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The association of electrophysiological sensitisation, i. It is at odds with the electrophysiological pattern associating high amplitude in 1st block and normal habi-tuation found during migraine attacks [], but, as mentioned before, it has been described in the pre-ictal phase []. One possible explanation for the lack of habituation in episodic migraineurs between attacks is the “ceiling theory” [39] postulating that there is a low preactivation level of sensory cortices, also responsible for the low 1st block amplitudes, would allow a larger range of activation before habituation occurs [6,8].
The habituation deficit in NSAIDs overusers cannot be explained by the “ceiling theory” since their high 1st block amplitude indicates rather that the somatosensory cortex is sensitised.
There is at present no straight forward explanation for this pattern. It is likely, however, that other neurobiological mechanisms that participate in the production of habituation are impaired. For instance, inhibitory interneurons could be hypofunctioning because of the reduction in serotonergic transmission induced by the prolonged NSAID overconsumption. This hypothesis can be tested experimentally by searching if habituation normalizes during full-blown attacks in MOH patients like in episodic migraine and by exploring inhibitory cortical interneurons with dedicated neurophy-siological studies such as that of cortical silent periods using transcranial magnetic stimulation.
Given the similar neural mechanisms underlying sensory and behavioural sensitization [40], the interesting question arises.
Behavioural sensitiza-tion is paradigmatic of how the serotonergic, dopaminer-gic, and noradrenergic systems interact and contribute to central sensitization [41].
Brain circuits involved in addictive behaviour include ventral and dorsal striatum, amygdala and orbitofrontal cortex and are heavily modulated by dopaminergic projections from the ventral tegmental area of the midbrain, serotonergic projections from the median and dorsal raphe nuclei, and noradrenergic projections from the locus coeruleus [4,42].
The latter has been associated with orbito-frontal cortex hypoactivity [44], an abnormality also found in subgroups of MOH patients [5]. The orbito-frontal cortex is thought to modulate habituation mechanisms [45] and orbito-frontal lesions induce SEP sensitization and lack of habituation [46], precisely the two sensory abnormalities we found in patients with MOH.
Our findings along with current knowledge on the neurobiology of drug overuse therefore suggest that future studies seeking correlations between electrophy-siological and metabolic measures should focus on the orbito-frontal cortex. In our study we did not control for associated depression and anxiety. Despite the evidence that cortical pain-related evoked potentials in MOH do not differ between subgroups of patients with or without depressive symptoms [28], it may still be appropriate to control for psychiatric comorbidity in future studies.
Cortical responses to repetitive sensory stimuli are abnormal in patients with MOH. Increased response amplitudes after low numbers of stimuli indicate sensory sensitization and lack of amplitude decrease during subsequent stimulations reflects a habituation deficit. This cortical response pattern is similar the one found in the immediate pre-ictal phase in episodic migraine, but different from the interictal and ictal patterns. It suggests that the somatosensory cortex has become persistently sensitized and that the migraine generating mechanisms in the central nervous system are not shut off.
The sen-sitization is obvious in patients overusing NSAIDs and almost non-existent or masked in those who overuse only triptans. The different electrophysiological pattern between drug classes may be related to the clinical observation that withdrawal headache is shorter lasting in triptan overusers than in NSAID overusers. We postulate that the abnormal sensory processing in MOH patients reflects a drug-induced impairment of central serotonin neurotransmission, that the decrease of sero-tonergic activity is more profound after chronic NSAID overconsumption and that the cortical sensory sensitization parallels the behavioural sensitization that.
University Dept. GC made substantialcontributions to acquisition of data, analysis and interpretation of data as wellas in drafting the manuscript. AC, VP, JS and FP were implied in the interpretation of data as wellas in drafting the manuscript; gave critical revision of the manuscript for important intellectual content. All authors read and approved the final manuscript. Cephalalgia , 26 6 Eur J Neurol , 13 4 Cephalalgia , 25 6 Trends Pharmacol Sci , 26 2 Brain , Pt 2 Schoenen J: Deficient habituation of evoked cortical potentials in migraine: a link between brain biology, behavior and trigeminovascular activation?
Biomed Pharmacother , 50 2 Cephalalgia , 27 12 Cephalalgia , 19 5 Kropp P, Gerber WD: Prediction of migraine attacks using a slow cortical potential, the contingent negative variation. Neurosci Lett , 2 Siniatchkin M, Kropp P, Gerber WD, Stephani U: Migraine in childhood-are periodically occurring migraine attacks related to dynamic changes of cortical information processing? Neurosci Lett , 1 Kropp P, Gerber WD: Contingent negative variation during migraine attack and interval: evidence for normalization of slow cortical potentials during the attack.
Cephalalgia , 15 2 Judit A, Sandor PS, Schoenen J: Habituation of visual and intensity dependence of auditory evoked cortical potentials tends to normalize just before and during the migraine attack.
Cephalalgia , 20 8 Cephalalgia , 29 11 Neurobiol Learn Mem , 92 2 Ozkul Y, Uckardes A: Median nerve somatosensory evoked potentials in migraine. Eur J Neurol , 9 3 Clin Neurophysiol , 8 Neurology , 65 9 Woolf CJ, Wall PD: Relative effectiveness of C primary afferent fibers of different origins in evoking a prolonged facilitation of the flexor reflex in the rat.
J Neurosci , 6 5 A MSI study. Brain Res , 1 Burstein R, Cutrer MF, Yarnitsky D: The development of cutaneous allodynia during a migraine attack clinical evidence for the sequential recruitment of spinal and supraspinal nociceptive neurons in migraine. Brain , Pt 8 Pain , 47 2 Headache , 48 2 Cephalalgia , 26 7 Neurology , 58 8 Cephalalgia , 26 9 Brain Res Mol Brain Res , Pain , Cephalalgia , 13 3 Neurology , 70 6 Dobson CF, Tohyama Y, Diksic M, Hamel E: Effects of acute or chronic administration of anti-migraine drugs sumatriptan and zolmitriptan on serotonin synthesis in the rat brain.
Cephalalgia , 24 1 Srikiatkhachorn A, Tarasub N, Govitrapong P: Effect of chronic analgesic exposure on the central serotonin system: a possible mechanism of analgesic abuse headache. Health care interventions for affected patients should be expanded by offering early or even preventive care for other diseases that go along with it.
