Die Luxation als seltene Komplikation des Oberflächenersatzes am Hüftgelenk

Resurfacing of the hip joint experienced a revival in the 1990s. Today metal-on-metal bearing is a therapy option especially for younger, active patients. In comparison to stemmed total hip replacements resurfacing offers advantages, in particular in view of the femoral bone loss. The short-term results are very good. In the current literature revision rates of less than 1% are reported.In comparison to conventional total hip replacement, dislocation is a rare complication. With conventional total hip replacement the dislocation rate is 2-5%. In the international literature the dislocation rate with resurfacing is 0.21%.     

Curcumin decreases acid sphingomyelinase activity in colon cancer Caco-2 cells

Curcumin has been shown to inhibit cell growth and induce apoptosis in colon cancer cells. The metabolism of sphingomyelin has implications in the development of colon cancert. We examined whether curcumin affects the enzymes that hydrolyse sphingomyelin in Caco-2 cells. The cells were cultured in both monolayer and polarized conditions and stimulated with curcumin. The activities of sphingomyelinases were determined. Sphingomyelin and its hydrolytic products were analysed by thin layer chromatography. The changes of acid sphingomyelinase protein were examined by Western blotting. We found that curcumin reduced the hydrolytic capacity of the cells against choline-labelled sphingomyelin, associated with a mild increase of cellular sphingomyelin in the cells. Analysis of the hydrolytic products revealed that the activity was derived from acid sphingomyelinase not from phospholipase D. The curcumin-induced reduction of acid SMase required more than 8 h stimulation. Western blotting showed reduced acid sphingomyelinase protein after curcumin stimulation. The inhibitory effect was more potent in monolayer cells than in polarised cells. No changes of other sphingomyelinases were identified. In the concentrations inhibiting acid sphingomyelinase, curcumin inhibited DNA synthesis and induced cell death. In conclusion, curcumin inhibits acid sphingomyelinase and the effect might be involved in its antiproliferative property against colon cancer cells.     

ROS scavenging effects of organic extract of diesel exhaust particles on human neutrophil granulocytes and rat alveolar macrophages

Diesel exhaust particles are major constituents of ambient air pollution, and are associated with respiratory and cardiovascular diseases and lung cancer. The organic part of the particles is heterogenic and complex, and seems to be responsible for many of the adverse effects.

Increased formation of ROS is often connected to the adverse effects. We have therefore investigated the effect of an organic extract of diesel exhaust particles on the reactive oxygen species (ROS) status in human neutrophil granulocytes and rat alveolar macrophages in vitro. ROS formation were studied by three different assays namely the use of DCFH-DA, lucigenin and luminol. The organic extract increased ROS assayed with DCFH-DA, but it decreased the amount of ROS in cells stimulated by PMA in all three assays. The identities of the ROS affected were further studied in cell free systems. The cell free studies confirmed that the extract had scavenging effects against superoxide, hypochlorite and to a smaller extent against peroxynitrite, but not against the hydroxyl radical and nitric oxide. ROS take part in the intracellular signalling pathways as well as in the defence against invading microorganisms, and the possible effects of interference of the redox status in the cells are discussed.     

Still going strong: perceptions of the body among 85-year-old people in Sweden

Background.  Studies on the lived experience of an aging body are scarce.
Aim and objectives.  The aim of this study was to illuminate the experiences of the body among elderly people.
Design.  This study is part of the Umeå 85+ Study, a cross-sectional investigation into successful aging and threats against successful aging. The present study has an explorative design.
Methods.  The text from 40 thematic interviews with 85-year-olds was analysed using qualitative content analysis.
Results.  Two themes and seven subthemes were developed. The theme: Still going strong encompassed the subthemes of Exercising and being active, Caring for one's body, Standing on one's own two feet and Feeling healthy. The theme: Adapting to a failing body encompassed the subthemes of Not being able to perform activities and manage by oneself, Feeling fatigued and Compensating for bodily decline.
Conclusions.  The participants felt that the body was still a source of pleasure, in spite of its defects. Assistive devices were important for the maintenance of independence when the body declined.
Relevance to clinical practice.  When caring for elderly people with declining bodily function, it is important to have appropriate and well-tested equipment in readiness.     

Myocardial infarction: psychosocial aspects, gender differences and impact on pre-hospital delay

Title.  Myocardial infarction: psychosocial aspects, gender differences and impact on pre-hospital delay.
Aim.  This paper is a report of a study to explore gender differences in psychosocial aspects in the year prior to first-time myocardial infarction, and the association between these aspects and pre-hospital delay.
Background.  The time from symptom onset to hospital admission is critical for patient survival; therefore influences on pre-hospital delay are of interest. The prevalence of stressful psychosocial factors is higher among patients before acute myocardial infarction than among healthy controls.
Method.  Patients diagnosed with first-time acute myocardial infarction were recruited from five Norwegian hospitals over a 13-month period in 2003–2004. Of 738 eligible patients, 149 women and 384 men completed a self-administered questionnaire (response rate 72%).
Findings.  Depression, high family stress, high work stress and major life events had no statistically significant impact on patient delay or total pre-hospital delay. Depression, sleep disturbances and high family stress were reported among more women than men in the year prior to the event. Women and men aged 65 years and younger were more likely to report major depression and major life events than those older than 65. Low education and low partner education predicted prolonged patient delay in men but not in women. Low partner education also predicted prolonged total pre-hospital delay in men.
Conclusion.  The process between symptom onset and hospital admittance is complex, and more knowledge about factors influencing this process is vital to reduce pre-hospital delay. Significant others should be included in information-giving in relation to myocardial infarction as they seem to play a vital role in patients' decision-making processes.     

