Maximale Blutalkoholkonzentration nach forciertem Konsum von alkoholfreiem Bier

In recent years sales of non-alcoholic beer have constantly increased. In Germany, so-called non-alcoholic beer may still have an ethanol content of up to 0.5% (by volume). This marginal amount of ethanol might have negative implications for certain groups of persons such as novice drivers. So far no reliable data regarding the blood ethanol concentration after consumption of non-alcoholic beer have been published. Therefore, a drinking experiment was performed as follows: after 5 days of abstinence from ethanol 78 test persons were asked to drink 1.5?l of non-alcoholic beer (ethanol content 0.41–0.42%) within 1?h. Blood samples were taken on a regular basis and analyzed for ethanol by headspace gas chromatography-flame ionization detection (HS-GC-FID). A total of 67 data sets could be interpreted and in 20 test persons ethanol was detected in blood with a limit of detection (LOD) of 0.0005?g/l. The maximum blood ethanol concentration was 0.0056‰. The results of the study suggest that even after consumption of unrealistically high amounts of non-alcoholic beer negative forensic implications are not to be expected.     

Ruptur einer zerebralen arterioven?sen Malformation

Arteriovenous malformations are vascular anomalies characterised by the presence of an arteriovenous shunt in the absence of a normally structured capillary bed. The prevalence of manifestations in the brain is given in specialist literature with a high level of variability. Brain hemorrhages resulting from a lesion of a cerebral arteriovenous malformation and leading to sudden unexpected death are relatively seldom in forensic autopsy material. The forensic significance of this syndrome may be illustrated by the example of a 16-year-old female who was found dead in the bathroom of her parents?? home for reasons which were initially unexplained.     

Synthetische Cannabinoide

In recent years a flood of new psychoactive substances offered as “legal highs” appeared on the drugs market worldwide. In some parts of the world amphetamine-type stimulants are predominant but in Germany synthetic cannabinoids represent the bigger problem. The high dynamics which are maintained by the “cat and mouse game” of scheduling substances and the producers circumventing the regulations by adding new, chemically modified substances, poses a great challenge for both forensic science and toxicology.     

Rückblick auf 10 Jahre Infektionsschutzgesetz

In 2001, the German Protection against Infection Act came into force, implementing a variety of new regulations. For the first time, obligatory infection control visits of the public health departments in surgical ambulatory practices were implemented, as well as optional infection control visits in all medical, dental and paramedical practices using invasive methods. Based on the data of the public health department of the city of Frankfurt am Main, Germany, an evaluation of this new regulation is given in this paper. First, prioritization of these new tasks was mandatory. First priority was given to the obligatory visits in surgical practices, second priority to the hygiene visits in practices performing endoscopy in gastroenterology as well as in urology and in practices of traditional healers, and third priority was given to all other doctors’ practices. After receiving preliminary information and further training of the doctors etc., the control visits were performed by members of the public health department, using a checklist based on the guidelines of the German Commission on Hospital Infection Prevention (“Kommission für Krankenhaushygiene und Infektionsprävention”). Since 2001, more than 1100 infection control visits in medical practices in Frankfurt am Main were documented. Not only in surgical, but also in gastroenterological and urological practices great improvement could be achieved, regarding not only hand hygiene and reprocessing surface areas, but especially in reprocessing medical devices. In practices for internal medicine and those of general practitioners, errors in hand hygiene, skin antiseptic and surface disinfection also decreased. According to our results, especially regarding the improved quality of structure as well as quality of process and with regard to the public discussion on this hygiene topic, our evaluation is absolutely positive. The new regulation proved worthwhile.     

Posterior spinal cord block: a dosimetric study

To determine the optimal width of a midline posterior spinal block (MPSB) (to avoid delivering too great a dose to the cord and too small a dose to adjacent tissue), the authors determined with magnetic resonance (MR) imaging normal ranges of cord depth and width and correlated them with film dosimetric data. In 59 randomly selected patients there was a wide range for both depth and width. The average depths of the anterior and posterior surfaces of the cord were 6.7 cm +/- 1.4 and 5.4 cm +/- 1.3, respectively. The average cord width was 1.6 cm +/- 0.4. Optimal cord block width as a function of cord width was determined for a 6-MV photon beam. The optimal cord block width at the surface (half-value layer [HVL] thickness = 6) varied from 1.5 to 3.0 cm for cord widths of 0.8-2.4 cm, which correspond to two standard deviations from the average. There was no significant dependence on depth of the cord. For optimal treatment outcome, the MPSB width may have to be determined for each patient individually.     

Psychosoziale Aspekte bei Infertilität

The last few years have brought huge advances in the consideration of psychosocial aspects of infertility. This review begins with a presentation of the important demographic and medical preconditions involved. This is followed by an overview of psychosocial features typical of infertile couples and a discussion of the connections between distress and infertility. The psychological effects of reproductive medical treatment are described, and the long-term impact of involuntary childlessness is outlined. The basic principles, aims, and effects of counselling and psychotherapy with infertile couples are set out in detail, together with urgent requirements for the future.     

Wundinfektionen in der Gynäkologie und Geburtshilfe

Surgical site infections (SSI) are the second most frequent type of nosocomial infections. Increasing age and multimorbidity of gynecologic patients reduce the otherwise noticeable benefits of modern surgical procedures and antibiotic therapies. The most important prophylaxis of SSIs consists of the application of a single shot antibiotic 30-60 min before surgical incision. The diagnosis of SSI is made by clinical aspects and is based on classical symptoms. Therapeutically, local measures should first be applied and in cases of generalized symptoms empiric antibiotic therapy must be given. Abscesses should be opened widely and rinsed. The inlay of antiseptic substances or materials reduces the number of bacteria and improves granulation. For large-scale wounds good experience has been made with closed vacuum systems (VAC). Infections with methicillin-resistant S. aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) play an important role in intensive care and neonatology units and require close cooperation with microbiologists and hygiene specialists.