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Tendinopathien gehören zu den häufigsten und gleichzeitig herausforderndsten Verletzungen des Sportlers. Die Injektionstherapie kann hierbei als adjuvante Therapie eine wichtige Rolle einnehmen. In Anbetracht der steigenden Anzahl an verfügbaren und potenziell wirksamen Pharmaka zur Behandlung von Tendinopathien werden in dieser Übersichtsarbeit ausgewählte Wirkstoffe vorgestellt und anhand der potentiellen Wirkmechanismen, Nebenwirkungsprofile und klinischen Anwendungen diskutiert. Tendinopathies are one of the most common and challenging injuries in sports. Beside others, the injection therapy is an established procedure in the treatment of tendinopathies. A large number of different pharmaceutical agents are available. The present review provides a overview on commonly applied agents ephazizing it's molecular mechanism, side effects and clinical implications. With special focus on future directions innovative agents are included and discussed as well. [ABSTRACT FROM AUTHOR]

Foam Rolling (FR) as a technique of self-massage has become a widely used intervention in clinical and sports practice. It is assumed that FR leads to an increased intramuscular microvascular blood flow (MBF), and therefore is commonly recommended as a warm-up or regeneration method. However, no data validate the effects of FR on MBF. This study aimed to assess whether FR increases intramuscular MBF using contrast-enhanced ultrasound (CEUS). Ten healthy athletes performed a standardized FR intervention applied to the lateral thigh (3 sets: 45 s FR, 20 s rest). Intramuscular perfusion was determined by CEUS under resting conditions (t 0), immediately (t 1), and 30 min (t 2) after the intervention. Peak enhancement (PE), wash-in rate (WiR), and wash-in perfusion index (WiPI) were evaluated as quantitative perfusion parameters in vastus lateralis (VL) and intermedius (VI) muscle separately via regions of interest mapping. Immediately after the intervention (t 1), perfusion parameters showed a non-significant decrease in VL (p = 0.3; PE: -32.1%, WiPI: -29.6%, WiR: -50.4%) and VI (p = 0.4; PE: -10.3%, WiPI: -6.4%, WiR: -35.6%). A non-significant decrease was found at t 2 in VL (p = 0.2; PE: -34%, WiPI -33.9%, WiR -61.2%) and VI (p = 0.2; PE -17.6%, WiPI -13.8%, WiR -43.2%). The common assumption of intramuscular MBF improvement due to FR could not be confirmed for up to 30 min after the intervention. If an increase in intramuscular metabolism or MBF is intended, we recommend that alternative methods (i.e., traditional warm-up) should be preferred. • Foam Rolling does not increase intramuscular microperfusion. • Reduction of microvascular blood flow in muscle tissue after a foam rolling intervention. • Contrast-enhanced ultrasound is a reliable method for examining muscular perfusion. • If hyperperfusion is desired, the use of foam rolling is not recommended. [ABSTRACT FROM AUTHOR]

Muskuloskelettale Punktionen gehören zu den häufigsten interventionellen Eingriffen im Fachgebiet Orthopädie und Unfallchirurgie. Die Anwendung bei Sportlern bzw. im Rahmen von sportorthopädischen Behandlungen ist ebenso allgegenwärtig. Für Injektionen und Punktionen jeglicher Art gilt insbesondere für die Einhaltung hygienischer Vorgaben und für die korrekte Durchführung eine unabdingbare Sorgfaltspflicht. Punktionen jeglicher Art müssen stets mit einer rechtfertigenden Indikation verbunden sein und können dabei aus therapeutischen oder diagnostischen Zwecken notwendig werden. Für die Anwendung bei Sportlern müssen weitere, spezifische Aspekte berücksichtigt werden. Die vorliegende Übersichtsarbeit stellt die unterschiedlichen Verfahren und Techniken der muskuloskelettalen Punktion dar und berücksichtigt dabei sportmedizinische Besonderheiten und praktische Empfehlungen. Muskuloskelettale Punktionen bei Sportlern bzw. im Rahmen von sportorthopädischen Behandlungen sind im Alltag häufig durchgeführte Proceduren. Mit Punktionen jeglicher Art sind relevante Risiken und potentielle Komplikationen verbunden. Das strukturierte Erlernen einer sicheren und treffsicheren Punktionstechnik ist unerlässlich. Grundlegend sind die korrekte Indikationsstellung, die Aufklärung des Patienten, die sachgemäße Medikamenten- bzw. Wirkstoffauswahl und die korrekte technische Durchführungsweise, wichtige Kernaspekte für eine erfolgreiche Punktion. Für die Anwendung bei Sportlern müssen die gültigen Anti-Doping-Richtlinien und sportpraktische Besonderheiten berücksichtigt werden. Musculoskeletal injections are one of the most common procedures in orthopedics and traumatology. Injections with various substances are also frequently used in sports medicine. For injections of any type, special care must be taken to proper hygiene and technical execution. The indication must be guided by the underlying musculoskeletal diagnosis and the goal of the injection (i.e., diagnostic or therapeutic) has to be worked out. With special focus on sports, specific aspects have to be considered. The present review provides the different clincal approaches and techniques of musculoskeletal injections emphaziszing sports specific aspects and pracitical considerations. [ABSTRACT FROM AUTHOR]

