger in a triple system, leaving behind the eccentric binary seen today. This gives a self-consistent scenario that may explain interacting transients across a wide range of initial mass.
Early versus Delayed Extracranial-Intracranial Bypass Surgery in Symptomatic Atherosclerotic Occlusion
Authors: Rice Cory J , Cho Sung-Min , Taqui Ather , Moore Nina Z , Witek Alex M , Bain Mark D , Uchino Ken 
Published: August 2018

Abstract

Background
Clinical trials of extracranial-intracranial (EC-IC) bypass surgery studied patients in subacute and chronic stage after ischemic event.

OBJECTIVE
To investigate the short-term outcomes of EC-IC bypass in progressive acute ischemic stroke or recent transient ischemic attacks.

Methods
The study was a retrospective review at a single tertiary referral center from 2008 to 2015. Inclusion criteria consisted of EC-IC bypass within 1 yr of last ischemic symptoms ipsilateral to atherosclerotic occlusion of internal carotid or middle cerebral artery. Early bypass group who underwent surgery within 7 d of last ischemic symptoms were compared to late bypass group who underwent surgery >7 d from last ischemic symptom. The primary endpoint was perioperative ischemic or hemorrhagic stroke or intracranial hemorrhage within 7 d of surgery.

Results
Of 126 patients who underwent EC-IC bypass during the period, 81 patients met inclusion criteria, 69 (85%) persons had carotid artery occlusion, 7 (9%) had proximal MCA occlusion, and 5 (6%) had both. Early surgery had a 31% (9/29) perioperative stroke rate compared to 11.5% (6/52) of patients undergoing late bypass (P = .04). Of patients with acute stroke within 7 d of surgery, 41% (7/17) had perioperative stroke within 7 d (P = .07). Six of nine patients (67%) with blood pressure dependent fluctuation of neurologic symptoms had perioperative stroke (P = .049).

Conclusion
EC-IC bypass in setting of acute symptomatic stroke within 1 wk may confer higher risk of perioperative stroke. Patients undergoing expedited or urgent bypass for unstable or fluctuating stroke symptoms might be at highest risk for perioperative stroke.
Clinically Relevant Effect of UGT1A4*3 on Lamotrigine Serum Concentration Is Restricted to Postmenopausal Women—A Study Matching Therapeutic Drug Monitoring and Genotype Data From 534 Patients
Authors: Smith Robert L. , Haslemo Tore , Chan Hilde F. , Refsum Helge , Molden Espen 
Published: August 2018

Background:
Previous studies have reported inconsistent findings regarding the impact of the UGT1A4*3 variant allele on lamotrigine (LTG) exposure. As no studies have controlled for nongenetic factors, the aim of this study was to compare serum concentrations of LTG in carriers versus noncarriers of UGT1A4*3 adjusting for differences in age, sex, and valproic acid (VPA) comedication.

Methods:
Matched data on serum concentration of LTG and UGT1A4 genotype patients with known information about VPA comedication were included retrospectively from a therapeutic drug monitoring service. Linear mixed-model analysis was used to evaluate the impact of the UGT1A4*3 variant on dose-adjusted serum concentrations (C/D ratio) of LTG. Subanalyses were performed to assess the impact of UGT1A4*3 in relation to age, sex, and VPA comedication.

Results:
In total, 534 patients (1735 LTG serum concentrations) were included. In the study population, UGT1A4*3 carriers (n = 87; 16.3%) were estimated to have a 13% lower LTG C/D ratio compared with noncarriers (P = 0.01). Subanalyses showed that the quantitative impact of UGT1A4*3 was greatest in postmenopausal women (>50 years) without VPA comedication. In these patients (n = 99), UGT1A4*3 carriers displayed a 40% lower LTG C/D ratio than noncarriers (P = 0.001). The UGT1A4*3 variant had no significant effect on LTG C/D ratio in the other subpopulations (P > 0.1). Regardless of patient subgroup, the concomitant use of VPA was the strongest determinant of LTG exposure by increasing the C/D ratio 2.5-fold (P < 0.001).

