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Purpose: A retrospective analysis of clinical outcomes and complication rates of patients treated with the latest implant design of the so-called Endo-Exo-Femoral Prosthesis (EEFP) was performed. The aim is to gain specific information on long-term complications of this treatment-method., Methods: In January 2019, data of all transfemoral amputees who were treated with TOPS at an acute clinic in Schleswig-Holstein from 2010 to 2016 were retrospectively analysed. This was done with special consideration of postoperative complications. For this purpose, all examination findings from routine clinical follow-up examinations were used. The complications were divided into stoma problems, orthopaedic-technical (OT) problems, fractures and explantations. All EEFPs had the same implant design (3rd generation). This implant is currently the only TOPS in Germany that is clinically used. Descriptive statistics as well as ratio information about occurred complications were calculated., Results: A total of 68 implantations were performed during this period. Average observation time was 6.32 years (±2.16 years). The mean age of the patients was 51.84 years±12.12 years. Cause of amputation was mainly trauma (82,35%). Stoma-associated problems had the highest incidence (7%) among all observed patient-related complications and posed the greatest challenges during the rehabilitation process. Looking only at surgical complications, 81% had no complications at all. In total, 15% had technical problems, 6% had peri-prosthetic fractures, 7% had stoma problems and 3% had to be explanted due to infection., Conclusion: The analysis of collected data shows that TOPS (here the 3rd generation EEFP) can be a successful alternative treatment method to shaft prostheses after transfemoral amputation. The indication should only be given after the failure of a shaft-prosthesis and contraindications must be comprehensively excluded. The greatest challenges in the rehabilitation process are the avoidance of stoma complications, infections and OT-problems. The rehabilitation of amputees treated with TOPS therefore requires an interdisciplinary, specialized rehabilitation team and lifelong rehabilitative care., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Farmers are exposed to a complex mixture of airborne substances which can represent a health hazard. Especially animal production on a farm can be a risk factor for respiratory diseases. Most studies in this context focused on bioaerosols, compounds attached to bioaerosols or on gases such as ammonia or hydrogen sulfide. Less attention was paid to volatile organic compounds (VOCs) which may also cause respiratory diseases. This pilot study presents results of measuring VOCs in the air of the dwellings and stables, as well as in the outdoor environment, of cattle farms in Northern Germany in spring and autumn. Farmers on all selected farms complained of symptoms such as asthma, rhinitis and conjunctivitis which occurred especially during work in the stable but also in the dwellings. The mean concentration of total VOC (TVOC) for the outdoor environment, the dwellings, and the stables were 100 microg m(-3), 763 microg m(-3), 322 microg m(-3) in spring and 143 microg m(-3), 544 microg m(-3), 595 microg m(-3) in autumn, respectively. There was no significant difference in season. TVOC concentrations in dwellings on farms were elevated when compared to dwellings in other environments, probably because of an additional exposure to fuels and chemicals used in agriculture. Aliphatic and alicyclic hydrocarbons, aromatic compounds, and terpenes were main compounds of the dwellings and ketones, alcohols, and esters of the stables. Terpene concentrations in the stables were low probably because straw, which was not a strong terpene emitter, was used instead of sawdust as floor covering. Large amounts of methylethylketone were encountered in the air of one stable, probably from animal exhalation caused by increased animal activity. However, it was unlikely that this caused respiratory symptoms. Generally it was likely that the concentrations of VOCs were too low to have health effects on their own. On the other hand, the VOC concentrations were in a multifactor concentration range in which health effects could occur depending on the interaction with other exposure factors. Fungal spores and bacteria were observed in addition to VOCs at the examined locations. Therefore it is possible that the observed VOCs played a role in exacerbating respiratory symptoms in this multifactor exposure.