Sociodemographic and clinical features of men and women with eating disorders: a diagnosis-matched, retrospective comparison among inpatients.

Introduction: Eating disorders (EDs) are among the most severe mental disorders in women and men, often associated with high symptom burden and significant limitations in daily functioning, frequent comorbidities, chronic course of illness, and even high mortality rates. At the same time, differences between men and women with EDs remain poorly explored. Methods: In this study, we compared 104 men to 104 diagnosis-matched women with EDs regarding sociodemographic and clinical features. Using latent class mixture modelling, we identified four distinct patient subgroups based on their sociodemographic features. Results: Men with EDs had significantly higher odds than women to belong to a "single-childfree-working" class. Moreover, while there were few overall differences in ED-related symptoms and general psychopathology between men and women, single-childfree-working men with EDs presented with higher general psychopathology symptoms than men in the other classes. Discussion: We discuss how considering sex and gender along with further sociodemographic differences in EDs may help to improve ED diagnosis and treatment.

Understanding of arthrofibrosis: New explorative insights into extracellular matrix remodeling of synovial fibroblasts.

Arthrofibrosis following total knee arthroplasty is a fibroproliferative joint disorder marked by dysregulated biosynthesis of extracellular matrix proteins, such as collagens and proteoglycans. The underlying cellular events remain incompletely understood. Myofibroblasts are highly contractile matrix-producing cells characterized by increased alpha-smooth muscle actin expression and xylosyltransferase-I (XT-I) secretion. Human XT-I has been identified as a key mediator of arthrofibrotic remodeling. Primary fibroblasts from patients with arthrofibrosis provide a useful in vitro model to identify and characterize disease regulators and potential therapeutic targets. This study aims at characterizing primary synovial fibroblasts from arthrofibrotic tissues (AFib) regarding their molecular and cellular phenotype by utilizing myofibroblast cell culture models. Compared to synovial control fibroblasts (CF), AFib are marked by enhanced cell contractility and a higher XT secretion rate, demonstrating an increased fibroblast-to-myofibroblast transition rate during arthrofibrosis. Histochemical assays and quantitative gene expression analysis confirmed higher collagen and proteoglycan expression and accumulation in AFib compared to CF. Furthermore, fibrosis-based gene expression profiling identified novel modifier genes in the context of arthrofibrosis remodeling. In summary, this study revealed a unique profibrotic phenotype in AFib that resembles some traits of other fibroproliferative diseases and can be used for the future development of therapeutic interventions.

[Surgical treatment of arthrofibrosis of the knee joint]. / Operative Therapie der Arthrofibrose des Kniegelenks.

Arthrofibrosis of the knee joint is a severe complication following trauma and surgical procedures, which often results in long-term impairment of joint function. Early mobilization techniques and anesthesia are still employed without sufficient clarification of the underlying processes. While the early stages of arthrofibrosis can be successfully treated with conservative measures for pain reduction and wound healing, in the late stage tense collagenous scar tissue is frequently present that permanently limits joint mobility. In this stage an improvement of joint mobility has no chance of success without a surgical intervention. In surgical treatment a differentiation should be made between localized (mostly secondary) arthrofibrosis (e.g. cruciate ligament surgery) and generalized arthrofibrosis (in the majority of cases primarily after total knee arthroplasty) and the treatment planned accordingly. Comorbid pathological alterations (transplant position, instability of the total knee endoprosthesis, implant attrition, low-grade infection, patellofemoral instability or maltracking, patella baja) must be taken into consideration in the treatment. A multimodal accompanying treatment including physiotherapy, pain therapy and psychosomatics is necessary to ensure successful treatment.

[Clinical diagnostics, differential diagnostics, pathogenesis and stage model of arthrofibrosis]. / Klinische Diagnostik, Differenzialdiagnostik, Pathogenese- und Stadienmodell der Arthrofibrose.

Arthrofibrosis (AF) is one of the most frequent complications of injuries and surgical interventions on joints, particularly after total knee replacement and anterior cruciate ligament reconstruction. Even though all joints can be affected, most cases involve the knee joint. Patients feel a painful impairment of the range of motion caused by fibrotic tissue formation within and sometimes also outside the joint. The normal healing process is disturbed by mechanical and emotional stressors and severe pain. In 90% of the cases AF occurs even within the first few days after the injury or surgery, so that the quality standards cannot be achieved. Physiotherapy and rehabilitation often do not result in a substantial amelioration of symptoms, so that the activities of daily living (ADL) are severely limited. The clinical diagnostics, differential diagnostics and a novel pathogenesis and stage model of the primary AF with the treatment principles derived from this are presented in this article.

Human xylosyltransferases--mediators of arthrofibrosis? New pathomechanistic insights into arthrofibrotic remodeling after knee replacement therapy.

Total knee replacement (TKR) is a common therapeutic option to restore joint functionality in chronic inflammatory joint diseases. Subsequent arthrofibrotic remodeling occurs in 10%, but the underlying pathomechanisms remain unclear. We evaluated the association of xylosyltransferases (XT), fibrotic mediators catalyzing glycosaminoglycan biosynthesis, leading to arthrofibrosis as well as the feasibility of using serum XT activity as a diagnostic marker. For this purpose, synovial fibroblasts (SF) were isolated from arthrofibrotic and control synovial biopsies. Basal α-smooth muscle actin expression revealed a high fibroblast-myofibroblast transition rate in arthrofibrotic fibroblasts. Fibrotic remodeling marked by enhanced XT activity, α-SMA protein expression as well as xylosyltransferase-I, collagen type III-alpha-1 and ACTA2 mRNA expression was stronger in arthrofibrotic than in control fibroblasts treated with transforming growth factor-ß1 (TGF-ß1). Otherwise, no differences between serum levels of XT-I activity or common fibrosis markers (galectin-3 and growth differentiation factor-15 levels (GDF-15)) were found between 95 patients with arthrofibrosis and 132 controls after TKR. In summary, XT-I was initially investigated as a key cellular mediator of arthrofibrosis and a target for therapeutic intervention. However, the blood-synovial-barrier makes arthrofibrotic molecular changes undetectable in serum. Future studies on monitoring or preventing arthrofibrotic remodeling should therefore rely on local instead of systemic parameters.