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The worldwide prevalence of obesity has nearly tripled since 1975. Between 1999 and 2017 it rose from 30.5 to 42.4% in the USA and from 11.5 to 16.3% in Germany (1). Obesity is a risk factor for osteoarthritis of the hip and even more so of the knee, which is why obese patients often present for joint replacement. However, they have a greater risk of complications in comparison with the non-obese. So far, studies dealing with this issue have only examined smaller cohorts, while data from Germany are lacking altogether. The aim of our study was to examine the association between obesity and complication rates, revision rates, and mortality after primary and revision replacement surgery of the hip and knee (HRS, R-HRS, KRS, R- KRS), respectively. [ABSTRACT FROM AUTHOR]

The article focuses on the importance of treating combat post-traumatic stress disorders (PTSD) as a bio-psycho-social-spiritual phenomenon. Topics discussed include treatment of PTSD under the Department of Veteran's Affairs (VA) and Department of Defense (DoD) guidelines, social and spiritual aspects of the combat and impact of the combat on mental health of the veterans. It also discusses the recovery and treatment methods of PTSD.

Background: The treatment of children is a core domain of anthroposophic medicine (AM) since its beginnings almost 80 years ago. However, a systematic analysis of AM-therapies in paediatric primary care is still missing. This study aims to investigate this field of AM. Methods: A total of 38 primary care physicians in Germany participated in this prospective, multicentre observational study. Prescriptions, diagnoses, and non-pharmacological therapies were reported for each consecutive patient. Multiple logistic regression was used to determine factors associated with anthroposophic prescriptions. Results: During the 1-year study period (year 2005), a total of 107,903 prescriptions for 18,440 children under 12 years (48.1% female) were included. The most frequent single diagnoses were acute upper respiratory tract infections (URTI) (22.7%), bronchitis (9.0%), and otitis media (6.6%). Anthroposophic medication accounted for 41.8% of all drugs prescribed and decreased with patient age (47.3% under 2 years, 41.1% 2–6 years, and 37.4% 6–11 years; p for trend <0.001). The Odds Ratio (OR) for receiving an anthroposophic remedy was significantly greater than 1 for the first consultation (OR=1.19; CI: 1.16–1.23), for disorders of conjunctiva (OR=2.47; CI: 2.27–2.70), otitis media (OR=1.50; CI: 1.43–1.59), URTI (OR=1.28; CI: 1.23–1.33), other diseases of the respiratory system (OR=1.15; CI: 1.07–1.24), symptoms involving the digestive system and abdomen (OR=1.39; CI: 1.28–1.51), and general symptoms and signs (OR=1.25; CI: 1.16–1.36). The chance for a prescription of an anthroposophic remedy decreased with patient age (OR=0.96; CI: 0.95–0.96), treatment by a paediatrician (OR=0.43; CI: 0.42–0.44), chronic lower respiratory diseases (OR=0.87; CI: 0.82–0.92), and noninfective enteritis and colitis (OR=0.82; CI: 0.75–0.89). Of the 2475 therapeutic procedures prescribed (26.7% anthroposophic), the most frequent were physiotherapy, speech therapy, logopaedics, and breathing therapy. Conclusion: This study is the first to provide a systematic overview of everyday anthroposophic practice for children in primary care. We found that AM in terms of an integrative medicine combines conventional and anthroposophical concepts. More detailed studies on indications and drug classes should be conducted in the future to complement and specify these findings. [Copyright &y& Elsevier]