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  1. Introduction of a Diagnosis Related Groups’ Case Flat Rate System: Hopes and Fears (einfuerhrng eines drg-fallpauschalensystems - hoffnungen und aengste)

    Science.gov (United States)

    2000-06-01

    Anwendung und Pflege des neuen Systems dienen soil, wenn die entscheidenden Vorgaben bereits durch die Deckelung gegeben sind. Oder denkt man an den...Software und die da- mit verbundenen Lizenzgebuhren, sondern auch in der Folge um die Schulung der Mitarbeiter sowie die Pflege und Weiterentwicklung...sung an die medizinische Entwicklung" sowie von "Verfahren zur laufen- den Pflege des VergOtungssystems" gesprochen. Es mossen jedoch klare

  2. Diagnosis and differential diagnosis of hydrocephalus in adults; Diagnostik und Differenzialdiagnostik des Hydrozephalus beim Erwachsenen

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    Langner, Soenke; Mensel, Birger; Kuehn, Jens Peter; Kirsch, Michael [Univ. Medicine Greifswald (Germany). Inst. for Diagnostic Radiology and Neuroradiology; Fleck, Steffen; Baldauf, Joerg [Univ. Medicine Greifswald (Germany). Dept. of Neurosurgery

    2017-08-15

    Hydrocephalus is caused by an imbalance of production and absorption of cerebrospinal fluid (CSF) or obstruction of its pathways, resulting in ventricular dilatation and increased intracranial pressure. Imaging plays a crucial role in the diagnosis, differential diagnosis and planning of treatment. This review article presents the different types of hydrocephalus und their typical imaging appearance, describes imaging techniques, and discusses differential diagnoses of the different forms of hydrocephalus. Imaging plays a central role in the diagnosis of hydrocephalus. While magnetic resonance (MR) imaging is the first-line imaging modality, computed tomography (CT) is often the first-line imaging test in emergency patients.

  3. Radiological diagnosis of pulmonary metastases: imaging findings and diagnostic accuracy; Bildgebende Diagnose und Differenzialdiagnose von Lungenmetastasen

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    Diederich, S. [Institut fuer Diagnostische und Interventionelle Radiologie/Nuklearmedizin, Marienhospital Duesseldorf (Germany)

    2004-07-01

    Pulmonary metastases typically present as mostly multiple and bilateral, well-defined, non-calcified pulmonary nodules with predominantly basal and peripheral location. Ill-defined, cavitating, calcified and endobronchial metastases are uncommon. In the absence of pathognomonic findings precise differentiation from other - even benign - pulmonary nodules is almost impossible. Demonstration of contrast enhancement at CT or MRI or evidence of growth at serial examinations support the diagnosis of pulmonary metastases. In uncertain cases percutaneous fine-needle aspiration or cutting needle biopsy will allow diagnosis with acceptable risk of complications and patient discomfort. The only relatively common complication of pneumothorax can and should be controlled by the interventional radiologist by aspiration or drainage. (orig.) [German] Lungenmetastasen stellen sich bildgebend typischerweise als meist multiple und bilaterale, scharf begrenzte weichteildichte Lungenrundherde mit basal und peripher betonter Lokalisation dar. Unscharfe Begrenzung, Einschmelzungen, Verkalkungen oder endobronchiale Lage sind selten. Aufgrund fehlender pathognomonischer Befunde ist eine eindeutige differenzialdiagnostische Abgrenzung von anderen - auch benignen - Lungenrundherden jedoch kaum moeglich. Der computertomographische oder magnetresonanztomographische Nachweis einer Kontrastmittelaufnahme oder von Wachstum in Verlaufsuntersuchungen unterstuetzt die Diagnose. In Zweifelsfaellen fuehrt die perkutane Biopsie als Feinnadelaspiration oder Stanzbiopsie bei vertretbarer Belastung des Patienten meist zur Diagnose. Die einzige relativ haeufige Nebenwirkung - der postpunktionelle Pneumothorax - kann und sollte vom interventionellen Radiologen durch Aspiration oder Katheterdrainage selbst therapiert werden. (orig.)

  4. Sports-related injuries of the spine; Sportverletzungen und -schaeden der Wirbelsaeule

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    Hochmuth, K. [Orthopaedische Universitaetsklinik, Stiftung Friedrichsheim der Johann-Wolfgang-Goethe-Universitaet Frankfurt am Main (Germany); Institut fuer Diagnostische und Interventionelle Radiologie der Johann-Wolfgang-Goethe-Universitaet Frankfurt am Main (Germany); Mack, M.G.; Vogl, T.J. [Institut fuer Diagnostische und Interventionelle Radiologie der Johann-Wolfgang-Goethe-Universitaet Frankfurt am Main (Germany); Kurth, A.A.; Zichner, L. [Orthopaedische Universitaetsklinik, Stiftung Friedrichsheim der Johann-Wolfgang-Goethe-Universitaet Frankfurt am Main (Germany)

    2002-10-01

    Different sports show different patterns and frequencies of injuries, which are discussed in this paper. About 3% of all sports accidents relate to the spine. These injuries often have far-reaching consequences for the patients. A very early and extensive diagnosis of all changes is decisive for the start of an adequate therapy and thus for the prognosis of the injury. Radiological diagnosis is also of decisive importance for the documentation of late injuries and in the question of rehabilitation. Here special focus is put on MRT and CT diagnostics.A healthy spine of humans is normally able to resist all static and dynamic strains of the usual sports. However, anomalies and dysfunctions of the spine can reduce its capacity to resist strain. The recommendations of sporting activities are given according to the extent of deflection and the expected growth. The importance of radiology in primary diagnosis and in the follow-up due to typical changes like scoliosis, Morbus Scheuerman, spondylolysis and spondylolisthesis is discussed here as well. (orig.) [German] Die verschiedenen Sportarten weisen unterschiedliche Verletzungshaeufigkeiten und -muster auf, die im Rahmen dieser Uebersichtsarbeit diskutiert werden sollen. Circa 3% der Sportunfaelle betreffen die Wirbelsaeule. Diese Verletzungen sind haeufig von besonderer Tragweite fuer den Patienten. Eine fruehestmoegliche und umfassende Diagnose aller Veraenderungen ist dabei entscheidend fuer die Einleitung einer adaequaten Therapie und somit fuer die Prognose der Verletzung. Auch in der Dokumentation von Spaetschaeden und in der Frage der Rehabilitation kommt der radiologischen Diagnostik eine entscheidende Bedeutung zu. Ein besonderer Fokus wird dabei auf die Magnetresonanztomographie-(MRT-)und Computertomographie-(CT-)Diagnostik gelegt.Die gesunde Wirbelsaeule des Menschen ist in der Regel allen statischen und dynamischen Belastungen der ueblichen Sportarten gewachsen. Formanomalien und Funktionsstoerungen der

  5. Diagnosis and differential diagnosis of Graves' orbitopathy in MRI; Diagnose und Differenzialdiagnose der endokrinen Orbitopathie in der MRT

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    Daubner, D.; Spieth, S.; Engellandt, K.; Kummer, R. von [Universitaetsklinikum Carl Gustav Carus, Technische Universitaet Dresden, Abteilung Neuroradiologie, Institut und Poliklinik fuer Radiologische Diagnostik, Dresden (Germany)

    2012-06-15

    Imaging of Graves' orbitopathy (GO) includes radiological and nuclear medicine procedures. Depending on the method used they provide information about the distribution and activity of the disease. Magnetic resonance imaging (MRI) is not only a helpful tool for making the diagnosis it also enables differentiation of the active and inactive forms of GO due to intramuscular edema. The modality is therefore appropriate to evaluate the disease activity and the course of therapy. The disease leads to the typical enlargement of the muscle bodies of the extraocular muscles. The inferior rectus, medial rectus and levator palpebrae muscles are mostly involved. Signal changes of the intraconal and extraconal fat tissue are possible and a bilateral manifestation is common. The differential diagnosis includes inflammatory diseases and tumors, of which orbital pseudotumor (idiopathic, unspecific orbital inflammation), ocular myositis and orbital lymphoma are the most important. The specific patterns (localization, involvement of orbital structures and signal changes) can be differentiated by MRI. (orig.) [German] Die Bildgebung der endokrinen Orbitopathie (EO) umfasst radiologische und nuklearmedizinische Verfahren, die je nach Methode Aussagen zur Verteilung und Aktivitaet der Erkrankung liefern. Die Magnetresonanztomographie (MRT) ist nicht nur zur Diagnosestellung hilfreich, sondern auch in der Lage, die aktive von der inaktiven Form anhand des intramuskulaeren Oedems zu unterscheiden. Das Verfahren eignet sich deshalb auch zur Aktivitaetsbeurteilung und zur Bewertung einer Therapie im Verlauf. Die Erkrankung fuehrt zu einer typischen Verdickung des Muskelbauchs der extraokulaeren Augenmuskeln, wobei die Mm. rectus inferior, rectus medialis und levator palpebrae am haeufigsten betroffen sind. Signalveraenderungen des intra- und extrakonalen Fettgewebes sind moeglich, und eine bilaterale Manifestation ist haeufig. Die Differenzialdiagnose umfasst neben anderen

  6. Neoplastic lesions of the temporomandibular joint (TMJ): diagnosis, differential diagnosis and intervention; Neoplasien des Temporomandibulargelenks (TMG). Diagnostik, Differenzialdiagnostik und Intervention

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    Vogl, T.J.; Abolmaali, N.; Schedel, H.; Bergh, B. [Frankfurt Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Maeurer, J. [Radiologische Praxis am Prinzregentenplatz, Muenchen (Germany)

    2001-09-01

    Purpose. To evaluate the effectiveness of diagnostic and interventional radiological techniques for neoplastic lesions of the temporomandibular joint (TMJ). Material and methods. Modern diagnosis of the TMJ is based on the clinical use of conventional X-ray techniques, computed tomography (CT), magnetic resonance imaging (MRI) and interventional techniques like biopsies, vascular occlusion and ablation. Results. Conventional X-ray still forms the basic diagnostic procedure applied in open and closed mouth position. CT improves the diagnostic information and serves as the standard diagnostical instrument for cartaliganeous or osseous neoplastic lesions. MRI evaluates soft tissue infiltration in multiplanar techniques and high spatial resolution. Interventional vascular and ablative techniques improve the treatment of neoplastic disorders. (orig.) [German] Zielsetzung. Vorstellung der Wertigkeit bildgebender Verfahren fuer die diagnostische und interventionelle Radiologie des Temporomandibulargelenks (TMG). Material und Methodik. Die moderne Radiologie des TMG basiert auf dem Einsatz der konventionellen Roentgendiagnostik, der Computertomographie (CT) und der Magnetresonanztomographie (MRT), sowie interventioneller Verfahren wie der Biopsie, vaskulaerer Embolisationsverfahren und tumorablativer Verfahren. Ergebnisse. Als Basisdiagnostik dient die konventionelle Diagnostik in offener und geschlossener Mundposition der Erfassung von Funktionsstoerungen sowie ossaerer Destruktionen. Die CT erweitert das diagnostische Spektrum und verbessert die Differenzialdiagnostik fuer ossifizierende Prozesse. Der Einsatz der MRT erlaubt die Erfassung der Weichteilinfiltration sowie der Gelenkstrukturen. Vaskulaere interventionelle Verfahren dienen der praetherapeutischen Okklusion bzw. der palliativen Tumortherapie in Form der okklusiven Embolisation, der Chemoembolisation, oder auch der Tumorablation. (orig.)

  7. Chronic pulmonary embolism - radiological imaging and differential diagnosis; Chronische Lungenembolie - Radiologische Bildmorphologie und Differenzialdiagnose

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    Coppenrath, E.; Herzog, P.; Attenberger, U.; Reiser, M. [Klinikum Innenstadt der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2007-08-15

    In chronic pulmonary embolism branches of the pulmonary arterial tree remain partially or totally occluded. This may lead to pulmonary hypertension with the development of right ventricular hypertrophy as well as structural changes of pulmonary arteries. Imaging of chronic pulmonary embolism should prove vessel occlusions (pulmonary angiography, MSCT, MRI) and reduction of regional lung perfusion (lung scanning, MSCT, MRI). According to current guidelines ventilation-perfusion lung scanning and pulmonary angiography are still recommended as the methods of choice. MSCT and MRI provide technical alternatives which are helpful in differential diagnosis versus other types of pulmonary hypertension. In spite of medical and surgical measures (in rare cases pulmonary thromboendarterectomy) the prognosis of chronic pulmonary embolism remains unfavourable. (orig.) [German] Bei der chronischen Lungenembolie sind Abschnitte der arteriellen Lungenstrombahn dauerhaft verschlossen. Dies kann zu einer Erhoehung des pulmonal-arteriellen Drucks mit den Folgen einer Rechtsherzbelastung und strukturellen Veraenderungen der Pulmonalarterien fuehren. Bildmorphologisch nachzuweisen sind Gefaessverschluesse (Pulmonalisangiographie, MSCT, MRT) und die Minderperfusion des Lungenparenchyms (Szintigraphie, MSCT, MRT). Nach den bisherigen Empfehlungen gelten fuer die Diagnostik der chronischen Lungenembolie die Lungenszintigraphie (Ventilation/Perfusion) und die Pulmonalisangiographie als Methoden der ersten Wahl. Die MSCT und MRT (Angiographie/Perfusion) stellen technische Alternativen dar. Differenzialdiagnostisch sind andere Formen der pulmonalen Hypertonie abzugrenzen. Trotz medikamentoeser und chirurgischer Therapiemassnahmen (z. B. pulmonale Thrombendarterektomie) bleibt die Prognose der chronischen Lungenembolie unguenstig. (orig.)

  8. Efficient radiologic diagnosis of pelvic and acetabular trauma; Rationelle bildgebende Diagnostik von Becken- und Azetabulumverletzungen

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    Kreitner, K.F.; Mildenberger, P.; Thelen, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Rommens, P.M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Unfallchirurgie

    2000-01-01

    In spite of the widespread availability of CT scanners, conventional X-ray radiographs remain the basic imaging modality in patients with pelvic and/or acetabular trauma. However, the extent of their use will depend on local utilities (e.g., availability of CT scanners) and on the patient's clinical condition. Regarding the inaccuracy of conventional radiography in the diagnosis of injuries of the dorsal pelvic ring and of the acetabulum, computed tomography represents the most important imaging modality in the clinically stable patient. CT provides an exact staging of the extent of trauma and allows for differentiation of pelvic instabilities. CT clearly demonstrates the severity of acetabular trauma and is superior in the detection of local complicating factors, i.e., impressions fractures and (sub-)luxations of the femoral head as well as free intraarticular fragments. CT findings provide the basis for definite treatment regimens of the injured patient. By extension of the examination, all relevant organs and systems (craniospinal, cardiovascular, gastrointestinal, respiratory, genitourinary) can be imaged during one session. The speed of spiral CT scanners and their diagnostic accuracy will play a major role in the management of, especially, polytraumatized patients. The indication for angiography with the option of therapeutic embolization exists if a pelvic bleeding persists even after reposition and operative fixation of the injury. (orig.) [German] Bei der Klaerung einer Verletzung des Beckens oder des Azetabulums stellen konventionelle Uebersichtsaufnahmen weiterhin die Basis der bildgebenden Diagnostik dar. Art und Umfang werden bestimmt von lokalen Gegebenheiten (z.B. Verfuegbarkeit von CT-Geraeten) sowie vom klinischen Zustand des Patienten. Aufgrund der diagnostischen Ungenauigkeit der konventionellen Roentgendiagnostik gerade im Bereich des stabilitaetsbedeutsamen dorsalen Beckenringes und des Azetabulums schliesst sich beim klinisch stabilen

  9. Actual approaches in diagnosis and therapy of malignant lymphoma; Staging und Therapiekontrolle bei Lymphomen

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    Moog, F. [LMU, Muenchen (Germany). Klinik fuer Nuklearmedizin; Roemer, W. [Technische Univ. Muenchen (Germany). Klinik fuer Nuklearmedizin

    1998-07-01

    Actual molecular strategies in therapy of lymphoma attempt to utilize the immune system to target and eliminate residual lymphoma cells after first line therapy. Therefore lymphoma-specific vaccines are used. Therapy was already successful in vitro, in vivo studies are planned for the near future. In the past two decades, prognosis of lymphoma patients has improved due to advances in staging as well as in therapy control. The introduction of duplex sonography allows the decision on dignity of suspicious lymph nodes not only by size criteria but also by different perfusion pattern. Similar advances have been made in cross sectional imaging like computed tomography and magnetic resonance imaging. The development of lymph node specific contrast agents present new tools for further investigation. In nuclear medicine, functional imaging using positron-emission tomography presents new perspectives especially in diagnosis and treatment control of malignant lymphoma. The visualization of the glucose metabolism using the radiolabeled glucose analogue fluorodeoxyglucose (FDG) allows the detection of involved lymph nodes independent of arbitrary criteria such as lesion diameter. First studies on the use of FDG-PET in staging and restaging of lymphoma patients show promising results. (orig.) [Deutsch] Das 2. Muenchner Nuklearmedizin-Symposium hatte unter anderem das Staging und die Therapiekontrolle bei malignen Lymphomen zum Thema. Neben molekular- und zellbiologischen Ansaetzen zur Lymphomvakzinierung wurde der aktuelle Stand der Moeglichkeiten beim Staging und der Therapiekontrolle aus der Sicht des Radiologen und des Nuklearmediziners vorgetragen. Moderne molekularbiologische Strategien basieren auf einer Modifikation der Immunantwort mit dem Ziel, minimale Tumorreste nach einer konventionellen Therapie zu eleminieren. Dabei kommt in erster Linie das Prinzip der `Tumorimpfung` zum Einsatz. Tumorzellen werden spezifisch ueber einen virusassoziierten Gentransfer oder einen

  10. Cervical spine injury. Diagnosis, prognosis and management; Trauma der Halswirbelsaeule. Diagnose, Prognose und Management

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    Schueller-Weidekamm, C. [AKH, Medizinische Universitaet Wien (Austria). Abteilung fuer Neuroradiologie und Muskuloskelettale Radiologie

    2008-05-15

    Cervical spine injuries are a common occurrence in multi-trauma patients and should be taken into account when planning further clinical management. This review describes in detail upper and lower cervical spine injuries and introduces the sub-axial injury classification (SLIC) that is based on three components: injury morphology, integrity of the discoligamentous complex and the neurologic status of the patient. If the total SLIC score is <3, non-surgical treatment is recommended. If the total is {>=}5, operative treatment is indicated as such a score is associated with instability and probably neurologic deficits. The precise diagnosis of the radiologist, which would include the SLIC classification, should facilitate clinical decision-making about further management. (orig.) [German] Halswirbelsaeulenverletzungen sind bei polytraumatisierten Patienten haeufig und sollten beim klinischen Management des Patienten beruecksichtigt werden. Verletzungen der oberen Halswirbelsaeule werden als Sonderformen eingeteilt. Die subaxialen Verletzungen koennen nach der SLIC-Klassifikation ('sub-axial injury classification') gescort werden, die auf der Morphologie der Verletzung, dem diskoligamentaeren Komplex und dem neurologischen Status basiert. Bei einem Score <3 wird ein konservatives Management empfohlen. Bei einem Score {>=}5 sollte eine operative Versorgung der Halswirbelsaeule vorgenommen werden, da die Verletzung eine Instabilitaet und moeglicherweise auch ein neurologisches Defizit verursacht. Anhand einer praezisen Diagnose des Radiologen unter Beruecksichtigung der SLIC-Klassifikation sollte dem Kliniker die Entscheidung fuer das weitere Management erleichtert werden. (orig.)

  11. Bone and bone marrow - nuclear medicine in the diagnosis of disorders of the hematopoetic system; Skelett und Knochenmark - nuklearmedizinische Diagnostik bei onkologischen und haematologischen Systemerkrankungen

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    Cremerius, U. [Technische Hochschule Aachen (Germany). Klinik fuer Nuklearmedizin

    1997-10-01

    Significant progress has been achieved during the last years regarding therapy of neoplastic and non-neoplastic diseases of the hematopoietic system by introduction of new therapeutic modalities like highdose chemotherapy, bone marrow and stem cell transplantation, interferon-therapy and others. Diagnosis is still based on biopsy and histopathology of bone marrow. Imaging methods, however, provided by radiology and nuclear medicine, are now increasingly employed to give an additional macroscopic view over morphological and functional changes of the entire bone marrow. Bone marrow scintigraphy either using radiocolloids or immunoscintigraphy against granulocyte-antigenes may be performed as an alternative or an addition to nuclear magnetic resonance imaging. Bone scintigraphy has been successful in the detection of additional bony lesions for more than two decades. Positron emission tomography using 18-fluorine-deoxyglucose has recently been employed as a new and promising tool also for assessment of bone marrow infiltration in malignant lymphomas. (orig.) [Deutsch] Die Therapie onkologischer und haematologischer Systemerkrankungen wie der malignen Lymphome, des Plasmozytoms und der Osteomyelofibrose hat in den letzten Jahren grosse Fortschritte durch die Anwendung neuer Therapiemodalitaeten (Hochdosischemotherapie, Knochenmark- und Stammzelltransplantation, Einsatz von Interferon u.a.) erfahren. Grundlage der Diagnostik ist nach wie vor die histologische Beurteilung des Knochenmarks nach Biopsie. Ergaenzend spielen bildgebende radiologische und nuklearmedizinische Verfahren zur makroskopischen Beurteilung morphologischer und funktioneller Veraenderungen des gesamten Knochenmarkraumes eine zunehmende Rolle. Die Knochenmarkszintigraphie mit Radiokolloiden bzw. die Knochenmarkimmunszintigraphie stellen hierbei wichtige Methoden alternativ oder ergaenzend zur Kernspintomographie dar. Die Skelettszintigraphie als bewaehrte Methode vermag zusaetzlich ossaere

  12. Non-traumatic avascular necrosis of the hip in the adult. Pt. 2. Radiological diagnosis and staging; Die nichttraumatische Hueftkopfnekrose des Erwachsenen. T. 2. Radiologische Diagnostik und Stadieneinteilung

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    Kramer, J [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). MR-Institut, Abteilung fuer Osteologie; Hofmann, S [Orthopaedisches Krankenhaus Gersthof, Wien (Austria). 1. Abteilung; Imhof, H [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). MR-Institut, Abteilung fuer Osteologie

    1994-01-01

    In recent years diagnosis, and in particular early diagnosis, of osteonecrosis of the hip has been much improved by modern imaging modalities. Magnetic resonance imaging is widely accepted as the primary imaging modality for the early detection of this disorder and can help to facilitate the therapeutic management in later stages. However, plain radiographs, bone scans and computed tomography are still important techniques, which cannot be avoided in most cases. This paper describes the relative values of the different modalities. The staging system used is the international ARCO system. (orig.) [Deutsch] Die Diagnose und insbesondere die Frueherkennung der Hueftkopfnekrose hat sich in den letzten Jahren durch den Einsatz der modernen bildgebenden Verfahren entscheidend verbessert. Die Magnetresonanztomographie hat sich mittlerweile zur Methode der Wahl entwickelt und wird sowohl zur Fruehdiagnostik als auch in spaeteren Stadien zur Therapieplanung eingesetzt. Trotzdem kann auf die anderen Methoden wie Nativroentgen, Szintigraphie und Computertomographie vielfach nicht verzichtet werden. Diese Arbeit beschreibt die Wertigkeit der verschiedenen radiologischen Methoden bei der nichttraumatischen HKN des Erwachsenen, wobei die internationale klinische ARCO-Stadieneinteilung verwendet wird. (orig.)

  13. Ductal adenocarcinoma and unusual differential diagnosis; Duktales Adenokarzinom und ungewoehnliche Differenzialdiagnosen

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    Haage, P.; Schwartz, C.A.; Scharwaechter, C. [Universitaet Witten/Herdecke, Zentrum fuer Radiologie HELIOS Universitaetsklinikum Wuppertal, Wuppertal (Germany)

    2016-04-15

    Ductal pancreatic adenocarcinoma is by far the most common solid tumor of the pancreas. It has a very poor prognosis, especially in the more advanced stages which are no longer locally confined. Due to mostly unspecific symptoms, imaging is key in the diagnostic process. Because of the widespread use of imaging techniques, incidental findings are to a greater extent discovered in the pancreas, which subsequently entail further work-up. Ductal pancreatic adenocarcinoma can be mimicked by a large number of different lesions, such as anatomical variants, peripancreatic structures and tumors, rarer primary solid pancreatic tumors, cystic tumors, metastases or different variants of pancreatitis. Additionally, a number of precursor lesions can be differentiated. The correct classification is thus important as an early diagnosis of ductal pancreatic adenocarcinoma is relevant for the prognosis and because the possibly avoidable treatment is very invasive. All major imaging techniques are principally suitable for pancreatic imaging. In addition to sonography of the abdomen, usually the baseline diagnostic tool, computed tomography (CT) with its superior spatial resolution, magnetic resonance imaging (MRI) with its good soft tissue differentiation capabilities, possibly in combination with MR cholangiopancreatography (MRCP), endosonography with its extraordinary spatial resolution, conceivably with additional endoscopic retrograde CP or the option of direct biopsy and finally positron emission tomography CT (PET-CT) as a molecular imaging tool are all particularly useful modalities. The various techniques all have its advantages and disadvantages; depending on the individual situation they may need to be combined. (orig.) [German] Das duktale Adenokarzinom ist der weitaus haeufigste solide Tumor des Pankreas. Die Prognose ist sehr schlecht, insbesondere bei fortgeschrittenen, nicht mehr lokal begrenzten Tumoren. Bei meist unspezifischen geringen Beschwerden kommt der

  14. Functional MRI procedures in the diagnosis of brain tumors. Perfusion- and diffusion-weighted imaging; Funktionelle MR-Verfahren in der Diagnostik intraaxialer Hirntumoren. Perfusions- und Diffusions-Bildgebung

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    Hartmann, M. [Universitaetsklinikum Heidelberg (Germany). Neurologische Klinik, Abteilung Neuroradiologie; Heiland, S.; Sartor, K.

    2002-08-01

    Despite the increased diagnostic accuracy of contrast material enhanced MR imaging, specification and grading of brain tumors are still only approximate at best: neither morphology, nor relaxation times or contrast material enhancement reliably predict tumor histology or tumor grade. As histology and tumor grade strongly influence which therapy concept is chosen, a more precise diagnosis is mandatory. With diffusion- and perfusion-weighted MR imaging (DWI, PWI) it is now possible to obtain important information regarding the cellular matrix and the relative regional cerebral blood volume (rrCBV) of brain tumors, which cannot be obtained with standard MR techniques. These dynamic-functional imaging techniques are very useful in the preoperative diagnosis of gliomas, lymphomas, and metastases, as well as in the differentiation of these neoplastic lesions from abscesses, atypical ischemic infarctions, and tumor-like manifestations of demyelinating disease. Additionally, they appear suitable for determining glioma grade and regions of active tumor growth which should be the target of stereotactic biopsy and therapy. After therapy these techniques are helpful to better assess the tumor response to therapy, possible therapy failure and therapy complications such as radiation necrosis. (orig.) [German] Die radiologische Diagnostik intraaxialer Hirntumoren ist durch die Magnetresonanztomographie (MRT) erheblich verbessert worden, besonders nach Einfuehrung der paramagnetischen Kontrastmittel. Mit konventionellen MR-Verfahren ist aber noch keine verlaessliche Unterscheidung zwischen Gliomen, Metastasen, primaeren Lymphomen und tumorsimulierenden entzuendlichen Erkrankungen moeglich. In dieser Hinsicht vielversprechend sind neue, funktionell-dynamische MR-Verfahren, mit denen sich nicht-invasiv die zerebrale Wasserdiffusion und Mikrozirkulation erfassen lassen und die eine bessere Gewebecharakterisierung erlauben als die herkoemmlichen MR-Methoden. Die Perfusions-MRT erfasst

  15. Radiological diagnosis and differential diagnosis of headache; Radiologische Diagnostik und Differenzialdiagnostik bei Kopfschmerzen im Erwachsenenalter

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    Langner, S.; Kirsch, M. [University Medicine Greifswald (Germany). Inst. for Diagnostic Radiology and Neuroradiology

    2015-10-15

    Headache is very common and affects almost everyone at some point. It is one of the most common disorders that leads patients to see their physician. All different forms have the nociception via trigeminal nerve fibers in common. Beside the clinical course headaches are classified as either primary or secondary, with the latter having an identifiable structural or biochemical cause. Imaging has a low diagnostic yield in primary headache but play an important role in the differential diagnosis of secondary forms. An overview of different forms of secondary headache is given, outlining diagnostic procedures and the morphologic imaging features of each syndrome.

  16. Radiological imaging in early diagnosis of rheumatoid arthritis. The role of ultrasound and magnetic resonance imaging; Radiologische Fruehdiagnostik der rheumatoiden Arthritis. Stellenwert von Ultraschall und Magnetresonanztomographie

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    Platzgummer, H.; Schueller-Weidekamm, C. [AKH, Medizinische Universitaet Wien, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2012-02-15

    For optimal therapy management of patients with rheumatoid arthritis (RA) specific and sensitive diagnostic methods are essential for assessment of disease activity. In addition to projection radiography, imaging techniques, in particular magnetic resonance imaging (MRI) and ultrasound (US) are becoming increasingly more important for the early diagnosis of RA. The MRI and US techniques play a key role in the early imaging diagnostics of RA. Measurement of inflammation activity represents the basis of therapeutic decision-making and can be quantitatively and qualitatively determined with MRI and US. Synovitis and bone marrow edema are predictors of erosion. (orig.) [German] Fuer das optimale Therapiemanagement bei Patienten mit rheumatoider Arthritis (RA) sind spezifische und sensible diagnostische Methoden zur Beurteilung der Krankheitsaktivitaet unerlaesslich. Neben der Projektionsradiographie gewinnen die bildgebenden Methoden zur Fruehdiagnostik der RA, insbesondere die Magnetresonanztomographie (MRT) und der Ultraschall (US), zunehmend an Bedeutung. MRT und US spielen eine Schluesselrolle in der bildgebenden Fruehdiagnostik der RA. Die Messung der Entzuendungsaktivitaet stellt die Basis fuer die Therapieentscheidung dar. Sie kann mit dem US und der MRT quantitativ und semiquantitativ bestimmt werden. Synovialitis und Knochenmarkoedem sind Praediktoren fuer Erosionen. (orig.)

  17. Chronic pancreatitis. Diagnosis, therapy and follow-up results; Chronische Pankreatitis. Diagnostik, Therapie und Langzeitergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Moessner, J. [Medizinische Klinik und Poliklinik 2, Zentrum fuer Innere Medizin, Univ. Leipzig (Germany)

    1996-09-01

    The incidence of chronic pancreatitis is increasing in industrialized countries due to the steady increase of alcohol abuse. The pathogenesis of this disease is still incompletely understood. A cure is not possible. The knowledge of the patients history and a thorough clinical investigation together with the availability of a wide array of laboratory tests and imaging procedures enable the physician to characterize the stage of the disease. Exact knowledge of the present pancreatic morphology, potential complications of the disease, and knowledge about the present exocrine and endocrine function capacity are prerequisites for adequate therapeutic decision making. The therapeutic possibilities include termination of alcohol abuse, various options of treatment of pain according to the various pathogenetic possibilities leading to pain, pancreatic digestive enzyme supplementation, treatment of diabetes, and either endoscopic or surgical treatments of complications of the disease. (orig.) [Deutsch] Die Inzidenz der chronischen Pankreatitis nimmt in den Industrienationen aufgrund der Zunahme des Alkoholabusus an Haeufigkeit zu. Die Diagnose der chronischen Pankreatitis wird oft spaet gestellt. Eine Heilung ist noch nicht moeglich. Eine detailierte Anamnese, Beurteilung der Klinik, Laborparameter, Pankreasfunktionsanalysen und eine ganze Palette unterschiedlicher bildgebender Verfahren ermoeglichen eine Charakterisierung des jeweiligen Krankheitszustandes. Dies ist die Voraussetzung zur differenzierten Einleitung einer medikamentoesen und/oder interventionellen endoskopischen und/oder chirurgischen Therapie. Wie bei jedem nicht heilbaren chronischen Krankheitsbild ist eine stadiengerechte Therapie erforderlich. (orig.)

  18. The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas; CT und MRT des erworbenen Cholesteatoms: Prae- und postoperative Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Krestan, C.; Czerny, C. [Abteilung fuer Osteologie, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria); Gstoettner, W. [Univ.-Klinik fuer Hals-Nasen-Ohren-Heilkunde, Frankfurt (Germany); Franz, P. [Univ.-Klinik fuer Hals-Nasen-Ohren-Heilkunde, Wien (Austria)

    2003-03-01

    The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas will be described in this paper. The pre- and postoperative imaging of the temporal bone was performed with HRCT and MRI. HRCT and MRI were performed in the axial and coronal plane. MRI was done with T2 weighted and T1 weighted sequences both before and after the intravenous application of contrast material. All imaging findings were confirmed clinically or surgically. The preoperative cholesteatoma-caused complications depicted by HRCT included bony erosions of the ossicles, scutum, facial canal in the middle ear, tympanic walls including the tegmen tympani, and of the labyrinth. The preoperative cholesteatoma-caused complications depicted by MRI included signs indicative for labyrinthitis, and brain abscess. Postoperative HRCT depicted bony erosions caused by recurrent cholesteatoma, bony defects of the facial nerve and of the labyrinth, and a defect of the tegmen tympani with a soft tissue mass in the middle ear. Postoperative MRI delineated neuritis of the facial nerve, labyrinthitis, and a meningo-encephalocele protruding into the middle ear. HRCT and MRI are excellent imaging tools to depict either bony or soft tissue complications or both if caused by acquired cholesteatomas. According to our findings and to the literature HRCT and MRI are complementary imaging methods to depict pre- or postoperative complications of acquired cholesteatomas if these are suspected by clinical examination. (orig.) [German] In dieser Arbeit wird die Rolle der hochaufloesenden Computertomographie (HRCT) und der Magnetresonanztomographie (MRT) zur Abklaerung prae- und postoperativ bedingter Komplikationen erworbener Cholesteatome beschrieben. Die Bildgebung wurde sowohl mit der HRCT als auch mit der MRT durchgefuehrt. Die HRCT und die MRT wurden in axialer und koronaler Ebene (auch

  19. The debate over diagnosis related groups.

    Science.gov (United States)

    Spiegel, A D; Kavaler, F

    1985-01-01

    With the advent of the Prospective Payment System (PPS) using Diagnosis Related Groups (DRGs) as a classification method, the pros and cons of that mechanism have been sharply debated. Grouping the comments into categories related to administration/management, DRG system and quality of care, a review of relevant literature highlights the pertinent attitudes and views of professionals and organizations. Points constantly argued include data utilization, meaningful medical classifications, resource use, gaming, profit centers, patient homogeneity, severity of illness, length of stay, technology limitations and the erosion of standards.