Copyright of Sport-Orthopadie - Sport-Traumatologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Sport-Orthopadie - Sport-Traumatologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Muskelverletzungen zählen als typische „time-loss Verletzungen" und sind regelhaft mit Einschränkungen der Spiel- bzw. Wettkampffähigkeit verbunden. Selbst milde Verletzungsformen führen zu erheblichen Einschränkungen der muskulären Kraftentfaltung und letztlich der Leistungsfähigkeit im Sport. Die Versorgung von Muskelverletzungen erfolgt üblicherweise konservativ. Das Ziel der vorliegenden Übersichtsarbeit ist es, ausgewählte Aspekte auf dem Gebiet der Muskelverletzungen unter Berücksichtigung der vorliegenden Publikationen zum GOTS-Expertenmeeting 2016 im zeitlichen Verlauf erneut zu beleuchten und im Kontext pathophysiologischer und muskelbiomechanischer Erkenntnisse zu diskutieren. Kernthemen dieser Übersichtsarbeit fokussieren sich auf die konservative Therapie mit den Schwerpunkten der Akutversorgung, der komplexen Zusammenhänge mit der exzentrischen Muskelarbeit sowie der aktuellen Überlegungen zu überlastungsbedingten Verletzungen. Muscle injuries are denoted as „time-loss injuries" and are commonly associated with reduced participance in training or competition. Although some injuries can be classified as mild types of muscle damage, injuries are associated with compromised muscle and sportive performances in a significant manner. Most of the injuries can be treated conservatively or nonoperatively. The aim of the present work was to provide an overview on the nonoperative treatment strategies in regard to the results of the GOTS (German-Austrian-Swiss Society for Orthopaedic Traumatologic Sports Medicine) Expert Meeting of 2016 with the focus on muscle and tendon injuries. The review includes recent considerations emphazising the initial and on-field treatment, muscle biomechanics and it's relation to ultrastructural muscle injuries. [ABSTRACT FROM AUTHOR]

Copyright of Sport-Orthopadie - Sport-Traumatologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Plant constructors maintain the performance of plant by health diagnosis and replacements of deteriorated components. The maintenance business becomes one of the important revenue sources for the constructors because profit rate of the maintenance business sometimes becomes much higher than that of new plant construction. To respond this business requirement, a fast automatic path finding system for replacement tasks has been proposed. The system realizes interactive planning operations for a large size of plant 3D-CAD model data. That is, the algorithm finds optimal carry-out/carry-in paths for the replacement tasks automatically, by a collision configuration posture map of the replacement component at each point in a carry-out/carry-in path. Since the creation of those maps take a huge number of calculation steps, it is processed by a parallel computing process on GPGPU hardware. And some experimental results revealed the proposed algorithm is over 200 times faster than a conventional serial computing process. Finally, the proposed algorithm realized the interactive planning operation. Today, this research result has been utilized in multiple power plant sites. [ABSTRACT FROM AUTHOR]

Abstract: We report the first Lattice QCD calculation using the almost physical pion mass that agrees with experiment for four fundamental isovector observables characterizing the gross structure of the nucleon: the Dirac and Pauli radii, the magnetic moment, and the quark momentum fraction. The key to this success is the combination of using a nearly physical pion mass and excluding the contributions of excited states. An analogous calculation of the nucleon axial charge governing beta decay has inconsistencies indicating a source of bias at low pion masses not present for the other observables and yields a result that disagrees with experiment. [Copyright &y& Elsevier]

