Social neighborhood environment and sports participation among Dutch adults: does sports location matter?

Studies on the relation between the social neighborhood environment and sports participation have produced inconsistent results. Use of generic sports outcomes may have obscured associations only apparent for sports at certain locations. This study aims to assess the association between the social neighborhood environment and three location-specific sports outcomes. Repeated cross-sectional data on sports participation (any type of sports, sports at indoor sports clubs, sports at outdoor sports clubs, sports on streets) were obtained from 20 600 adults using the Dutch national health survey 2006-2009. Data on neighborhood social safety and social capital were obtained using the Dutch Housing Research 2006. Over 40% of Dutch adults participated in any type of sports. Indoor sports clubs were most popular. Multilevel logistic regression analyses revealed that neighborhood social safety was positively associated with sports at indoor sports clubs [odds ratio (OR) = 1.25, 95% confidence interval (CI) = 1.06-1.48), but not with the other sports outcomes. Contrary, neighborhood social capital was positively associated with sports on streets only (OR = 1.69, 95% CI = 1.17-2.44). The results suggest that a positive social neighborhood environment enhances sports participation, but that this impact depends on the location of the sports activity. This study highlights the importance of using location-specific sports outcomes when assessing environmental determinants.

Memory and mood during the night and in the morning after repeated evening doses of MDMA.

Previously it has been shown that MDMA causes memory impairment during daytime testing. However, MDMA is usually taken in the evening or during the night. In addition, it is known that sleep deprivation also causes memory impairment. The present study aimed to assess whether evening doses of MDMA added to, or interacted with the memory impairment due to sleep deprivation. Fourteen healthy subjects participated in a double-blind, placebo-controlled, two-way cross-over study. Treatments consisted of MDMA 75 and 50 mg divided over the evening or double placebo. Memory tests and subjective measures of mood were conducted at baseline and three times post dosing that is at 6.30 pm, 9.30 pm, 1.30 am and 7 am, respectively -1.5, 1.5, 5.5 and 11 h relative to drug intake (first dose). Memory performance detoriated progessively over time as a function of sleep loss, independent of treatment. MDMA added to this impairment as indicated by a significant main effect of MDMA on verbal and spatial memory performance. Mood ratings and response speed revealed an MDMA by Time interaction. After administration of MDMA response speed improved and feelings of vigor, friendliness, elation, anxiety, confusion, arousal and positive mood increased in magnitude during the night, while all these parameters returned to placebo-like levels on the final morning session. It is concluded that evening doses of MDMA selectively impair memory performance, and that this impairment is additional to the effect of sleep deprivation on memory performance.

Acute effects of nocturnal doses of MDMA on measures of impulsivity and psychomotor performance throughout the night.

INTRODUCTION: Previous studies on the acute effects of MDMA on psychomotor performance and impulsivity showed that MDMA acts as a stimulant. These studies assessed performance during daytime, whereas in real life, dance-attendees leaving a party use the drug during the night. OBJECTIVES: The present study aimed to assess the effects of nocturnal doses of MDMA on psychomotor performance and impulsivity during the night and after a night of sleep deprivation. MATERIALS AND METHODS: Fourteen healthy subjects participated in a double-blind, placebo-controlled, two-way within-subject study. The treatment was MDMA (75 and 50 mg) divided over the evening or double placebo. Psychomotor and impulsivity tasks were conducted four times throughout the evening and night. A vigilance test was conducted once, at 5 A.M.,: and a sleepiness scale was presented to the subjects ten times throughout the evening and night. RESULTS: MDMA impaired tracking performance in a simple tracking task. Divided attention task performance was also impaired as indicated by a decrease in secondary task performance under the influence of MDMA compared with placebo. MDMA did not affect impulsivity measures. Vigilance performance decreased as a function of time on task, but this decrement was less during MDMA treatment compared to placebo. After the administration of MDMA, the sleepiness scale scores were lower during the night when compared with placebo. This difference between MDMA and placebo disappeared in the morning. CONCLUSION: It is concluded that nocturnal doses of MDMA may produce impairments of tracking performance and divided attention throughout the night that are additive to performance impairment produced by sleep loss.

