Regulation der Laktation

At birth the human newborn is immature and has not yet acquired fully competent organ functions. During lactation especially the digestive tract and the immune system gain competence. Lactation is regulated by a complex interaction of numerous hormonal factors. Most important are probably prolactin and oxytocin—two hormones produced and secreted in the pituitary. The production and secretion of these two hormones is again regulated by several factors in the central nervous system and these mechanisms can be disturbed by a variety of exogenous factors such as drugs and any other substances interacting with dopamine metabolism in the brain. It is important to know these physiological interactions to be able to understand the regulation of lactation and to be able to assess which factors could interfere with this process.     

Endoprothesenlockerungen

The life time of hip endoprostheses is in part limited by aseptic loosening. The aim of this study was to produce a digital system for recording shaft loosening in such endoprostheses using acceleration sensors. Four identical prosthetic shafts were each set with 3.2-axial acceleration sensors and placed in artificial femurs. In order to simulate a firm fit, one prosthesis was fixed with bone cement; a loose fit was fixed with a surrounding silicon shell 0.5 mm thick. Simulation of the transition from firm to loose in the other two prostheses was attained by the distal 2/3 or 1/3 being cemented, with the rest surrounded by a silicone shell. A weak oscillation was initiated via a damped falling weight. Using a fast Fourier transformation it was possible to make a global evaluation of the measurement curves. A wavelet transformation could be used to differentiate firm or loose prostheses. A third order Daubechies filter recognized the deviation in the main oscillation, made visible by an increase in amplitude. The results encourage the development of an implantable, telemetrically functioning total system which would allow digital quality assurance when integrated into the endoprosthesis.     

Vom Konzept zur Praxis – Aktuelles in der Luftrettung

The 2006, annual meeting of the senior physicians and emergency medical technicians of the German Air Rescue Service (Deutschen Rettungsflugwacht, DRF) was titled “From Concept to Practice”. The themes of security in the air rescue services and the current practice of cardiopulmonary respiration were discussed. In addition, different concepts and networks for treating patients with acute coronary syndrome or severe trauma were presented. The training of emergency technicians and quality assessment using the database of the whole TeamDRF was explained. New helicopter stations as well as long-range transport using normal aviation by the TeamDRF were presented.     

Psychosoziale Rehabilitation von Kindern und Jugendlichen mit körperlicher und/oder psychischer Erkrankung

The guidelines regarding medical rehabilitation have changed. When applying for medical rehabilitation, the International Classification of Functioning (ICF) must be used for young adults with somatic and/or psychiatric diseases. The ICF is an appropriate tool to assess the outcome of rehabilitation in children and adolescents. Nowadays the ICF is used in rehabilitation hospitals; in former times the Functional Independence Measure (FIM) was used. The different criteria of the ICF such as personal factors, environmental factors, body function and structure (impairment), activities (limitation) and participation (restriction) are explained. A case report is presented which shows the outcome of rehabilitation according to FIM and ICF in graphic form.     

Notfälle bei extrapyramidalen Erkrankungen

Zusammenfassung Extrapyramidalen Störungen liegen zwar meist chronische Erkrankungen zugrunde, jedoch kommt es unter Umständen auch zum akuten Auftreten oder zu einer dramatischen Verschlechterung bis hin zu lebensbedrohlichen Zuständen. So kann ein Infekt, Medikamentenentzug oder eine Exikkose bei Parkinson-Patienten eine akinetische Krise auslösen. Auch akute, therapieassoziierte Psychosen mit Halluzinationen, Verwirrtheits- und Unruhezuständen können beim Parkinson-Patienten eine Notfallbehandlung erforderlich machen. Akute medikamenteninduzierte Dystonien treten nach einer Latenz von Stunden bis Tagen nach der Therapie mit Neuroleptika auf. Diese Frühdyskinesien können mit i.v.-Gabe von Anticholinergika effektiv behandelt werden. Seltene Folge einer Neuroleptikatherapie ist das maligne neuroleptische Syndrom, das mit Hyperthermie, Rigor und Bewusstseinsveränderungen einhergeht und zur kardiopulmonalen Dekompensation führen kann. Auch hier ist eine rasche Diagnosestellung entscheidend.     

Crigler-Najjar Syndrom Typ I infolge segmentaler paternaler Isodisomie 2

Ohne Zusammenfassung