[Comparative evaluation of trabecular bone density in Hounsfield units in the lumbar native CT cross-section for osteoporosis diagnosis and fracture risk determination by different examiners].

Background: An increasing loss of bone mineral density (BMD) in the axial skeleton leads to osteoporosis and fractures, with an increase found in the thoracic and thoracolumbar regions.

Research Question: The extent to which an examiner-independent assessment of the extent of osteoporosis and fracture risk determination is possible by determining the trabecular density in Hounsfield units (HU) in the spine should be examined. The next question was whether quantitative BMD values can be calculated from the HU values.

Biomechanical Analysis of Diffuse Idiopathic Skeletal Hyperostosis and Osteoporosis: Vertebral Fracture Risk Evaluation Using Finite Element Modeling with Clinical and Micro-CT Data in an Elderly Donor.

Biomechanical analysis of spinal structures is crucial in the evaluation of injuries, the risk of fracture, and age-related changes. Osteoporotic vertebrae are very fragile and therefore constitute a serious risk, especially in the elderly. At present, clinically relevant decision making in fracture risk assessment is predicated upon finite element analysis (FEA), which utilizes high-resolution computed tomography (CT) scans from clinical practice alongside micro-CT scans from laboratory settings.

[Impact of legal documentation requirements on physician practice using a regional specialty hospital as an example: an inventory].

Background:  Doctors in German hospitals are critical of their working conditions. They complain about long working hours, inadequate remuneration for their work, poor training and development opportunities, and increasing time spent on administrative tasks. As these points of criticism are largely based on subjective perception, in the present study we documented in detail the workflows of physicians in a major regional hospital, determined the time taken for the workflows, and performed a statistical evaluation of the data.

Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture.

Background: Trabeculae in vertebral bodies are unequally distributed within the cervical spine (CS), the thoracic spine (TS), and lumbar spine (LS). Such structures are also unequally distributed within the individual vertebrae. Exact knowledge of the microstructure of these entities could impact our understanding and treatment of fractures caused by osteoporosis and possibly improve surgical approaches.

Interobserver variability in the determination of bone mineral density in Hounsfield units from differently configured fields of measurement in the cancellous bone of vertebral bodies from elderly body donors.

Background: Due to the absence of suitable diagnostic procedures, osteoporosis (OP) is frequently detected late or not at all. Many elderly persons undergo computed tomographies (CT). The routine determination of Hounsfield units (HU) in bone as a part of these examinations could close a gap here.

Evaluation of bone density and hand grip strength in the course of drug treatment for osteoporosis : A real-world study.

Background: The aim of this clinical investigation was to assess the physical performance in osteoporotic patients undergoing drug treatment (DT) for years by measuring hand grip strength (HGS) and bone mineral density (BMD). A further aim was to detect the time until the occurrence of vertebral fractures (VF) and influencing factors.

Material And Methods: The investigation comprised 346 persons (276 women, 70 men) aged on average 66.

Regional variations in the intra- and intervertebral trabecular microarchitecture of the osteoporotic axial skeleton.

Trabecular structures in vertebral bodies are unequally distributed in the cervical, thoracic and lumbar spine, and also within individual vertebrae. Knowledge of the microstructure of these entities could influence our comprehension and treatment of osteoporotic fractures, and even surgical procedures. Appropriate investigations may clarify the pathomechanisms of various osteoporotic fractures (fish, wedge-shaped, and flat vertebrae).

Comparative outcome of different treatment options for fragility fractures of the sacrum.

Background: Fragility fractures of the sacrum (FFS) have been detected more and more frequently in recent times, and the incidence will continue to increase due to increasing life expectancy. The aim of this study was to compare the clinical outcome of conservative, interventional and surgical treatment of FFS.

Methods: Retrospectively, 292 patients (276 women, 16 men) with confirmed FFS were followed up over a period of 2 years.

[Impact of osteoporosis on physical performance parameters of middle-aged and elderly individuals-a cross-sectional study].

