Die blöde Kuh macht muuhh: Eigenschaften, die wir Tieren zuerkennen (German Edition)

High energy trauma mechanism OR 1. In polytrauma patients, most DDI were found during hospital admission but after tertiary survey. This demonstrates that the tertiary survey should be an ongoing process and thus repeated daily in polytrauma patients. Most frequent DDI were extremity injuries, especially injuries of the hand and foot.

• .
• .
• The Art Of Self Empowerment (The little book of happiness. 3).
• Reel with a Jilt (The Quadrille Book 2)?

Risk profile and prognostic factors. In the German population, the percentage of elderly patients is increasing, and consequently there are more elderly patients among trauma cases, and particularly cases of polytrauma. The aim of this study was to present clinical results and a risk profile for geriatric polytrauma patients. Review of geriatric over 65 years of age polytrauma patients who received prehospital treatment was performed. Age, hemoglobin Hb level, systolic blood pressure BP , Glasgow Coma Scale GCS score, timing of and necessity for intubation were analyzed in relation to mortality and in comparison with younger patients.

Despite equivalent severity of injury HPTS less age points in geriatric and non-geriatric groups, mortality rate was 4 times higher in geriatric group. Major blood loss with Hb polytrauma patients. Rostock Germany ; Sonnenburg, M. Rostock Germany ; Scheufler, O. Frankfurt am Main Germany. An vier Fallbeispielen werden rationale Diagnostik und Therapie erlaeutert.

Vier Patienten stellten sich in der Ambulanz mit chronischen Beschwerden beim Kauen und Fremdkoerpergefuehl in der Tonsillenregion vor. Bei der gezielten Palpation unterhalb des Kieferwinkels verstaerkte sich ein in die Ohrregion hineinziehender Schmerz. Eine Lokalanaesthesie mittels Lidocain fuehrte bei allen Patienten lediglich zur temporaeren Beschwerdefreiheit.

Die dann durchgefuehrte bildgebende Diagnostik umfasste zunaechst Schaedeluebersichtsaufnahmen nach Clementschitsch sowie im lateralen Strahlengang und ein OPTG. Eine elektive Resektion bei lateral externem Zugangsweg von retromandibulaer wurde als Therapie durchgefuehrt. Die geometrisch korrigierte Addition der axialen CT-Schnittbilder ergab eine absolute Laenge von mm. Eine Ossifikation des Ligamentum stylohyoideum konnte unter Beruecksichtigung der bildgebenden Verfahren in jedem Fall ausgeschlossen werden. Nach Resektion des Megastyloid waren alle Patienten vollstaendig beschwerdefrei.

Als Therapie der Wahl gilt die Resektion des Megastyloid, wobei sich ein von aussen lateral gewaehlter Zugangsweg bewaehrt hat. Bladder injuries frequently missed in polytrauma patients. Bladder injuries are very common in patients who have had road traffic accidents. The method of diagnosis and management of such injuries is well established and accepted. However, trauma to the bladder can be associated with other life-threatening injuries which are frequently missed, and often diagnosed during laparotomy for other reasons.

The aim of this study was to diagnose bladder injury in polytrauma patients as early as possible, taking into consideration the fact that these patients are hemodynamically unstable and require rapid evaluation and management. In order to achieve our objective, we used bedside sonography with retrograde instillation of normal saline to diagnose bladder injury in addition to use of the conventional retrograde cystogram. Commonly chronic obstructive pulmonary disease COPD is the cause of dyspnoe or loss of performance in the horse. Tracheobronchoscopy, cytology of tracheobronchial aspirates, interpleural pressure measurement, and arterial blood gas analysis improved diagnosis of equine respiratory disorders.

Yet some intrathoraeie diseases, especially chronic pneumonia, are differential diagnosis problems. Radiography of the thorax improves the diagnosis of pneumonia and some other intrathoraeie diseases. The technique of the radiography of the thorax is described and radiographic findings in horses suffering from respiratory diseases are evaluated.

Tracheobronchoskopie, Tracheobronchialsekretzytologie, interpleurale Druckmessung und arterielle Blutgasanalyse verbesserten die Diagnostik respiratorischer Erkrankungen. Dennoch bestehen Probleme hinsichtlich der Differentialdiagnose zur COB, und zwar insbesondere bei chronischen Pneumonien. Fractures of the cervical spine. Diagnostic procedures in patients with severe cranio-cervical trauma; HWS-Frakturen. Diagnostik bei polytraumatisierten Patienten. Muenster Germany ; Schuierer, G. Muenster Germany ; Hufendiek, A. Muenster Germany ; Peters, P. The purpose of our study was to analyze diagnostic procedures of the cervical spine in severely traumatized patients.

Findings in plain radiographs and computer radiography of patients were evaluated. The image quality of the plain radiographs was examined. Casualty reports were evaluated retrospectively. Frequency, distribution and morphology of cervical spine fractures were analyzed: Twenty of the fractures diagnosed in CT were not diagnosed in plain radiography and 7 fractures were uncertain findings; 5 fractures were not detected at the casualty site.

A new screening procedure in patients with severe head injury is introduced. Retrospektiv wurden Roentgenaufnahmen und Computertomogramme der HWS von polytraumatisierten Patienten analysiert. Konventionelle HWS-Aufnahmen wurden in bezug auf ihre Qualitaet untersucht und der Befund der konventionellen Aufnahmen mit dem der Computertomographie verglichen.

Die Befunde vom Unfalltag wurden den retrospektiv validierten Befunden gegenuebergestellt. Ein neues Untersuchungsprotokoll mit routinemaessiger computertomographischer Untersuchung von HWK 1 und 2 bei Schaedel-Hirn-Traumata wird vorgestellt. A rat model of concurrent combined injuries polytrauma. Polytrauma , a combination of injuries to more than one body part or organ system, is common in modern warfare and in automobile and industrial accidents.

