Intra-articular injection of bone marrow aspirate concentrate (mesenchymal stem cells) in KL grade III and IV knee osteoarthritis: 4 year results of 37 knees.

Cell based therapies are increasingly used and results of bone marrow aspirate concentrate (BMAC) show encouraging short- to middle term results, superior to hyaluronic acid and platelet rich plasma (PRP). Most studies describe patients with mild to moderate arthritis and results of patients with KL III and IV osteoarthritis of the knee are limited to short term evaluations. Hence, the aim of this prospective study was to investigate the mid-term outcome of BMAC injections in patients with severe osteoarthritis of the knee. The BMAC was retrieved from the iliac crest as previously published with the "reorientation technique" from the iliac crest in supine position in analgosedation and injected into the patients' osteoarthritic knees. Patients were followed-up for 4 years. WOMAC, IKDC, SF 36 and walking distance were measured in a total of 37 participants. There was an improvement of IKDC and WOMAC from the first year onwards and a significant improvement beginning from year 2 up to the mid-term follow-up: IKDC increased significantly from 56 ± 12 (range 34-81) to 73 ± 13 (range 45-100), p < 0.001. WOMAC decreased significantly from 40 ± 23 (range 6-96) to 18 ± 18 (range 0-67), p < 0.001. 35 of 37 knees improved regarding IKDC and WOMAC score from the first to the last follow-up. Not a single protheses had to be implanted. Elaborate statistical analysis was done to exclude covariates and confounders (age, time, BMI,…). In summary, this is the first study on BMAC injections into 37 osteoarthritic knees with a 4-year follow up showing significant improvements in IKDC and WOMAC scores, and with a 95% success rate and significant improvement in walking distance.Clinical relevance Describes the 4-year outcome of BMAC injections for knees with severe osteoarthritis.

Reorientation technique has benefits in bone marrow aspiration of stem cells.

We treated patients with osteoarthritis of the knee using injections of bone marrow aspirate concentrate (stem cell therapy). Since multiple controversial harvesting methods using different sites, needles, volumes and techniques have been described, we aimed to compare those methods. Four different harvesting sites at the iliac crest, three different types of needles, three different types of volumes and two different harvesting techniques were compared in 48 bone marrow aspirations. The conventional technique (Group 1) was compared with a reorientation technique (Group 2). The number of leucocytes and CD34 + cells and the viability in bone marrow aspirate (BMA) were analysed with a CytoFLEX Flow Cytometer. The reorientation technique showed significantly higher cell counts than the conventional technique in all parameters. Leucocytes per nl increased from 5 ± 2 to 12 ± 4 (p < .001), and CD 34 + cells per µl increased from 40 ± 40 to 140 ± 98 (p = .003). There was no difference between anterior and posterior harvesting at the iliac crest or between use of a thick and use of a thin needle. Use of the reorientation technique, compared to employing the conventional technique, has a significant advantage since the number of leucocytes and CD34 + cells can be tripled. For the use of bone marrow aspirate in the case of arthritis, it might therefore be a future option to harvest a maximum cell yield through the new reorientation technique and to omit centrifugation. However, the clinical relevance of these findings remains the subject of future studies.Level of Evidence: Level I.Clinical relevance: Enhanced technique of BMA for knee surgeons to ensure the maximum cell yield for stem cell therapy in regenerative medicine.

Effects of Finding the Speech-Language Pathologist Likeable on Postlaryngectomy Speech Intelligibility Outcomes.

INTRODUCTION: Speech-language pathologists (SLPs) work with patients after total laryngectomy (TL) to regain verbal communication. The influence of the quality of the therapeutic relationship on the success of TL voice rehabilitation in terms of speech intelligibility is not known. Finding each other likeable is an important factor in establishing and maintaining interpersonal relationships in everyday life. The fit of therapist and client is relevant to the therapeutic relationship. The purpose of this study therefore was to assess the association between the degree of SLPs' likeability ratings and postlaryngectomy speech intelligibility. METHODS: In a multicentre prospective cohort study, participants rated their SLPs' likeability after finishing TL rehabilitation. Speech intelligibility was measured objectively with the Post-Laryngectomy Telephone Intelligibility Test and subjectively with the Questionnaire for Adjustment after Laryngectomy. The association of SLPs' likeability with speech intelligibility was analysed using hierarchical logistic regression, expressed with odds ratios (OR) with corresponding 95% confidence intervals (CI). RESULTS: Altogether 124 patients from 13 institutions participated. The degree of finding the SLP likeable was not significantly associated with objective speech intelligibility (OR 1.30; 95% CI 0.78-2.18; p = 0.32) or subjective speech intelligibility (OR 1.01; 95% CI 0.60-1.72; p = 0.96) after controlling for age, sex and education factors. DISCUSSION/CONCLUSION: In this patient cohort, there was no evidence for an association between ratings of SLPs' likeability and speech intelligibility outcomes after rehabilitation. Future studies could consider the use of alternative instruments for measuring likeability.