Conclusions:
This study shows that UGT1A4*3 generally has a modest impact on LTG exposure, but it could lead to clinically relevant lowering in LTG serum concentration among postmenopausal women. The clinical impact of UGT1A4*3 in these patients needs to be assessed in relation to comedication with VPA, which is associated with a substantial increase in serum concentration of LTG.
Patterns of pain-related activity: replicability, treatment-related changes, and relationship to functioning
Authors: Cane Douglas , Nielson Warren R. , Mazmanian Dwight 
Published: August 2018

Abstract
Changes in activity patterns frequently accompany the experience of chronic pain. Two activity patterns, avoidance and overdoing, are hypothesized to contribute to the development of ongoing pain and pain-related disability, while activity pacing is frequently introduced to enhance pain management and functioning. Two studies were conducted to assess whether reliable subgroups with differing activity patterns could be identified in different pain populations and to evaluate changes in these subgroups after a group format, pain management program. In study 1, individuals with ongoing pain being assessed for treatment at 2 different tertiary care pain centres completed a measure of pain-related activity. Separate cluster analyses of these samples produced highly similar cluster solutions. For each sample, a 2-cluster solution was obtained with clusters corresponding to the activity patterns described by the avoidance–endurance model of pain. In study 2, a subset of individuals completing a 12-session, group format, pain management program completed measures of pain-related activity, pain intensity, and physical and psychological functioning at the beginning and end of the program. At the conclusion of the program, 4 clusters of pain-related activity were identified. Individuals who used high levels of activity pacing and low levels of avoidance consistently reported significantly better functioning relative to all other individuals. Observed changes in activity patterns from pre-treatment to post-treatment suggested that decreasing the association between activity pacing and avoidance was associated with better functioning. These results have implications for both the assessment of activity pacing and for its use as an intervention in the management of ongoing pain.
Nonalcoholic steatohepatitis, obesity, and cardiac dysfunction
Authors: Mathews Sherin E. , Kumar Rekha B. , Shukla Alpana P. 
Published: August 2018

Purpose of review
Obesity and nonalcoholic steatohepatitis (NASH) are epidemiologically and pathophysiologically linked disorders. Here, we summarize the effect of obesity on NASH and how it has a cascading effect on cardiovascular dysfunction. We also review the current and emerging treatment options for NASH.

Recent findings
The link between NASH and cardiac dysfunction has been further delineated in recent studies demonstrating endothelial dysfunction, diastolic dysfunction, and increased coronary artery calcification in patients with known NASH. Standard treatment of obesity with lifestyle interventions including diet, exercise, and behavioral modification has been shown to improve NASH as well as reduce cardiovascular dysfunction. In addition to FDA-approved drugs like vitamin E and pioglitazone, several agents including NGM282, obeticholic acid, elafibranor, and liraglutide are currently being investigated for their therapeutic potential in NASH. Recent studies show that bariatric surgery results in significant improvement or resolution of NASH.

Summary
Obesity is a major factor in the development of nonalcoholic fatty liver disease (NAFLD) and its progression to steatohepatitis. Patients with NAFLD have a significant increase in cardiovascular disease risk. For biopsy-proven NASH, vitamin E and pioglitazone are the recommended medical treatments in addition to lifestyle modification.
Engaging Stakeholders to Develop a Patient-centered Research Agenda
Authors: Haynes Sarah C. , Rudov Lindsey , Nauman Elizabeth , Hendryx Lindsay , Angove Rebekah S.M. , Carton Thomas 
Published: August 2018

Background:Patient-centered research requires a focus on the needs and priorities of patients. Because patient engagement can result in the discovery of important topics not currently prioritized by research programs, topic generation, and prioritization activities conducted with patients, caregivers, and other stakeholders are essential. To develop patient-centered research agendas for obesity and diabetes, the Research Action for Health Network conducted topic generation and prioritization activities with multistakeholder research advisory groups.Objectives:The purpose of this case study was to demonstrate how methods for engaging patients in topic generation and prioritization can be implemented in practice for the development of a patient-centered research agenda.Research Design:Four multistakeholder groups comprising patients, clinicians, and researchers met 4–5 times between November 2014 and July 2015 to generate and prioritize topics for obesity and diabetes research. Topics were prioritized using an iterative engagement process, in which themes were identified and resulting topics were refined and ranked over multiple meetings.Participants:Sixty-four patients, clinicians, and researchers participated in 2 obesity and 2 diabetes advisory groups. The majority of participants (64.0%) were patients, followed by clinicians (23.4%), researchers (9.4%), and parents of children with diabetes (3.1%).Results:Ten and 12 priority topics were identified for obesity and diabetes, respectively. The resulting research agendas were disseminated to patients, researchers, and clinicians.Conclusions:Patient engagement has the potential to enrich our understanding of patient priorities for research. The results from this process suggest that convening in-person multistakeholder groups can be an effective way to generate research topics that reflect patients’ priorities. Engagement strategies should be focused not only on the development of patient-centered research topics but also on the implementation of these topics into research studies.