006, 0.002, 0.048, respectively). Postoperative chemotherapy did not statistically significantly influence any outcome measure. Contralateralization of the tongue was significantly decreased in the postoperative radiotherapy group (p = 0.029). The length of the flap showed highly negative correlation with articulation and intelligibility (p = 0.009, p less then 0.001, respectively). The width of the flap was not correlated with the outcomes. CONCLUSION  We proved that unlike chemotherapy, postoperative radiotherapy influences the functional outcome of tongue reconstruction. The dimensions, particularly the length of the flap, were also important for restoring the reconstructed tongue function. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.BACKGROUND  Pain management approaches in autologous breast reconstruction have become a topic of great interest in the era of enhanced recovery after surgery protocols, as well as the opioid epidemic. The management of postoperative pain is of critical importance for women undergoing breast reconstruction; however, these protocols have yet to be synthesized and compared in the primary literature. Herein, we present a systematic review of approaches to provide optimal pain control while minimizing narcotic use and its associated potential negative sequelae in autologous breast reconstruction. METHODS  A comprehensive systematic review of the published literature was conducted using Ovid Medline/PubMed database without timeframe limitations, in compliance with the guidelines outlined in the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Inclusion criteria were selected for studies reporting objective outcomes of pain modulation in autologous breast reconstruction. Articles for inclusion were stratified based on intervention. RESULTS  A total of 101 articles were identified on initial search query. After full-text review and final screening of all articles and review of included studies’ references, 28 studies met the inclusion criteria and were analyzed. CONCLUSION  There continues to be a substantial need for evidence-based guidelines in the plastic surgery literature. Mitigating postoperative pain can improve health-related quality of life, reduce health care resource utilization and costs, and minimize perioperative opiate use. Given the increasing popularity of and access to autologous approaches to breast reconstruction, we hope this area of study continues to be a top priority for plastic surgeons to allow for optimized postoperative care. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.in English, German EINLEITUNG Internetabhängigkeit geht mit einem hohen Maß an komorbiden psychischen Störungen sowie einem erheblichen Leidensdruck einher. Im Hinblick auf das hieraus resultierende Gefahrenpotenzial untersucht die vorliegende Arbeit die Häufigkeit auftretender suizidaler Gedanken und Verhaltensweisen bei Patienten mit Internetabhängigkeit im Vergleich zu einer klinischen und einer gesunden Stichprobe. METHODEN 60 Patienten mit Internetabhängigkeit (29 Patienten mit komorbider und 31 ohne komorbide psychische Störung) wurden mit Patienten der allgemeinen Ambulanz, die an anderen Störungen aus dem psychosomatischen Fachgebiet litten (n=35) und 57 gesunden Kontrollprobanden im Hinblick auf Symptombelastung und Suizidalität untersucht. ERGEBNISSE 48,3% der Internetabhängigen Patienten (mit und ohne Komorbidität) zeigten im Vergleich zu den gesunden Probanden (3,5%) signifikant häufiger suizidale Symptome. In allen klinischen Stichproben zeigte sich eine signifikant größere Ausprägung der suizidaechende Risiken bei Entzug und Entwöhnung.in English, German ZIELE DER STUDIE Bislang fehlten für Deutschland breit angelegte, bevölkerungsrepräsentative Daten zur Analyse von Lebenszeit-Erfahrungen heterosexueller Erwachsener mit verschiedenen sexuellen Praktiken. Generationenunterschiede wurden daraufhin untersucht, ob sich bestimmte sexuelle Erfahrungen in der Generation der 18- bis 30-Jährigen (der Digital Natives) weiter verbreitet zeigten als in den älteren Generationen, insbesondere mit Bezug auf die Generation der 61- bis 75-Jährigen, deren sexuelle Sozialisation noch nicht in die Präsenz der neuen Medien eingebettet war. Für das junge Erwachsenenalter wurde überdies analysiert, inwieweit sich Erweiterungen des sexuellen Repertoires abbilden lassen. METHODIK Im Rahmen einer Pilotstudie (1) zu GeSiD – Gesundheit und Sexualität in Deutschland – wurde im Jahr 2017 eine repräsentative Befragung an 1155 Personen im Alter von 18 bis 75 Jahren durchgeführt. Die Angaben heterosexueller Männer und Frauen zu Lebenszeit-Erfahrungen mit unterschiedlichenntalen gesellschaftlichen Wandel ein, der sich auch in unterschiedlichen Bandbreiten sexueller Erfahrungen der Generationen widerspiegelt. SCHLUSSFOLGERUNG Aus den Befunden lassen sich erste Einblicke über heterosexuelle Praktiken unterschiedlicher Generationen in Deutschland gewinnen, die wertvolle Hinweise zur Steuerung von Informations- und Aufklärungskampagnen und eine psychoedukative Grundlage für die paar- und sexualtherapeutische Arbeit liefern können.The purpose was to determine the physiological correlates to cycling performance within a competitive paratriathlon. Five wheelchair user and ten ambulant paratriathletes undertook laboratory-based testing to determine their peak rate of oxygen uptake; blood lactate- and ventilatory-derived physiological thresholds; and, their maximal aerobic power. These variables were subsequently expressed in absolute (l∙min -1 or W), relative (ml∙kg-1∙min -1 or W∙kg -1) and scaled relative (or ml∙kg - 0.82 ∙min -1, ml∙kg - 0.32 ∙min -1 or W∙kg -0.32) terms. All athletes undertook a paratriathlon race with 20 km cycle. Pearson’s correlation test and linear regression analyses were produced between laboratory-derived variables and cycle performance to generate correlation coefficients (r), standard error of estimates and 95% confidence intervals. For wheelchair users, performance was most strongly correlated