Rotatorenmanschettenläsionen – Was gibt es Neues

Ohne Zusammenfassung     

Was gibt’s Neues beim Harnblasenkarzinom*

Ohne Zusammenfassung* Präsentation im Rahmen des Schlussforums der Jahrestagung der Deutschen Gesellschaft für Urologie, Düsseldorf 2005     

Physikalische Therapieoptionen bei rheumatologischen Erkrankungen: Was gibt es an Evidenz?

Rheumatic diseases usually progress towards morphological and functional deficits and thus cause impairment of physical health and function. Based on this fact, physiotherapeutic options are elementary and indispensable. This article focuses on the significance and importance of physiotherapy in inflammatory and degenerative rheumatic diseases. Furthermore, an overview is presented on the consequences of rheumatic diseases, the reality of supply of physiotherapy, the principles and therapeutic options, and the evidence.     

Nierenzellkarzinom – Gibt es Neuigkeiten?

Ohne Zusammenfassung     

Update PONV – Was gibt es Neues bei der Prophylaxe und Therapie von postoperativer Übelkeit und postoperativem Erbrechen?

Die Anaesthesiologie - Auch wenn für Anästhesiologen über Jahrzehnte die Prophylaxe und Therapie postoperativer Schmerzen im Rahmen des postoperativen Patientenkomforts an vorderster...     

Die DRGs im Jahr 2010

After 5 years of experience with the German diagnosis-related group (G-DRG) system, there are still many problems that have not yet been solved. The extremely complex German system, consisting of several federal laws, regulations, and statutes, makes it very difficult for the physician to understand how to work with this system. In addition, the health insurance companies try to take advantage of the complexity of the system for their reimbursements. This article gives an overview of the different important regulations and tries to sharpen the reader‘s insight into the essential necessities of coding, because it is neither useful nor possible to try to give exact instructions within one article on how to code correctly in all situations. Nevertheless, concrete suggestions about what is new this year and how to apply this knowledge in daily work are given.     

Wie viele potenzielle Organspender gibt es wirklich?

Die Anaesthesiologie - Systematische Untersuchungen zu Ursachen nichterfolgter Diagnostik des irreversiblen Hirnfunktionsausfalls (IHA-D) fehlen in Deutschland. Eine flächendeckende Analyse...     

Was bedeutet Sicherheit im Krankenhaus?

Patient safety in hospitals is difficult to define and is not measurable by operational safety parameters as in other fields. So-called adverse events (AE) are a collective of complications, failures, mistakes, errors and violations. Estimations of at least 9.2?% AEs in surgery with 0.1?% fatalities are given worldwide but there are no correlations between objective quantification of AEs and subjective or public perception of safety during the perioperative period. Patient safety during this period is mostly endangered by wound infections (safety 98?%) and nosocomial infections (safety 97?%). In spite of these facts, safety parameters for problems in anesthesia, blood transfusion, in retaining surgical instruments and so-called index events, such as patient and side identification errors are much higher. Patient safety is maintained in hospitals by objective means (surgical). Checklists have been proven to improve safety and critical incidence reporting, training and changing of attitudes could have further advantages but they are difficult to measure.     

Elektronische Einsatzdokumentation im Rettungsdienst: Was muss ein gutes System leisten?

Notfall + Rettungsmedizin -     

Gibt es eine habituelle Luxation im unteren Sprunggelenk?

Zusammenfassung Durch Mitteilung einer wechselseitigen wiederholten Verrenkung im unteren Sprunggelenk (Luxatio pedis sub talo) bei einer 16jährigen wurde an Hand des einschlägigen Schrifttums auf die Möglichkeit habitueller Lockerungen im unteren Sprunggelenk hingewiesen, die auch bei gutachterlichen Zusammenhangsfragen zu berücksichtigen ist.Mit 4 Textabbildungen (12 Einzelbilder)     

Was ist neu … im Notfallsanitätergesetz?

Die Anaesthesiologie -     

Aktive Tetanusimmunisierung im Verletzungsfall – machen wir es richtig?

Background

Unscheduled tetanus vaccination after injury is daily routine for medical staff in emergency departments.

Aim

The aim of the study was to gain information about the daily practice of active tetanus vaccination in cases of injury in German hospitals and to evaluate the understanding of and adherence to the existing recommendations of the standing commission (STIKO).

Material and method

A questionnaire with 14 questions on this topic was sent out to 450 members of the German Society for Interdisciplinary Emergency and Acute Medicine (DGINA) via electronic mail.

Results

Of the questionnaires returned 70 could be evaluated. The majority of responders stated that every second patient injured could recall the vaccination status and half of these could show a vaccination certificate. More than 90?% understood the STIKO recommendations to vaccinate without delay and, that this has to be done within the first 24 h (around 50?% of emergency department physicians even comprehended this as promptly). Based on the lack of information concerning the vaccination status and the acute need to vaccinate, it is assumed that unnecessary vaccinations may occur. For adults the STIKO recommends a combined vaccine for active vaccination. As almost 70?% use tetanus as a single toxoid only, this recommendation might not be consistently followed.

Conclusions

The current practice of active tetanus vaccination in emergency departments in Germany seems to be poorly standardized. Following the STIKO recommendations, quality of care could be optimized in the emergency departments. Unnecessary vaccinations would be prevented by better information concerning patient vaccination status.     

Protektion der Mukosabarriere durch Strategien der Ernährung Welche therapeutische Optionen gibt es?

The dysfunction of intestinal barrier allows the translocation of both endotoxin and whole bacterial organisms. It plays an important role in the development of multiple organ failure (MOF). The mucosa ia one component of this barrier. Trauma, atrophie and the “systemic inflammatory response syndrom” increase gastrointestinal permeability. These abnormalities may contribute to the pathophysiology of sepsis. Malnutrition per se compromises the gut's barrier function. Maintenance of gastrointestinal blood flow may be facilitated by (glutamin-enriched?) enteral diets. The most important conclusions of the majority of controlled trials support the concept of the very early enteral nutrition (within 24 hours after trauma): the outcome of seriously ill patients is improved, the rate of complications and infections is reduced. Gastrointstinal motility disorders may interfere with the initiation and tolerance of early enteral nutrition. They may be managed by prokinetic agents (cisapride, erythromycin) or by bypassing the stomach with a nasoenteric tube.