Abstract: Objectives: To evaluate initial treatment and risk factors for amputation-free survival in patients with critical limb ischaemia (CLI). Design: Prospective clinical cohort study at a single vascular surgical centre in Germany. Methods: Data on 104 consecutive patients (115 ischaemic limbs) presenting with their first episode of CLI were collected prospectively over a 3-year period. Initial treatment was classified as conservative therapy, intervention, surgery, or major amputation. Patient co-morbidities were assessed by uni- and multivariate analysis to determine risk factors for limb salvage, survival and amputation-free survival. Results: Indications for treatment were rest pain in 27 (23.5%) and tissue loss in 88 (76.5%) limbs. Revascularisation was attempted in 65% of all limbs: 45% by intervention and 55% by surgery. In 9% primary amputation was necessary and 22% received conservative therapy. Median follow-up was 28 months (1–42). The 3-year limb salvage, patient survival, and amputation-free survival rates were 73%, 41%, and 31%, respectively. Diabetes, cardiac disease and renal insufficiency were associated with poor survival. Combined cardiac and renal disease adversely affected amputation-free survival (HR, 3.68; 95% CI, 1.51–8.94; P < 0.001). Conclusions: At least two third of all patients presenting with CLI can be offered some type of direct revascularisation. In patients with major cardiac disease and renal insufficiency, a poor outcome in terms of amputation-free survival is to be anticipated. [Copyright &y& Elsevier]

Abstract: Objectives: To assess health-related quality of life (HRQoL) up to 24 months after successful infrageniculate bypass surgery for limb-threatening ischaemia. Methods: 89 patients with infrageniculate bypass surgery for limb-salvage were studied. HRQoL was assessed using the Short Form (SF)-36v1 questionnaire before, 6, 12, and 24 months after revascularisation. Results: 47 patients (53%) with intact limb and functioning graft were assessed after 24 months, 27 patients (30%) died, further 7 required secondary amputation, 3 suffered irremediable graft occlusion, and 4 were lost to follow-up. The 24-months HRQoL-values were significantly improved in 4 domains: physical functioning (p <0.01), bodily pain (p <0.01), mental health (p =0.04), and social functioning (p =0.01). Except for baseline-values, HRQoL remained inferior in diabetics compared to non-diabetics throughout follow-up. Maximum improvement of HRQoL was delayed in diabetics (12 months vs. 6 months) and less pronounced. After 24 months non-diabetic patients maintained improvement in 5 domains and diabetic patients only in bodily pain. Conclusions: Improvement in HRQoL is sustained for more than 12 months after successful infrageniculate bypass surgery. Therefore, an aggressive approach towards revascularisation seems to be justified from the patient''s perspective. However, this benefit in quality of life is less in diabetic patients, despite similar limb-salvage rates. [Copyright &y& Elsevier]

Abstract: Objectives: The aim of the study was to assess the change in health related quality of life (HRQoL) after infrageniculate bypass grafting in patients with critical limb ischaemia (CLI). Design: Observational, prospective clinical study. Materials and methods: In total, 86 patients (72% male; age 71 (IQR, 64–78) years) undergoing infrageniculate bypass grafting for limb salvage were assessed by the short form (SF)-36 questionnaire before and 6 months after surgery. In subgroup analysis, the influence of diabetes mellitus, age, gender, and stage of peripheral arterial occlusive disease on HRQoL-outcome were assessed. Results: Following revascularization HRQoL significantly improved in all eight dimensions of the SF-36. While baseline HRQoL-values of diabetic and non-diabetic patients did not differ significantly, postoperative improvement was significantly less in the diabetes group. Conclusions: An aggressive approach towards infrageniculate bypass surgery for limb salvage is justified by quality of life improvement. However, this improvement tends to be less in patients with diabetes mellitus. [Copyright &y& Elsevier]

The milling of bone is a time-consuming and straining effort during surgery at the cranial vault. In order to determine possible advantages of a robotic system, the registration of different milling parameters during defined surgical procedures was the aim of this study. Eleven neurosurgeons were asked to mill a bovine scapula. The task consisted of geometric figures (one line and a circle) that had to be milled in a depth of 3 mm. Main focus was laid on the accuracy of the milling. In addition, the registered parameters such as forces, temperature and speed will be used as a reference for the design and validation of the robotic system. The same task was done by a robotic (hexapod) system, constructed at the Helmholtz-Institute Aachen (HIA). In comparison with the surgeon, the robotic system showed a higher accuracy at a greater velocity. The forces and temperatures showed minor differences. If further test results are consistent, it would be advantageous to use a robotic system to perform large craniectomies, especially in cosmetically relevant areas due to its advantage in accuracy and speed compared to a surgeon. [Copyright &y& Elsevier]

The center vortex model for the infrared sector of Yang–Mills theory, previously studied for the SU(2) gauge group, is extended to SU(3). This model is based on the assumption that vortex world-surfaces can be viewed as random surfaces in Euclidean space–time. The confining properties are investigated, with a particular emphasis on the finite-temperature deconfining phase transition. The model predicts a very weak first order transition, in agreement with SU(3) lattice Yang–Mills theory, and also reproduces a consistent behavior of the spatial string tension in the deconfined phase. The geometrical structure of the center vortices is studied, including vortex branchings, which are a new property of the SU(3) case. [Copyright &y& Elsevier]