  20. Diagnosis of structures. Practical applications and future tasks of non-destructive testing. Papers; Bauwerksdiagnose. Praktische Anwendungen Zerstoerungsfreier Pruefungen und Zukunftsaufgaben. Vortraege

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    The CD contains 17 papers and 20 posters on the subject of non-destructive diagnosis of structures. The titles of the 17 papers are: 1. Non-destructive testing in transition - from quality testing to life management; 2. Non-destructive testing of bridges on German motorways; 3. Structural diagnosis of concrete components - results obtained by a group of scientists of Deutsche Forschungsgemeinschaft; 4. Building diagnosis - its relevance and options for the building authorities; 5. Optimisation of permanent monitoring of structures by non-destructive test methods; 6. Assessment of Structures using Fibre-optic Sensors; 7. Methods and results in wood structure diagnosis; 8. The collapse of the roof of the Bad Reichenhall ice-skating rink - how could it have been prevented? 9. Integration of non-destructive structural tests in structure management of PPP models (Powerpoint); 10: Elements of sustainable life cycle management of engineering structures; 11. Structure monitoring as a component of life management systems; 12. Chloride and Sulfate analysis using LIBS - from the laboratory to the construction site; 13. Applications of georadar und ultrasonics - examples from the working practice of an engineering consultants' office; 14. Bridge analysis by automatic methods - new developments; 15. Fast large-area condition monitoring of reinforced-concrete bridges, floors and ceilings; 16. Influence of roof gap pressing on non-destructive thickness testing of the inner shells of motorway tunnels; 17. Non-destructive test methods for structure diagnosis - status and perspectives. [German] Die CD enthaelt 17 Vortraege und 20 Posterbeitraege zum Thema: ''Zerstoerungsfreie Pruefverahren fuer die Bauwerksdiagnose''. Die Themen der 17 Vortraege sind: 1. Die Zerstoerungsfreie Pruefung im Wandel - Von der Qualitaetspruefung zum Lebensdauermanagement; 2. ZfPBau-Verfahren fuer die Zustandserfassung von Bruecken der Bundesfernstrassen; 3. Strukturbestimmung von

  1. Diagnosis of climbing related overuse injuries

    International Nuclear Information System (INIS)

    Klauser, A.; Frauscher, F.; Helweg, G.; Nedden, D. zur; Hochholzer, T.; Kramer, J.

    2002-01-01

    Sport climbing shows an enormous increase in participation, evolving to more popularity, including even school sport activity on high standards. Therefore the number of climbing related injuries is increasing and becomes a more frequently encountered medical problem. Typical climbing associated injuries involve predominantly the upper limb. Overuse injuries are the most common climbing related injuries.The clinical examination is the first line investigation, which is often limited especially in the acute phase. However, an exact diagnosis is desireable for therapeutic management. Imaging modalities have shown to be capable for detection of climbing related injuries. An overview about the current use of x-ray, ultrasound and magnetic resonance imaging in different climbing related overuse injuries is presented. (orig.) [de

  2. Diagnostic systems for motor vehicles. From diagnosis and moni; Diagnosesysteme fuer Kraftfahrzeuge. Von der Diagnose und Ueberwachung bis zum E-Commerce

    Energy Technology Data Exchange (ETDEWEB)

    Baeker, B.; Forchert, T. [DB DaimlerChrysler AG, Stuttgart (Germany). Abt. FT2/ED

    2001-07-01

    Starting from the technical necessity of having monitoring and diagnostic systems in all compartments of modern passenger cars, the contribution discusses how new service concepts can be integrated as well. New diagnostic approaches are outlined which, in addition to failure detection, also enable optimization of the development process chain. At the same time, the depth of diagnosis is improved in order to obtain a multitude of new meta information while driving, which will serve as a basis for installing new services in the vehicle. [German] Gestiegend Komfortanforderungen und die gewachsene Komplexitaet in heutigen und zukuenftigen Elektrik/Elektronik-Systemen fuer Kraftfahrzeuge erfordern leistungsfaehige Diagnosesysteme. Um gleichzeitig im Rahmen der Globalisierung die Wertschoepfungskette weiter zu staerken, muessen als logische Konsequenz des Marktes Ansaetze fuer neuartige Dienstleistungskonzepte erdacht und integriert werden. Dieser Aufsatz diskutiert ausgehend von der technischen Notwendigkeit zukuenftiger Ueberwachungs- und Diagnosesysteme in allen Bereichen moderner Kraftfahrzeuge moegliche Wege zu derartigen Ansaetzen denkbarer systemuebergreifender Dienstleistungsschritte am Fahrzeug. Dabei werden technologisch neuartige Diagnoseansaetze skizziert, die neben einer Fehlererkennung auch die Optimierung der Entwicklungsprozesskette zulassen. Eine gleichzeitige Erhoehung der Diagnosetiefe schafft die Grundlage, eine Vielzahl neuer Meta-Informationen waehrend der Fahrt zu generieren. Diese bilden die Basis fuer neue Dienste am Fahrzeug. (orig.)

  3. Diagnosis of Epilepsy and Related Episodic Disorders.

    Science.gov (United States)

    St Louis, Erik K; Cascino, Gregory D

    2016-02-01

    This review identifies the diverse and variable clinical presentations associated with epilepsy that may create challenges in diagnosis and treatment. Epilepsy has recently been redefined as a disease characterized by one or more seizures with a relatively high recurrence risk (ie, 60% or greater likelihood). The implication of this definition for therapy is that antiepileptic drug therapy may be initiated following a first seizure in certain situations.EEG remains the most commonly used study in the evaluation of people with epilepsy. Routine EEG may assist in diagnosis, classification of seizure type(s), identification of treatment, and monitoring the efficacy of therapy. Video-EEG monitoring permits seizure classification, assessment of psychogenic nonepileptic seizures, and evaluation of candidacy for epilepsy surgery. MRI is pivotal in elucidating the etiology of the seizure disorder and in suggesting the localization of seizure onset. This article reviews the new International League Against Epilepsy practical clinical definition for epilepsy and the differential diagnosis of other physiologic paroxysmal spells, including syncope, parasomnias, transient ischemic attacks, and migraine, as well as psychogenic nonepileptic seizures. The initial investigational approaches to new-onset epilepsy are considered, including neuroimaging and neurophysiologic investigations with interictal and ictal video-EEG. Neurologists should maintain a high index of suspicion for epilepsy when children or adults present with a single paroxysmal spell or recurrent episodic events.

  4. Public relations and media - a challenge to the power industry; Oeffentlichkeitsarbeit und Medien - eine Herausforderung an den Stromsektor

    Energy Technology Data Exchange (ETDEWEB)

    Heierle, M. [Verband Schweizerischer Elektrizitaetswerke (VSE), Zuerich (Switzerland); Kleinpeter, M. [Organisation der Kernenergieerzeuger (Open), Paris (France)

    1996-10-07

    The authors attempt to discuss the interdependences between efficient public relations activities of public utilities and their presence in the communication media. In view of the importance of the public media, the authors attempt to show how public relations activities can be made credible, competent, and close to the customer. (orig.) [Deutsch] Die Verfasser versuchen, die Zusammenhaenge zwischen einer effizienten Medientaetigkeit und einer gezielten Oeffentlichkeitsarbeit der Energieversorgungsunternehmen in einer kritischen Darstellung zu eroertern. Medien sind absolut notwendig, wie auch die Energiebereitstellung. Die Verfasser wollen nicht die eventuell zu beanstandende Dynamik der verschiedenen Akteure beschreiben, sondern eher die Wege, Mittel und Organe, die zu einer glaubwuerdigen, kompetenten, empfaengernahen Oeffentlichkeitsarbeit fuehren, aufzeigen. (orig.)

  5. Development of a system for detection and diagnosis of errors in the operation of space HVAC systems; Entwicklung eines Systems zur Erkennung und Diagnose von Fehlern beim Betrieb von HLK-Anlagen

    Energy Technology Data Exchange (ETDEWEB)

    Bach, H.; Bauer, M.; Grob, R.F. [Stuttgart Univ. (Germany). Lehrstuhl fuer Heiz- und Raumlufttechnik

    1997-12-31

    Buildings with heating and space HVAC systems require considerable automatic control effort to ensure engergy-efficient operation. Faults are only to be avoided by the use of automatic fault detection systems. The contribution describes the procedure adopted in operation monitoring, the IKE system for fault detection and diagnosis, and the evaluation of the FDD system. (MSK) [Deutsch] Gebaeude mit heiz-und raumlufttechnischen Anlagen erfordern bei energetisch rationellem Bertrieb einen grossen Aufwand an Steuerungs-und Regelungstechnik. Um ohne Fehler zu arbeiten erfordert diese Steuerungs-und Regelungstechnik den Einsatz von automatischen Fehlererkennungssystemen. Im Folgenden werden die Vorgehensweise bei der Betriebsueberwachung, das IKE-System zur Fehlererkennung und Diagnose sowie die Evaluierung des FDD-Systems (Fault Detection and Diagnosis System) erlaeutert.

  6. Sigmoid volvulus. Diagnosis and interdisciplinary treatment. Sigmavolvulus, Diagnostik und Moeglichkeit einer interdisziplinaeren Primaertherapie

    Energy Technology Data Exchange (ETDEWEB)

    Schoen, G. (Innsbruck Univ. (Austria). Klinik fuer Radiodiagnostik); Offer, C.; Glaser, K. (Innsbruck Univ. (Austria). Klinik fuer Chirurgie 2)

    1991-02-01

    Sigmoid volvolus is an emergency which requires rapid diagnosis and immediate adequate treatment. Diagnosis is primarily radiological. Emergency laparotomy carries a high mortality and should therefore not be the immediate treatment. In our opinion, detorsion by colonoscopy under radiological control is a promising form of treatment. Selective resection of the sigmoid, thereby removing the cause of the abnormality, should not be forgotten, since this prevents recurrences. For this method, mortality after adequate gut preparation is only 5.4%. An exception to the above is gangrene of the bowel, when an emergency laparotomy cannot be avoided. (orig.).

  7. Battery diagnosis and battery monitoring in hybrid electric vehicles; Batteriediagnostik und Batteriemonitoring in Hybridfahrzeugen

    Energy Technology Data Exchange (ETDEWEB)

    Sanders, T.; Kowal, J.; Waag, W.; Gerschler, J.B.; Sauer, D.U. [RWTH Aachen (DE). Inst. fuer Stromrichtertechnik und Elektrische Antriebe (ISEA)

    2007-07-01

    Even in conventional passenger cars the load on the batteries is at its limit due to the increasing number of electrical loads. It is therefore of special importance to know the status and the power capability of the battery at any time. To fulfil these requirements it is necessary that the battery diagnostics has a precise current measurement available in addition to the voltage and temperature measurements. Battery diagnosis is most successful of different algorithms are combined and errors from the measurements and the algorithms are taken actively into account. The general structure of battery diagnosis algorithms can be used for lead-acid, lithium-ion and NiMH batteries. However, the complexity is highest for lead-acid batteries. (orig.)

  8. Infectious diseases of the brain: imaging and differential diagnosis; Infektioese Hirnerkrankungen: Bildgebung und differenzialdiagnostische Aspekte

    Energy Technology Data Exchange (ETDEWEB)

    Haehnel, S.; Seitz, A. [Abt. Neuroradiologie, Neurologische Klinik, Universitaetsklinikum Heidelberg (Germany); Storch-Hagenlocher, B. [Abt. Neurologie, Neurologische Klinik, Universitaetsklinikum Heidelberg (Germany)

    2006-09-15

    Infectious diseases of the central nervous system have to be considered in differential diagnosis particularly in immunocompromised persons. Neuro-imaging, specifically advanced techniques such as diffusion weighted MRI and perfusion MRI contribute much to the differentiation of brain infections and for differentiating brain infections from other, for instance, neoplastic diseases. In this review we present the imaging criteria of the most important brains infections in adults and in pediatric patients and discuss differential diagnostic aspects in detail. (orig.)

  9. Neuroendokrine Tumore (NET des Gastrointestinaltraktes: Nuklearmedizinische Optionen in Diagnose und Therapie // Neuroendocrine Tumours (NET of the Gastrointestinal Tract: Nuclear Medicine Methods in Diagnosis and Therapy

    Directory of Open Access Journals (Sweden)

    Gabriel M

    2017-01-01

    Full Text Available In the diagnosis of tumours of neuroendocrine origin PET-CT plays a central role using 68Ga-DOTA-conjugated peptides. In addition to primary diagnosis with clinical and biochemical suspicion, this diagnostic procedure also is essential for staging and further therapy decision, showing in many cases better diagnostic performance than radiological cross-sectional imaging. The detection of unexpected lesions changes therapy management in about one-third of cases. In addition, the 18F-FDG, which is mainly used in non-neuroendocrine tumours, can be an option in poorly differentiated neuroendocrine tumours (NET and, to a certain extent, for estimation of prognosis.br New findings in a prospective randomized multicentre study (NETTER-1 Phase III study strongly confirm the efficacy and safety of radionuclide peptide therapy (PRRT using 177Lu-DOTATATE (Lutathera®. It has been used in several European and US centers including a total of 230 patients with a grade 1–2 midgut tumours. It is evident from the data so far that patients with advanced midgut NETs who are treated with Lutathera have a statistically significantly longer PFS and the OS might be also positively influenced. Although no comparable prospective ranomized study is available for 90Y-DOTA-TOC so far, a comparable therapy efficiency and also good tolerability can be assumed for this compound as indicated by numerous monocentric studies with an overall high number of patients being treated.br In patients with preferential hepatic involvement, the selective internal radiotherapy (SIRT, also called radioembolisation, represents a possible alternative for the local intrahepatic radiation treatment of liver metastases.br bKurzfassung:/b Bei der Diagnose von Tumoren neuroendokrinen Ursprungs spielt die PET-CT mittels 68Ga-DOTA-konjugierter Peptide eine zentrale Rolle. Neben der Primärdiagnose bei klinischem und biochemischem Verdacht erweist sich dieses Diagnoseverfahren auch bei der

  10. Prognostic impact of hepatobiliary scintigraphy in diagnosis and postoperative follow-up of newborns with biliary atresia; Prognostische Wertigkeit der hepatobiliaeren Funktionszintigraphie in Diagnostik und Nachsorge der Gallengangsatresie

    Energy Technology Data Exchange (ETDEWEB)

    Rossmueller, B.; Porn, U.; Dresel, S.; Hahn, K. [Muenchen Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Schuster, T. [Muenchen Univ. (Germany). Kinderchirurgische Klinik; Lang, T. [Muenchen Univ. (Germany). Kinderklinik

    2000-01-01

    Aim: To investigate the prognostic relevance of hepatobiliary scintigraphy (HBS) in newborns suffering from biliary atresia (BA) for establishing the primary diagnosis and in the postoperative follow-up after portoenterostomy (Kasai). Methods: Twenty newborns with direct hyperbilirubinemia and 6 children after operative treatment of BA (Kasai) underwent HBS with Tc-99m-DEIDA. In patients without intestinal drainage, hepatocellular extraction was estimated visually and calculated semiquantitatively by means of liver/heart-ratio 5 min p.i. Results: 10/20 patients with hyperbilirubinemia did not display biliary drainage; 6 had BA, 3 intrahepatic hypoplasia, and one showed a bile plug syndrom. 4/6 with BA but none of the 4 children with diagnoses other than BA presented with a good extraction. All of the 4 children with BA, who had either pre- or postoperatively a bad extraction, needed liver transplantation due to liver failure. Both of the two newborns with BA and favourable outcome after Kasai had a good extraction in the preoperative HBS and demonstrated good intestinal drainage in the postoperative scan. Conclusion: HBS rules out BA with high accuracy by demonstrating drainage of bile into the intestine. In newborns without drainage a good extraction favours the diagnosis of BA. In newborns with BA a bad extraction seems to indicate a poor postoperative prognosis after Kasai operation. HBS might therefore help to select those children who will not benefit from portoenterostomy. Postoperatively, HBS can easily and quickly confirm the successful hepatobiliary anastomosis by demonstrating biliary drainage into the intestine. (orig.) [German] Ziel der Studie war es, die diagnostische Wertigkeit und die prognostische Aussagekraft der hepatobiliaeren Funktionsszintigraphie (HB-FS) in der Primaerdiagnostik der Gallengangsatresie (GG-Atresie) und bei postoperativen Kontrollen nach Portoenterostomie (Kasai-OP) zu ueberpruefen. Methoden: 20 Neugeborene (Alter: 3-119 d) mit

  11. Imaging diagnosis of bronchial asthma and related diseases

    International Nuclear Information System (INIS)

    Sakai, Fumikazu; Fujimura, Mikihiko; Kimura, Fumiko; Fujimura, Kaori; Hayano, Toshio; Nishii, Noriko; Machida, Haruhiko; Toda, Jo; Saito, Naoko

    2002-01-01

    We describe imaging features of bronchial asthma and related diseases. The practical roles of imaging diagnosis are the evaluation of severity and complications of bronchial asthma and differential diagnosis of diseases showing asthmatic symptoms other than bronchial asthma. (author)

  12. Customers and markets. International components for win-win relations; Kunden und Maerkte. Internationale Bausteine fuer Win-Win-Relationen

    Energy Technology Data Exchange (ETDEWEB)

    Lamprecht, F.

    1998-09-01

    In deregulated energy markets, power supply companies change from commodity suppliers to service providers. The core of the process of change is a change in attitude, from producer to customer-oriented marketer; the means applied in the process are a diversified and integrated marketing strategy, targeting both external and internal conditions, which fits into a comprehensive concept of an integrated communications strategy. An international conference held in mid-June in Lisbon, organised by the associations Unipede and EURELECTRIC as well as the International Energy Agency (IEA), supplied a wealth of information on this topical issue spanning a broad range of interesting aspects, as eg. approaches to identify customer needs and correspondingly develop new services, or the quest for new business segments and possibilities of finding win-win relations for both customers and power producers. (orig./CB) [Deutsch] Auf liberalisierten Strommaerkten entwickeln sich die Energieversorger zu Dienstleistern. Kern des Wandels ist der Weg von der Produktions- zur Kundenorientierung, Mittel eine differenzierte und integrierte Marketingstrategie, die nach aussen wie nach innen gerichtet ist und in ein umfassendes Konzept einer integrierten Kommunikationsstrategie eingepasst ist. Eine von den Verbaenden Unipede und EURELECTRIC sowie der Internationalen Energie-Agentur (IEA) Mitte Juni in Lissabon ausgerichtete internationale Konferenz lieferte hierzu eine Fuelle an Material. Es wurde thematisch ein weiter Bogen gespannt. Von der Ermittlung unterschiedlicher Kundenbeduerfnisse ueber Methoden, sich danach auszurichten sowie speziell entwickelte Marketingstrategien, bis hin zu neuen Betaetigungsfeldern wurde nach Moeglichkeiten gesucht, Win-Win-Relationen fuer Kunden und EVU darzustellen. (orig.)

  13. Postictal MR-changes. A rare and important differential diagnosis; Postiktale MR-Veraenderungen. Eine seltene und wichtige Differenzialdiagnose

    Energy Technology Data Exchange (ETDEWEB)

    Hattingen, E.; Raab, P.; Lanfermann, H.; Zanella, F.E.; Weidauer, S. [Johann-Wolfgang-Goethe-Universitaet Frankfurt/Main, Institut fuer Neuroradiologie, Frankfurt (Germany)

    2008-11-15

    Postictal MR findings are analyzed in the context of MR morphological differential diagnoses. Postictal MRI was performed in 11 patients. The patterns of MR changes and their differential diagnoses were analyzed. Focal accentuation of signal increase in the cortex was found on T2-weighted images in 90% of these cases, pial enhancement in 70% and signal changes of the pulvinar/thalamus in 40%. The most common differential diagnoses were encephalitis, and in tumor patients carcinomatous involvement of the meninges. Postictal MR changes vary widely and are difficult to differentiate from illnesses such as encephalitis and carcinomatosis involving the meninges. Nevertheless, knowledge of the typical pattern of postictal MR findings and the clinical course may help to avoid mistaken diagnoses. (orig.) [German] Postiktale MR-Veraenderungen werden im Kontext ihrer Differenzialdiagnosen analysiert. Elf Patienten wurden postiktal im MRT untersucht. Ausgewertet wurden die MR-tomographischen Befundmuster und ihre Differenzialdiagnosen. Bei 90% der Patienten fanden sich fokale kortikal betonte Signalsteigerungen in der T2-Wichtung, bei 90% Diffusionseinschraenkungen, bei 70% piale Anreicherungen und bei 40% Signalalterationen des Pulvinars/Thalamus. Haeufigste Differenzialdiagnosen waren die Enzephalitis und bei entsprechender Tumoranamnese die Meningeosis carcinomatosa. Postiktale MR-Veraenderungen sind vielgestaltig und nicht immer leicht von Erkrankungen wie insbesondere der Enzephalitis oder der Meningeosis carcinomatosa zu unterscheiden. Dennoch helfen die Kenntnis typischer postiktaler Befallsmuster und der klinische Verlauf, Fehldiagnosen zu vermeiden. (orig.)

  14. Radiological diagnosis and intervention of cholangiocarcinomas (CC); Radiologische Diagnostik und Intervention von Cholangiokarzinomen (CC)

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Zangos, S.; Eichler, K.; Gruber-Rouh, T.; Hammerstingl, R.M.; Weisser, P. [Frankfurt Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Trojan, J. [Frankfurt Univ. (Germany). Medizinische Klinik I: Gastroenterologie, Endokrinologie, Pneumologie/Allergologie

    2012-10-15

    To present current data on diagnosis, indication and different therapy options in patients with cholangiocarcinoma (CC) based on an analysis of the current literature and clinical experience. The diagnostic routine includes laboratory investigations with parameters of cholestasis and also serum tumor markers CA19 - 9 and CEA. After ultrasound for clarifying a tumor and/or dilated bile ducts, contrast-enhanced magnetic resonance imaging (MRI) should be performed with magnetic resonance cholangiography (MRCP). The accuracy (positive predictive value) for diagnosing a CC is 37 - 84 % (depending on the location) for ultrasound, 79 - 94 % for computed tomography (CT), and 95 % for MRI and MRCP. An endoscopic retrograde cholangiography (ERCP) can then be planned, especially if biliary drainage or cytological or histological specimen sampling is intended. A curative approach can be achieved by surgical resection, rarely by liver transplantation. However, many patients are not eligible for surgery. In addition to systemic chemotherapy, locoregional therapies such as transarterial chemoembolization (TACE), hepatic arterial infusion (HAI) - also known as chemoperfusion -, drug eluting beads-therapy (DEB) as well as thermoablative procedures, such as laser-induced thermotherapy (LITT), microwave ablation (MWA) and radiofrequency ablation (RFA) can be provided with a palliative intention.

  15. Public Relations Manager Involvement in Strategic Issue Diagnosis.

    Science.gov (United States)

    Lauzen, Martha M.

    1995-01-01

    Reports on an exploratory study that seeks to build theoretical understanding of how public relations practitioner involvement in one type of strategic organizational decision making--strategic issue diagnosis--is related to shared values with top management, diagnosis accuracy, strategy pursued, and the power of the public relations function. (TB)

  16. Diagnosis and staging of testicular cancer; Diagnostik und Staging von malignen Hodentumoren

    Energy Technology Data Exchange (ETDEWEB)

    Eiers, Michael; Bender, Karen; Hallscheidt, Peter J. [Universitaetsklinikum Heidelberg (Germany). Abt. Diagnostische und Interventionelle Radiologie

    2010-03-15

    With an incidence of just 2 % of all maligne tumour diseases testicular cancer is a relative rare tumour disease. In comparison to other tumours, orchiectomy is performed as a first step therapy straight after primary staging which is performed by palpation, ultrasonography and evaluation of the tumour markers. In a second diagnostic step initial staging will be done by re-evaluation of the tumour markers, X-ray of the thorax in some cases also by CT, CT of the abdomen/pelvis or MRI of the abdomen, in progressive disease additional MRI of the head. Follow-up after curative therapy will be performed according to the histological type (seminoma - non-seminoma) and tumour staging. (orig.)

  17. Emotions as a site-related factor. The attitudes of the population towards energy policy and environmental protection; Emotionen als Standortfaktor. Die Einstellungen der Bevoelkerung zu Energiepolitik und Umweltschutz

    Energy Technology Data Exchange (ETDEWEB)

    Koecher, R. [Inst. fuer Demoskopie, Allensbach (Germany)

    1997-06-01

    For years, debate has been raging on the future competitiveness of Germany. The discussions focus on wages and incidental wage costs, working hours, the education and training system, technological changes, flexibilization and the fight against red tape as well as social consensus. But one site-related factor hardly crops up in public discussion and in economic-science textbook and expertises, although it quite essentially influences competitiveness, now even more than formerly: the mentality of the population. It includes priorities held by society, target concepts such as the openness of the population towards innovation and its attitude towards technology and technical progress as well as the way in which discussions are conducted in society and decisions taken, especially also people`s inclination to rationality or irrationality, and proneness to emotions or ideological thinking. (orig.) [Deutsch] Seit Jahren wird ueber die Zukunft des Standortes Deutschland diskutiert und gestritten. Im Mittelpunkt der Diskussion stehen Loehne und Lohnnebenkosten, Arbeitszeiten, das Bildungs- und Ausbildungssystem, technologische Veraenderungen, Flexibilisierung und Entbuerokratisierung und der soziale Frieden. Ein Standortfaktor kommt dagegen in der oeffentlichen Diskussion wie auch in den wirtschaftswissenschaftlichen Lehrbuechern und Expertisen kaum vor, obwohl er die Standortqualitaet ganz wesentlich beeinflusst, heute noch mehr als frueher: Die Mentalitaet der Bevoelkerung. Dazu gehoeren die gesellschaftlichen Prioritaeten und Zielvorstellungen wie die Innovationsoffenheit der Bevoelkerung, ihre Einstellung zu Technik und technischem Fortschritt wie die Art, gesellschaftliche Diskussionen zu fuehren und Entscheidungen zu treffen, besonders auch die Neigung zu Rationalitaet und Irrationalitaet, die Anfaelligkeit fuer Emotionen und Ideologisierung. (orig.)

  18. Diagnosis of structures. Practical applications and future tasks of non-destructive testing; Bauwerksdiagnose. Praktische Anwendungen Zerstoerungsfreier Pruefungen und Zukunftsaufgaben

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-05-01

    The preservation of buildings is increasingly becoming the focus of public attention, not least because of traffic restrictions on roads and bridges, which have grown significantly in recent years. Here the building inspectors is of particular importance to assess the causes and extent of repair work as required. This non-destructive testing in the construction industry (ZfPBau method) have become indispensable. However, very few rules are found in construction in contrast to the classical industrial NDT. Also the offers to the qualification of examiners are low, but but in the meantime available. The symposium takes this conflict area to less regulation and a high demand of professional services. One of tasks of the future is the reliable evaluation of existing structures. The foundation was laid by the adoption of the directive for the recalculation of road bridges in 2011 to have results of non-destructive examination incorporated in recalculations. Meanwhile are first experiences on investigations and recalculations of bridges that will be presented at the symposium for the first time. [German] Die Erhaltung von Bauwerken rueckt immer mehr in den Fokus der Oeffentlichkeit, nicht zuletzt durch Verkehrseinschraenkungen an Strassen und Bruecken, die in den letzten Jahren spuerbar zugenommen haben. Dabei kommt den Bauwerkspruefern eine besondere Bedeutung zu, Ursachen und Umfang von Instandsetzungsmassnahmen bedarfsgemaess abzuschaetzen. Hierbei sind zerstoerungsfreie Pruefverfahren im Bauwesen (ZfPBau-Verfahren) nicht mehr wegzudenken. Allerdings sind im Gegensatz zur klassischen industriellen ZfP im Bauwesen sehr wenige Regelwerke anzutreffen. Auch die Angebote zur Qualifizierung von Pruefern sind gering aber mittlerweile vorhanden. Die Fachtagung greift dieses Spannungsfeld geringer Regelsetzung und grossem Bedarf qualifizierter Dienstleistungen auf. Ein Aufgabenfeld der Zukunft ist die zuverlaessige Bewertung von Bestandsbauwerken. Durch das Inkrafttreten der

  19. Intramural hemorrhage of the thoracic aorta - imaging features and differential diagnosis; Das intramurale Haematom der thorakalen Aorta: Bildgebende Diagnostik und Differentialdiagnose

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, T. [Bonn Univ. (Germany) Radiologische Klinik; Abu-Ramadan, D. [Bonn Univ. (Germany). Klinik fuer Herz- und Gefaesschirurgie; Busch, M. [Bonn Univ. (Germany) Radiologische Klinik; Bierhoff, E. [Bonn Univ. (Germany). Pathologische Inst.; Kreft, B. [Bonn Univ. (Germany) Radiologische Klinik; Kuhl, C. [Bonn Univ. (Germany) Radiologische Klinik; Lutterbey, G. [Bonn Univ. (Germany) Radiologische Klinik; Keller, E. [Bonn Univ. (Germany) Radiologische Klinik; Schild, H. [Bonn Univ. (Germany) Radiologische Klinik

    1996-09-01

    Purpose: Aortic wall thickening due to intramural hemorrhage may be the only sign of aortic dissection. The aim of this study was to evaluate the incidence, imaging features and differential diagnoses of intramural hemorrhage (IMH) of the thoracic aorta. Methods: 98 patients with clinically suspected aortic dissection were investigated via Spiral-CT and MRT. Diagnosis of IMH based on the presence of smooth crescentic or concentric wall thickening over a longer segment of the thoracic aorta without flow visualization and without compression or distortion of the aortic lumen. Results: 69 patients had classic aortic dissections and 7 patients were diagnosed to have IMH of the thoracic aorta. One patient with IMH of the ascending aorta died of aortic rupture and subsequent pericardial tamponade 12 hours after onset of symptoms. In one patient with IMH of the descending aorta on initial examination, there was a progression of overt aortic dissection at follow-up after three weeks. In two patients with IMH of the descending aorta, wall thickening decreased in size at follow-up (10-15 weeks), whereas in one patient it remained unchanged. Conclusion: IMH of the aorta should be considered a precursor of aortic dissection. At follow-up IMH may decrease in size, rupture or progress to overt aortic dissection. (orig.) [Deutsch] Ziel: Eine aortale Wandverdichtung als Ausdruck eines intramuralen Haematoms kann die einzige Manifestation einer Aortendissektion sein. Ziel dieser Arbeit war die Evaluierung der Inzidenz, bildgebenden Aspekte und Differentialdiagnosen dieses in der deutschsprachigen Literatur wenig bekannten Krankheitsbildes. Methode: 98 Patienten mit klinischem Verdacht auf eine Aortendissektion wurden MR- und computertomographisch untersucht. Kriterium fuer das Vorliegen eines intramuralen Haematoms war der Nachweis einer laengerstreckigen aortalen Wandverdickung ohne Flussnachweis sowie ohne Konfigurationsaenderung des aortalen Lumens. Ergebnisse: 69 Patienten

  20. Early diagnosis of skeletal disorders in childhood and adolescence by MRI; Fruehdiagnose orthopaedischer Erkrankungen des Kindes- und Jugendalters mit der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Meurer, A.; Schwitalle, M.; Engelhardt, O.; Heine, J. [Johannes Gutenberg-Univ. Mainz (Germany). Orthopaedische Klinik und Poliklinik; Kreitner, K.F. [Johannes Gutenberg-Univ. Mainz (Germany). Inst. fuer Klinische Strahlenkunde

    1998-09-18

    The early diagnosis of such disorders is of major importance because, in most cases, severe consequences can only be averted by early treatment. The value of magnetic resonance imaging (MRI) in many orthopaedic and traumatological conditions is generally accepted. The value of MRI in this particular field is illustrated by typical case reports on common clinical problems [Deutsch] Der Fruehdiagnose von Erkrankungen des Kindes- und Jugendalters kommt grosse Bedeutung zu, da oftmals nur durch eine daraus resultierende Fruehbehandlung schwerwiegende Folgen vermieden werden koennen. Die Kernspintomographie (Magnetresonanztomographie=MRT) ist in zahlreichen orthopaedischen-traumatologischen Fragestellungen bereits etabliert. An ausgewaehlten Fallbeispielen haeufiger klinischer Problemstellungen soll in der vorliegenden Arbeit der Stellenwert der MRT dargestellt werden. (orig.)

  1. Initial diagnosis of therapeutically relevant thoracic lesions in polytraumatised patients; Zur Akutdiagnostik therapierelevanter Thoraxverletzungen bei schwer- und polytraumatisierten Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Danz, B. [Radiologische Abt., Bundeswehrkrankenhaus Ulm (Germany); Biehl, C. [Radiologische Abt., Bundeswehrkrankenhaus Ulm (Germany); Baehren, W. [Radiologische Abt., Bundeswehrkrankenhaus Ulm (Germany)

    1996-04-01

    To determine the value of supine chest radiography in comparison to orientating chest CT in the initial diagnostic evaluation of severely polytraumatised patients. 303 patients with primary indication for a cranial CT following trauma were investigated between 1988 and 1993. After performing the cranial CT all patients underwent a chest CT with an average of 6 CT slices without changing the position of the patient and with a median scan time of 4 minutes. The results of the chest CT were correlated with the findings of the supine chest radiography in regard to therapeutically relevant pathological changes. The sensitivity in detection of pneumothorax in supine chest radiography was 53% versus 97% in CT, atelectasis 20% versus 94%, lung contusion 79% versus 99%, haemotothorax 62% versus 97%. More fractures were found conventionally (sensitivity 94%) than by chest CT (sensitivity 44%). Supine chest radiography of polytraumatised patients is clearly inferior to orientating chest CT in demonstrating posttraumatic lesions; obtaining therapeutically relevant information justifies the additionally needed small amount of time. (orig.) [Deutsch] Das Ziel dieser retrospektiven Untersuchung bestand darin, die Wertigkeit der a.p. Thoraxaufnahme im Liegen im Vergleich zur orientierenden Computertomographie der Thoraxorgane im Rahmen der Akutdiagnostik bei schwer- und polytraumatisierten Patienten zu analysieren. Im Zeitraum von 1988 bis 1993 bestand bei 303 Patienten wegen eines Schaedel-Hirn-Traumas die primaere Indikation zu einem CCT. Im Anschluss an das CCT wurde routinemaessig ein orientierendes CT der Thoraxorgane mit im Durchschnitt 6 Schichten ohne Umlagerung und einem medianen Zeitaufwand von 4 Minuten durchgefuehrt. Die Befunde des CT des Thorax wurden mit den Ergebnissen der durchgefuehrten a.p. Thoraxliegendaufnahmen im Hinblick auf die Erfassung therapierelevanter pathologischer Veraenderungen verglichen. Die Sensitivitaet fuer die Erkennung eines Pneumothorax in

  2. The thickened left ventricle: etiology, differential diagnosis and implications for cardiovascular radiology; Der dicke linke Ventrikel. Ursachen und Differenzialdiagnose der linksventrikulaeren Hypertrophie und Implikationen fuer die kardiovaskulaere Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Bischoff, P.; Barkhausen, J.; Hunold, P. [Universitaetsklinikum Schleswig-Holstein, Luebeck (Germany). Klinik fuer Radiologie und Nuklearmedizin; Radke, P.W. [Universitaetsklinikum Schleswig Holstein, Luebeck (Germany). Medizinische Klinik II

    2012-08-15

    Hypertrophy of the left ventricular myocardium is a common finding and can be reliably detected by echocardiography, CT and MRI. Common causes include diseases associated with increased cardiac afterload as well as primary and secondary cardiomyopathy. With the opportunity to determine functional parameters and myocardial mass precisely as well as to detect structural changes of the cardiac muscle simultaneously, cardiac MRI is the most precise imaging method for quantifying left ventricular hypertrophy as well as determining the cause and the exact characterization of the myocardial changes. It is mandatory, however, to create a flexible, individually adapted examination protocol. This review presents useful diagnostic algorithms in relation to different underlying pathologies in patients with left ventricular hypertrophy. (orig.)

