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Purpose: The prevalence of lifestyle diseases has escalated, and effective exercise training programmes are warranted. This study tested the hypothesis that regular participation in small-sided team handball training could provide beneficial health effects on cardiovascular, skeletal, and muscular parameters in young adult untrained men., Method: Twenty-six untrained 20-30-year-old men were randomly allocated to either a team handball training group (HG; n = 14), which completed 1.9 ± 0.3 training sessions per week over 12 weeks, or an inactive control group (CG; n = 12). Physiological training adaptations were assessed pre- and post interventions by DXA scans, blood samples, muscle biopsies, and physical tests., Results: The average heart rate during training was equivalent to 84 ± 4% of maximal heart rate. Compared to CG, HG displayed significant increases in VO 2max (11 ± 6%), proximal femur bone mineral density (2 ± 1%), whole-body bone mineral content (2 ± 1%), intermittent endurance performance (32 ± 16%), incremental treadmill test performance (16 ± 7%) and muscle citrate synthase activity (22 ± 28%) as well as decreases in total fat mass (7 ± 7%) and total fat percentage (6 ± 7%) (all p < 0.05). There were no significant changes in muscle mass, blood pressure, resting heart rate, muscle hydroxyl-acyl-dehydrogenase activity, or blood lipids (all p > 0.05)., Conclusion: Participation in regular recreational team handball training was associated with positive cardiovascular, skeletal, and muscular adaptations, including increased maximal oxygen uptake, increased muscle enzymatic activity, and improved bone mineralization as well as lower fat percentage. These findings suggest that recreational team handball training may be an effective health-promoting activity for young adult men.

This review presents the current knowledge on the diagnosis and treatment of hypophosphatasia, a rare genetic disease, caused by mutations in the tissue non-specific alkaline phosphatase (TNSALP) gene. The clinical spectrum of hypophosphatasia is highly variable ranging from lethal infantile forms to mild forms diagnosed in adults. Although the disease rarely occurs, correct diagnosis is important to provide appropriate treatment and to avoid worsening by use of harmful drugs such as bisphosphonates. Low serum values of alkaline phosphatase (ALP) is the main feature of HPP, but by itself not sufficient for diagnosis, as it can occur under different conditions. Diagnosis can be established by the combination of reduced levels of ALP, elevated ALP substrates (PLP, PEA, PPi) and typical symptoms and can be confirmed by genetic testing of ALPL mutations. Enzyme replacement therapy is now available for affected patients with onset of the disease during childhood and adolescence. Early results of enzyme replacement therapy are encouraging. However, a multidisciplinary approach remains the core of the treatment including nutritional support, monitoring of vitamin D, calcium and phosphate levels, physical therapy and regular dental care.

Background: Bone health is a crucial requirement for individual mobility. Preventive, diagnostic, and therapeutic actions to preserve or restore bone health are major tasks for orthopedic surgeons and health practitioners in musculoskeletal medicine., Results: In the context of the widespread vitamin D deficiency in Germany, it is relevant to keep in mind thatserum calcitriol levels above > 30 µg/l are necessary for optimal bone metabolism and bone health. In particular, because vitamin D deficiency not only increases the amount of non-mineralized bone matrix (osteoid), but it can also cause negative changes in the mineralized bone tissue. Widening of the osteons and osteocyte lacunae, together with increased bone aging under the osteoid layer, can lead to reduced fracture resistance., Conclusion: Integration of bone metabolism into the orthopedic strategy is an important concept for optimizing treatment in modern musculoskeletal medicine.