Maximum mandibular mobility in patients with temporomandibular disorders.

Assessment of mandibular mobility is an integral part of many dental examinations. Yet, information on the maximum range of mandibular motion in large groups of patients with temporomandibular disorders (TMDs) is limited. Therefore, we analyzed the corresponding data of 500 TMD patients who had presented at the University Center for Dental Medicine Basel. All measurements had been carried out by one examiner. The average maximal values for unassisted jaw opening, protrusion, and movement to the right and left were 49.3 mm (SD: 9.1), 8.8 mm (SD: 2.3), 9.4 mm (SD: 2.5), and 11.8 mm (SD: 3.1), respectively. Since activities such as chewing, talking, oral hygiene or even yawning require neither very wide openings nor extensive lateral or protrusive excursions, we would like to propose the following general threshold values for impaired mandibular function: maximum interincisal distance < 30 mm; maximum laterotrusion as well as maximum protrusion < 5 mm. These cut-off values, which are lower than those traditionally suggested in the dental literature, appear to be sufficient to carry out functionally undisturbed mandibular movements. By lowering the traditionally higher thresholds, the spectrum of anatomical and functional variability is increased. In this way, patients and non-patients may be protected against medicalization, overdiagnosis, and overtreatment.

Improved Injection Technique of Ethanol for Morton's Neuroma.

BACKGROUND: Morton's neuroma is a common cause of forefoot pain. Various conservative methods (injections of various pharmacologic agents) have been published with an outcome of 6%-75% success rate (free of pain in daily life) per injection. The aim of the present study was to assess the outcome of an improved localization technique, a higher dosage, and a higher percentage of ethanol. METHODS: Using fluoroscopic and electroneurographic guidance, 2.5 mL of 70% ethanol were injected into 33 feet with a magnetic resonance imaging (MRI)-verified neuroma. We evaluated patients at up to 5-year follow-up. RESULTS: A "success rate" of more than 82% per single injection (defined as free of pain in daily life) was achieved and no recurrence was seen over 5 years. All scores (visual analog scale; Short Form-36 subscales, American Orthopaedic Foot & Ankle Society ankle-hindfoot score) showed significant improvement (P < .0001). Mean 1.2 injections were necessary. No significant side effects were seen. However, some mild pain persisted in some patients who participated in sports. CONCLUSION: The injection of 2.5 mL of 70% ethanol under fluoroscopic and electroneurographic guidance was a safe method for the treatment of MRI-verified Morton's neuromas. Combining the effect of a higher percentage of alcohol and a higher dosage and an improved localization technique resulted in a high rate of patients without pain. LEVEL OF EVIDENCE: Level IV, cases series, prospective.

Long-Term Weight-Loss Maintenance by a Meal Replacement Based Weight Management Program in Primary Care.

OBJECTIVE: Structured obesity treatment programs at primary care level are becoming increasingly important. However, evidence from current treatment approaches in the long term is lacking. In view of this fact we evaluated a standardized, meal replacement-based weight loss program (myLINE®; AENGUS, Graz, Austria) according to the currently applicable guidelines. METHODS: Data of overweight and obese individuals (n = 70) who participated at least 36 months in the program were analyzed. Data were collected at baseline (T0) as well as after 1, 3, 6, 12, 24, and 36 (T1-T36) months. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis. RESULTS: Compared to T0, a maximum weight, BMI, fat mass, absolute body cell mass (BCM) reduction and an increase of relative BCM could be seen at T6. Subsequently, the findings reveal a significant reduction of body weight and body fat and a satisfying development of body cell mass during the observation period of 36 months. CONCLUSION: The evaluated program complies with national and international guidelines for the therapy of obesity in adults and is efficient and meaningful for a long-term therapeutic use in primary care..