The dataset analysed during the present study is available from the Robert Koch Institute for researchers who meet the criteria for access, [doi: EM and MTP devised the basic idea for the manuscript. MTP performed the statistical analysis, with contributions by EM. MTP and MK drafted the manuscript. All authors read and approved the final manuscript.
Ethics approval and participant consent was not necessary as this study involved the use of a previously-published de-identified database secondary data analysis according to national guidelines and recommendations in secondary data analysis [ 22 ].
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Manuela Klaschik, Email: ed. Matthias Schmid, Email: ed. Klaus Weckbecker, Email: ed. BMC Musculoskelet Disord.
Published online May Author information Article notes Copyright and License information Disclaimer. Corresponding author.
Received Dec 22; Accepted Apr Abstract Background Knowledge on prevalence of osteoporosis stratifying for socioeconomic background is insufficient in Germany. Results Overall, 8. Conclusions There was no clear evidence of socioeconomic differences regarding osteoporosis for adults in Germany. Background Osteoporosis and its consequences are a major public health concern and amount in high expenses for health care systems [ 1 , 2 ].
Results The total number of participants aged 50 years and older was 10, Female Medium Ex-smoker Never Open in a separate window. Discussion The underlying study provides representative data on prevalence rates and comorbidities of osteoporosis based on the German population aged 50 years and older. Conclusions The disease burden in adults with osteoporosis is of high relevance.
Availability of data and materials The dataset analysed during the present study is available from the Robert Koch Institute for researchers who meet the criteria for access, [doi: Notes Ethics approval and consent to participate Ethics approval and participant consent was not necessary as this study involved the use of a previously-published de-identified database secondary data analysis according to national guidelines and recommendations in secondary data analysis [ 22 ].
Competing interests The authors declare that they have no competing interests. References 1. Reginster J-Y, Burlet N. Osteoporosis: a still increasing prevalence. Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos. World Health Organization. Accessed 03 Apr Differences in adults’ health and health behaviour between 16 European urban areas and the associations with socio-economic status and physical and social environment.
Eur J Pub Health. Robert Koch-Institut. Gesundheitliche Ungleichheit in verschiedenen Lebensphasen. Gesundheitsberichterstattung des Bundes. Gemeinsam getragen von RKI und Destatis. Accessed 24 May Socioeconomic inequalities in morbidity and mortality in western Europe. Socioeconomic inequalities in health in 22 European countries. N Engl J Med. The association between socioeconomic status and osteoporotic fracture in population-based adults: a systematic review.
Osteoporos Int. Association between socioeconomic status and bone mineral density in adults: a systematic review. Risk factors in osteoporosis. Body mass index as a predictor of fracture risk: a meta-analysis.
Assessment of fracture risk. Public Use File first Version. Gesundheitsmonitoring am Robert Koch-Institut. Sachstand und Perspektiven Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. Int J Epidemiol. Accessed 02 May In: Gabler S, editor. Telefonstichproben in Deutschland. Opladen u. Kish L. A procedure for objective respondent selection within the household. J Am Stat Assoc.
RKI, Berlin. Accessed 31 Jan Accessed 04 Oct Obesity – preventing and managing the global epidemic: report on a WHO consultation. Geneva: World Health Organization; Palermo, Italy, June 12 – 14, Porto Alegre, Brazil: Zenodo. Salford Manchester , United Kingdom, June 05 – 07, Chengdu, Sichuan, China, May , Glasgow, Scotland, May 04 – 09, Glasgow, Uk, May 4 – 9, Glasgow, Scotland UK, May 4 – 9, Glasgow, UK, May 4 – 9, Osaka, Japan, March 23 – 27, Springer Nature, Cham.
Hanna Schneider Designing for empowerment – An investigation and critical reflection It – Information Technology, Paphos, Cyprus, September , bib. ACM Interact. Wearable Ubiquitous Technol. Volume 25, Issue 4, Cairo, Egypt. November 25 – 28, Beijing, China, November 13 – 16, Tampere, Finland, October 10 – 11, Singapore, October 8, Toronto, ON, Canada.
September 23 – 25, Montreal, QC, Canada, April 22, Warsaw, Poland, Munich, Germany, June , Heilbronn, Germany. May 14 – 15, Montreal, Canada, April 21 – 26, Montreal, QC, Canada, April 21 – 26, Palanque, Andreas Riener, Andrew L.
Paper , 7 pages. Tokyo, Japan, March 7 – 11, ACE Lecture Notes in Computer Science, vol Hogrefe Publishing bib. Cairo, Egypt, November , bib.
Mumbai, India, September , Springer International Publishing. HC], November Brighton, UK, October 17 – 20, Mumbai, India, September 25 – 29, Springer-Verlag, Berlin, Heidelberg.
Balkrishan D. Oldenburg, Germany, September , Bastian Pfleging , Andrew L. Vienna, Austria, September , Student Research Competition. Springer Vieweg, Berlin, Heidelberg bib. Lugano, Switzerland, June , Hilversum, The Netherlands, June , ACM bib. Amsterdam, The Netherlands.
Spinger, Berlin-Heidelberg. Pawel W. Lars Lischke , Pawel W. Rovaniemi, Finland, December , ACM October 23 – 27, , Gothenburg, Sweden. Florence, Italy, September 6 – 9, Weyers, A. Dittmar Eds. Internet Society bib. Daniel Buschek There is more to biometrics than user identification: Making mobile interactions personal, secure and representative It – Information Technology, July bib. Brisbane, Australia, June 4 – 8, Oulu, Finland, June , Oulu, Finland, June 20 – 26, Bari, Italy, June 7 – 10, Sydney, Australia, June 1 – 4, Bastian Pfleging , Drea K.
Fekety, Albrecht Schmidt , Andrew L. Springer, Berlin, Germany, ISBN MVG Verlag. Madeira, Portugal, November 15 – 18, Hanna Schneider Pervasive Health bib. Bamberg, Germany, September , Stuttgart, Germany, September 06 – 09, Nottingham, UK, September , Copenhagen, Denmark, August 24 – 27, Ottawa, Kanada, July 22 – 24, Buy A New One?
