Sex‐related Disparity in Surgical Mortality among Pediatric Patients

Background. It has been reported that gender differences in cardiovascular outcomes found in adults also are present in children who undergo surgical repair for congenital heart disease. Methods. California statewide hospital discharge data 1989–99 were used to study outcomes in children <18 years undergoing cardiac surgery. Hospital discharge data were linked to death registry data to study postdischarge death within 30 days of discharge. We used logistic regression to evaluate the effect of gender on mortality controlling for age, race and ethnicity, type of insurance, household income, date and month of surgery, type of admission, hospital case volume, and various types of procedures. Results. There were 25 402 cardiac surgery cases with 1505 in‐hospital deaths (mortality rate of 5.92%). An additional 37 deaths occurred within 30 days after hospital discharge. Crude mortality rates for males (5.99%) and females (5.84%) were not significantly different. However, fewer neonates were female and females underwent a higher proportion of low‐risk procedures than males. Logistic regression revealed that females, compared with males, had a significantly higher odds ratio (OR) for in‐hospital mortality (OR = 1.18, P < .01) and overall (up to 30 days post discharge) mortality (OR = 1.18, P < .01). The risk‐adjusted length of hospital stay was similar between females and males while charges per hospital day were slightly higher in females than males. The prevalence of Down syndrome, pulmonary hypertension, and failure to thrive were higher in females. Conclusions. Female gender is associated with an 18% higher in‐hospital and 30‐day postdischarge mortality as compared with male gender. There was no difference in length of hospital stay between males and females. The mechanism by which female gender acts as a risk factor requires further investigation.     

Littoral‐cell angioma as a rare cause of splenomegaly

We report the case of a littoral‐cell angioma of the spleen, a recently described benign vascular tumour, whose imaging and pathological characteristics have been discussed only by a few authors. The diagnosis was made after elective splenectomy. The CT images, scintigraphy and histological specimens are presented, and differential diagnoses discussed.     

Aufrechnung des Schuldsaldos eines früher allein praktizierenden Vertragsarztes nach Eintritt in eine GP mit Honoraransprüchen der GP durch die KV

Abstrakt Die ?ffentlich-rechtliche Bindung des Honoraranspruchs kann nicht dadurch unterlaufen werden, dass ein Vertragsarzt, zu dessen vertrags?rztlichen Pflichten die Rückzahlung überzahlten Honorars geh?rt, sich durch Gründung einer Gemeinschaftspraxis dieser Verpflichtung entzieht. (Leitsatz des Bearbeiters)     

Zum Widerruf der Approbation wegen Unzuverlässigkeit und Unwürdigkeit

Abstrakt Zur Frage der beruflichen Unzuverl?ssigkeit und Unwürdigkeit eines Arztes, dessen Verhalten innerhalb eines Zeitraumes von etwa zehn Jahren mehrfach als Missbrauch seiner not?rztlichen Dienstpflichten sowie seiner Pflicht zur gewissenhaften Medikation straf- und /oder heilberufsgerichtlich geahndet worden ist.