Postgraduate training in Oral- and Maxillofacial Surgery: Results of a survey among 74 German interns

The aim of this study was to asses a survey of residents to obtain relevant information about their current situation in training in Oral and Maxillofacial Surgery in Germany. Special focus was given to the personal and clinical preferences of the residents, their main subjects of interest and plans after residency. Furthermore, the different principles of education at German teaching hospitals were evaluated.Overall, 74 questionnaires were completed on a voluntary and anonymous basis by German residents for Oral and Maxillofacial Surgery. Participants’ mean age was 32.74 years (68% male, 27% female). Most participants were in the fifth year of training (32%) and members of the German Association of Oral and Maxillofacial Surgery (70%). This rate increased with progress in residency (p = 0.006). Most residents (70%) were employed at university hospitals, followed by non-university hospitals (26%) and private practices (4%). Residents from university hospitals (3.06 ± 0.39 years) were less advanced in training compared to residents from non-university hospitals and private practices (4.10 ± 0.54 years; p = 0.005). Part-time employed residents were significantly younger (30.64 ± 2.37 years) than full-time employed residents (33.25 ± 0.64 years, p = 0.002).Structured concepts of training existed in 64% of the hospitals, while training depending on the current year of residency (42%) was most common. Most of the residents would prefer a systematic rotation system (59%). Main subjects of clinical interest were aesthetic (50%) and orthognathic surgery (46%). The interest in dento-alveolar surgery (34%) significantly increased with participants’ age (p = 0.008). Clefts and malformations were favoured by few residents (16%). Most participants planned to specialize in facial plastic surgery after residency (76%).The data collected might give evidence for an increasing importance of structured training concepts in Oral and Maxillofacial Surgery. It might be relevant to enhance the interest and the excitement of residents for oncology, traumatology, cleft and malformation surgery.     

A preceding airway reaction to one allergen may lead to priming of the airway responses to another allergen

This study aimed to determine whether a preceding airway response to one allergen leads to priming of the airway responses to another allergen. Twelve asthmatic children who had positive prick tests to two allergens, Dermatophagoides pteronyssinus (D.p.) and German cockroach (CR), participated in a randomized, placebo-controlled crossover study. We performed two consecutive inhalation challenges, D.p. challenge being followed 48 h later by CR challenge. The effect of initial (D.p.) challenge on the early and late airway responses to the subsequent (CR) challenge (CR2) was examined by comparing the responses with those to CR challenge preceded by sham challenge (CR1). The geometric mean PD²⁰ of CR allergen in the CR2 was 2.8 BU (breath unit) (range of 1 SD; 0.77-10.4), which was 12.0-fold less than that (33.7 BU, 10.8-105.2) in the CR1. The administration of a 6.1–fold less dose (8.9 BU, 2.7-28.8) in the CR2 than hi the CR1 (54.5 BU, 44.1-69.3) provoked a similar degree of late-phase reactions (18.7±7.3% vs 15.8 ± 9.6%). Our data indicated that the early- and late-phase reactions to CR challenge were augmented by the preceding reaction to D.p. This suggests that a preceding airway response to one allergen may lead to priming, with enhancement of the early and late airway responses to the subsequent challenge with another allergen.     

Ludo van Bogaert (1897–1989) and the Bunge Institute

Ludo van Bogaert (1897-1989) was one of the most distinguished neuroscientists of the 20th century. He enjoyed worldwide recognition for his 753 publications, his countless lectures at Belgian and foreign universities and at international congresses, and his training of more than 300 specialists from all over the world in the Bunge Institute and the Born-Bunge Foundation. Finally, in 1957 he became the founder and president--during two terms of 4 years--of the World Federation of Neurology (WFN). His lifework finally merged in the University Institution Antwerp (UIA)--since 2003 University of Antwerp (UA)--and his memory also lives on by the generous donations of his library to the Royal Library Albert I at Brussels and his Rik Wouters' collection to the Royal Museum of Fine Arts at Antwerp.     

