[Importance of osteoporosis-related fractures for patients]. / Bedeutung osteoporosebedingter Frakturen für den Patienten.

BACKGROUND: Osteoporosis is a common disease that affects both women and men. Due to a reduced bone mineral density and increasing age, the risk for atraumatic fractures increases. These fractures cause pain due to the fracture itself and also have far-reaching sequelae in nearly all areas of life of patients. OBJECTIVE: The aim of this article is to summarize the consequences of osteoporotic fractures from the patient's point of view and to highlight the consequences of osteoporosis for the patient. The necessity for timely diagnostics and treatment after a fracture event is explained. MATERIAL AND METHODS: For each term a literature search was performed using key topic-related terms and the results are presented as a narrative review. RESULTS: Various areas of importance for patients were identified. A direct assessment of the patient's point of view was not feasible using a literature search; however, studies with surveys of patients could be identified and therefore, the patient's point of view could be integrated. Areas of interest that could be identified in the literature were pain, psychological well-being, cognitive abilities, mortality and long-term need for nursing. CONCLUSION: The effects of osteoporosis and fractures are multifactorial and often severe for the patient. The measures for prevention of osteoporotic fractures should be consistently implemented in the daily clinical routine and the necessary diagnostics and treatment should be rapidly initiated.

A Photorhabdus natural product inhibits insect juvenile hormone epoxide hydrolase.

Simple urea compounds ("phurealipids") have been identified from the entomopathogenic bacterium Photorhabdus luminescens, and their biosynthesis was elucidated. Very similar analogues of these compounds have been previously developed as inhibitors of juvenile hormone epoxide hydrolase (JHEH), a key enzyme in insect development and growth. Phurealipids also inhibit JHEH, and therefore phurealipids might contribute to bacterial virulence.

Regio- and Stereoselective Modification of Chiral α-Amino Ketones by Pd-Catalyzed Allylic Alkylation.

Chiral α-amino ketones are excellent nucleophiles for stereoselective palladium-catalyzed allylic alkylations. Both chiral as well as achiral allylic substrates can be applied, while the stereochemical outcome of the reaction is controlled by the chiral ketone enolate. The substituted amino ketones formed can be reduced stereoselectively, and up to five consecutive stereogenic centers can be obtained. This approach can be used for the synthesis of highly substituted piperidine derivatives.

Total syntheses and biological evaluation of miuraenamides.

The miuraenamides, relatively simple representatives of a class of cyclodepsipeptides with high antitumor activity, can be easily and flexibly obtained by the concept of peptide modification. A reaction sequence consisting of an aldol reaction, oxidation, and methylation of the glycine subunit of the cyclodepsipeptides allows the incorporation of the unusual α,ß-unsaturated dehydroamino acid in one of the last steps of the synthesis.

Xenortide Biosynthesis by Entomopathogenic Xenorhabdus nematophila.

The biosynthesis gene cluster of the xenortides and a new derivative, xenortide D, which is produced in only trace amounts, was identified in Xenorhabdus nematophila. The structure of xenortide D was elucidated using a combination of labeling experiments followed by MS analysis and was confirmed by synthesis. Bioactivity tests revealed a weak activity of tryptamine-carrying xenortides against Plasmodium falciparum and Trypanosoma brucei.

Acute Compartment Syndrome of the Lower Leg Using Navigated Endoprosthesis of the Knee. / Akutes Kompartmentsyndrom des Unterschenkels nach navigierter Kniegelenksendoprothetik ­ ein Fallbericht.

Acute compartment syndrome of the lower leg following computer navigated primary total knee arthroplasty is rare but potentially devastating. This could be triggered by a setting of the bicortical tibial navigation pin. It is essential to take care during the operation, and to implement close post-operative control, especially if there are risk factors or nerve blocks.

[Juvenile osteochondrosis and osteonecrosis]. / Juvenile Osteochondrosen und Osteonekrosen.