Copenhagen, Denmark, August 24th – 27th, Duisburg, Germany, June 23 – 26, Seoul, South Korea, April 18 – 23, Seoul, Republic of Korea, April 18 – April 23, Seoul, Korea, April 18 – April 23, Seoul, Korea, April 18 – 23, Do You? Seoul, Republic of Korea, April 18 – 23, ISBN: bib. Hamburg, Germany, March 2 – 6,
Validation request – Related topics
The latter has been associated with orbito-frontal cortex hypoactivity [44], an abnormality also found in subgroups of MOH patients [5]. The orbito-frontal cortex is thought to modulate habituation mechanisms [45] and orbito-frontal lesions induce SEP sensitization and lack of habituation [46], precisely the two sensory abnormalities we found in patients with MOH.
Our findings along with current knowledge on the neurobiology of drug overuse therefore suggest that future studies seeking correlations between electrophy-siological and metabolic measures should focus on the orbito-frontal cortex. In our study we did not control for associated depression and anxiety. Despite the evidence that cortical pain-related evoked potentials in MOH do not differ between subgroups of patients with or without depressive symptoms [28], it may still be appropriate to control for psychiatric comorbidity in future studies.
Cortical responses to repetitive sensory stimuli are abnormal in patients with MOH. Increased response amplitudes after low numbers of stimuli indicate sensory sensitization and lack of amplitude decrease during subsequent stimulations reflects a habituation deficit.
This cortical response pattern is similar the one found in the immediate pre-ictal phase in episodic migraine, but different from the interictal and ictal patterns. It suggests that the somatosensory cortex has become persistently sensitized and that the migraine generating mechanisms in the central nervous system are not shut off. The sen-sitization is obvious in patients overusing NSAIDs and almost non-existent or masked in those who overuse only triptans.
The different electrophysiological pattern between drug classes may be related to the clinical observation that withdrawal headache is shorter lasting in triptan overusers than in NSAID overusers. We postulate that the abnormal sensory processing in MOH patients reflects a drug-induced impairment of central serotonin neurotransmission, that the decrease of sero-tonergic activity is more profound after chronic NSAID overconsumption and that the cortical sensory sensitization parallels the behavioural sensitization that.
University Dept. GC made substantialcontributions to acquisition of data, analysis and interpretation of data as wellas in drafting the manuscript. AC, VP, JS and FP were implied in the interpretation of data as wellas in drafting the manuscript; gave critical revision of the manuscript for important intellectual content. All authors read and approved the final manuscript. Cephalalgia , 26 6 Eur J Neurol , 13 4 Cephalalgia , 25 6 Trends Pharmacol Sci , 26 2 Brain , Pt 2 Schoenen J: Deficient habituation of evoked cortical potentials in migraine: a link between brain biology, behavior and trigeminovascular activation?
Biomed Pharmacother , 50 2 Cephalalgia , 27 12 Cephalalgia , 19 5 Kropp P, Gerber WD: Prediction of migraine attacks using a slow cortical potential, the contingent negative variation. Neurosci Lett , 2 Siniatchkin M, Kropp P, Gerber WD, Stephani U: Migraine in childhood-are periodically occurring migraine attacks related to dynamic changes of cortical information processing? Neurosci Lett , 1 Kropp P, Gerber WD: Contingent negative variation during migraine attack and interval: evidence for normalization of slow cortical potentials during the attack.
Cephalalgia , 15 2 Judit A, Sandor PS, Schoenen J: Habituation of visual and intensity dependence of auditory evoked cortical potentials tends to normalize just before and during the migraine attack. Cephalalgia , 20 8 Cephalalgia , 29 11 Neurobiol Learn Mem , 92 2 Ozkul Y, Uckardes A: Median nerve somatosensory evoked potentials in migraine.
Eur J Neurol , 9 3 Clin Neurophysiol , 8 Neurology , 65 9 Woolf CJ, Wall PD: Relative effectiveness of C primary afferent fibers of different origins in evoking a prolonged facilitation of the flexor reflex in the rat. J Neurosci , 6 5 A MSI study. Brain Res , 1 Burstein R, Cutrer MF, Yarnitsky D: The development of cutaneous allodynia during a migraine attack clinical evidence for the sequential recruitment of spinal and supraspinal nociceptive neurons in migraine.
Brain , Pt 8 Pain , 47 2 Headache , 48 2 Cephalalgia , 26 7 Neurology , 58 8 Cephalalgia , 26 9 Brain Res Mol Brain Res , Pain , Cephalalgia , 13 3 Neurology , 70 6 Dobson CF, Tohyama Y, Diksic M, Hamel E: Effects of acute or chronic administration of anti-migraine drugs sumatriptan and zolmitriptan on serotonin synthesis in the rat brain.
Cephalalgia , 24 1 Srikiatkhachorn A, Tarasub N, Govitrapong P: Effect of chronic analgesic exposure on the central serotonin system: a possible mechanism of analgesic abuse headache. Headache , 40 5 Krasne F, Edwards D: Modulation of the crayfish escape reflex -physiology and neuroethology. Integ Comp Biol , Neurology , 57 9 Headache , 48 7 Schoenbaum G, Shaham Y: The role of orbitofrontal cortex in drug addiction: a review of preclinical studies.
Biol Psychiatry , 63 3 Cite this article as: Coppola et al. Abnormal cortical responses to somatosensory stimulation in medication-overuse headache Academic research paper on ” Clinical medicine “.
CC BY. Cortical functional correlates of responsiveness to short-lasting preventive intervention with ketogenic diet in migraine: a multimodal evoked potentials study.
Prevalence rates may be biased as a consequence of misclassification as our results are based on self-reported diagnoses that were not clinically verified.
Since osteoporosis is not associated with any symptoms prior to a fracture and information on possible fractures were not available within GEDA, prevalence rates may be underestimated by not taking account of yet undiagnosed adults. On the other hand, considering arthritis, for example, prevalence rates may be overestimated as it is known that patients with other joint disorders often falsely state to suffer from rheumatoid arthritis [ 20 , 39 ].
Using self-reported information on sociodemographic characteristics such as BMI values may lead to biased estimates as well reporting bias. Moreover, only adults living in private households were contacted, hospitalized adults or adults living in care homes could not be considered.
