Wie Angst sportliche Leistung beeinträchtigt – und was man dagegen tun kann: Das Kraftspeichermodell der Selbstkontrolle im Sportkontext

Die meisten SportlerInnen kennen die Situation: Man befindet sich mitten in einem wichtigen sportlichen Wettkampf und plötzlich überkommt einen ein Gefühl von Angst. Die einfachsten motorischen Bewegungen möchten einfach nicht mehr gelingen, man kann das Optimum nicht abrufen und versagt. Doch Abhilfe ist unterwegs: Neueste Studien liefern Hinweise darauf, dass man dem negativen Einfluss von Angst im Sportkontext entgegenwirken kann, wenn man über ausreichend Selbstkontrollkraft verfügt.

Schmerz und Angst sind bei Kindern besonders zu berücksichtigen

Bei Kindern heilen Wunden wie beim Erwachsenen in verschiedenen Phasen ab. Insbesondere beim jüngeren Kind erfolgt die Wundheilung tendenziell schneller und komplikationsarmer. Es stehen rascher Fibroblasten zur Verfügung und Granula­tionsgewebe wird schneller produziert. Kinder verfügen über weniger subkutanes Fettgewebe und haben somit einen geringeren «Totraum», welchem in der Entstehung von Infektionen eine Rolle zugeschrieben wird. Allgemein verfügen Kinder über ein funktionierendes Gefässsystem und leiden an anderen ­Komorbiditäten als Erwachsene. Diese Faktoren tragen dazu bei, dass Wunden in der Pädiatrie in der Regel primär (Sanatio per primam intentionem) heilen.

Interaction of small molecules with specific immune receptors: the p-i concept and its consequences

Drugs may stimulate the immune system by forming stable new antigenic complexes consisting of the drug or drug metabolite which is covalently bound to a protein or peptide (hapten-carrier complex). Both, B- and T-cell immunity may arise, the latter directed to hapten modified peptides presented by HLA molecules. Beside this immunological stimulation, drugs can also stimulate the immune system through binding by non-covalent bonds to proteins like immune receptors. This so-called “pharmacological interaction with immune receptors” concept (“p-i concept”) may occur with HLA or TCR molecules themselves (p-i HLA or p-i TCR), and not the immunogenic peptide. It is a type of “off-target” activity of the drug on immune receptors, but more complex as various cell types, cell interactions and functionally different T cells are involved. In this review the conditions which lead to activation of T cells by p-i are discussed: important factors for a functional consequence of drug binding is the location of binding (p-i HLA or p-i TCR); the exact site within these immune receptors; the affinity of binding and the finding that p-i HLA can stimulate the immune system like an allo-allele. The p-i concept is able to solve some puzzles of drug hypersensitivity reactions and are a basis to better treat and potentially avoid drug hypersensitivity reactions. Moreover, the p-i concept shows that in contrast to previous beliefs small molecules do interact with immune receptors with functional consequence. But these interactions are not based on “immune recognition”, are at odds with some immunological concepts, but may nevertheless open new possibilities to understand and even treat immune reactions

Dynamic intraligamentary stabilization and primary repair: A new concept for the treatment of knee dislocation.

BACKGROUND Traumatic knee dislocation represents a rare but devastating injury. Several controversies persist regarding type of treatment, surgical timing, graft selection, repair versus reconstruction of the medial and lateral structures, surgical techniques and postoperative rehabilitation. A new technique for primary ACL stabilization, dynamic intaligamentary stabilization (DIS) was developed at the authors' institution. The purpose of this study was to analyze the clinical and radiological outcomes of surgically treated traumatic knee dislocations by means of the DIS technique for the ACL, primary suturing for PCL, MCL and LCL. METHODS Between 2009 and 2012, 35 patients treated surgically for traumatic knee dislocation with primary anterior cruciate ligament (ACL) reconstruction with DIS, suturing of the posterior cruciate ligament (PCL) and primary complete repair of collaterals, were evaluated clinically (IKDC score, SF12 health survey, Lysholm score, Tegner score) and radiologically with a mean follow up of 2.2 years (range 1.00-3.50 years) years. Instrumented anterior-posterior translation was measured (KT-2000). RESULTS Anterior/posterior translation (KT-2000) for the healthy and injured limb was 4.8mm (range 3-8mm) and 7.3mm (range 5-10) (89N) respectively. Valgus and varus stress testing in 30° flexion was normal in 26 (75%) and 29 (83%) patients, respectively. The IKDC score was B in 29 (83%) and C in 6 (17%) patients, while the mean Tegner score was 6 (range 4-8). The mean Lysholm score was 90.83 (range 81-95) and mean SF-12 physical and mental scores were 54.1 (range 45-60) and 51.0 (range 39-62) respectively. In 2 patients, a secondary operation was performed. CONCLUSIONS Early, one stage reconstruction with DIS can achieve good functional results and patient satisfaction with overall restoration of sports and working capacity without graft requirements.