  3. Positionsspezifischer Nachweis und relative Quantifizierung von Modifikationen des alpha-s1-Caseins in Milch mittels MALDI-TOF-MS

    OpenAIRE

    Vollmer, Gregor

    2013-01-01

    Milch und Milchprodukte spielen eine bedeutende Rolle in der menschlichen Ernährung. Vor der Abgabe an den Verbraucher wird Milch in den allermeisten Fällen hitzebehandelt, um mikrobielle Stabilität sicherzustellen und die Haltbarkeit zu verlängern. Allerdings kann diese Hitzebehandlung die in Milch enthaltenen Nährstoffe, unter anderem Kohlenhydrate, Lipide, Proteine und Vitamine, erheblich schädigen. Vitamine werden durch starke Erhitzung zerstört, bei den Lipiden kann es zu Abbaureaktionen...

  4. Comparing EU hospital efficiency using diagnosis-related groups

    NARCIS (Netherlands)

    Rhodes, G.; Wiley, M.; Tomas, R.; Casas, M.; Leidl, R.

    1997-01-01

    This article considers the feasibility of comparing the differences in efficiency and price in the provision of hospital products defined on the basis of diagnosis-related groups (DRGs). Two measures of resource use are compared, the length of stay and the administrative price, both independently

  5. Prognostic significance of gastrointestinal symptoms and diagnosis in relation to the acute radiation syndrome. A retrospective analysis based on the data base SEARCH; Prognostische Bedeutung von gastrointestinalen Symptomen und Befunden in Zusammenhang mit dem aktuen Strahlensyndrom. Eine retrospektive Datenanalyse anhand der Datenbank SEARCH

    Energy Technology Data Exchange (ETDEWEB)

    Hoebbel, Mathias Niklaus Johannes

    2016-11-17

    The following thesis explores the prognostic significance of gastrointestinal symptoms and diagnoses in relation to acute radiation syndrome. This is a retrospective analysis based on the SEARCH (System of Evaluation and Archiving of Radiation Accidents based on Case Histories) database, which was created by a team of researchers in Ulm in 1998. The SEARCH database compiled health status data of individuals involved in a total of 78 ionized radiation accidents between 1945 and 2003. In the past changes in bloodbuilding systems were considered the defining factor in determining a prognosis regarding survival times. Treatment decisions were made in line with these findings, including stem-cell transplants. In recent history, especially after the nuclear disaster in Chernobyl in 1986, the focus shifted onto other organ systems. As a result it has been proven that significant cutaneous damages present an important influence on survival regardless of haematopoiesis. Several researchers have looked at changes in the gastrointestinal tract and possible correlations with radiation induced multiple organ failure. In this paper, all of the data recorded in SEARCH in regards to gastrointestinal symptoms have been analyzed. These include symptoms such as nausea, vomiting and changes in bowel movement as well as their onset and severity. Radiation-induced oral mucositis was also further investigated. Despite the occasional gaps in data in SEARCH, results from the analysis proved that the occurrence of certain symptoms, their severity and their onset were directly correlated to life expectancy, regardless of the dose estimation, and the pending blood test results. An immediate triage of these patients by skilled medical professionals is imperative to accurate categorization.

  6. New aspects in diagnosis and therapy of breast cancer. Neue Aspekte der Diagnostik und Therapie des Mammakarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Sauer, R

    1981-01-01

    Papers from a symposium are presented that was held on the occasion of the inanguration of the high-voltage department of Erlangen university hospital in September 1980. The lectures dealt with the state of the art in diagnosis (e.g. techniques of mammography, lower doses in mammography and ultrasonic diagnosis) and therapy (e.g. radiotherapy, therapy planning, surgical methods, postoperative radiotherapy, supplementary chemotherapy).

  7. Polycythemia vera: diagnosis, different therapy modalities and clinical value of the treatment with radiophosphorus today; Polycythaemia vera: Diagnostik, Differenzialtherapie und Stellenwert der {sup 32}P-Behandlung heute

    Energy Technology Data Exchange (ETDEWEB)

    Bredow, J.; Pinkert, J.; Franke, W.G. [Klinik und Poliklinik fuer Nuklearmedizin TU Dresden (Germany); Schuler, U. [Medizinische Klinik und Poliklinik I, Universitaetsklinikum ' ' Carl Gustav Carus' ' an der TU Dresden (Germany)

    2001-07-01

    The definition, diagnostic criteria and clinical findings as well as the treatment with radioactive phosphorus is described more in detail. Today, the treatment with {sup 32}P is estimated to be an easy and safe method, especially for elderly patients (65 years or above), providing a cost-effective alternative to anti-proliferative drugs like hydroxyurea. (orig.) [German] Es wird auf das Krankheitsbild per se, die Diagnostikkriterien und klinischen Befunde eingegangen und die Radiophosphortherapie bei Patienten mit PCV beschrieben. Aus heutiger Sicht steht mit der Radiophosphortherapie der Polycythaemia vera ein einfaches und sicheres Verfahren zur Verfuegung, welches insbesondere bei aelteren (ueber 65-jaehrigen) Patienten eine praktikable und kostenguenstige Alternative zur medikamentoesen antiproliferativen Therapie mit Hydroxyharnstoff darstellt. (orig.)

  8. Generation und Familie – über die Ambivalenz eines multistrukturellen Verhältnisses Generation and Family—On the Ambivalence of Multi-Structural Relationships

    Directory of Open Access Journals (Sweden)

    Vera Bollmann

    2008-07-01

    Full Text Available Der Sammelband Generationen und Familien, welcher dem Soziologen Kurt Lüscher zum 70. Geburtstag gewidmet ist, stellt eine kritische Gegenwartsdiagnose des aktuellen Theorie- und Forschungsstandes zu diesem Thema dar. Schon in ihrem Vorwort machen die beiden Herausgeber auf die Diversität und den Facettenreichtum des Familien- und Generationenkonzeptes in modernen Gesellschaften aufmerksam: familiale Generationenbeziehungen werden in ganz unterschiedlicher Weise gelebt, und je nach theoretischer Lesart ergeben sich vielfältige Deutungsmuster. Die Beiträge nähern sich der Verflechtung von Familie, Generation und Gesellschaft sowohl in theoretischer als auch in empirischer Hinsicht. Inhaltlich reihen sie sich in drei übergeordnete Themenblöcke ein: „Generationen, Generationenverhältnisse und Generationenbeziehungen“, „Familie, Alltag und Identität“ und „Soziologie, Recht und Politik”.The collected volume Generationen und Familien, which is dedicated to the sociologist Kurt Lüscher on his 70th birthday, presents a critical diagnosis of the current state of theory and research on this theme. The editors point to the diversity and multi-structural nature of the concept of family and generation in their forward to the volume: Familial relations between generations are experienced in very different ways and, depending upon the theoretical reading, they provide multiple patterns for interpretation. The contributions approach the linkage between family, generation, and society in a theoretical and an empirical manner. The contents can be divided into three general thematic blocks: “Generation, generational relations, and generational relationships,” “family, daily life, and identity,” and “sociology, law, and politics.”

  9. Age-Related Macular Degeneration: Advances in Management and Diagnosis

    Directory of Open Access Journals (Sweden)

    Yoshihiro Yonekawa

    2015-02-01

    Full Text Available Age-related macular degeneration (AMD is the most common cause of irreversible visual impairment in older populations in industrialized nations. AMD is a late-onset deterioration of photoreceptors and retinal pigment epithelium in the central retina caused by various environmental and genetic factors. Great strides in our understanding of AMD pathogenesis have been made in the past several decades, which have translated into revolutionary therapeutic agents in recent years. In this review, we describe the clinical and pathologic features of AMD and present an overview of current diagnosis and treatment strategies.

  10. Labor Relations and Social Dialogue: Measurement and Diagnosis Instruments

    Directory of Open Access Journals (Sweden)

    Viorel Lefter

    2007-02-01

    Full Text Available Social dialogue and tripartism play an important role in promoting and strengthening fundamental principles and rights at work, promoting job creation and expanding social protection. In the context of the severe challenges of globalization, a growing number of developing countries are recognizing the need to faster dialogue, partnership and participatory approaches to decision-making. Thus, social dialogue becomes a prerequisite for efficient corporate governance and means to attain national economic and social objectives and to contribute to poverty reduction policies. We shall propose a diagnosis and analysis system in order to measure and monitor the evolution of the industrial relations and social dialogue.

  11. Australian diagnosis related groups: Drivers of complexity adjustment.

    Science.gov (United States)

    Jackson, Terri; Dimitropoulos, Vera; Madden, Richard; Gillett, Steve

    2015-11-01

    In undertaking a major revision to the Australian Refined Diagnosis Related Group (ARDRG) classification, we set out to contrast Australia's approach to using data on additional (not principal) diagnoses with major international approaches in splitting base or Adjacent Diagnosis Related Groups (ADRGs). Comparative policy analysis/narrative review of peer-reviewed and grey literature on international approaches to use of additional (secondary) diagnoses in the development of Australian and international DRG systems. European and US approaches to characterise complexity of inpatient care are well-documented, providing useful points of comparison with Australia's. Australia, with good data sources, has continued to refine its national DRG classification using increasingly sophisticated approaches. Hospital funders in Australia and in other systems are often under pressure from provider groups to expand classifications to reflect clinical complexity. DRG development in most healthcare systems reviewed here reflects four critical factors: these socio-political factors, the quality and depth of the coded data available to characterise the mix of cases in a healthcare system, the size of the underlying population, and the intended scope and use of the classification. Australia's relatively small national population has constrained the size of its DRG classifications, and development has been concentrated on inpatient care in public hospitals. Development of casemix classifications in health care is driven by both technical and socio-political factors. Use of additional diagnoses to adjust for patient complexity and cost needs to respond to these in each casemix application. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. The role of nuclear medicine in diagnosis and treatment of feline hyperthyroidism; Nuklearmedizinische Diagnostik und Therapie der felinen Hyperthyreose

    Energy Technology Data Exchange (ETDEWEB)

    Puille, Max; Puille, N. [MVZ fuer Diagnostik und Therapie, Regensburg (Germany)

    2010-03-15

    Feline hyperthyroidism is the most common endocrinological disorder of older cats. Diagnosis is established by assessment of thyroid stimulating hormone (TSH) and free thyroxine (FT4). In hyperthyroidism FT4 is found up to ten times above the normal range. Thyroid scintigraphy using {sup 99m}Tc-pertechnetate shows goiter size, which can reach more than 20 ml, and differentiates between unifocal and multifocal thyroid adenoma. In rare cases, ectopic tracer accumulation may be found, suggesting thyroid carcinoma. Radioiodine is the safest, simplest and most effective treatment for benign thyroid disease in the cat. Normal thyroid function is usually established within two weeks. Practical and legal radiation protection rules are strictly to be observed. Even so, the rapid elimination of {sup 131}I usually allows patient discharge within one week. Internal and external radiation risks are very low for clinic staff and cat owners. (orig.)

  13. Acetazolamide in cerebral diagnosis: Physiological and pathophysiological aspects. Acetazolamid in der zerebrovaskulaeren Diagnostik: Physiologische und pathophysiologische Aspekte

    Energy Technology Data Exchange (ETDEWEB)

    Lerch, H.; Franke, W.G.; Templin, A. (Medizinische Akademie ' Carl Gustav Carus' , Klinik fuer Nuklearmedizin, Dresden (Germany) Medizinische Akademie ' Carl Gustav Carus' , Klinik fuer Psychiatrie und Neurologie, Abt. Neurologie, Dresden (Germany))

    1990-01-01

    The sensitivity in the diagnosis of cerebrovascular diseases using radiotracers can be enhanced by the use of the acetazolamide test. In this paper we present and discuss some physiological and pathophysiological aspects of its mechanism. The physiological action of the carboanhydrase inhibitor is like the action of enhanced pCO{sub 2} in the tissue, thus acting at the site of metabolic regulation. The reaction of the vascular bed is influenced in part by subcortical structures. Pathologically the reaction can be disturbed at first by an altered regulation with the vessels being mechanically intact, e.g. in hypoxia or transient ischemia. Secondly, the mechanics of the vessels may be not intact e.g., in atherosclerosis or surrounding edema. Lastly, the vessels have already dilated, e.g. poststenotically. All these facts have to be taken into consideration interpreting an acetazolamid test. (orig.).

  14. Effectiveness of geriatric rehabilitation among patients with secondary diagnosis dementia [Effektivität der ambulanten und stationären geriatrischen Rehabilitation bei Patienten mit der Nebendiagnose Demenz

    Directory of Open Access Journals (Sweden)

    Korczak, Dieter

    2012-09-01

    Full Text Available [english] Often geriatric patients with secondary diagnosis dementia do not receive a rehabilitation treatment, although it is an obligatory service offered by the statutory health insurance. Scientists have examined the benefit of relevant measures for patients who are slightly or moderately affected with dementia. Thus, also these patients would profit by a rehabilitation.[german] Geriatrische Patienten mit Nebendiagnose Demenz erhalten oft keine Rehabilitation, obwohl diese zu den Pflichtleistungen der gesetzlichen Krankenkasse gehört. Wissenschaftler haben untersucht, ob und wenn ja, welchen Nutzen entsprechende Maßnahmen für leicht bis moderat demenzkranke Patienten haben. Demnach profitieren durchaus auch diese Patienten von einer Rehabilitation.

  15. Sport und soziale Integration

    OpenAIRE

    Turan, Günes

    2012-01-01

    Sport und soziale Integration : Chancen, Probleme und Perspektiven für Städte und Kommunen ; Tagungsband der gleichnamigen Tagung am 28. und 29. Juni 2011 in Augsburg / Helmut Altenberger ... (Hrsg.). - Hamburg : Feldhaus, Ed. Czwalina, 2012. - 104 S. - (Sportwissenschaft und Sportpraxis ; 161)

  16. Fractures of the atlantoaxial complex in the elderly: assessment of radiological spectrum of fractures and factors influencing imaging diagnosis; Frakturen des Atlas und Axis bei aelteren Patienten: Untersuchung des Radiologischen Spektrums der Frakturen und bedeutsamer Faktoren fuer die Bildgebende Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Lomoschitz, F.M. [Universitaetsklinik fuer Radiodiagnostik, AKH Wien, Wien (Germany); Dept. of Radiology, Harborview Medical Center, Univ. of Washington, Seattle, WA (United States); Blackmore, C.C.; Linnau, K.F.; Mann, F.A. [Dept. of Radiology, Harborview Medical Center, Univ. of Washington, Seattle, WA (United States); Stadler, A. [Universitaetsklinik fuer Radiodiagnostik, AKH Wien, Wien (Germany)

    2004-02-01

    Objective: to describe patterns of atlantoaxial fractures in a population of consecutive elderly patients, including assessment of type, distribution and associated clinical and radiological findings, and to analyze any influence of the causative trauma mechanism on the individual fracture pattern. Materials and methods: the distribution and type of 123 atlantoaxial fractures in 95 subjects older than 65 years (range: 65-102; mean age: 79 years) were retrospectively assessed. For each subject, trauma mechanism and clinical and neurological status were recorded at admission. Initial imaging studies of the cervical spine were reviewed. Preexistent degenerative changes were assessed and the atlantoaxial fractures classified. Data were evaluated for the frequency of different types of fractures of C1 and C2 and for accompanying fractures of cervical vertebrae or the occipital condyles, respectively. Results: the majority of patients with injuries of the atlantoaxial complex had fractures of C2 (90 of 95, 95%). A large proportion of these patients (67 of 90, 74%) had odontoid fractures. An isolated fracture of C1 was present in only 5 (5%) patients. Associated fractures of the occipital condyles or other cervical vertebrae were rare (10 of 95, 11%). The main trauma mechanism for atlantoaxial injuries was a fall (56 of 95, 59%). Elderly patients injured in motor vehicle accidents were more likely to have isolated fractures of C2 and Type III fractures of the odontoid (p < 0.02). Conclusion: in elderly patients, fractures of the atlantoaxial complex are mainly caused by falls and almost always involve C2. The trauma mechanism influences the fracture pattern (orig.) [German] Untersuchung von Frakturen des Atlas (C1) und Axis (C2) in einer konsekutiven Population aelterer Patienten ({>=} 65 Jahre) hinsichtlich Fraktur-Typus, -Haeufigkeit, und -Kombinationen, und Analyse von assoziierter Klinik sowie Einfluss von unfall-ursaechlichen Faktoren auf Frakturen des atlanto

  17. Meniscus and ligament injuries; Meniskus- und Bandlaesionen

    Energy Technology Data Exchange (ETDEWEB)

    Glaser, C.; Trumm, C. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie (Germany); Scheidler, J.; Heuck, A. [Radiologisches Zentrum Muenchen, Pasing (Germany)

    2006-01-01

    The knee is one of the major weight-bearing joints and is relatively exposed to trauma. Capsuloligamentous structures are essential to provide joint stability and - in turn - persistent instability bears a risk for osteoarthritis that needs timely and comprehensive diagnosis. Using MRI it may be beneficial to routinely apply (T)SE sequences in all three major planes as a basic protocol and to add additional sequences according to the clinical information available and imaging findings in the basic protocol. Especially fat-suppressed sequences (STIR, T2w/PDw FS TSE) are very useful because they sensitively depict bone marrow edema pattern (BMEP)-like changes. This finding often alerts the reader to - sometimes only discrete - underlying pathologies and may - if found in typical locations - give information about the mechanism of injury and thus lead the radiologist to look for specific concomitant capsuloligamentous, cartilage, and/or meniscal injury. BMEP is quite prominent in contusion injury, whereas often it is but discrete in avulsion lesions. There is extensive literature about the signs, possible pitfalls, and the accuracy of MRI for the diagnosis of specific pathologies such as meniscal tears or cruciate or collateral ligament ruptures. However, combined injuries of more than one structure are frequent and affect the therapeutic approach. Thus, the primary goal of the radiologist is to go beyond the description of any isolated lesion and to give a comprehensive description of (or to reliably exclude) any injury to other structures. A necessary prerequisite to accomplish this is a thorough knowledge of the - in some locations - complex anatomic relationships, pitfalls, and locations where lesions typically occur and where they may be overlooked. (orig.) [German] Das Knie ist vergleichsweise exponiert gegenueber Traumata. Sein Kapsel-Band-Apparat ist ein wesentlicher Faktor fuer die Gelenkstabilitaet. Umgekehrt erhoeht persistierende Instabilitaet das Risiko

  18. S3 Guideline. Diagnosis and treatment of colorectal carcinoma. Relevance for radiologic imaging and interventions; Aktualisierte S3-Leitlinie zur Diagnostik und Therapie des kolorektalen Karzinoms. Bedeutung fuer die radiologische Diagnostik und Intervention

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Fischer, S. [Universitaetsklinikum Frankfurt (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Schmiegel, W.; Pox, C. [Bochum Univ. (Germany). Medizinische Universitaetsklinik; Pereira, P.L. [SLK Kliniken, Heilbronn (Germany). Klinik fuer Radiologie, Minimal-Invasive Therapien und Nuklearmedizin; Brambs, H.J. [Universitaetsklinikum Ulm (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Lux, P. [Universitaetsklinikum Erlangen (Germany). Chirurgische Klinik

    2013-08-15

    The new German S3 guideline 'Colorectal Carcinoma' was created as part of the German Guideline Program in Oncology of the Association of the Scientific Medical Societies in Germany, the German Cancer Society and the German Cancer Aid under the auspices of the German Society for Digestive and Metabolic Diseases and replaces the guideline from 2008. With its evidence-based treatment recommendations, the guideline contains numerous updates and detailed definitions regarding the diagnosis and treatment of colon and rectal cancer. In particular, consensus-based recommendations regarding early detection, preoperative diagnostic method selection, and the use of interventional radiological treatment methods are detailed. The guideline also includes quality indicators so that standardized quality assurance methods can be used to optimize patient-related processes. The present article discusses the significance of the current recommendations for radiological diagnosis and treatment and is intended to enhance the quality of patient information and care by increasing distribution. (orig.)

  19. Leibniz's relationalism and the crisis of Anschauung in quantum mechanics; Der Relationalismus von Leibniz und die Krise der Anschauung in der Quantenmechanik

    Energy Technology Data Exchange (ETDEWEB)

    Herbig, Ralf

    2009-05-07

    Heisenberg's pioneering work ''Ueber quantentheoretische Umdeutung kinematischer und mechanischer Beziehungen'' (1925) illustrates corner points of Leibniz's theory of knowledge. It succeeds to distill kinematics of circles with velocity from an analysis of the Larmor model for the Zeeman effect. Aim of this novel kinematics is Heisenberg's time-free quantum algebra. The circle kinematica are strictly relational, and they can serve as fundament of a prototheory of quantum physics just to be developed. The kinematics of the circles implicates finally a staged term of illustrativeness. [German] Heisenbergs Pionierarbeit ''Ueber quantentheoretische Umdeutung kinematischer und mechanischer Beziehungen'' (1925) illustriert Eckpunkte der Leibnizschen Erkenntnistheorie. Es gelingt, eine Kinematik von Kreisen mit Geschwindigkeit aus einer Analyse des Larmor-Modells fuer den Zeeman-Effekt herauszudestillieren. Zielrichtung dieser neuartigen Kinematik ist Heisenbergs zeitfreie Quantenalgebra. Die Kreiskinematik ist strikt relational, und sie kann als Fundament einer erst noch zu entwickelnden Prototheorie der Quantenphysik dienen. Die Kinematik der Kreise mit Geschwindigkeit impliziert schliesslich einen gestuften Begriff von Anschaulichkeit. (orig.)

  20. Diagnosis and treatment of sarcomas and related tumors

    International Nuclear Information System (INIS)

    1978-01-01

    The Cancergram focuses on clinical aspects of sarcomas involving soft tissue and bone, and also includes abstracts on related malignant and benign tumors. Soft tissues are considered as all non-epithelial extra-skeletal tissues of the body, with the exception of the reticuloendothelial system, the neuroglia, and visceral and parenchymal organs. Included, therefore, are sarcomas of the vascular system, fatty tissue, muscle tissues, connective tissues, and synovial tissues. Bone tumors included are osteosarcoma, chondrosarcoma, adamantinoma, chrondroblastoma, Ewing's sarcoma, and other benign and malignant disorders of the bone. This Cancergram excludes disorders of the bone marrow, which are the subjects of separate Cancergrams (see series CT03 for leukemias, and series CT12 for multiple myeloma). The scope includes diagnosis and staging, supportive care, evaluation, and therapy. Selected abstracts concerning epidemiology, etiology and other pre-clinical studies will also be included where they have direct clinical relevance

  1. Diagnosis-Related Groups (DRG and Hospital Business Performance Management

    Directory of Open Access Journals (Sweden)

    Szynkiewicz Piotr

    2014-12-01

    Full Text Available The goal of this article is to present the possibility of using Diagnosis- Related Groups (DRG in the hospital management process and to analyse the need for business performance management on the part of hospital management staff. The following research methods were used: literature analysis, case studies, and poll analysis. It is not possible to increase the effectiveness of operation of healthcare entities without increasing the importance of IT systems and using DRG more effectively in the management process. Training users in IT and the use of DRGs is important to achieving hospital effectiveness. The increased importance of analyses and planning in a hospital should be reflected in the organisational structure of service providers. Hospital controllers should have a similar role to those present in most companies in other industries.

  2. Optimisation of single-pipe heating systems with heating cost distribution and supporting room air processes in industrial housing construction in the new Laender. Pt. 2. Heating cost distribution and energy diagnosis; Optimierung von Einrohrheizungsanlagen mit Heizkostenverteilung sowie flankierenden Raumluftprozessen im industriellen Wohnungsbau der NBL. T. 2. Heizkostenverteilung und Energiediagnose

    Energy Technology Data Exchange (ETDEWEB)

    Bach, H; Bauer, M; Eisenmann, G; Haupt, C; Tritschler, M

    1996-12-01

    The second part of the present research report focusses on energy diagnosis and heating cost distribution in single-pipe heating systems. It describes energy diagnosis with regard to its aims and methods. The subject of heating cost distribution is addressed with a statistical evaluation of the field studies carried out in the course of the research project. The use of heating cost distributors is examined by simulation calculations and assessed on this basis. (HW) [Deutsch] Die Themenschwerpunkte des 2. Teils des Forschungsberichtes sind die Energiediagnose und die Heizkostenverteilung in Einrohranlagen. Bezueglich der Energiediagnose werden Ziel und Methoden beschrieben. Zur Thematik Heizkostenverteilung werden die durchgefuehrten Feldversuche statistisch ausgewertet. Der Einsatz der Heizkostenverteilsysteme wird durch Simulationsrechnungen untersucht und beurteilt. (HW)

  3. Pretherapeutic and posttherapeutic laryngeal imaging; Prae- und posttherapeutische Larynxbildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Becker, M.; Burkhardt, K.; Allal, A.S.; Dulguerov, P.; Ratib, O.; Becker, C.D. [Hopitaux Universitaires de Geneve, Abteilung fuer Hals-Nasen-Ohren-Radiologie, Geneve (Switzerland)

    2009-01-15

    Cross-sectional imaging with CT, MRI and more recently PET CT plays an indispensable complementary role to endoscopy in the pretherapeutic diagnostic and staging of laryngeal neoplasms and in the evaluation of the operated or irradiated larynx. Adequate interpretation of the CT, PET CT and MR images requires a thorough knowledge of the patterns of submucosal spread and familiarity with the diagnostic signs of neoplastic invasion as seen with each modality. In addition, one should be aware of the implications of imaging for staging and treatment. Both CT and MR imaging are highly sensitive for the detection of neoplastic invasion of the preepiglottic and paraglottic spaces, subglottic region and cartilage. The high negative predictive value of both CT and MRI allows a relatively reliable exclusion of neoplasm cartilage invasion. The specificity of both CT and MRI is, however, moderately high and both methods may, therefore, overestimate the extent of tumor spread. However, recent investigations have shown that the specificity of MRI may be significantly improved by using new diagnostic criteria which allow differentiation of tumor from peritumoral inflammation in many instances. Both cross-sectional imaging methods also significantly improve the pretherapeutic staging accuracy of laryngeal tumors if used in addition to clinical examination and endoscopic biopsy. In the presence of a submucosal mass, CT and MRI play a key role for the diagnosis, as they may characterize the lesion, reliably depict its submucosal extent and guide the endoscopist to perform deep biopsies which allow the definitive histological diagnosis. Cross-sectional imaging also plays a key role in the evaluation of laryngoceles, recurrent laryngeal nerve paralysis and fractures. (orig.) [German] Sowohl CT als auch MRT und neuerdings die PET-CT sind unentbehrliche Zusatzuntersuchungen zur Diagnostik und Stadieneinteilung von Tumoren des Larynx. Sie sind der klinischen Untersuchung (einschliesslich

  4. Diagnosis-Related Groups in Hand Surgery – a comparison of six European countries [Fallpauschalen in der Handchirurgie – ein Vergleich von sechs europäischen Ländern

    Directory of Open Access Journals (Sweden)

    Stahl, Stephane

    2012-04-01

    Full Text Available [english]
    Diagnosis-Related Group (DRG is a classification system, which groups patients according to their diagnosis and resource consumption. Common hand surgical diagnoses and procedures were processed using national DRG-groupers of six European countries. The upper thresholds of length of stay (LoS are indicated for every country with the exception of Spain. The mean value in the series was 9.9 days for Germany, 4.5 days for Austria, 10.7 days for Italy, 9.7 days for Sweden and 9.4 days for the United Kingdom (UK. Germany and Austria also have lower thresholds of LoS and the average LoS.Multiple finger replantation presented the highest single case reimbursement in Germany, Austria and the UK (13,825 €, 10,576 € and Scaphoid non-union had the highest single case reimbursement in Italy (2,676 €, flap coverage of wounds in Spain (5,506 € and trapeziometacarpal arthritis in Sweden (5,350 €. The mean values for single case reimbursement were as follows: Germany 3,211 €, Austria 2,821 €, Italy 1,947 €, Spain 3,594 €, Sweden 2,403 € and the UK 3,253 €. Ten out of 19 cases showed the highest reimbursement in Spain, followed by the UK (5 cases, Sweden (2 cases, Germany and Austria (1 case each. Applying the case numbers of our clinic to the reimbursement system of each country, total proceeds would be 2.25 million € in Spain, in Germany as well as the UK, 1.75 million € in Austria, in Sweden and 1.22 million € in Italy. The consequences of international differences in efficiency and reimbursement are hard to assess as they are influenced by multiple factors that are seldom purely market-driven. However, the consideration of international data for benchmarking and refinement of national compensation systems should be a useful instrument. [german]
    Diagnosis-Related Groups (DRG bezeichnet ein Klassifikationssystem, welches Patienten anhand ihrer Diagnosen und des Ressourcenverbrauchs einteilt. H

  5. Introducing diagnosis-related groups: is the information system ready?

    Science.gov (United States)

    Jian, Weiyan; Lu, Ming; Han, Wei; Hu, Mu

    2016-01-01

    Diagnosis-related group (DRG) system is a classification system widely used in health managements, the foundation of which lies in the medical information system. A large effort had been made to improve the quality of discharge data before the introduction of DRGs in Beijing. We extract discharge data from 108 local hospitals spanning 4 years before and after standardization to evaluate the impact of standardization on DRG grouping performance. The data was grouped on an annual basis in accordance with Beijing's local DRG system. Proportion of ungrouped data, coefficient of variation (CV) and reduction in variance (RIV) were used to measure the performance of the DRG system. Both the descriptive and regression analysis indicate a significant reduction in terms of ungrouped data and CV for expenditure, increase of RIV for expenditure and length of stay. However, when there was no intervention, that is, between 2005 and 2006 and between 2008 and 2009, changes in these indicators were all insignificant. Therefore, the standardization of discharge data did improve data quality and consequently enhanced the performance of DRGs. Developing countries with a relatively weak information infrastructure should strengthen their medical information system before the introduction of the DRG system. Copyright © 2014 John Wiley & Sons, Ltd.

  6. Ein nicht-erwerbszentrierter Blick auf die Geschlechterverhältnisse in der DDR und Ostdeutschland A Look at Gender Relations in the GDR and East Germany, Focussing on the Social, Domestic, and Family Sphere

    Directory of Open Access Journals (Sweden)

    Sylka Scholz

    2001-11-01

    Full Text Available Im Mittelpunkt des Buches von Susanne Stolt steht die Frage nach alltäglichen Geschlechterbeziehungen in Ostdeutschland nach der Wende und der individuellen Suche nach Anerkennung von Männern und Frauen. Theoretisch stützt Stolt sich dabei v.a. auf den psychoanalytisch geprägten Ansatz von Jessica Benjamin mit der Fokussierung auf das Anerkennungsproblem und empirisch auf qualitative Interviews von Frauen und Ehepaaren. Sie distanziert sich von „erwerbszentrierten Perspektiven“, die die Dominanz des Erwerbssystems und die Abwertung von Fürsorgearbeit fortschreiben und damit die in die Erwerbssphäre eingeschriebene männliche Herrschaft reproduzieren.Stolt’s work investigates everyday gender relations in post-socialist East Germany, focusing on the search for recognition of individual men and women. Stolte’s work is informed by Jessica Benjamin’s psychoanalytical work on the search for recognition; furthermore, Stolte draws on qualitative interviews which she conducted with women and with heterosexual couples. Stolte makes a point of distancing herself from approaches which focus on the sphere of “gainful employment,” arguing that approaches which focus on a narrowly defined sphere of work do not problematise dominant ideas about the value of unpaid work (e.g., caretaking, and thus serve to reproduce male bias and male dominance which are intrinsic to the sphere of gainful employment.

  7. Mountain biking. Breezy ups and traumatic downs; Mountainbiking. Luftige Hoehen und traumatische Tiefen

    Energy Technology Data Exchange (ETDEWEB)

    Schueller, G. [Medizinische Universitaet Wien, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria)

    2010-05-15

    For more than two decades the popularity of mountain biking as a national pastime as well as a competitive sport has been undiminished. However, its related risks are not monitored as closely as those, for example, of skiing. The injuries caused by mountain biking are specific and cannot be compared with those caused by other cycling sports. This is due not only to the characteristics of the terrain but also to the readiness to assume a higher risk compared to cycle racing. The particular value of radiology is in the acute trauma setting. Most often musculoskeletal lesions must be examined and digital radiography and MRI are the most useful techniques. Severe trauma of the cranium, face, spine, thorax and abdomen are primarily evaluated with CT, particularly in dedicated trauma centers. Therefore, radiology can play a role in the rapid diagnosis and optimal treatment of the trauma-related injuries of mountain biking. Thus, the unnecessarily high economical damage associated with mountain biking can be avoided. (orig.) [German] Mountainbiking erfreut sich seit mehr als 2 Jahrzehnten sowohl im Breiten- als auch Wettkampfsport einer ungebrochenen Popularitaet. Die assoziierten Risiken werden allerdings nicht mit derselben Aufmerksamkeit beobachtet wie etwa jene des Skisports. Die Verletzungen beim Mountainbiking sind spezifisch und nicht mit den Verletzungen vergleichbar, die bei anderen Radsportarten entstehen. Dies ist z. T. durch die Besonderheiten des Terrains und z. T. durch eine im Vergleich zum Rennradfahren hoehere Risikobereitschaft zu erklaeren. Die Radiologie hat ihren Stellenwert besonders in der Akutdiagnostik. Hier beschaeftigt sie sich v. a. mit muskuloskelettalen Verletzungen und setzt in erster Linie auf die digitale Projektionsradiographie und die MRT. Zur Evaluierung schwerer Verletzungen des Kopfs, der Wirbelsaeule, des Thorax und des Abdomens wird die CT bevorzugt, insbesondere in dezidierten Traumazentren. Damit kann die Radiologie ihren Teil

  8. Radioimmunoassays and related procedures in the diagnosis of parasitic infections

    International Nuclear Information System (INIS)

    Dessaint, J.P.; Cesbron, J.Y.; Lutsch, C.; Nogueira-Queiroz, J.A.; Capron, A.

