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Positive Effekte kognitiver und physischer Trainings auf die Kognition gesunder alterer Menschen sind gut belegt. Zunehmend wird diskutiert, ob durch deren Kombination starkere Effekte erreicht werden konnen. In dieser Arbeit wird der Forschungsstand dazu aufgearbeitet. Vier randomisierte kontrollierte Studien (RCTs) und vier kontrollierte Studien wurden gefunden. In drei Studien, jedoch keiner RCT, wurde tatsachlich eine Uberlegenheit von kombiniertem Training im Vergleich zu Einzelinterventionen in Bezug auf die Kognition gefunden. Wenngleich also positive Hinweise vorliegen, ist der Forschungsstand aufgrund der insgesamt geringen Studienzahl, des Mangels an Evidenz aus RCTs und der mangelnden Vergleichbarkeit der Studien hinsichtlich der Studiendesigns, der Art der Intervention und der Messzeitpunkte als unzureichend zu bewerten. Forschungslucken werden aufgezeigt, wesentliche Aspekte fur zukunftige Studien genannt und mogliche neurobiologische Mechanismen von Trainingseffekten diskutiert.

We studied whether common shared environmental or behavioral risk factors, other than tobacco smoking, underlie both atherosclerotic diseases and cancer. We identified a group of 96,891 one-year survivors of acute myocardial infarct through the Danish Hospital Discharge Register between 1977 and 1989. We calculated the incidence of cancer in this group by linking it to the Danish Cancer Registry for the period 1978-1993. There was no consistent excess over the expected figures for any of the categories of cancer not related to tobacco smoking. Specifically, the rates of colorectal cancer in acute myocardial infarct patients were similar to those of the general population, as were the rates for hormone-related cancers, including endometrial and postmenopausal breast cancers. We found a moderate increase in the risk for tobacco-related cancers, which was strongest for patients with early onset of acute myocardial infarct and for female patients. Overall, there do not seem to be major shared environmental or behavioral risk factors for acute myocardial infarct and cancers, except for smoking, and there seems to be no common inherited susceptibility to the development of these diseases.

We studied whether exposure to Agent Orange and its contaminant, 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin), during the Vietnam War is related to current testosterone, follicle-stimulating hormone, luteinizing hormone, or testicular abnormalities, sperm count, sperm abnormalities, or testicular volume. The index subjects were veterans of-Operation Ranch Hand, the unit responsible for aerial herbicide spraying in Vietnam from 1962 to 1971. The referent cohort comprises Air Force veterans who served in Southeast Asia during the same period but were not involved with spraying herbicides. Referents were matched to Ranch Hands on date of birth, race, and military occupation. We found no consistent or meaningful association between serum dioxin levels and any of these outcome variables.

The possible relationship between exposure to Agent Orange and its contaminant, 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin), during the Vietnam War and chloracne was investigated. The index subjects were veterans of Operation Ranch Hand, the unit responsible for aerial herbicide spraying in Vietnam from 1962 to 1971. Other Air Force veterans who served in Southeast Asia during the same period, but who were not involved with spraying herbicides, served as comparisons. None of the Ranch Hand veterans were diagnosed with chloracne; therefore, we restricted our analyses to acne. We found no meaningful or consistent association between dioxin exposure and prevalence of acne without or with regard to anatomical location. These results suggested that exposure of Ranch Hand veterans to dioxin was insufficient for the production of chloracne or perhaps the exposure may have caused chloracne that resolved and was currently undetectable.

We studied whether paternal exposure to Agent Orange and its dioxin contaminant (2,3,7,8-tetrachlorodibenzo-p-dioxin) during the Vietnam War is related to adverse reproductive outcomes after service in Southeast Asia. The index cohort comprises conceptions and children of veterans of Operation Ranch Hand, the unit responsible for aerial spraying of herbicides in Vietnam from 1962 to 1971. The comparison cohort comprises conceptions and children of Air Force veterans who served in Southeast Asia during the same period but who were not involved with spraying herbicides. We found no meaningful elevation in risk for spontaneous abortion or stillbirth. In analyses of birth defects, we found elevations in risk in some organ system categories, which, after review of the clinical descriptions, were found to be not biologically meaningful. There was an increase in nervous system defects in Ranch Hand children with increased paternal dioxin, but it was based on sparse data. We found no indication of increased birth defect severity, delays in development, or hyperkinetic syndrome with paternal dioxin. These data provide little or no support for the theory that paternal exposure to Agent Orange and its dioxin contaminant is associated with adverse reproductive outcomes.