The combination of injuries can include burn injury, fracture, hemorrhage, trauma to the extremities, and trauma to specific organ systems. To investigate the effects of combined injuries, we have developed a new and highly reproducible model of polytrauma. This model combines burn injury with soft tissue and gastrointestinal GI tract trauma. We asked whether multiple minor injuries, when combined, would result in a distinct phenotype, different from single minor injuries or a more severe single injury. It has been suggested that models utilizing combinatorial injuries may be needed to more accurately model the human condition.

We believe our model is ideal for studying the complex sequelae of polytrauma , which differs from single injuries. Insights gained from this model may suggest better treatment options to improve patient outcomes. Clinical diagnosis versus autopsy findings in polytrauma fatalities. Full Text Available Abstract Objectives The aim of the study was to determine if differences in clinical diagnosis versus autopsy findings concerning the cause of death in polytrauma fatalities would be detected in 19 cases of fatal polytrauma from a Level 1 trauma centre.

Methods Clinical diagnoses determining the cause of death in 19 cases of fatal polytrauma - from a Level 1 trauma centre were correlated with autopsy findings. Obvious and marginal discrepancies mostly occurred in the early phase of treatment, especially when severely injured patients were admitted to the emergency room undergoing continued cardiopulmonary resuscitation, i. Conclusions Autopsy as golden standard to define the cause of death in fatal polytrauma varies from the clinical point of view, depending on the patient's pre-existing condition, mechanism of polytrauma , necessity of traumatic cardiopulmonary resuscitation, survival time, and thus the possibility to perform emergency diagnostics.

An autopsy should be performed at least in cases of early fatal polytrauma to help establishing the definite cause of death. Moreover, autopsy data should be included in trauma registries as a quality assessment tool. Full Text Available Abstrak: Tujuan penelitian adalah mengembangkan dan menerapkan tes diagnostik pilihan ganda tiga tingkat untuk mengukur pemahaman representasi grafik mahasiswa terkait esensi inkuiri sains dan materi optika geometri.

Instrumen tes diagnostik terlebih dahulu didesain kemudian disempurnakan selama proses, direvisi, dan digunakan untuk mendeteksi dan menilai pemahaman representasi grafik mahasiswa calon guru fisika. Instrumen tes telah dikembangkan untuk dapat mendiagnosis dan memperbaiki kesalahan-kesalahan yang dilakukan calon guru fisika terkait dengan keterampilan mengonstruk grafik, menemukan kesulitan-kesulitan dalam membaca dan menginterpretasi grafik.

Analisis data dilakukan secara kualitatif dan kuantitatif. Hasil studi menunjukkan pembacaan grafik dan keterampilan menginterpretasi grafik calon guru fisika masih belum memadai dan juga kemahiran dalam menganalisis grafik bergantung pada jenis grafik dan level atau tipe pertanyaan yang dikembangkan. The study was conducted using mixed methods and carried out with 83 prephysics teachers at a University of Teachers Education in North Sumatera. Test instrument was developed to diagnose and correct the mistakes made by pre-service physics teachers about construction graphic skills, difficulties in the reading and interpretation.

Catecholamine dependency in a polytrauma patient: A year-old polytrauma patient was admitted post-operatively to the intensive care unit. His situation deteriorated with hemodynamic instability and continuous high fever. An infectious focus could not be found and repeated cultures remained negative. Empirical administration of antibiotics and. Management of pediatric polytrauma patients is one of the most difficult challenges for orthopaedic surgeons. Multisystem injuries frequently include complex orthopaedic surgical problems that require intervention.

The physiology and anatomy of children and adolescent trauma patients differ from the physiology and anatomy of an adult trauma patient, which alters the types of injuries sustained and the ideal methods for management. Errors of pediatric polytrauma care are included in two broad categories: Diagnoses may be missed most frequently because of a surgeon's inability to reliably assess patients who have traumatic brain injuries and painful distracting injuries. Cervical spine injuries are particularly difficult to identify in a child with polytrauma and may have devastating consequences.

In children who have multiple injuries, the stabilization of long bone fractures with pediatric fixation techniques, such as elastic nails and other implants, allows for easier care and more rapid mobilization compared with cast treatments. Adolescent polytrauma patients who are approaching skeletal maturity, however, are ideally treated as adults to avoid complications, such as loss of fixation, and to speed rehabilitation. Ellbogen- und Handgelenksendoprothetik beim Rheumatiker - Richtlinien und Rehabilitation.

An beiden Gelenken haben sich einzelne Implantate oder Designs durchgesetzt. Operationstechniken und Nachuntersuchungsergebnisse sind publiziert. Epidemiology of distal radius fractures in polytrauma patients and the influence of high traumatic energy transfer. For several extremity fractures differences in morphology, incidence rate and functional outcome were found when polytrauma patients were compared to patients with an isolated injury.

This is not proven for distal radius fractures DRF. Therefore, this study aimed to analyse fracture morphology in relation to energy transfer in both poly- and mono-trauma patients with a DRF. This was a retrospective cohort study. All patients aged 16 years and older with a DRF were included.

Patients with an Injury Severity Score of 16 or higher were classified as polytrauma patients. Injuries were defined as high or low energy. The incidence rate of DRF in polytrauma patients was 3. More type C DRF were found in polytrauma and high-energy monotrauma patients versus low-energy monotrauma patients. Operative intervention rates for all types of DRF were similar for polytrauma and high-energy monotrauma patients.

Non-union rates were higher in polytrauma patients. Higher energy mechanisms of injury, in polytrauma and high-energy monotrauma patients, were associated with more severe complex articular distal radius fractures and more ipsilateral upper extremity injuries. Polytrauma and high-energy monotrauma patient have a similar fracture morphology. However, polytrauma patients have in addition to more injured body regions also more non-union related interventions than high-energy monotrauma patients.