As all interviews were carried out in German, adults had to speak and understand German, thus marginalized groups such as migrants could not be regarded [ 20 ]. Low-level educated adults agreed less often to participate in the telephone interview than people with a medium or high level of education [ 20 ].
A weighting factor provided by the Robert Koch Institute was used to approach the adult residential population structure in Germany [ 20 ]. Osteoporosis represents a major public health concern and its prevention is crucial to the maintenance of health [ 40 ]. It is a systemic condition characterized by changes in bone microarchitecture and a reduction of bone mass, both of which lead to decreased bone strength and at the same time to increased fracture risks.
As a consequence, treatment at all ages aims at retaining bone mass to prevent any type of fracture e. Fractures with severe complications are serious consequences of osteoporosis that have an influence on morbidity, functional impairment of health, a decrease in quality of life as well as an increase in medical costs [ 40 , 41 ]. Additionally, at the time of a fracture, comorbidities in osteoporosis patients play a key role.
Further, drug-drug interactions may affect the progress of the disease. Regarding osteoporosis, especially the consumption of drugs that have an effect on bone metabolism is of interest. In GEDA however, data on the use of pharmaceuticals were not collected and an evaluation of the use of different drug classes could therefore not be done.
In the present study nearly all adults with osteoporosis reported at least one comorbid condition, but the cross-sectional design did not allow for an analysis of cause and effect. In the GEDA study population participants that stated to suffer from osteoporosis were for example more than twice as likely to also suffer from depression.
Drosselmeyer et al. Physical disability following fractures affects the capacity for independent living and complicates social participation. Besides, as physical activity is reduced in depressive patients but important to improve or at least stabilize bone mineral density, it would be important to recognize and treat the disease early.
Of interest is also the association between arthrosis and osteoporosis. In the present study, participants with osteoporosis showed more than three times higher odds of having arthrosis.
However, in most cross-sectional studies [ 43 ], arthrosis was negatively connected with osteoporosis in the sense that people with arthrosis showed higher BMD. Despite this negative association, the risk of osteoporotic fractures in patients with arthrosis remains the same [ 43 ]. Generally, arthrosis is associated with stiffness and pain in the affected joints, and this may reduce physical activity, which subsequently leads to instability and higher fracture risks.
Hence, the relation of osteoporosis and arthrosis appears to be very complex and needs to be analysed further. The disease burden in adults with osteoporosis is of high relevance. Physicians need to be aware of the high occurrence of multimorbidity in adults with osteoporosis. Health care interventions for affected patients should be expanded by offering early or even preventive care for other diseases that go along with it.
The dataset analysed during the present study is available from the Robert Koch Institute for researchers who meet the criteria for access, [doi: EM and MTP devised the basic idea for the manuscript. MTP performed the statistical analysis, with contributions by EM. MTP and MK drafted the manuscript.
All authors read and approved the final manuscript. Ethics approval and participant consent was not necessary as this study involved the use of a previously-published de-identified database secondary data analysis according to national guidelines and recommendations in secondary data analysis [ 22 ].
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Manuela Klaschik, Email: ed. Matthias Schmid, Email: ed. Klaus Weckbecker, Email: ed. BMC Musculoskelet Disord. Published online May Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Dec 22; Accepted Apr Abstract Background Knowledge on prevalence of osteoporosis stratifying for socioeconomic background is insufficient in Germany.
Results Overall, 8. Conclusions There was no clear evidence of socioeconomic differences regarding osteoporosis for adults in Germany. Background Osteoporosis and its consequences are a major public health concern and amount in high expenses for health care systems [ 1 , 2 ]. Results The total number of participants aged 50 years and older was 10, Female Medium Ex-smoker Never Open in a separate window.
Discussion The underlying study provides representative data on prevalence rates and comorbidities of osteoporosis based on the German population aged 50 years and older. Conclusions The disease burden in adults with osteoporosis is of high relevance. Availability of data and materials The dataset analysed during the present study is available from the Robert Koch Institute for researchers who meet the criteria for access, [doi: Notes Ethics approval and consent to participate Ethics approval and participant consent was not necessary as this study involved the use of a previously-published de-identified database secondary data analysis according to national guidelines and recommendations in secondary data analysis [ 22 ].
Competing interests The authors declare that they have no competing interests. References 1. Reginster J-Y, Burlet N. Osteoporosis: a still increasing prevalence. Osteoporosis in the European Union: a compendium of country-specific reports.
Arch Osteoporos. World Health Organization. Accessed 03 Apr Differences in adults’ health and health behaviour between 16 European urban areas and the associations with socio-economic status and physical and social environment.
Eur J Pub Health. Robert Koch-Institut. Shanghai, China, June , Tampere, Finland, June 1 – 3, Yokohama, Japan, May 8 – 13, CHI EA Virtual Conference, March 27 – April 02, MDPI bib. HC], March Virtual Conference, November 09 – 13, Virtual Event, Canada, November , Virtual Conference, October 25 – 29, Springer London. Virtual Conference. October 05 – 08, September 21 – 22, Copenhagen, Denmark. July Listen to the sounds.
Atlanta, USA, March 22 – 26, Human-Computer Interaction Series. Springer, Cham. Association for Computing Machinery, bib. Springer, Berlin, Germany. DeGruyter Oldenbourg bib. Utrecht, Netherlands. September 22 – 25, Hamburg, Germany, September 8 – 11, Paphos, Cyprus, September 2 – 6, DOI: Best Conference-Paper Award. Palermo, Italy, June 12 – 14, Porto Alegre, Brazil: Zenodo. Salford Manchester , United Kingdom, June 05 – 07, Chengdu, Sichuan, China, May , Glasgow, Scotland, May 04 – 09, Glasgow, Uk, May 4 – 9, Glasgow, Scotland UK, May 4 – 9, Glasgow, UK, May 4 – 9, Osaka, Japan, March 23 – 27, Springer Nature, Cham.
Hanna Schneider Designing for empowerment – An investigation and critical reflection It – Information Technology, Paphos, Cyprus, September , bib. ACM Interact. Wearable Ubiquitous Technol. Volume 25, Issue 4, Cairo, Egypt. November 25 – 28, Beijing, China, November 13 – 16, Tampere, Finland, October 10 – 11, Singapore, October 8, Toronto, ON, Canada.
