Notes

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2 and 0.7 in the other 4 cases. No patient died as a direct consequence of the firearm injury.

Injuries caused by firearms are relatively rare in Germany and mostly have asuicidal background. The pattern of the injury of the ocular structures is very variable. Areconstruction attempt is principally recommended. In the care of patients interdisciplinary cooperation between ophthalmologists and neurosurgeons, orofacial surgeons, ear nose and throat (ENT) surgeons and psychiatrists is necessary.
Injuries caused by firearms are relatively rare in Germany and mostly have a suicidal background. The pattern of the injury of the ocular structures is very variable. A reconstruction attempt is principally recommended. In the care of patients interdisciplinary cooperation between ophthalmologists and neurosurgeons, orofacial surgeons, ear nose and throat (ENT) surgeons and psychiatrists is necessary.Multimodal imaging is able to image the retina in unprecedented detail, and the joint analysis (integration) of these data not only enables the securing of diagnoses, but also a more precise definition; however, humans encounter temporal and cognitive limitations in the analysis of this amount of information, so that the potential of a joint examination of the findings is largely unused to date. Automatic image processing and methods, which are summarized under the collective term of artificial intelligence (AI), are able to overcome the bottleneck in the evaluation and to exploit the full potential of the available data. A basic understanding of AI methods and the ability to implement them will become increasingly more important for ophthalmologists in the future. In this article we give an insight into the functionality of AI methods and the current state of research in the field of automatic image analysis.Climate change is a worldwide challenge. Its consequences do encompass severe threats not only for the existence and somatic health, but also for the mental health of children and adolescents. Mental health can be impaired by three types of consequences. Direct consequences of climate change, such as natural disasters and indirect consequences, such as loss of land, flight and migration, exposure to violence, change of social, ecological, economic or cultural environment. Moreover, the increasing awareness of the existential dimension of climate change in children and adolescents can influence their well-being or challenge their mental health. Consequences of climate change for somatic health may interact with mental health or have psychological sequelae in children and adolescents. Based on the estimates by the United Nations Intergovernmental Panel on Climate Change, we have summarized current data on these differential pathways as to how climate change affects the mental health of children worldwide through selective literature research on Pubmed. Mental health sequelae of direct and indirect consequences of climate change, increased awareness and physical health problems caused by climate change are presented. We give insights into special vulnerabilities of children and adolescents and identify high-risk groups. As the "Fridays for Future" movement has been initiated in northern Europe, we will discuss these results with a focus on children and adolescents in Europe. The results indicate that climate change is a serious threat to children and adolescent mental health. Children´s rights, mental health and climate change should not continue to be seen as separate points; instead, they need to be brought together to address this major challenge determining the future of our children and their descendants.
Due to a high prevalence of low back pain (LBP) among children and adolescents, it is significant to seek effective prevention and therapeutic procedures. One idea for the programmes is a potential relation between the occurrence of LBP and the level of physical activity. The aim of this review was to analyse the current knowledge regarding the association between physical activity and LBP among children and adolescents.

Publications were retrieved by searching the following databases PubMed, The Cochrane library, Web of Science, Medline and SportDiscus with Full Text (EBSCO). The search strategy included keywords related to physical activity and LBP. The studies included were assessed for methodological quality. PRISMA guidelines were followed for the systematic review.

The total sample size of the nine included studies consisted of 75,233 subjects, with an age range of 9-19years. All the studies were assessed to be of high quality. One cohort study and five cross-sectional studies found the association between physical activity and LBP in children and adolescents. The remaining studies found no relationship between physical activity and LBP. These findings showed that both extremes of activity levels (i.e. being very low and very high physically active) are associated with LBP.

There is moderate evidence for the association between physical activity and LBP in children and adolescents. The results highlight the need for continued research. It seems that for clear evaluation of the analysed association the prospective cohort studies should be conducted.
There is moderate evidence for the association between physical activity and LBP in children and adolescents. The results highlight the need for continued research. It seems that for clear evaluation of the analysed association the prospective cohort studies should be conducted.
The use of lipid-lowering therapies in patients with idiopathic inflammatory myopathies (IIM) is complicated and there are no guidelines for diagnosing, monitoring, or treating atherosclerotic cardiovascular disease (ASCVD) in this group of patients.

The use of lipid-lowering therapies, especially statins, is recommended in patients with increased risk for ASCVD, which includes patients with inflammatory diseases, based on recent American College of Cardiology/American Heart Association (ACC/AHA) guidelines for ASCVD management. There is accumulating evidence that patients with IIM are at increased risk for ASCVD, similar to other inflammatory diseases. find more Lipid-lowering therapies have side effects that may be pronounced or confounding in myositis patients, potentially limiting their use. Statins are specifically contraindicated in patients with anti 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibodies. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been shown to be safe and potentially beneficial in patients with IIM.
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