The complexity of the cases of critically ill polytrauma patients is given by both the primary, as well as the secondary, post-traumatic injuries.

1. Internet: « Que sais-je ? » n° 3073 (French Edition)!
2. Weight Loss Boss: Eating Disorders Battle Won by Taking Charge of Your 20 day Burn Fat,Weight Loss Motivation (Get Fit Especially for Women)?
3. New Realm Vol. 01 No. 10.
4. !

The severe injuries of organ systems, the major biochemical and physiological disequilibrium, and the molecular chaos lead to a high rate of morbidity and mortality in this type of patient. The 'gold goal' in the intensive therapy of such patients resides in the continuous evaluation and monitoring of their clinical status. Moreover, optimizing the therapy based on the expression of certain biomarkers with high specificity and sensitivity is extremely important because of the clinical course of the critically ill polytrauma patient. In this paper we wish to summarize the recent studies of biomarkers useful for the intensive care unit ICU physician.

For this study the available literature on specific databases such as PubMed and Scopus was thoroughly analyzed. Each article was carefully reviewed and useful information for this study extracted. The keywords used to select the relevant articles were "sepsis biomarker", "traumatic brain injury biomarker" "spinal cord injury biomarker", "inflammation biomarker", "microRNAs biomarker", "trauma biomarker", and "critically ill patients".

For this study to be carried out original type articles were analyzed, as well as case reports and reviews. For this review, 89 articles with relevant topics for the present paper were selected. The critically ill polytrauma patient, because of the clinical complexity the case presents with, needs a series of evaluations and specific monitoring.

Recent studies show a series of either tissue-specific or circulating biomarkers that are useful in the clinical status evaluation of these patients. The biomarkers existing today, with regard to the critically ill polytrauma patient, can bring a significant contribution to increasing the survival rate, by adapting the therapy according to their expressions. Nevertheless, the necessity remains to. Abteilung Neuroradiologie; Universitaetsklinikum Heidelberg Germany. Neurologische Klinik; Schmitter, M. Poliklinik fuer zahnaerztliche Prothetik; Universitaetsklinikum Heidelberg Germany.

The radiologist must be familiar with the anatomy and pathology of the TMJ. Therefore close interdisciplinary cooperation between dentist and radiologist is necessary. Diese Uebersicht stellt neben MRT-Protokollen die Anatomie und die pathologischen Befunde des Kiefergelenks bei geoeffnetem und geschlossenem Mund anhand von Abbildungen und Graphiken systematisch dar. Bildgebende Diagnostik des Kiefergelenks gruendet sich auf eine standardisierte klinische und magnetresonanztomographische Untersuchung und erfordert eine enge interdisziplinaere Kooperation zwischen Zahnmedizin und Radiologie.

Injury mechanisms, patterns and outcomes of older polytrauma patients: An analysis of the Dutch Trauma Registry. Background Polytrauma patients nowadays tend to be older due to the growth of the elderly population and its improved mobility. The aim of this study was to compare demographics, injury patterns, injury mechanisms and outcomes between younger and older polytrauma patients. Characteristics of polytrauma patients with posttraumatic stress disorder in a level 1 trauma center.

Tuinebreijer Wim ; L. Meylaerts Sven ; S. The aims of this study were to determine if the severity of injury is related to the prevalence of posttraumatic stress disorder PTSD in polytrauma patients and to review the personality traits of patients with PTSD. During and , polytrauma patients were. Full Text Available The components of mitochondria from the cells damaged by injury are a key component for the development of systemic inflammatory response syndrome SIRS under aseptic conditions.

At the same time, there is a significant increase in the plasma level of mitochondrial DNA mtDNA, which may be a prognostic marker for infectious complications in patients with severe polytrauma. Seven healthy volunteers and 25 polytrauma with polytrauma of a mean injury severity score ISS of There was a more than 2. Despite the growing role of imaging, trauma remains the leading cause of death in people below the age of 45 years in the western industrialized countries.

Trauma has been touted as the largest epidemic in the 20th century. The advent of MDCT has been the greatest advance in trauma care in the last 25 years. However, there are still challenges in CT imaging of the polytrauma individual including time restraints, diagnostic errors, radiation dose effects and bridging the gap between anatomy and physiology. This article will analyze these challenges and provide possible solutions offered by the unique design of the dual source CT scanner.

The utilization of dual source CT in imaging of polytrauma. Nitric oxide as an indicator for severity of injury in polytrauma. Patients with injuries to multiple organs or organ systems are in a serious risk of shock, multiorgan failure and death. Although there are scoring systems available to assess the extent of polytrauma and guide the prognosis, their usefulness is limited by their considerably subjective nature.

As the production of nitric oxide NO by many cell types is elevated in tissue injury, we hypothesized that serum concentration of NO and its oxidation products, NOx represents a suitable marker of polytrauma correlating with prognosis. We wanted to prove that nitric oxide could serve as an indicator for severity of injury in polytrauma. We measured serum NOx and standard biochemical parameters in 93 patients with various degrees of polytrauma , 15 patients with minor injuries and 20 healthy volunteers.

On admission, serum NOx was higher in patients with moderate polytrauma than both in controls and patients with minor injury, and it was even higher in patients with severe polytrauma. Surprisingly, NOx on admission was normal in the group of patients that required cardiopulmonary resuscitation or died within 48 hours after admission. In the groups, where it was elevated on admission, serum NOx dropped to normal values within 12 hours.

