SRH Hochschule für Gesundheit Gera

The present study employed a large scaled multicenter nationwide study data analysis to elucidate the impact of thromboembolism prophylaxis (TEP) in the context of bariatric and metabolic surgery and to investigate the peri- and postoperative complications associated with TEP. A total of 63,909 patients who underwent primary bariatric surgery between 2005 and 2020 were included in the analysis. The data were collected prospectively and multicentrically in the German Bariatric Surgery Registry (GBSR) and subsequently analyzed retrospectively. A p value of ≤ 0.05 was deemed to correspond to a significant result. 96.65% of patients were prophylactically anticoagulated postoperatively. 99.3% of the anticoagulated patients received low molecular weight heparin on a median of 7 days. With regard to postoperative complications, a significantly higher incidence of transfusion (p < 0.001) or postoperative bleeding requiring surgery (p = 0.002) was observed in the group of patients who underwent TEP. At 0.67% and 0.87% respectively, these were nevertheless rare complications. The incidence of deep vein thrombosis (DVT) (TEP n = 46, no TEP n = 1; p = 0.642) and pulmonary artery embolism (PAE) was 0.1% each (TEP n = 57, no TEP n = 2; p = 0.985). The surgical technique was associated with a minimal risk of consequences for DVT. Here was the occurrence of DVT following surgical procedures in patients with TEP 0.1% for gastric banding (GB) and sleeve gastrectomy (SG), and less than 0.1% for Roux-Y gastric bypass (RYGB). The mortality rate was between patients with TEP and patients without TEP not significantly different (n [TEP] = 102; 0.17%, n [no TEP] = 6; 0.28%) (p = 0.198). The study’s findings validate the efficacy of TEP in bariatric surgery. However, to prevent adverse TEP consequences, like hemorrhage, the dosage and timing of prophylactic medication must be appropriately modified. However, it is evident that randomized controlled trials are necessary to establish uniform, high-quality recommendations on TEP.

Rosmarinic acid is a polyphenol found in numerous fruits and vegetables, consumed in supplement form, and tested in numerous clinical trials for therapeutic applications due to its putative chemopreventive properties. Rosmarinic acid has been extensively studied at the cellular, whole animal, and molecular mechanism levels, presenting a complex array of multi-system biological effects. Rosmarinic acid-induced hormetic dose responses are widespread, occurring in numerous biological models and cell types for a broad range of endpoints. Consequently, this article provides the first assessment of rosmarinic acid-induced hormetic concentration/dose responses, their quantitative features, mechanistic foundations, extrapolative strengths/limitations, and their biomedical, clinical, and public health implications.

Chronic diseases often bring along psychosocial problems. Being diagnosed with a chronic disease during adolescence, when psychosocial problems are known to occur frequently, creates a multiplier effect. Drama, whose therapeutic effect on psychosocial health has been known for many years, may benefit adolescents with asthma. However, there is no study on this subject in the literature. Therefore, this study aimed to develop a creative drama-based support program for adolescents with asthma. It was tested on twenty adolescents with asthma aged 13–17 years, recruited from a child allergy outpatient clinic using a quasi-experimental, one-group, pre-test–post-test design. In the evaluation of psychosocial problems in adolescents, Achenbach’s Youth Self-Report Scale (YSR/11–18), which is widely used in many countries and has been shown to be valid and reliable, was utilized. YSR/11–18 was administered before and one month after participation in the program. After completion of the program, YSR/11–18 scores were significantly improved. Creative drama is a potentially useful tool to help adolescents with asthma cope with their disease more effectively.

Zusammenfassung Die vorliegende S2k‐Leitlinie wurde auf Initiative und unter Federführung der Deutschen Gesellschaft für Phlebologie und Lymphologie (DGPL) e.V. erstellt. Ihr Ziel ist es, die Diagnostik und Therapie des Lipödems zu optimieren. Sie soll die unterschiedlichen Herangehensweisen der jeweiligen Berufsgruppen konsensbasiert zusammenführen und damit ein Grundkonzept für die bestmögliche Behandlung von Patientinnen mit Lipödem bieten. Insgesamt wurden 60 Empfehlungen zu den Themenbereichen Diagnostik, konservative und chirurgische Therapieoptionen sowie psychosoziale Faktoren und Selbstmanagement formuliert und abgestimmt. Die Leitlinie soll den aktuellen Stand der Wissenschaft widerspiegeln und als Dokument für Diagnose‐ und Therapieempfehlungen bei Patientinnen mit Lipödem breite Anwendung finden. Insbesondere nimmt die Leitlinie Stellung zu Diagnosekriterien, Differenzialdiagnosen und koinzidenten Krankheitsbildern sowie deren Einfluss auf Diagnose und Therapie, sinnvollen Therapiemaßnahmen und Möglichkeiten des Selbstmanagements. Die Leitlinie Lipödem fasst die aktuelle nationale und internationale Evidenz sowie den deutschen Expertenkonsens zusammen und leitet daraus Empfehlungen ab, die zu bestmöglicher Behandlung von Patientinnen mit Lipödem führen sollen. Die Empfehlungen verstehen sich als Orientierungshilfe im Sinne von Handlungs‐ und Entscheidungskorridoren, von denen in begründeten Fällen abgewichen werden kann.

