Evaluation of a four-week Adjunct Compensatory Training for the treatment of climbing-specific overstrain syndromes of the shoulder.

BACKGROUND: Although climbing is an increasingly popular sport, there is a lack of scientific evaluation of suitable training methods for climbers, especially with a view to prevention and rehabilitation. A specific rehabilitation program, Adjunct Compensatory Training (ACT), has recently been presented, but it has not been evaluated scientifically to date. OBJECTIVE: To investigate the effects of Adjunct Compensatory Training on climbing-specific overstrain syndromes of the shoulder. METHODS: Twenty active boulderers and climbers with an average age of 28.9 (±â€Š7.4) years performed a guided shoulder program of six specific exercises from the ACT program over a period of four weeks. They were examined before and after the intervention. Pre- and post-interventional measurements included the Constant-Murley Score, the QuickDASH Score and the measurement of shoulder ROM (range of motion). RESULTS: The Constant-Murley Score increased from 82 (±â€Š10.0) to 104.1 (±â€Š8.2) at follow-up (p < 0.001). The VAS value for bouldering and climbing decreased from 5.25 (±â€Š1.4) before to 2.4 (±â€Š1.6) after the intervention (p < 0.001). Shoulder flexion increased from 167.5 (±â€Š14.9) to 173.1 (±â€Š7.7) after the intervention (p < 0.05), abduction from 172.5 (±â€Š14.9) to 179.6 (±â€Š5.9) (n. s.), external rotation from neutral zero position from 77.6 (±â€Š16.8) to 86.3 ± (8.3) (p < 0.05). Feasibility and acceptance of the intervention were good. Ninety-five percent of the participants continued to exercise, and 100 percent recommended the program to others. CONCLUSION: The ACT led to an improvement in pain, activities of daily living, range of motion and strength in boulderers and climbers with overstrain symptoms of the shoulder. It is also classified as a realistically feasible workout. The extent to which this effect will continue, and whether or not the program can prevent injuries, remains to be seen. It can only be presumed that regular exercises prevent shoulder injuries in the climbing population.

[Graduates of the Model Study Courses in the Health Professions in North Rhine-Westphalia: Employment Characteristics and Competencies in Professional Practice]. / Verbleib der Absolventinnen und Absolventen der Modellstudiengänge in den Gesundheitsfachberufen in Nordrhein-Westfalen: Ergebnisse zu Beschäftigungsmerkmalen und Kompetenzen in der Berufspraxis.

AIM: The aim of this article was to present key results of the graduates' survey VAMOS. The study examined the professional status of the graduates of 12 model study courses in the health professions in North Rhine-Westphalia. The focus of the article was on the employment characteristics of the current main jobs and the application of the academic competencies in everyday professional life. METHODS: In the early summer of 2018 (April to June), 515 graduates of the model study courses in nursing (N=244), physiotherapy (N=97), speech therapy (N=95), occupational therapy (N=47), and midwifery (N=32) were included in an online cross-sectional survey. Graduating classes between the winter semester 2013/2014 and the summer semester 2017 were included. In addition, employers (N=109) were interviewed who hired graduates from the model study courses. RESULTS: The main jobs of the graduates were mostly located in hospitals and outpatient therapy practices. Eight out of ten graduates (84%) performed tasks in direct contact with patients as the main part of their employment. In 71% of these cases, the regular tasks were combined with extended activities in comparison to colleagues without an academic degree. On average, the graduates felt confident in all competency dimensions examined in this study. In all dimensions, employers perceived a "competence advantage" for graduates compared to colleagues without an academic degree. CONCLUSION: The results of this graduate survey support the current recommendation to have the study programs in the five health care professions governed by professional laws and to enable the programs to be carried out at universities.

Concomitant deregulation of HIF1alpha and cell cycle proteins in VHL-mutated renal cell carcinomas.

Renal cell carcinomas (RCCs) of the clear cell type are associated with alteration of the von Hippel-Lindau (VHL) tumour suppressor gene as well as subsequent stabilization and over-expression of hypoxia inducible factor (HIF), which causes up-regulation of cyclin D1. On the basis of their ability to interact with cyclin D1 we investigated a number of cell cycle proteins to shed further light on the downstream effects of HIF dysregulation. Expression of HIF1alpha, cyclin D1, cyclin-dependent kinase 4 and cyclin-dependent kinase inhibitors p16, p21 and p27 was studied by immunohistochemistry. Since NFkappaB1/RelA have been shown to bind to the cyclin D1 promoter, mRNA expression of these transcription factors was further analysed by quantitative PCR. In RCCs harbouring VHL mutations/hypermethylation, over-expression of HIF1alpha was parallelled by up-regulation of cyclin D1 and CDK4 and down-regulation of p21 and p27. Moreover, p27 expression was inversely correlated with tumour cell differentiation. Comparison of non-tumorous autologous kidney tissues revealed a significant down-regulation of NFkappaB1 mRNA expression in patients harbouring RCC with VHL mutations/hypermethylation. Our data support the notion of a link between VHL deficiency/HIF dysfunction and disturbances of cell cycle control in the tumorigenesis of VHL-negative RCC.

Immunohistochemical detection of EGFR in paraffin-embedded tumor tissues: variation in staining intensity due to choice of fixative and storage time of tissue sections.

The epidermal growth factor receptor (EGFR) is highly expressed in a variety of solid malignant tumors and its expression has been correlated with disease progression and poor survival. With the advent of targeted therapies, especially IMC-C225 (Cetuximab), a monoclonal antibody (MAb) directed against the EGFR, there is an increasing interest in immunohistochemistry (IHC)-based EGFR screening methods using paraffin-embedded tumor specimens to select cancer patients eligible for treatment with Cetuximab. With the EGFRpharmDX kit, a complete assay for demonstration of EGFR is now available. Because no information about the preservation of the EGFR under various conditions of fixation is available, we performed a prospective study on a panel of commonly used fixatives to determine optimal tissue preservation protocols. The stability of the epitope on cut tissue sections stored for a period up to 24 month was also tested using material originating from patients with head and neck cancer, non-small-cell lung carcinomas, and colorectal adenocarcinomas. Depending on the fixative used and the time of storage of cut tissue sections, a variation in the determined level of EGFR expression was demonstrated compared with the most optimal fixation procedure.