Ist die Fachrichtung assoziiert mit der Selbstsicherheit im Umgang mit rationaler Antibiotikaverordnung?

Die Anaesthesiologie - Vor dem Hintergrund einer stetig zunehmenden Gesundheitsgefährdung durch multiresistente Erreger spielt neben der Bevölkerungsaufklärung, der Fachkenntnis und...     

Hat die Farbduplexsonographie noch eine Bedeutung gegenüber der Kontrastmittelsonographie in der Endoleak-Diagnostik nach EVAR?

Background and objectives

Multislice computed tomography angiography (CTA) is considered to be the gold standard for surveillance control after endovascular aneurysm repair (EVAR). In comparison color-coded duplex sonography (CCDS) showed less sensitivity in studies on the diagnostics of endoleaks but contrast-enhanced ultrasonography (CEUS) was comparable to CTA in sensitivity and specificity. The question arises whether CCDS can still play a role in surveillance control.

Material and Methods

This study gives a critical review of available literature between 1998 and 2013 in comparison to own results on the value of CCDS and the question whether Doppler sonographic assessment of the hemodynamics can contribute to assessing the danger of rupture of type II endoleaks.

Results and conclusion

The CCDS technique shows a sensitivity and specificity of over 95 % in the detection of type I and type III endoleaks and in studies on type II endoleaks these value were between 60 and 100 %.The advantages of CCDS compared to CEUS and CTA are in the assessment of flow characteristics and flow velocity (measured in the ostium of endoleaks) and the hemodynamics in endoleaks. It can differentiate between high-flow and low-flow endoleaks, show whether several endoleaks are present and therefore deliver additional information on the danger of rupturing. Endoleaks which are in danger of rupturing with higher spontaneous thrombosis rates show pendulum (bidirectional) flow with velocities less than 50 cm/s. For the detection of therapy relevant endoleaks, CCDS is sufficient for use as a surveillance control after EVAR given sufficient sound conditions and adequate adjustment of the equipment. In doubtful cases the findings should be controlled using CEUS or CTA.     

Testing a Gypsum Composite Based on Raw Gypsum with a Direct Admixture of Paraffin and Polymer to Improve Thermal Properties

The implemented new legal regulations regarding thermal comfort, the energy performance of residential buildings, and proecological requirements require the design of new building materials, the use of which will improve the thermal efficiency of newly built and renovated buildings. Therefore, many companies producing building materials strive to improve the properties of their products by reducing the weight of the materials, increasing their mechanical properties, and improving their insulating properties. Currently, there are solutions in phase-change materials (PCM) production technology, such as microencapsulation, but its application on a large scale is extremely costly. This paper presents a solution to the abovementioned problem through the creation and testing of a composite, i.e., a new mixture of gypsum, paraffin, and polymer, which can be used in the production of plasterboard. The presented solution uses a material (PCM) which improves the thermal properties of the composite by taking advantage of the phase-change phenomenon. The study analyzes the influence of polymer content in the total mass of a composite in relation to its thermal conductivity, volumetric heat capacity, and diffusivity. Based on the results contained in this article, the best solution appears to be a mixture with 0.1% polymer content. It is definitely visible in the tests which use drying, hardening time, and paraffin absorption. It differs slightly from the best result in the thermal conductivity test, while it is comparable in terms of volumetric heat capacity and differs slightly from the best result in the thermal diffusivity test.     

Effect of beta-adrenergic blockade on hormonal responses during continuous and intermittent exercise

Summary The modifying effect on exercise performance and neuroendocrine response of the nonselective beta blocker timolol (10 mg b.i.d. for 5 days) and the beta₁-selective beta blocker metoprolol (100 mg b.i.d. for 5 days) was studied. The hormones studied were growth hormone, prolactin, cortisol, renin, epinephrine, dopamine, and norepinephrine. The response was studied during short-term maximal dynamic exercise, using two different exercise protocols; continuous (n=11) and intermittent (n=9) bicycle ergometry, in normal healthy young men. Accumulated work on placebo was nearly identical in the two studies, but was significantly reduced by 10.4% and 6.6% with timolol and by 4.7% and 6.7% with metoprolol, during continuous and intermittent exercise, respectively. During continuous exercise, accumulated work was 5.8% lower (p<0.05) with timolol than with metoprolol. The hormonal plasma concentrations of all hormones except renin were higher during continuous exercise than during intermittent exercise. Beta blockade had no effect on baseline hormonal levels, but the response was markedly changed during exercise. Maximum epinephrine, cortisol, and prolactin responses increased after beta blockade; dopamine remained nearly unchanged; while the renin responses were attenuated. Norepinephrine concentrations were slightly increased during continuous exercise by beta blockade and rose in direct proportion to the increase in workload. During intermittent exercise, maximum norepinephrine levels were significantly reduced by beta blockade compared with placebo. Thus the effect of beta₁-selective and nonselective beta receptor blockade on circulating hormones does not seem to explain the reduced exercise capacity following beta blockade.     

Incorporation of N-acetyl-[14C]D-glucosamine and [3H]L-leucine by isolated pig gastric mucosal cells

Glycoprotein and protein production of isolated pig gastric mucosal cells were determined by the incorporation of N-acetyl-[14C]D-glucosamine ([14C]GlcNAc) and [3H]L-leucine ([3H]Leu) into acid-insoluble macromolecules (AIM). In four cell fractions (F1-F4), obtained by counterflow centrifugation, specific [14C]GlcNAc incorporation was greatest in the mucous cell-enriched F2. Tracer incorporation by F2 cells, proceeded linearly up to 20 h, was inhibited by cycloheximide or incubation at 0 degree C, and enhanced by PGE2 1 mumol/l. Gel chromatography of released AIM revealed that PGE2-stimulated [14C]GlcNAc incorporation was predominantly directed into high molecular weight (2 X 10(6) daltons) glycoproteins, whereas [3H]Leu incorporation was mainly related to proteins of albumin-like molecular weight. We conclude that incorporation of [14C]GlcNAc by enriched pig gastric mucous cells (F2), further analyzed by gel chromatography, is a suitable probe to study the production of high molecular weight gastric mucous glycoproteins in vitro.