Selective verbal and spatial memory impairment after 5-HT1A and 5-HT2A receptor blockade in healthy volunteers pre-treated with an SSRI.

Serotonergic neurotransmission has been implicated in memory impairment. It is unclear however if memory performance is mediated through general 5-HT availability, through specific 5-HT receptors or both. The aim of the present study was to assess the contribution of 5-HT reuptake inhibition and specific blockade of 5-HT(1A) and 5-HT(2A) receptors to memory impairment. The study was conducted according to a randomized, double-blind, placebo-controlled, four-way cross-over design including 16 healthy volunteers. The treatment consisted of oral administration of escitalopram 20 mg + placebo, escitalopram 20 mg + ketanserin 50 mg, escitalopram 20 mg + pindolol 10 mg and placebo on 4 separate days with a washout period of minimum 7 days. Different memory tasks were performed including verbal memory, spatial working memory and reversal learning. Escitalopram showed an impairing effect on immediate verbal recall which nearly reached statistical significance. No effects of escitalopram were found on other types of memory. In combination with pindolol, immediate verbal recall was significantly impaired. Escitalopram in combination with ketanserin impaired spatial working memory significantly. No effects were found on reversal learning. Selective impairment of immediate verbal recall after a 5-HT(1A) partial agonist and selective impairment of spatial working memory performance after 5-HT(2A) receptor antagonist, both in combination with a selective serotonergic reuptake inhibitor (escitalopram), suggests that 5-HT(1A) and 5-HT(2A) receptors are distinctly involved in verbal and spatial memory.

Serotonin and human cognitive performance.

In the past decade, experimental studies involving healthy human volunteers have revealed that manipulations of the central serotonin (5-HT) system can produce quite specific changes in cognitive functioning, independent of overt mood changes. Reduced 5-HT turnover is consistently associated with impaired long-term memory functioning. Low 5-HT function may also impair cognitive flexibility and improve focused attention. On the other hand, stimulation of central 5-HT has repeatedly been found to impair performance in a true vigilance task. Currently, there is little evidence for mirrored cognitive changes due to opposite 5-HT manipulations in healthy volunteers. Given the mounting evidence for a role of 5-HT in human cognition, reduced 5-HT function could be directly linked to cognitive disturbances in certain conditions, such as in depression and Alzheimer's Disease (AD). There is evidence that stimulating (i.e. normalizing) 5-HT activity in depression may have specific beneficial effects on cognition, independent of a general relief of depressive symptoms, but this premise needs to be confirmed by larger-scale clinical studies. Recently, a potential role of 5-HT in the cognitive symptoms in AD has been identified, but there is insufficient data to evaluate the effects of 5-HT stimulation on cognitive symptoms in AD. It is concluded that serotonin is a potential target for pharmacological cognition enhancement, particularly for restoration of impaired cognitive performance due to 5-HT dysfunction. Further differentiation of the role of 5-HT in normal and disturbed cognition and evaluation of the effects of 5-HT manipulations in various populations is required to establish the full potential of 5-HT drugs as cognition enhancers.

[Gastrointestinal bleeding. Diagnostics and therapy by interventional radiology]. / Gastrointestinale Blutung. Interventionell-radiologische Diagnostik und Therapie.

Modern imaging modalities such as (multislice) helical CT allow new diagnostic strategies for gastrointestinal hemorrhage. Today, interventional radiology with superselective transcatheter embolization or TIPS procedures allow minimally invasive therapeutic management which can support or replace surgery. This review is a synopsis of the possibilities and relative merits of diagnostic and therapeutic radiological procedures for gastrointestinal bleeding. Which of them to use should be decided collaboratively by gastroenterologist, surgeon, and radiologist depending on local availability, personal experience, and individual patient factors.