    1986-01-01

    Immunological tests for the diagnosis of parasitic infections have long been used, yet the marked variability in seroreactivity of infected patients is still a challenge to immunoparasitologists. In the case of helminth parasites, especially schistosomes and filariae, immunoassays have benefited by numerous advances in the characterization and purification of antigens and by the use of monoclonal antibodies. The identification of functional antigens allows the detection of putative protective (or blocking) antibody responses by competitive RIAs using monoclonal antibodies in schistosomiasis. While progress has been made in the investigation of immunity in man, immunoassays for antibodies do not accurately correlate with parasite load, especially at lower antibody responses or after chemotherapy. Immunoassays for circulating parasite antigens have received much attention in recent years. Immunoradiometric assays and related procedures using infection sera or monoclonal antibodies are now being investigated in field conditions. Cross-reactions among circulating antigens from different parasites can decrease the specificity of such assays, whereas circulating immune complexes can interfere with the test. The recent use of RIAs to measure parasite antigens in the urine of patients with schistosomiasis or filariasis appears a promising approach. (author)

  9. Diagnosis of IgG4-related sclerosing cholangitis

    Science.gov (United States)

    Nakazawa, Takahiro; Naitoh, Itaru; Hayashi, Kazuki; Miyabe, Katsuyuki; Simizu, Shuya; Joh, Takashi

    2013-01-01

    IgG4-related sclerosing cholangitis (IgG4-SC) is often associated with autoimmune pancreatitis. However, the diffuse cholangiographic abnormalities observed in IgG4-SC may resemble those observed in primary sclerosing cholangitis (PSC), and the presence of segmental stenosis suggests cholangiocarcinoma (CC). IgG4-SC responds well to steroid therapy, whereas PSC is only effectively treated with liver transplantation and CC requires surgical intervention. Since IgG4-SC was first described, it has become a third distinct clinical entity of sclerosing cholangitis. The aim of this review was to introduce the diagnostic methods for IgG4-SC. IgG4-SC should be carefully diagnosed based on a combination of characteristic clinical, serological, morphological, and histopathological features after cholangiographic classification and targeting of a disease for differential diagnosis. When intrapancreatic stenosis is detected, pancreatic cancer or CC should be ruled out. If multiple intrahepatic stenoses are evident, PSC should be distinguished on the basis of cholangiographic findings and liver biopsy with IgG4 immunostaining. Associated inflammatory bowel disease is suggestive of PSC. If stenosis is demonstrated in the hepatic hilar region, CC should be discriminated by ultrasonography, intraductal ultrasonography, bile duct biopsy, and a higher cutoff serum IgG4 level of 182 mg/dL. PMID:24282356

  10. Sports-related concussions: diagnosis, complications, and current management strategies.

    Science.gov (United States)

    Hobbs, Jonathan G; Young, Jacob S; Bailes, Julian E

    2016-04-01

    Sports-related concussions (SRCs) are traumatic events that affect up to 3.8 million athletes per year. The initial diagnosis and management is often instituted on the field of play by coaches, athletic trainers, and team physicians. SRCs are usually transient episodes of neurological dysfunction following a traumatic impact, with most symptoms resolving in 7-10 days; however, a small percentage of patients will suffer protracted symptoms for years after the event and may develop chronic neurodegenerative disease. Rarely, SRCs are associated with complications, such as skull fractures, epidural or subdural hematomas, and edema requiring neurosurgical evaluation. Current standards of care are based on a paradigm of rest and gradual return to play, with decisions driven by subjective and objective information gleaned from a detailed history and physical examination. Advanced imaging techniques such as functional MRI, and detailed understanding of the complex pathophysiological process underlying SRCs and how they affect the athletes acutely and long-term, may change the way physicians treat athletes who suffer a concussion. It is hoped that these advances will allow a more accurate assessment of when an athlete is truly safe to return to play, decreasing the risk of secondary impact injuries, and provide avenues for therapeutic strategies targeting the complex biochemical cascade that results from a traumatic injury to the brain.

  11. Public relations and conflict management at regional bio energy projects; Oeffentlichkeitsarbeit und Konfliktmanagement bei regionalen Bioenergieprojekten

    Energy Technology Data Exchange (ETDEWEB)

    Turk, Thomas [IGLux Witzenhausen GmbH, Witzenhausen (Germany)

    2012-07-01

    The development of facilities for the production of renewable energies as well as the expansion of transmission lines related to it, have an immediate impact on the living environment of many people. In this context an alarming decrease of acceptance of renewable power facilities in the vicinity becomes evident. This article shows the causes and makes suggestions on how investors, approving authorities and local affairs may produce relief and get the local discussion to a more objective level. Aport from a professional communitation strategy, measures such as the preparation of a site appraisal - known from rather unpopular projects such as landfill construction - can be useful. (orig.)

  12. Emission certificates. Legal, tax-related and practical aspects; Emissionszertifikate. Rechtliche, steuerliche und praktische Aspekte

    Energy Technology Data Exchange (ETDEWEB)

    Hack, Christoph; Bartholl, Carsten; Hartmann, Astrid (eds.)

    2011-07-01

    The book discusses the issue of emission certificates from the view of public law, civil law and tax law, in consideration of practical experience with emission reduction projects. The subjects discussed range from emission trading from the view of public law to the civil law and regulatory law aspects of emission trading and taxation law. The legal situation in Germany is covered from the view of public and private law. The state of legislation on emission reduction in the USA is gone into, and practical experience relating to the Clean Development Mechanism is presented. (orig./RHM)

  13. Focal lesions in whole-body MRI in multiple myeloma. Quantification of tumor mass and correlation with disease-related parameters and prognosis; Fokale Laesionen in der Ganzkoerper-MRT beim multiplen Myelom. Quantifizierung der Tumorlast und Korrelation mit krankheitstypischen Parametern und Prognose

    Energy Technology Data Exchange (ETDEWEB)

    Brandelik, S.C.; Kauczor, H.U. [Universitaetsklinikum Heidelberg, Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Krzykalla, J.; Hielscher, T. [Deutsches Krebsforschungszentrum (dkfz), Biostatistik, Heidelberg (Germany); Hillengass, J. [Universitaetsklinikum Heidelberg, Haematologie und Onkologie, Heidelberg (Germany); Kloth, J.K. [Radiologie Loebau, Loebau (Germany); Weber, M.A. [Universitaetsklinikum Heidelberg, Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaetsmedizin Rostock, Diagnostische und Interventionelle Radiologie, Rostock (Germany)

    2018-01-15

    In this study, we evaluated methods of quantification of tumor mass in whole-body MRI (wb-MRI) in multiple myeloma and correlated these with disease-related parameters in serum and bone marrow. We retrospectively evaluated wb-MRIs of 52 patients with focal infiltration pattern and a total of 700 focal lesions (subsequently called lesions). We determined the longest diameter (LD), the segmented volume (SV), and the morphology (spherical or non-spherical). We correlated total number/volume of the lesions with clinical parameters and prognosis and furthermore LD with SV. After that we analyzed the agreement of SV and estimated volume (EV) using the volume formula of a sphere based on LD. Results showed no significant correlations of total number/volume with prognosis or clinical parameters. The latter were situated predominantly in the normal range. Furthermore, 10% of lesions were spherical. SV and LD correlated significantly in single lesions and on patient level. SV was in lesions <6 cm{sup 3} systematically larger and in lesions ≥6 cm{sup 3} smaller than EV. In 95%, we found in small lesions a deviation of EV versus SV from +0.9 cm{sup 3} to -4.6 cm{sup 3} and in large lesions from +160 cm{sup 3} to -111 cm{sup 3} (EV-SV). Quantification of tumor mass in the focal infiltration pattern is performed more accurately by volumetry than LD due to the predominant existence of non-spherical lesions. The patient cohort with clinical parameters predominantly in the normal range is distributed to ISS stage I and partly pretreated, a fact that makes interpretation of absent correlations more difficult. Consider also a variation in activity of lesions and a diffuse infiltration not detectable by MRI. (orig.) [German] In dieser Studie wurden Methoden der Tumorlastquantifizierung in der Ganzkoerper-Magnetresonanztomographie (GK-MRT) beim Multiplen Myelom untersucht und mit krankheitstypischen Parametern in Serum und Knochenmark korreliert. Die GK-MRT von 52 Patienten mit

  14. Diagnosis and therapy of dysfunctions of human leukocytes after irradiation. Final report; Diagnose und Therapie von Funktionsstoerungen menschlicher Leukozyten nach Bestrahlung. Abschlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Beuningen, D. van; Kaffenberger, W. [Sanitaetsakademie der Bundeswehr, Muenchen (Germany); Baaske, C.; Leipert, D.

    1999-08-01

    Experiments were performed with isolated human PMN and with the promyelocytic HL-60 cell line, induced to differentiate along the granulocytic lineage with dimethyl sulfoxid. The respiratory burst reaction was triggered with soluble stimuli (chemotactic agent: formylated tripeptide, f-MLP, immune complexes, or phorbol ester) and measured flow cytometrically or as chemiluminescence signals with indicator molecules dihydrorhodamine 123 or luminol, respectively. The presence of enzymes was postulated, verified with Western blotting, and their activities were inhibited pharmacologically, lipid 2{sup nd}-messengers (diacylglycerol) were measured by HPLC. Our results identify protein kinase (PK) C activity as the central element of signal transduction cascades involved in the activation of the NADPH oxidase. In addition, several phospholipases ({beta}, {gamma}), protein tyrosine- as well as protein serine/threonine kinases and DAG kinases in combination with phosphatidate phosphohydrolase contribute to intracellular signal transduction processes. For the first time, besides PKC activity new cytoplasmic/membrane-bound elements of signal transduction processes (DAG concentration and DAG kinase activity, phosphatidylinositol 3-kinase activity), and the FC{gamma} receptor-mediated respiratory burst of PMN were identified as radiosensitive ''targets'' for doses < 5 Gy. Theses results provide a basis for causally-oriented therapeutic approaches and could help to explain immunodeficiencies observed after exposure to ionizing radiation. (orig./MG) [German] Die intrazellulaeren Signaluebertragungsprozesse zur Aktivierung der NADPH-Oxidase sind Gegenstand der vorliegenden Untersuchung an bestrahlten PMN des Menschen und an einem PMN-Modell: HL-60 Promyelozyten, die mit Dimethylsulfoxid zur Differenzierung zu Neutrophilen-aehnlichen induziert wurden. Behandlung der Zellen mit loeslichen Rezeptor-abhaengigen oder -unabhaengigen Stimuli (Chemotaxin und

  15. Benign thyroid disorders, radioiodine therapy and diagnosis related groups (DRGs): aspects of cost/benefit; Benigne Schilddruesenerkrankungen, Radioiodtherapie und Diagnosis Related Groups (DRGs): Kosten-Nutzen-Aspekte

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. zu Koeln (Germany)

    2005-06-01

    The increasing prevalence of goiter and thyroid nodules in older patients is accompanied by an increasing frequency of treatment and cost. Cost-effectiveness is given for programs of prophylaxis (primary prevention, e.g. alimentary iodine supplementation), for programs of screening (secondary prevention. e.g. TSH-screening), and for therapeutic strategies to avoid complications of thyroid dysfunction (atrial fibrillation, myocardial infarction, death for cardiac reasons) and to minimize iatrogenic complications (tertiary prevention). Examples of tertiary prevention are radioiodine-therapy of Graves' disease in patients who have an increased risk of relapse after antithyroid drugs (ATD), radioiodine therapy of ouvert or subclinical hyperthyroidism, and radioiodine therapy of large goiters in older patients or in patients suffering from a relevant co-morbidity. A cost-effectiveness-analysis for different therapeutic strategies of Graves' disease has been published using a lifelong time-horizon. The ablative radioiodine dose-regime is cost-effective as a first line therapy if the risk of relapse after ATD exceeds 60%. Cost-minimization-analysis, comparing resection of goiter and radioiodine, has shown lower cost of radioiodine therapy for toxic multinodular goiter up to 100 ml and for Graves' disease up to 60 ml goiter volume. Medical aspects (volume of goiter, uptake of nodules, regressive goiter, suspicion on malignancy, patients' age, co-morbidity, patients' decision) remain decisive for the choice of treatment. (orig.)

  16. Digitalisierung und Selbstbestimmung

    Directory of Open Access Journals (Sweden)

    Bezemek, Christoph

    2017-12-01

    Full Text Available Der vorliegende Beitrag skizziert das Zusammenspiel von Digitalisierung und individueller Selbstbestimmung, stellt die Frage, welche Herausforderungen dieses Zusammenspiel birgt und diskutiert, wie ihnen begegnet werden kann.

  17. Emotion, Motivation und Volition

    OpenAIRE

    Ulich, Dieter

    1996-01-01

    Emotion, Motivation und Volition / D. Ulich ; V. Brandstätter ; P. M. Gollwitzer. - In: Psychologie / hrsg. von Dietrich Dörner ... - 2., überarb. und erw. Aufl. - Stuttgart u.a. : Kohlhammer, 1996. - S. 115-135

  18. Informationskompetenz und Information Literacy

    OpenAIRE

    Ingold, Marianne

    2012-01-01

    Informationskompetenz ist heute als Begriff , Konzept und praktisches Tätigkeitsfeld von Bibliotheken weltweit etabliert. Entstehung, Verbreitung und Entwicklung von „Informationskompetenz“ im deutschsprachigen Raum stehen in engem Zusammenhang mit dem in den USA und international seit den 1980er Jahren diskutierten und praktisch umgesetzten Konzept der „Information Literacy“. Auch wenn die beiden Begriffe in der Regel gleichbedeutend verwendet werden, zeigt ein Vergleich der vorwiegend aus e...

  19. Diagnosis of shoulder impingement syndrome; Diagnostik des Schulterimpingementsyndroms

    Energy Technology Data Exchange (ETDEWEB)

    Hodler, J. [Orthopaedische Universitaetsklinik Balgrist, Zuerich (Switzerland)

    1996-12-01

    This article reviews the pathogenesis and clinical and imaging findings in shoulder impingement syndrome. Different stages of impingement syndrome are described. Stage I relates to edema and hemorrhage of the supraspinatus tendon. Stage II is characterized by bursal inflammation and fibrosis, as well as tendinopathy. In stage III there is a tear of the rotator cuff. Clinical signs many overlap. Moreover, calcifying tendinitis, fractures and pain originating from the cervical spine may mimic shoulder impingement syndrome. Imaging is important for the exact diagnosis. Standard radiographs are the basis of imaging in shoulder impingement syndrome. They may demonstrate subchondral sclerosis of the major tuberosity, subacromial spurs, and form anomalies of the acromion. They are also important in the differential diagnosis of shoulder impingement syndrome and demonstrate calcifying tendinitis, fractures and neoplasm. Ultrasonography has found acceptance as a screening tool and even as a final diagnostic method by many authors. However, there is a high interobserver variability in the demonstration of rotator cuff tears. Its usefulness has therefore been questioned. MR imaging is probably the method of choice in the evaluation of the rotator cuff and surrounding structures. Several investigations have demonstrated that differentiation of early findings, such as tendinopathy versus partial tears, may be difficult with MR imaging. However, reproducibility for fullthickness tears appears to be higher than for sonography. Moreover, specificity appears to be superior to sonography. MR arthrography is not universally accepted. However, it allows for more exact differentiation of discrete findings and may be indicated in preoperative planning. Standard arthrography and CT have a limited role in the current assessment of the rotator cuff. (orig.) [Deutsch] Grundlage des Impingementsyndroms ist eine Kompression des Supraspinatus am akromioklavikularen Bogen vor allem bei Flexion

  20. Modified diagnosis of cardiovascular diseases: Application and comparison of diagnostic techniques in clinical medicine, radiology, ultrasonography and nuclear medicine. Final report. Einsatz und Vergleich klinischer, roentgenologischer, sonographischer und nuklearmedizinischer Methoden zur abgestuften Diagnostik von Herzkrankheiten. Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Adam, W.; Boettcher, D.; Christl, H.; Baew-Christow, T.; Holper, H.; Meindl, S.; Meyer, U.; Pfannenstiel, P.

    1985-01-01

    The main point of interest of the project is the question whether ultrasonography, myocardial scintiscanning, and radionuclide angiocardiography can replace the invasive techniques of cardiovascular diagnosis, and thus save costs at that. The results show that the above non-invasive techniques are indispensable in case of a diagnosis for cardiosurgery, almost sufficient in case of valvular heart disease, and sufficient in all cases of cardiomyopathy. Optimally planned application of the non-invasive methods could save about DM 7.3 millions a year in the FRG. (TRV).

  1. Ecological relations between fish assemblages and their habitats in the Elbe River (ELFI). Final report; Oekologische Zusammenhaenge zwischen Fischgemeinschafts- und Lebensraumstrukturen der Elbe (ELFI). Abschlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Nellen, W.; Kausch, H.; Thiel, R.; Ginter, R. (eds.)

    2002-12-01

    In the framework of the joint project, extensive data were obtained with regard to ecomorphology and hydro-dynamics of fish habitats, species diversity, age structure, abundance, habitat quality, habitat use, larval drift, migrations, growth, health status and population genetics of the fish fauna of the middle Elbe River. The data were stored in data banks and were used as basis to assess the middle Elbe River, to formulate a fish-ecological guiding view, and to develop predictive habitat models for different life stages of indicatory fish species. The data and results of the joint project will be stored in fish data banks of the ARGE Elbe and of the Federal Institute of Hydrology. The information is useful for the development of decision support systems. (orig.) [German] Im Rahmen des Verbundprojekts wurden umfangreiche Daten zu Oekomorphologie und Hydrodynamik von Fischhabitaten, zu Artendiversitaet, Altersstruktur, Abundanz, Habitatqualitaet und -nutzung, Larvendrift, Wanderungen, Wachstum, Gesundheitsstatus und Populationsgenetik der Fischfauna in der Mittelelbe erhoben und in Datenbanken abgelegt. Darauf aufbauend wurde die Mittelelbe fischoekologisch bewertet, ein fischoekologisches Leitbild formuliert und prognosefaehige Habitatmodelle fuer verschiedene Lebensstadien von Indikatorfischarten entwickelt. Die Daten und Ergebnisse des Verbundprojekts fliessen in die Fischdatenbanken der ARGE Elbe und der Bundesanstalt fuer Gewaesserkunde ein und stehen fuer die Entwicklung von DSS (Decision Support Systems) zur Verfuegung. (orig.)

  2. Romanistik und gender studies

    Directory of Open Access Journals (Sweden)

    Susanne Schlünder

    2000-11-01

    Full Text Available Die beiden Bände bieten ein breites Spektrum von Beiträgen zur französischen, italienischen und spanischen Literaturwissenschaft. Gedankliche Grundlage der im einzelnen unterschiedlichen Ansätze und Zielsetzungen ist ein im Anschluß an Judith Butler gender-reflektierendes, diskursives Konzept von Geschlecht, dessen wissenschaftsgeschichtliche Herleitung und Perspektiven Renate Kroll einleitend darlegt. Die einzelnen Artikel beschäftigen sich zum einen mit literarischen Strategien, die Schriftstellerinnen vom Mittelalter bis zur Gegenwart erprobt haben, und hinterfragen dabei die Rolle weiblicher Autoren in Literaturgeschichte und Literaturgeschichtsschreibung. Zum anderen widmen sie sich den literarischen Inszenierungs- und Repräsentationsformen von Weiblichkeit und stellen darüber einen Bezug zur Lebenswelt der behandelten Autorinnen her.

  3. Relational Reasoning in Medical Education: Patterns in Discourse and Diagnosis

    Science.gov (United States)

    Dumas, Denis; Alexander, Patricia A.; Baker, Lisa M.; Jablansky, Sophie; Dunbar, Kevin N.

    2014-01-01

    Relational reasoning, which has been defined as the ability to discern meaningful patterns within any informational stream, is a foundational cognitive ability associated with education, including in scientific domains. This study entailed the analysis of instructional conversations in which an attending clinical neurologist and his team of…

  4. S2k guidelines for diverticular disease and diverticulitis. Diagnosis, classification, and therapy for the radiologist; S2k-Leitlinie Divertikelkrankheit und Divertikulitis. Diagnostik, Klassifikation und Therapie fuer die Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Schreyer, A.G. [University Hospital Regensburg (Germany). Inst. of Radiology; Layer, G. [Ludwigshafen Hospital (Germany). Central Inst. for Diagnostic and Interventional Radiology

    2015-08-15

    Diverticular disease and diverticulitis represent an increasingly common disease especially in patients with advanced age. The German Society of Digestive and Metabolic Diseases (DGVS) as well as the German Society of General and Visceral Surgery (DGAV) in collaboration with the German Radiology Society (DRG) created and published S2k guidelines regarding this topic. Knowledge of the diagnosis and therapy of this common disease is extremely important for the radiologist for the daily clinical routine. In this article we review and discuss the most important clinical situations and algorithms of this disease focusing on radiological topics. Additionally, we introduce the new CCD (classification of diverticular disease) system regarding radiology.

  5. FDG-PET in the diagnosis of neuropsychiatric Lupus erythematosus and comparison with computed tomography and magnetic resonance imaging. Einsatz der FDG-PET bei der Diagnostik des zentralnervoesen Lupus erythematodes und Vergleich mit CT und MRI

    Energy Technology Data Exchange (ETDEWEB)

    Stoppe, G [Medizinische Hochschule Hannover (Germany, F.R.). Neurologische Klinik mit Klinischer Neurophysiologie; Wildhagen, K [Medizinische Hochschule Hannover (Germany, F.R.). Abt. Immunologie und Transfusionsmedizin; Meyer, G J [Medizinische Hochschule Hannover (Germany, F.R.). Abt. Nuklearmedizin und Spezielle Biophysik; Schober, O [Muenster Univ. (Germany, F.R.). Klinik und Poliklinik fuer Nuklearmedizin

    1989-10-01

    Central nervous system involvement has been found in 30-75% of all cases of systemic lupus erythematosus (SLE). Up to now, clinical diagnosis is difficult and there are no markers for disease activity. We have compared cranial computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) using fluorodesoxyglucose (FDG) in two cases. FDG-PET is shown to be the most sensitive method demonstrating even reversible deficits and a better correlation with other neurological findings. MRI seems to be more sensitive than CT. A survey of the literature concerning imaging methods in neuropsychiatric SLE is given. The special problem of neuronal desactivation by antineuronal activity is discussed. (orig.).

  6. Update on procedure-related risks for prenatal diagnosis techniques

    DEFF Research Database (Denmark)

    Tabor, Ann; Alfirevic, Zarko

    2010-01-01

    Introduction: As a consequence of the introduction of effective screening methods, the number of invasive prenatal diagnostic procedures is steadily declining. The aim of this review is to summarize the risks related to these procedures. Material and Methods: Review of the literature. Results: Data...... from randomised controlled trials as well as from systematic reviews and a large national registry study are consistent with a procedure-related miscarriage rate of 0.5-1.0% for amniocentesis as well as for chorionic villus sampling (CVS). In single-center studies performance may be remarkably good due...... not be performed before 15 + 0 weeks' gestation. CVS on the other hand should not be performed before 10 weeks' gestation due to a possible increase in risk of limb reduction defects. Discussion: Experienced operators have a higher success rate and a lower complication rate. The decreasing number of prenatal...

  7. Inpatient Prospective Payment System (IPPS) Provider Summary for the Top 100 Diagnosis-Related Groups (DRG)

    Data.gov (United States)

    U.S. Department of Health & Human Services — A provider level summary of Inpatient Prospective Payment System (IPPS) discharges, average charges and average Medicare payments for the Top 100 Diagnosis-Related...

  8. Neue Technologien und Erziehung/Bildung

    Directory of Open Access Journals (Sweden)

    Norbert Meder

    2015-03-01

    Full Text Available Es wird gezeigt, dass Computertechnologie zur pädagogischen Aufgabe wird, weil es sich um eine Kulturtechnik handelt. Ausgehend vom Begriff der Bildung als Ausbildung eines Verhältnisses zu mir selbst, zu anderen und zur Welt wird Computertechnologie als Problemlösungsautomat, Sprachentwicklungsmaschine, Simulationsmaschine, Kommunikationsmaschine, Bildschirmgestaltungsmaschine, Schlüsselloch und Superzeichenmaschine analysiert. Die Analyse zeigt, daß Computertechnologie ein neues Bildungsideal erforderlich macht: Den Sprachspieler. Der Sprachspieler kennt sein doppelt reflexives Verhältnis zu sich selbst, zu anderen und zur Welt und beherrscht so das Spiel mit der Sprache zur Ausübung von Macht und Gewalt in der Informationsgesellschaft. Der Text geht in folgenden Schritten vor: Zunächst werden mit den Begriffen "Kulturtechnik" und "Bildung" die Prinzipien der Analyse bestimmt. Anschließend wird eine Sachanalyse der Computertechnologie durchgeführt und die gefundenen Eigenschaften jeweils in Relation zum Kulturtechnik- und Bildungsbegriff gesetzt. Computer technology becomes a challenge for education if it is understood as a cultural technology. Starting with the term bildung as the formation of relations to my self, to others and the world, computer technology is analysed as problem solving machine, language development machine, simulation machine, communication machine, screen design machine, keyhole, and super sign machine. It is shown, that computertechnology reqiures a new ideal for bildung: the language player. The language player knows his double reflective relation to his self, to others and the world and thus rules the game with language that is used to excercise power and force in the information society. The text argues in the following steps: At first the principles of the analyses are defined with the terms cultural technology and bildung. Susequently, computer technology is analysed. The identified qualities are finally

  9. Non-invasive diagnosis in cerebral ischemia by means of magnetic resonance imaging and near-infrared spectroscopy; Nichtinvasive Diagnostik zerebraler Ischaemie mit Kernspintomographie und Nahe-Infrarotspektroskopie

    Energy Technology Data Exchange (ETDEWEB)

    Piepgras, A. [Heidelberg Univ., Mannheim (Germany). Neurochirurgische Klinik; Gueckel, F. [Heidelberg Univ., Mannheim (Germany). Inst. fuer Klinische Radiologie; Laemmler, B. [Heidelberg Univ., Mannheim (Germany). Neurochirurgische Klinik; Weigel, R. [Heidelberg Univ., Mannheim (Germany). Neurochirurgische Klinik; Schmiedek, P. [Heidelberg Univ., Mannheim (Germany). Neurochirurgische Klinik

    1994-11-01

    We describe the non-invasive assessment of cerebrovascular reserve capacity by means of near-infrared spectroscopy (NIRS) and magnetic resonance imaging. Both methods are compared with transcranial Doppler sonography. There is a good correlation of the three methods in the changes in cerebral oxygen saturation and in blood velocity following acetazolamide stimulation of cerebral blood flow, except found in one patient with unilateral carotid artery occlusion. In this patient we found a decreased cerebrovascular reserve capacity, revealed by a magnetic resonance technique designed to quantify CBV and CBF. We postulate a raised oxygen extraction as raised oxygen extraction as the cause of his changes in oxygen saturation. (orig.) [Deutsch] Die Abschaetzung der zerebrovaskulaeren Reservekapazitaet unter Verwendung der Nahe-Infrarotspektroskopie und der Kernspintomographie zur nichtinvasiven klinischen Anwendung wird beschrieben. Beide Verfahren werden mit der transkraniellen Dopplersonographie verglichen. Bei Normalpersonen (n=3) zeigte sich eine gute Uebereinstimmung von Aenderungen der zerebralen Sauerstoffsaettigung mit Aenderungen der Blutflussgeschwindigkeit nach Acetazolamidstimulation der Hirndurchblutung. Diese Uebereinstimmung war bei einem Patienten mit kernspintomographisch nachgewiesener eingeschraenkter zerebrovaskulaerer Reservekapazitaet bei unilateralem Verschluss der A.carotis interna nicht gegeben. Dies wird auf eine pathologisch ehoehte Sauerstoffausschoepfung zurueeckgefuehrt. (orig.)

  10. Diagnosis and Treatment of IgG4-Related Disease.

    Science.gov (United States)

    Kamisawa, Terumi; Okazaki, Kazuichi

    2017-01-01

    It is critical to differentiate IgG4-related disease (IgG4-RD) from malignant tumor and similar disease of the affected organ to apply appropriate therapy and avoid unnecessary surgery. IgG4-RD is diagnosed on combination of typical radiological findings; elevation of serum IgG4 levels; histopathological findings of abundant infiltration of IgG4-positive plasma cells and lymphocytes, storiform fibrosis , and obliterative phlebitis ; association with other IgG4-related diseases; and response to steroids. Histopathological approach is particularly recommended. Systemic glucocorticoids are currently the first-line approach for IgG4-RD, and the indications are symptoms. The initial recommended dose of oral prednisolone for induction of remission is 0.6 mg/kg/day, administered for 2-4 weeks. This dose is gradually tapered to a maintenance dose of 2.5-5 mg/day over a period of 2-3 months. As IgG4-RD sometimes relapses after steroids, maintenance therapy is usually performed in Japan. However, as IgG4-RD patients are typically elderly and are at high risk of developing steroid-related complications, cessation of the medication should be attempted at least within 3 years. For relapsed IgG4-RD, re-administration or dose up of steroid is effective, but the addition of immunomodulatory drugs such as azathioprine has been considered to be appropriate. B cell depletion with rituximab (an anti-CD20 antibody) is effective, even in many patients in whom treatment with immunomodulatory drugs was unsuccessful. The short-term clinical, morphological, and functional outcomes of most IgG4-RD patients treated with steroid therapy are good, but the long-term outcomes are less clear due to several unknown factors such as relapse, developed fibrosis, and associated malignancy.

  11. Diagnosis and Management of AIDS-related Diarrhea

    Directory of Open Access Journals (Sweden)

    John F Johanson

    1996-01-01

    Full Text Available The spectrum of illness associated with the acquired immunodeficiency syndrome (AIDS has been increasing since the initial description in 1981. While virtually all organ systems may be affected, the gastrointestinal tract appears to be a major target. Diarrhea is the most common symptom, affecting up to half of all AIDS patients during the course of their disease. Although diarrhea occurs frequently, its optimal management remains controversial. An extensive evaluation including stool studies and endoscopic biopsies of both the colon and small intestine has been widely recommended to identify all potential pathogenic organisms. An alternative approach is a more limited evaluation consisting of stool and blood cultures followed by symptomatic treatment with antidiarrheal agents if no specific organisms are identified. The clinical presentation of the most common opportunistic pathogens are reviewed, including several recently discovered organisms. Recommendations for treatment are followed by a brief discussion of management strategies used to care for patients with AIDS-related diarrhea.

  12. Interobserver variability in the differential diagnosis of benign bone tumors and tumor-like lesions; Interobservervariabilitaet in der Differentialdiagnose gutartiger Knochentumoren und tumoraehnlicher Knochenlaesionen

    Energy Technology Data Exchange (ETDEWEB)

    Scheitza, P.; Hauschild, O.; Zwingmann, J.; Suedkamp, N.P. [University Medical Centre Freiburg (Germany). Dept. of Orthopaedics and Traumatology; Uhl, M. [St. Josefshospital Freiburg (Germany). Dept. of Diagnostic and Therapeutic Radiology; Bannasch, H. [University Medical Centre Freiburg (Germany). Dept. of Plastic and Hand Surgery; Kayser, C. [University Medical Centre Freiburg (Germany). Dept. of Pathology; Herget, G.W. [University Medical Centre Freiburg (Germany). Dept. of Orthopaedics and Traumatology/Comprehensive Cancer Centre Freiburg CCCF

    2016-05-15

    The interobserver-variability of radiological diagnosis of benign bone tumors (BBT) and tumor-like lesions (TLL) was examined in order to identify difficult-to-diagnose entities, to examine the frequency of advanced diagnostics and to describe the number of interdisciplinary tumor center diagnoses (IDT) in comparison with diagnoses upon referral (ED) and radiologists' diagnoses (RD). We retrospectively reviewed 413 patients with 272 BBT and 141 TLL, classified either histologically or through interdisciplinary consultation. Discrepancies between groups were analyzed and rates of additional imaging and biopsy to establish diagnosis were assessed. In BBT the number of identical radiological diagnoses was 56 (ED) and 81 % (RD) compared to the IDT, while in the latter additional imaging were obtained in 30 % cases. In 21 % (12 % to establish diagnosis) BBT were biopsied, the ED matching the histology 40 %, the RD 60 % and the IDT 76 % of the time. For TLL diagnosed through radiology, ED and RD matched IDT 31 % and 61 % of the time, with additional imaging being obtained in 21 % of cases (IDT). In 36 % (27 % to establish diagnosis) biopsy was performed, with histological diagnosis matching the IDT, RD and ED in 51, 27 and 20 %. Diagnostic challenges were apparent in enchondromas, non-ossifying fibromas (NOF), solitary (SBC) and aneurysmal bone cysts (ABC). Ganglia can be misinterpreted as a tumor. Establishing a definitive diagnosis for BBT and TLL can be challenging with the latter posing greater difficulties. An interdisciplinary approach involving radiologists, orthopedics and pathologists was found to improve diagnostic accuracy.

  13. Psychiatric diagnosis – is it universal or relative to culture?

    Science.gov (United States)

    Canino, Glorisa; Alegría, Margarita

    2009-01-01

    Background There is little consensus on the extent to which psychiatric disorders or syndromes are universal or the extent to which they differ on their core definitions and constellation of symptoms as a result of cultural or contextual factors. This controversy continues due to the lack of biological markers, imprecise measurement and the lack of a gold standard for validating most psychiatric conditions. Method Empirical studies were used to present evidence in favor of or against a universalist or relativistic view of child psychiatric disorders using a model developed by Robins and Guze to determine the validity of psychiatric disorders. Results The prevalence of some of the most common specific disorders and syndromes as well as its risk and protective factors vary across cultures, yet comorbid patterns and response to treatments vary little across cultures. Cross-cultural longitudinal data on outcomes is equivocal. Conclusions The cross-cultural validity of child disorders may vary drastically depending on the disorder, but empirical evidence that attests for the cross-cultural validity of diagnostic criteria for each child disorder is lacking. There is a need for studies that investigate the extent to which gene–environment interactions are related to specific disorders across cultures. Clinicians are urged to consider culture and context in determining the way in which children’s psychopathology may be manifested independent of their views. Recommendations for the upcoming classificatory system are provided so that practical or theoretical considerations are addressed about how culture and ethnic issues affect the assessment or treatment of specific disorders in children. PMID:18333929

  14. Wie sind Zeit, Raum und Zustand sprachlich verbunden?

    DEFF Research Database (Denmark)

    Colliander, Peter

    Seit Einstein weiß man, dass Zeit und Raum keine voneinander unabhängigen Phänomene sind, sondern zumindest wenn man sich der Lichtgeschwindigkeit nähert- dass sie in Relation zueinander stehen, was in der Relativitätstheorie mit dem Begriff ,Raumzeit‘ terminologisch festgehalten wird. Ich möchte...... jdm . einen guten Start in die neue Woche -Jd. hat in der kommenden Woche Urlaub). Diese an und für sich banalen Tatsachen wurden in der Forschung kaum und in den DaF-Lehrwerken erst recht nicht beachtet, wobei die Tatsache, dass die deutsche Sprache einen Schritt weitergeht und Zustande genauso...

  15. Kasseler symposium on energy-related system engineering: renewable energy sources and rational energy use. Proceedings '98; Kasseler Symposium Energie-Systemtechnik: Erneuerbare Energien und Rationelle Energieverwendung. Tagungsband '98

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, R. [comp.

