Stürze und ihre Folgen

Ohne Zusammenfassung     

Severe mitral regurgitation in Tako-Tsubo cardiomyopathy

Severe emotional or physical stress precedes Tako-Tsubo cardiomyopathy (TTC) which is characterized by transient left ventricular impairment in absence of coronary artery disease. In this case we report from a female patient presenting with characteristic features of TTC after examination of upper gastrointestinal. Additionally, severe mitral regurgitation due to acute rupture of the posteromedial papillary muscle was present. Normal left ventricular function was documented before surgical valve repair was performed. TTC is reported to be associated with several complications. This is the first report of TTC accompanied by severe mitral valve regurgitation due to rupture of a papillary muscle.     

2008 update of the guideline: early detection of breast cancer in Germany

Introduction  The goal of the 2008 updated guideline: early detection of breast cancer in Germany is to support physicians as well as healthy and affected women in the decision-making process involved in the diagnostic chain for the early detection of breast cancer by providing them with evidence- and consensus-based recommendations. The updated guideline replaces the guideline issued in 2003. Materials and methods  The guideline forms the basis for developing an effective and efficient national early breast cancer detection program that meets the standards set by the Council of Europe and WHO for cancer control programs. The guideline presents the current, evidence- and consensus-based state of scientific knowledge in a multidisciplinary approach for the entire diagnostic chain, consisting of history taking and risk consultation, information on health behavior, clinical breast examination, diagnostic imaging, image-guided percutaneous tissue-acquisition techniques, open surgical excisional biopsy and pathomorphological tissue evaluation. The guideline recommends a set of quality indicators to assure resource availability, performance quality and outcomes enhancing total quality management for early breast cancer diagnosis. Conclusion   Currently, early detection of breast cancer offers the most promising possibility to optimize the diagnosis and treatment of breast cancer and, as a result, reduce breast cancer mortality and improve health related quality of life in women. The original German version of this paper has been published in Geburtsh Frauenheilk 2008; 68:251–261. Dedication: In memory of Klaus-Dieter Schulz, in highest respect for his contributions to improve breast health care, founder of the guideline task force Concerted Action Early Detection of Breast Cancer in Germany (“Konzertierte Aktion Brustkrebs-Früherkennung in Deutschland”) in 1999, who passed away on 29 September 2007.     

Reliability of the abbreviated version of the Late Life Function and Disability Instrument--a meaningful and feasible tool to assess physical function and disability in the elderly

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Soziale Ungleichheit in der regionalen Ausbreitung von SARS-CoV-2

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Ob sozioökonomische Faktoren die Ausbreitung von SARS-CoV‑2 beeinflussen, ist nicht ausreichend beantwortet, da...     

A 3-D-Printed Patient-Specific Ultrasound Phantom for FAST Scan

Ultrasound phantoms are commonly used to assess the performance of ultrasound systems and ensure their proper functionality, in addition to providing opportunities for medical training. However, Focused Assessment with Sonography for Trauma (FAST) phantoms, in particular, are prohibitively expensive and procedure specific. This work explores the use of additive manufacturing to fabricate a patient-specific, full-scale torso ultrasound phantom. Phantom geometry was derived from anonymized computed tomography scans and segments into discrete organs. The digital organs (torso, skeleton, liver, spleen) were 3-D printed and used as castable molds for producing their respective body features. These organs were integrated with artificial hemorrhages to produce a realistic training tool for FAST scans. The resulting phantom is low in cost, has a verified shelf-life of at least 1 y and was positively reviewed by a trauma and emergency radiologist for its ability to provide accurate geometric and ultrasound information.     

Primary sarcomas of the spine: population-based demographic and survival data in 107 spinal sarcomas over a 23-year period in Ontario,Canada

Background contextSpinal sarcomas are a rare, heterogeneous group of mesenchymal tumors. Current literature reporting demographic variables and survival information is limited to small case series, and a single registry with variable treatment modalities and time periods.PurposeWe report on population-level data regarding all spinal sarcomas diagnosed over a 23-year period in Ontario, Canada, for the purposes of calculating incidence and prevalence of these tumors. Secondarily, survival is assessed by tumor type as well as adjuvant therapies during this time period.Study designRetrospective Cohort StudyPatient samplePopulation-based data from the Institute for Clinical Evaluative Sciences (ICES) between 1993 and 2015.Outcome measuresOutcome measures include incidence and prevalence of spinal osteosarcoma, Ewing's sarcoma, and chondrosarcoma of the spine, as well as 2-, 5-, 10- and 15-year survival and prevalence of adjuvant therapies.MethodsUtilizing population-based data from the Institute for Clinical Evaluative Sciences (ICES) between 1993 and 2015, ICD codes were searched and available data extracted for the purposes of reporting basic demographic information and calculation of Kaplan Meyer survival curves. Databases include the Ontario Cancer Registry, Discharge Abstract Database, Ontario Health Insurance Plan, National Ambulatory Care Reporting System, Registered Persons DataBase (death) were analyzed.ResultsOne hundred and seven spinal sarcomas were identified, with a mean incidence was 0.38 sarcomas per million population per year, that was stable over time. The mean prevalence was 8.1 sarcomas per million population. The most common diagnosis was Ewing's sarcoma (48 [44.9%] patients), followed by chondrosarcoma (33 [30.8%] patients), and osteosarcoma (26 [24.3%] patients). Chondrosarcoma had the highest survival rates with 77.2% and 64.2% 5- and 10-year survival rates, respectively, followed by Ewing's sarcoma with 48.1% and 44.9% 5 and 10-year survival and osteosarcoma with 36.0% and 30.9% 5- and 10-year survival.ConclusionsSpinal sarcoma is a rare disease with variable survival depending on the histologic diagnosis. This population-level study involves a heterogeneous group of patients with variable stages of disease at presentation and variable treatments. Our data fit with the published literature for survival for those treated conservatively and surgically. Our data show considerable improvement in 5- and 10-year mortality when compared with previous population level studies on earlier patient cohorts, likely reflecting improvements in systemic and surgical treatments.