to relative aerobic lactate threshold (W∙kg -1) (r=-0.99; confidence intervals -0.99 to -0.99; standard error of estimate=22 s). For ambulant paratriathletes, the greatest correlation was with maximal aerobic power (W∙kg -0.32) (r=-0.91; -0.99 to -0.69; standard error of estimate=88 s). Race-category-specificity exits regarding physiological correlates to cycling performance in a paratriathlon race with further differences between optimal scaling factors between paratriathletes. This suggests aerobic lactate threshold and maximal aerobic power are the pertinent variables to infer cycling performance for wheelchair users and ambulant paratriathletes, respectively. © Georg Thieme Verlag KG Stuttgart · New York.The aim of this study was to determine the influence of body weight or lean body mass-based load on Wingate Anaerobic Test performance in male and female endurance trained individuals. Thirty-one participants (22 male cyclists and triathletes and 9 female triathletes) completed two randomized Wingate Anaerobic Test (body weight and lean body mass loads) in stationary start. There were no significant differences in power outputs variables between loads in any group. However, when comparing specific groups within the sample (e. g. cyclists vs cyclists) medium to large effect sizes were observed for Relative Mean Power Output (ES=0.53), Relative Lowest Power (ES=0.99) and Relative Power Muscle Mass (ES=0.54). Regarding gender differences, male cyclists and triathletes displayed higher relative and absolute power outputs (p less then 0.001) compared to female triathletes regardless of the protocol used. FI was lower in female triathletes compared to male triathletes and cyclists in body weight (p less then 0.001) and lean body mass (p less then 0.01) protocols. Body composition and anthropometric characteristics were similar in male cyclists and triathletes, but there were differences between genders. These results suggest that using either body weight-based or lean body mass-based load can be used interchangeably. However, there may be some practically relevant differences when evaluating this on an individual level. © Georg Thieme Verlag KG Stuttgart · New York.This study examined whether professional footballers with previous biceps femoris long head (BFLH) injury in the last 3-years present a smaller proximal aponeurosis (Apo-BFLH) size compared to footballers with no previous injury. We examined the Apo-BFLH and BFLH size using magnetic resonance imaging and tested the knee flexor maximal isometric strength in 80 thighs of 40 footballers. Apo-BFLH size parameters were processed using a semi-automated procedure. Outcomes were compared between thighs with (n=9) vs. without (n=71) previous BFLH injury. No differences were observed between injured and non-injured thighs for the Apo-BFLH and BFLH size parameters (p>0.05) except for Apo-BFLH volume, which was higher in the non-injured thighs of athletes with previous injury (3692.1±2638.4 mm3, p less then 0.006) compared to the left (2274.1±798.7 mm3) thighs of athletes without previous injury. A higher knee flexor isometric strength was observed in the injured limb of athletes with previous BFLH injury (196.5±31.9 Nm, p less then 0.003) compared to the left (156.2±31.4 Nm) and right (160.0±31.4 Nm) thighs of non-injured athletes. The present results suggest that BFLH proximal aponeurosis size should not be considered as an independent risk factor for strain injury. © Georg Thieme Verlag KG Stuttgart · New York.Primary aldosteronism (PA) is the most common cause of secondary hypertension. Increasing evidence has demonstrated an increased cardiovascular risk in patients with PA compared to those with essential hypertension (EH), including atrial fibrillation (AF), the most prevalent arrhythmia among adults that is associated with an elevated risk of subsequent cerebro-cardiovascular adverse events. The mechanisms of increased prevalence of AF in PA patients are complex. Excessive aldosterone production is regarded to be a key component in the pathogenesis of AF, in addition to arterial hypertension and electrolyte imbalance. In addition, several translational and clinical studies have reported that structural remodeling with atrial fibrosis and electrical remodeling with arrhythmogenicity induced by an excess of aldosterone also play major roles in AF genesis. Clinical studies from several registries and meta-analysis have reported an increased prevalence and risk of AF in PA patients compared to EH patients. Recent trials have further demonstrated a reduction in the risk of new-onset atrial fibrillation (NOAF) after adrenalectomy, while the results of medical treatment with mineralocorticoid receptor antagonists (MRAs) have been inconsistent. This review outlines the current evidence of the relationship between PA and AF, and highlights recent progress in the management of PA with regards to the development of AF. © Georg Thieme Verlag KG Stuttgart · New York.The CYP11B2 enzyme is the terminal enzyme in the biosynthesis of aldosterone. Immunohistochemistry using antibodies against CYP11B2 defines cells of the adrenal ZG that synthesize aldosterone. CYP11B2 expression is normally stimulated by angiotensin II, but becomes autonomous in primary hyperaldosteronism, in most cases driven by recently discovered somatic mutations of ion channels or pumps. Cells expressing CYP11B2 in young normal humans form a continuous band beneath the adrenal capsule; in older individuals they form discrete clusters, aldosterone-producing cell clusters (APCC), surrounded by non-aldosterone producing cells in the outer layer of the adrenal gland. Aldosterone-producing adenomas may exhibit a uniform or heterogeneous expression of CYP11B2. APCC frequently persist in the adrenal with an aldosterone-producing adenoma suggesting autonomous CYP11B2 expression in these cells as well. This was confirmed by finding known mutations that drive aldosterone production in adenomas in the APCC of clinically normal people.