    1999-07-01

    The ISET ended the 10th anniversary year since its foundation in 1998 with already the third Kassel symposium on energy-related system engineering: renewable energy sources and rational energy use. Covering several special subjects talks were given about the topics modelling and simulation in the fields of wind energy, photovoltaic systems, hybrid systems or sewage water treatment. The keen interest of the participants shows the importance that modelling of conditions or processes has gained in the meantime in the field of system engineering of renewable energy sources. The core of each simulation is the integration of differential equations, which describe the system. Properties of the system can be easily varied and affects on the overall system can be easily investigated. Critical conditions can be discovered and be taken into consideration at the hardware engineering. Mistakes in terms of component design can be avoided and engineering cost can be reduced considerably. The present conference book gives an ideal overview of the topics discussed during the symposium. (orig.) [German] Sein Jubilaeumsjahr zum zehnjaehrigen Bestehen beschloss das ISET 1998 mit dem nun bereits 3. Kasseler Symposium Energie-Systemtechnik - Erneuerbare Energien und Rationelle Energieverwendung. Fachgebietsuebergreifend wurde zu den Themen Modellbildung und Simulation in Bereichen wie Windenergie, Photovoltaik, Hybridsysteme oder Abwasserbehandlung referiert. Das rege Interesse der Teilnehmer unterstreicht die Bedeutung, die die Modellierung von Zustaenden oder Prozessen in der Systementwicklung bei den erneuerbaren Energien inzwischen gewonnen hat. Der Kern einer jeden Simulation ist die Integration der systembeschreibenden Differentialgleichungen. Eigenschaften des Systems koennen in einfacher Weise variiert und die Auswirkungen auf das Gesamtsystem untersucht werden. Kritische Zustaende koennen entdeckt und in der Entwicklung der Hardware entsprechend beruecksichtigt werden. Fehler

  16. Fotografie und atomare Katastrophe

    OpenAIRE

    Bürkner, Daniel

    2015-01-01

    Die Dissertation setzt sich mit den fotografischen Repräsentationen der Atombombenabwürfe auf Hiroshima und Nagasaki sowie der Havarie des Kernkraftwerks Tschernobyl auseinander. Dabei werden künstlerische, dokumentarische und touristische Bilder analysiert, die sich der jeweiligen Strahlenkatastrophe oftmals erst Jahre nach dem Ereignis annehmen und ikonografische oder medial-materielle Bezüge zu ihr aufweisen. Es zeigen sich zentrale Strategien, atomare Katastrophen, seien sie militäri...

  17. Radioimmunoassay of serum myoglobin and its signifance for diagnosis and therapy of musculoskeletal diseases. Der radioimmunologische Myoglobinnachweis im Serum und seine Bedeutung bei der Diagnostik und Therapie von Skelettmuskelerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Kiessling, W.R.

    1982-01-01

    A commercial test kit for radioimmunologic proof of myoglobin in serum was tested with regard to its specificty, sensitivity, precision, reproducibility, recovery and use in the diagnosis and therapy of musculoskeletal diseases. In the serum of 164 healthy control persons (age: 2-79 years) the individual myoglobin concentrations ranged from 4 to 60 ng/ml. Among 300 patients with muscular diseases extreme myoglobinaemia in acute rhabdomyolysis, polymyositis and dermatomyositis and different progressive muscular dystrophies could be detected. Slightly increased myoglobin concentrations could be proved in a number of patient with amyotrophic lateral sklerosis, neural muscular atrophy and in all cases of spinal muscular atrophy of the Kugelberg-Welander type. Confirmed DMD patients exhibited in about 80% of the cases hypermyoglobinaemia, and about 11% of 43 possible DMD patients showed an increase in myoglobin. Taking acute rhabdomyolysis and myositis as an example, it was found that myoglobin correlates well with the clinical course of these diseases and permits safe inferences as to the efficiency of the therapy chosen.

  18. The discourse of health managers on aspects related to the delay in tuberculosis diagnosis

    Directory of Open Access Journals (Sweden)

    Lenilde Duarte de Sa

    2013-10-01

    Full Text Available The aim of this study was to analyze the discourse of health managers on aspects related to delay in tuberculosis diagnosis. This was a qualitative research study, conducted with 16 Family Health Unit managers. The empirical data were obtained through semi-structured interviews. The analysis was based on the theoretical framework of the French school of discourse analysis. According to the managers’ statements, the delay in tuberculosis diagnosis is related to patient and health service aspects. As for patient aspects, managers report fear, prejudice and lack of information as factors that may promote a delayed diagnosis. Regarding health service aspects, structural problems and lack of professional skills were reported. The discourse of managers should be considered to qualify tuberculosis control actions and to prevent delays in diagnosis.

  19. Versicherung und volkswirtschaftlicher Kreislauf

    OpenAIRE

    Lampert, Heinz

    1982-01-01

    Versicherung und volkswirtschaftlicher Kreislauf : zur Behandlung d. Privatversicherung in d. volkswirtschaftl. Gesamtrechnung. - In: Zeitschrift für die gesamte Versicherungswissenschaft. 71. 1982. S. 189-210

  20. Appendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries

    OpenAIRE

    Quentin, Wilm; Scheller-Kreinsen, David; Geissler, Alexander; Busse, Reinhard

    2012-01-01

    Background As part of the EuroDRG project, researchers from 11 countries (i.e., Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their diagnosis-related groups (DRG) systems deal with appendectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods National or regional databases were used to identify hospital cases with a diagnosis of appendicitis treated with a procedure ...

  1. The humanities and innovation; Geisteswissenschaften und Innovationen

    Energy Technology Data Exchange (ETDEWEB)

    Meyer-Krahmer, F.; Lange, S. [eds.] [Fraunhofer-Institut fuer Systemtechnik und Innovationsforschung (ISI), Karlsruhe (Germany)

    1999-07-01

    The book discusses the concept and process of innovation from the perspective of linguistics, historical sciences, and philosophy. Inter-disciplinary relations become evident when it comes to research into human consciousness and behaviour, dealing with language and texts, or the growing significance of the historical sciences with respect to topical developments in technology and the economy. The cross-disciplinary discourse between the various disciplines of the humanities, natural sciences, technology and the social sciences, and between science, industry and public administration has revealed a new playing field for cross-disciplinary dialogue and cooperative action that may be rewarding. The book discusses aspects such as the innovative potential of the humanities, or their possible contributions to innovation, their capabilities to generate innovative changes in the way of thinking, to prepare the ground for innovation, strengthen innovative abilities, and on the other hand to hold aloof and keep a watchful eye on innovation. (orig./CB) [German] Das Buch beschaeftigt sich mit Innovationen aus sprachwissenschaftlicher, historischer und philosophischer Sicht. Querbezuege werden deutlich, wenn es um die Erforschung von Bewusstsein und Verhalten, dem Umgang mit Sprache und Texten oder die wachsende Bedeutung der historischen Wissenschaften fuer die aktuelle technologische und wirtschaftliche Entwicklung geht. Das Gespraech ueber Fachgrenzen hinweg zwischen den verschiedenen Disziplinen der Geisteswissenschaften, der Natur-, Technik- und Sozialwissenschaften und zwischen Wissenschaft, Industrie und oeffentlicher Verwaltung hat Aufgaben deutlich gemacht, die die Zusammenarbeit lohnen. In diesem Band wird diskutiert, welches Innovationspotential die Geisteswissenschaften bieten, wie diese zu Innovationen beitragen, Innovationen im Denken hervorbringen, Vorarbeiten fuer Innovationen leisten, die Innovationsfaehigkeit staerken und die kritische Distanz zu Innovationen

  2. The diagnosis of inflammatory muscular and vascular conditions using MRT with STIR sequences. Diagnostik entzuendlicher Muskel- und Gefaesserkrankungen in der MRT mit STIR-Sequenzen

    Energy Technology Data Exchange (ETDEWEB)

    Beese, M.S. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany)); Winkler, G. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany) Neurologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany)); Nicolas, V. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany)); Maas, R. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany)); Kress, D. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany)); Kunze, K. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany) Neurologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany)); Buecheler, E. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany))

    1993-06-01

    The role of MRT in the prebiopsy diagnosis of muscular and vascular inflammatory conditions was evaluated prospectively and an optimal method of examination was investigated. 92 patients with a suspected diagnosis of myositis (60 cases) or vasculitis (32 cases) were examined, in each case two extremities were studied using transverse T[sub 1] and T[sub 2] weighted SE sequences and double echo STIR sequences on a 0.5 Tesla (56 patients) or 1.5 Tesla magnet (36 patients; T5/S15 Gyroscan, Philips). The site of the biopsy depended on the MRT findings. In 41 patients the suspected diagnosis was confirmed histologically, in two patients an infective myositis was diagnosed on clinical grounds despite negative histology. MRT demonstrated muscle oedema in 86% of patients. There were negative findings after immuno-suppressive therapy (two patients), in focal myositis (3 out of 4 patients) and in one of 7 patients with untreated vasculitis. Amongst 49 patients in whom the suspected diagnosis could not be confirmed there was muscle oedema in 11 cases (9 neuropathies out of 22, two myopathies out of 10). Oedema indicated inflammatory muscular or vascular disease with a sensitivity of 97% (except in treated patients and for focal myositis). The number of false negative biopsies can be greatly reduced by the use of MRT. (orig.)

  3. Clinical and imaging diagnosis of IgG4-related disease in the head and neck

    International Nuclear Information System (INIS)

    Yu Changliang; Liu Bin; Yu Yongqiang

    2013-01-01

    IgG4-related disease in the head and neck is a newly recognized multi-organ system disease characterized by elevated serum IgG4, infiltration of numerous IgG4-positive plasma cells, tissue fibrosis, and dramatic response to corticosteroid treatment. IgG4-related disease of the head and neck has some relative characteristics on CT and MRI, which can provide valuable information for the diagnosis and differential diagnosis, and are helpful for the clinical treatment, evaluation of therapeutic effects and prediction of prognosis. (authors)

  4. MRI in cardiac sarcoidosis and amyloidosis; MRT bei kardialer Sarkoidose und Amyloidose

    Energy Technology Data Exchange (ETDEWEB)

    Bauner, K.U. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Wintersperger, B. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); University of Toronto, Department of Medical Imaging, Toronto General Hospital, Toronto, ON (Canada)

    2013-01-15

    Sarcoidosis and amyloidosis are both multisystem disorders, which may involve the heart; however, isolated cardiac disease is rare. Diagnosis of cardiac sarcoidosis and amyloidosis is crucial because the patient prognosis is dependent on cardiac involvement and early treatment. Echocardiography is the first line imaging modality in the diagnostic work-up of both diseases, possibly giving hints towards the correct diagnosis. Besides myocardial biopsy and radionuclide studies cardiac magnetic resonance imaging (MRI) is routinely performed in patients suspect of having infiltrative cardiomyopathy. The T1 mapping procedure is currently being evaluated as a new technique for detection and quantification of global myocardial enhancement, as seen in cardiac amyloidosis. Sensitivities and specificities for detection of cardiac sarcoidosis and amyloidosis can be significantly improved by MRI, especially with late gadolinium enhancement (LGE) imaging. In cardiac sarcoidosis the use of LGE is outcome-related while in amyloidosis analysis of T1-mapping may be of prognostic value. If cardiac involvement in sarcoidosis or amyloidosis is suspected cardiac MRI including LGE should be performed for establishing the diagnosis. (orig.) [German] Die Sarkoidose und Amyloidose sind Multisystemerkrankungen, in deren Verlauf es zu einer kardialen Beteiligung kommen kann. Bildgebend wird als primaeres Verfahren die Echokardiographie eingesetzt. Zur weiteren Diagnostik wird neben der Biopsie und nuklearmedizinischen Verfahren v. a. die MRT herangezogen. Als neuere Technik zur Darstellung globaler diffuser Kontrastmittelanreicherungen, wie sie im Rahmen der Amyloidose vorkommen, wird z. Z. das T1-Mapping evaluiert. Durch den Einsatz der MRT, insbesondere des Late-Gadolinium-Enhancements (LGE), koennen die Sensitivitaet und Spezifitaet in der Diagnostik der kardialen Sarkoidose und Amyloidose entscheidend verbessert werden. Bei der Sarkoidose stellt das Vorhandensein eines LGE einen

  5. Nursing dependency, diagnosis-related groups, and length of hospital stay

    OpenAIRE

    Halloran, Edward J.; Kiley, Marylou

    1987-01-01

    Most efforts to modify the diagnosis-related group (DRG) case classification system focus on variables related to medical management. In this study, we investigated the separate but related natures of medicine and nursing by examining 1,288 adult medical and surgical patients in an urban teaching hospital. The complexity of medical treatment was measured by use of the DRG relative cost weight. The nursing indicator was derived from a set of nursing diagnoses. We found that the DRG cost weight...

  6. Milch, Milchprodukte, Analoge und Speiseeis

    Science.gov (United States)

    Coors, Ursula

    Die Produktpalette Milch und Erzeugnisse aus Milch beinhaltet Konsummilch, die aus Milch oder Bestandteilen der Milch hergestellten Milcherzeugnisse wie Sauermilch-, Joghurt-, Kefir-, Buttermilch-, Sahne-, Kondensmilch-, Trockenmilch- und Molkenerzeugnisse, Milchmisch- und Molkenmischprodukte (Produkte mit beigegebenen Lebensmitteln), Milchzucker, Milcheiweißerzeugnisse, Milchfette und Käse.

  7. Übergewicht und Adipositas in Kindheit und Jugend

    OpenAIRE

    Nitzko, Sina

    2010-01-01

    Einführend wird auf wesentliche Entwicklungsaspekte der interessierenden Lebensphasen Kindheit und Jugend eingegangen. Im Anschluss daran werden verschiedene Aspekte von Übergewicht und Adipositas in Kindheit und Jugend thematisiert. Neben der Definition und Diagnostik, wird auf Möglichkeiten der Klassifikation sowie die Epidemiologie eingegangen. Dargestellt werden darüber hinaus körperliche und psychische Folgestörungen, welche mit Adipositas assoziiert sein können. Basierend auf der...

  8. Diagnosis and treatment of the splenic abscess, shown by three rare cases; Diagnostik und Therapie des Milzabszesses am Beispiel dreier seltener Faelle

    Energy Technology Data Exchange (ETDEWEB)

    Riediger, H. [Rostock Univ. (Germany). Inst. fuer Diagnostische Radiologie; Schareck, W.D. [Rostock Univ. (Germany). Chirurgische Universitaetsklinik; Pfeffer, F. [Rostock Univ. (Germany). Chirurgische Universitaetsklinik; Sievers, K.W. [Rostock Univ. (Germany). Inst. fuer Diagnostische Radiologie; Hopt, U.T. [Rostock Univ. (Germany). Chirurgische Universitaetsklinik

    1997-08-01

    The diagnostic tools and possible treatments are shown with the example of the three cases. The radiologic interventions may, in some cases, avoid surgery, but their potentials are restricted by a couple of conditions such as localisation of the lesions near to the hilus, multiple abscesses, ropy pus, or fistulae. Therefore, splenectomy continues to be the golden standard. Given adequately fast diagnosis and therapy, lethality can be reduced today to less than 10 %.

  9. Use of error-detection and diagnosis methods in existing buildings - Final report; Einsatz von Fehlerdetektions- und Diagnosemethoden in realen Gebaeuden (IEA Annex 34) - Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Gruber, P.

    2000-10-15

    This report for the Swiss Federal Office of Energy (SFOE) discusses the results of tests made with two expert systems used for error-detection and diagnosis in existing buildings. These expert systems were developed within the framework of the International Energy Agency's (IEA) Annex 25 Project entitled 'Real Time Simulation of Heating, Ventilation and Air-conditioning (HVAC) Systems for Building Optimisation, Fault Detection and Diagnosis'. The aim of using these tools was to help detect planning, installation and commissioning errors. These cannot only affect system performance but also can cause increased energy consumption and a reduction of the working life of the system's components. The tests of the tools took place within the framework of the IEA's Annex 34 'Computer-aided Evaluation of HVAC System Performance: the Practical Application of Fault Detection and Diagnosis Techniques in Real Buildings'. Experience gained with the two tools is presented and discussed. The quality of the results and the use of the systems in practice are discussed and commented on. They strongly differ from one tool to the other.

  10. Mediastinal fibrosis with pulmonary artery obstruction; diagnosis and investigation with helical CT imaging including 3-dimensional reconstructions; Pulomonalarterienstenose bei aggresiver Mediastinalfibrose; Diagnostik und 3D-Darstellung mittels helikaler CT-Untersuchung

    Energy Technology Data Exchange (ETDEWEB)

    Kolbe, M. [Inst. fuer Diagnostische Radiologie, Kantonsspital Basel (Switzerland); Helwig, A. [Inst. fuer Diagnostische Radiologie, Kantonsspital Basel (Switzerland); Habicht, J.M. [Klinik fuer Herz-Torax-Chirurgie, Universitaetskliniken Basel (Switzerland); Steinbruch, W. [Inst. fuer Diagnostische Radiologie, Kantonsspital Basel (Switzerland)

    1997-07-01

    An aggressive mediastinal fibrosis was found in a 42-year-old female, suffering from dysphagia, stabbing pain in the chest, and an unclear weight loss. In this case, the rare combination of esophageal involvement, bronchial narrowing, and pulmonary artery obstruction could easily be demonstrated with a barium study and a helical CT examination including three-dimensional reconstructions. (orig.) [Deutsch] Wir stellen den Fall einer 42jaehrigen Patientin vor, welche zur Abklaerung einer zunehmenden Dysphagie, stechender Thoraxschmerzen und eines Gewichtsverlustes hospitalisiert wurde. Mittels klinischer und radiologischer Abklaerung konnte eine aggressive Mediastinalfibrose diagnostiziert werden. Die seltene Kombination einer Oesophaguseinengung mit Pulmonalarterienstenosen sowie einer Bronchuskompression konnte nichtinvasiv mittels Oesophagogramm und helikaler CT-Untersuchung zuverlaessig und schnell dargestellt werden. (orig.)

  11. Thermodynamik grundlagen und technische anwendungen

    CERN Document Server

    Baehr, Hans Dieter

    2009-01-01

    Für die aktualisierte 14. Auflage des bewährten Lehrbuchs der Technischen Thermodynamik wurde das Kapitel über Wärmekraftanlagen gründlich bearbeitet und durch einen Abschnitt zur Energiewandlung ergänzt: Die Energiebedarfsstruktur von Deutschland wird erläutert, und die möglichen Energiewandlungspfade werden diskutiert. Schwerpunkt des Buches ist die ausführliche und auch dem Anfänger verständliche Darstellung der Grundlagen der Thermodynamik mit der sorgfältigen Einführung der thermodynamischen Begriffe und den fundamentalen Bilanzgleichungen für Energie, Entropie und Exergie. Die thermodynamischen Eigenschaften reiner Fluide und fluider Gemische werden eingehend erläutert. Darauf aufbauend wird die Thermodynamik der Gemische und der chemischen Reaktionen entwickelt. Auch die thermodynamischen Aspekte wichtiger energie- und verfahrenstechnischer Anwendungen werden praxisnah behandelt: - Strömungs- und Arbeitsprozesse, - thermische Stofftrennverfahren, - Verbrennungsprozesse und Verbrennungsk...

  12. A Sepsis-related Diagnosis Impacts Interventions and Predicts Outcomes for Emergency Patients with Severe Sepsis.

    Science.gov (United States)

    Kim, Mitchell; Watase, Taketo; Jablonowski, Karl D; Gatewood, Medley O; Henning, Daniel J

    2017-10-01

    Many patients meeting criteria for severe sepsis are not given a sepsis-related diagnosis by emergency physicians (EP). This study 1) compares emergency department (ED) interventions and in-hospital outcomes among patients with severe sepsis, based on the presence or absence of sepsis-related diagnosis, and 2) assesses how adverse outcomes relate to three-hour sepsis bundle completion among patients fulfilling severe sepsis criteria but not given a sepsis-related diagnosis. We performed a retrospective cohort study using patients meeting criteria for severe sepsis at two urban, academic tertiary care centers from March 2015 through May 2015. We included all ED patients with the following: 1) the 1992 Consensus definition of severe sepsis, including two or more systemic inflammatory response syndrome criteria and evidence of organ dysfunction; or 2) physician diagnosis of severe sepsis or septic shock. We excluded patients transferred to or from another hospital and those <18 years old. Patients with an EP-assigned sepsis diagnosis created the "Physician Diagnosis" group; the remaining patients composed the "Consensus Criteria" group. The primary outcome was in-hospital mortality. Secondary outcomes included completed elements of the current three-hour sepsis bundle; non-elective intubation; vasopressor administration; intensive care unit (ICU) admission from the ED; and transfer to the ICU in < 24 hours. We compared proportions of each outcome between groups using the chi-square test, and we also performed a stratified analysis using chi square to assess the association between failure to complete the three-hour bundle and adverse outcomes in each group. Of 418 patients identified with severe sepsis we excluded 54, leaving 364 patients for analysis: 121 "Physician Diagnosis" and 243 "Consensus Criteria." The "Physician Diagnosis" group had a higher in-hospital mortality (12.4% vs 3.3%, P < 0.01) and compliance with the three-hour sepsis bundle (52.1% vs 20.2%, P

  13. Steuern und Governance

    Directory of Open Access Journals (Sweden)

    Eduard Müller

    2014-05-01

    Full Text Available ENGLISH: Taxation, in the modern state, has long been a mass phenomenon with an interdisciplinary outlook. On the macro level of the state, a new generation of administrative reforms has crystallized under the label “good public governance”. These reforms seek to resolve regulatory interdependence of state and non - state actors by way of cooperation and interaction. In parallel, on the micro level of businesses, “corporate governance” – voluntary compliance with legal and ethical standards – has become an increasingly important issue. With a view to tax law and tax collection, these developments open up new possibilities to raise tax compliance by means of consensual and cooperative instruments and, accordingly, address taxation as a mass phenomenon. DEUTSCH: Besteuerung ist im modernen Staat ein Massenphänomen und längst interdisziplinär ausgerichtet. Auf der Makro-Ebene des Staates hat sich unter dem Begriff Good Public Governance eine neue Generation von Staats- und Verwaltungsreformen herausgebildet, die Regelungsbeziehungen von staatlichen und nichtstaatlichen Akteuren durch Kooperationen und Interaktionen zu lösen versucht. Parallel dazu hat auf der Mikro-Ebene der Unternehmen mit dem Thema Corporate Governance die freiwillige Einhaltung von rechtlichen und ethischen Regeln an Bedeutung gewonnen. Für das Steuerrecht und den Steuervollzug resultieren aus diesen Entwicklungen neue Möglichkeiten, durch Nutzung konsens- und kooperationsorientierter Instrumente die Tax Compliance zu erhöhen und so dem Massenphänomen Besteuerung gerecht zu werden.

  14. Imaging techniques and investigation protocols in pediatric emergency imaging; Aufnahmetechnik und Untersuchungsprotokolle beim paediatrischen Notfall

    Energy Technology Data Exchange (ETDEWEB)

    Scharitzer, M.; Hoermann, M.; Puig, S.; Prokop, M. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2002-03-01

    Paediatric emergencies demand a quick and efficient radiological investigation with special attention to specific adjustments related to patient age and radiation protection. Imaging modalities are improving rapidly and enable to diagnose childhood diseases and injuries more quickly, accurately and safely. This article provides an overview of imaging techniques adjusted to the age of the child and an overview of imaging strategies of common paediatric emergencies. Optimising the imaging parameters (digital radiography, different screen-film systems, exposure specifications) allows for substantial reduction of radiation dose. Spiral- and multislice-CT reduce scan time and enable a considerable reduction of radiation exposure if scanning parameters (pitch setting, tube current) are properly adjusted. MRI is still mainly used for neurological or spinal emergencies despite the advent of fast imaging sequences. The radiologist's task is to select an appropriate imaging strategy according to expected differential diagnosis and to adjust the imaging techniques to the individual patient. (orig.) [German] Das akut erkrankte Kind erfordert eine rasche radiologische Abklaerung mit besonderer Beruecksichtung der geaenderten Untersuchungsparameter bei gleichzeitig hohem Anspruch an den Strahlenschutz. Hochaufloesende Schallkoepfe, Multislice-CT und schnelle MR-Sequenzen erlauben eine bessere Anpassung der Untersuchungsmethoden an die Beduerfnisse in der Kinderradiologie. Ziel dieses Artikels ist eine Uebersicht ueber die verschiedenen radiologischen Untersuchungstechniken sowie deren Anpassung an kindliche Anforderungen und die Angabe von Untersuchungsalgorithmen der haeufigsten paediatrischen Notfaelle. In der Projektionsradiographie erlaubt die Optimierung der Aufnahmetechnik (digitale Radiographie, unterschiedliche Klassen von Film-Folien-Systemen, Belichtungsparameter) eine deutliche Reduktion der Strahlendosis bei diagnostisch ausreichender Qualitaet. Spiral- oder

  15. Osteoporose und Laktoseintoleranz

    Directory of Open Access Journals (Sweden)

    Obermayer-Pietsch B

    2008-01-01

    Full Text Available Laktosemalabsorption oder Laktoseintoleranz ist eine symptomatische Unverträglichkeit von Milchzucker (Laktose, zumeist aufgrund einer autosomal rezessiv erblichen, irreversiblen Abnahme des Enzyms Laktase im Jugendalter, die bei etwa der Hälfte der Weltbevölkerung auftritt. Die Betroffenen meiden oft instinktiv Milch und Milchprodukte wegen der damit verbundenen Malabsorptions-Symptome. Damit scheiden diese Nahrungsmittel aber auch als Kalziumlieferanten aus und es kann zu einer Mangelversorgung des Knochens mit Kalzium und damit zu Osteoporose kommen. Da in Österreich etwa 20–25 % der Bevölkerung betroffen sind, ist diese Stoffwechselveränderung nicht zu vernachlässigen. Diagnostische und begleitende ernährungsmedizinische Maßnahmen und gegebenenfalls eine osteotrope Therapie sollten zum Erhalt der Knochenmasse eingesetzt werden.

  16. Neuausrichtung und Konsolidierung

    Science.gov (United States)

    Grohmann, Heinz

    Mit der Wahl von Wolfgang Wetzel zum Vorsitzenden der Deutschen Statistischen Gesellschaft im Jahre 1972 begann eine 32jährige Ära, in der die praktische und die theoretische Statistik in einem ausgewogenen Verhältnis gepflegt wurden. Ein regelmäßiger vierjähriger Wechsel im Vorsitz stärkte die Gemeinschaft und die praktische wie die wissenschaftliche Arbeit gleichermaßen. Die jährlichen Hauptversammlungen behandelten gesellschaftlich aktuelle wie zukunftsorientierte Themen, und die Ausschüsse sowie weitere Veranstaltungen gaben Gelegenheit zur Förderung und Pflege einer Vielzahl von Arbeitsgebieten der Statistik. Darüber wird nicht nur in diesem Kapitel, sondern auch in den Teilen II und III des Bandes berichtet.

  17. Local recurrences after conservative surgery and irradiation for breast cancer: Diagnosis with mammography and ultrasound. Mammographie und Sonographie in der Rezidivdiagnostik nach brusterhaltender Therapie des Mammakarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Buchberger, W; Hamberger, L; Schoen, G [Innsbruck Univ. (Austria). Universitaetsklinik fuer Radiodiagnostik; Steixner, G; Fritsch, E [Innsbruck Univ. (Austria). Universitaetsklinik fuer Strahlentherapie

    1991-06-01

    89 patients, who underwent conservative surgery for breast cancer were followed up with mammography and real-time sonography. 78 patients underwent postoperative irradiation. Depending on the time interval between irradiation and examination various alterations in mammographic and sonographic patterns were evident. Of 14 biospy-confirmed local recurrences, 11 were diagnosed by mammography and 12 by sonography. Combined use of mammography and sonography should therefore lead to better results in the diagnosis of local recurrences and to a reduction of unnecessary biopsies. (orig./GDG).

  18. The diagnosis and treatment of non-occlusive gut ischaemia. Aktueller Stand der Diagnostik und Therapie der nicht-okklusiven Darmischaemie (NOD)

    Energy Technology Data Exchange (ETDEWEB)

    Schindler, G.; Bruch, H.P. (Wuerzburg Univ. (Germany). Abt. fuer Roentgendiagnostik Wuerzburg Univ. (Germany). Chirurgische Universitaetsklinik)

    1991-08-01

    Non-occlusive gut ischaemia is a disease of advanced age. Its causes are reduced cardiac output or shock, facilitated by digitalis, adrenaline, ergotamine and diuretics. The persisting microcirculation and development of gut necrois leads to an increase in certain serum enzymes, such as lactate, LDH and CK-NB. The early application of mesenteric angiography using a DSA technique reveals four grades of under-perfusion. Early and correct diagnosis of the disease should lead to intra-arterial treatment with prostaglandin. In 10 out of 42 cases, conservative therapy led to re-perfusion of the gut. (orig.).

  19. Development and implementation of a new onboard diagnosis method for automotive lithium-ion-batteries; Entwicklung und Implementierung einer neuen Onboard-Diagnosemethode fuer Lithium-Ionen-Fahrzeugbatterien

    Energy Technology Data Exchange (ETDEWEB)

    Brill, Michael

    2012-11-01

    The author of the contribution under consideration reports on a onboard diagnosis for lithium ion accumulators which determines the actual state of aging of a high voltage drive battery during the normal usage of hybrid vehicles and electrically driven vehicles. Due to the limited computing time and storages resources in the battery control unit a combined process is shown which analyses the state of aging of the total battery as a unit and additionally the scattering of the battery cells. Furthermore the procedure is design to supply an optimal result with the available measurement signals.

  20. Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity.

    Science.gov (United States)

    Elli, Luca; Branchi, Federica; Tomba, Carolina; Villalta, Danilo; Norsa, Lorenzo; Ferretti, Francesca; Roncoroni, Leda; Bardella, Maria Teresa

    2015-06-21

    Cereal crops and cereal consumption have had a vital role in Mankind's history. In the recent years gluten ingestion has been linked with a range of clinical disorders. Gluten-related disorders have gradually emerged as an epidemiologically relevant phenomenon with an estimated global prevalence around 5%. Celiac disease, wheat allergy and non-celiac gluten sensitivity represent different gluten-related disorders. Similar clinical manifestations can be observed in these disorders, yet there are peculiar pathogenetic pathways involved in their development. Celiac disease and wheat allergy have been extensively studied, while non-celiac gluten sensitivity is a relatively novel clinical entity, believed to be closely related to other gastrointestinal functional syndromes. The diagnosis of celiac disease and wheat allergy is based on a combination of findings from the patient's clinical history and specific tests, including serology and duodenal biopsies in case of celiac disease, or laboratory and functional assays for wheat allergy. On the other hand, non-celiac gluten sensitivity is still mainly a diagnosis of exclusion, in the absence of clear-cut diagnostic criteria. A multimodal pragmatic approach combining findings from the clinical history, symptoms, serological and histological tests is required in order to reach an accurate diagnosis. A thorough knowledge of the differences and overlap in clinical presentation among gluten-related disorders, and between them and other gastrointestinal disorders, will help clinicians in the process of differential diagnosis.

  1. Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity

    Science.gov (United States)

    Elli, Luca; Branchi, Federica; Tomba, Carolina; Villalta, Danilo; Norsa, Lorenzo; Ferretti, Francesca; Roncoroni, Leda; Bardella, Maria Teresa

    2015-01-01

    Cereal crops and cereal consumption have had a vital role in Mankind’s history. In the recent years gluten ingestion has been linked with a range of clinical disorders. Gluten-related disorders have gradually emerged as an epidemiologically relevant phenomenon with an estimated global prevalence around 5%. Celiac disease, wheat allergy and non-celiac gluten sensitivity represent different gluten-related disorders. Similar clinical manifestations can be observed in these disorders, yet there are peculiar pathogenetic pathways involved in their development. Celiac disease and wheat allergy have been extensively studied, while non-celiac gluten sensitivity is a relatively novel clinical entity, believed to be closely related to other gastrointestinal functional syndromes. The diagnosis of celiac disease and wheat allergy is based on a combination of findings from the patient’s clinical history and specific tests, including serology and duodenal biopsies in case of celiac disease, or laboratory and functional assays for wheat allergy. On the other hand, non-celiac gluten sensitivity is still mainly a diagnosis of exclusion, in the absence of clear-cut diagnostic criteria. A multimodal pragmatic approach combining findings from the clinical history, symptoms, serological and histological tests is required in order to reach an accurate diagnosis. A thorough knowledge of the differences and overlap in clinical presentation among gluten-related disorders, and between them and other gastrointestinal disorders, will help clinicians in the process of differential diagnosis. PMID:26109797

  2. Neurogenic myopathies and imaging of muscle denervation; Neurogene Myopathien und Bildgebung der Muskeldenervation

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, M. [Universitaetsklinikum Heidelberg, Abteilung fuer Neuroradiologie, Heidelberg (Germany); Wolf, C. [Reha-Zentrum Gernsbach, Neurologie, Gernsbach (Germany); Weber, M.A. [Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)

    2017-12-15

    Neurogenic myopathies are primary diseases of the nervous system, which secondarily result in denervation of the target musculature. The spectrum of potential causes is manifold ranging from acute traumatic injuries and chronic compression to neurodegenerative, inflammatory, metabolic and neoplastic processes. The medical history, clinical neurological examination, and electrophysiological tests including electromyography and nerve conduction studies are crucial in diagnosing neuropathic myopathies. Electromyography is the gold standard for diagnosing muscle denervation. Additional imaging methods and magnetic resonance imaging (MRI) in particular, are capable of contributing valuable information. The MRI examination of denervated musculature shows edema, an increase in the apparent diffusion coefficient (ADC) and hyperperfusion. Chronic denervation results in fatty degeneration and atrophy of affected muscles, which are also detectable by MRI. Although the MRI findings in muscle denervation are relatively unspecific, they show a high sensitivity, comparable to electromyography. Dedicated MR neurography may often visualize the underlying lesion(s) of the innervating nerve(s). Besides high sensitivity, comparable to electromyography, MRI is capable of evaluating muscles which are inaccessible for needle electromyography. Due to its non-invasive character, MRI is ideal for follow-up examinations. The use of MRI is often a meaningful addition to the diagnostics of neurogenic myopathies. The extent and distribution pattern of muscular alterations often provide information on the localization of the causative nerve damage. A correct diagnosis or at least a narrowing down of possible differential diagnoses can often be achieved using MRI. (orig.) [German] Neurogene Myopathien sind Erkrankungen des Nervensystems, die sekundaer zur Denervierung der Zielmuskulatur fuehren. Das Spektrum potenzieller Ursachen ist vielfaeltig und umfasst akute traumatische Verletzungen

  3. Outcome of a working diagnosis of \\"psychosis\\" in relation to DSM ...

    African Journals Online (AJOL)

    Outcome of a working diagnosis of \\"psychosis\\" in relation to DSM-IV diagnostic criteria in a Kenyan in-patient cohort at Mathari hospital, Nairobi. D M Ndetei, L I Khasakhala, F A Ongecha, V Mutiso, D A Kokonya ...

  4. Lifestyle after Colorectal Cancer Diagnosis in Relation to Survival and Recurrence

    NARCIS (Netherlands)

    Zutphen, van Moniek; Kampman, Ellen; Giovannucci, Edward L.; Duijnhoven, van Fränzel J.B.

    2017-01-01

    Purpose of Review: This review summarizes the evidence regarding diet, physical activity, smoking, and body composition after colorectal cancer (CRC) diagnosis in relation to all-cause and CRC-specific mortality and disease recurrence and gives suggestions for future research directions. Recent

  5. Lifestyle after Colorectal Cancer Diagnosis in Relation to Survival and Recurrence: A Review of the Literature

    NARCIS (Netherlands)

    Zutphen, M. van; Kampman, E.; Giovannucci, E.L.; Duijnhoven, F.J. van

    2017-01-01

    Purpose of Review: This review summarizes the evidence regarding diet, physical activity, smoking, and body composition after colorectal cancer (CRC) diagnosis in relation to all-cause and CRC-specific mortality and disease recurrence and gives suggestions for future research directions. Recent

  6. Environment-related health disorders. Experience and perspectives in the care of patients with environment-related health disorders; Umweltbezogene Gesundheitsstoerungen. Erfahrungen und Perspektiven umweltmedizinischer Patientenversorgung

    Energy Technology Data Exchange (ETDEWEB)

    Hornberg, C.; Malsch, A.K.F. [Bielefeld Univ. (Germany); Weissbach, W. [Universitaetsklinikum Aachen (Germany); Wiesmueller, G.A.

