Denosumab can be effective in the treatment of refractory hypercalcemia in parathyroid cancer. It may also be of potential use in settings of benign hyperparathyroid-related hypercalcemia such as parathyromatosis, where hypercalcemia is not amenable to surgery or medical therapy with bisphosphonates and calcium receptor agonists.
Electronic media play an important role in the everyday lives of children and adolescents and have been shown to be associated with sleep problems. The objective of this study was to assess the associations between time spent using different electronic media and insomnia complaints (IC) in German adolescents with particular respect to gender differences in use patterns and associations with IC. Cross-sectional data of a weighted total of 7533 adolescents aged 11-17 stem from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS study) that was conducted from 2003 to 2006. The assessment of IC and time spent using different electronic media (television, computer/internet, video games, total screen time, mobile phones, and music) was included in a self-report questionnaire. Binary logistic regression analyses were performed to assess associations between time spent per day with each electronic media and IC. Age, SES, emotional problems (anxiety/depression) and presence of a medical condition were considered as covariates in the adjusted model. Boys and girls were considered separately. For boys: computer/internet use of ≥3 h/d (AOR = 2.56, p < 0.05) and total screen time of ≥8 h/d (AOR = 2.45, p < 0.01) were associated with IC in users. Playing video games for 0.5-2 h/d reduced the odds for IC (AOR = 0.60, p < 0.05) compared to nonusers. For girls: Listening to music for ≥3 h/d was associated with IC (AOR = 4.24, p < 0.05) compared to non-listeners. Everyday use of electronic media devices is associated with IC in adolescents. Clinicians dealing with adolescents referred for sleep problems should be aware of gender-specific patterns of media use and sleep problems.
Neurotoxicity of first-generation antipsychotics (FGAs) may be involved in lipid peroxidation, which is the pathogenesis of extrapyramidal symptoms, including tardive dyskinesia (TD). Blood samples at day 0, 7, and 21 drawn from patients taking antipsychotics were analyzed for malondialdehyde (MDA) in plasma, a marker of lipid peroxidation, by high-performance liquid chromatography. Of 115 patients enrolled, 92 patients completed the study. Most MDA levels were within normal ranges (<1.0 micromol/liter). Malondialdehyde levels in patients receiving clozapine (p = 0.002), quetiapine (p = 0.003), amisulpride (p = 0.008), and risperidone (p = 0.008) were significantly lower than within the first generation antipsychotic group. The authors conclude that lipid peroxidation is significantly higher in treatment with FGAs.
Molecular genetic tests enable a differentiated view of patho-physiological correlation of sensori-neural hearing impairment. On the basis of 4791 records of the German Central Registry on Childhood Hearing Loss (Deutsches Zentralregister für kindliche Hörstörungen (DZH)) it was shown that 35% of all permanent hearing impairment in Germany is caused genetically and 20% are acquired. The proportion of indistinct etiology remains at 45%. The number of children who have a hearing impairment by birth is also vague. It has to be expected that approximately 5% of these children develop a hearing impairment afterwards albeit its genetic determination. In 4791 cases a syndromal phenotype was assumed in 8.9%. Practical advice is given for clinical routine diagnostics with pragmatic suggestions and some distinct syndromes are described. Hitherto identified deafness genes reveal their role in pathological auditory function. Future diagnostic and therapeutic strategies are outlined on the basis of molecular genetic methods.
The purpose of the study was to study the associations of tobacco, alcohol, marijuana, and coffee use and insomnia complaints (IC) in adolescents with special consideration of the influence of coffee consumption on these relationships. 7698 Subjects aged 11-17 years were investigated in a cross-sectional study within the German Health Interview and Examination Survey for Children and Adolescents. Self-report questionnaires were distributed to the participants. Hierarchical regression analyses were performed to assess possible effects of coffee consumption on the association of tobacco, alcohol, and marijuana use with IC. Common risk factors for insomnia were included in the adjusted analyses. Tobacco, alcohol, marijuana and coffee use displayed significant bivariate associations with IC. After adjusting the first three substances for coffee consumption, their associations with IC were reduced considerably. After additionally adjusting for other potential confounders (age, gender, socio-economic status, externalizing and internalizing psychiatric problems, media use, bodyweight, medical condition), frequent coffee consumption, high alcohol intake and frequent smoking contributed to the prediction of IC in male subjects while frequent coffee consumption and high alcohol intake predicted the occurrence of IC in females. Coffee consumption could be an important risk factor for IC in adolescents and it significantly affects the association of smoking, alcohol, and marijuana with IC. Future research that includes long-term studies about psychoactive substance use (PSU) and sleep should also consider coffee consumption. Parents, educators, clinicians, and researchers should be aware of the potentially hazardous influence of PSU, especially coffee, alcohol and tobacco, on sleep in young individuals.