Computer-assisted planning, navigation, and robotic craniotomy, with optional skull reconstruction using customized implants are of increasing clinical interest in craniofacial and neurosurgery. The aim of the CRANIO project presented in the first part of this paper is to develop a system that integrates the entire surgical process, from planning, customized implant manufacturing, optional robot programming, up to intraoperative navigation and robot-assisted execution. In the second part of the paper, we present new algorithms developed in the framework of CRANIO project. This work is especially related to the manipulation of 3-D geometry data of the skull for planning and definition of craniotomy. The results of our work are presented, together with results and objectives for further development. [Copyright &y& Elsevier]

The scalability of today’s metallization in interconnect technology is demonstrated and nano-interconnects of critical dimension regarding the International Technology Roadmap for Semiconductors (ITRS) roadmap requirements for the 22 nm technology node are shown. Sub-50 nm copper damascene lines were fabricated using an adapted spacer technique with current optical lithography and standard manufacturing equipment for processing 150 or 200 mm diameter wafers. For comparison an electron beam microscope based lithography was used for direct writing of patterns with narrow pitches. For both methods particular attention will be paid to issues of patterning and adaptation of unit processes as well as metal deposition. Electrical measurements for assessing the fabricated nano-interconnects with respect to the influences of barrier and seed layer thicknesses are shown briefly. The feasibility of interconnects with end-of-roadmap feature sizes demonstrated by these measurements gives reason to expect a bright future of copper interconnect processing technology. [Copyright &y& Elsevier]

To examine the role and benefits of transcervical fibroid ablation (TFA) in the treatment of submucous and large uterine fibroids. Subgroup analysis of two multicenter, prospective, controlled trials. Academic and community hospitals in the UK, the Netherlands, the US and Mexico. 197 women who underwent TFA with the Sonata® System within the FAST-EU and SONATA clinical trials. TFA was used to ablate fibroids under clinical trial protocol. Key outcomes were changes in menstrual blood loss, symptom severity and health-related quality of life on the Uterine Fibroid Symptom and Quality-of-Life Questionnaire, health-related quality of life on the EQ-5D questionnaire, and surgical reinterventions for heavy menstrual bleeding. Among 197 women (with 534 treated fibroids), 86% of women with only submucous fibroids and 81% of women with large fibroids (>5 cm) experienced bleeding reduction within 3 months post-ablation. Overall symptom severity and health-related quality of life showed sustained, significant improvements over 12 months. Additional fibroid mapping of large fibroids with magnetic resonance imaging in the FAST-EU trial showed an average volume reduction of 68%. Among women with only submucous fibroids, the rate of surgical reintervention through 1 year of follow up was 3.7% in FAST-EU and 0.0% in SONATA. With the Sonata System, TFA is an effective single-stage treatment option for non-pedunculated submucous myomata, and larger or deeper uterine fibroids (including fibroid clusters) for which hysteroscopic treatment is not suitable. [ABSTRACT FROM AUTHOR]

Transcervical radiofrequency ablation of uterine fibroids is an incisionless procedure to treat nonpedunculated uterine fibroids, including those that are not amenable to operative hysteroscopy. However, its safety and effectiveness regarding fertility and fecundity have not been established, including among women with infertility. This is a report of a pregnancy that occurred in a woman after transcervical radiofrequency (RF) ablation of uterine fibroids and assisted reproduction. Case report. Community hospital in Warendorf, Germany A 38-year-old nullipara with infertility since 2008 and a recent complaint of refractory dysmenorrhea in association with a uterine fibroid Transcervical RF ablation with the Sonata® system to treat the symptomatic myoma. Unsuccessful assisted reproduction (intracytoplasmic sperm injection/embryo transfer; ICSI/ET) as confirmed by negative pregnancy testing had been attempted 1 month pre-ablation, and a second embryo transfer after thawing of the previously cryopreserved pronuclei was carried out 7 months post-ablation. Transcervical RF ablation resulted in a 68% reduction in fibroid volume by sonography at 2 months post-treatment along with resolution of the patient's dysmenorrhea, and there was no residual fibroid noted on sonography at 7 months post-ablation. The second attempt at assisted reproduction produced an uncomplicated pregnancy that resulted in the vacuum-assisted vaginal delivery of a liveborn infant at term weighing 3670 gms with Apgar scores of 91/105/1010. Pelvic sonography four months postpartum revealed an unremarkable uterus, again with no evidence of a fibroid remnant. This is the first report of a pregnancy and delivery in an infertile couple who underwent transcervical RF ablation of a uterine fibroid followed by assisted reproduction. [ABSTRACT FROM AUTHOR]