Das Verhalten des Blutglykogens während des Menstruationscyclus

Zusammenfassung Bei 25 normalgewichtigen, 18–28jährigen Frauen mit stabilem Menstruationscyclus wurden vor und nach der Ovulation während eines Cyclus Blutglykogen- und Blutglucosebestimmungen durchgeführt. Bei den Blutglykogenwerten konnte eine signifikante Differenz festgestellt werden. Die Durchschnittswerte betrugen vor dem Eisprung 2,99±0,4 mg-%, in der lutealen Phase 2,10±0,1 mg-%. Dabei zeigten die Werte in der lutealen Phase eine deutliche und signifikante Differenz zu den Werten vergleichbarer Normalpersonen einer früheren Untersuchungsreihe (2,89±0,2 mg-%). Eine direkte Beziehung zur Konzentration der Blutglucose war nicht festzustellen. Gleichzeitig zu dem signifikanten Abfall des Blutglykogens erfolgt in der lutealen Phase des Cyclus ein Anstieg des Progesterons, der zum Zeitpunkt der Blutabnahme einen Höhepunkt erreicht. Diese Beobachtung bestätigt die Ergebnisse früherer Untersuchungen bei Graviden in Beziehung zum Schwangerschaftsmonat. Bei dieser Untersuchung konnte ebenfalls ein Abfall des Blutglykogens mit dem gleichzeitigen Anstieg des Progesterons festgestellt werden.

---

Summary Blood glycogen and blood glucose have been measured in 25 women with regular period (normal weight; age ranging from 18–28). Blood levels were determined before and after ovulation. The determination of blood glycogen revealed a significant difference. The average value was 2,99±0,4 mg-% before ovulation and 2,10±0,1 mg-% during the luteal phase. The values of the luteal phase also showed a significant difference in comparison with the values of a control group (2,89±0,2 mg-%). There was no correlation between the levels of blood glycogen and blood glucose. During the period of significant decrease of blood glycogen concentration progesteron levels increase remarkably. Present results confirm our previous findings in pregnant women concerning the blood glycogen in comparison to the stage of pregnancy. In that previous study we could demonstrate a certain correlation between the decrease of blood glycogen and the increase of progesteron.

     

Untersuchungen über den diagnostischen Wert der intravenösen Belastung mit Tolbutamid

Ohne Zusammenfassung     

Minimal injection site pain and high patient satisfaction during treatment with long-acting risperidone

Long-acting injectable antipsychotic formulations of conventional antipsychotics were developed to address the problem of partial adherence among patients with schizophrenia. Injection site pain, other skin reactions and patient satisfaction with treatment were assessed in two large, multicentre studies of long-acting injectable risperidone (Risperdal CONSTA, Janssen Pharmaceutica Products, Titusville, New Jersey, USA), the first available long-acting atypical antipsychotic agent. Patients rated injection site pain using a 100-mm Visual Analogue Scale (VAS), and investigators rated injection site pain, redness, swelling and induration. Patient satisfaction with treatment was assessed with the Drug Attitude Inventory (DAI). VAS pain ratings were low at all visits across all doses in both studies, and decreased from first to final injection. In the 12-week, double-blind study, mean +/- SD VAS scores at the first and final injections were 15.6 +/- 20.7 and 12.5 +/- 18.3 for placebo-treated patients, and 11.8 +/- 14.4 (first) and 10.0 +/- 12.4 (final) for 25 mg; 16.3+/-21.9 (first) and 13.6 +/- 21.7 (final) for 50 mg; and 16.0 +/- 17.9 (first) and 9.6 +/- 16.0 (final, P<0.01) for 75 mg of long-acting risperidone. Mean VAS scores in the 50-week, open-label study at the first and final injection were: 17.9 +/- 22.2 (first) and 9.5 +/- 16.7 (final, P<0.0001) for 25 mg; 18.1 +/- 19.7 (first) and 10.4 +/- 14.8 (final, P<0.0001) for 50 mg; and 18.5 +/- 21.6 (first) and 13.6 +/- 19.9 (final, P = 0.0001) for 75 mg of long-acting risperidone. Overall, there was no or minimal injection site pain and skin reactions were rare. Mean DAI ratings were available for the 50-week study and indicated high patient satisfaction throughout the trial (baseline = 7.30; endpoint = 7.70; P<0.0001 versus baseline). These findings may positively affect patient and clinician attitudes towards long-term therapy with long-acting injectable risperidone.     