This report investigates the relationship between birth defects and reproductive outcomes versus paternal TCDD levels among children and conceptions of members of Operation Ranch Hand, the unit responsible for the aerial spraying of herbicides in Vietnam and a comparison group. At a baseline physical examination in 1982 and again in 1985 and 1987, participants were asked to report occurrences of birth defects, miscarriages, stillbirths, infant deaths and neonatal deaths of their children. The birth defect status and outcome of all conceptions (N = 10,843) fathered by participants were verified by medical record review. Of these, 8,099 resulted in live births and birth defect status verified for 8,090 (99.9%). During the same period, the Air Force collaborated with the Centers for Disease Control to assay blood of the 1987 physical examination participants for 2,3,7,8 TCDD. The final interpretation of these data is deferred, pending further analyses.

OBJECTIVE : To assess the efficacy of aggressive nonsurgical therapy for urinary incontinence in women and to determine if it is advantageous to perform invasive urodynamic testing prior to initiating treatment. STUDY DESIGN : We subjectively assessed 202 incontinent women three months to four years following nonsurgical therapy for urinary incontinence. Therapy in all patients included behavioral modification in the form of timed voiding and pelvic floor exercises. Depending on the suspected diagnosis and menopausal state, patients were also treated with various combinations of pharmacologic agents and estrogen replacement therapy. Based on initial evaluation, patient preference and referring physician preference, 100 women were started on therapy after a minimal evaluation, while 102 women were treated based on invasive urodynamic testing. A subjective assessment of treatment outcome was made via a telephone interview in which patients were asked standardized questions. RESULTS : One hundred nineteen cases (59%) were subjectively improved or cured with nonsurgical therapy. Performing urodynamic testing prior to initiating therapy did not increase the overall success rate : 69 of 100 patients (69%) treated on the basis of history, physical examination and a minimal office evaluation were improved or cured, while only 50 of 102 patients (49%) having electronic multichannel urodynamic testing were improved or cured. CONCLUSION : All women with urinary incontinence should be initially offered nonsurgical therapy since a large percentage will obtain satisfactory results. It is not beneficial or cost-effective to perform electronic urodynamic testing prior to initiating therapy.

The Air Force Health Study is a 20-year comprehensive assessment of the health of Air Force veterans of Operation Ranch Hand, the unit responsible for aerial spraying of herbicides in Vietnam. The study compares the health and noncombat mortality of Ranch Hand veterans with a comparison group of Air Force veterans primarily involved with cargo missions in Southeast Asia but who were not exposed to herbicides. This report summarizes the health of these veterans as determined at the third in a series of physical examinations. Nine hundred ninety-five Ranch Hands and 1299 comparison subjects attended the second follow-up examination in 1987. The two groups were similar in reported health problems, diagnosed skin conditions, and hepatic, cardiovascular, and immune profiles. Ranch Hands have experienced significantly more basal cell carcinomas than comparison subjects. The two groups were not different with respect to melanoma and systemic cancer.

The purpose of this investigation was to determine the prevalence of the palato-gingival groove in maxillary incisor teeth and the health status of the lingual periodontal tissues adjacent to maxillary incisor teeth with and without the grooves. A total of 531 individuals aged 17 to 35 years were examined for the presence or absence of palato-gingival grooves in their maxillary incisor teeth. A Plaque Index (PII), Gingival Index (GI), and Periodontal Disease Index (PDI) were recorded for the lingual aspect of the four maxillary incisors. Tooth mobility was also recorded. The prevalence of the palato-gingival grooves in the 531 individuals examined was 8.5%. Of the 2,099 maxillary incisor teeth examined, 2.33% had a palato-gingival groove. Most of the palato-gingival grooves (93.8%) were in maxillary lateral incisor teeth. Statistical analyses revealed no differences in groove prevalence on the basis of sex or race. Results of the study also indicate that the palato-gingival groove is associated with poorer periodontal health as measured by the GI and PDI and more plaque accumulation as measured with the PII.

This study represents the first, comprehensive baseline survey of dental needs conducted in the US Air Force. The air force population was stratified by command, base, and grade, and 5,805 active duty air force members, aged 17 to 57 years (mean, 27.83), were examined at random to determine their overall oral health status. Data were collected from 42 air force bases, representing 11 worldwide commands, which comprised 90% of all active duty members. This article presents the methodology for the study, a summary of the findings, and a comparison of dental needs among recruits and all other grades of active duty air force personnel. Results indicate a significant level of unmet dental needs in the US Air Force. For example, the average active duty individual presently serving in the air force would require eight hours and 48 minutes of chairside care to provide comprehensive treatment. Each entry level recruit would need an average of ten hours and 23 minutes of dental treatment.