[Transcatheter embolization of pulmonary arteriovenous fistulas]. / Transkatheterembolisation pulmonaler arterio-venöser Fisteln.

AIM: Evaluation of technical success, complications and long-term results of transcatheter coil embolisation in pulmonary arteriovenous malformations (pAVMs). MATERIAL AND METHODS: Transcatheter embolisations of 46 pAVMs in 14 patients were analysed retrospectively, and, 5 years after treatment, the patients were interviewed by telephone concerning persistent symptoms and complications. Main symptoms before embolisation were dyspnoe (86%), hypoxaemia (100%), cerebral ischemia (21%), and hemoptysis (14%); 11 patients (79%) suffered from hereditary hemorrhagic telangiectasia. RESULTS: Embolisation with an average of 3.9 coils (min. 1, max. 19 coils) per pAVM yielded technical success in all cases. Only two minor complications, transitory pleuritis and a small lung infarction were observed. On follow up examination after 5 years either no residual complaints or substantial improvement of dyspnoe were reported; no patient suffered from neurologic or hemorrhagic complications after the embolisation. CONCLUSION: Transcatheter embolisation is a safe and minimally invasive therapy for pAVMs and has rightfully replaced surgical resection as the therapy of choice.

[Local lysis with alteplase for the treatment of acute embolic leg ischemia following the use of the duett closure device: preliminary results]. / Lokale Alteplase-Lyse zur Therapie der akuten embolischen Beinischämie nach Einsatz des Duett-Verschluss-Systems: vorläufige Ergebnisse.

PURPOSE: To analyze retrospectively the result of the alteplase lysis therapy of embolic complications following the use of the Duett closure device. METHODS AND MATERIALS: For 3.5 years, the Duett closure device was used in 1,398 angiographies to close the femoral puncture site. The Duett device consists of a balloon and a liquid procoagulant containing collagen and thrombin, which is injected into the puncture tract under endovascular balloon protection of the arterial puncture site. In 9 patients (0.64 %), the procoagulant was incidentally injected into the femoral artery causing acute leg ischemia. Eight patients received local lysis therapy with alteplase via a contralateral femoral access. One patient underwent surgery. On average, 21 mg alteplase (4 - 35 mg) were administered within 14 h (4 - 21 h). The course of the lysis was followed angiographically and clinically. All patients were interviewed by telephone 23 months (4 - 35 months) later. RESULTS: In 3 patients, lysis was complete. In 5 patients, only little thrombotic material remained. In all patients, symptoms of ischemia resolved completely within the first hours after initiation of lysis. In 5 cases, bleeding occurred at the puncture site closed with the Duett device during lysis, including development of a false aneurysm in 2 cases. Complications led to premature termination (n = 2) or interruption of the lysis (n = 3). All complications were treated conservatively. Clinically, long-term sequelae were paresthesia and hypoesthesia in the lower leg and foot in 2 patients treated with lysis, and in the patient who underwent surgery. CONCLUSION: Very rarely occurring embolic complications after use of the Duett closure device can be effectively treated with alteplase lysis. A high rate of complications is to be expected at the puncture site closed with the Duett device.

Implantation of a new access device for hemodialysis (Dialock): initial experience in 5 patients.

PURPOSE: A new hemodialysis access port system was implanted. METHODS: The Dialock consists of a port-like double-valve, implanted subcutaneously below the clavicle, which is attached to two catheters, placed in the right atrium via the jugular vein. The device has been implanted in 5 patients (4 female, 1 male). RESULTS: In all 5 patients the implantation of the catheters and the port was technically successful. Total average duration of dialysis was 3.6 months. Two patients developed a port pocket hematoma 10-14 days post implantation, one of them required surgical revision. One port was explanted due to septicemia, whereas a port infection was not confirmed. One patient showed a thrombotic occlusion of both catheter tips 8 days after implantation, fixed by catheter exchange. Another patient presented with slight migration of the port catheters, which was managed by refixation of the port within the pocket. Beside these complications, the devices were working well. CONCLUSION: The Dialock system offers an interesting alternative to external catheters for hemodialysis. With respect to the complications it deserves further studies to determine its future role in the field of vascular access.