Effects of serotonin on neurite outgrowth from thalamic neurons in vitro

Altering levels of serotonin in the primary somatosensory cortex during early postnatal life influences thalamocortical development. Recent in vivo experiments suggest that serotonin may have direct effects on the growth of thalamocortical axons, and the present study was undertaken to determine whether this amine influences process outgrowth from thalamic cells maintained in culture. Ventrobasal thalamic neurons were harvested from newborn rats and maintained in culture for eight days. At the end of this period, 0, 10, 25, 50 or 100 microM serotonin was added to the culture medium. After an additional six days, cultures were fixed and stained with neuron-specific enolase. Quantitative analysis of >500 cells from each condition indicated that 25 microM serotonin, but not the other concentrations of this amine, significantly increased the length of the primary (longest) process growing out from the cell body (P < 0.001), the total (summed) length of all processes (P < 0.0001), total neurites per cell (P < 0.05), number of branch points per cell (P < 0.01) and branch points on the primary neurite (P < 0.0005). These results demonstrate that exposing thalamic cells to serotonin increases process outgrowth from them in the absence of their cortical targets.     

Long-term risk factors for impaired burn-specific health and unemployment in patients with thermal injury

The success of acute burn therapy has led to an increased demand for high-quality rehabilitation. When optimizing burn care programs, knowledge of long-term risk factors associated with impaired health and unemployment of the patient may be significant. The health and work status of 95 patients (82.1% males; mean age 43.7 (S.D.: 14.5) years; mean total body surface burn 18.5 (S.D.: 14.2) % were assessed 47.0 (S.D.: 23.8) months after injury, using the Norwegian version of the abbreviated burn-specific health scale (BSHS-N) and a questionnaire asking for socio-demographic and medical characteristics. A regression model demonstrated that the BSHS-N total score was significantly reduced by chronic pain (P<0.001), psychological illness (P<0.001), and living alone (P=0.030), as well as full-thickness facial (P=0.011) and foot (P=0.013) burns. Unemployment was significantly associated with housing and economic problems (P=0.001), chronic pain (P=0.001), the extent of full-thickness injury (P=0.005), the presence of deformities (P=0.037), the number of operations (P=0.001) and the length of hospital stay (P=0.016). Thus, socio-demographic factors, non-burn-related morbidity and the injury itself significantly impaired long-term physical and psychosocial health and work status.     

Risk of accidents and unintentional injuries in men and women with attention deficit hyperactivity disorder across the adult lifespan

Introduction

Attention deficit hyperactivity disorder (ADHD) is associated with risk-taking behavior, leading to accidents and unintentional injuries (summarized here as incidents). Main aim of this study is to determine if men and women with and without ADHD differ in the risk of mild (treated outpatient) and severe (treated inpatient) incidents across the adult lifespan (age groups: 18–29; 30–59, and ≥60 years). Secondary aim: investigate the role of comorbid mental disorders and drugs for the treatment of these comorbidities, and ADHD-medication.

Methods

Using anonymized German claims data (N = 4,575,027), adults with ADHD diagnosis during 2016–2019 (N = 17,041) were compared with a 1:4 age and sex-matched group without ADHD diagnosis. Regression analyses statistically tested group differences.

Results

Incidents occur in a U-shaped form across the adult lifespan. Individuals with ADHD show the same pattern but at a substantially increased risk of both mild and severe incidents throughout the lifespan. Women without ADHD are at lower risk in young adulthood than men but at higher risk in older adulthood. Women with ADHD show the same pattern for severe incidents, but for mild incidents they have the highest risk throughout the lifespan. Co-occurring anxiety disorder and the use of psycholeptics and ADHD-medication decreased the incident risk.

Conclusion

We extend available knowledge which has hitherto focused on young adult males and traffic accidents. ADHD is associated with increased incidents across the adult lifespan, with distinct patterns regarding age, sex, and incident severity. An accurate diagnosis of ADHD in adulthood provides the first step towards prevention of accidents and unintentional injuries.     

Inactivation of exogenous endoparasite stages by chemical disinfectants: current state and perspectives

Chemical disinfection is common practice and inevitable to achieve sufficient control over parasites particularly in intensive animal housing systems. To identify suitable chemicals, reliable data on antiparasitic efficacy of disinfectants are required. This review summarizes recently published experience with procedures applied to evaluate the viability of a variety of endoparasites following physical or chemical stress. It is concluded that laboratory models used to assess antiparasitic efficacy of e.g. commercial disinfectants should consider the most resistant stages of both helminths and protozoa, i.e. ascarid eggs and coccidia oocysts. To ensure reproducibility and transparency, standardized protocols are pivotal. Such protocols are established on a national level (e.g. DVG guidelines in Germany); however, internationally accepted certification procedures are currently lacking.