Skapula- und Glenoidfrakturen

Trauma und Berufskrankheit - Nur 0,4–1% aller Frakturen betreffen die Skapula, die meisten davon können erfolgreich konservativ funktionell behandelt werden. Zur Identifikation der...     

Minderung der Erwerbsfähigkeit (MdE) in der gesetzlichen Unfallversicherung

Trauma und Berufskrankheit - Die Expertengruppe zur Reform der Minderung der Erwerbsfähigkeit (MdE) unter der Schirmherrschaft der Deutschen Gesetzlichen Unfallversicherung (DGUV) hat die...     

Semmelweis und kein Ende

More than 150 years ago Ignaz Philipp Semmelweis introduced a method of infection prevention involving disinfection of the hands, which could be carried out by every patient. This method proved to be an effective way to lower the rate of complications and infections in his patients. Some 30 years later bacteria were identified as the cause of infections and therefore provided scientific support for the hypothetical hygiene regulations inaugurated by Semmelweis. Nowadays physicians have to cope with an ever-increasing number of multidrug-resistant bacteria and the development of new antibiotics cannot keep up with the increasing number of resistant strains. A more rational application of antibiotics in animal factory farming and human medicine has to be accomplished in order to reduce the selection pressure. The World Health Organization (WHO) and the G7 summit meeting in 2015 have recognized the problem and both have announced global action plans for more rationale in treatment with antibiotics. Nevertheless, the regulations Semmesweis thought out 150 years ago to prevent infections are still the most powerful tools in the fight against infections.     

Navigated total knee replacement. A meta-analysis

BACKGROUND: Proponents of navigated knee arthroplasty stress its potential to increase the precision of component placement. We conducted a systematic review and meta-analysis to substantiate the validity and relevance of this contention. METHODS: We searched major medical and publishers' databases for randomized trials and any other studies comparing navigated with conventional knee arthroplasty. Major periodicals were searched manually. We made no restrictions for types of studies or language. Methodological features were rated independently by two reviewers. After testing for publication bias and heterogeneity was done, the data were aggregated by random-effects modeling. We estimated the weighted mean differences of mechanical limb axes and functional scales and the risk ratios of deviations from the straight axis with 95% confidence intervals. RESULTS: We included thirty-three studies (eleven randomized trials) of varying methodological quality involving 3423 patients with a mean age (and standard deviation) of 67.3 +/- 4.1 years (62.6% were women, and 83.7% had primary osteoarthritis). The mean preoperative deviation from the mechanical axis was 2.3 degrees +/- 5.1 degrees. There was no evidence of publication bias, but there was strong statistical heterogeneity. The alignment of the mechanical axes did not differ between the navigated and conventional surgery group (weighted mean difference, 0.2 degrees; 95% confidence interval, -0.2 degrees to 0.5 degrees). Patients managed with navigated surgery had a lower risk of malalignment at critical thresholds of >3 degrees (risk ratio, 0.79; 95% confidence interval, 0.71 to 0.87) and >2 degrees (risk ratio, 0.76; 95% confidence interval, 0.71 to 0.82). No conclusive inferences could be drawn on functional outcomes or complication rates. Navigation lengthened the mean duration of surgery by 23%. CONCLUSIONS: Navigated knee replacement provides few advantages over conventional surgery on the basis of radiographic end points. Its clinical benefits are unclear and remain to be defined on a larger scale.     

Freiburger Arbeitsunfallstudie II (FAUST-II)

The background, design, and (preliminary) results of the ??Freiburg Study?? on the short- and long-term sequelae of accidental injury and effects on mental health are presented. The study evaluates whether systematic, initial screening for patients at risk to develop accident-related mental health problems is a useful first step in delivering more specific forms of psychodiagnosis and treatment. The implementation of a screening-based algorithm for diagnosis and treatment of mental health problems and disorders following work-related accidents is being studied under routine conditions in 18 trauma departments. Results for the first phase of this study are presented. Preliminary conclusions are discussed with reference to clinical guidelines for acute traumatization and diagnosis and treatment of chronic PTSD.     

