Das Laufverhalten von Patienten mit künstlichem Hüftgelenkersatz und dessen Folgeerscheinungen

2017 ◽  
Vol 37 (04) ◽  
pp. 232-238
Author(s):  
T. Pohl ◽  
T. Horstmann ◽  
S. Perschke
Keyword(s):  
Mesh Term ◽  
Körperliche Funktion

ZusammenfassungLaufen wird als Sportart mit hoher Stoßbelastung eingestuft und Patienten mit einem künstlichen Hüftgelenk nicht empfohlen. Entgegen dieser Empfehlungen kehren einige Läufer nach einer Operation dennoch zum Laufsport zurück. Es sind wissenschaftliche Erkenntnisse zum allgemeinen postoperativen Sportverhalten vorhanden, allerdings kaum Ergebnisse zum Laufen im Speziellen. Auf Basis der aktuellen Datenlage soll dieses Review die Fragen bearbeiten, (1) wie hoch der Läuferanteil unter den Patienten ist, (2) welche Trainingsparameter festzustellen sind und (3) ob negative Folgeerscheinungen für die Prothesenhaltbarkeit auftreten. In PubMed wurde mit einer spezifischen MeSH-Term-Suche gearbeitet. Nach der Analyse von Titel, Abstract und Volltext erfüllten drei von ursprünglich 39 Artikeln die Einschlusskriterien. Postoperativ betrug der Anteil an joggenden Patienten zwischen 3,8 % und 16,3 %. Nur zwei der Studien berichteten von Trainingsparametern: Die wöchentliche Trainingsfrequenz lag bei 3,5–4-Mal pro Woche mit Läufen zwischen 14,4–28,4 km, 116–186 Minuten und 7,7–9,2 km/h. Ein Pa-tient nahm sogar an einem Marathon über 42,5 km teil. In der eingeschlossenen Literatur wurde in keinem Fall von Prothesenlockerung oder erhöhter Abnutzung berichtet. Positiv ist, dass die Läufer eine bessere körperliche Funktion und weniger Schmerzen zeigten als nicht laufende Hüftprothesen-Patienten. Es bleibt zu beachten, dass die eingeschlossene Literatur keine ausreichende Evidenz über Langzeit -effekte auf Hüftgelenkersatz durch Laufen liefert. Erstens ist die Anzahl an Studien mit hoher Qualität gering und zweitens lagen die beobachteten Follow-Up-Längen bei 3,9 Jahren und sind folglich unzulänglich kurz. Neben Longitudinalstudien würde eine biomechanische Untersuchung helfen, die Empfehlungen zum Laufen nach Hüftgelenkersatz weiterzuentwickeln.

Das Laufverhalten von Patienten mit künstlichem Hüftgelenkersatz und dessen Folgeerscheinungen: Ein systematisches Review zum aktuellen Forschungsstand

2017 ◽  
Vol 37 (04) ◽  
pp. 232-238
Author(s):  
T. Pohl ◽  
T. Horstmann ◽  
S. Perschke
Keyword(s):  
Mesh Term ◽  
Systematisches Review ◽  
Körperliche Funktion

ZusammenfassungLaufen wird als Sportart mit hoher Stoßbelastung eingestuft und Patienten mit einem künstlichen Hüftgelenk nicht empfohlen. Entgegen dieser Empfehlungen kehren einige Läufer nach einer Operation dennoch zum Laufsport zurück. Es sind wissenschaftliche Erkenntnisse zum allgemeinen postoperativen Sportverhalten vorhanden, allerdings kaum Ergebnisse zum Laufen im Speziellen. Auf Basis der aktuellen Datenlage soll dieses Review die Fragen bearbeiten, (1) wie hoch der Läuferanteil unter den Patienten ist, (2) welche Trainingsparameter festzustellen sind und (3) ob negative Folgeerscheinungen für die Prothesenhaltbarkeit auftreten. In PubMed wurde mit einer spezifischen MeSH-Term-Suche gearbeitet. Nach der Analyse von Titel, Abstract und Volltext erfüllten drei von ursprünglich 39 Artikeln die Einschlusskriterien. Postoperativ betrug der Anteil an joggenden Patienten zwischen 3,8 % und 16,3 %. Nur zwei der Studien berichteten von Trainingsparametern: Die wöchentliche Trainingsfrequenz lag bei 3,5–4-Mal pro Woche mit Läufen zwischen 14,4–28,4 km, 116–186 Minuten und 7,7–9,2 km/h. Ein Patient nahm sogar an einem Marathon über 42,5 km teil. In der eingeschlossenen Literatur wurde in keinem Fall von Prothesenlockerung oder erhöhter Abnutzung berichtet. Positiv ist, dass die Läufer eine bessere körperliche Funktion und weniger Schmerzen zeigten als nicht laufende Hüftprothesen-Patienten. Es bleibt zu beachten, dass die eingeschlossene Literatur keine ausreichende Evidenz über Langzeiteffekte auf Hüftgelenkersatz durch Laufen liefert. Erstens ist die Anzahl an Studien mit hoher Qualität gering und zweitens lagen die beobachteten Follow-Up-Längen bei 3,9 Jahren und sind folglich unzulänglich kurz. Neben Longitudinalstudien würde eine biomechanische Untersuchung helfen, die Empfehlungen zum Laufen nach Hüftgelenkersatz weiterzuentwickeln.