September 23 – 25, Montreal, QC, Canada, April 22, Warsaw, Poland, Munich, Germany, June , Heilbronn, Germany. May 14 – 15, Montreal, Canada, April 21 – 26, Montreal, QC, Canada, April 21 – 26, Palanque, Andreas Riener, Andrew L.
Paper , 7 pages. Tokyo, Japan, March 7 – 11, ACE Lecture Notes in Computer Science, vol Hogrefe Publishing bib. Cairo, Egypt, November , bib. Mumbai, India, September , Springer International Publishing. HC], November Brighton, UK, October 17 – 20, Mumbai, India, September 25 – 29, Springer-Verlag, Berlin, Heidelberg. Balkrishan D. Oldenburg, Germany, September , Bastian Pfleging , Andrew L. Vienna, Austria, September , Student Research Competition.
Springer Vieweg, Berlin, Heidelberg bib. Lugano, Switzerland, June , Hilversum, The Netherlands, June , ACM bib. Amsterdam, The Netherlands. Spinger, Berlin-Heidelberg. Pawel W. Lars Lischke , Pawel W. Rovaniemi, Finland, December , ACM October 23 – 27, , Gothenburg, Sweden. Florence, Italy, September 6 – 9, Weyers, A.
Dittmar Eds. Internet Society bib.
Louise Élisabeth d’Orléans – Wikiwand – Question Info
In the present study, participants with osteoporosis showed more than three times higher odds of having arthrosis. However, in most cross-sectional studies [ 43 ], arthrosis was negatively connected with osteoporosis in the sense that people with arthrosis showed higher BMD. Despite this negative association, the risk of osteoporotic fractures in patients with arthrosis remains the same [ 43 ].
Generally, arthrosis is associated with stiffness and pain in the affected joints, and this may reduce physical activity, which subsequently leads to instability and higher fracture risks. Hence, the relation of osteoporosis and arthrosis appears to be very complex and needs to be analysed further. The disease burden in adults with osteoporosis is of high relevance. Physicians need to be aware of the high occurrence of multimorbidity in adults with osteoporosis.
Health care interventions for affected patients should be expanded by offering early or even preventive care for other diseases that go along with it. The dataset analysed during the present study is available from the Robert Koch Institute for researchers who meet the criteria for access, [doi: EM and MTP devised the basic idea for the manuscript. MTP performed the statistical analysis, with contributions by EM. MTP and MK drafted the manuscript. All authors read and approved the final manuscript.
Ethics approval and participant consent was not necessary as this study involved the use of a previously-published de-identified database secondary data analysis according to national guidelines and recommendations in secondary data analysis [ 22 ]. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Manuela Klaschik, Email: ed. Matthias Schmid, Email: ed. Klaus Weckbecker, Email: ed. BMC Musculoskelet Disord. Published online May Author information Article notes Copyright and License information Disclaimer.
Corresponding author. Received Dec 22; Accepted Apr Abstract Background Knowledge on prevalence of osteoporosis stratifying for socioeconomic background is insufficient in Germany. Results Overall, 8. Conclusions There was no clear evidence of socioeconomic differences regarding osteoporosis for adults in Germany. Background Osteoporosis and its consequences are a major public health concern and amount in high expenses for health care systems [ 1 , 2 ].
Results The total number of participants aged 50 years and older was 10, Female Medium Ex-smoker Never Open in a separate window. Discussion The underlying study provides representative data on prevalence rates and comorbidities of osteoporosis based on the German population aged 50 years and older. Conclusions The disease burden in adults with osteoporosis is of high relevance.
Availability of data and materials The dataset analysed during the present study is available from the Robert Koch Institute for researchers who meet the criteria for access, [doi: Notes Ethics approval and consent to participate Ethics approval and participant consent was not necessary as this study involved the use of a previously-published de-identified database secondary data analysis according to national guidelines and recommendations in secondary data analysis [ 22 ].
Competing interests The authors declare that they have no competing interests. References 1. Reginster J-Y, Burlet N. Osteoporosis: a still increasing prevalence. Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos. World Health Organization. Accessed 03 Apr Differences in adults’ health and health behaviour between 16 European urban areas and the associations with socio-economic status and physical and social environment.
Eur J Pub Health. Robert Koch-Institut. Gesundheitliche Ungleichheit in verschiedenen Lebensphasen. Gesundheitsberichterstattung des Bundes. Gemeinsam getragen von RKI und Destatis. Accessed 24 May Socioeconomic inequalities in morbidity and mortality in western Europe.
Socioeconomic inequalities in health in 22 European countries. N Engl J Med. The association between socioeconomic status and osteoporotic fracture in population-based adults: a systematic review. Osteoporos Int. Association between socioeconomic status and bone mineral density in adults: a systematic review.
Risk factors in osteoporosis. Body mass index as a predictor of fracture risk: a meta-analysis. Assessment of fracture risk. Public Use File first Version. Gesundheitsmonitoring am Robert Koch-Institut. Sachstand und Perspektiven Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. Int J Epidemiol. Accessed 02 May In: Gabler S, editor. Telefonstichproben in Deutschland.
Opladen u. Kish L. Association for Computing Machinery, bib. Springer, Berlin, Germany. DeGruyter Oldenbourg bib. Utrecht, Netherlands. September 22 – 25, Hamburg, Germany, September 8 – 11, Paphos, Cyprus, September 2 – 6, DOI: Best Conference-Paper Award. Palermo, Italy, June 12 – 14, Porto Alegre, Brazil: Zenodo. Salford Manchester , United Kingdom, June 05 – 07, Chengdu, Sichuan, China, May , Glasgow, Scotland, May 04 – 09, Glasgow, Uk, May 4 – 9, Glasgow, Scotland UK, May 4 – 9, Glasgow, UK, May 4 – 9, Osaka, Japan, March 23 – 27, Springer Nature, Cham.
Hanna Schneider Designing for empowerment – An investigation and critical reflection It – Information Technology, Paphos, Cyprus, September , bib. ACM Interact. Wearable Ubiquitous Technol. Volume 25, Issue 4, Cairo, Egypt. November 25 – 28, Beijing, China, November 13 – 16, Tampere, Finland, October 10 – 11, Singapore, October 8, Toronto, ON, Canada. September 23 – 25, Montreal, QC, Canada, April 22, Warsaw, Poland, Munich, Germany, June , Heilbronn, Germany.