Wheat and ultra high diluted silver nitrate--further experiments and re-analysis of data.

BACKGROUND: Since 1926, an influence of a dilution of silver nitrate (24x) on the growth of coleoptiles of wheat seedlings was described. The aim of the study discussed here is the critical proof of the reliability of a test system which has been quoted as a basic model for the research on homoeopathy for decades. METHODS: Grains of winter wheat (Triticum aestivum) were observed under the influence of extremely diluted silver nitrate (10(-23)) prepared by stepwise dilution and agitation according to a protocol derived from homeopathy ('24x'). Analogously prepared water and/or inert water was used for control. Thirty experiments including 5000+5000 grains were performed by 5 researchers. RESULTS: Stalk lengths clearly indicate that development is enhanced by the probe silver nitrate 24x as compared to control. When the experiments 1989-1995 were pooled, means and SD for silver nitrate 24x-groups were 42.3±26.9 mm and for water control groups 34.7±22.2 mm. Verum stalk length was 21.9% bigger than control (100%) (p<0.01; d=0.31, i.e. small). For the experiments 1998-2014, means and SD were 73.7±21.7 mm and 60.5±20.9 mm. Verum stalk length was 21.7% bigger than control (100%) (p<0.01; d=0.62, i.e. medium). From the results one may hypothesize that the result is more marked in experiments showing an average mean of stalk length between ca. 50 and 90 mm in contrast to smaller or bigger mean lengths. CONCLUSION: The previous findings were confirmed by the results.

Amphibians and ultra high diluted thyroxine--further experiments and re-analysis of data.

BACKGROUND: A model of thyroxine and metamorphosis of highland amphibians is frequently mentioned as an example of experiments on extremely diluted substances in discussions around 'homeopathy'. METHODS: The model was scrutinized by reanalysing the results of the initial researcher A and a second researcher B as well as of 5 external researchers C between 1990 and 2013. Rana temporaria larvae were taken from an alpine highland biotope. The test solution was thyroxine 10(-30) (T30x), tetra-iodo-thyronine sodium pentahydrate diluted with pure water in 26 steps of 1:10, being agitated after each step. Analogously prepared water (W30x) was used for control. Tadpoles were observed from the 2-legged to the 4-legged stage. Experiments were performed in different years, at different times of season, and their duration could vary. Frequencies of 4-legged animals, effect sizes and areas under the curves (AUCs) were calculated and regression analyses were performed to investigate possible correlations between year, season, duration etc. Experiments were in line with animal protection guidelines. RESULTS: The total set of data A + B + C as well as subsets A (initial researcher, N=286+293), B (second centre, 965 + 965) and C (5 external researchers, 690 + 690) showed an effect of extremely diluted agitated thyroxine reverse to that known of molecular thyroxin, i.e. test values were below control by 11.4% for A, 9.5% for B and 7.0% for C (p<0.001 for each of the subsets). The effect size (Cohen's d) was >0.8 (large) for both A and B and 0.74 (medium) for C. CONCLUSION: Although a perfect reproducibility was not obtained, this paradoxical phenomenon was generally consistent in different observations. Correlations were found between details of laboratory handling, as well as environment temperature, and the size of the results.

Wheat and ultra high diluted gibberellic acid--further experiments and re-analysis of data.

