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Objective: To analyze the effect of adverse preoperative patient and tumor characteristics on perioperative outcomes of open (ORP) and robot-assisted radical prostatectomy (RARP).
Material and Methods: We retrospectively analyzed 656 patients who underwent ORP or RARP according to intraoperative blood loss (BL), operation time (OR time), neurovascular bundle preservation (NVBP) and positive surgical margins (PSM). Univariable and multivariable logistic regression models were used to identify risk factors for impaired perioperative outcomes.
Results: Of all included 619 patients, median age was 66 years. BMI (<25 vs. 25-30 vs. ≥30) had no influence on blood loss. Prostate size >40cc recorded increased BL compared to prostate size ≤ 40cc in patients undergoing ORP (800 vs. 1200 ml, p < 0.001), but not in patients undergoing RARP (300 vs. 300 ml, p = 0.2). Similarly, longer OR time was observed for ORP in prostates >40cc, but not for RARP. Overweight (BMI 25-30) and obese ORP patients (BMI ≥30) showed longer OR time compared to normal weight (BMI <25). Only obese patients, who underwent RARP showed longer OR time compared to normal weight. NVBP was less frequent in obese patients, who underwent ORP, relative to normal weight (25.8% vs. 14.0%, p < 0.01). BMI did not affect NVPB at RARP. No differences in PSM were recorded according to prostate volume or BMI in ORP or RARP. In multivariable analyses, patient characteristics such as prostate volume and BMI was an independent predictor for prolonged OR time. Moreover, tumor characteristics (stage and grade) predicted worse perioperative outcome.
Conclusion: Patients with larger prostates and obese patients undergoing ORP are at risk of higher BL, OR time or non-nervesparing procedure. Conversely, in patients undergoing RARP only obesity is associated with increased OR time. Patients with larger prostates or increased BMI might benefit most from RARP compared to ORP.
Background: In order to classify and analyze the parameters of upper body posture, a baseline in the form of standard values is demanded. To this date, standard values have only been published for healthy men aged 18–35 and 41–50 years. Data for male adults aged between 31 and 40 years are lacking.
Methods: The postural parameters of 101 symptom-free male volunteers aged 31–40 (35.58 ± 2.88) years were studied. The mean height of the men was 179.89 ± 7.38 cm, with a mean body weight of 86.36 ± 11.58 kg and an average BMI of 26.70 ± 3.35 kg/m2. By means of video rasterstereography, a 3-dimensional scan of the upper back surface was measured in a habitual standing position. The means or medians, confidence interval, tolerance range, and group comparisons and correlations of BMI and physical activity were calculated for all parameters.
Results: The habitual standing position was found to be almost symmetrical and the axis aligned in the spine, pelvis, and shoulder region, while the spine position was marginally inclined ventrally. The kyphosis angle of the thoracic spine was greater than the lordosis angle of the lumbar spine. All deviations fell under the measurement error margin of 1 mm/1°. The greater the BMI, the greater was the pelvic and scapular distance. The lower the BMI, the further caudally positioned was the right shoulder. The pelvic and scapular distances were also lower with the increasing athleticism of the participants.
Conclusion: The upper body posture of men between the ages of 31 and 40 years was found to be almost symmetrical and axis-conforming, with the kyphosis angle, pelvic distance, and shoulder distance enlarging with increasing BMI. Consequently, postural parameters presented in this survey allow for comparisons with other studies, as well as the evaluation of clinical diagnostics and applications.
Das Ziel dieser Arbeit war, Unterschiede bezüglich der Körperbautypen an Elitekarateka zu eruieren. Hierzu wurden die Konstitutionstypologien nach Conrad, Knußmann, Parnell sowie Heath und Carter, Proportionsfiguren, und das Phantom stratagem verwendet, ebenso wie die Hautfettfalten-Dickenmessungen, die Bioelektrische-Impedanz-Analyse (BIA) und der Body-Mass-Index (BMI). Unter der Annahme Großmeisters Funakoshis, dass es durch ständiges Karatetraining zu körperbaulichen Konstitutionstypusänderungen kommt, wurde diese sportanthropologische Studie durchgeführt. Es sollte geklärt werden, ob innerhalb der Karatewettkampfdisziplinen Kata und Kumite unterschiedliche Körperbautypen, unter Einbeziehung des Sexualdimorphismus, zu finden sind. Die 80 untersuchten männlichen und weiblichen Karateka kamen aus den Disziplinen Kata (Schattenboxen) und Kumite (Freikampf). Im Vergleich dazu wurden 62 und 66 Breitensportkarateka als Kontrollgruppe gegenübergestellt. Das Vergleichskollektiv wurde aus zwei Fitnessstudios rekrutiert, in denen die Probanden 2 - 4 mal pro Woche trainierten. Die Messungen wurden unter standardisierten Bedingungen vom Verfasser dieser Arbeit (und einer Kollegin) durchgeführt. Die Ergebnisse wurden statistisch