May 14 – 15, Montreal, Canada, April 21 – 26, Montreal, QC, Canada, April 21 – 26, Palanque, Andreas Riener, Andrew L. Paper , 7 pages.
Tokyo, Japan, March 7 – 11, ACE Lecture Notes in Computer Science, vol Hogrefe Publishing bib. Cairo, Egypt, November , bib. Mumbai, India, September , Springer International Publishing.
HC], November Brighton, UK, October 17 – 20, Mumbai, India, September 25 – 29, Springer-Verlag, Berlin, Heidelberg. Balkrishan D. Oldenburg, Germany, September , Bastian Pfleging , Andrew L. Vienna, Austria, September , Student Research Competition.
Springer Vieweg, Berlin, Heidelberg bib. Lugano, Switzerland, June , Hilversum, The Netherlands, June , ACM bib. Amsterdam, The Netherlands. Spinger, Berlin-Heidelberg. Pawel W. Lars Lischke , Pawel W. Rovaniemi, Finland, December , ACM October 23 – 27, , Gothenburg, Sweden. Florence, Italy, September 6 – 9, Weyers, A. Dittmar Eds. Internet Society bib. Daniel Buschek There is more to biometrics than user identification: Making mobile interactions personal, secure and representative It – Information Technology, July bib.
Brisbane, Australia, June 4 – 8, Oulu, Finland, June , Oulu, Finland, June 20 – 26, Bari, Italy, June 7 – 10, Sydney, Australia, June 1 – 4, Bastian Pfleging , Drea K. Fekety, Albrecht Schmidt , Andrew L. Springer, Berlin, Germany, ISBN MVG Verlag.
Madeira, Portugal, November 15 – 18, Hanna Schneider Pervasive Health bib. Bamberg, Germany, September , Stuttgart, Germany, September 06 – 09, Nottingham, UK, September , Copenhagen, Denmark, August 24 – 27, Ottawa, Kanada, July 22 – 24, Buy A New One? Copenhagen, Denmark, August 24th – 27th, The habituation deficit in NSAIDs overusers cannot be explained by the “ceiling theory” since their high 1st block amplitude indicates rather that the somatosensory cortex is sensitised.
There is at present no straight forward explanation for this pattern. It is likely, however, that other neurobiological mechanisms that participate in the production of habituation are impaired. For instance, inhibitory interneurons could be hypofunctioning because of the reduction in serotonergic transmission induced by the prolonged NSAID overconsumption. This hypothesis can be tested experimentally by searching if habituation normalizes during full-blown attacks in MOH patients like in episodic migraine and by exploring inhibitory cortical interneurons with dedicated neurophy-siological studies such as that of cortical silent periods using transcranial magnetic stimulation.
Given the similar neural mechanisms underlying sensory and behavioural sensitization [40], the interesting question arises. Behavioural sensitiza-tion is paradigmatic of how the serotonergic, dopaminer-gic, and noradrenergic systems interact and contribute to central sensitization [41]. Brain circuits involved in addictive behaviour include ventral and dorsal striatum, amygdala and orbitofrontal cortex and are heavily modulated by dopaminergic projections from the ventral tegmental area of the midbrain, serotonergic projections from the median and dorsal raphe nuclei, and noradrenergic projections from the locus coeruleus [4,42].
The latter has been associated with orbito-frontal cortex hypoactivity [44], an abnormality also found in subgroups of MOH patients [5]. The orbito-frontal cortex is thought to modulate habituation mechanisms [45] and orbito-frontal lesions induce SEP sensitization and lack of habituation [46], precisely the two sensory abnormalities we found in patients with MOH.
Our findings along with current knowledge on the neurobiology of drug overuse therefore suggest that future studies seeking correlations between electrophy-siological and metabolic measures should focus on the orbito-frontal cortex.
In our study we did not control for associated depression and anxiety. Despite the evidence that cortical pain-related evoked potentials in MOH do not differ between subgroups of patients with or without depressive symptoms [28], it may still be appropriate to control for psychiatric comorbidity in future studies. Cortical responses to repetitive sensory stimuli are abnormal in patients with MOH. Increased response amplitudes after low numbers of stimuli indicate sensory sensitization and lack of amplitude decrease during subsequent stimulations reflects a habituation deficit.
This cortical response pattern is similar the one found in the immediate pre-ictal phase in episodic migraine, but different from the interictal and ictal patterns. It suggests that the somatosensory cortex has become persistently sensitized and that the migraine generating mechanisms in the central nervous system are not shut off. The sen-sitization is obvious in patients overusing NSAIDs and almost non-existent or masked in those who overuse only triptans.
The different electrophysiological pattern between drug classes may be related to the clinical observation that withdrawal headache is shorter lasting in triptan overusers than in NSAID overusers. We postulate that the abnormal sensory processing in MOH patients reflects a drug-induced impairment of central serotonin neurotransmission, that the decrease of sero-tonergic activity is more profound after chronic NSAID overconsumption and that the cortical sensory sensitization parallels the behavioural sensitization that.
University Dept. GC made substantialcontributions to acquisition of data, analysis and interpretation of data as wellas in drafting the manuscript. AC, VP, JS and FP were implied in the interpretation of data as wellas in drafting the manuscript; gave critical revision of the manuscript for important intellectual content.
All authors read and approved the final manuscript. Cephalalgia , 26 6 Eur J Neurol , 13 4 Cephalalgia , 25 6 Trends Pharmacol Sci , 26 2 Brain , Pt 2 Schoenen J: Deficient habituation of evoked cortical potentials in migraine: a link between brain biology, behavior and trigeminovascular activation?
Biomed Pharmacother , 50 2 Cephalalgia , 27 12 Cephalalgia , 19 5 Kropp P, Gerber WD: Prediction of migraine attacks using a slow cortical potential, the contingent negative variation. Neurosci Lett , 2 Siniatchkin M, Kropp P, Gerber WD, Stephani U: Migraine in childhood-are periodically occurring migraine attacks related to dynamic changes of cortical information processing?
