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Preclinical studies in cell culture systems as well as in whole animal chronic kidney disease (CKD) models showed that parathyroid hormone (PTH), oxidized at the 2 methionine residues (positions 8 and 18), caused a loss of function. This was so far not considered in the development of PTH assays used in current clinical practice. Patients with advanced CKD are subject to oxidative stress, and plasma proteins (including PTH) are targets for oxidants. In patients with CKD, a considerable but variable fraction (about 70 to 90%) of measured PTH appears to be oxidized. Oxidized PTH (oxPTH) does not interact with the PTH receptor resulting in loss of biological activity. Currently used intact PTH (iPTH) assays detect both oxidized and non-oxPTH (n-oxPTH). Clinical studies demonstrated that bioactive, n-oxPTH, but not iPTH nor oxPTH, is associated with mortality in CKD patients.
When local poverty is more important than your income: Mental health in minorities in inner cities
(2015)
Stress and bone health
(2019)
Acute ankle sprain leads in 40% of all cases to chronic ankle instability (CAI). CAI is related to a variety of motor adaptations at the lower extremities. Previous investigations identified increased muscle activities while landing in CAI compared to healthy control participants. However, it remains unclear whether muscular alterations at the knee muscles are limited to the involved (unstable) ankle or are also present at the uninvolved leg. The latter might potentially indicate a risk of ankle sprain or future injury on the uninvolved leg. Purpose: To assess if there is a difference of knee muscle activities between the involved and uninvolved leg in participants with CAI during perturbed walking. Method: 10 participants (6 females; 4 males; 26±4 years; 169±9 cm; 65±7 kg) with unilateral CAI walked on a split-belt treadmill (1m/s) for 5 minutes of baseline walking and 6 minutes of perturbed walking (left and right side, each 10 perturbations). Electromyography (EMG) measurements were performed at biceps femoris (BF) and rectus femoris (RF). EMG amplitude (RMS; normalized to MVIC) were analyzed for 200ms pre-heel contact (Pre200), 100ms post heel contact (Post100) and 200ms after perturbation (Pert200). Data was analyzed by paired t-test/Wilcoxon test based on presence or absence of normal distribution (Bonferroni adjusted α level p≤ 0.0125). Results: No statistical difference was found between involved and uninvolved leg for RF (Pre200: 4±2% and 11± 22%, respectively, p= 0.878; Post100: 10± 5 and 18±31%, p=0.959; Pert200: 6±3% and 13±24%, p=0.721) as well as for BF (Pre200: 12±7% and 11±6, p=0.576; Post100: 10±7% and 9±7%, p=0.732; Pert200: 7±4 and 7±7%, p=0.386). Discussion: No side differences in muscle activity could be revealed for assessed feedforward and feedback responses (perturbed and unperturbed) in unilateral CAI. Reduced inter-individual variability of muscular activities at the involved leg might indicate a rather stereotypical response pattern. It remains to be investigated, whether muscular control at the knee is not affected by CAI, or whether both sides adapted in a similar style to the chronic condition at the ankle.