Full text of "PC Player German Magazine 2001-06" - Internet Archive

Blood lactate levels on admission were elevated in proportion to the severity of subsequent clinical course. Elevated serum NOx and blood lactate in patients with polytrauma are markers of serious clinical course, while normal NOx combined with a very high lactate may signal a fatal prognosis Fig.

Injury mechanisms, patterns and outcomes of older polytrauma patients—An analysis of the Dutch Trauma Registry. Differences in injury severity, trauma mechanism only data for the year , vital signs, injury patterns, ICU characteristics and hospital mortality were analyzed. Results Data of 25, polytrauma patients were analyzed. The older patients represented Trauma mechanism in the older patients was more likely to be a bicycle accident A: However, serious head injuries were seen more often in the older patients A: The hospital mortality was doubled for the older polytrauma patients Conclusion Elderly are involved more often in polytrauma.

Although injury severity did not differ between groups, the older polytrauma patients were at a higher risk of dying than their younger counterparts despite sustaining less high-energy accidents. Injury mechanisms, patterns and outcomes of older polytrauma patients-An analysis of the Dutch Trauma Registry. Polytrauma patients nowadays tend to be older due to the growth of the elderly population and its improved mobility.

Data of 25, polytrauma patients were analyzed. Elderly are involved more often in polytrauma. Full Text Available Introduction: The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, missed injuries still significant affect modern trauma services and its outcome.

Firstly assessed and treated accordingly to Advanced Trauma Life Support ATLS guidelines and treat the life threading conditions if present with follow-up short outcome for 28 days. The most common precipitate factor for missed injuries in my study was clinical evaluation error due to Inadequate diagnostic workup in And the second risk factor was Deficiency in Physical Examination in Lastly Incomplete assessment due to patient instability in And mostly increase the period of stay in the hospital and affect the outcome of polytrauma patients.

Are we making appropriately guided decisions? In order to improve care, an audit was performed of 59 patients meeting our own selection criteria for orthopaedic polytrauma between 1st January and 31st December It facilitates provision of best practice Early Appropriate Care, encompassing - multidisciplinary consultant decisions around the patient in our Neurological and Trauma Critical Care Unit, early full body trauma CT scans, serial measurements of lactate and fibrinogen levels, and out-of-hours orthopaedic theatre reserved for life-and-limb threatening injuries. Re-audit was conducted of 15 patients meeting selection criteria, admitted between 1st October and 31st March Significant improvements in recording of lactate and fibrinogen were demonstrated, both on admission lactate - ppolytrauma patients and it is recommended that either the GOS-E, or the EQ-5D scoring systems be introduced to assess this.

Published by Elsevier Ltd. Klinik fuer Chirurgie; Wick, M. Description and time analysis of a row MDCT protocol in the evaluation of multiple trauma patients considering transport, time of scanning, patient positioning, image reconstruction, and image interpretation. All time intervals including transport, patient positioning, scanning, duration of MPR, total time in the examination room, and time to first and final image interpretation were prospectively evaluated.

Furthermore, patient characteristics, trauma profiles, and mortality rates were recorded. Time analysis of row MDCT revealed the following results mean time standard deviation: Emergency room treatment and transport The mortality rate was Interleukin-6 and interleukin plasma levels and mRNA expression in polytrauma patients.

The pattern of cytokine levels in inflammation response has great impact on the outcome of polytrauma patients. Further study at the genetic level is needed to investigate inflammation process which may influence patient's outcome. Onkologische Diagnostik und Therapie. Highly specific methods are required for the diagnostic workup of focal hepatic lesions, since benign circumscribed liver changes are very common. Although cross-sectional imaging techniques have a high diagnostic accuracy, radionuclide imaging techniques such as colloid, red blood cell, or hepatobiliary scan are commonly performed when a benign lesion is assumed since these permit a definite diagnosis with high specificity.

The diagnosis of a primary or secondary malignant liver tumor, however, usually relies on radiological imaging techniques along, supported by needle biopsy. Whether positron emission tomography as a primary or supplementary diagnostic tool will have a role in the routine staging of malignant tumors remains to be determined. Hierfuer sind radiologische Schnittbildtechniken grundsaetzlich gut geeignet. Wenn aufgrund der sonographischen, computertomographischen oder magnetresonanztomographischen Befunde eine gutartige Laesion anzunehmen ist, werden jedoch haeufig ergaenzend die Kolloiderythrozyten- oder hepatobiliaere Szintigraphie - ggf.

Bei malignen primaeren oder sekundaeren Lebertumoren hingegen werden nuklearmedizinische Zusatzuntersuchungen seltener angefordert, da der radiologische Befund, ggf. Inwieweit sich der primaere oder ergaenzende Einsatz der Positronenemissionstomographie im Vergleich zu radiologischen Schnittbildtechniken beim Staging boesartiger Tumoren bewaehrt, ist noch nicht abschliessend geklaert. The deterioration of hemodynamics instantly endangers the patients' life after polytrauma. As accidental hypothermia frequently occurs in polytrauma , therapeutic hypothermia still displays an ambivalent role as the impact on the cardiopulmonary function is not yet fully understood.

We have previously established a porcine polytrauma model including blunt chest trauma, penetrating abdominal trauma, and hemorrhagic shock. We documented cardiovascular parameters and basic respiratory parameters. Pigs were euthanized after Our polytrauma porcine model displayed sufficient trauma impact. Resuscitation showed adequate restoration of hemodynamics. Induced hypothermia had neither harmful nor major positive effects on the animals' hemodynamics.

Though heart rate significantly decreased and mixed venous oxygen saturation significantly increased during therapeutic hypothermia. Mean arterial blood pressure, central venous pressure, pulmonary arterial pressure, and wedge pressure showed no significant differences comparing normothermic trauma and hypothermic trauma pigs during hypothermia.