BACKGROUND: Following studies (a) on wheat seedlings and ultra high diluted silver nitrate, and (b) on amphibians and an ultra high diluted hormone, (c) a bio-assay on wheat and extremely diluted gibberellic acid was standardized. This assay was intended to combine the easy-to-handle aspect of (a) and biologically interesting aspects of (b). The purpose of the data analysis presented here was to investigate the influence of an extreme dilution of gibberellic acid on wheat stalk length and to determine the influence of external factors on the experimental outcome. METHODS: Grains of winter wheat (Triticum aestivum, Capo variety) were observed under the influence of extremely diluted gibberellic acid (10(-30)) prepared by stepwise dilution and agitation according to a protocol derived from homeopathy ('G30x'). Analogously prepared water was used for control ('W30x'). 16 experiments including 8000+8000 grains were performed by 9 researchers. RESULTS: Experiments that were performed between January and April showed inconsistent results, whereas most of the experiments performed between September and December showed shorter stalks in the G30x group. This was confirmed by correlation analysis (p<0.01). Thus winter/spring experiments and autumn experiments were analysed separately. When all 10 autumn experiments were pooled, mean stalk lengths (mm) were 48.3±21.4 for the verum group and 52.1±20.4 for control (mean±SD) at grain level (N=5000 per group) and ±5.3 and ±5.1 respectively at dish level. In other words, verum stalk length (92.67%) was 7.33% smaller than control stalk length (100%). The effect size is small when calculation is done on the basis of grains (d=0.18) but, due to the smaller SD at dish level, medium when done on the basis of dishes (d=0.73). The inhibiting effect was observed by 6 of the 6 researchers who performed the autumn experiments. CONCLUSION: The model may be useful for further research as there exists a theoretical justification due to previous studies with wheat and extremely diluted silver nitrate, as well as to previous studies with amphibians and diluted hormones, and its methods are well standardized. Data confirm the hypothesis that information can be stored in the test liquid, even at a dilution of the original substance beyond Avogadro's value; and that the wheat bio-assay is sensitive to such information.

Evaluation of a meal replacement-based weight management program in primary care settings according to the actual European Clinical Practice Guidelines for the Management of Obesity in Adults.

INTRODUCTION: The purpose of this study was the evaluation of a weight loss program in primary care settings with respect to the European Clinical Practice Guidelines for the Management of Obesity in Adults with regard to the long-term success of changes in body weight and composition. METHODS: Overweight and obese patients (n = 1167) who underwent a standardized meal replacement-based weight loss program (myLINE(®), AENGUS, Austria) in primary care settings were included in this evaluation. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis (AKERN BIA101(®), BIACORPUS RX4000(®), SoftwareBodycomp Version 8.4 Professional). Data of patients who participated at least 12 months in the program were analyzed retrospectively and compared with their baseline data. RESULTS: After 12 months, a weight loss of 8.6 ± 7.5 kg (mean ± standard deviation) or 8.2 ± 7.8 % from baseline was seen (p < 0.001). In all, 71.9 % of all patients achieved a minimal weight loss of 5 %, and 18.8 % lost 15 % of their initial weight. In comparison with the baseline (35.7 ± 11.5 kg), body fat decreased to 29.6 ± 10.7 kg, which is 83.7 ± 18.9 % from baseline (100 %; p < 0.001). Body cell mass showed an absolute reduction of - 1.4 ± 2.2 kg (p < 0.001), although a relative increase of 1.5 ± 2.5 % (p < 0.001). There were no significant differences between male and female subjects regarding changes in weight, body fat, and body cell mass. CONCLUSION: The evaluated program complies with the European Clinical Practice Guidelines for Management of Obesity in Adults (2008), which recommend a weight reduction of 5-15 % from initial weight within 6 months. Furthermore, the data showed a significant reduction of body fat and a relative increase of body cell mass.

Heart rate variability and the influence of craniosacral therapy on autonomous nervous system regulation in persons with subjective discomforts: a pilot study.

BACKGROUND: Subjective discomforts in a preclinical range are often due to imbalanced autonomic nervous system activity, which is a focus of craniosacral therapy. OBJECTIVE: The aim of this work was to determine any changes in heart rate variability (HRV) in a study on craniosacral therapy. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This is a quasi-experimental (controlled) study with cross-over design. In a private practice, measurements were performed on 31 patients with subjective discomforts before and after a control and an intervention period. HRV was determined using a device that requires a measuring time of 140 s and electrode contact only with the fingertips. Main PRIMARY OUTCOME MEASURES: HRV change under the influence of a defined one-time intervention (test intervention) with craniosacral therapy versus control (defined rest period). RESULTS: Standard deviation of all RR-intervals (ms) and total power of RR-interval variability in the frequency range (ms(2)) were together interpreted as an indicator of test subjects' autonomic nervous activity and as a measure of their ability to cope with demands on their health. Neither of these parameters increased during the control period (P>0.05), whereas during the test intervention period there was an increase in both (P<0.05, P<0.01). Nevertheless, interactions between treatment and the increase were statistically not significant (P>0.05). No changes were observed in the low frequency/high frequency ratio (sympathetic-vagal balance) in the course of the control or the test intervention period (P>0.05). CONCLUSION: Craniosacral treatment had a favourable effect on autonomic nervous activity. This in itself is an interesting result, but further research will be needed to distinguish specific effects of craniosacral therapy technique from less specific therapist-client interaction effects.