    2004-08-15

    Environmental medicine outpatient clinics, counseling centers, and practicing physicians have observed environment-related health disorders in patient groups of mixed age as well as for groups consisting only of adults or children. Practicing physicians suspected correlations between environmental factors and health disorders in 36-45% of cases, environmental medicine outpatient clinics and counseling centers in 4-34% for mixed-age groups, 0-24% for adults, and 9-13% for children. A comparison of these data is difficult due to differences in data acquisition, evaluation methods, and descriptive statistics used. Furthermore, data on children are insufficient. Patient-oriented environmental medicine faces a number of problems regarding determination of exposure, effects, and susceptibility, including a lack of scientifically verified cause-and-effect models as well as incorrect diagnoses, attributions, and conclusions. In view of the scope and intensity of environment-related health disorders, the topic cannot be ignored. A functioning program of environmental medicine counseling and patient care is needed for practicing physicians, universities and/or the public sector to deliver effective primary medical care in this field. As always, the building blocks of environmental medicine counseling are medical history, physical examination, differential diagnosis, human biomonitoring, and on-site inspection with environmental monitoring while also taking gender differences into account. Uniform basic documentation procedures and health science analyses will help to optimize patient care in environmental medicine. The value of a diagnostic algorithm in the care of patients with environment-related health disorders is beyond dispute. Last but not least, quality assurance and control are a sine qua non of patient-oriented environmental medicine. (orig.)

  7. Batteries and accumulators: everything you always wanted to know. Batteries, accumulators and the environment - questions and answers; Batterien und Akkus - Das wollten Sie wissen.. Fragen und Antworten zu Batterien, Akkus und Umwelt

    Energy Technology Data Exchange (ETDEWEB)

    Leuthold, S.; Minkos, A. (comps.)

    2006-07-15

    Batteries and accumulators are part of our everyday life. This brochure answers problems related to their use and disposal, chargers and charging. Starter batteries for motor vehicles are left out of account, as are special batteries e.g. for electric fences or lights on building sites. The brochure also explains the legal fundamentals for disposal of batteries and provides information on environmental problems relating to production and disposal. Frequently asked questions are answered on the final pages. [German] Batterien und Akkus begleiten unseren Alltag. Solange sie die noetige mobile Versorgung ermoeglichen, sind sie gern gesehen. Versagen sie ihren Dienst, beginnen die Probleme: Wohin mit der leeren Batterie, dem nicht mehr funktionsfaehigen Akku (Keinesfalls in den Hausmuell.)? Welches ist das richtige Ladegeraet und das richtige Ladeverfahren fuer den Akku? Zu diesen und anderen Fragen rund um Geraetebatterien und -akkus gibt diese Broschuere Auskunft. Nicht betrachtet werden hier allerdings Starterbatterien (z.B. fuer Autos und Motorraeder) und bestimmte Spezialbatterien (z.B. fuer Weidezaeune oder Baustellenlampen), die einen Sonderfall darstellen. Die Broschuere erlaeutert auch die gesetzlichen Grundlagen fuer die Entsorgung unbrauchbarer Batterien und Akkus und gibt Informationen zur Umweltbelastung durch Herstellung und Entsorgung. Am Ende der Broschuere werden haeufig gestellte Fragen und deren Antworten zusammengestellt.

  8. Teilchendetektoren Grundlagen und Anwendungen

    CERN Document Server

    Kolanoski, Hermann

    2016-01-01

    In diesem Buch werden die experimentellen Grundlagen von Teilchendetektoren und ihre Anwendung in Experimenten beschrieben. Die Entwicklung von Detektoren ist ein wichtiger Bestandteil der Teilchen-, Astroteilchen- und Kernphysik und gehört daher zum Handwerk des Experimentalphysikers in diesen Gebieten. Dieses umfassende Werk beinhaltet den kompletten Stoff für entsprechende Master-Module in der experimentellen Teilchenphysik, geht aber im Inhalt auch darüber hinaus. Zielgruppe sind Studierende, die sich in die Materie vertiefen möchten, aber auch Lehrende und Wissenschaftler, die das Buch zum Einstieg in das wissenschaftliche Arbeiten an Detektorentwicklungen verwenden können. Zielrichtung des Buches ist, die physikalischen Grundlagen für die Detektoren und ihrer verschiedenen Ausführungen so klar wie möglich und so tiefgehend wie nötig darzustellen. Die Breite des für die Detektorentwicklung nötigen Wissens umfasst viele Bereiche der Physik und Technik, von den Wechselwirkun...

  9. Mediendidaktik und Wissensmanagement

    Directory of Open Access Journals (Sweden)

    Gabi Reinmann-Rothmeier

    2002-10-01

    Full Text Available Mediendidaktik und Wissensmanagement – das ist auf den ersten Blick ein ungleiches Paar: Die Mediendidaktik ist eine Teildisziplin der (Medien- Pädagogik, während Wissensmanagement ein genuin wirtschaftliches Thema mit betriebswirtschaftlichen Akzenten ist. Annäherungen zwischen der Mediendidaktik und Wissensmanagement gibt es zum einen durch den sog. E-Learning-Trend seitens der Wirtschaft, der mediendidaktisches Wissen und Können auf den Plan ruft, zum anderen durch wachsendes Interesse am Thema Wissensmanagement seitens der Pädagogik. Der Beitrag beschreibt sowohl für das E-Learning als auch für das Wissensmanagement aus pädagogisch-psychologischer Sicht jeweils ein Orientierungsmodell; beide Modelle machen die Berührungspunkte zwischen Mediendidaktik und Wissensmanagement deutlich. Neben einem Überblick über wirtschaftliche Argumente für eine Verschmelzung von E-Learning und Wissensmanagement werden aufbauend auf den beiden Orientierungsmodellen theoretische und praktische Verbindungslinien zwischen E-Learning und Wissensmanagement sowie die Rolle der Mediendidaktik in dem daraus entstehenden Wechselverhältnis herausgearbeitet.

  10. Early diagnosis of myocardial infarction using absolute and relative changes in cardiac troponin concentrations

    OpenAIRE

    Irfan Affan Bin; Reichlin Tobias R.; Twerenbold Raphael; Meister Marc; Moehring Berit; Wildi Karin; Bassetti Stefano; Zellweger Christa; Gimenez Maria Rubini; Hoeller Rebeca; Murray Karsten; Sou SeoungMann; Mueller Mira; Mosimann Tamina; Reiter Miriam

    2013-01-01

    Background: Absolute changes in high sensitivity cardiac troponin T (hs cTnT) seem to have higher diagnostic accuracy in the early diagnosis of acute myocardial infarction compared with relative changes. It is unknown whether the same applies to high sensitivity cardiac troponin I (hs cTnI) assays and whether the combination of absolute and relative change might further increase accuracy. Methods: In a prospective international multicenter study high sensitivity cardiac troponin (hs cTn) was ...

  11. Relative changes in earned income five years after diagnosis with diabetes

    DEFF Research Database (Denmark)

    Cleal, Bryan; Panton, Ulrik Haagen; Willaing, Ingrid

    2017-01-01

    $ 924 (3.03%) among women. The effect was generally largest in the youngest age-group, in lower earners and among men. CONCLUSIONS: The results clearly indicate that a diagnosis of diabetes has a significant impact on earnings. Age and earnings at the time of diagnosis appear to play a moderating role.......,090 people with diabetes were included in the study and matched to 91,090 controls in the general population. The analysis revealed highly significant loss of earnings for people with diabetes when compared with people without diabetes, with an overall relative loss of US $ 3694 (8.01%) among men and US......OBJECTIVE: With previous studies indicating that diabetes affects employment status and lifetime earnings, the aim of this study was to determine the impact on earnings in the immediate period after diagnosis. Recognising that earnings and employment status are dynamic over the life course, we...

  12. Lessing und der Islam

    OpenAIRE

    Muslim, Zahim Mohammed

    2010-01-01

    „Lessing und der Islam“ beschäftigt sich unparteiisch mit Lessings Auseinandersetzung mit dem Islam. Die Arbeit setzt sich das Ziel, den Leser und den Literaturkennern sowie der deutschen Bibliothek der Germanistik etwas von Lessings Auseinandersetzung mit dem Islam in die Hand zu geben, die bis heute als großes Modell für die interkulturelle und interreligiöse Menschheitstoleranzdebatte im Gedächtnis der deutschen Literatur vorhanden ist. Im ersten Teil widmet sich die vorliegende Arbeit de...

  13. Trauma und Terror

    OpenAIRE

    Szyszkowitz, T. (Tessa)

    2007-01-01

    1. Einleitung Ausgehend von der Fragestellung, warum gerade bei Tschetschenen und Palästinensern der Selbstmordterrorismus in den letzten Jahren so populär geworden ist, analysiert die Autorin die Geschichte dieser beiden Völker. Einer der Gründe ist bisher wenig beachtet worden. Der Einfluss eines kollektiven Traumas, das als solches nicht anerkannt, behandelt und auch nicht einer politischen Lösung zugeführt wurde. 2. Geschichte der Palästinenser und Tschetschenen Im Zuge der Err...

  14. Bone scintigraphy compared to MRI and ultrasound in the early diagnosis of arthritis; Skelettszintigraphie im Vergleich mit MRT und Sonographie beim Fruehnachweis der Arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Sandrock, D. [Klinikum Chemnitz gGmbH, Klinik fuer Nuklearmedizin, Chemnitz (Germany)

    2006-12-15

    Chronic inflammatory arthritis is recognized specifically by bone erosions, caused by characteristic pannus tissue. In the finger joints dynamic low-Tesla MRI is nearly double but not completely sensitive in the detection of erosions than conventional radiography, sonography takes an intermediate position. Less specific signs of synovitis and tenosynovitis are shown with high sensitivity by both 3(2)-phase bone scintigraphy and ultrasound, MRI is less sensitive in this respect. However, standard situation of inflammation in bone scintigraphy - positive finding in early as well as late phase - is of surprisingly low sensitivity, any singular finding in the early or late phase has to be regarded as positive. Specificity of these singular findings is nevertheless sufficiently high, acute inflammatory joint changes and even erosions are also seen with MRI in obviously healthy persons. Only 2-phase bone scintigraphy is easily able to present a simultaneous survey of all joints of the body. For this reason 2-phase bone scintigraphy is most suitable for exclusion but also for primary diagnosis of disease, specification must be done afterwards by other imaging modalities or by laboratory findings. (orig.)

  15. Fault Diagnosis Method Based on Information Entropy and Relative Principal Component Analysis

    Directory of Open Access Journals (Sweden)

    Xiaoming Xu

    2017-01-01

    Full Text Available In traditional principle component analysis (PCA, because of the neglect of the dimensions influence between different variables in the system, the selected principal components (PCs often fail to be representative. While the relative transformation PCA is able to solve the above problem, it is not easy to calculate the weight for each characteristic variable. In order to solve it, this paper proposes a kind of fault diagnosis method based on information entropy and Relative Principle Component Analysis. Firstly, the algorithm calculates the information entropy for each characteristic variable in the original dataset based on the information gain algorithm. Secondly, it standardizes every variable’s dimension in the dataset. And, then, according to the information entropy, it allocates the weight for each standardized characteristic variable. Finally, it utilizes the relative-principal-components model established for fault diagnosis. Furthermore, the simulation experiments based on Tennessee Eastman process and Wine datasets demonstrate the feasibility and effectiveness of the new method.

  16. Integration, Informationslogistik und Architektur

    OpenAIRE

    Turowski, Klaus

    2006-01-01

    Integration, Informationslogistik und Architektur : DW2006 ; 21./22.09.2006 in Friedrichshafen, Germany / Klaus Turowski ... (Hrsg.). - Bonn : Ges. für Informatik, 2006. - 490 S. - (GI-Edition / Proceedings ; 90)

  17. Supraleitung Grundlagen und Anwendungen

    CERN Document Server

    Buckel, Werner

    2004-01-01

    Seit nunmehr drei Jahrzehnten ist der "Buckel" das Referenzwerk in deutscher Sprache zum Thema Supraleitung. Immer wieder aktualisiert, hat das Lehrbuch Generationen von Studenten begleitet. In der 6., vollständig überarbeiteten Auflage wird das bewährte didaktische Konzept beibehalten, inhaltlich wurde der Band dem aktuellen Stand von Forschung und Technik angepasst. Das Autorenteam um Prof. Kleiner verzichtet auf komplizierte mathematische Herleitungen. Es baut ganz auf das bewährte Step-by-Step-Prinzip: Der Schwierigkeitsgrad wird von Kapitel zu Kapitel gesteigert. So können auch Einsteiger ohne einschlägige Vorkenntnisse dem Stoff bequem folgen. Dank seiner klaren Sprache und zahlreicher Abbildungen eignet sich der Band hervorragend als einführendes Lehrbuch - und zwar nicht nur für Physik-Studenten, sondern auch für Studierende angrenzender Natur- und Ingenieurwissenschaften. Grundlegende Eigenschaften, supraleitende Elemente, Cooper-Paarung, Thermodynamik, kritische Ströme, Josephsonkontakte...

  18. Ausbildung und Erwartungshaltung

    Science.gov (United States)

    Knoke, Holger

    1997-09-01

    werden Geologiestudenten zeitgemäß ausgebildet? Wird in der Angewandten Geologie das gelehrt, was in Wirtschaftsunternehmen an Wissen von einem Geologen erwartet wird? Erfolgt die spezielle Ausbildung zum Hydrogeologen fundiert und umfassend? Eine Antwort auf diese Fragen kann sicherlich nicht allumfassend gegeben werden, da sie von der jeweiligen Sichtweise abhängig ist. Ein Geologieprofessor wird die Ausbildung seiner Studenten im Großen und Ganzen als zeitgemäß einstufen, eventuell hier und da Verbesserungen für möglich halten. Auffällig ist die hohe Anzahl der in den letzten Jahren bereits geänderten oder zur Änderung anstehenden Studienordnungen. Es zeigt, daß die Straffung des Studiums sowie eine zumindest teilweise neue Wichtung der Schwerpunkte notwendig war bzw. ist, wobei im allgemeinen eine höhere Stundenzahl in den Grundlagenfächern Mathematik, Physik und Chemie angesetzt wird. Betrachtet man die Gesamtstundenzahlen der alten und der reformierten Studienordnungen, kann jedoch von einer Kürzung der Pflichtstunden in den meisten Fällen nicht die Rede sein. Eine grundlegende Reform des Geologiestudiums ist zur Zeit nicht zu erkennen, eher eine Verschulung des Studienganges. Die Entwicklung scheint zur Zeit weg von der freien Kurswahl und hin zu Modulangeboten mit vorgegebenen Kursen und Reihenfolgen zu gehen. Für die Hydrogeologie-Professoren ist es sicherlich nicht einfach zu entscheiden und in ihrem Kollegenkreis durchzusetzen, was aus dem generellen geowissenschaftlichen Kursangebot für einen Hydrogeologen notwendig oder aber entbehrlich ist. Genügen die Grundlagen der Paläontologie und der Mineralogie? Kann man ganz darauf verzichten? Was erwarten Behörden und Wirtschaftsunternehmen an allgemeinen und Spezialkenntnissen? Geologische Landesämter z. B. wollen, pauschal betrachtet, Geologen alten Stils. Ist ausdrücklich ein Angewandter Geologe oder speziell ein Hydrogeologe erwünscht, soll dieser die Spezialkenntnisse zus

  19. Diffuser Haarausfall und klinische Endokrinologie: Neue Erkenntnisse

    Directory of Open Access Journals (Sweden)

    Liptak J

    2013-01-01

    Full Text Available Diffuser Haarausfall ist ein häufiges Krankheitsbild in der täglichen Praxis, dessen Diagnostik allerdings oft eine Herausforderung darstellt. In den vergangenen 10 Jahren wurden große Fortschritte in der Erforschung der Effekte diverser Hormone erzielt. In murinen Haarfollikeln wird Corticoliberin (Corticotropin-releasing Hormone [CRH] mit einem Peak in der Anagenphase (Wachstumsphase exprimiert. Ein stressinduziert erhöhter CRH-Spiegel kann durch Aktivierung von Mastzellen zu erhöhtem Haarverlust führen. Melatonin wird ebenfalls im Haarfollikel exprimiert und wirkt dort auf unterschiedliche Rezeptoren. Besonders der nukleäre Retinoic Acid Receptor-(RAR- Related Orphan-Receptor alpha (RORα scheint regulatorisch auf haarzyklusabhängige Prozesse zu wirken und wird auch abhängig vom Haarzyklus exprimiert. Melatonin greift zudem in androgen- und östrogenvermittelte Signaltransduktionswege ein. Eine topische Anwendung von Melatonin kann zu einer Zunahme der Anagenhaare führen. Auch Leptin wird im Haarfollikel exprimiert und beeinflusst Haarwachstum und Hautregeneration durch Aktivierung von STAT3. Bei Mäusen konnte durch Leptin die Anagenphase induziert werden. Über den Zusammenhang zwischen androgenetischer Alopezie und Metabolischem Syndrom wurden zahlreiche widersprüchliche Daten veröffentlicht. Zuletzt wies eine große koreanische Studie eine positive Assoziation der Krankheitsbilder bei Frauen nach, jedoch nicht bei Männern. Prolaktin induziert den verfrühten Übergang zur Katagenphase, senkt die Proliferationsrate der Keratinozyten im Haarfollikel und steigert deren Apoptoserate. Eine zu Haarausfall führende Hyperprolaktinämie kann unter anderem durch diverse Medikamente, insbesondere typische und atypische Neuroleptika, hervorgerufen werden. Zahlreiche Studien an Mäusen konnten belegen, dass der Vitamin-D-Rezeptor (VDR eng mit dem Haarwachstum assoziiert ist. Dieser scheint den Haarzyklus unabhängig von seinen Liganden

  20. Nationale und transnationale Vernetzung polnischer Städte und Regionen: Auf dem Weg zu einer nachhaltigen Stadt- und Regionalentwicklung

    OpenAIRE

    Dorsch, Pamela

    2003-01-01

    "Die Studie 'Nationale und transnationale Vernetzung polnischer Städte und Regionen - Bedeutung für eine nachhaltige Stadt- und Regionalentwicklung' liefert einen Überblick über die Einbindung polnischer Kommunen und Wojewodschaften in allgemeine und politikfeldspezifische Netzwerke auf nationaler und transnationaler Ebene. Besondere Berücksichtigung findet hierbei die Vernetzung in Fragen von Nachhaltigkeit und des Umweltschutzes. Einführend zeigt die Studie den Prozess zunehmender Dezentral...

  1. Three-Dimensional post-myelographic CT reconstruction in the diagnosis and therapy planning for spinal development disorders; Dreidimensionale postmyelographische CT-Rekonstruktion in der Diagnostik und Therapieplanung spinaler Entwicklungsstoerungen

    Energy Technology Data Exchange (ETDEWEB)

    Wicht, L. [Strahlenklinik und Poliklinik, Virchow Klinikum, Humboldt-Univ. zu Berlin (Germany); Schedel, H. [Strahlenklinik und Poliklinik, Virchow Klinikum, Humboldt-Univ. zu Berlin (Germany); Benndorf, G. [Strahlenklinik und Poliklinik, Virchow Klinikum, Humboldt-Univ. zu Berlin (Germany); Beier, J. [Strahlenklinik und Poliklinik, Virchow Klinikum, Humboldt-Univ. zu Berlin (Germany); Haberl, H. [Neurochirurgische Abt., Virchow-Klinikum, Humboldt-Univ. zu Berlin (Germany); Felix, R. [Strahlenklinik und Poliklinik, Virchow Klinikum, Humboldt-Univ. zu Berlin (Germany)

    1996-05-01

    Dysrhaphia is often associated with severe osseous aberrations of the spine such as, for example scoliosis, hemivertebra, and synostosis. With the advanced possibilities of the post-processing of CT-data (segmentation, three-dimensional reconstruction), post-myelo-CT is an excellent method for the evaluation of osseous structures and the myelon in preoperative planning. (orig.) [Deutsch] Dysraphien gehen haeufig mit ausgepraegten ossaeren Veraenderungen der Wirbelsaeule wie Skoliose, Halbwirbelbildungen und Synostosen einher. Mit den verbesserten Moeglichkeiten der Datennachbearbeitung (Segmentierung, 3D-dimensionale Rekonstruktion) stellt die postmyelographische Computertomographie vor allem bei komplexen Fehlbildungen ein geeignetes Verfahren zur praeoperativen Beurteilung der ossaeren Strukturen der Wirbelsaeule und des Myelons dar. (orig.)

  2. Laser diagnosis and plasma technology: Fundamentals for reduction of emissions and fuel consumption in DI internal combustion engines. Sub-project: Purification of diesel exhaust in pulsed plasma. Final report; Laserdiagnostische und plasmatechnologische Grundlagen zur Verminderung von Emissionen und Kraftstoffverbrauch von DI-Verbrennungsmotoren. Teilvorhaben: Reinigung von Dieselabgasen in gepulsten Plasmen. Abschlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Hammer, T.; Kishimoto, T.; Birckigt, R.

    2000-12-01

    Selective catalytic reduction using ammonia based reducing agents is known to reduce the NOx-emissions from Diesel cars. However, it does not work efficiently under cold starting and urban driving conditions, because efficient reduction requires catalyst temperatures above 170 C. Without additional measures, pulsed plasma treatment does not cause reduction but mainly oxidation of nitric oxides preferably emitted as NO. By the combination of pulsed DBD-plasma treatment with selective catalytic reduction efficient NOx-reduction was obtained at catalyst temperatures below 170 C. It could be shown, that this low temperature reduction is a synergistic effect caused by plasma induced oxidation of some fraction of the NO. Based on this knowledge of the reaction mechanism plasma- and SCR-reactors were built, which were tested on a test bench equipped with a modern cars Diesel engine. Under cold starting and urban driving conditions by application of average plasma powers below 300 W the NOx-emissions were reduced for about 60%, the maximum degree of NOx-reduction was 85%. The plasma induced removal of hydrocarbons and particles, as well as the formation of by-products and the influence of hydrocarbons on the plasma induced selective catalytic reduction processes were investigated. No disadvantageous by-products could be found. (orig.) [German] Die selektive katalytische Reduktion mit Ammoniak als Reduktionsmittel ist ein bekanntes Verfahren zur Reduktion der Stickoxidemissionen von Diesel-Pkw, arbeitet aber erst ab Katalysatortemperaturen oberhalb 170 C und ist damit unter Kaltstart- und Stadtverkehrsbedingungen wenig wirksam. Gepulste Plasmen bewirken ohne zusaetzliche Massnahmen keine ausreichende chemische Reduktion sondern ueberwiegend Oxidation der als NO emittierten Stickoxide. Durch Kombination von DBE-Plasmen mit der selektiven katalytischen Reduktion hingegen konnte auch bei Katalysatortemperaturen unter 170 C wirkungsvolle NOx-Reduktion erzielt werden. Es konnte

  3. Comparison of alternative weight recalibration methods for diagnosis-related groups

    Science.gov (United States)

    Rogowski, Jeannette Roskamp; Byrne, Daniel J.

    1990-01-01

    In this article, alternative methodologies for recalibration of the diagnosis-related group (DRG) weights are examined. Based on 1984 data, cost and charge-based weights are less congruent than those calculated with 1981 data. Previous studies using 1981 data demonstrated that cost- and charge-based weights were not very different. Charge weights result in higher payments to surgical DRGs and lower payments to medical DRGs, relative to cost weights. At the provider level, charge weights result in higher payments to large urban hospitals and teaching hospitals, relative to cost weights. PMID:10113568

  4. Climate protection and competition; Klimaschutz und Wettbewerb

    Energy Technology Data Exchange (ETDEWEB)

    Diekmann, M. [Stadtwerke Braunschweig GmbH (Germany)

    1998-06-01

    Discussions on energy-related matters have recently been dominated above all by the two issues climate protection and the introduction of competition. The public utility Stadtwerke Braunschweig GmbH and its subsidiaries Braunschweiger Versorgungs-AG and Braunschweiger Verkehrs-AG have committed themselves to the cause of climate protection. The ongoing implementation of the utility`s energy supply concept is making a substantial contribution to energy conservation and air pollution control. [Deutsch] Die Diskussionen zum Thema Energie werden in der letzten Zeit im wesentlichen von zwei Themen beherrscht: Klimaschutz und Einfuehrung von Wettbewerb. Die Stadtwerke Braunschweig GmbH mit ihren Tochtergesellschaften Braunschweiger Versorgungs-AG und Braunschweiger Verkehrs-AG engagieren sich im Klimaschutz. Die fortlaufende Umsetzung des Energieversorgungskonzepts der Stadtwerke traegt wesentlich zur Energieeinsparung und zur Reduzierung von Schadstoff-Emissionen bei. (orig./MSK)

  5. Immunoglobulin G4-related tubulointerstitial nephritis: A not to be missed diagnosis

    Directory of Open Access Journals (Sweden)

    Smita Mary Matthai

    2017-01-01

    Full Text Available Immunoglobulin G4-related tubulointerstitial nephritis (IgG4-TIN is a newly recognized clinicopathological entity characterized by a dense interstitial infiltrate of IgG4-positive plasma cells accompanied by fibrosis and obliterative phlebitis causing acute or chronic renal dysfunction amenable to corticosteroid therapy. IgG4-TIN is the dominant manifestation of renal involvement in IgG4-related disease (IgG4-RD which is a novel, immune-mediated, fibroinflammatory and multiorgan disorder. We describe a case of IgG4-TIN with isolated renal involvement in an elderly male patient with poor response to corticosteroid therapy. The distinctive serological, histopathological, and ultrastructural features of this condition which can facilitate differential diagnosis of TIN are highlighted to emphasize the need for early diagnosis and preservation of kidney function.

  6. Zwischen Freakout und Normcore

    Directory of Open Access Journals (Sweden)

    Beate Großegger

    2017-06-01

    Full Text Available Bis Ende des 20. Jahrhunderts war Rebellion jugendkulturell ein großes Thema. Heute hat die Jugend das so genannte Establishment aus den Augen verloren; die breite Mehrheit gibt sich postheroisch, setzt auf individualitätsbezogene Werte und träumt, eingeschlossen in ihre bunten Lifestyleblasen, von einem perfekten Leben. Bezugnehmend auf aktuelle Befunde der Jugend- und Generationenforschung gibt Beate Großegger in ihrem Beitrag einen Überblick über die wichtigsten Werte- und Lifestyletrends im frühen 21. Jahrhundert und zeigt dabei, wie sehr die heutige Jugend Kind ihrer Zeit und Produkt gesellschaftlicher Rahmenbedingungen ist. Until the late 20th century rebellion was an important aspect of various youth subcultures. But today’s youth has a different mindset. The majority acts post-heroically, i.e. they rather focus on their individual, their private lifestyle than opposing against the establishment. Wrapped in their lifestyle filterbubbles, they dream of a perfect life. Based on recent youth und generation studies Beate Großegger gives an overview of the most important youth cultural trends in the fields of values and lifestyles and introduces today’s youth as a child of our times.

  7. Neue Laser und Strahlquellen - alte und neue Risiken?

    DEFF Research Database (Denmark)

    Paasch, Uwe; Schwandt, Antje; Seeber, Nikolaus

    2017-01-01

    Die Entwicklungen im Bereich dermatologischer Laser, hochenergetischer Blitzlampen, LED und neuer Energie- und Strahlquellen der letzten Jahre haben gezeigt, dass mit neuen Wellenlängen, Konzepten und Kombinationen zusätzliche, zum Teil über den ästhetischen Bereich hinaus gehende therapeutische ...

  8. Distribution des durées de séjour par Diagnosis Related Group

    OpenAIRE

    Eggli, Yves; Koehn, Véronique; Paccaud, Fred; Moyard M. (Collab.),

    1988-01-01

    Ce cahier fournit les principales informations concernant les durées de séjour et le nombre de sorties observées dans 33 hôpitaux suisses pour l'années 1984. La description des clientèles hospitalières est fondée sur les "Diagnosis Related Groups" (DRG), qui forment une classification de 472 groupes de patients hospitalisés. [Auteurs, p. 1

  9. Cholecystectomy and Diagnosis-Related Groups (DRGs): Patient Classification and Hospital Reimbursement in 11 European Countries

    OpenAIRE

    Gerli Paat-Ahi; Ain Aaviksoo; Maria Świderek

    2014-01-01

    Background As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods National or regional databases were used to identify hospital cases with a procedure of cholecystectom...

  10. Diagnosis-Related Groups for Stroke in Europe: Patient Classification and Hospital Reimbursement in 11 Countries

    OpenAIRE

    Peltola, Mikko; Quentin, Wilm

    2013-01-01

    Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich. This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively. Background: Diagnosis-related groups (DRGs) are increasingly being used for various purposes in many countries. However, there are no studies comparing different DRG systems...

  11. Funding intensive care - approaches in systems using diagnosis-related groups.

    OpenAIRE

    Ettelt, S; Nolte, E

    2010-01-01

    This report reviews approaches to funding intensive care in health systems that use activitybased payment mechanisms based on diagnosis-related groups (DRGs) to reimburse hospital care. The report aims to inform the current debate about options for funding intensive care services for adults, children and newborns in England. Funding mechanisms reviewed here include those in Australia (Victoria), Denmark, France, Germany, Italy, Spain, Sweden and the United States (Medicare). Approaches to org...

  12. Führung und Machiavellismus

    NARCIS (Netherlands)

    Belschak, F.D.; den Hartog, D.N.; Felfe, J.

    2015-01-01

    In diesem Beitrag wird der Zusammenhang zwischen Führung und Machiavellismus aus zwei verschiedenen Perspektiven betrachtet. Zum einen werden neuere Forschungsergebnisse referiert, wie machiavellistische Mitarbeiter auf verschiedene Führungsstile ihres Vorgestzten reagieren und so mit Hinblick auf

  13. Netzformen und VDE-Bestimmungen

    Science.gov (United States)

    Bernstein, Herbert

    Der Verband Deutscher Elektrotechniker (VDE) hat eine Reihe von Vorschriften ausgearbeitet, die dem Schutz von Leben und Sachen beim Umgang mit elektrischer Energie dienen. Besonders wichtig sind die in den VDE-Bestimmungen 0100 und 0411 festgelegten Vorschriften.

  14. Delegation und Kooperation im Gesundheitswesen

    OpenAIRE

    Rosenau, Henning

    2010-01-01

    Delegation und Kooperation im Gesundheitswesen. - In: Tıpta işbirliği ve hukuksal sorunlar = Delegation und Kooperation im Gesundheitswesen / ed.: Hakan Hakeri ... - Samsun : Adalet, 2010. - S. 7-18

  15. Exposure of the French population to ionizing radiations related to medical diagnosis procedures in 2012

    International Nuclear Information System (INIS)

    2014-01-01

    This report updates (for 2012) data concerning the exposure of the French population related to diagnosis imagery tests using ionizing radiations. It notably outlines the characteristics of this medical exposure with respect to imagery modality (conventional radiology, scans, diagnosis interventional radiology, and nuclear medicine), to anatomic examined region, to age and to patient gender, and the share of the French population (quantity, age, gender) actually submitted to diagnosis procedures in 2012. The authors report the selection of procedure types, the determination of their frequency, the assessment of associated doses (choice of the efficient dose as indicator, assessment of efficient doses associated with each procedure type), the exposure of the French population in 2012 (general assessment, distribution of procedures and of the collective efficient dose, distribution in terms of age and gender), the characteristics of the actually exposed population. The representativeness of data is discussed, as well as the evolution of diagnosis medical exposure from 2007 to 2012. Data are compared with European and international data

  16. Risiko Video- und Computerspiele? Eine Studie über Video- und Computerspielnutzung und Aggression bei 12- und 16- jährigen Jugendlichen

    OpenAIRE

    Schiller, Eva-Maria; Strohmeier, Dagmar; Spiel, Christiane

    2009-01-01

    Video -und Computerspielen ist heutzutage eine beliebte Freizeitaktivität von Kindern und Jugendlichen, besonders von Jungen. Trotz der großen Vielfalt der angebotenen Video- und Computerspiele für Kinder und Jugendliche, konzentriert sich die Forschung vorwiegend auf negative Einflüsse von gewalthaltigen Video- und Computerspielen. Da nicht alle Kinder und Jugendliche ausschließlich gewalthaltige Video- und Computerspiele spielen, betrachten wir diesen Fokus in der Wissenschaft als zu eng ge...

  17. Conventional angiography in comparison with magnetic resonance tomography and arthroscopy for the diagnosis of knee joint lesion - specific indications?; Die konventionelle Arthrographie im Vergleich zu Magnetresonanztomographie und Arthroskopie bei Kniegelenkbinnenlaesionen: Verbleiben Indikationen?

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, H. [Universitaetsklinikum Steglitz, Radiologische Klinik, Abt. fuer Roentgendiagnostik und Nuklearmedizin, FU Berlin (Germany); Andresen, R. [Universitaetsklinikum Steglitz, Radiologische Klinik, Abt. fuer Roentgendiagnostik und Nuklearmedizin, FU Berlin (Germany); Radmer, S. [Orthopaedisches Institut, Berlin (Germany); Schmidt, M. [Krankenhaus Moabit, Roentgenabteilung, Berlin (Germany); Wolf, K.J. [Universitaetsklinikum Steglitz, Radiologische Klinik, Abt. fuer Roentgendiagnostik und Nuklearmedizin, FU Berlin (Germany)

    1995-03-01

    Twenty-one patients with suspected internal knee joint lesions were examined prospectively. In all patients an MRI was carried out first and was followed within two weeks by an arthrography and an arthrocopy. Lesions of the menisci, cruciate ligaments, hyaline cartilage, and synovial tissues were evaluated. Arthroscopy findings were defined as the `gold standard`. MRI achieved an accuracy of 96.4%, a sensitivity of 93.6%, and a specifity of 92.5%, whereas arthrography achieved an accuracy of 67.8%, a sensitivity of 66.6%, and a specifity of 71.4%. These statistical data as well as the single findings revealed no special indications for arthrography in suspected knee joint lesions. (orig.) [Deutsch] In einer prospektiven Studie wurden insgesamt 21 Patienten mit suspekten Kniegelenksbinnenlaesionen untersucht. Bei allen Patienten erfolgte zunaechst eine Magnetresonanztomographie (MRT), anschliessend innerhalb von zwei Wochen eine Arthrographie und Arthroskopie des Kniegelenks. Beurteilt wurden Laesionen der Meniski, der Kreuzbaender, des hyalinen Gelenkknorpels und des Synovialgewebes. Bezogen auf den Arthroskopiebefund als `Gold-Standard` erreichte die MRT eine Treffsicherheit von 96,4%, eine Sensitivitaet von 93,6% und eine Spezifitaet von 92,5%; dagegen die Arthrographie eine Treffsicherheit von 67,8%, eine Sensitivitaet von 66,6% und eine Spezifitaet von 71,4%. Sowohl eine Uebersicht als auch die Auswertung der Einzelbefunde ergaben keine speziellen Indikationen zur Durchfuehrung einer Kniegelenksarthrographie bei suspekten Binnenlaesionen. (orig.)