Induced hypothermia after polytrauma is feasible. No major harmful effects on hemodynamics were observed. Therapeutic hypothermia revealed hints for tissue protective impact. But the chosen length for therapeutic hypothermia was too short. Nevertheless, therapeutic hypothermia might be a useful tool for intensive care after polytrauma. Future studies should extend therapeutic hypothermia. Full Text Available Background. Diagnostic imaging of compression neuropathy; Bildgebende Diagnostik von Nervenkompressionssyndromen. Compression-induced neuropathy of peripheral nerves can cause severe pain of the foot and ankle.

Early diagnosis is important to institute prompt treatment and to minimize potential injury. Although clinical examination combined with electrophysiological studies remain the cornerstone of the diagnostic work-up, in certain cases, imaging may provide key information with regard to the exact anatomic location of the lesion or aid in narrowing the differential diagnosis.

MR imaging and ultrasound provide direct visualization of the nerve and surrounding abnormalities. Bony abnormalities contributing to nerve compression are best assessed by radiographs and CT. Knowledge of the anatomy, the etiology, typical clinical findings, and imaging features of peripheral neuropathies affecting the peripheral nerves of the foot and ankle will allow for a more confident diagnosis.

Eine fruehzeitige Diagnose ist entscheidend, um den Patienten der richtigen Therapie zuzufuehren und potenzielle Schaedigungen zu vermeiden oder zu verringern. Obschon die klinische Untersuchung und die elektrophysiologische Abklaerungen die wichtigsten Elemente der Diagnostik peripherer Nervenkompressionssyndrome sind, kann die Bildgebung entscheidend sein, wenn es darum geht, die Hoehe des Nervenschadens festzulegen oder die Differenzialdiagnose einzugrenzen. In gewissen Faellen kann durch Bildgebung sogar die Ursache der Nervenkompression gefunden werden.

In anderen Faellen ist die Bildgebung wichtig bei der Therapieplanung, insbesondere dann, wenn die Laesion chirurgisch angegangen wird. Magnetresonanztomographie MRT und Sonographie ermoeglichen eine. Diagnostic imaging in neonatal stroke; Bildgebende Diagnostik des Neonatal stroke. A cerebral artery infarction is an important differential diagnosis in the newborn with neurological abnormalities. Based on clinical data, its incidence is estimated to be 1 in newborns. Since the course is often subclinical, the true incidence is probably higher.

Cerebral ultrasound and Doppler sonography as readily available screening tools play a central role in the initial diagnosis of neonatal cerebral infarction. Definitive diagnosis is made by computed tomography or magnetic resonance imaging. Beside symptomatic anticonvulsive therapy, treatment aims at the prevention of secondary ischemic injury. Three term infants with different clinical courses of neonatal stroke are presented to sensitize the clinician and the radiologist for this probably underdiagnosed entity.

The role of imaging modalities in the diagnosis and follow-up of neonatal cerebral infarction is discussed. Die Inzidenz wird anhand von klinischer Daten auf 1: Da der Verlauf oft subklinisch ist, liegt die wahre Inzidenz wahrscheinlich hoeher. Bei der Diagnosestellung kommen dem Schaedelultraschall und der Doppelsonographie als leicht verfuegbaren Screening-Methoden eine zentrale Rolle zu.

Die definitive Diagnose wird, je nach Verfuegbarkeit, mittels Computertomographie oder Kernspintomographie gestellt. Die Behandlung ist neben der symptomatischen antikonvulsiven Therapie auf die Vermeidung von ischaemischen Sekundaerschaeden gerichtet. Wir wollen mit der vorliegenden Arbeit anhand von 3 Kindern mit verschiedenen klinischen Verlaeufen eines sog. Neonatal stroke den Stellenwert der bildgebenden Verfahren bei der Diagnostik und Verlaufskontrolle aufzeigen und die Sensibilitaet fuer dieses vermutlich unterdiagnostizierte Krankheitsbild erhoehen.

Diagnostic imaging in child abuse; Bildgebende Diagnostik der Kindesmisshandlung. Diagnostic imaging in child abuse plays an important role and includes the depiction of skeletal injuries, soft tissue lesions, visceral injuries in 'battered child syndrome' and brain injuries in 'shaken baby syndrome'. The use of appropriate imaging modalities allows specific fractures to be detected, skeletal lesions to be dated and the underlying mechanism of the lesion to be described.

Du dumme Kuh!

The imaging results must be taken into account when assessing the clinical history, clinical findings and differential diagnoses. Computed tomography CT and magnetic resonance imaging MRI examinations must be performed in order to detect lesions of the central nervous system CNS immediately. CT is necessary in the initial diagnosis to delineate oedema and haemorrhages. Early detection of brain injuries in children with severe neurological symptoms can prevent serious late sequelae. MRI is performed in follow-up investigations and is used to describe residual lesions, including parenchymal findings.

Trotz scheinbar leerer Anamnese gelingt es, typische Verletzungsmuster als Misshandlungsfolge zu erkennen, sowohl im Bereich des Skeletts, der Weichteile, des Abdomens 'battered child syndrome', heute: Den klinischen Symptomen entsprechend, wird im Verdachtsfall ein adaequates diagnostisches Verfahren eingesetzt, das erwartete charakteristische Befunde nachweist, den Mechanismus der Verletzung aufzeigt und das Alter der Laesionen annaehernd festlegt. Radiologische Skelettbefunde werden hinsichtlich ihrer Spezifitaet fuer eine Misshandlung bewertet.

Alle Resultate der Bildgebung sind zusammen mit Anamnese und klinischen Befunden zu deuten. Whole body staging stands at the beginning of the diagnostic algorithm in CUP syndrome to localize a potential primary tumor. In der Ganzkoerperbildgebung hat die CT eine hohe Sensitivitaet fuer Tumoren, die haeufig als metastasierte Tumorerkrankung auftreten.

