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verweight and obesity are a growing global public health problem (1). Epidemiological analyses have projected that overweight will be one of the top 4 global causes of preventable years of life lost in the future, besides hypertension, diabetes, and smoking (2). Already in 2007, the social costs of overweight amounted to 16 billion Pound Sterling in the United Kingdom (corresponding to 1% of their gross national product), with a strong upward trend. According to guideline recommendations on the prevention of myocardial infarction, stroke, and diabetes, physicians should offer lifestyle interventions to their overweight patients (3, 4). The 13 th nutrition report of the German Nutrition Society (DGE, Deutsche Gesellschaft für Ernährung e. V.) highlights the need to stop this obesity epidemic in Germany and calls for urgent action (5).According to the World Health Organization (WHO), in 2016 worldwide 39% of adults were overweight with a body mass index (BMI) of ≥ 25 kg/m 2 , while 11% of men and 15% of women were obese with a BMI of ≥ 30 kg/m 2 (6). The prevalence of obesity is high in Germany. Of the adult population, 54% have a BMI of ≥ 25 kg/m 2 and 18% of >30 kg/m 2 (7). In the United States, prevalence rates are even higher, with 36% of the population being obese (8).For weight-loss interventions to be successful, people need to be aware of the fact that they are overweight; without this awareness, a behavioral change is unlikely to happen (9-11). The agreement between self-perception and measured weight status has already been evaluated in numerous studies on a variety of populations; however, an aggregation of these data for the general adult population is missing.The aim of this review is to organize the available data from studies on weight perception in adults, to identify areas that need to be addressed in future research, and to provide summarized answers to the following questions:• How often is the self-perceived BMI categorization accurate?• Is misclassification based on overestimation or underestimation?• What groups of persons show good weight selfperception and what groups do not? SummaryBackground: Overweight and obesity are an increasingly serious public health problem in Western societies, including Germany. The tendency of overweight and obese people not to classify themselves as such limits the efficacy of information on the health risks of these conditions and lessens the motivation to change behavior accordingly. In this article, we summarize the available study data on the selfperception of weight class. We present and discuss the differences between selfreported body-mass index (BMI) category and the actual category of the BMI when it is calculated from the individual's measured height and weight.Methods: We systematically searched the Medline, EMBASE, and Cochrane Library databases in August 2017 for pertinent publications. The study protocol was published in the PROSPERO register (CRD42017064230). Meta-analyses were calculable for a number of subgroup analyses.Results: A total of 50 st...

Strong evidence supports the use of ultrasound imaging for certain indications in the detection of fractures.

Few human cell strains are suitable and readily available as in vitro adipocyte models. We used resected lipoma tissue from a patient with germline phosphatase and tensin homolog (PTEN) haploinsufficiency to establish a preadipocyte cell strain termed LipPD1 and aimed to characterize cellular functions and signalling pathway alterations in comparison to the established adipocyte model Simpson-Golabi-Behmel-Syndrome (SGBS) and to primary stromal-vascular fraction cells. We found that both cellular life span and the capacity for adipocyte differentiation as well as adipocytespecific functions were preserved in LipPD1 and comparable to SGBS adipocytes. Basal and growth factor-stimulated activation of the PI3 K/AKT signalling pathway was increased in LipPD1 preadipocytes, corresponding to reduced PTEN levels in comparison to SGBS cells. Altogether, LipPD1 cells are a novel primary cell model with a defined genetic lesion suitable for the study of adipocyte biology.

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Summary Background Potential additive effects of polypharmacy are rarely considered in adverse events of geriatric patients living in long-term care facilities. Our aim, therefore, was to identify adverse events in this setting and to assess plausible concomitant drug causes. Methods A cross-sectional observational study was performed in three facilities as follows: (i) adverse event identification: we structurally identified adverse events using nurses’ interviews and chart review. (ii) Analysis of the concomitantly administered drugs per patient was performed in two ways: (ii.a) a review of summary of product characteristics for listed adverse drug reactions to identify possible causing drugs and (ii.b) a causality assessment according to Naranjo algorithm. Results (i) We found 424 adverse events with a median of 4 per patient (range 1–14) in 103 of the 104 enrolled patients (99%). (ii.a) We identified a median of 3 drugs (range 0–11) with actually occurring adverse events listed as an adverse drug reaction in the summary of product characteristics. (ii.b) Causality was classified in 198 (46.9%) of adverse events as “doubtful,” in 218 (51.2%) as “possible,” in 7 (1.7%) as “probable,” and in 1 (0.2%) adverse event as a “definitive” cause of the administered drugs. In 340 (80.2%) of all identified adverse events several drugs simultaneously reached the highest respective Naranjo score. Conclusion Patients in long-term facilities frequently suffer from many adverse events. Concomitantly administered drugs have to be frequently considered as plausible causes for adverse events. These additive effects of drugs should be more focused in patient care and research.

Background: Over the last two decades, ultrasonography (US) has been shown to be an accurate tool for the diagnosis of suspected bone fractures; however, the integration of this application of US into routine care and outpatient settings needs to be explored. In this study, we surveyed German general practitioners (GPs) to assess their knowledge, attitudes, and utilization of US for the diagnosis of suspected fractures. Methods: Notification of the study, a self-designed questionnaire, and a reminder were mailed to 600 randomly selected GPs in Saxony and Saxony-Anhalt. Results: The response rate was 47.7% (n = 286), and respondents did not differ from the population of all GPs in respect to sex and practice type. Among GPs surveyed, 48.6% used an US device in their practice. On average, GPs diagnosed six patients with suspected fractures per month, yet only 39.3% knew about the possibility of ultrasonographic fracture diagnosis, and only 4.3% of GPs using US applied it for this purpose. Among participants, 71.9% believed that US is inferior to conventional X-rays for the diagnosis of bony injuries. Users of US were better informed of and more commonly used US for fracture diagnosis compared to non-users. Conclusion: The need to rule out possible fractures frequently arises in general practice, and US devices are broadly available. Further efforts are needed to improve the knowledge and attitudes of GPs regarding the accuracy of US for fracture diagnosis. Multicenter controlled trials could explore the safety, usefulness, and effectiveness of this still seldom used diagnostic approach for suspected fractures.