Immigration to the Federal Republic of Germany as a demographic and social problem.

"Addressing the question of immigration to Western Europe and especially to Germany from east and southeast Europe and from developing countries of the South, this article considers whether such immigration can compensate for reductions in population in developed countries. It is argued that the demographic deficits of an aging population can only be corrected to a limited extent through immigration. Any solution, in order to be effective, must include a simultaneous increase in the birthrates of Germany and other European Community countries. With particular regard to future social development in Germany and the EC, it would be advisable for governments to effect measures that will provide both for controlled admissions of immigrants from outside the EC and an increase in local reproductive capabilities."

[Overview of current population trends in the Federal Republic of Germany and prospects for the future]. / Uberblick uber die gegenwartige Bevolkerungsentwicklung in der Bundesrepublik Deutschland und Perspektiven fur die Zukunft

PIP: Current population trends in the Federal Republic of Germany are first reviewed. Topics discussed include demographic aging, ethnic composition, declining fertility, and households. Population projections to the year 2030 are then presented by age group using several different models. Finally, the economic and social policy consequences of long-term population trends are examined, with particular reference to the economically active population and the dependency burden.^ieng

Verbal memory performance during subchronic challenge with a selective serotonergic and a mixed action antidepressant.

OBJECTIVES: Effects of escitalopram 10-20 mg/day and mirtazapine 30-45 mg/day on verbal memory of 18 healthy participants were assessed in a randomized, double-blind, placebo-controlled, three-way crossover trial. METHOD: Each treatment period lasted for 15 days and was separated from the next period by a washout period of at least 13 days. Participants received an evening dose of escitalopram 10 mg, mirtazapine 30 mg, or placebo from days 1 to 7 and an evening dose of escitalopram 20 mg, mirtazapine 45 mg, or placebo from days 8 to 15. On days 2, 9, and 16 a visual verbal memory task was performed measuring drug effects during the acute phase, after dose increase and at steady state. RESULTS: Escitalopram did not affect immediate or delayed verbal memory score throughout treatment. During mirtazapine treatment, participants performed less well in the overall immediate recall score compared to placebo. This impairment was most pronounced in the final trial of the visual verbal learning task. CONCLUSION: Verbal memory was not affected by acute and subchronic escitalopram treatment in healthy participants. Overall immediate verbal memory was slightly but significantly impaired throughout mirtazapine treatment, probably due to a general reduction in overall arousal caused by H1 blockade.

[Aspects of demographic development in West Germany]. / Aspekte der demographischen Entwicklung in der Bundesrepublik Deutschland.

This report starts by giving some information on the aim and purpose of model-computations of the population development and shows some fundamental tendencies of this development. In the author's view it is not only the numerical population decline but especially the changes in age structure and ethnical composition, in household and family structures as well as the changing patterns of regional distribution and development of population that must be considered. All these different aspects are discussed in the light of the total development and, using the three-generations' contract as an example, are analysed with regard to the consequences for policy and planning. The author doubts that either simple solutions or a mere strategy of adaptation could help managing the problems to come. He emphasizes that counter measures should be taken including as one of the main subjects a demographic orientated family-policy which also takes into account the necessary solidarity among generations ("generationensolidarische Familienpolitik").

MR imaging fails to detect bone marrow oedema in osteomyelitis: report of two cases.

Bone marrow oedema is the earliest and most sensitive sign in diagnostic imaging of osteomyelitis. In the two demonstrated cases of acute and chronic osteomyelitis, MRI was not able to detect bone marrow oedema due to accompanying haemosiderosis and sclerosis surrounding a bone abscess.