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This paper gives an overview of the changes in the sector of accident insurance companies over recent months and a prognosis for the changes that can still be expected, especially with reference to the election results.     

Ärztliche Beratung und Wahl der Geburtsklinik

The requirements for an efficient regionalization of high risk obstetrics include, among other things, a combination of out- and inpatient obstetricians, advice for pregnant woman provided in the antenatal care guidelines on the choice of the maternity hospital, and the acceptance of the gynecologist’s advice on the part of the pregnant woman with or without a high risk factor. The advice given in the antenatal care unit and the choice of maternity hospital were investigated using a random sample survey of clientele of a health insurance company. Some 20% of pregnant women with high risk did not receive a recommendation for a particular obstetrical unit. In approximately two thirds of all pregnant women, the choice of maternity hospital was not mentioned. Thus, the influence of the gynecologist on the choice of hospital was low.     

Modulation of locomotor activity of polymorphonuclear cells by cationic substances and cationic lysosomal fractions from human neutrophils

Seven cationic substances — human and egg-white lysozyme, RNase, protamine, histone, poly-l-lysine and poly-l-arginine; five cationic lysosomal fractions from human polymorphonuclears (PMNs); RNA; poly-l-glutamic acid; DNA; heparin; endotoxin; mastocytotropic agent compound 48/80; and cytochalasin B were tested for the influence on chemotaxis and random migration of human PMNs using under-agarose migration and Boyden chambers with two filters and [⁵¹Cr]PMNs. The above substances were either preincubated with PMNs, added to chemoattractants, or used instead of chemoattractants. In under-agarose migration method chemotaxis was inhibited by 11–35% when egg-white lysozyme, protamine, heparin, endotoxin, or compound 48/80 was added to the cells. High concentration of cytochalasin B inhibited chemotaxis by 73 %. Cationic fractions I and V and low concentration of cytochalasin B enhanced chemotaxis by 11%, 41%, and 30%, respectively. When human and egg-white lysozyme, DNA, or cytochalasin B was added to the chemoattractants, motility of PMNs was inhibited. Cationic fractions II and V from human PMNs, when used as chemoattractants, enhanced cellular motility by 143–167%. Random migration was enhanced by heparin and inhibited by cytochalasin B and by cationic fractions from human PMNs. These findings suggest that various cationic and anionic substances and cationic fractions from human PMNs have heterogeneous influence on random migration and chemotactic activity of human PMN. Analysis relating chemotaxis to phagocytosis and to intracellular bactericidal activity (ICBA) has shown several patterns. Protamine, poly-l-lysine, poly-l-arginine, and agent compound 40/80 all inhibit chemotaxis and enhance phagocytosis and ICBA; cationic fractions II and V enhanced all three functions, whereas cytochalasin B suppressed phagocytosis and ICBA and had concentration-dependent modulatory influence on chemotaxis. It implies diverse mechanisms of action and possible impact on inflammatory reactions.Supported by agrant-in-aid from the Medical Research Council of Canada.     

An Inexpensive and Easy Ultrasound Phantom

Ultrasound models, commonly referred to as “phantoms,” are simulation tools for ultrasound education. Commercially produced phantoms are available, but there are “homemade” alternatives such as raw poultry and gelatin molds. Precooked, processed meat, better known as SPAM (Hormel Foods Corporation, Austin, MN), can be used as an ultrasound phantom to teach several ultrasound applications. It is a versatile, hygienic, and easily manipulated medium that does not require refrigeration or preparatory work and can be easily discarded at the end of use.     

Swine-to-Human Transmission of Influenza A(H3N2) Virus at Agricultural Fairs,Ohio, USA, 2012

Agricultural fairs provide an opportunity for bidirectional transmission of influenza A viruses. We sought to determine influenza A virus activity among swine at fairs in the United States. As part of an ongoing active influenza A virus surveillance project, nasal swab samples were collected from exhibition swine at 40 selected Ohio agricultural fairs during 2012. Influenza A(H3N2) virus was isolated from swine at 10 of the fairs. According to a concurrent public health investigation, 7 of the 10 fairs were epidemiologically linked to confirmed human infections with influenza A(H3N2) variant virus. Comparison of genome sequences of the subtype H3N2 isolates recovered from humans and swine from each fair revealed nucleotide identities of >99.7%, confirming zoonotic transmission between swine and humans. All influenza A(H3N2) viruses isolated in this study, regardless of host species or fair, were >99.5% identical, indicating that 1 virus strain was widely circulating among exhibition swine in Ohio during 2012.     

Qualitätssicherung im ambulanten D-Arzt-Verfahren

Trauma und Berufskrankheit - Nach einem Arbeitsunfall erfolgt die ambulante medizinische Versorgung von Patienten durch spezialisierte Durchgangsärzte. Bisher existiert für diesen Sektor...     

Utility of snout wipe samples for influenza A virus surveillance in exhibition swine populations

Background

Sporadic influenza A virus (IAV) outbreaks in humans and swine have resulted from commingling of large numbers of people and pigs at agricultural fairs in the United States. Current antemortem IAV surveillance strategies in swine require collecting nasal swabs, which entails restraining pigs with snares. Restraint is labor-intensive for samplers, stressful for pigs, and displeasing to onlookers because pigs often resist and vocalize.

Objective

To evaluate the utility of snout wipes in exhibition swine as a method to make IAV surveillance efforts less intrusive, less labor-intensive, and more widely accepted among pig owners and exhibition officials.

Methods

Three materials (rayon/polyester gauze, cotton gauze, and Swiffer® Sweeper dry cloths) were inoculated with IAV, and viral recoveries from these materials were quantified using qRT-PCR and TCID₅₀ assays. In a field trial, paired cotton gauze snout wipes and gold standard polyester-tipped nasal swabs were collected from 553 pigs representing 29 agricultural fairs and the qualitative results of rRT-PCR and viral isolation were compared.

Results and Conclusions

Viral recoveries from potential snout wipe materials ranged from 0·26 to 1·59 log₁₀ TCID₅₀/ml less than that of the positive control in which no substrate was included; rayon/polyester gauze performed significantly worse than the other materials. In the field, snout wipes and nasal swabs had high levels of agreement for both rRT-PCR detection and virus isolation. Although further investigation and refinement of the sampling method is needed, results indicate that snout wipes will facilitate convenient and undisruptive IAV surveillance in pigs at agricultural fairs.