[Adherence with daily and weekly administration of oral bisphosphonates for osteoporosis treatment]. / Adhärenz mit täglichen und wöchentlichen oralen Bisphosphonaten in der Osteoporosetherapie.

BACKGROUND AND OBJECTIVE: Bisphosphonates provide efficacious treatment for osteoporosis. However, side effects often lead to patients discontinuing this treatment. This study analyses differences in adherence (including acceptance, persistence and compliance) between daily (ALD-D) and weekly (ALD-W) administration of alendronate among German patients with osteoporosis. METHODS: Prescription claims data of two random groups of subjects (144 patients each) taking ALD-D and ALD-W, respectively, were observed for 12 months after starting the given prescription. Termination was defined as the moment when the last prescription had been used up. The percentage of patients continuing the drug treatment after the first prescription was used as a measure for acceptance. Compliance was measured by the medication possession ratio (MPR), namely the percentage of days on which the patient was supplied with the medication. An MPR > 80% is therapeutically relevant because the risk of fractures is significantly reduced. RESULTS: 31.3% (ALD-W) vs. 45.8% (ALD-D) of patients discontinued therapy after one prescription. 53.5% (ALD-W) vs. 72.2% (ALD-D) of patients discontinued therapy throughout the year. The proportion of those who discontinued the treatment was significantly higher with daily administration (p=0.0035). Mean time until discontinuation was 220 days (ALD-W) vs. 169 days (ALD-D). Mean compliance among any patients was 51.7% (ALD-W) vs. 37.7% (ALD-D); Only 30.6% (ALD-W) vs. 19.2% (ALD-D) (p=0,0295) of patients reached a therapeutically relevant compliance level. CONCLUSIONS: A large proportion of patients discontinued treatment with bisphosphonates, a majority of discontinuing patients not even refilling their first prescription. Adherence, although enhanced by less frequent dosing, was suboptimal in all of its aspects, i.e. acceptance, persistence and compliance. There is a need for treatment strategies to increase adherence.

Nuclear charge radii of 9,11Li: the influence of halo neutrons.

The nuclear charge radius of 11Li has been determined for the first time by high-precision laser spectroscopy. On-line measurements at TRIUMF-ISAC yielded a 7Li-11Li isotope shift (IS) of 25 101.23(13) MHz for the Doppler-free [FORMULA: SEE TEXT]transition. IS accuracy for all other bound Li isotopes was also improved. Differences from calculated mass-based IS yield values for change in charge radius along the isotope chain. The charge radius decreases monotonically from 6Li to 9Li, and then increases from 2.217(35) to 2.467(37) fm for 11Li. This is compared to various models, and it is found that a combination of halo neutron correlation and intrinsic core excitation best reproduces the experimental results.

[Inpatient health care utilization for musculoskeletal disorders and injuries: a forecast study for Germany up to 2010]. / Stationäre Inanspruchnahme bei muskuloskelettalen Erkrankungen und Verletzungen: Vorausberechnung für Deutschland bis zum Jahr 2010.

BACKGROUND: The study is part of the project "Orthopaedics 2010 -- evaluation of the demand for the orthopaedic work force in the year 2010", initiated by the professional association of orthopaedists (BVO). The aim is to estimate the prospective number of orthopaedists for the sufficient medical care of musculoskeletal disorders and injuries. METHODS: The main data source was the official statistics of discharge rates from 1994 to 1999 and the German population forecasts from 1994 to 2010 of the Federal Office of Statistics, Wiesbaden, Germany. An univariate forecasting analysis was done using the Granger and Newbold method. RESULTS: All diagnostic categories of musculoskeletal disorders (arthropathies, dorsopathies, rheumatism, osteopathies) will increase up to four-fold from 1994 to 2010. Three of the four diagnostic categories of injuries (dislocations, sprains and strains; contusion; injuries and open wounds) will decrease by up to 15 percent, the diagnostic category of fractures will increase (10 percent). The stratified analyses by gender and age reveal that women and persons over 65 years old are more often affected by musculoskeletal disorders and injuries. CONCLUSIONS: Both demographic changes and changes in the utilization of inpatient care will lead to a substantial increase of hospital cases up to 2010. The presented results should be looked at together with their confidence limits as interval estimations. In addition, there are independent external factors such as the new prospective payment system (G-DRGs) that will influence the hospital admission rates as well.

Nuclear charge radii of 8,9Li determined by laser spectroscopy.

The 2s-->3s transition of (6,7,8,9)Li was studied by high-resolution laser spectroscopy using two-photon Doppler-free excitation and resonance-ionization detection. Hyperfine structure splittings and isotope shifts were determined with precision at the 100 kHz level. Combined with recent theoretical work, the changes in the nuclear-charge radii of (8,9)Li were determined. These are now the lightest short-lived isotopes for which the charge radii have been measured. It is found that the charge radii monotonically decrease with increasing neutron number from 6Li to 9Li.

[Osteology--100 years]. / Osteologie--100 Jahre.

As is the case for many other subspecialties of medical science, osteology has developed in tandem with technological progress over the last 100 years. The discover of X-rays made visualization of the skeletal system possible. Progress in surgery and hygiene permitted examination and treatment of bones in vivo. Optical techniques made it possible to gain insight into the microarchitecture of the bone. Chemistry and biochemistry opened the door for pathophysiology and microcellular assessment of the bone so that modern osteology deals with interventions in cellular mechanisms, in particular for the treatment of bone diseases. The realization that the bone represents a dynamic tissue, characterized by processes of generation and degeneration, was decisive. These events have a profound influence on the treatment of osteoporosis. Questions pertaining to osteology have been subject to heightened interdisciplinary debate in the past few years, which is reflected in interdisciplinary associations and co-operative groups, and ultimately the umbrella Society of Osteology. Contemplation of the subject from an interdisciplinary viewpoint shows what a significant and natural role orthopedics plays in research on bone metabolism, but also in the treatment of bone diseases. Interdisciplinary cooperation aids quality control and is also reflected in the formulation of common guidelines for the clinical picture of osteoporosis, which constitutes a major epidemiological disease.

Prevalence and histopathology of shell disease in turtles from Lake Blackshear, Georgia.

Turtles in Lake Blackshear, Crisp County, Georgia (USA) were evaluated for shell disease during intensive trapping efforts on 8 and 9 May 1990. The disease was most prevalent in Pseudemys concinna (74%) and Trachemys scripta (35%). The degree of necrosis on the carapace was significantly positively correlated with the degree of necrosis on the plastron in T. scripta (rs = 0.50), but not in P. concinna (rs = 0.06). Female T. scripta with lesions were significantly larger than females without lesions. Lesions were not detected on six other species of turtles. Some areas contained multinucleate osteoclasts that were destroying bone. No tumors were detected in soft tissue samples.

Lipids and proteins in the Rathke's gland secretions of the North American mud turtle (Kinosternon subrubrum).

Lipids and proteins in the Rathke's gland secretions of the North American mud turtle (Kinosternon subrubrum, Kinosternidae) were analyzed by gas chromatography-mass spectrometry (GC-MS) and SDS-polyacrylamide gel electrophoresis (SDS-PAGE), respectively. Analysis by GC-MS indicates 2,3-dihydroxypropanal and C3-C24 free or esterified fatty acids. Analysis by SDS-PAGE indicates a major protein component with an approximate molecular mass of 60 kDa and minor components ranging from ca. 23 to 34 kDa. The major component of K. subrubrum glandular secretions exhibits a mobility that matches that of the Kemp's ridley sea turtle (Lepidochelys kempi, Cheloniidae), suggesting that these proteins are evolutionarily conserved.