Endoprothesenlockerungen

The life time of hip endoprostheses is in part limited by aseptic loosening. The aim of this study was to produce a digital system for recording shaft loosening in such endoprostheses using acceleration sensors. Four identical prosthetic shafts were each set with 3.2-axial acceleration sensors and placed in artificial femurs. In order to simulate a firm fit, one prosthesis was fixed with bone cement; a loose fit was fixed with a surrounding silicon shell 0.5 mm thick. Simulation of the transition from firm to loose in the other two prostheses was attained by the distal 2/3 or 1/3 being cemented, with the rest surrounded by a silicone shell. A weak oscillation was initiated via a damped falling weight. Using a fast Fourier transformation it was possible to make a global evaluation of the measurement curves. A wavelet transformation could be used to differentiate firm or loose prostheses. A third order Daubechies filter recognized the deviation in the main oscillation, made visible by an increase in amplitude. The results encourage the development of an implantable, telemetrically functioning total system which would allow digital quality assurance when integrated into the endoprosthesis.     

Synthesis and antimalarial activity of new atovaquone derivatives

In this paper we describe the design and synthesis of 18 derivatives of the antimicrobial atovaquone which were substituted at the 3-hydroxy group by ester and ether functions. The compounds were evaluated in vitro for their activity against the growth of Plasmodium falciparum, the malaria causing parasite. All the compounds showed potent activity, with IC₅₀ values in the range of 1.25–50 nM, comparable to those of atovaquone and much higher than chloroquine or quinine.     

Vom Konzept zur Praxis – Aktuelles in der Luftrettung

The 2006, annual meeting of the senior physicians and emergency medical technicians of the German Air Rescue Service (Deutschen Rettungsflugwacht, DRF) was titled “From Concept to Practice”. The themes of security in the air rescue services and the current practice of cardiopulmonary respiration were discussed. In addition, different concepts and networks for treating patients with acute coronary syndrome or severe trauma were presented. The training of emergency technicians and quality assessment using the database of the whole TeamDRF was explained. New helicopter stations as well as long-range transport using normal aviation by the TeamDRF were presented.     

Patch testing with beryllium alloy samples in guinea pigs

An experimental study was conducted in guinea pigs for the predictive assessment of the beryllium alloy hazard in occupational exposure of the skin to beryllium compounds. Guinea pigs were sensitized to beryllium sulfate according to the maximized Magnusson and Kligman test, and challenged with beryllium alloys and metallic copper, beryllium and aluminum samples. Results showed a delayed skin hypersensitivity reaction in 30 to 60% of pre-sensitized guinea pigs challenged with copper-beryllium alloys and aluminum-beryllium alloy. An inflammatory follicular reaction was induced by copper in both controls and pre-sensitized guinea pigs.     

Implications of a diagnosis of anorexia nervosa in a ballet school

Competitive pressures to achieve a slim body shape may be of importance in the etiology of eating disorders in ballet dancers. This study examines the presence of anorexia nervosa-like symptoms in a group of 49 female ballet students (mean age = 18.9 years, SD ± 1.9). All students were assessed for certain physical (weight and height) and psychological (Eating Attitude Test [EAT]) indices at the start of their academic training year. Thereafter, all subjects who presented with anorexia nervosa-like symptoms (EAT ≥ 30, and/or with current secondary amenorrhea or primary amenorrhea if aged 16 years or over) at the initial assessment, were invited for a semistructured interview (Morgan-Russel scales) to determine their diagnostic status. Another aim of the study was to assess the prognostic implications of a diagnosis of anorexia nervosa in this sample. All subjects previously interviewed were invited for a follow-up assessment at 10 months. Anorexia nervosa could be diagnosed in 2 students (4.1%), whilst another 4 students (8.2%) presented with “partial syndrome” anorexia nervosa. All diagnosed students managed to complete their academic training year. The development and implications of a diagnosis of anorexia nervosa in the ballet students are discussed.     

Psychosoziale Rehabilitation von Kindern und Jugendlichen mit körperlicher und/oder psychischer Erkrankung

The guidelines regarding medical rehabilitation have changed. When applying for medical rehabilitation, the International Classification of Functioning (ICF) must be used for young adults with somatic and/or psychiatric diseases. The ICF is an appropriate tool to assess the outcome of rehabilitation in children and adolescents. Nowadays the ICF is used in rehabilitation hospitals; in former times the Functional Independence Measure (FIM) was used. The different criteria of the ICF such as personal factors, environmental factors, body function and structure (impairment), activities (limitation) and participation (restriction) are explained. A case report is presented which shows the outcome of rehabilitation according to FIM and ICF in graphic form.     

Notfälle bei extrapyramidalen Erkrankungen

Zusammenfassung Extrapyramidalen Störungen liegen zwar meist chronische Erkrankungen zugrunde, jedoch kommt es unter Umständen auch zum akuten Auftreten oder zu einer dramatischen Verschlechterung bis hin zu lebensbedrohlichen Zuständen. So kann ein Infekt, Medikamentenentzug oder eine Exikkose bei Parkinson-Patienten eine akinetische Krise auslösen. Auch akute, therapieassoziierte Psychosen mit Halluzinationen, Verwirrtheits- und Unruhezuständen können beim Parkinson-Patienten eine Notfallbehandlung erforderlich machen. Akute medikamenteninduzierte Dystonien treten nach einer Latenz von Stunden bis Tagen nach der Therapie mit Neuroleptika auf. Diese Frühdyskinesien können mit i.v.-Gabe von Anticholinergika effektiv behandelt werden. Seltene Folge einer Neuroleptikatherapie ist das maligne neuroleptische Syndrom, das mit Hyperthermie, Rigor und Bewusstseinsveränderungen einhergeht und zur kardiopulmonalen Dekompensation führen kann. Auch hier ist eine rasche Diagnosestellung entscheidend.     

Schlaganfallverbund Essen

Modern stroke care is now comparable to the care for cardiac ischemia. Although there are 100 stroke units in Germany, only a few patients can be treated with all the options available with evidence-based medicine. The stroke network in Essen is based on a concept, which optimizes all elements of stroke care, from the acute onset to rehabilitation. The Essen manual on stroke summarizes all results of the local round table talks. Logistics for acute situations, recommendations for prehospital care, and requirements at admission are explained in detail. With networks for stroke, patient care can be optimized and costs can be saved.