Der Notfallplan des Krankenhauses bei allgemeingefährlichen Infektionskrankheiten

Patients with imported highly contagious diseases like viral hemorrhagic fever (VHF), pneumonic plague or anthrax require special preventive measures and strict isolation. In addition, new emerging infections like severe acute respiratory syndrome (SARS) and epidemic influenza also have to be taken into account. At present five high security infectious disease units for patient care are available in Germany. Due to the relatively nonspecific symptoms, a patient with one of these infections may also be admitted to any other hospital. Therefore each hospital should develop a concept for the management and control of these lifethreatening highly contagious diseases. The present article describes the current emergency plan developed for the management of patients with highly contagious diseases at Hannover Medical School.     

High-resolution imaging of progressive articular cartilage degeneration.

The objective of this study was to develop and verify a new technique for monitoring the progression of osteoarthritis (OA) by combining a rat model with the imaging modality optical coherence tomography (OCT). Time-sequential, in vivo, OCT imaging was performed on the left femoral condyles of 12 Wistar rats following sodium-iodoacetic acid-induced OA progression. The right femoral condyles (untreated) were also imaged and served as controls. Imaging was performed on days 0, 10, 20, 30, and 60 with an OCT system capable of acquiring images at four frames per second and an axial resolution of 5 microm. Progressive changes were analyzed using an OA scoring system. OCT successfully identified progressive cartilage degeneration as well as alteration of the cartilage/bone interface. Significant changes to both of these structures were observed in the sodium-iodoacetic acid-injected condyles. Structural changes detected with OCT were confirmed histologically. OCT in combination with a well-known model used in arthritis research represents a powerful tool for following degenerative joint disease progression in a given animal by detecting changes to the cartilage/bone interface and articular cartilage.     

Patterns of sexual arousal of accused child molesters involved in custody disputes

Penile plethysmography was used to examine sexual preferences of individuals accused of child molestation in the course of custody conflicts. Information regarding the alleged offenders, victims, and sex offense was gathered. In comparison to accused offenders who are not engaged in custody disputes, the subjects were more often accused of sexually abusing a younger child who was a biological relative. The source of accusations was usually the mother. Additionally, the custody-dispute subjects were less likely to have a prior criminal history. Penile tumescence data suggested that the subjects involved in custody disputes were less sexually aroused by children than those subjects who were not involved in custody conflicts. However, the results revealed that in both groups a substantial number of subjects responded equally or more to the child stimuli. In sum, the alleged offenders involved in custody disputes appeared less deviant on several measures.     

Comparative effects of enoximone and theophylline on plasma catecholamines and haemodynamics in cardiosurgical patients

Summary The release of endogenous catecholamines in aorto-coronary bypass graft patients receiving either 0.5 mg/kg enoximone (n=10), 4.0 mg/kg theophylline (n=10) or saline solution (control,n=10) has been studied, as well as certain haemodynamic parameters. Adrenaline (A) and noradrenaline (NA) concentrations were not significantly changed by the administration of enoximone. Theophylline caused a small increase in NA (+ 40% in the 1st min) and a marked increase in A (approximately + 7000% in the 1st min), which still remained elevated at the end of the investigation period (+ 220% in the 30th min). The major haemodynamic effects of enoximone were a significant increase in cardiac index (CI; + 35%) and a decrease in pulmonary capillary wedge pressure (PCWP; −27%), pulmonary artery pressure (PAP; −21%), RVEDV and RVESV, while the heart rate (HR) remained almost unchanged. The dominant haemodynamic effects of theophylline were an increase in HR (+ 26%; arrhythmia in 3 patients), PAP (+ 22%), and RVEDV (+ 19%), while REVESV (+ 26%), MAP (−16%), CI (−14%), and RVEF (−15%) fell significantly. It is concluded that the haemodynamic actions of enoximone are not mediated by catecholamine release, whereas the adverse cardiovascular effects of theophylline might partly be explained by the significant increase in plasma adrenaline.     

Aspiration cytologic, ultrastructural, and DNA cytometric findings of solid and papillary tumor of the pancreas.

Solid and papillary epithelial neoplasm of the pancreas (SPENP) is a rare lesion characteristically occurring in young women. By contrast with pancreatic ductal adenocarcinomas, SPENP is a slow-growing tumor that rarely metastasizes or is fatal. The current report describes light and electron microscopic and histochemical findings with DNA flow cytometric analyses of two cases of SPENP. The first patient was a 24-year-old woman; the second, a 72-year-old man. Although SPENP is rare in older men, both patients had characteristic radiographic and light microscopic features of SPENP. Ultrastructural evidence of acinar differentiation was seen in the first patient; the second patient had focal neuroendocrine differentiation. Flow cytometric analysis of the first tumor demonstrated diploid-range DNA content with a 5.8% S-phase fraction (SPF). The DNA cytometric analysis of a biopsy specimen from the second tumor revealed diploid-range DNA content with a 6.1% SPF, although subsequent sampling of the resected tumor showed an aneuploid population with a DNA index of 1.8 and SPF of 2.1%.     

An analysis of school nurse leadership styles.

New programs, such as care of pregnant teens and substance abuse education, are more commonplace in the school setting today. The school nurse is increasingly involved with professionals and others inside and outside the school system. Thus, the nurse's effectiveness may greatly depend upon the ability to lead others.