  18. Ellbogen- und Handgelenksendoprothetik beim Rheumatiker - Richtlinien und Rehabilitation

    Directory of Open Access Journals (Sweden)

    Chochole M

    2008-01-01

    Full Text Available Die Endoprothetik an Ellbogen und Handgelenk ist seit etwa drei Jahrzehnten etabliert. An beiden Gelenken haben sich einzelne Implantate oder Designs durchgesetzt. Operationstechniken und Nachuntersuchungsergebnisse sind publiziert. Wenig ist jedoch zum Thema Nachbehandlung und Nachsorge veröffentlicht. Diese Arbeit beschäftigt sich detailliert mit der ärztlichen und therapeutischen Betreuung nach Implantation einer Ellbogen- oder Handgelenksendoprothese beim Patienten mit rheumatischer Arthritis unter Aufgliederung in Krankenhausaufenthalt, ambulanter Nachsorge sowie stationärer Rehabilitation. Dabei werden Zeitrahmen, Therapieziele und Behandlungen gesondert angeführt.

  19. Altautoverwertung zwischen Staat und Markt: Bedingungen und Potentiale zur Modernisierung von Lagerhaltung und Marketing gebrauchter Autoteile

    OpenAIRE

    Lucas, Rainer

    2000-01-01

    Das Arbeitspapier diskutiert vor dem Hintergrund veränderter gesetzlicher Rahmen-und Wettbewerbsbedingungen in der Autoverwertung Ziele und Maßnahmen zurStärkung kleiner und mittelständischer Verwertungsbetriebe. Der Bereich GebrauchteAutoteile wird im Rahmen eines regionalen Fallbeispiels einer tiefergehenden Analyseunterzogen. Hieraus werden Vorschläge zur regionalen Netzwerkbildung innerhalb derBranche und neue Dienstleistungsperspektiven abgeleitet. Ein wesentliches Koope-rationsfeld ist ...

  20. Early diagnosis of myocardial infarction using absolute and relative changes in cardiac troponin concentrations.

    Science.gov (United States)

    Irfan, Affan; Reichlin, Tobias; Twerenbold, Raphael; Meister, Marc; Moehring, Berit; Wildi, Karin; Bassetti, Stefano; Zellweger, Christa; Gimenez, Maria Rubini; Hoeller, Rebeca; Murray, Karsten; Sou, Seoung Mann; Mueller, Mira; Mosimann, Tamina; Reiter, Miriam; Haaf, Philip; Ziller, Ronny; Freidank, Heike; Osswald, Stefan; Mueller, Christian

    2013-09-01

    Absolute changes in high-sensitivity cardiac troponin T (hs-cTnT) seem to have higher diagnostic accuracy in the early diagnosis of acute myocardial infarction compared with relative changes. It is unknown whether the same applies to high-sensitivity cardiac troponin I (hs-cTnI) assays and whether the combination of absolute and relative change might further increase accuracy. In a prospective, international multicenter study, high-sensitivity cardiac troponin (hs-cTn) was measured with 3 novel assays (hs-cTnT, Roche Diagnostics Corp, Indianapolis, Ind; hs-cTnI, Beckman Coulter Inc, Brea, Calif; hs-cTnI, Siemens, Munich, Germany) in a blinded fashion at presentation and after 1 and 2 hours in a blinded fashion in 830 unselected patients with suspected acute myocardial infarction. The final diagnosis was adjudicated by 2 independent cardiologists. The area under the receiver operating characteristic curve for diagnosing acute myocardial infarction was significantly higher for 1- and 2-hour absolute versus relative hs-cTn changes for all 3 assays (P Siemens, 0.96 [95% CI, 0.93-0.99]) were high and provided some benefit compared with the use of absolute change alone for hs-cTnT, but not for the hs-cTnI assays. Reclassification analysis confirmed the superiority of absolute changes versus relative changes. Absolute changes seem to be the preferred metrics for both hs-cTnT and hs-cTnI in the early diagnosis of acute myocardial infarction. The combination of absolute and relative changes provides a small added value for hs-cTnT, but not for hs-cTnI. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Different communication strategies for disclosing a diagnosis of schizophrenia and related disorders.

    Science.gov (United States)

    Farooq, Saeed; Johal, Rupinder K; Ziff, Charlotte; Naeem, Farooq

    2017-10-24

    Delivering the diagnosis of a serious illness is an important skill in most fields of medicine, including mental health. Research has found that communication skills can impact on a person's recall and understanding of the diagnosis, treatment options and prognosis. People may feel confused and perplexed when information about their illness is not communicated properly. Sharing information about diagnosis of a serious mental illness is particularly challenging. The nature of mental illness is often difficult to explain since there may be no clear aetiology, and the treatment options and prognosis may vary enormously. In addition, newly diagnosed psychiatric patients, who are actively ill, often may not accept their diagnosis due to lack of insight or stigma attached to the condition. There are several interventions that aim to help clinicians to communicate life changing medical diagnoses to people; however, little is known specifically for delivering a diagnosis of schizophrenia. To evaluate evidence from randomised controlled trials (RCTs) for the efficacy of different communication strategies used by clinicians to inform people about the diagnosis and outcome of schizophrenia compared with treatment as usual and to compare efficacy between different communication strategies. On 22 June 2015 and 29 June 2016, we searched the Cochrane Schizophrenia Group's Study-Based Register of Trials. We also searched sources of grey literature (e.g., dissertations, theses, clinical reports, evaluations published on websites, clinical guidelines and reports from regulatory agencies). We planned to include all relevant RCTs that included adults with schizophrenia or related disorders, including schizophreniform disorder, schizoaffective disorder and delusional disorder. The trials would have investigated the effects of communication strategy or strategies that helped clinicians deliver information specifically about a diagnosis of schizophrenia (which can also include

  2. The role of energy-related consultancy in increasing the energy performance in small and mid-sized enterprises. Feedback analysis of a survey among SMEs and energy consultants in Baden-Wuerttemberg. Final report to the Ministry of environment and transport of Baden-Wuerttemberg; Die Rolle der Energieberatung bei der rationellen Energienutzung in kleinen und mittleren Unternehmen. Auswertung einer Umfrage unter kleinen und mittleren Unternehmen und Energieberatern in Baden-Wuerttemberg. Endbericht an das Ministerium fuer Umwelt und Verkehr Baden-Wuerttemberg

    Energy Technology Data Exchange (ETDEWEB)

    Schmid, C. (comp.); Gruber, E.; Weigert, K.

    2000-10-01

    The small and mid-sized enterprises (SMEs) have to cope with typical shortcomings due to tight technical, financial, or human resources, in attempts to implement energy performance improvement measures in their shops. As a rule, none of the persons employed has the time to qualify for and perform the functions of an energy efficiency specialist. This is why consultancy by external specialists is the adequate solution (when doubts about the cost efficiency and general usefulness of such services have been removed). The document contains the important aspects of a survey carried out in order to gather information about availability of consultancy services for SMEs in the producing sector, and available experience and results. The survey covers about 50 enterprises of the mechanical engineering and printer's shop branches, as well as about 50 consulting firms in Baden-Wuerttemberg. (orig./CB) [German] In kleinen und mittleren Unternehmen existieren eine Reihe von technischen, oekonomischen und einstellungsbedingten Hemmnissen bei der Umsetzung von Massnahmen der rationellen Energienutzung. Aufgrund der geringen Mitarbeiterzahl gibt es in diesen Unternehmen in der Regel niemanden, der fuer Fragen der rationellen Energienutzung zustaendig ist und moegliche Einsparmassnahmen verfolgt. Gerade fuer kleinere Unternehmen ist daher die Inanspruchnahme externer Energiefachleute sinnvoller als der kostenintensive Aufbau von eigenem Know-how. Allerdings werden Energieberatungen u. a. aus Kostengruenden und Zweifel am Nutzen haeufig nicht in Anspruch genomen. In der vorliegenden Studie wurden das Angebot von und Erfahrungen mit Energieberatungen fuer kleine und mittlere Unternehmen des produzierenden Gewerbes untersucht. Dazu wurden auch Fragen zum Umfeld, vor allem zur Wirkung und Ueberwindung von Hemmnissen in den Betrieben und zur Bereitschaft zur Durchfuehrung von Massnahmen rationeller Energienutzung beruecksichtigt. Ziel der Arbeit war es, einen Einblick in den

  3. Klima- und umweltbezogene Lernprozesse in partizipativen Produktentwicklungsverfahren: Möglichkeiten und Grenzen

    Directory of Open Access Journals (Sweden)

    Marlen Arnold

    2009-08-01

    Full Text Available Für erfolgreiche und nachhaltige Produktentwicklung reichen heute Marktbeobachtung und Kund/innenbefragungen alleine nicht mehr aus. Mit Verfahren zur partizipativen Produktentwicklung (PPE können sowohl das kreative Potenzial von Nutzer/innen für die Produktentwicklung erschlossen als auch marktfähige nachhaltige Produkte entwickelt werden. Sie ermöglichen so aktives Nachhaltigkeitsmanagement. Am Beispiel des INNOCOPE-Pilotverfahrens wird diskutiert, wie nachhaltigkeitsbezogene Lernprozesse in PPE-Prozessen initiiert werden können und welche Faktoren dabei wesentlich sind. Insgesamt zeigt sich, dass vor allem die sich wiederholende, direkte und möglichst gleichberechtigte Interaktion von Unternehmensvertreter/innen und von Konsument/innen einen themenbezogenen Wissensaustausch und wechselseitige Lernprozesse ermöglicht. Dabei sind der inhaltliche Aufbau der Treffen und der zeitlich gestaffelte Einsatz von Lernmethoden wesentlich.Today, market observation and customer surveys alone do not suffice to develop successful and sustainable products. Methods of participatory product development (PPD allow to open up the creative potential of users for product development, and to develop marketable sustainable products. Thereby, they support active sustainability management. Taking the INNOCOPE pilot process as an example, we discuss the possibilities and the relevant factors to initiate sustainability- and climate-related learning processes within PPD processes. Our findings indicate that repeated, direct and equitable interaction between company representatives and customers are fundamental for relevant knowledge exchange and mutual learning processes. Other key issues are the thematic structure of the meetings and the timing of learning methods.

  4. Ein Integraler Gestalt-Ansatz fuer Therapie und Beratung

    Directory of Open Access Journals (Sweden)

    Martina Gremmler-Fuhr

    2005-06-01

    Full Text Available Zusammenfassung: In diesem Text stellen wir unseren Ansatz für Psychotherapie und Beratung auf dem Hintergrund des integralen Paradigmas dar. Wir erläutern zunächst kurz vier Anforderungen an ein integrales Konzept in diesem professionellen Bereich: Umgang mit Komplexität und Vielperspektivität, Berücksichtigung gerichteter, vieldimensionaler Entwicklung, Orientierungs- und Sinngebungsfunktion, Realisierung relationaler Qualitäten in der Arbeit. Nach einer Begriffsbestimmung von „Therapie“, „Beratung“ und „Bildung“ charakterisieren wir das seit vielen Jahren von uns entwickelte Konzept für den Integralen Gestalt-Ansatz unter den Fragen nach (1 den Intentionen und Aufgaben von Therapie und Beratung, (2 der Gestaltung der Kommunikation und Beziehung, (3 der Art der Problemdefinition und dem Umgang mit Diagnostik sowie (4 den Strategien und Methoden – alle unter Rückkopplung an die zuvor erläuterten Anforderungen an ein integrales Konzept. Abstract: In this text we present our approach to psychotherapy and counseling on the background of the integral paradigm. We shortly explain four major requirements for such an integral concept: handling complexity and multi-perspectivity, considering directed and multi-dimensional development, offering orientation and meaning, relational qualities. After defining the terms „psychotherapy“, „counselling“, and „education“ we present our concept for the Integral Gestalt Approach which we have developed and evaluated for many years by dealing with four questions: (1 the intentions and tasks of therapy and counselling, (2 the formation of communication and relationship, (3 the specific way of defining problems and using diagnostics, and (4 the strategies and methods – all related back to the major requirements of an integral concept.

  5. The child with an acute limp; Das hinkende Kind. Radiologische Differenzialdiagnostik der akuten Gangstoerung des Kinder- und Jugendalters

    Energy Technology Data Exchange (ETDEWEB)

    Stadler, A.; Puig, S.; Eisenhuber, E.; Rand, T. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2002-03-01

    Limping is a common and often challenging problem in children and adolescents. A limp is defined as asymetric deviation from a normal gait pattern. A systematic approach is necessary to determine the cause of the limp, so the radiologist should combine a thorough history, clinical information and pertinent radiologic testing. The possible differential diagnosis is extensive and includes many pathologies of the lower extremity and spine like trauma, infection, neoplasia, furthermore inflammatory, developmental and congenital disorders. In cases with knee or tight pain, an underlying hip condition should be considered. The childs age can narrow the possible differential diagnoses, because certain entities are age-related. Despite this wide bandwidth of entities, potential catastrophic causes like septic arthritis and malignant disease should be excluded first. Plain radiographs are often diagnostic. The choice of further imaging modalities like ultrasonography, magnetic resonance imaging, computed tomography and bone scan should be guided by the history and clinical findings. (orig.) [German] Die Abklaerung der hinkenden Gangstoerung bei Kindern und Jugendlichen ist ein haeufiges und oft komplexes diagnostisches Problem. Hinken ist definiert als eine asymmetrische Abweichung vom normalen Gangmuster. Um die Ursache des Hinkens suffizient abklaeren zu koennen, ist ein systematisches Vorgehen mit sorgfaeltiger Anamneseerhebung, orientierender klinischer Untersuchung, sowie eine adaequate Wahl der radiologischen Modalitaet durch den Radiologen notwendig. Das weite Spektrum der moeglichen Differenzialdiagnosen umfasst viele Pathologien der unteren Extremitaet wie Trauma, infektioese, neoplastische und entzuendliche Erkrankungen sowie erworbene und angeborene Stoerungen. In Faellen, in denen das Kind Knie- oder Oberschenkelbeschwerden angibt, muss zusaetzlich an eine Erkrankung der Huefte gedacht werden. Da viele Erkrankungen eine bestimmte Altersgruppe bevorzugen, kann

  6. First contact diagnosis and management of contact lens-related complications.

    Science.gov (United States)

    Fagan, Xavier J; Jhanji, Vishal; Constantinou, Marios; Amirul Islam, F M; Taylor, Hugh R; Vajpayee, Rasik B

    2012-08-01

    To describe the spectrum of contact lens-related problems in cases presenting to a tertiary referral eye hospital. A retrospective case record analysis of 111 eyes of 97 consecutive patients was undertaken over a period of five months at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia. Contact lens-related complications (CLRC) were classified into microbial keratitis, sterile corneal infiltrates, corneal epitheliopathy and contact lens-related red eye (CLARE). Main parameters examined were nature of the first contact, clinical diagnosis, and management pattern. Forty-two percent of the initial presentations were to health care practitioners (HCPs) other than ophthalmologists. Mean duration from the onset of symptoms to presentation was 6.3 ± 10.9 days. Forty-nine percent (n = 54) of patients had an associated risk factor, most commonly overnight use of contact lenses (n = 14, 13 %). Most common diagnosis at presentation was corneal epitheliopathy (68 %) followed by sterile infiltrates (10 %), CLARE (8 %) and microbial keratitis (6 %). No significant differences were found in the pattern of treatment modalities administered by ophthalmologists and other HCPs. HCPs other than ophthalmologists are the first contact for contact lens-related problems in a significant proportion of patients. These HCPs manage the majority of CLRC by direct treatment or immediate referral.

  7. Rosetta und Yella

    Directory of Open Access Journals (Sweden)

    Urs Urban

    2009-11-01

    Full Text Available L’apparition de l’homo oeconomicus marque la fin des grands récits et par là de l’ensemble social que ceux-ci avaient légitimé. En même temps cependant il entre dans les récits littéraires – et filmiques, par exemple dans Rosetta (1999 des frères Dardenne et Yella (2007 de Christian Petzold. L’article se propose de montrer comment ces derniers réussissent à mettre en scène les apories existentielles d’un sujet produit par le dispositif économique en appliquant des procédés narratifs permettant de problématiser la narration elle-même.Mit dem Auftauchen des homo oeconomicus scheint das Ende der großen Erzählungen und des von diesen legitimierten sozialen Zusammenhangs besiegelt. Genau in diesem Moment indes beginnen sich die kleinen, die literarischen und filmischen Erzählformen für den ökonomischen Menschen zu interessieren. In dem Artikel geht es darum zu zeigen, wie die Brüder Dardenne und Christian Petzold die Aporien eines vom ökonomischen Dispositiv produzierten Subjekts in ihren Filmen Rosetta (1999 und Yella (2007 erzählerisch umsetzen und dabei genau diese erzählerische Umsetzbarkeit in Frage stellen.

  8. Supraleitung Grundlagen und Anwendungen

    CERN Document Server

    Buckel, Werner

    2013-01-01

    Grundlegende Konzepte und Eigenschaften von Supraleitern, die Herstellung und Entwicklung von neuen supraleitenden Materialien sowie moderne Anwendungsbereiche sind die Schwerpunktthemen des Buches. Das größte Potential zur Nutzung der Supraleitung liegt in der Energietechnik. Fast unbemerkt trägt die Einführung von Kabeln, Magneten, Transformatoren oder Lagern aus supraleitenden Materialien bei zur Effizienzsteigerung bei der Stromübertragung oder in Motoren. Durch seiner klare Sprache und zahlreiche erläuternde Abbildungen eignet sich der Band hervorragend als einführendes Lehrbuch. Der Schwierigkeitsgrad wird von Kapitel zu Kapitel gesteigert. So können auch Einsteiger ohne einschlägige Vorkenntnisse dem Stoff folgen. Dank der über 350 Literaturhinweise bekommt der Leser außerdem einen Überblick über die wichtigsten Publikationen zum Thema. Ein unverzichtbares Lehrbuch also für Physik-Studenten und Studierende der Ingenieurwissenschaften. Fachleuten in Forschung und Praxis leistet das Buch au...

  9. Der Nahostkonflikt und die Medien

    Directory of Open Access Journals (Sweden)

    Carola Richter

    2014-06-01

    Full Text Available Diese Einführung in eine Themenausgabe zu den vielfältigen Rollen der Medien im Nahostkonflikt skizziert die Probleme, die sich für Medien und Journalisten als Akteure im Konflikt, Adressaten der Konfliktparteien und Anlass für Konflikt durch ihre Berichterstattung ergeben. Das Konfliktgebiet Israel und Palästina ist sowohl für Forschung über Auslandsbericht-erstattung, über transnationale Agenda Building- und Public Diplomacy-Prozesse als auch über mediensystemische Entwicklungen in Besatzer- und Besatzungsgebieten interessant. Der Artikel gibt einen Überblick über das Feld und führt dabei in die in der Themenausgabe präsentierten empirischen Studien zum Nahostkonflikt und den Medien ein.

  10. Germany and the nuclear non-proliferation; Current situation and prospects; Deutschland und die nukleare Nichtverbreitung; Zwischenbilanz und Ausblick

    Energy Technology Data Exchange (ETDEWEB)

    Preisinger, J.

    1993-07-01

    A summary is given of the consequences, both positive and negative, of international non-proliferation policy. The numerous, complex branches and connections of national measures and inter-stake agreements for the peaceful, controlled uses of nuclear technology and related military technologies are expertly described, and assessed on their effectiveness. Weak aspects of the nuclear non-proliferation regime are pointed out and past reforms are illustrated and assessed in the light of recent developments. The interests of the German Federal Republic from the centre of this analysis. The author shows that, after a certain hesitary, German diplomacy has now become active in the establishment of an international non-proliferation regime. He concludes that Germany should take a strong initiative role in maintaining a peaceful international nuclear order. (orig.) [Deutsch] Es wird ein Resuemee der bisherigen Erfolge und Misserfolge internationaler Nichtverbreitungspolitik gezogen. Die komplexen, vielfach veraestelten und verschachtelten nationalen Massnahmen und zwischenstaatlichen Vereinbarungen zur Ueberwachung und friedlichen Zweckbindung von Nukleartechnologie und militaerisch relevanten Anschlusstechnologien werden sachkundig erlaeutert und auf ihre Wirksamkeit ueberprueft. Schwachstellen des nuklearen Nichtverbreitungsregimes werden offengelegt, Reformschritte der vergangenen Jahre werden dargestellt und im Lichte der juengsten Entwicklungen bewertet. Dabei steht die Interessenlage der Bundesrepublik Deutschland im Zentrum der Analyse. Der Autor zeigt, dass die deutsche Diplomatie sich nach einer gewissen Zurueckhaltung schliesslich aktiv in die Gestaltung des internationalen Nichtverbreitungsregimes eingeschaltet hat. Er plaediert fuer eine kraftvolle Initiativrolle Deutschlands zur Erhaltung einer friedlichen internationalen Nuklearordnung. (orig.)

  11. Laser diagnosis and plasma technology: fundamentals for reduction of emissions and fuel consumption in DI internal combustion engines. Spray/wall-interaction under diesel engine conditions. Final report; Laserdiagnostische und plasmatechnologische Grundlagen zur Verminderung von Emissionen und Kraftstoffverbrauch von DI-Verbrennungsmotoren. Spray/Wand-Wechselwirkung bei der motorischen Einspritzung. Abschlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Renz, U.; Meingast, U.

    2001-02-01

    Spray/wall-interaction under diesel engine conditions is not yet investigated extensively in detail with high spatial resolution and high time resolution as those experiments require extremely accurate techniques. Numerical modelling to predict fluiddynamic and heat transfer processes are validated mostly under non engine conditions. The processes during spray/wall interaction under internal combustion engine conditions were investigated experimentally in an injection chamber using enhanced laser optical methods. To enable validation and development of numerical spray/wall models the data was collected under well known and reproducible conditions. Microscopic visualisation tools, Phase-Doppler Anemometry (PDA) to measure droplet diameter and velocity as well as fluorescence based film measurement technique and high speed surface thermocouples to determine the wall heat flux were used. The numerical predictions of the spray wall interaction using Computational Fluid Dynamics (CFD) including two spray/wall models from the literature show qualitatively good agreement with the experiments. However, quantitatively some insufficiencies are observed because the models base on experiments under atmospheric conditions disregarding the influences of high pressure and high temperature. Here more detailed investigation is necessary in the future. The present results build up a comprehensive basis to validate future models and their interaction. Progress was done in using measurement techniques to investigate complex mechanisms under challenging conditions. (orig.) [German] Die Spray/Wand Wechselwirkung unter dieselmotorischen Bedingungen ist bisher nicht mit hoher Zeit- und Ortsaufloesung umfassend charakterisiert worden, weil deren Untersuchung hohe Anforderungen an die Messtechniken stellt. Numerische Modelle zur Vorhersage der Stroemungs- und Waermetransportvorgaenge sind nur teilweise unter reale Bedingungen verifiziert worden. Die Vorgaenge beim Auftreffen eines

  12. Die biene und ihre produkte in der kunst und im alltagsleben (Fruhchristliche und byzantinische Zeit

    Directory of Open Access Journals (Sweden)

    Liveri Angeliki

    2010-01-01

    Full Text Available Die vorliegende Arbeit ist in zwei Teile geteilt: den kunst- und kulturhistorischen Teil. Im ersten Teil werden Darstellungen uber Bienen Bienenzucht, Honig und Wachs seit der fruhchristlichen bis zur spatbyzantinischen Zeit vorgefuhrt. Daher ist es als Beitrag in der "Ikonographie" der Biene wahrend dieser Zeit zu verstehen. Im kulturhistorischen Teil werden Informationen uber die Bienenzucht, den Handel mit Honig und Wachs sowie ihre vielfaltige Anwendung von der byzantinischen Gesellschaft an Hand der primaren Quellen, des Standes der Forschung und der archaologischen Funden erwahnt. Damit ist erwunscht ein moglichst gutes Bild der byzantinischen Bienenzucht wieder zu geben und die Nutzung der Bienenprodukte in Byzanz anschaulich zu machen.

  13. Innovations with services relating to energy efficiency. Basic information and examples; Innovationen mit Dienstleistungen im Bereich Energieeffizienz. Basisinformationen und Beispiele

    Energy Technology Data Exchange (ETDEWEB)

    Knoll, Michael; Kollnig, Sarah; Oertel, Britta

    2010-07-01

    This study describes how the ''Energy Efficient City'' competition is intended to promote activities towards greater energy efficiency which relate to cities as systems, are innovative, and conceive of and incorporate services as part of the solution. ''Innovation with services'' is not only about the further development of existing services but more particularly about the creation of high-quality services in growth areas which can serve to speed up innovation and create new application potentials for technical developments. They should be based on a holistic view on urban processes of energy use and energy supply and give consideration to all relevant stakeholders. The ''Energy Efficient City'' competition is aimed at systematically linking innovations with services to energy efficiency issues. The implementation of these goals will be facilitated by accompanying research. To this end the present text provides information on how services can be geared to energy efficiency.

  14. Digitalisierung und Selbstbestimmung

    Directory of Open Access Journals (Sweden)

    Eisenberger, Iris

    2017-12-01

    Full Text Available Kurztext: Der Beitrag beleuchtet das Verhältnis von Digitalisierung und Recht. Am Beispiel der Blockchain-Technologie wird aufgezeigt, wie neue Formen und Räume der Selbstbestimmung geschaffen werden können. In distribuierten Systemen ist die Tendenz erkennbar, dass sich die rechtliche hin zu einer technologischen Steuerung verlagert. Wenn Funktionen, die für gewöhnlich der demokratisch legitimierte Gesetzgeber wahrnimmt, auf andere Systeme übergehen, führt dies zu Herausforderungen für rechtsstaatliche Demokratien. Fundamentale Fragen von Kontrolle und Machtbeschränkung iZm Digitalisierung stehen im Fokus. Der Beitrag plädiert schließlich für „legal foresight“-Forschung im Bereich neuer Technologien.

  15. Differential diagnosis in pediatric radiology. Vol. 1. Skull, spine, skeleton; Differentialdiagnostik in der paediatrischen Radiologie. Bd. 1. Schaedel, Wirbelsaeule, Skelett

    Energy Technology Data Exchange (ETDEWEB)

    Ebel, K D [ed.; Willich, E [ed.; Richter, E [ed.; Benz-Bohm, G; Bliesener-Harzheim, J A; Ebel, K D; Oestreich, A E; Reinwein, H; Schaper, J; Schumacher, R; Stoever, B

    1995-06-01

    The book presents in-depth material covering the full scope of tasks and problems of differential diagnostic radiology in children. The particular approach chosen by the authors provides information that will solve even the most difficult cases, guiding the reader on his way from radiographic findings to appropriate diagnosis. All radiographic findings have been characterized and classified and put into a tabulated system relating them to the relevant differential diagnosis. The system of reference adopted specifies a given lesion or disease by reference to the most significant diagnostic keywords obtained from anamnesis, clinical data, and further diagnostic evaluation. The tentative diagnosis is taken as the basis for further specification illustrated by the characteristic X-ray pictures and full-text descriptions. Almost all diagnoses are accompanied by a comprehensive image documentation obtained by all currently available imaging methods. (MG) [Deutsch] Das vorliegende Buch gibt einen kompletten Ueberblick ueeber die gesamte Bandbreite der Differentialdiagnostik in der Paediatrischen Radiologie und soll so auch in schwierigen Faeellen den Weg vom Roentgensymptom zur Diagnose ermoeglichen. Alle relevanten Roentgensymptome werden systematisch charakterisiert und die entsprechenden Differentialdiagnosen tabellarisch zusammengestellt. Jede Erkrankung wird durch Verweise auf die wichtigsten differentialdiagnostischen Stichworte aus Anamnese, Klinik und weiterfuehrende Diagnostik naeher eingegrenzt. Ausgehend von der Verdachtsdiagnose werden wegweisende Roentgenbefunde in Wort und Bild dargestellt. Fast alle erwaehnten Befunde werden durch Abbildungen unter Beruecksichtigung aller moderner bildgebenden Verfahren dokumentiert. (MG)

  16. "Deutsche Kultur" und Werbung

    OpenAIRE

    Schug, Alexander

    2010-01-01

    Die Arbeit präsentiert die Geschichte der modernen Wirtschaftswerbung in der ersten Hälfte des 20. Jahrhunderts und zeigt, dass Werbung trotz kultureller Barrieren die Alltagswelten der Deutschen kolonialisierte und Einfluss auf die „deutsche Kultur“ nahm. Die Arbeit zeigt, dass das Konstrukt der „deutschen Kultur“ nicht ausschließlich durch die bürgerliche Hochkultur definiert wurde, sondern zunehmend auch durch Einflüsse der Konsumkultur bestimmt war. Die Bilderwelten der Werbung prägten na...

  17. Work-Life-Balance und Frauenbiographien

    OpenAIRE

    Macha, Hildegard

    2006-01-01

    Work-Life-Balance und Frauenbiographien. - In: Bildungs- und Karrierewege von Frauen / Anne Schlüter (Hrsg.). - Opladen : Budrich, 2006. - S. 17-32. - (Reihe: Frauen- und Geschlechterforschung in der Erziehungswissenschaft ; 2)

  18. Nutzerorientiertes Management von materiellen und immateriellen Informationsobjekten

    OpenAIRE

    Hübsch, Chris

    2001-01-01

    Schaffung einer stabilen, erweiterbaren und skalierbaren Infrastruktur für die Bereitstellung von Diensten im Umfeld von Bibliotheken und ähnlichen wissensanbietenden Einrichtungen unter Verwendung von XML-RPC und Python.

  19. Health-related quality of life in patients with dual diagnosis: clinical correlates

    Directory of Open Access Journals (Sweden)

    Benaiges Irina

    2012-09-01

    Full Text Available Abstract Background Although the studies published so far have found an affectation in the Health Related Quality of Life (HRQOL in both psychiatric and substance use dependence disorders, very few studies have applied HRQOL as an assessment measure in patients suffering both comorbid conditions, or Dual Diagnosis. The aim of the current study was to assess HRQOL in a group of patients with Dual Diagnosis compared to two other non-comorbid groups and to determine what clinical factors are related to HRQOL. Methods Cross-sectional assessment of three experimental groups was made through the Short Form – 36 Item Health Survey (SF-36. The sample consisted of a group with Dual Diagnosis (DD; N = 35, one with Severe Mental Illness alone (SMI; N = 35 and another one with Substance Use Dependence alone (SUD; N = 35. The sample was composed only by males. To assess the clinical correlates of SF-36 HRQOL, lineal regression analyses were carried out. Results The DD group showed lower scores in most of the subscales, and in the mental health domain. The group with SUD showed in general a better state in the HRQOL while the group with SMI held an intermediate position with respect to the other two groups. Daily medication, suicidal attempts and daily number of coffees were significantly associated to HRQOL, especially in the DD group. Conclusions The DD group showed lower self-reported mental health quality of life. Assessment of HRQOL in dual patients allows to identify specific needs in this population, and may help to establish therapeutic goals to improve interventions.

  20. Adverse effects of immunotherapy. Clinical aspects, radiological and nuclear medicine results; Unerwuenschte Wirkungen der Immuntherapie. Klinik, radiologische und nuklearmedizinische Befunde

    Energy Technology Data Exchange (ETDEWEB)

    Widmann, G.; Plaickner, J.; Jaschke, W. [Medizinische Universitaet Innsbruck, Universitaetsklinik fuer Radiologie, Innsbruck (Austria); Nguyen, V.A. [Medizinische Universitaet Innsbruck, Universitaetsklinik fuer Dermatologie, Venerologie und Allergologie, Innsbruck (Austria)

    2017-10-15

    The increasing use of immunotherapy in oncology increases the need for radiologic evaluation of frequent and severe immune-related adverse events. Determination of the incidence and manifestation of radiologic and nuclear medicine findings of immune-related adverse events. Literature review of clinical and imaging findings of immune-related adverse events induced by the immune checkpoint inhibitors ipilimumab, nivolumab and pembrolizumab. Findings are illustrated with pictorial examples and contrasted to other relevant differential diagnoses. The most frequent imaging manifestations are colitis, hepatitis, pancreatitis, hypophysitis, pneumonitis, arthritis and sarcoid-like lymphadenopathy. Severe to life-threatening complications may result from colitis, pneumonitis and hypophysitis. A clear differentiation from other autoimmune diseases and discrimination of immune-related and infectious pulmonary findings can be very difficult and need close multidisciplinary collaboration. Knowledge of clinical and imaging findings of adverse events induced by immunotherapy is essential for timely and adequate therapeutic decisions. In addition to staging and follow-up imaging, identification and monitoring of immune-related adverse events adds to the radiologic responsibility in oncologic care. (orig.) [German] Mit zunehmendem Einsatz von Immuntherapien in der Onkologie steigt die Bedeutung der radiologischen Beurteilung haeufiger und schwerwiegender immunbedingter Nebenwirkungen. Inzidenz und Manifestation radiologischer und nuklearmedizinischer Befunde der immunbedingten Nebenwirkungen. Literaturuebersicht zu Klinik und bildgebenden Befunden immunbedingter Nebenwirkungen der Immuncheckpointinhibitoren Ipilimumab, Nivolumab und Pembrolizumab. Veranschaulichung mit Bildbeispielen und Gegenuebergestellung mit anderen relevanten Differenzialdiagnosen. Die haeufigsten bildgebenden Manifestationen sind Kolitis, Hepatitis, Pankreatitis, Hypophysitis, Pneumonitis, Arthritis und die

  1. Dental health economics and diagnosis related groups/casemix in Indonesian dentistry

    Directory of Open Access Journals (Sweden)

    Ronnie Rivany

    2009-12-01

    Full Text Available Background: Dental Health Economics is a branch of transdiciplinary science that refers to the Economic and Public Health science. On the other hand, in other developed countries, Diagnosis Related Groups (DRG’s /Casemix has been used as a basic in creating the same perception between providers, patients and insurance companies in many aspects such as health planning, healthcare financing and quality assurance. Purpose: The objective of this review is to propose a new paradigm of economics to be applied in Indonesian Dentistry. Reviews: The Dental Health Economics should be considered as an important aspect in Indonesian Dentistry, which is used to determine the dental treatment fee based on unit cost, cost containment, and cost recovery rate analysis. Referring to Australian Refined Diagnosis Related Group, health care industry in Indonesia has starting to try a more structured way in grouping disease pattern in order to come up with more precise health care services to their patients. The on going development of Indonesian DRG’s is meant to confirm the disease pattern and partition. Conclusion: The development of Indonesian DRG’s concept, especially the Dental & Oral Disorders, needs a new paradigm, so the practitioners and academics could group and calculate the unit cost from each dental treatment according to the Indonesian DRG version (INA-DRG’s.