scholarly journals Incidentalomas: concept, relevance and challenges for medical practice

2015 ◽  
Vol 10 (35) ◽  
pp. 1-9 ◽  
Author(s):  
María Ana Mariño
Keyword(s):  
High Resolution ◽  
Medical Practice ◽  
Incidental Finding ◽  
Diagnostic Procedures ◽  
Mesh Term ◽  
Medical Databases

Incidentaloma (which has not been included as a MeSH term neither in other medical databases or Bioportal) is a neologism used to describe an incidentally discovered mass (or abnormality) in asymptomatic persons. Incidentaloma, or incidental finding, is extremely common now and in most cases harmless, but sometimes it is not possible to exclude the possibility of real damage and in very few cases, some people can get benefit from its discovery. Therefore, most of incidentalomas represent overdiagnosis originated by the massive use of high-resolution diagnostic procedures. In many cases, incidentaloma causes anxiety, consume time and resources, and can even cause further damage to patients’ health as a result of procedures performed in the post-finding follow-up. Thus, it is important to recognize the problem to try to avoid it if possible, and learn strategies to deal with it once we stumbled upon an incidentaloma.

Thoracic Spinal Angiolipomas: A Systematic Review

2021 ◽  
Author(s):  
Giuseppe Emmanuele Umana ◽  
Massimiliano Visocchi ◽  
Elena Roca ◽  
Maurizio Passanisi ◽  
Marco Fricia ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Surgical Techniques ◽  
Mesh Term ◽  
Motor Deficits ◽  
Benign Tumors ◽  
Type Ii ◽  
Thoracic Spinal ◽  
Type Ia ◽  
Spinal Angiolipomas

Abstract Background Spinal angiolipomas (SAs) are rare, benign tumors, representing 0.0004 to 1.2% of angiolipomas, usually located at the extradural and posterior thoracic level, with multimetameric extension. Methods A systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The authors searched on PubMed and Scopus databases for published articles with the Mesh term “spinal angiolipoma” and pertinent associations. Language restriction to English papers was applied. The authors also reported three emblematic cases of patients who underwent surgical resection of spindle-shaped (type IA) and dumbbell-shaped (type II) SAs between 2014 and 2020. Results Of the 256 retrieved articles, 33 were included in the meta-analysis. These 33 studies, together with our 3 reported cases, included a total of 60 patients, 36 females (60%) and 24 males (40%), with a mean age of 53.12 ± 12.82 years (range: 12–77 years).T5 was the most represented level (22 patients). Usually, the localization of SA was extradural, with 53 patients suffering from spindle-shaped type IA SA (88.3%) and 7 patients from dumbbell-shaped type II SA (11.6%). Almost all patients underwent laminectomy (78.3%) and presented a full recovery of motor deficits (85%). Gross total removal (GTR) was performed in 93.3% of patients. The mean follow-up was of 22.71 ± 21.45 months (range: 2–80 months). There was no documented recurrence at follow-up magnetic resonance imaging in any of the patients. Conclusions SAs are rare, benign tumors with a great vascular component that presents a favorable outcome. GTR is the gold standard treatment and usually an adjuvant therapy is not required. Even infiltrative lesions, which are more complex, can be treated successfully with a good prognosis. Dumbbell-shaped SAs must be differentiated from schwannomas and meningiomas, and require different surgical techniques, given the profuse bleeding associated with the attempt of debulking. En block resection is the key to treat these common benign tumors with acceptable blood loss.

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

Brief summary of Kleť photographic search programme for minor planets

1999 ◽  
Vol 173 ◽  
pp. 189-192
Author(s):  
J. Tichá ◽  
M. Tichý ◽  
Z. Moravec
Keyword(s):  
Ccd Camera ◽  
Minor Planet ◽  
Minor Planets ◽  
Main Belt

AbstractA long-term photographic search programme for minor planets was begun at the Kleť Observatory at the end of seventies using a 0.63-m Maksutov telescope, but with insufficient respect for long-arc follow-up astrometry. More than two thousand provisional designations were given to new Kleť discoveries. Since 1993 targeted follow-up astrometry of Kleť candidates has been performed with a 0.57-m reflector equipped with a CCD camera, and reliable orbits for many previous Kleť discoveries have been determined. The photographic programme results in more than 350 numbered minor planets credited to Kleť, one of the world's most prolific discovery sites. Nearly 50 per cent of them were numbered as a consequence of CCD follow-up observations since 1994.This brief summary describes the results of this Kleť photographic minor planet survey between 1977 and 1996. The majority of the Kleť photographic discoveries are main belt asteroids, but two Amor type asteroids and one Trojan have been found.