Nuclear medicine pulmonary diagnosis; Nuklearmedizinische Diagnostik der Lunge. The most important indication for ventilation scintigraphy is the prediction of postoperative pulmonary function, which is still performed in many hospitals with perfusion scintigraphy, and with which, in turn, intrapulmonary right-left shunts can be simply and also semiquantitatively recorded.

The self-cleaning mechanism of the lung can be quantitatively examined using mucociliary and resorptive clearance. The clinical areas of application are limited for methodical reasons. Wichtigste Indikation fuer die Ventilationsszintigraphie ist die Voraussage der postoperativen Lungenfunktion, die vielerorts noch mit der Perfusionsszintigraphie durchgefuehrt wird, mit der sich wiederum intrapulmonale Rechts-links-Shunts einfach und auch semiquantitativ erfassen lassen. Die Selbstreinigungsmechanismen der Lunge lassen sich mit der mukoziliaeren.

Diagnosis of shoulder impingement syndrome; Diagnostik des Schulterimpingementsyndroms. Die 3 Stadien Einblutung und Oedem, Tendionpathie und Bursitis, Rotatorenmanschettenlaesion sind klinisch nicht einfach zu unterscheiden und zu quantifizieren. Die bildgebende Diagnostik spielt eine wesentliche Rolle zur Diagnose und Therapieplanung. Sie beginnt in der Regel mit konventionellen Roentgenaufnahmen. Damit werden indirekte Zeichen eines Schulterimpingements dargestellt, wie subchondrale Sklerosierung des Tuberculum majus, subakromiale Osteophyten und Formvarianten des Aktromions.

Fortgeschrittene Rupturen sind infolge Humerushochstands direkt erkennbar. Die Roentgenuntersuchung stellt auch Differentialdiagnosen wie die Tendinitis calcarea, Frakturen und Neoplasien dar. Als Zusatzuntersuchung fuer die Weichteildiagnostik ist die Sonographie geeignet. Sie stellt Veraenderungen der Rotatorenmanschetten und der Bursa subacromialis dar. Voraussetzungen fuer reproduzierbare Resultate sind allerdings eine geeignete Ausruestung und ein erfahrener Untersucher. Die MRT ist wegen ihrer geringeren Untersuchungsabhaengigkeit und hoeherer Spezifitaet vor allem fuer chirurgische Therapieentscheide und die dazugehoerende Operationsplanung vorzuziehen.

Early structural changes of the heart after experimental polytrauma and hemorrhagic shock. Evidence is emerging that systemic inflammation after trauma drives structural and functional impairment of cardiomyocytes and leads to cardiac dysfunction, thus worsening the outcome of polytrauma patients. This study investigates the structural and molecular changes in heart tissue 4 h after multiple injuries with additional hemorrhagic shock using a clinically relevant rodent model of polytrauma.

We determined mediators of systemic inflammation keratinocyte chemoattractant, macrophage chemotactic protein 1 , activated complement component C3a and cardiac troponin I in plasma and assessed histological specimen of the mouse heart via standard histomorphology and immunohistochemistry for cellular and subcellular damage and ongoing apoptosis. Further we investigated spatial and quantitative changes of connexin 43 by immunohistochemistry and western blotting.

Our results show significantly increased plasma levels of both keratinocyte chemoattractant and cardiac troponin I 4 h after polytrauma and 2 h after induction of hypovolemia. Although we could not detect any morphological changes, immunohistochemical evaluation showed increased level of tissue high-mobility group box 1, which is both a damage-associated molecule and actively released as a danger response signal. Additionally, there was marked lateralization of the cardiac gap-junction protein connexin 43 following combined polytrauma and hemorrhagic shock.

These results demonstrate a molecular manifestation of remote injury of cardiac muscle cells in the early phase after polytrauma and hemorrhagic shock with marked disruption of the cardiac gap junction. This disruption of an important component of the electrical conduction system of the heart may lead to arrhythmia and consequently to cardiac dysfunction.

Molecular Characterization of the Early Inflammatory Response. The molecular mechanisms of the immune response after polytrauma are highly complex and far from fully understood. In this paper, we characterize a new standardized polytrauma model in rats based on the early molecular inflammatory and apoptotic response. Sham-operated rats served as negative controls. Polytraumatized PT rats showed a significant systemic and intrapulmonary release of cytokines, chemokines, and complement anaphylatoxins, compared to rats with isolated injuries or selected combinations of injuries.

This new rat model appears to closely mimic the early immunological response of polytrauma observed in humans and may provide a valid basis for evaluation of the complex pathophysiology and future therapeutic immune modulatory approaches in experimental polytrauma. Kernpunkt dieser Arbeit ist die Entwicklung eines Sensorsystems zur medizinischen Diagnostik von Immunreaktionen. Als physikalische Grundlage dienen Senso Stabile KHK und Hypertonie: Goldstandard bleibt daher die Koronarangiographie. Imaging of chronic osteomyelitis; Chronische Infektionen des Skelettsystems.

Domaene der Computertomographie sind Beurteilung diskreter oder komplexer knoecherner Veraenderungen sowie die CT-gesteuerte Biopsie und ggf. Die MRT erbringt die hoechste Sensitivitaet und Spezifitaet bei derzeit optimalem Kontrast im Knochenmark und den Weichteilen sowie gleichzeitig hoher anatomischer Aufloesung.

Exemplarisch werden am Beispiel der primaer chronischen Osteomyelitiden, der posttraumatischen Osteomyelitis sowie der tuberkuloesen Spondylitis und der Infektion beim Diabetiker die Befunde der Bildgebung und ihre Wertigkeit mit besonderer Beruecksichtigung der MRT dargestellt. Polytrauma Defined by the New Berlin Definition: Polytrauma patients are expected to have a higher risk of mortality than that obtained by the summation of expected mortality owing to their individual injuries.