Background: Osteoporosis (OP) in the elderly is accompanied by reduced muscle mass and reduced muscle strength, also known as sarcopenia. This results in functional limitations and a high risk of falls and injuries. The determination of physical performance parameters such as grip strength and trunk strength on the one hand, and balance abilities on the other, provide information about the individual's general neuromuscular condition and serve as an indicator of physical performance in the elderly.

Histomorphometric analysis of osteocyte density and trabecular structure of 92 vertebral bodies of different ages and genders.

Background: Knowledge of the histomorphometric structure of the vertebral body and factors influencing the structure is essential for a fundamental understanding of osteoporosis and osteoporotic fractures. The present study is focused on osteocyte density - a parameter seldom investigated so far - and trabecular width as well as bone area over tissue area in human vertebral bodies.

Methods: Ninety-two vertebral body specimens (C5, C6, Th8, Th12, L1, L2) from 12 males and seven females were studied (Ethics Application Number A 2017-0072).

[Sacral fragility fractures: risk factors and outcomes after cement sacroplasty].

Background: The objective of the present study on patients with fragility fractures of the sacrum (FFS) was to assess existing risk factors and clinical outcomes after cement sacroplasty (CSP).

Patients And Methods: 68 patients (64 women, 4 men) with previous FFS were followed up retrospectively. CT and MRI images were used to classify fractures according to Denis et al.

Adsorptive cytapheresis for ulcerative colitis with focus on removing platelets and platelet-aggregates.

Introduction: Platelet abnormalities and secondary thrombocytosis are clinical features of ulcerative colitis (UC) and seem to play a relevant role in pathogenesis. This work analyzed the adsorption characteristics of the adsorber Immunopure.

Methods: A prospective study was performed to investigate the module in vitro with blood from healthy donors in a down-scaled recirculation model and in vivo in six patients suffering from UC.

[Insufficiency fractures of the spine in relation to cancellous bone density : An in vitro study].

Background: The risk of osteoporotic insufficiency fractures (Fx) at the axial skeleton increases with decreasing bone density, with an accumulation in the thoracic and thoracolumbar regions. To better understand the differential distribution of Fx along the spine, morphological and osteodensitometric studies were performed by computed tomography (CT) in the various spine sections. In addition, we aimed to clarify whether Hounsfield units (HU) found on CT examinations from other indications correlate with bone density and could be grounds for osteologic diagnosis.

Breaking strength and bone microarchitecture in osteoporosis: a biomechanical approximation based on load tests in 104 human vertebrae from the cervical, thoracic, and lumbar spines of 13 body donors.

Background: The purpose of the study was to investigate associations between biomechanical resilience (failure load, failure strength) and the microarchitecture of cancellous bone in the vertebrae of human cadavers with low bone density with or without vertebral fractures (VFx).

Methods: Spines were removed from 13 body donors (approval no. A 2017-0072) and analyzed in regard to bone mineral density (BMD), Hounsfield units (HU), and fracture count (Fx) with the aid of high-resolution CT images.

Why Insufficiency Fractures are Rarely Found in the Cervical Spine, Even with Osteoporosis.

Introduction: The human bone structure changes with an increase in age. Both material and structural properties affect bone strength. Despite the ageing of society, however, hardly any data are available on these parameters for elderly individuals.

A comparison, using X-ray micro-computed tomography, of the architecture of cancellous bone from the cervical, thoracic and lumbar spine using 240 vertebral bodies from 10 body donors.

The vertebral trabecular bone has a complex three-dimensional microstructure with an inhomogeneous morphology. Correct identification and assessment of the weakest segments of the cancellous bone may lead to better prediction of fracture risk. The aim of this study was to compare cancellous bone from 240 vertebrae of the cervical, thoracic and lumbar spine of ten body donors with osteoporosis in regard to bone volume fraction (BVF), trabecular thickness, separation, trabecular number and degree of anisotropy, to ascertain why cervical vertebrae rarely fracture, even with severe osteoporosis.

[Clinical outcome and revenue situation after conservative, interventional and surgical/osteosynthetic treatment of sacral insufficiency fractures].