Prestimulation of wheat seedlings with gibberellic acid followed by application of an agitated high dilution of the same hormone

In previous multicentre studies, the influence of a homeopathic ultra-high dilution of gibberellic acid on wheat growth was scrutinized. Data showed that this test dilution slowed down stalk growth when experiments were performed in the autumn season. The aim of this work was to test the hypothesis that pretreatment of grains with high concentrations of gibberellic acid would enhance the growth-inhibiting effect of the ultra-high dilution of the plant hormone. Grains of winter wheat (Triticum aestivum, 500 or 1000 per group) were pretreated with (non-agitated) gibberellic acid 10-5, 10-4 and 10-3 parts by weight (Ge-5, Ge-4, Ge-3) or with water (?W0?) for control prior to further treatment. Grains were then observed under the influence of extremely diluted gibberellic acid (10-30 parts by weigth) prepared by stepwise dilution and agitation according to a protocol derived from homeopathy (?G30x?). Analogously prepared water was used for control (?W30x?). Seedlings were allowed to develop under standardized conditions for 7 days; plants were harvested and stalk lengths were measured. Of the four pretreatment variants under study, Ge-3 yielded most growth, followed by Ge-4 , Ge-5 and finally W. This outcome was modulated by the application of G30x in that the inhibition obtained with G30x as compared to W30x was the greater the lower the pretreatment concentration of G had been. The hypothesis that pretreatment of grains with high concentrations of gibberellic acid would enhance the growth inhibiting effect of G30x had to be rejected. Rather, G30x slowed down stalk growth most in the W0 group with p < 0.001, only moderately in the Ge-5 and Ge-4 group and not at all in the Ge-3 group.

Prestimulation of wheat seedlings with gibberellic acid followed by application of an agitated high dilution of the same hormone

In previous multicentre studies, the influence of a homeopathic ultra-high dilution of gibberellic acid on wheat growth was scrutinized. Data showed that this test dilution slowed down stalk growth when experiments were performed in the autumn season. The aim of this work was to test the hypothesis that pretreatment of grains with high concentrations of gibberellic acid would enhance the growth-inhibiting effect of the ultra-high dilution of the plant hormone. Grains of winter wheat (Triticum aestivum, 500 or 1000 per group) were pretreated with (non-agitated) gibberellic acid 10-5, 10-4 and 10-3 parts by weight (Ge-5, Ge-4, Ge-3) or with water (?W0?) for control prior to further treatment. Grains were then observed under the influence of extremely diluted gibberellic acid (10-30 parts by weigth) prepared by stepwise dilution and agitation according to a protocol derived from homeopathy (?G30x?). Analogously prepared water was used for control (?W30x?). Seedlings were allowed to develop under standardized conditions for 7 days; plants were harvested and stalk lengths were measured. Of the four pretreatment variants under study, Ge-3 yielded most growth, followed by Ge-4 , Ge-5 and finally W. This outcome was modulated by the application of G30x in that the inhibition obtained with G30x as compared to W30x was the greater the lower the pretreatment concentration of G had been. The hypothesis that pretreatment of grains with high concentrations of gibberellic acid would enhance the growth inhibiting effect of G30x had to be rejected. Rather, G30x slowed down stalk growth most in the W0 group with p < 0.001, only moderately in the Ge-5 and Ge-4 group and not at all in the Ge-3 group.(AU)

Seasonal variation of the effect of extremely diluted agitated gibberellic acid (10e-30) on wheat stalk growth: a multiresearcher study.

The influence of a homeopathic high dilution of gibberellic acid on wheat growth was studied at different seasons of the year. Seedlings were allowed to develop under standardized conditions for 7 days; plants were harvested and stalk lengths were measured. The data obtained confirm previous findings, that ultrahigh diluted potentized gibberellic acid affects stalk growth. Furthermore, the outcome of the study suggests that experiments utilizing the bioassay presented should best be performed in autumn season. In winter and spring, respectively, no reliable effects were found.