Patients with burn injury or incomplete registered data were excluded. Categorical data were compared with two-sided Fisher exact or Pearson chi-square tests. The unpaired Student t -test and the Mann-Whitney U -test was used to analyze normally distributed continuous data and non-normally distributed data, respectively. Propensity-score matched cohort in a 1: The polytrauma patients had a significantly higher ISS than non- polytrauma patients median interquartile range Q1-Q3 , 29 vs.

In addition, a higher proportion of polytrauma patients were admitted to the intensive. Full Text Available Penelitian ini bertujuan untuk: Penelitian ini menggunakan pendekatan Research and Development dengan perangkat lunak. Model pengembangan yang digunakan dalam penelitian ini adalah model modifikasi linear sequential yang disebut juga sebagai classic life cycle atau model waterfall yang memiliki 4 langkah. Analisis kebutuhan sistem dan perancangan sistem telah dilakukan pada tahun kedua.

Implementasi dan validasi program dilakukan pada tahun keempat. Validasi sistem dilakukan dengan angket yang diberikan kepada 6 dosen yang mengampu di jurusan teknik pendidikan mesin untuk melihat aspek kinerja, rancangan, dan aksesbilitas sistem. Analisis data validasi dilakukan dengan statistik deskriptif.

Langkah terakhir, evaluasi pemanfaatan sistem, akan dilaksanakan pada tahun kelima. Sistem tes diagnostik kesulitan belajar akan dikembangkan dengan arsitektur web client-server. Sistem ini memiliki tiga kelompok pengguna, yaitu admin, dosen, dan mahasiswa. Hasil analisis aspek kinerja, rancangan, dan adaptabilitas sistem secara keseluruhan akan dianalisis dari angket yang mempunyai rata-rata penilaian yang diperoleh dari skala 1—4, sehingga termasuk kategori sangat baik. Karena itu sistem yang telah dikembangkan dapat digunakan pada penelitian lebih lanjut pada tahun keenam, yaitu evaluasi pemanfaatan sistem.

Des Weiteren konnten mithilfe von anatomischen Fractures and dislocations of the hand in polytrauma patients: Incidence, injury pattern and functional outcome. Injuries of the hand can cause significant functional impairment, diminished quality of life and delayed return to work. However, the incidence and functional outcome of hand injuries in polytrauma patients is currently unknown.



The aim of this study was to determine the incidence, distribution and functional outcome of fractures and dislocation of the hand in polytrauma patients. A single centre retrospective cohort study was performed at a level 1 trauma centre. Polytrauma was defined as patients with an Injury Severity Score of 16 or higher. Fractures and dislocations to the hand were determined. Patients were contacted years after trauma. In a cohort of polytrauma patients 72 patients 3. As an example, of the 5 patients with the worst outcome scores 3 suffered an isolated phalangeal injury, all had concomitant upper extremity injury or neurological injuries 3 plexus injuries, 1 severe brain injury.

The incidence of hand injuries in polytrauma patients is 3. Metacarpal and carpal bones were most frequently affected. The functional extremity specific outcome scores are highly influenced by concomitant injuries upper extremity injuries, neurological injuries and higher ISS. Evaluation of standardized and applied variables in predicting treatment outcomes of polytrauma patients. Polytrauma is defined as an injury where they are affected by at least two different organ systems or body, with at least one life-threatening injuries.

Given the multilevel model care of polytrauma patients within KCUS are inevitable weaknesses in the management of this category of patients. To determine the dynamics of existing procedures in treatment of polytrauma patients on admission to KCUS, and based on statistical analysis of variables applied to determine and define the factors that influence the final outcome of treatment, and determine their mutual relationship, which may result in eliminating the flaws in the approach to the problem.

The study was based on polytrauma patients. Parametric and non-parametric statistical methods were used. Basic statistics were calculated, based on the calculated parameters for the final achievement of research objectives, multicoleration analysis, image analysis, discriminant analysis and multifactorial analysis were used. After the multicoleration analysis, since the image analysis gave a reliable measurement results, we started the analysis of eigenvalues, that is defining the factors upon which they obtain information about the system solve the problem of the existing model and its correlation with treatment outcome.

The study singled out the essential factors that determine the current organizational model of care, which may affect the treatment and better outcome of polytrauma patients. This analysis has shown the maximum correlative relationships between these practices and contributed to development guidelines that are defined by isolated factors. The aim of this retrospective study was an analysis of the occurrence of chest injuries in polytrauma patients and their surgical treatment in the Trauma Centre or Department of Surgery of the University Hospital Pilsen in a five-year period.

The demographic characteristics, mechanism of multiple trauma, ISS value and chest injury were recorded in each patient. The number of injured patients in each year of the study was noted. In the patients with chest injury, the type of injury and method of treatment were assessed. The therapy was further analysed including its timing. The number of deaths due to polytrauma involving chest injury, the cause of death and its time in relation to the patient's admission to the Trauma Centre were evaluated.

The average ISS of the whole group was 35 points. Chest injury was diagnosed in patients A total of patients with chest injury underwent surgery Chest drainage was the major surgical procedure used in the whole group. Of 61 patients who died, 52 had chest injury.

Full text of "PC Player German Magazine 2001-06" - Internet Archive

In the whole group, 32 polytrauma. The use of the Statscan digital X-ray unit in paediatric polytrauma. We present a 3-year review of clinical paediatric experience with the statscan Lodox Systems, Johannesburg, South Africa , a low-dose, digital, whole-body, slit-scanning X-ray machine. While focusing on the role of the unit in paediatric polytrauma , insight into its applications in other paediatric settings is provided. Sustaining family-centered care in Polytrauma Rehabilitation Centers.