Neurosci Lett , 1 Kropp P, Gerber WD: Contingent negative variation during migraine attack and interval: evidence for normalization of slow cortical potentials during the attack. Cephalalgia , 15 2 Judit A, Sandor PS, Schoenen J: Habituation of visual and intensity dependence of auditory evoked cortical potentials tends to normalize just before and during the migraine attack. Cephalalgia , 20 8 Cephalalgia , 29 11 Neurobiol Learn Mem , 92 2 Ozkul Y, Uckardes A: Median nerve somatosensory evoked potentials in migraine.
Eur J Neurol , 9 3 Clin Neurophysiol , 8 Neurology , 65 9 Woolf CJ, Wall PD: Relative effectiveness of C primary afferent fibers of different origins in evoking a prolonged facilitation of the flexor reflex in the rat. J Neurosci , 6 5 A MSI study. Brain Res , 1 Burstein R, Cutrer MF, Yarnitsky D: The development of cutaneous allodynia during a migraine attack clinical evidence for the sequential recruitment of spinal and supraspinal nociceptive neurons in migraine.
Brain , Pt 8 Pain , 47 2 Headache , 48 2 Cephalalgia , 26 7 Neurology , 58 8 Cephalalgia , 26 9 Brain Res Mol Brain Res , Pain , Cephalalgia , 13 3 Neurology , 70 6 Dobson CF, Tohyama Y, Diksic M, Hamel E: Effects of acute or chronic administration of anti-migraine drugs sumatriptan and zolmitriptan on serotonin synthesis in the rat brain.
Cephalalgia , 24 1 Srikiatkhachorn A, Tarasub N, Govitrapong P: Effect of chronic analgesic exposure on the central serotonin system: a possible mechanism of analgesic abuse headache. Headache , 40 5 Krasne F, Edwards D: Modulation of the crayfish escape reflex -physiology and neuroethology. Integ Comp Biol ,
Windows update 1709 download manuella – windows update 1709 download manuella.Get the latest Windows update
The new PMC design is here! Learn more about navigating our updated article layout. The PMC legacy view will also be available for a limited time. Federal government websites often end in. The site is secure. Knowledge on prevalence of osteoporosis stratifying for socioeconomic background is insufficient in Germany.
Little is known in Europe about other diseases that go along with it although these aspects are important for implementing effective public health strategies.
GEDA provides information on self-reported diseases and sociodemographic characteristics for nearly 20, adults. Descriptive statistical analysis and multiple logistic regression were used to examine the association between osteoporosis and age, sex, other diseases and education defined by ISCED.
Analyses were limited to participants aged 50 years and older. Overall, 8. The odds for arthrosis OR 3. Education showed no significant association with osteoporosis. Больше информации was no clear evidence of socioeconomic differences regarding osteoporosis for adults in Germany.
However, clinicians need to be aware that multimorbidity is very common in adults with osteoporosis. Health care interventions for osteoporosis could be improved by offering preventive care for other diseases that go along with powerpoint – free download powerpoint 2021. Over- or under-diagnosis in different socioeconomic levels has to be further explored.
Osteoporosis and its consequences are a major public health concern and amount in high expenses for health care systems [ 12 ]. For the affected patients it results in serious impairment in quality of life [ windows update 1709 download manuella – windows update 1709 download manuella ].
Exact data of the prevalence and comorbidities for the German population are rare. In men the prevalence was 2. In total numbers this sums up to an estimated million people with osteoporosis in Germany [ 4 ].
As the population structure is constantly changing towards a higher median age the overall share of osteoporosis patients is expected to grow continuously. We wanted to ссылка на продолжение a closer look at the prevalence of osteoporosis in Germany, stratifying not only for more narrowly defined age groups and sex but also for socioeconomic level.
This analysis is of high interest as the link between socioeconomic level and health and health behaviour is well documented [ 5 — 8 ] but is still lacking for osteoporosis [ 910 ]. Beyond BMD, however, there are additional factors that similarly contribute to the disease. In addition to unchangeable factors as female gender, age, ethnicity or family history of fractures many preventable factors as poor lifestyle habits or physical читать далее have a significant impact on osteoporosis and fracture risk [ windowws — 13 ].
When discussing the health problems of osteoporosis patients the main focus is usually directed towards bone fractures as these are the most immediate consequences of the disease.
Examining the association ссылка osteoporosis with a range of different medical conditions might help to improve the health care for affected patients by offering early or even preventive care for diseases that winows along with it. The Robert Koch Institute is a federal institution financed by the German Federal Ministry of Health that in addition to the research of infectious diseases is responsible for analysing national long-term public health trends [ 15 manuepla.
As part of driverpack online health monitoring, the cross-sectional survey GEDA collected подробнее на этой странице about a range of health related topics wjndows current health conditions and medical history as well as sociodemographic characteristics [ 16 ]. The target population included fluently German-speaking adults of at least 18 years of age who were living in private households with windows update 1709 download manuella – windows update 1709 download manuella telephone.
Using a two-stage sampling procedure, the ADM-Sampling-System covered all possible phone numbers in Germany and was applied for the selection at household level [ 1718 ]. The study involved the use of a previously-published windows update 1709 download manuella – windows update 1709 download manuella database secondary updxte analysis so ethics approval and participant consent was not necessary [ 22 ]. The PUF contains data on survey participants in an anonymous form and provides information on self-reported health conditions including osteoporosis and 14 other medical diagnoses.
The analyses were limited to participants aged 50 years and older as only those нажмите чтобы увидеть больше asked about a medical manuepla of osteoporosis [ 20 ]. To assess current health conditions, we considered only participants that stated suffering from osteoporosis in the past 12 months.
The same criterion was used for any of the other medical diagnoses, namely hypertension, chronic heart failure, diabetes mellitus, bronchial asthma, hypercholesterolemia, chronic bronchitis, chronic liver disease, arthrosis, arthritis and depression.
Lifetime history was only assessed for four diagnoses associated with long-term damages coronary heart disease, myocardial infarction, cancer and stroke. In addition, data on self-reported chronic low downloaad pain for at least 3 months was considered. Details on the exact definitions of the aforementioned diseases have already been published [ 20 ]. For age-specific analyses, 5-year age groups were used that were given by years, years, years, years, years, years, years and 85 years or older.