Beyond treatment – Psychosocial and behavioural issues in cancer survivorship research and practice

The population of cancer survivors has grown steadily over the past several decades. Surviving cancer, however, is not synonymous with a life free of problems related to the disease and its treatment. In this paper we provide a brief overview of selected physical and psychosocial health problems prevalent among cancer survivors, namely pain, fatigue, psychological distress and work participation. We also address issues surrounding self-management and e-Health interventions for cancer survivors, and programmes to encourage survivors to adopt healthier lifestyles. Finally, we discuss approaches to assessing health-related quality of life in cancer survivors, and the use of cancer registries in conducting psychosocial survivorship research. We highlight research and practice priorities in each of these areas. While the priorities vary per topic, common themes that emerged included: (1) Symptoms should not be viewed in isolation, but rather as part of a cluster of interrelated symptoms. This has implications for both understanding the aetiology of symptoms and for their treatment; (2) Psychosocial interventions need to be evidence-based, and where possible should be tailored to the needs of the individual cancer survivor. Relatively low cost interventions with self-management and e-Health elements may be appropriate for the majority of survivors, with resource intensive interventions being reserved for those most in need; (3) More effort should be devoted to disseminating and implementing interventions in practice, and to evaluating their cost-effectiveness; and (4) Greater attention should be paid to the needs of vulnerable and high-risk populations of survivors, including the socioeconomically disadvantaged and the elderly.     

Partial inpatient oncologic rehabilitation--results of a model project

Medical rehabilitation in Germany is traditionally performed primarily in the inpatient setting. It was not until recent years that model forms of outpatient offers were first tested. In this article we will present the results of a comparative evaluation of inpatient and outpatient/partially outpatient oncological rehabilitation measures. Within the framework of a retrospective questionnaire study, oncological rehabilitants from both settings will be compared with regard to questions concerning the process of participation, rehabilitative goals, oncological interventions and perceived outcome from the perspective of the patient. An overall result is that persons who were treated in the outpatient setting, when compared with those treated in the inpatient setting, show more congruency than discrepancy with regard to all of these key topics. The results will be discussed with respect to further development of the rehabilitative health care system.     

Indirect comparison of the antiviral efficacy of peginterferon alpha 2a plus ribavirin used with or without simeprevir in genotype 4 hepatitis C virus infection,where common comparator study arms are lacking: a special application of the matching adjusted indirect comparison methodology

Background:

The need to assess relative efficacy in the absence of comparative clinical trials is a problem that is often encountered in economic modeling. The use of matching adjusted indirect comparison (MAIC) in this situation has been suggested. We present the results of a MAIC used to evaluate the incremental benefit offered by adding simeprevir (SMV) to standard therapy in the treatment of patients infected with genotype 4 hepatitis C virus (HCV).

Methods:

Individual patient data for a single arm study evaluating the use of SMV with peginterferon alfa 2a?+?ribavirin (PR) in genotype 4 HCV were available (RESTORE study). A systematic literature review was used to identify studies of PR alone used in the same patient group. By applying the inclusion criteria for each study in turn to the RESTORE dataset and then applying the published MAIC covariate matching algorithm, a series of pseudosamples from RESTORE were generated. After assessment of the matching outcomes, the best matched comparisons were used to derive estimates of efficacy for SMV?+?PR in patients equivalent to those participating in the PR trial.

Results:

Five potential comparator studies were identified. After applying the matching process, two emerged as offering the greatest equivalence with the generated RESTORE pseudosamples and were used to estimate SMV?+?PR efficacy, expressed as the percentage of patients achieving sustained viral response (SVR). In one comparison, SVR in the SMV?+?PR group was 85% versus 63% for PR alone. In the second comparison, the corresponding SVRs were 77% and 44% respectively.

Conclusions:

After matching for varying baseline characteristics, both comparisons of RESTORE versus studies of PR alone yielded a benefit for SMV?+?PR vs PR alone in genotype 4 HCV-infected patients. The incremental gain in SVR associated with use of SMV ranged from 22% to 33%. In the absence of direct comparative studies, the MAIC gives a better perspective than simple comparison of absolute SVR from individual studies.     

Synthesizing dental radiographs for human identification

The task of identifying human remains based on dental comparisons of post mortem (PM) and ante mortem (AM) radiographs is labor-intensive, subjective, and has several drawbacks, including: inherently poor image quality, difficulty matching the viewing angles in PM radiographs to those taken AM, and the fact that the state of the dental remains may entirely preclude the possibility of obtaining certain types of radiographs PM. The aim of the present study was to investigate the feasibility of using radiograph-like images reconstructed from PM x-ray computed tomography (CT) data to overcome the shortcomings of conventional radiographic comparison. Algorithms for computer synthesis of panoramic, periapical, and bitewing images are presented. The algorithms were evaluated with data from clinical examinations of two persons. The results demonstrate the efficacy of the CT-based approach and that, in comparison with conventional radiographs, the synthesized images exhibit minimal geometric distortion, reduced blurring, and reduced superimposition of oral structures.