Variação sazonal do efeito do ácido giberélico altamente diluído (10-30) sobre o crescimento do trigo - um estudo com vários pesquisadores / Seasonal variation of the effect of extremely diluted agitated gibberellic acid (10-30) on wheat stalk growth - a multi researcher study

Control experiments were performed at different seasons of the year as a follow-up to pilot experiments [1] where a homeopathic high dilution of gibberellic acid had influenced growth in a wheat bio assay (7 days). Grains of winter wheat (Triticum aestivum, Capo variety) were observed under the influence of extremely diluted gibberellic acid (10-30) prepared by stepwise dilution and agitation according to a protocol derived from homeopathy (“G30x”). Analogously prepared water was used for control (“W30x”). Following up on 5 pilot experiments (4 in autumn 2007, 1 in spring 2008), 10 experiments were performed (5 in autumn 2008 or 2009 and 5 in winter 2009 or 2010) with a total of 9 experiments in autumn season (5 researchers, about 9,000 grains), and 6 in winter/spring (4 researchers, about 6,000 grains).(AU)

Experimentos controlados foram realizados em diferentes estações do ano, em continuação a um experimento-piloto [1] onde o ácido giberélico altamente diluído e agitado influenciaram o crescimento de trigo, em um ensaio biológico (7 dias). Grão de trigo de inverno (Triticum aestivum, variedade Capo) foram observados sob a influência do ácido giberélico altamente diluído (10-30) preparado por um processo serial de diluição e agitação, de acordo com um protocolo derivado da homeopatia (“G30x”). Analogamente, o mesmo protocol foi usado para preparar a amostra controle, apenas com água (“W30x”). Em continuidade a realização de 5 experimentos-piloto (4 no outono de 2007, 1 na primavera de 2008), 10 experimentos foram realizados (5 no outono de 2008 ou 2009 e 5 no inverno de 2009 ou 2010) com um total de 9 experimentos na estação do outono (5 pesquisadores, aproximadamente 9.000 grãos) e 6 no inverno/primavera (4 pesquisadores, aproximadamente 6.000 grãos).(AU)

The effect of extremely diluted agitated gibberellic acid (10e-30) on wheat stalk growth--a two researcher pilot study.

OBJECTIVE: Use of a wheat growth bio assay after 7 days in research on homeopathic dilutions of gibberellic acid. METHODS: Grains of winter wheat (Triticum aestivum, Capo variety) were observed under the influence of extremely diluted gibberellic acid (10(-30)) prepared by stepwise dilution and agitation according to a protocol derived from homeopathy (30×). Analogously prepared water was used for control. In a two centre study, 3 experiments with a total of 4880 grains were performed. RESULTS: Data were found to be rather homogeneous within the control group as well as within the verum group in general. Germination rates were around 95%, with no significant difference between verum and control group (p>0.05). Mean stalk lengths (mm) were 40.63±20.96 for the verum and 44.33±21.11 for the control group (mean±S.D.) at grain level (N=2440 per group) and ±5.33 and ±5.89, respectively at dish level (122 cohorts of 20 grains per treatment group). In other words, verum stalk length (91.65%) was 8.35% smaller than control stalk length (100%). This difference is statistically highly significant (p<0.001) and was found by both researchers involved independently. CONCLUSION: These results suggest that there was an influence of gibberellic acid 30× on wheat seedling development, i.e. the wheat growth bio assay can be a useful tool for further experiments on homeopathic dilutions of gibberellic acid.

Sleep profile and symptoms of sleep disorders in patients with stable mild to moderate chronic obstructive pulmonary disease.