An epidemiological survey of dog bites presenting to the Emergency Department of a children''s hospital

German shepherds are the most popular registered breed of dog in South Australia, but are also the most hazardous to children, biting more often and more severely. A study of the victims of dog bites presenting to the Emergency Department of the Adelaide Children's Hospital over an 18 month period revealed that, although many breeds were involved, only German shepherds were implicated more frequently than their prevalence in the community. Attacks occurred most often in a domestic setting involving a friendly dog that was known to the victim. Boys were more often bitten than girls and children aged 1-6 years most commonly involved. Injuries to the face and scalp were frequent and the usual ones to require admission for suture under general anaesthetic. Some scarring was a common sequel and resulting fear of dogs remained with some children. Most attacks were reported to be unprovoked and a previous biting history on the part of the dog was uncommon. Parents who are contemplating obtaining a dog for a family pet should be made aware of these facts and advised regarding the biting hazards and possible prevention. The German shepherd situation especially should be brought to their attention.     

Functional properties of accessory atrioventricular pathways in Wolff-Parkinson-White syndrome: Clinical implications

The Wolff-Parkinson-White syndrome is an uncommon cardiac disorder due to the presence of an accessory atrioventricular pathway resulting in ventricular pre-excitation and supraventricular tachycardias. The recognition of the Wolff-Parkinson-White syndrome is important because of the potential for the development of extremely rapid ventricular rates during atrial fibrillation that may lead to ventricular fibrillation and sudden death. The diagnosis of the Wolff-Parkinson-White syndrome is obvious when classic delta waves and short P-R intervals are present, but the electrocardiographic manifestations of the syndrome may be subtle and vary considerably from patient to patient. Certain commonly used antiarrhythmic medications may be useful for the treatment of reciprocating tachycardia in these patients and yet prove to be ineffective—or even deleterious—in preventing excessively rapid conduction to the ventricles during atrial fibrillation. An appreciation of the functional properties of the accessory pathways in the Wolff-Parkinson-White syndrome and how they are affected by pharmacologic agents should result in improved recognition of this entity and more effective medical management of patients with a risk of sudden death.     

159例德国偏头痛患者的中医证候规律分析

该研究采用数据挖掘研究方法,收集从2013年1月—2015年3月期间在德国TCM-Klinik Bad K9tzting偏头痛患者住院病例159例。将病例内容分解为年龄、性别、职业等基本信息与头痛特点、头痛程度、伴随症状、舌脉诊等诊疗信息,并分别建立相应数据库。对原始数据进行数据标准化和数据清洗等,形成适合数据分析的数据形式。采用SPSS统计软件对数据库中性别、年龄、职业、头痛症状、伴随症状等变量进行频数统计分析,运用因子分析及聚类分析方法对症状信息进行分析。结果显示:德国偏头痛发生具有年龄普遍性;发病人群主要以脑力劳动者为主;具有发病周期长,且容易复发特点。归纳临床常见中医证型有:肝阳上亢型及气虚痰湿型。德国偏头痛发作时以前额部刺痛、反复发作、伴恶心呕吐,舌暗、苔薄白、弦脉、滑脉为最常见症状。     

Post-exposure prophylaxis for measles with immunoglobulins revised recommendations of the standing committee on vaccination in Germany

Passive immunisation with immunoglobulins as post-exposure prophylaxis after contact with measles is recommended by the German Standing Committee on Vaccination (STIKO) particularly for unprotected individuals at high risk of complications for whom active immunization is contraindicated, such as infants <6 months of age, immunocompromised patients and pregnant women. The efficacy of passive immunisation in preventing measles depends on how soon after exposure it is administered, the concentration of measles antibodies in the immunoglobulin products and dosage. Since the global introduction of standard active immunisation against measles and the concomitant reduction in virus circulation, the levels of measles virus (MV)-specific IgG antibodies in the population have dropped. Thus, the concentration of MV-specific antibodies in immunoglobulin products derived from human plasma donors has declined as the proportion of vaccinated donors has increased. The MV-neutralizing capacity of immunoglobulin products is not routinely tested in Germany. No official data exist on the concentrations of MV-specific IgG antibodies in individual batches of immunoglobulins available in Germany and the required minimum level for MV-specific IgG is not stipulated.The STIKO re-evaluated available data and measurements of MV-neutralizing capacities of available immunoglobulin (IgG) products in Germany at the National Reference Centre Measles, Mumps, Rubella at the Robert Koch Institute. Based on the findings, STIKO modified its previous recommendations on the post-exposure use of immunoglobulins (2001), especially with respect to risk groups, application and dosage. STIKO now recommends a single intravenous administration of immunoglobulins (400 mg/kg body weight) as soon as possible, preferably within six days, after exposure to measles, specifically for infants aged <6 months, susceptible pregnant women and immunocompromised patients.