Monophasische orale Kontrazeptiva im Langzyklus

Oral contraceptives are usually taken for 21 days followed by a 7 day pill-free interval. This interval results in a monthly bleeding pattern that is perceived as natural but which is not physiologically necessary and in some women is even associated with considerable discomfort. The present paper explains the theoretical background of the extended cycle regimen (i.e. the continuous intake over a longer period of time) and reviews the practical experience available to date.     

Totale Pankreatektomie

Permanent reduction of morbidity and death in centers for pancreatic surgery has led to a change in the indication for total pancreatectomy from rescue pancreatectomy for complications of pancreatic surgery increasingly to elective surgery, especially in the management of advanced intraductal papillary mucinous neoplasms. We discuss the indication for oncologic total pancreatectomy, rescue pancreatectomy, and removal of the whole pancreas for chronic pancreatitis. Furthermore we describe technical and metabolic aspects following total pancreatectomy.     

Therapie des schweren Schädel-Hirn-Traumas

The main target of treatment in patients with head trauma is to maintain the physiological parameters within the following normal limits: intracranial pressure (ICP) below 20 mmHg, cerebral perfusion pressure (CPP) between 50 and 70 mmHg, normoxemia (SpO₂ >90%), normocapnia (paCO₂: 35–38 mmHg), normoglycemia (80–130 mg/dl) and normothermia (36.0–37.5°C). Space-occupying intracranial bleeding or edemas must be evacuated immediately. If these interventions do not result in adequate control of ICP and CPP, the next step would be to administer mannitol and barbiturates. Mild hyperventilation, therapeutic hypothermia, or decompressive craniectomy should be used solely in patients with a persistent ICP increase. Infusion of calcium antagonists or glucocorticoids is never indicated in patients with head trauma.     

Meeting the Challenges of Neuroimaging Genetics

As research encompassing neuroimaging and genetics gains momentum, extraordinary information will be uncovered on the genetic architecture of the human brain. However, there are significant challenges to be addressed first. Not the least of these challenges is to accomplish the sample size necessary to detect subtle genetic influences on the morphometry and function of the healthy brain. Aside from sample size, image acquisition and analysis methods need to be refined in order to ensure optimum sensitivity to genetic and complementary environmental influences. Then there is the vexing issue of interpreting the resulting data. We describe how researchers from the east coast of Australia and the west coast of America have embarked upon a collaboration to meet these challenges using data currently being collected from a large-scale twin study, and offer some opinions about future directions in the field. Submitted to: New Horizons in Human Brain Imaging—A Focus on the Pacific Rim—A Special Issue of Brain Imaging and Behavior