Last fall, JBS Editor Nanci Healy facilitated a roundtable discussion among Clare Morgan (Oxford University), Kirsten Lange (Boston Consulting Group, Munich) and Ted Buswick (Boston Consulting Group, Boston) on poetry and business strategy, two subjects that don't ordinarily go together. The editor thanks the participants for sharing their ideas and creativity with JBS readers and possibly opening up new avenues of thought for business leaders.Healy: Clare, can you talk about the workshop you recently conducted with a high tech company in England that included poetry as part of business strategy?Morgan: This was a young UK company that wanted to expand quickly and make sure the strategies for expansion were right. My own company had been doing some organization development work with them, and the CEO wanted to spend time at a strategy retreat developing the thinking of his management team as well as addressing the concrete issues that faced them. We'd kept him informed about the work within the Boston Consulting Group Strategy Institute on poetry and thinking, and -being a poetry reader himself -he was eager to see how exposure to some poetry would affect the way his team approached certain key issues.Healy: How did you decide what line to take in presenting such an unusual subject?Morgan: We decided to focus on the real topic at hand -making decisions. We chose a poem that showed how complex making decisions is: complex, that is, in terms of how so many different elements can affect how we see ''the facts''. The CEO was very pleased that the content of the poem opened up a wide-ranging discussion of real issues like: When is the right time to kill off a project? What influences we may not be aware of are affecting how we prioritize value and make fine judgments? The poem also opened up how we may be judged, for making tough choices that affect the lives of others. The CEO liked the way the discussion highlighted that in many cases there is not a clear cut right or wrong to the decision we're faced with. Sometimes the information we have is incomplete, or the different strands of need cannot be definitively prioritized. The poem we used at the workshop was Traveling Through the Dark, by William Stafford, and it reminded the management team just how much ''in the dark'' we often are at important decision-making moments.Healy: Was your goal to find a poem that suited the topic and explore it?Morgan: That, and more. The right choice of topic is important in getting the interest of a busy executive. If the pay-off were just the new and expanded visions about decision making, or risk, or leadership, or power, or any of the other many areas of relevance a poem could be dealing with -that wouldn't be enough of a reason, in most companies, for playing the wild card of a poem, rather than, say, organizing a discussion group. Buswick:The big thing it offered was the skills it began to develop. Reading poetry opens up new thinking spaces, and accessing those spaces requires you to develop a new set of thinking skills.
<span class="fett">Fragestellung:</span> Um typische Charakteristika einer Abhängigkeit von GABA-A-Rezeptor-agonistischen Nichtbenzodiazepin-Hypnotika zu erfassen, wurde die Literatur nach Fallberichten durchsucht, die von einer Abhängigkeitsentwicklung unter Anwendung dieser Substanzen berichten. </p><p> <span class="fett">Methodik:</span> Es erfolgte eine Medline-Recherche bis Juni 2006. Um relevante Publikationen zu identifizieren, wurden die Termini zolpidem, zopiclone, zaleplon und eszopiclone mit den Termini abuse, addiction, dependence, intoxication und withdrawal kombiniert. </p><p> <span class="fett">Ergebnisse:</span> Seit 2002 wurden 35 Abhängigkeitsfälle für Zolpidem und 11 für Zopiclon identifiziert, davon 24 Zolpidem- und 8 Zopiclonfälle bei Patienten mit Suchtvorgeschichte. </p><p> <span class="fett">Schlussfolgerungen:</span> Die Indikation für die Verabreichung der Substanzen an Patienten mit Suchtvorgeschichte ist eng zu stellen.
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