BACKGROUND: Juvenile osteonecrosis is an important topic in orthopedics. A wide variety of body regions of the growing patient are affected, predominantly during adolescence. All are characterized by a usually unknown aetiology as well as a stadium-like course. The main problem is a local osseous circulatory disorder, which causes osteonecrosis. RISK FACTORS: Mechanical overloading due to increased body weight, axial misalignment, and sports activity is discussed as a risk factor. Healing depends on the localization and extent of the osseous necrosis. DIAGNOSTICS: Diagnostically, radiologic imaging is used, in which the typical bony remodeling can be followed. THERAPY: The therapeutic procedure depends on the affected region but is usually accompanied by a reduction of mechanical loading. If the clinical and radiological findings worsen, surgical treatment must be considered. The recognition and treatment of juvenile osteonecrosis is important and significantly influences the further development of the patient.

The Prevalence and Effects of Stalking.

BACKGROUND: In 2003, we carried out the first epidemiological study on the frequency and effects of stalking in Germany that was based on a random population sample. We repeated the study with the same design in 2018 in order to assess any potential alterations over time in the frequency of stalking and of psychological problems in the affected persons. As far as we know, this is the first replication study of this kind to be carried out anywhere. METHODS: 1000 women and 1000 men were randomly chosen from the residents' registration data of Mannheim, Germany. Each one of them received, by mail, a comprehensive questionnaire about stalking, as well as the WHO-5 Well-Being Index and the German version of the Patient Health Questionnaire (PHQ-D). RESULTS: In the Mannheim population samples (2003: N = 675; 2018: N = 444), the lifetime prevalence of being stalked was 11.6% in 2003 (95% confidence interval, [9.2; 14.4]) and 10.8% in 2018 [8.1; 13.7]. In both 2003 and 2018, persons who had been stalked had significantly worse mental well-being than unaffected persons (WHO-5 summated score 2003: 11.2 [9.7; 12.6] vs. 15.5 [15.1; 16.0], WHO-5 summated score 2018: 11.8 [10.1; 13.6] vs. 14.5 [13.9; 15.0]). A markedly higher percentage of persons who had been stalked also fulfilled the syndrome criteria for at least one mental disorder (PHQ-D 2003: 50.0% vs. 22.5%; odds ratio [OR]: 3.5 [2.1; 5.6], PHQ-D 2018: 46.5% vs. 24.4%; OR: 2.7 [1.4; 5.1]). In 2018, as in 2003, persons who had been stalked were dissatisfied with, or unaware of, the opportu - nities that they had to get help from the police and the judicial system. CONCLUSION: Stalking remains a major problem that must be taken seriously. Physicians and psychologists should be well informed about it in order to help affected persons who turn to them for medical and psychological assistance.

[Mental Health Status in the Community During the COVID-19-Pandemic]. / Psychisches Befinden in der Bevölkerung während der COVID-19-Pandemie.

OBJECTIVE: Analysis of associations between perceived daily life strain during the COVID-19-crisis and personality aspects with current psychological wellbeing in the general population and comparison of mental health indicators with those from a previous survey in 2018. METHODS: Written survey in a random sample from the general population (n = 721) on Corona-related assessments, personality aspects and current mental health (WHO-5, PHQ-D). RESULTS: Fear for the health of close persons, strain regarding going out restrictions, increased substance use and psychological risk- and resilience factors were independently related to current mental health. Extent and frequencies of mental health symptomatology did not differ between 2018 and 2020. CONCLUSION: This is a first study in Germany reporting results from a population-based random sample on determinants of mental health during the COVID-19-crisis and a comparison of mental health symptomatology with prepandemic data from the same population.

Influence of carrageenan on the rheology and skin permeation of microemulsion formulations.

Three different microemulsions (A-C) and one semisolid preparation D were investigated in terms of viscoelastic properties and skin permeation of the model compound sodium fluorescein. The influence of the polysaccharide carrageenan on these parameters was investigated. Carrageenan is frequently used as food additive and has very interesting properties like good adhesiveness on skin which can be a benefit for topical application. The viscoelastic properties of the preparations (A-D) and of mixtures with carrageenan (A'-D') were characterized by oscillatory measurements. It was possible to adjust the rheologic properties of the formulations and to increase the sodium fluorescein permeation through porcine skin by mixing them with carrageenan gels. Therefore, the presented formulations as well as mixtures with carrageenan might be promising alternative drug carrier systems for topical pharmaceutical as well as cosmetics.