The study assessed sustainability of the Family Care Map, a family-centered approach to providing care for Veterans with polytrauma -related injuries, in four Department of Veterans Affairs Polytrauma Rehabilitation Centers. We applied a mixed-methods approach. Staff surveys used standardized measures of sustainability, commitment to change, information, and participation during implementation. Qualitative inquiry assessed Family Care Map implementation and facilitators and barriers to sustainability. Staff sustainability perceptions had a significant positive correlation with affective commitment to change, participation, and information received about the change process.

Family Care Map integration into standard practices and use of its concepts with patients and families related to staff perceptions about sustainability. Some successful sustainability strategies included integration into daily workflow and organizational culture. Examples of sustainability barriers included staff awareness and use and outdated information. Some practices, such as measuring and documenting the use of the Family Care Map in treatment plans, may not routinely occur. The focus on family-centered care will require further evaluation of organization-, staff-, and innovation-level attributes that influence sustainability of changes designed to improve family-centered care.



1. Full text of "German American Annals".
2. Shopping Cart!
3. Africa after Apartheid: South Africa, Race, and Nation in Tanzania.
4. Ulnaris-Wetter in Leipzig.
5. Another Mr. Right!
6. .
7. ?

Is the golden hour optimally used in South Africa for children presenting with polytrauma? The major paediatric public health problem worldwide is injury or trauma. In , children died as a result of injury. The aim of this study was to evaluate the logistics of medical care after paediatric polytrauma within the first hours after arrival into. The aim of this study was to determine the incidence,. Effects of exogenous ubiquitin in a polytrauma model with blunt chest trauma. Objective To determine whether treatment with the CXC chemokine receptor CXCR 4 agonist ubiquitin results in beneficial effects in a polytrauma model consisting of bilateral femur fractures plus blunt chest trauma Injury Severity Score Subjects Seventeen Yorkshire pigs.

Measurements and Main Results Anesthetized, mechanically ventilated pigs underwent polytrauma , followed by a simulated 60 min shock phase. Ubiquitin treatment reduced arterial lactate levels and prevented a continuous decrease in arterial oxygenation, which occurred in the albumin group during resuscitation. Wet weight to dry weight ratios of the lung contralateral from the injury, heart, spleen and jejunum were lower with ubiquitin.

Conclusions Administration of exogenous ubiquitin modulates the local inflammatory response, improves resuscitation, reduces fluid shifts into tissues and preserves arterial oxygenation after blunt polytrauma with lung injury. This study further supports the notion that ubiquitin is a promising protein therapeutic and implies CXCR4 as a drug target after polytrauma. Severely injured patients represent a relevant financial cost factor in the health system especially for high level trauma centres. The introduction of a"diagnosis-related group" DRG system in Germany further revealed the potential negative economic impact of severely injured patients for trauma centres.

In recent years several changes of the specific DRG for severely injured patients occurred with the aim of a convenient reimbursement for the trauma patient. The present study analysed 38 multiply injured patients admitted in the first half of the year These patients were analysed in terms of the respective DRG that was attributed to the patient on the basis of the definition criteria for and In addition for the same patient group the total inpatient treatment costs were calculated according to the algorithm developed by the Working Group on Polytrauma of the German Trauma Society.

The analysis revealed three major problems in the reimbursement for severely injured patients according to the German DRG system: This attribution aspect is also currently relevant, since the definition criteria for a polytrauma DRG were not changed in or We conclude that besides the recent changes in the reimbursement for polytrauma DRGs, which have been at least partly adapted to the real financial burden of these patients, the definition of a severely injured patient in the German DRG system may also need to be revised.

Das ist das Ergebnis vieler Analysen und Entwicklungen der letzten Zeit. So stellte etwa die KPMG-Studie heraus, dass es beim E-Learning nicht nur auf gute Technologie ankommt, sondern die betriebliche Lernkultur und der Lerner wesentlich mehr als bisher einzubeziehen sind. Hvad kommer spytbaseret diagnostik til at betyde i klinisk odontologi fremover? Hopp, hopp, hopp im Schweinsgalopp? Dazu wird vom Wildschwein ausgehend das Normalverhalten betrac Sloboda und Alf Gabrielsson. C-Reactive Protein and Cytokines in Polytrauma.

Full Text Available Objective: Eighty-four victims with severe concomitant injury were examined. Glucocorticoids and specific immune drugs resulted in a reduction or complete disappearance of CRP. When the latter were discontinued, CRP appeared in the quantity reflecting the effect of treatment. In the absence of multiple organ dysfunctions, the level of CRP decreased as the infectious process diminished. The low level of CRP and the activation of an infectious process suggest the areactivity of an organism. Daily blood CRP analysis in injury makes it possible to predict visceral.

Full Text Available BackgroundSeverely injured patients experience substantial immunological stress in the aftermath of traumatic insult, which often results in systemic immune dysregulation. Regulatory T cells Treg play a key role in the suppression of the immune response and in the maintenance of immunological homeostasis. Little is known about their presence and dynamics in blood after trauma, and nothing is known about Treg in the porcine polytrauma model. Here, we assessed different subsets of Treg in trauma patients TP and compared those to either healthy volunteers HV or data from porcine polytrauma.

Your display name should be at least 2 characters long. At Kobo, we try to ensure that published reviews do not contain rude or profane language, spoilers, or any of our reviewer's personal information. You submitted the following rating and review. We'll publish them on our site once we've reviewed them.

Join Kobo & start eReading today

Item s unavailable for purchase. Please review your cart. You can remove the unavailable item s now or we'll automatically remove it at Checkout. Continue shopping Checkout Continue shopping. Ratings and Reviews 0 0 star ratings 0 reviews. Overall rating No ratings yet 0.