Background: Insufficiency fractures of the sacrum are being detected increasingly more frequently, whereby their incidence will no doubt increase further as a result of the rise in life expectancy.

Objective: The clinical appearance of sacral insufficiency fractures, the treatment approach taking into account the clinical outcomes and the DRG proceeds are discussed on the basis of clinical examples.

Patients And Methods: Three female patients (average age 78.

Irisin: Still chasing shadows.

Objective: Considerable uncertainty remains regarding the veracity of measuring myokine irisin more than seven years after its original description. Unresolved issues include the nature of transcription of the irisin precursor fibronectin type III domain containing 5 (FNDC5) gene across species, the reliability of irisin levels measured with commercial enzyme-linked immunosorbent assays (ELISAs), and the overall validity of the recently published reference values for human serum measured with quantitative mass spectrometry. We utilized multiple species and measures to evaluate the robustness of commonly used reagents and methods for reporting irisin.

Clinical Improvement and Cost-effectiveness of CT-guided Radiofrequency Sacroplasty (RFS) and Cement Sacroplasty (CSP) - a Prospective Randomised Comparison of Methods.

Introduction: The objective of this study was a comparative analysis of cement augmentation by means of RFS and CSP with regard to outcome and cost-effectiveness.

Patients And Methods: CT-guided cement augmentation was performed on 100 patients with a total of 168 non-dislocated insufficiency fractures, 50 patients being treated with RFS and 50 patients with CSP. Leakages were detected by CT.

Selective blood sampling for FGF-23 in tumor-induced osteomalacia.

Unlabelled: Tumor-induced osteomalacia (TIO) is caused by the hormone fibroblast growth factor 23 (FGF-23). It is mainly produced in the tissue of mesenchymal tumors. Patients with TIO frequently suffer from a chronic decompensated pain syndrome and/or muscle weakness with postural deformity.

The Treatment of Illnesses Arising in Pregnancy.

Background: The treatment of pregnant women who have illnesses unrelated to pregnancy can cause uncertainty among physicians.

Methods: We searched the PubMed database and specialty guidelines from Germany and abroad (the guidelines of the German Society for Gynecology and Obstetrics, the American Congress of Obstetri cians and Gynecologists, and the Royal College of Obstetricians and Gynaecologists) over the period 2007-2016 for information on standards for the diagnosis and treatment of five illnesses that can arise in pregnancy: bronchial asthma, migraine, hypothyroidism, hyperthyroidism, and varicose veins.

Results: Any diagnostic tests that are carried out in pregnant women should be simple and goal-directed.

CT-guided cement sacroplasty (CSP) as pain therapy in non-dislocated insufficiency fractures.

Introduction: In elderly patients with reduced bone quality, insufficiency fractures of the sacrum are relatively common and are typically associated with severe disabling pain. The objective of the present study was to examine the feasibility of cement augmentation by CSP, to determine post-interventional leakages and other complications, and to present the outcome of pain over the course of 18 months.

Materials And Methods: In 23 patients (20 women and 3 men) with an average age of 81.

Biomechanics of the osteoporotic spine, pain, and principles of training.

Introduction: A fracture is a clinical manifestation of osteoporosis and is one of the main causes of functional limitations and chronic pain in patients with osteoporosis. Muscle and coordination training are recommended to the patients as general measures. We inquired whether sling training is better than traditional physiotherapy in relieving pain and improving abilities of daily living.

Comparison of the 18-month outcome after the treatment of osteoporotic insufficiency fractures by means of balloon sacroplasty (BSP) and radiofrequency sacroplasty (RFS) in comparison: a prospective randomised study.

Purpose: The objective of this prospective, randomised study was to examine the feasibility and clinical outcome of balloon sacroplasty and radiofrequency sacroplasty.

Methods: In 40 patients with a total of 57 sacral fractures, CT-guided cement augmentation was performed by means of BSP or RFS. For BSP, the balloon catheter was inflated and deflated in the fracture zone, and the hollow space, thus, created was then filled with PMMA cement.