Eine künstliche Hand

Ohne Zusammenfassung (Mit 2 Abbildungen.)     

Teledermatologie und künstliche Intelligenz

Telemedicine with the special application of teledermatology (eHealth) is the use of telecommunication technologies to exchange medical information for diagnostics, consultation, therapy and teaching. Using artificial intelligence (AI), machines can learn and thus be used flexibly under changing environmental conditions. Teledermatology and AI-supported mobile image analysis systems as part of eHealth are expected to have a significant potential to improve prevention, diagnostics, therapy adherence and follow-up of patients with (impending) occupational skin diseases. Dermatological teleconsultation could help occupational physicians and company physicians in the care of workers in high-risk occupations, as well as in skin cancer screening of outdoor workers, thereby contributing to a better prevention or recognition of an occupational disease. Modern mobile smartphone apps supported by AI technologies could improve self-monitoring of workers in high-risk occupations, early occupational health intervention and dermatological therapy counselling.     

Über die künstliche Operationssaalbeleuchtung

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Über die künstliche Unterkühlung

Ohne Zusammenfassung Mit 4 Textabbildungen.     

Die künstliche Epithelisierung der Witzelschen Magenfistel

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Der künstliche pyelovesikale und pyelokutane Bypass

MATERIALS AND METHODS. Since 2/02 to 2/03 a total of 13 patients underwent either pyelovesical bypass (10 patients) or pyelocutaneous bypass (3 patients). A composite implant, consisting of two coaxial tubes internal pure smooth silicone covered by coiled e-PTFE has been designed to serve as the ureteral replacement. This prothesis in inserted percutaneously into the renal pelvis, tunnelled subcutaneously, and introduced through a small suprapubic incision in the bladder or out directly through a cutaneous orifice. RESULTS. One encrustation of the subcutaneous pyelocutaneous bypass was observed, no angulation or dislocation during a mean follow up of 6.2 month. Improvement in the quality of life was stressed in all patients. CONCLUSIONS. The subcutaneous urinary division using a silicone-PTFE prothesis is an efficient and minimal-invasive technique to attend malignant obstructions of the ureter.     

Ausbildungsinitiative der Deutschen Gesellschaft für Urologie für innovative Forschung

The tasks of the Working Group on Urological Research (AuF) of the German Society of Urology (DGU) are to support communication and initiation of joint ventures in German urology and to cooperate with associated subjects and neighboring countries. The annual “wet lab workshops” needs a space between annual and “wet lab workshops” on the topics of tumor cell culture, gene silencing, proteomics, and tissue engineering and the use instead of annual topic-related symposium“urological research,” organized and carried out by the AuF as of 2009, serve to achieve a close change to closer integration of praxis and theory. This should contribute to a lasting quality improvement of the scientific work in urology. Accomplishing these objectives seems urgently necessary to preserve the interests of urologists, because more than ever research has become indispensable in an increasingly difficult environment of health care policy.     

Controllinginstrumente für OP-Manager

Management means developing, shaping and controlling of complex, productive and social systems. Therefore, operating room managers also need to develop basic skills in financial and managerial accounting as a basis for operative and strategic controlling which is an essential part of their work. A good measurement system should include financial and strategic concepts for market position, innovation performance, productivity, attractivity, liquidity/cash flow and profitability. Since hospitals need to implement a strategy to reach their business objectives, the performance measurement system has to be individually adapted to the strategy of the hospital. In this respect the navigation system developed by Gälweiler is compared to the “balanced score card” system of Kaplan and Norton.     

Behandlungspfade für Weichteilsarkome

Background

Soft tissue sarcomas represent only approximately 1% of malignant tumor diseases in adults with an incidence of 1.8–5.5/100,000 per year. Together with the heterogeneity and nonspecific clinical symptoms, this rarity often leads to delayed diagnosis and inconsistent therapy; however, a standardized diagnostic and therapeutic procedure is necessary for the best possible outcome.

Diagnostics

Patients typically present with a painless swelling. Depending on the exact location, there may be movement restriction and sometimes neurological symptoms. Due to its good contrast and reproducibility, the gold standard for local imaging is magnetic resonance imaging (MRI) with contrast medium. After completion of the local imaging, the histological tumor verification is performed with a core needle biopsy or open biopsy. Excisional biopsy should only be considered in exceptional cases. If malignancy is confirmed, a staging of the patient and search for metastases is mandatory before initiation of therapy. This is usually done by computed tomography (CT) of the thorax and abdomen or, in special cases, by positron emission tomography CT (PET-CT).

Therapeutic algorithm

The therapeutic approach is determined by an interdisciplinary tumor board. For local easily resectable tumors without metastases an R0 resection is indicated. This is followed by adjuvant radiotherapy in the case of high-grade sarcomas. For locally advanced tumors or metastases, neoadjuvant or adjuvant chemotherapy as well as surgical resection of metastases are used.

Follow-up

The tumor follow-up includes regular clinical and radiological control of the former tumor region as well as the search for metastasis. This should be performed as far as possible at the primarily treating tumor center.

     

McPeek-Punktesystem für Polytraumapatienten

Purpose

For outcome analysis of trauma patients, outcome measurements such as commonly used trauma scores could be improved for difficult scientific and epidemiological purposes. The current study investigated if the McPeek score, which is established in scheduled abdominal surgery, could be modified for multiple trauma patients and whether it could become an additional helpful tool.

Methods

A systematic review of adult trauma patients admitted to the emergency department of the University Hospital of Berne, Switzerland, from 2002 to 2004 was performed. Common trauma scores were used to calculate a modified McPeek score. Correlation, regression and graphical analyses were performed.

Results

A total of 565 multiple trauma patients were included in the study and the observed McPeek score was allocated to each patient based on the total poulation. Subsequently, the predicted McPeek score was calculated by using common trauma scores (ordinal regression, p?<?0.0001, pseudo-R²?=?0.532) and a residual (observed – predicted) McPeek score could then be calculated. With this modified McPeek scoring system, the influence of age, head injury and blood glucose (as examples of known factors influencing outcome) on outcome could be exactly quantified.

Conclusion

The modified McPeek scoring system is a helpful outcome analysis tool in multiple trauma patients. It may complement common trauma scores and may optimize comparative outcome measurements in therapy and research following prospective validation.     

Voraussetzungen für Propofolsedierung

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Die künstliche Hypothermie in der praktischen Chirurgie

Ohne ZusammenfassungMit 9 TextabbildungenMit Unterstützung der Deutschen Forschungsgemeinschaft     

Transportextensionsschiene für Oberschenkelbrüche

Ohne Zusammenfassung