Intranuclear Crystals in Regenerating Canine Kidneys

1973 ◽  
Vol 31 ◽  
pp. 412-413
Author(s):  
D.G. Osborne ◽  
L.J. McCormack ◽  
M.O. Magnusson ◽  
W.S. Kiser
Keyword(s):  
Epithelial Cell ◽  
Epithelial Cells ◽  
Tubular Epithelial Cell ◽  
Tubular Epithelial Cells ◽  
Cell Nuclei ◽  
Crystalline Structures ◽  
Small Crystals ◽  
Membrane Bound

During a project in which regenerative changes were studied in autotransplanted canine kidneys, intranuclear crystals were seen in a small number of tubular epithelial cells. These crystalline structures were seen in the control specimens and also in regenerating specimens; the main differences being in size and number of them. The control specimens showed a few tubular epithelial cell nuclei almost completely occupied by large crystals that were not membrane bound. Subsequent follow-up biopsies of the same kidneys contained similar intranuclear crystals but of a much smaller size. Some of these nuclei contained several small crystals. The small crystals occurred at one week following transplantation and were seen even four weeks following transplantation. As time passed, the small crystals appeared to fuse to form larger crystals.

Electron Microscopy of Human Gallstones

1971 ◽  
Vol 29 ◽  
pp. 296-297
Author(s):  
C. Wolpers ◽  
R. Blaschke
Keyword(s):  
Electron Microscopy ◽  
Room Temperature ◽  
Bile Pigment ◽  
X Ray Diffraction ◽  
Triclinic Crystal System ◽  
X Ray ◽  
Follow Up Study ◽  
Infra Red ◽  
Main Components

Scanning microscopy was used to study the surface of human gallstones and the surface of fractures. The specimens were obtained by operation, washed with water, dried at room temperature and shadowcasted with carbon and aluminum. Most of the specimens belong to patients from a series of X-ray follow-up study, examined during the last twenty years. So it was possible to evaluate approximately the age of these gallstones and to get information on the intensity of growing and solving.Cholesterol, a group of bile pigment substances and different salts of calcium, are the main components of human gallstones. By X-ray diffraction technique, infra-red spectroscopy and by chemical analysis it was demonstrated that all three components can be found in any gallstone. In the presence of water cholesterol crystallizes in pane-like plates of the triclinic crystal system.

Articulatory Intervention for the Visually Impaired

1979 ◽  
Vol 10 (3) ◽  
pp. 139-144
Author(s):  
Cheri L. Florance ◽  
Judith O’Keefe
Keyword(s):  
High School ◽  
High School Students ◽  
Behavior Change ◽  
Visually Impaired ◽  
School Students ◽  
Handicapped Children ◽  
Paired Stimuli ◽  
Visually Handicapped ◽  
Parent Program

A modification of the Paired-Stimuli Parent Program (Florance, 1977) was adapted for the treatment of articulatory errors of visually handicapped children. Blind high school students served as clinical aides. A discussion of treatment methodology, and the results of administrating the program to 32 children, including a two-year follow-up evaluation to measure permanence of behavior change, is presented.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

The Link Between Verbal Short-Term Memory and Anomia Treatment Gains

2019 ◽  
Vol 28 (3) ◽  
pp. 1039-1052
Author(s):  
Reva M. Zimmerman ◽  
JoAnn P. Silkes ◽  
Diane L. Kendall ◽  
Irene Minkina
Keyword(s):  
Short Term Memory ◽  
Controlled Trial ◽  
Treatment Success ◽  
Linear Regression Models ◽  
Language Performance ◽  
Short Term ◽  
Term Memory ◽  
Treatment Gains ◽  
Post Hoc

Purpose A significant relationship between verbal short-term memory (STM) and language performance in people with aphasia has been found across studies. However, very few studies have examined the predictive value of verbal STM in treatment outcomes. This study aims to determine if verbal STM can be used as a predictor of treatment success. Method Retrospective data from 25 people with aphasia in a larger randomized controlled trial of phonomotor treatment were analyzed. Digit and word spans from immediately pretreatment were run in multiple linear regression models to determine whether they predict magnitude of change from pre- to posttreatment and follow-up naming accuracy. Pretreatment, immediately posttreatment, and 3 months posttreatment digit and word span scores were compared to determine if they changed following a novel treatment approach. Results Verbal STM, as measured by digit and word spans, did not predict magnitude of change in naming accuracy from pre- to posttreatment nor from pretreatment to 3 months posttreatment. Furthermore, digit and word spans did not change from pre- to posttreatment or from pretreatment to 3 months posttreatment in the overall analysis. A post hoc analysis revealed that only the less impaired group showed significant changes in word span scores from pretreatment to 3 months posttreatment. Discussion The results suggest that digit and word spans do not predict treatment gains. In a less severe subsample of participants, digit and word span scores can change following phonomotor treatment; however, the overall results suggest that span scores may not change significantly. The implications of these findings are discussed within the broader purview of theoretical and empirical associations between aphasic language and verbal STM processing.

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