Self-reported smoking status was summarized into non-smoker, ex-smoker or current smoker daily or occasional [ 20 ]. To uldate for посетить страницу deviations of the GEDA study population from the German population, upeate rates were weighted according to the standardized weighting factor based on age, sex, education and residential region provided by the Robert-Koch Institute [ 20 ].
The unweighted number of participants in each subgroup is also displayed. Additional sensitivity analyses restricted to participants with valid data on all independent variables complete cases were performed. The total number of participants aged 50 years and older was 10, Of those, 84 participants were excluded from the analysis due to unknown or missing responses regarding a diagnosis of osteoporosis.
Sociodemographic characteristics of the study and osteoporosis population are summarized in Table 1. Unweighted n may not add up to total n due to missing responses. Missing responses were allocated to the reference category. In total, 8. The proportion of female adults with osteoporosis increased considerably with age; the prevalence updage osteoporosis for men remained nearly unchanged until the age of 84 years Fig.
Regarding the level of education, people with a low educational level showed higher prevalence rates of osteoporosis compared to those with a higher 2022 templates top cv level. Overweight or адрес страницы adults had smaller prevalence rates than people with a BMI within the normal range.
The prevalence of osteoporosis was higher for non-smokers in comparison to ex- and current smokers and participants with a moderate or high consumption of alcohol showed lower rates than respondents that stated to never drink alcohol Table 1. Age, sex, alcohol consumption and BMI showed a significant association with the odds for osteoporosis.
The odds of having osteoporosis were higher for female adults than male больше информации. Using 50 – 54 years old adults as reference, the odds for osteoporosis increased with age. Overweight or obese adults were associated with lower odds for osteoporosis in comparison to adults with normal weight Table 1.
For adults without osteoporosis, only As illustrated in Manuwlla 2arthrosis About one in every five adults with osteoporosis suffered from coronary dwnload disease In line with this, hypertension A separate regression model was fitted for each comorbidity.
Eleven out of donload comorbidities showed a significant association with osteoporosis. Of note, for adults with osteoporosis, the odds for arthrosis, chronic low back pain, arthritis, depression and chronic heart failure, respectively, were more than two times greater than for adults without osteoporosis Table 2. Sex-stratified analyses as well as analyses restricted to participants with odwnload data on all independent variables in regression complete cases showed similar results to the main analysis data not presented.
The underlying study provides representative data on prevalence rates and comorbidities of osteoporosis меня win 10 download kuyhaa что on the German population aged 50 years and older.
The overall prevalence was estimated to 8. According to multiple regression analysis, osteoporosis was significantly related to age, sex, BMI and alcohol consumption while smoking status and education showed no significant association.
Adults with osteoporosis showed more than twofold increased odds for arthrosis, arthritis, chronic low back pain, chronic heart failure and depression, respectively.
However, our results agree well with those of other studies on osteoporosis [ 27 — 32 ]. In comparison to other German studies ddownload 29 — нажмите сюда ], results on prevalence rates vary with regard to the methodology of measuring osteoporosis as well.
Similar to GEDADEGS1 provides nationally representative data on the health status of the adult population between 18 and 79 years of age and estimated a lifetime prevalence of osteoporosis self-reported for people aged between 50 and 79 years to 8.
Little differences with regard to socioeconomic status and an association with age for women were reported, too [ 29 ]. On the other hand, considering a study based on routine data of a statutory health insurance, prevalence rates were found to be upddate.
Deviating methodical procedures might be responsible for differences in prevalence. Results of studies examining the relationship between smoking and osteoporosis as well as alcohol consumption and osteoporosis including low BMD and fracture risk are inconsistent [ 33 — 37 ]. There was also no clear evidence of a relationship between osteoporosis and smoking in the present study.
While the prevalence of osteoporosis was significantly lower for higher educated adults in comparison to adults with a low educational level, results dwonload the present regression analysis основываясь на этих данных no significant effects. Prevalence rates may be biased as a consequence of misclassification as our results are based on self-reported diagnoses that were not clinically verified.
Since osteoporosis is not associated with any symptoms prior to a fracture and information on possible fractures were not available within GEDA, prevalence rates may be underestimated by not taking account of yet undiagnosed adults.
On the other hand, considering arthritis, for example, prevalence rates may be overestimated as it is known that patients with other joint disorders often falsely state to suffer from rheumatoid arthritis [ 2039 ].
Using self-reported information on sociodemographic characteristics such as BMI values may lead to biased estimates as well reporting bias. Moreover, only adults living mmanuella private households were contacted, hospitalized adults or adults living in care updatee could not be considered.
As all interviews were carried windows update 1709 download manuella – windows update 1709 download manuella in German, adults had to speak and understand German, windows update 1709 download manuella – windows update 1709 download manuella marginalized groups such as migrants could not be regarded [ 20 windows update 1709 download manuella – windows update 1709 download manuella.
Low-level educated adults agreed less often to participate in the telephone interview than people with a medium or high level of education [ 20 ]. A weighting factor provided by the Robert Koch Institute was used to approach the adult residential population structure in Germany [ 20 ]. Osteoporosis represents a major public health concern and its prevention is windows update 1709 download manuella – windows update 1709 download manuella to the maintenance of health [ 40 ].
It is a systemic condition characterized by changes in bone microarchitecture and a reduction of bone mass, both of which lead to decreased bone strength and at the same time to increased fracture risks. As a consequence, treatment at all ages aims at retaining bone mass to prevent any type of fracture e. Fractures with severe complications are serious consequences of osteoporosis that have an influence on windows update 1709 download manuella – windows update 1709 download manuella, functional impairment of health, a decrease in quality of life as well as an increase in medical costs [ 4041 ].
Additionally, at the time of a fracture, downlozd in osteoporosis patients play a key жмите. Further, drug-drug interactions may affect the progress посетить страницу источник the disease. Regarding osteoporosis, especially the consumption of drugs that have an effect on bone metabolism is of interest.
In GEDA however, data on the use of pharmaceuticals were not collected and an evaluation of the use of different drug classes could therefore not be done.
In the present study nearly all adults with osteoporosis reported at least one comorbid condition, but the cross-sectional design did not allow на этой странице an analysis of cause and effect.
In the GEDA study population participants that stated to suffer from osteoporosis windows update 1709 download manuella – windows update 1709 download manuella for example more than twice as likely to also suffer from depression.