Bemessung des Ärztekammerbeitrags für theoretische Mediziner

Ohne Zusammenfassung     

Chronische Rhinosinusitis im Kindesalter

Chronic rhinosinusitis (CRS) in childhood is a heterogeneous disease with a high incidence and is defined as nasal obstruction or/and secretions persisting over a minimum of 12 weeks, possibly associated with pain and pressure, impaired sense of smell and coughing. Epidemiological data on CRS in childhood are insufficient and there is a lack of controlled trials assessing the effects of medication and surgical therapy. As a specific problem in children with CRS adenoid vegetation causes or aggravates the symptoms in infants and allergies play an important role in triggering the disease in school age children. Additionally, CRS is a hallmark in many patients with immune defects and almost all patients with cystic fibrosis (CF) and primary ciliary dyskinesia (PCD). The symptoms impair the quality of life to a much greater extent than currently assumed and the impairment of nasal respiration with failure of the air conditioning function leads to inspiration of dry, cold and unfiltered air into the lower airways, which increases bronchial hyperreactivity. For pediatricians it is important to regularly use an otoscope for nasal inspection and to consistently apply conservative therapeutic options. These include nasal lavages in the presence of secretions and crusts (from the age of 1 year) and long-term use of topical steroids for nasal obstruction, adenoids and nasal polyps. As additional therapy in atopic children allergens should be avoided and antihistamines and specific immunotherapy can be helpful. In CF, PCD and immunodeficiency additional assessment of pathogen colonization from nasal lavages is essential together with an adapted antibiotic treatment. Close cooperation with otorhinolaryngologists is important, above all for specific problems and surgery if consistently administered conservative therapy is unsuccessful.     

A novel immunoassay based on monoclonal antibodies for the detection of Helicobacter pylori antigens in human stool

BACKGROUND AND AIM: With the Premier Platinum HpSA EIAtrade mark a new enzyme immunoassay was developed for diagnosis of H. pylori infection, using polyclonal antibodies against H. pylori antigens in human stool. Here we evaluated FemtoLab H. pyloritrade mark based on the use of monoclonal antibodies in comparison to established reference methods.METHODS: 53 consecutive patients (27male, 26 female, age: 17-85 years) undergoing routine upper gastrointestinal endoscopy were enrolled in this study. The H. pylori status was determined by 4 reference methods: Histology, rapid urease test (HUT), (13)C-urea breath test ((13)C-UBT) and serology. Patients were considered to be infected with H. pylori if at least 2 of the 4 reference tests were positive. Stool samples were aliquoted after reception and stored frozen (-20 degrees C) until tested. The FemtoLab H. pyloritrade mark (Connex GmbH, Germany) and the Premier Platinum HpSA EIAtrade mark (Meridian, Connecticut, Ohio, USA) were performed according to the manufacturers protocols. RESULTS: 26 of the 53 patients were H. pylori infected. 3 were false-negative by the FemtoLab H. pyloritrade mark and one false-positive result was obtained (sensitivity 88,5 %, specificity 96,3 %). The concordance between the 2 stool tests was 94,3 % (50/53 cases). CONCLUSION: The diagnostic quality of the novel FemtoLab H. pyloritrade mark Enzyme Immunoassay is comparable with the established Premier Platinum HpSA EIAtrade mark. The differences between positive and negative results obtained with the FemtoLab H. pyloritrade mark are greater in comparison to the Premier Platinum HpSA EIAtrade mark and therefore this test system allows a better distinction.     

Effect of mailed reminders on the response rate in surveys among patients in general practice.

Randomized trials were performed in Denmark and The Netherlands to determine the effect of mailed reminders on the response rate in surveys among patients in general practice. In both countries, general practitioners handed out questionnaires to 200 adult patients who came to visit them. An intervention group of 100 patients received reminders at 3 weeks after the visit, whereas a control group of the remaining 100 patients did not receive reminders. The response rate was significantly higher in the intervention groups than in the control group in The Netherlands (86% versus 55%, respectively) but not in Denmark (87% versus 81%, respectively). Mailed reminders can improve the response rate in surveys related to a general practice, but they are not effective in all situations.     

Nichtbestandenes Fachgespräch

Ohne Zusammenfassung