Soils on exposed Sunda shelf shaped biogeographic patterns in the equatorial forests of Southeast Asia

The marked biogeographic difference between western (Malay Peninsula and Sumatra) and eastern (Borneo) Sundaland is surprising given the long time that these areas have formed a single landmass. A dispersal barrier in the form of a dry savanna corridor during glacial maxima has been proposed to explain this disparity. However, the short duration of these dry savanna conditions make it an unlikely sole cause for the biogeographic pattern. An additional explanation might be related to the coarse sandy soils of central Sundaland. To test these two nonexclusive hypotheses, we performed a floristic cluster analysis based on 111 tree inventories from Peninsular Malaysia, Sumatra, and Borneo. We then identified the indicator genera for clusters that crossed the central Sundaland biogeographic boundary and those that did not cross and tested whether drought and coarse-soil tolerance of the indicator genera differed between them. We found 11 terminal floristic clusters, 10 occurring in Borneo, 5 in Sumatra, and 3 in Peninsular Malaysia. Indicator taxa of clusters that occurred across Sundaland had significantly higher coarse-soil tolerance than did those from clusters that occurred east or west of central Sundaland. For drought tolerance, no such pattern was detected. These results strongly suggest that exposed sandy sea-bed soils acted as a dispersal barrier in central Sundaland. However, we could not confirm the presence of a savanna corridor. This finding makes it clear that proposed biogeographic explanations for plant and animal distributions within Sundaland, including possible migration routes for early humans, need to be reevaluated.     

Endogenous retroviral syncytin: compilation of experimental research on syncytin and its possible role in normal and disturbed human placentogenesis

Placental syncytin was first described in the year 2000 as a fusogenic glycoprotein originally derived from a human endogenous retroviral envelope gene. Although the presence of stable integrated retroviral elements within the human genome has been known for many years, their biological significance is still obscure and has usually been designated as irrelevant or even harmful. Syncytin, however, demonstrates tissue-specific expression and distinctive receptor interaction during trophoblast cell differentiation and syncytium formation. These findings indicate an involvement of syncytin in the development of the human placenta. Disturbances in placental architecture leading to severe placental dysfunction, such as pre-eclampsia, may therefore be discussed as a consequence of an altered syncytin system. We evaluate the hypothesis that syncytin is essential for human placenta formation and may also have played an important role in human placental evolution.     

Semmelweis und kein Ende

Trauma und Berufskrankheit - Vor mehr als 150 Jahren hat Ignaz Philipp Semmelweis eine Methode zur Infektionsvermeidung entwickelt, die darin bestand, eine Händedesinfektion vor jedem...     

Extracti-Gel D chromatography is a simple, efficient method for removing digitonin during receptor purification: application to the kl opioid receptor

Digitonin is widely used for extracting active neurotransmitter receptors from membranes. However, its low critical micellar concentration has made its removal from samples problematic. Here we report that digitonin can be efficiently removed (> 90%) from solution using Extracti-Gel^TM D, a detergent-absorbing matrix. Active K_l opioid receptors solubilized from brain survive Extracti-Gel^TM D chromatography with a recovery of 50–55% and 25% dilution by added volume. The loss of receptor and the dilution, however, are compensated for to a large extent by the disinhibition of binding that results from the removal of digitonin. Extracti-Gel^TM D chromatography had little or no effect on the apparent equilibrium dissociation constant for [³H]U-69,593 binding to the K_l receptor. We conclude that Extracti-Gel^TM D column chromatography is a simple, highly efficient and practical method for markedly reducing the concentration of digitonin in biological samples. Application of the procedure should allow characterization of digitonin-solubilized receptors with minimal complications from bound digitonin and extend the usefulness of digitonin to studies going beyond the initial stages of receptor purification.     

Zusammenhangsfrage bei Kniegelenkverletzungen

Trauma und Berufskrankheit - Knie- und Schulterschäden sind in der gesetzlichen Unfallversicherung immer wieder Anlass für eine Beauftragung von Zusammenhangsgutachten. Diese stellen an...