geprüft. Die Konstitutionstypognosen von Conrad, die durch die Betrachtungen der Somatocharts von Parnell bzw. Heath und Carter bestätigt wurden, zeigten Unterschiede der Leistungssportler gegenüber den Kontrollgruppen. Demnach ist der typische Kata- und Kumiteathlet kleiner und wiegt weniger als die Sportler des Vergleichskollektivs der Fitnessprobanden. Er ist athletischer gebaut und weist ein günstiges Verhältnis von aktiver und passiver Körpermasse auf. Des Weiteren sind innerhalb der Karatedisziplinen die Katasportler endomorpher als ihre Kollegen. Die Kumiteathleten nehmen mehr ektomorphe Positionen in den Somatocharts (Parnell, Heath und Carter) ein. Anhand der Ergebnisse lässt sich die ursprüngliche Vermutung Funakoshis nach differenzierten Konstitutionstypen sowohl für die beiden Untersuchungskollektive als auch innerhalb des Karate für die Wettkampfdisziplinen Kata und Kumite bestätigen. Die vorliegende Studie lässt den Schluss zu, dass es sowohl den Kata- als auch den Kumite-Konstitutionstypus im Karate gibt. Weiterer Forschungsbedarf besteht hinsichtlich longitudinaler Datenerhebungen des Konstitutionswandels jugendlicher Karateka im Laufe ihrer Wettkampfkarriere. Die Karriere beeinflussende Faktoren wie Trainingshäufigkeit, „Trainingsalter“ und Verletzungshäufigkeit, bezogen auf das Leistungsniveau, lassen Spielraum für weiterführende Untersuchungen. Dies gilt auch für eventuelle ethnische Körperbauunterschiede und das Leistungsniveau der Athleten.
Background: A central aim of physical education is the promotion of basic motor competencies (in German: Motorische Basiskompetenzen; MOBAK), which are prerequisites for children's active participation in sports culture. This article introduces the MOBAK-1 test instrument for 6- to 8-year-old children and determines the construct validity of this test instrument. In addition, the relationship between MOBAK and motor ability (i.e., strength) as well as body mass index (BMI), sex, and age is investigated.
Methods: We analyzed data of 923 first and second graders (422 girls, 501 boys, age = 6.80 ± 0.44 years). The children's basic motor competencies were assessed by the MOBAK-1 test instrument. Besides analyses of frequency, correlation, and variance, 3 confirmatory factor analyses with covariates were performed.
Results: We found 2 MOBAK factors consisting of 4 items each. The first factor, locomotion, included the items balancing, rolling, jumping, and side stepping; the second factor, object control, included the items throwing, catching, bouncing, and dribbling. The motor ability strength had a significant influence on the factors locomotion (β = 0.60) and object control (β = 0.50). Older pupils achieved better results than younger pupils on object control (β = 0.29). Boys performed better on object control (β = −0.44), whereas girls achieved better results in locomotion (β = 0.07). Pupils with a high BMI achieved lower performance only on the factor locomotion (β = −0.28).
Conclusion: The MOBAK-1 test instrument developed for this study meets psychometric validity demands and is suitable to evaluate effects of sports and physical education.
Background: Previous studies have demonstrated that CF (Cystic Fibrosis) prognosis is dependent of three major parameters: FEV1 (Forced Expiratory Pressure in one second), BMI (Body Mass Index) and need of intravenous antibiotic therapy. The CF centres of Frankfurt, Germany, and Moscow, Russia, care for cystic fibrosis patients. We decided to investigate and compare both centers from 1990 to 2015. No comparable study has been published so far.
Method: German patient data was collected from the national cystic fibrosis database “Muko.web”. Missing values were extracted from the Hospital Information System. Russian patient data were taken directly from the medical records in Moscow. In a descriptive statistical analysis with Bias and R Studio the values were compared.
Result: A total of 428 patients from Moscow (217 male, 211 female; 348 (81,3%) were P. aeruginosa positive) and 159 patients from Frankfurt (92 male, 67 female; 137 (86,2%) with P. aeruginosa positive) were compared with regard to P. aeruginosa positivity, BMI, FEV1 and need of intravenous antibiotic therapy. CF patients in Moscow stratified by age groups had lower BMI than CF patients in Frankfurt (age 16-18: p=0,003; age 19-22: p=0,004; age 23-29: p<0,001; age 30-35: p<0,001; age 36-66: p=0,024). In a matching pairs analysis including 100 patients from Frankfurt and 100 patients from Moscow for the year 2015 FEV1 was significantly lower in Moscow patients (p<0,001).
Conclusion: BMI, FEV1 and need of intravenous therapy have significant impact on survival and on quality of life of CF patients. A lower BMI and a lower FEV1 result in a worse survival and determine the prognosis. This study showed a significant difference in prognostic parameters between Frankfurt and Moscow in the crosssectional analysis for the year 2015. A further study should evaluate this difference to show whether this difference will be found over a longer period of time.