Zusammenfassung Einleitung Auf Basis aktueller Standards der Behandlung wird international davon ausgegangen, dass eine vom biologischen Geschlecht abweichende Geschlechtsidentität keine psychische Erkrankung darstellt. Jedoch fordert der Medizinische Dienst des Spitzenverbandes Bund der Krankenkassen (MDS) die Absolvierung einer Psychotherapie, bevor sie trans* Personen entsprechende Leistungen im Rahmen des Prozesses geschlechtsangleichender Maßnahmen gewähren. Betroffene müssen so nach wie vor in Kauf nehmen, dass ihre geschlechtliche Selbstdefinition mit einer Diagnose versehen wird, auch wenn bei ihnen ansonsten kein psychischer Leidensdruck besteht. Hieraus entstehen seither Konflikte. Einerseits wird durch Vergabe der Diagnose der Zugang zu medizinischen Maßnahmen ermöglicht, andererseits werden Geschlechtsidentitäten (psycho-)pathologisiert. Forschungsziele Trans* Personen berichten dementsprechend aus unterschiedlichen Perspektiven von der psychotherapeutischen Begleittherapie im Rahmen ihrer Transition. Die Studie exploriert jene Erfahrungen und Einstellungen behandlungssuchender trans* Personen. Methoden Hierzu wurde eine qualitative Untersuchung durchgeführt. Die Datenerhebung basierte auf 20 leitfadengestützten, teilstrukturierten Interviews, welche inhaltsanalytisch ausgewertet wurden. Ergebnisse Die Ergebnisse gewähren einen differenzierten Einblick aus der Perspektive Betroffener. Die Auswertungen zeigen mehrheitlich positive Einstellungen hinsichtlich der Begleittherapie, welche den Zugang zu körpermodifizierenden Maßnahmen ermöglicht und sich primär durch die Gestaltung der therapeutischen Beziehung auszeichnet. Eine bedarfsgerechte psychotherapeutische Begleitung kann den Selbstwert, die Selbstakzeptanz und das Selbstbewusstsein betroffener trans* Personen positiv beeinflussen. Zugleich problematisieren die Daten jedoch den Therapiezwang und zeigen gravierende Schwachstellen des Versorgungssystems auf. Schlussfolgerung Eine bedarfsgerechte begleitende Psychotherapie ist für trans* Personen in Deutschland von Bedeutung und zeichnet sich durch eine vertrauensvolle und trans*-sensible Gestaltung der Beziehung zwischen Patient*in und Therapeut*in aus.

Aim Resveratrol is a natural polyphenolic compound with biological activities such as anti-inflammation and antioxidation. Its anti-fibrotic effect has been experimentally demonstrated in the pancreas and liver. This study aims to determine the anti-proliferative effect of resveratrol on fibroblasts obtained from hyperplastic gingival tissues from a patient diagnosed with Juvenile Hyaline Fibromatosis (JHF). Materials and methods Primary gingival fibroblast cell lines were obtained from gingival growth tissues by the gingivectomy of a patient with JHF. Gingival fibroblasts were treated with or without 3 different doses of resveratrol (50, 100, 200 µM). Cytotoxicity and cell proliferation were evaluated after 24, 48, and 72 h. Collagen, TGF, and CTGF were analyzed by ELISA in the 48-hour supernatants. Results All three doses of resveratrol suppressed the proliferation of JHF gingival fibroblasts at 24 and 48 h without showing any cytotoxic effect compared to the control group (p < 0.0001). At 72 h, 100 and 200 µM resveratrol showed significantly less proliferation (p < 0.0001), less collagen, CTGF, and TGF- β (p < 0.001) than the control group. Conclusion Resveratrol had a profound anti-proliferative effect on gingival fibroblasts obtained from gingival enlargements with JHF, suggesting that it can be used as a therapeutic to prevent excessive cell growth by suppressing collagen, CTGF, and TGF- β synthesis in the pathogenesis of hyperplasia.