BACKGROUND: Sleep problems associated with chronic obstructive pulmonary disease may have an important impact on quality of life and health outcome measures in patients. The aim of this study was to prospectively assess differences in symptom profile and polysomnographic parameters in patients with stable mild to moderate COPD and age, gender, and body-mass-index matched controls without airflow obstruction. METHODS: The Sleep Disorders Questionnaire was administered to both patients and controls prior to clinical and polysomnographic evaluation. Responses obtained from the questionnaire were used to construct four independent symptom scales: sleep apnea, periodic limb movement syndrome, psychiatric sleep disorder, and narcolepsy. Associations between each diagnostic scale and sleep parameters were considered by means of multiple analyses of covariance. RESULTS: Fifty-two patients with mild-to-moderate COPD (age 62±8 years, BMI 29±7 kg/sqm) and 52 age, gender, and body-weight matched controls without COPD were studied. Patients with COPD had overall lower sleep efficiency, a lower total sleep time, and lower mean overnight oxygen saturation compared to controls. Patients with COPD were significantly more likely to report symptoms such as insomnia and difficulty in initiating and maintaining sleep, resulting in overall higher psychiatric sleep disorder scale scores in patients compared with controls. Minimum oxygen saturation was an independent predictor for all symptom scales. After correcting for potentially confounding factors, including pack/years of smoking, total sleep time, sleep efficiency, arousal index, mean and minimum oxygen saturation, and apnea-hypopnea-index, the between group-differences for both the periodic limb movement and psychiatric sleep disorder scale scores remained statistically significant. CONCLUSIONS: We observed significant differences in both quantity and quality of sleep between patients with stable mild to moderate chronic obstructive pulmonary disease and respective controls.

[The sense of coherence among general practitioners]. / Kohärenzempfinden (Sense of Coherence) bei niedergelassenen Arztinnen und Arzten für Allgemeinmedizin.

The term "sense of coherence" (SOC) refers to a life perspective which spans affective states centering around notions of comprehensibility, manageability, meaningfulness of work or personal contribution, and self-confidence, in a context where demands are perceived as challenges. SOC is positively correlated with psychological well-being, stress management and negatively with anxiety, depression, and neuroticism. General practitioners licensed by the regional health insurance fund in Styria were the subject of a 29-item survey on Sense of Coherence as described by Antonovsky; the return rate was 78.3%. The SOC of GPs replying to the survey was categorized as "marginal" in 29.9% of cases, "significant" in 59.9%, and "rigid" (in the sense of a so-called "inauthentic" self-image) in 10.2% of cases. Overall, the value found was 5.30 +/- 0.56 (Likert scale = absolute 153.8 +/- 16.2; significant), which falls within the range of values for other comparable services or professions, and comes slightly on top over figures for a normative sample. No significant correlations were found for either age or gender (p > 0.05). Reported values for comprehensibility gained in proportion to the age of the general practice of the informant (p < 0.05).

What Contributes to the (Im)Balanced Division of Family Work Between the Sexes?

This study examines a comprehensive set of variables that have been proposed as explaining the imbalance of the division of family work between the sexes. The analyses use survey data of 735 dual-earner couples from Austria, the Netherlands, and Portugal. The results support theoretical explanations referring to time availability, gender ideology, relative resources, and the importance of characteristics of the family system. No support was obtained for the doing-gender perspective. Additional findings suggest that increased consideration of psychological concepts adds to the understanding of why women do more family work than men. The analyses revealed similarities, but also differences between the factors that contribute to the division of household labor and childcare.

Treatment of highland frogs from the two-legged stage with homeopathically prepared thyroxin (10-11 - 10-21).

The influence of moderately diluted, agitated, i.e., homeopathically prepared, thyroxin solutions (10-11 - 10-21, final concentration in the basin water 0.6 10-15 - 0.6 10-25 parts by weight after the first application) on metamorphosis in highland Rana temporaria from the two-legged stage was studied. In accordance with the homeopathic idea of effects of specially prepared dilutions being inverse to those of their mother substances, animals were treated either with thyroxin 10-11 - 10-21 or analogously prepared blank solution (water). Development was monitored by documenting the number of animals that had entered the four-legged stage. It has been found that animals treated with the thyroxin solutions metamorphosed more slowly than the control animals, i.e., the effect of the homeopathically prepared thyroxin was opposed to the usual effect of molecular thyroxin. The number of test animals that reached the four-legged stage at defined points in time was smaller (2-13.5%) in the group treated with homeopathically prepared thyroxin at the points in time, compared to control. The results in this study sustain the previous multiresearcher findings that show that diluted homeopathically prepared thyroxin is able to slow down metamorphosis of R. temporaria.