Background: The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, an analysis was conducted to understand how these elements continue to affect young populations in the post-pandemic era. Methods: In April 2023, a comprehensive online survey was administered to families in South Tyrol, Italy, with children aged 7–19 years, to ensure age and gender representation. The survey included parent ratings and adolescent (11–19 years) self-reports using standardized instruments to measure the symptoms of mental health problems (Strengths and Difficulties Questionnaire, SDQ), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and depression (Patient Health Questionnaire-2, PHQ-2). Statistical analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs). Results: Of the 4525 valid responses, 1831 were self-reported by adolescents. Notable gender differences in mental health outcomes were identified, along with significant demographic predictors, such as age, single parenthood, parental mental health problems, and immigrant background. Negative effects were associated with reduced family climate and increased screen time, whereas physical activity showed beneficial effects. Proxy reports overestimated adolescents’ mental health problems, whereas self-reports tended to underestimate them. Conclusions: Persistent mental health problems and gender disparities highlight the need for a public health approach. This should include accessible support services, resilience building, targeted support for vulnerable families and gender-specific interventions.

Objective To assess the effect of the toothbrush handle on video-observed toothbrushing behaviour and toothbrushing effectiveness. Methods This is a randomized counterbalanced cross-over study. N = 50 university students and employees brushed their teeth at two occasions, one week apart, using either a commercial ergonomically designed manual toothbrush (MT) or Brushalyze V1 (BV1), a manual toothbrush with a thick cylindrical handle without any specific ergonomic features. Brushing behaviour was video-analysed. Plaque was assessed at the second occasion immediately after brushing. Participants also rated their self-perceived oral cleanliness and directly compared the two brushes regarding their handling and compared them to the brushed they used at home. Results The study participants found the BV1 significantly more cumbersome than the M1 or their brush at home. (p < 0.05). However, correlation analyses revealed a strong consistency of brushing behavior with the two brushes (0.71 < r < 0.91). Means differed only slightly (all d < 0.36). These differences became statistically significant only for the brushing time at inner surfaces (d = 0.31 p = 0.03) and horizontal movements at inner surfaces (d = 0.35, p = 0.02). Plaque levels at the gingival margins did not differ while slightly more plaque persisted at the more coronal aspects of the crown after brushing with BV1 (d = 0.592; p 0.042). Discussion The results of the study indicate that the brushing handle does not play a major role in brushing behavior or brushing effectiveness.

Impacts of aqueous and ethanolic extracts of garlic were investigated in suppressing bacterial growth and biogenic amine (BA) formation by selected foodborne pathogens (Candida albicans, Salmonella paratyphi A, Escherichia coli and Staphylococcus aureus) and fish spoilage bacteria (Enterococcus faecalis, Photobacterium damselae and Pseudomonas luteola). The spread‐plate method was used to monitor bacterial growth in histidine decarboxylase broth (HDB), whereas the rapid high‐performance liquid chromatographic (HPLC) method was used for BA analysis. Bacterial growth and their ammonia and BA production were monitored using HDB. The results showed that bacterial growth on HDB was in the range from 9.13, for P. luteola, to 9.54 log CFU (colony‐forming units) mL⁻¹, for S. aureus and C. albicans. The presence of garlic extracts in HDB resulted considerably in lowering bacterial growth and BA formation (P < 0.05). The highest inhibitory activities of ethanolic and water garlic extracts were obtained for Gram‐positive S. aureus with 1.4 and 1.5 logarithmic reduction on bacterial growth, followed by Gram‐negative Salmonella Paratyphi A and E. coli. Application of garlic extracts, mainly ethanolic ones, showed a significant inhibitory effect on bacterial ammonia production, with 4‐100‐fold lower ammonia accumulation (P < 0.05). Bacteria produced all tested BAs, mainly dopamine, agmatine and tryptamine. The highest levels of histamine and tyramine (61.99 and 36.45 mg L⁻¹) were produced by S. aureus. In the presence of aqueous or ethanolic garlic extracts, putrescine production by E. faecalis was around 110‐fold lower than that of the control group. Results revealed that both garlic extracts are potent antimicrobials that can control the growth of foodborne pathogens and their harmful BA formation.