  2. An Efficient Quality-Related Fault Diagnosis Method for Real-Time Multimode Industrial Process

    Directory of Open Access Journals (Sweden)

    Kaixiang Peng

    2017-01-01

    Full Text Available Focusing on quality-related complex industrial process performance monitoring, a novel multimode process monitoring method is proposed in this paper. Firstly, principal component space clustering is implemented under the guidance of quality variables. Through extraction of model tags, clustering information of original training data can be acquired. Secondly, according to multimode characteristics of process data, the monitoring model integrated Gaussian mixture model with total projection to latent structures is effective after building the covariance description form. The multimode total projection to latent structures (MTPLS model is the foundation of problem solving about quality-related monitoring for multimode processes. Then, a comprehensive statistics index is defined which is based on the posterior probability of the monitored samples belonging to each Gaussian component in the Bayesian theory. After that, a combined index is constructed for process monitoring. Finally, motivated by the application of traditional contribution plot in fault diagnosis, a gradient contribution rate is applied for analyzing the variation of variable contribution rate along samples. Our method can ensure the implementation of online fault monitoring and diagnosis for multimode processes. Performances of the whole proposed scheme are verified in a real industrial, hot strip mill process (HSMP compared with some existing methods.

  3. Robust PLS approach for KPI-related prediction and diagnosis against outliers and missing data

    Science.gov (United States)

    Yin, Shen; Wang, Guang; Yang, Xu

    2014-07-01

    In practical industrial applications, the key performance indicator (KPI)-related prediction and diagnosis are quite important for the product quality and economic benefits. To meet these requirements, many advanced prediction and monitoring approaches have been developed which can be classified into model-based or data-driven techniques. Among these approaches, partial least squares (PLS) is one of the most popular data-driven methods due to its simplicity and easy implementation in large-scale industrial process. As PLS is totally based on the measured process data, the characteristics of the process data are critical for the success of PLS. Outliers and missing values are two common characteristics of the measured data which can severely affect the effectiveness of PLS. To ensure the applicability of PLS in practical industrial applications, this paper introduces a robust version of PLS to deal with outliers and missing values, simultaneously. The effectiveness of the proposed method is finally demonstrated by the application results of the KPI-related prediction and diagnosis on an industrial benchmark of Tennessee Eastman process.

  4. Das IHS und die Rolle der Forschungsinstitute

    OpenAIRE

    Keuschnigg, Christian

    2014-01-01

    Das Institut für Höhere Studien und wissenschaftliche Forschung (IHS) ist ein unabhängiges Forschungsinstitut und leistet Forschung und Ausbildung auf Spitzenniveau für Politik, Wirtschaft und Gesellschaft. Im Wettbewerb zwischen Universitäten und angewandten Forschungsinstituten ist das IHS einzigartig, weil es unter einem Dach Grundlagenforschung und forschungsnahe Lehre mit angewandter Forschung für die wissenschaftliche Politikberatung verbindet. Mit den drei Disziplinen Ökonomie, Soziolo...

  5. Testing a diagnosis-related group index for skilled nursing facilities

    Science.gov (United States)

    Cotterill, Philip G.

    1986-01-01

    Interest in case-mix measures for use in nursing home payment systems has been stimulated by the Medicare prospective payment system (PPS) for short-term acute-care hospitals. Appropriately matching payment with care needs is important to equitably compensate providers and to encourage them to admit patients who are most in need of nursing home care. The skilled nursing facility (SNF) Medicare benefit covers skilled convalescent or rehabilitative care following a hospital stay. Therefore, it might appear that diagnosis-related groups (DRG's), the basis for patient classification in PPS, could also be used for the Medicare SNF program. In this study, a DRG-based case-mix index (CMI) was developed and tested to determine how well it explains cost differences among SNF's. The results suggest that a DRG-based SNF payment system would be highly problematic. Incentives of this system would appear to discourage placement of patients who require relatively expensive care. PMID:10311674

  6. Effective acupuncture practice through diagnosis based on distribution of meridian pathways & related syndromes.

    Science.gov (United States)

    Chen, Yemeng; Zheng, Xin; Li, Hui; Zhang, Qunce; Wang, Tianfang

    2011-01-01

    This article discusses the importance of acupuncture practice utilizing diagnosis and distribution of various meridians and connecting channels based on meridian theory. The meridian system is considered as basic anatomy for acupuncture, so the corresponding pathways and related syndromes of different channels should play a key role in differentiation, known as meridian-related pattern differentiation. Since this doctrine originated in ancient times and was not so well developed in later generations, many acupuncturists are not able to utilize it efficiently. The authors survey how this doctrine was weakened during the past century, especially in acupuncture education for foreigners, and how this important method is currently being reinvigorated. This article also lays out the ways this doctrine can be applied clinically and introduces examples of a variety of indications including some difficult cases, such as whiplash injury, intervertebral disc herniation, oculomotor nerve paralysis, and eczema, etc.

  7. A Rolling Element Bearing Fault Diagnosis Approach Based on Multifractal Theory and Gray Relation Theory.

    Science.gov (United States)

    Li, Jingchao; Cao, Yunpeng; Ying, Yulong; Li, Shuying

    2016-01-01

    Bearing failure is one of the dominant causes of failure and breakdowns in rotating machinery, leading to huge economic loss. Aiming at the nonstationary and nonlinear characteristics of bearing vibration signals as well as the complexity of condition-indicating information distribution in the signals, a novel rolling element bearing fault diagnosis method based on multifractal theory and gray relation theory was proposed in the paper. Firstly, a generalized multifractal dimension algorithm was developed to extract the characteristic vectors of fault features from the bearing vibration signals, which can offer more meaningful and distinguishing information reflecting different bearing health status in comparison with conventional single fractal dimension. After feature extraction by multifractal dimensions, an adaptive gray relation algorithm was applied to implement an automated bearing fault pattern recognition. The experimental results show that the proposed method can identify various bearing fault types as well as severities effectively and accurately.

  8. Close relatives find meaning to cope with cancer diagnosis and treatment of family members.

    Science.gov (United States)

    Feyh, Janelle M; Levine, Ellen G; Clay, Karine

    2012-12-01

    Pediatric palliative care has recently become a priority in the health care field and is implemented at the time of diagnosis rather than days or weeks before the child's death. Social constructivism theory in which humans generate meaning from their experiences was utilized as a general framework to determine the impact of pediatric palliative care on close relatives. The purpose of this grounded theory study was to generate a substantive theory that explains how close relatives such as grandparents, aunts, and uncles of a child with cancer experience palliative care. The participants of the study included close relatives of children in palliative care. Semistructured interviews and journaling were used to collect data. Initial, focused, and axial coding procedures were used to manage the data and a content analysis of the textual data was performed. Findings from the data suggested a process of finding meaning which helps close relatives to let go of what they cannot control while holding on to what they can control. Social change implications of this study may include improving health care programming for close relatives utilizing supportive-expressive measures. This programming may promote mental health of the close relatives who will learn to deal with their adjustment difficulties and improve their coping skills.

  9. A novel relational regularization feature selection method for joint regression and classification in AD diagnosis.

    Science.gov (United States)

    Zhu, Xiaofeng; Suk, Heung-Il; Wang, Li; Lee, Seong-Whan; Shen, Dinggang

    2017-05-01

    In this paper, we focus on joint regression and classification for Alzheimer's disease diagnosis and propose a new feature selection method by embedding the relational information inherent in the observations into a sparse multi-task learning framework. Specifically, the relational information includes three kinds of relationships (such as feature-feature relation, response-response relation, and sample-sample relation), for preserving three kinds of the similarity, such as for the features, the response variables, and the samples, respectively. To conduct feature selection, we first formulate the objective function by imposing these three relational characteristics along with an ℓ 2,1 -norm regularization term, and further propose a computationally efficient algorithm to optimize the proposed objective function. With the dimension-reduced data, we train two support vector regression models to predict the clinical scores of ADAS-Cog and MMSE, respectively, and also a support vector classification model to determine the clinical label. We conducted extensive experiments on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset to validate the effectiveness of the proposed method. Our experimental results showed the efficacy of the proposed method in enhancing the performances of both clinical scores prediction and disease status identification, compared to the state-of-the-art methods. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Review of Diagnosis-Related Group-Based Financing of Hospital Care

    Directory of Open Access Journals (Sweden)

    Natasa Mihailovic

    2016-05-01

    Full Text Available Since the 1990s, diagnosis-related group (DRG-based payment systems were gradually introduced in many countries. The main design characteristics of a DRG-based payment system are an exhaustive patient case classification system (ie, the system of diagnosis-related groupings and the payment formula, which is based on the base rate multiplied by a relative cost weight specific for each DRG. Cases within the same DRG code group are expected to undergo similar clinical evolution. Consecutively, they should incur the costs of diagnostics and treatment within a predefined scale. Such predictability was proven in a number of cost-of-illness studies conducted on major prosperity diseases alongside clinical trials on efficiency. This was the case with risky pregnancies, chronic obstructive pulmonary disease, diabetes, depression, alcohol addiction, hepatitis, and cancer. This article presents experience of introduced DRG-based payments in countries of western and eastern Europe, Scandinavia, United States, Canada, and Australia. This article presents the results of few selected reviews and systematic reviews of the following evidence: published reports on health system reforms by World Health Organization, World Bank, Organization for Economic Co-operation and Development, Canadian Institute for Health Information, Canadian Health Services Research Foundation, and Centre for Health Economics University of York. Diverse payment systems have different strengths and weaknesses in relation to the various objectives. The advantages of the DRG payment system are reflected in the increased efficiency and transparency and reduced average length of stay. The disadvantage of DRG is creating financial incentives toward earlier hospital discharges. Occasionally, such polices are not in full accordance with the clinical benefit priorities.

  11. Case mix measures and diagnosis-related groups: opportunities and threats for inpatient dermatology.

    Science.gov (United States)

    Hensen, P; Fürstenberg, T; Luger, T A; Steinhoff, M; Roeder, N

    2005-09-01

    The changing healthcare environment world-wide is leading to extensive use of per case payment systems based on diagnosis-related groups (DRG). The aim of this study was to examine the impact of application of different DRG systems used in the German healthcare system. We retrospectively analysed 2334 clinical data sets of inpatients discharged from an academic dermatological inpatient unit in 2003. Data were regarded as providing high coding quality in compliance with the diagnosis and procedure classifications as well as coding standards. The application of the Australian AR-DRG version 4.1, the German G-DRG version 1.0, and the German G-DRG version 2004 was considered in detail. To evaluate more specific aspects, data were broken down into 11 groups based on the principle diagnosis. DRG cost weights and case mix index were used to compare coverage of inpatient dermatological services. Economic impacts were illustrated by case mix volumes and calculation of DRG payments. Case mix index results and the pending prospective revenues vary tremendously from the application of one or another of the DRG systems. The G-DRG version 2004 provides increased levels of case mix index that encourages, in particular, medical dermatology. The AR-DRG version 4.1 and the first German DRG version 1.0 appear to be less suitable to adequately cover inpatient dermatology. The G-DRG version 2004 has been greatly improved, probably due to proceeding calculation standards and DRG adjustments. The future of inpatient dermatology is subject to appropriate depiction of well-established treatment standards.

  12. Diagrammatik und Wissensorganisation

    Directory of Open Access Journals (Sweden)

    Sascha Freyberg

    2012-11-01

    Full Text Available EinleitungDie Formen des „Sichtbarmachens“ in der Wissenschaft reichen von „Abbildungen“ über „Modelle“ bis hin zu „Simulationen“. Sie können u.a. gezeichnet, fotografiert, geometrisch konstruiert oder durch Sensorik vermittelt, digital prozessiert werden. Ihre Funktionen erstrecken sich von der Orientierung bis hin zur (hypothetischen Voraussage und somit auch vom Überblick bis zur Evidenzsuggestion. Generell handelt es sich um vereinfachte (und vereinfachende Darstellungen von (teilweise sehr komplexen Sachverhalten, zu deren Verständnis sie beitragen sollen; daher können sie bei Lernprozessen, d.h. in der Vermittlung und auch bei der Organisation von Wissen eine wichtige Rolle spielen. Diese kommt ihnen nun nicht nur zu, weil sie – wie in den mittelalterlichen Mnemotechniken – als Gedächtnisstützen für bekannte Sachverhalte dienen. Sondern resultiert auch aus ihrem Potenzial für die Entdeckung von neuen Zusammenhängen. Der folgende Artikel diskutiert die Darstellungsform des Diagramms. Es wird hier mit dem Gedanken gespielt, dass die in der universalen Zeichentheorie von C.S. Peirce entwickelte Diagrammatik wichtige Impulse für eine Untersuchung des Zusammenhangs von Wissen und Bildlichkeit geben kann.

  13. Arbeitsgestaltung und Mitarbeiterqualifizierung

    Science.gov (United States)

    Weiss-Oberdorfer, Werner; Hörner, Barbara; Holm, Ruth; Pirner, Evelin

    Die Wertkette gliedert ein Unternehmen in strategisch relevante Tätigkeiten, um dadurch Kostenverhalten sowie vorhandene und potenzielle Differenzierungsquellen zu verstehen. Wenn ein Unternehmen diese strategisch wichtigen Aktivitäten billiger oder besser als seine Konkurrenten erledigt, verschafft es sich einen Wettbewerbsvorteil." Michael Porter, 1985

  14. Substanzbegriff und systematik

    NARCIS (Netherlands)

    Lütjeharms, W.J.

    1934-01-01

    Bei der Einteilung der Organismen, welche in dieser Arbeit mir von botanischem Gesichtspunkt betrachtet wird, ist die Frage nach „wesentlichen” Merkmalen oder Einteilungsgründen von grosser Wichtigkeit. Es ist die Frage nach der Substanz (Essenz) und den akzidentellen Merkmalen. Der Substanzbegriff

  15. Stenting und technische Stentumgebung

    Science.gov (United States)

    Hoffstetter, Marc; Pfeifer, Stefan; Schratzenstaller, Thomas; Wintermantel, Erich

    In hoch entwickelten Industrieländern stehen laut Weltgesundheitsorganisation (WHO) Herz-Kreislauf-Erkrankungen und speziell die Koronare Herzkrankheit (KHK) an erster Stelle der Todesursachen. In Deutschland betrug die Zahl der erfassten, an KHK erkrankten Personen ohne Berücksichtigung der Dunkelziffer allein im Jahre 2001 über 473.000. Die KHK war im Jahre 2003 mit 92.673 erfassten Todesfällen immer noch die häufigste Todesursache, obgleich in Deutschland die Häufigkeit der Koronarinterventionen zur Behandlung der KHK zwischen 1984 und 2003 um fast das 80fache von 2.809 auf 221.867 Eingriffe pro Jahr gestiegen ist [1]. Neben der hohen Zahl an Todesfällen haben die betroffenen Personen durch chronische Schmerzen und eingeschränkte körperliche Leistungsfähigkeit zusätzlich eine starke Beeinträchtigung der Lebensqualität [2].In Folge dessen wird die erkrankte Person häufig zum Pflegefall was neben den gesundheitlichen Aspekten auch eine sozioökonomische Komponente in Form der fehlenden Arbeitskraft und den auftretenden Pflegekosten nach sich zieht. Die Kosten für die Behandlung der KHK in Deutschland beliefen sich im Jahre 2002 laut Statistischem Bundesamt auf rund 6,9 Mrd. €. Verglichen mit ähnlichen Zahlen der USA dürfte sich der entstandene Schaden für die deutsche Volkswirtschaft im zwei- bis dreistelligen Milliardenbereich bewegen [3].

  16. Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm

    Science.gov (United States)

    Luo, Ai-Jing; Chang, Wei-Fu; Xin, Zi-Rui; Ling, Hao; Li, Jun-Jie; Dai, Ping-Ping; Deng, Xuan-Tong; Zhang, Lei; Li, Shao-Gang

    2018-01-01

    AIM To figure out the contributed factors of the hospitalization expenses of senile cataract patients (HECP) and build up an area-specified senile cataract diagnosis related group (DRG) of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund. METHODS The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector (E-CHAID) model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc. RESULTS The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases. CONCLUSION The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund. PMID:29487824

  17. Becoming the denigrated other: Group relations perspectives on initial reactions to a bipolar disorder diagnosis

    Directory of Open Access Journals (Sweden)

    Susan G. Goldberg

    2012-09-01

    Full Text Available The initial reactions to a bipolar disorder diagnosis of research participants in a small, qualitative study consisted of astonishment, dread of being mad, and extremely negative associations. All had prior mental health diagnoses, including episodes of severe depression (all but one and alcoholism (one. All participants reported mental health histories prediagnosis and most had spent years contending with mental health labels, medications, symptoms, and hospitalizations. In addition, most participants were highly educated health professionals, quite familiar with the behaviors that the medical system considered to comprise bipolar disorder. Their negative associations to the initial bipolar disorder diagnosis, therefore, appeared inconsistent with their mental health histories and professional knowledge. This article contextualizes these initial reactions of shock and distress and proposes interpretations of these findings from societal and psychodynamic group relations perspectives. The participants’ initial negative reactions are conceptualized as involving the terror of being transported from the group of normal people into the group of mad or crazy people, i.e., people with mental illnesses, who may constitute a societal denigrated other.

  18. Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm.

    Science.gov (United States)

    Luo, Ai-Jing; Chang, Wei-Fu; Xin, Zi-Rui; Ling, Hao; Li, Jun-Jie; Dai, Ping-Ping; Deng, Xuan-Tong; Zhang, Lei; Li, Shao-Gang

    2018-01-01

    To figure out the contributed factors of the hospitalization expenses of senile cataract patients (HECP) and build up an area-specified senile cataract diagnosis related group (DRG) of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund. The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector (E-CHAID) model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc. The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases. The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.

  19. Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm

    Directory of Open Access Journals (Sweden)

    Ai-Jing Luo

    2018-02-01

    Full Text Available AIM: To figure out the contributed factors of the hospitalization expenses of senile cataract patients (HECP and build up an area-specified senile cataract diagnosis related group (DRG of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund. METHODS: The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector (E-CHAID model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc. RESULTS: The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases. CONCLUSION: The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.

  20. Herausforderungen kleiner und mittlerer Unternehmen

    Science.gov (United States)

    Bergmann, Lars; Crespo, Isabel

    Vielfältige externe Herausforderungen, hervorgerufen durch die Dynamik, mit der sich die wirtschaftliche, technologische, soziokulturelle sowie politische Umwelt wandelt, muss jedes Unternehmen im Laufe der Zeit bestehen (Zäpfel 2000). Diese Herausforderungen werden heute insbesondere durch eine Globalisierung der Wettbewerbssowie Nachfragestrukturen verstärkt. Immer schnellere Prozessund Produktinnovationen, kürzere Produktlebenszyklen und Entwicklungszeiten, eine rasant steigende Variantenvielfalt, Nachfrageschwankungen sowie rasante Entwicklungen der Informations- und Kommunikationstechnologien sind einige der sich schnell verändernden Rahmenbedingungen. Zudem müssen sich Unternehmen an neue Gesetze und rechtliche Rahmenbedingungen anpassen. Im Bereich der Roh- und Einsatzstoffe sind Veränderungen insbesondere durch sich verknappende Rohstoffe und Primärenergieträger und in Folge dessen durch drastische Preissteigerungen für Materialien, Hilfsstoffe, Werkzeuge etc. geprägt.

  1. Polyzystisches Ovarsyndrom – ein aktueller Überblick über therapeutische Ansätze bei Kinderwunsch und metabolischen Komorbiditäten // PCOS – A Current Overview of Therapeutic Options for Infertility and Metabolic Co-Morbidities

    Directory of Open Access Journals (Sweden)

    Lunger F

    2017-01-01

    Full Text Available The diagnosis of the polycystic ovary syndrome continues to be made based on the 2003 Rotterdam criteria which include oligo- or anovulation, hyperandrogenemia and/ or clinical signs of androgen excess, and polycystic ovaries on ultrasound. Nonetheless, the diagnosis is not always clear. In cases where one is unsure whether a woman ovulates, a progesterone level in the mid-luteal phase of the cycle can confirm ovulation. Clinical signs of hyperandrogenemia are strongly influenced by ethnicity, which should be considered during the assessment, although no ethnicity- related norms have been published. Recent studies have shown that AMH in combination with LH can aid in differentiating sonographically observed PCO morphology (a common entity in younger women from true PCOS. For women desiring pregnancy, the first therapeutic step is weight reduction as part of a lifestyle modification. Ovulation induction in these anovulatory women can be accomplished with clomiphene or low-dose gonadotropins, and may be combined with metformin. Clomiphene continues to be the first-line treatment because of its ease of administration, low costs and success rates. Low-dose gonadotropins may have an even higher success rate of ovulation and pregnancy, especially in clomipheneresistant women, but are much more expensive. Metabolic co-morbidities are very common in women with PCOS and should be diagnosed and treated in order to prevent or reduce future consequences. International recommendations include screening women with PCOS for dia betes with fasting glucose and oral glucose tolerance test, especially those with adiposity, anovulation and positive family history. Fasting insulin or HOMA Index can be used to assess for IR. Targeted thera pies for the metabolic aspects of PCOS include diet and exercise as part of lifestyle modification, treatment of hypertension and hypercholesterolemia with appropriate medications, and the use of insulin sensitizers for insulin

  2. Clinical appearance and treatment of malignant pleural mesothelioma; Klinik und Therapie des malignen Pleuramesothelioms

    Energy Technology Data Exchange (ETDEWEB)

    Schiebe, M. [Tuebingen Univ. (Germany). Abt. fuer Strahlentherapie; Hoffmann, W. [Tuebingen Univ. (Germany). Abt. fuer Strahlentherapie; Kortmann, R.D. [Tuebingen Univ. (Germany). Abt. fuer Strahlentherapie; Bamberg, M. [Tuebingen Univ. (Germany). Abt. fuer Strahlentherapie

    1994-11-01

    We report about 7 of our own cases, treated with surgery and radiotherapy (4) or with a combination of surgery, radiotherapy and chemotherapy (3) and discuss the clinical aspects, diagnosis and the different ways of treatment of malignant pleural mesothelioma and its influence on survival. (orig.) [Deutsch] Wir berichten ueber sieben Patienten, die operiert und bestrahlt (vier) oder durch eine Kombination von operativen Massnahmen, Strahlen- und Chemotherapie behandelt wurden (drei). Klinische und diagnostische Aspekte sowie verschiedene Therapiemodalitaeten in der Behandlung des malignen Pleuramesothelioms werden im Ueberblick dargestellt. (orig.)

  3. Are work-related stressors associated with diagnosis of more advanced stages of incident breast cancers?

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Stahlberg, Claudia; Strandberg-Larsen, Katrine

    2008-01-01

    work pressure (HR = 1.17; 95% CI: 0.79, 1.73) nor women with self-reported low influence on work organization (0.98; 0.69, 1.39) or long working hours (0.93; 0.54, 1.58) were at higher risk of breast cancer than women with no such stressors. Women with high work tempo had a slightly higher risk......OBJECTIVE: To assess the relation between work-related stressors and breast cancer incidence and prognostic characteristics (estrogen receptor status, grade, lymph node status, size, stage) at the time of diagnosis. METHODS: The 18,932 women included in the Danish Nurse Cohort reported work...... of breast cancer (1.25; 1.02, 1.54) than women with a suitable work tempo, but there was no dose-response effect. There were no clear differences in the prognostic characteristics of breast tumors diagnosed in women with and without work-related stressors. CONCLUSIONS: Work-related stressors do not affect...

  4. 27 January 2012 - Mitglieder des Stiftungsrates Academia Engelberg und Gesellschaft zum Bettag Luzern Schweiz welcomed by Head of International Relations F. Pauss; visiting LHC tunnel at Point 5 and CMS experimental cavern; in the LHC superconducting magnet test hall SM18.

    CERN Multimedia

    Maximilien Brice

    2012-01-01

    27 January 2012 - Mitglieder des Stiftungsrates Academia Engelberg und Gesellschaft zum Bettag Luzern Schweiz welcomed by Head of International Relations F. Pauss; visiting LHC tunnel at Point 5 and CMS experimental cavern; in the LHC superconducting magnet test hall SM18.

  5. Socio-demographic factors related to under-diagnosis of childhood asthma in Upper Silesia, Poland.

    Science.gov (United States)

    Zejda, Jan E; Farnik, Małgorzata; Smółka, Irena; Lawson, Joshua; Brożek, Grzegorz M

    2017-06-07

    Introduction. The presented study of 4,535 children aged 7-17 years in the Upper Silesian region of Poland yielded 186 cases of previously known asthma, and 44 children with newly diagnosed asthma. The aim of the presented study was to identify non-medical factors that could explain why children with a newly established diagnosis ('undiagnosed asthma') had not been diagnosed in the past. Materials and method. The study was performed according to a case-control design. Parents of the children answered questionnaires on socio-economic status and family-related factors. Statistical determinants of undiagnosed asthma were explored using raw (OR) and logistic odds ratios with their 95% confidence intervals (logOR, 95%CI). Results. Children with undiagnosed asthma were younger compared to the group with previously known asthma (11.3±2.1 vs. 12.6±2.5 years; p=0.0008). Newly diagnosed cases were more frequent in children who had less parental attention (less than 1 hour/day spent by parent with child - OR=4.36; 95%CI: 1.76-10.81) and who were not registered with specialized health care (OR=2.20; 95%CI: 0.95-5.06). Results of logistic regression analysis suggest that under-diagnosis of asthma is related to age below 12 years - logOR = 3.59 (95%CI: 1.28-10.36), distance to a health centre > 5 km - logOR = 3.45 (95%CI: 1.05-11.36), time spent with child Conclusion. Among non-medical determinants of undiagnosed asthma the age of a child plays a major role. Another factors of importance is the large distance between residence and health centre, and low parental attention at home.

  6. The diagnosis value of endothelin, calcitonin gene-related peptide and the ratio in diabetic nephropathy

    International Nuclear Information System (INIS)

    Li Lusheng; Zhao Xin; Chi Liuying; Yang Xixiu; Mao Hongyu

    2007-01-01

    Objective: To evaluate the diagnosis value of Endothelin (ET), Calcitonin gene-related peptide(CGRP) and theratio in diabetic nephropathy(DN). Methods: To choose 54 healthy as the control group and 124 patients with diabetes or DN as test group. According to urinary albumin excretion rate (uAER), the test group was divided into three groups, which were diabetes group of normalalbuminmia (group A), early DN (group B) and clinical DN and renal failure group( group C ). Plasma concentration of ET and CGRP were measured with radioimmunossay for those in the Control group and patients with diabetes or DN. Results: The level of ET was significantly higher in diabetic nephropathy than that in the control group (P<0.01), and there was positive correlation between ET and uAER(r=0.591, P<0.01). The plasma level of CGRP was significantly lower in diabetic nephropathy than that in the control group (P<0.01), and there was negative correlation between CGRP and uAER(r-0.389, P<0.05). The level of ET, CGRP and ET/CGRP ratio have evidently changed with the uAER rised. Conclusion: (1)The level of ET, CGRP and type 2 diabetic nephropathy are closely related, and which probably plays a role in the development of DN. (2)ET/CGRP ratio, as a new way for diagnosis, can even more reflecte the seriousness of DN. (3)This experiment provide us a new way for the prevention and treatment of DN with extrinsic CGRP. (authors)

  7. On the relation of the theoretical foundations of quantum theory and general relativity theory; Ueber die Beziehung der begrifflichen Grundlagen der Quantentheorie und der Allgemeinen Relativitaetstheorie

    Energy Technology Data Exchange (ETDEWEB)

    Kober, Martin

    2010-07-01

    The specific content of the present thesis is presented in the following way. First the most important contents of quantum theory and general relativity theory are presented. In connection with the general relativity theory the mathematical property of the diffeomorphism invariance plays the deciding role, while concerning the quantum theory starting from the Copenhagen interpretation first the measurement problem is treated, before basing on the analysis of concrete phenomena and the mathematical apparatus of quantum theory the nonlocality is brought into focus as an important property. This means that both theories suggest a relationalistic view of the nature of the space. This analysis of the theoretical foundations of quantum theory and general relativity theory in relation to the nature of the space obtains only under inclusion of Kant's philosophy and his analysis of the terms space and time as fundamental forms of perception its full persuasive power. Then von Weizsaeckers quantum theory of the ur-alternatives is presented. Finally attempts are made to apply the obtained knowledge to the question of the quantum-theoretical formulation of general relativity theory.

  8. Numerical simulation of heavy precipitation events using mesoscale weather forecast models. Validation with radar data and diagnosis of the atmospheric moisture budget; Numerische Simulation von Starkniederschlagsereignissen mit mesoskaligen Wettervorhersagemodellen. Ueberpruefung mit Radar-Daten und Diagnose der atmosphaerischen Wasserbilanz

    Energy Technology Data Exchange (ETDEWEB)

    Keil, C.

    2000-07-01

    Convective precipitation systems contribute substantially to the summertime rainfall maximum in the northern Alpine region. The capability of mesoscale weather forecast models in capturing such heavy precipitation events is investigated. The complementary application of so far hardly used areal radar data and conventional rain gauge observations enables a case-study-type evaluation of summertime precipitation episodes. Different rainfall episodes are simulated with the former operational model (DM, meshsize 14 km) of Deutscher Wetterdienst (DWD). The influence of the horizontal resolution and the parameterization of moist convection is subsequently studied with a higher resolution atmospheric model (MC2, meshsize 2 km). Diagnostic studies on the atmospheric water budget regarding the rainfall episode, which instigated the Oder-flood in summer 1997, allow an examination of the origin of the moisture and the genesis of the copious precipitation. (orig.) [German] Konvektive Niederschlagssysterne tragen im Nordalpenraum wesentlich zum sommerlichen Niederschlagsmaximum bei. Die Faehigkeit mesoskaliger Wettervorhersagemodelle, solche Starkniederschlagsereignisse zu erfassen, wird in dieser Arbeit untersucht. Durch den komplementaeren Gebrauch von, bisher kaum genutzten, flaechendeckenden Radardaten und konventionellen Niederschlagsmessungen des Bodenmessnetzes werden Modellergebnisse sommerlicher Niederschlagssysteme fallstudienhaft detailliert ueberprueft. Fuer verschiedene Starkniederschlagsereignisse werden dazu Modellsimulationen mit dem in den 90er Jahren operationellen Modell (DM, Maschenweite 14 km) des Deutschen Wetterdienstes (DWD) durchgefuehrt. Zur Untersuchung des Einflusses der horizontalen Maschenweite und der Niederschlagsparametrisierung werden ferner numerische Simulationen mit einem hoeher aufloesdenden Atmosphaerenmodell (MC2, Maschenweite 2 km) behandelt. Anhand diagnostischer Untersuchungen der atmosphaerischen Wasserbilanz laesst sich ausserdem die

  9. Thermal management, systems and modules; Thermomanagement, Systeme und Module

    Energy Technology Data Exchange (ETDEWEB)

    Flik, M. [Behr GmbH und Co., Stuttgart (Germany)

    1999-11-01

    Up till now the individual systems for engine temperature control and air conditioning of the vehicle cabin have to a large extent been viewed independently of one another. With the progress of electronic control systems, however, Behr has adopted an integrative approach to managing all heat and substance flows outside of the engine. This perspective, which is known as thermal management, has significantly boosted the rate of innovation. In a short period of time, new and optimized modules and systems have allowed considerable improvements to be made in relation to passenger comfort and safety, the integration of subsystems and modules into the vehicle and environmental compatibility. This innovation drive, which also extends to the design of major modules, will continue to gain impetus in the future. (orig.) [German] Bisher wurden die verschiedenen Systeme zur Temperierung des Motors und zur Klimatisierung der Fahrzeugkabine weitgehend unabhaengig voneinander betrachtet. Mit dem Vordringen der elektronischen Regelung hat bei Behr jedoch eine gesamtheitliche Betrachtung aller Waerme- und Stoffstroeme ausserhalb des Motors eingesetzt. Diese Sichtweise, Thermomanagement genannt, hat eine erhebliche Innovationsdynamik ermoeglicht. Mit neuen und optimierten Modulen und Systemen konnten in kurzer Zeit betraechtliche Verbesserungen erzielt werden - bei Komfort und Sicherheit der Fahrzeuginsassen, bei der Integration der Subsysteme und Module ins Fahrzeug sowie bei seiner oekologischen Vertraeglichkeit. Diese Innovationsdynamik, die auch die Bildung von Grossmodulen einschliesst, wird in Zukunft noch zunehmen. (orig.)

  10. Sorption und Verbreitung per- und polyfluorierter Chemikalien (PFAS) in Wasser und Boden

    OpenAIRE

    Gellrich, Vanessa

    2014-01-01

    PFAS (= Perfluoroalkyl and Polyfluoroalkyl Substances) sind persistente organische Spurenstoffe, die weltweit in verschiedenen Umweltkompartimenten nachgewiesen werden konnten. Im Rahmen dieser Dissertation sollte die Frage geklärt werden, wie die physikalisch-chemischen Eigenschaften der PFAS - besonders ihre Sorption am Boden - ihr Verhalten und ihre Verbreitung in der Umwelt beeinflussen. Dazu wurde zunächst eine Messmethode entwickelt, optimiert und validiert, mit der 17 per- und polyf...

  11. Patient characteristics, diagnosis, and treatment of non-contact lens related Acanthamoeba keratitis.

    Science.gov (United States)

    Sharma, S; Garg, P; Rao, G N

    2000-10-01

    To review the clinical characteristics, diagnosis, and visual outcome in patients with non-contact lens related Acanthamoeba keratitis and compare the findings with reported series of contact lens associated Acanthamoeba keratitis. Medical and microbiology records of 39 consecutive patients with a diagnosis of Acanthamoeba keratitis, at a tertiary eyecare centre in India between January 1996 and June 1998, were analysed retrospectively. A majority of the patients presented with poor visual acuity and large corneal stromal infiltrates (mean size 38.20 (SD 26. 18) mm). A predisposing factor was elicited in 19/39 (48.7%) patients (trauma 15, dirty water splash three, leaf juice one). None of the patients had worn contact lenses. Most patients (26/39 (66. 6%)) came from a low socioeconomic background. Complaint of severe pain was not a significant feature and radial keratoneuritis was seen in 1/39 (2.5%) patients. A ring infiltrate was present in 41.1% of cases. A clinical diagnosis of fungal keratitis was made in 45% of the patients before they were seen by us. However, all patients were diagnosed microbiologically at our institute based on demonstration of Acanthamoeba cysts in corneal scrapings (34/39) and/or culture of Acanthamoeba (34/39). Treatment with biguanides (PHMB, 15/38 (39.4%), PHMB with CHx, 23/38 (60.5%), one patient did not return for treatment) resulted in healing with scar formation in 27 out of 31(87.0%) followed up patients (mean time to healing 106.9 days). Overall visual outcome was poor with no statistical difference between cases diagnosed within 30 days (early) or 30 days after (late) start of symptoms. The visual outcome in cases requiring tissue adhesive (five) and keratoplasty (three) was also poor. This is thought to be the largest series of cases of Acanthamoeba keratitis in non-contact lens wearers. In such cases, the disease is advanced at presentation in most patients, pathognomonic clinical features are often not seen, disease

  12. Role of atopy patch test for diagnosis of food allergy-related gastrointestinal symptoms in children.

    Science.gov (United States)

    Boonyaviwat, Onsuree; Pacharn, Punchama; Jirapongsananuruk, Orathai; Vichyanond, Pakit; Visitsunthorn, Nualanong

    2015-12-01

    Double-blind, placebo-controlled food challenge is the gold standard for diagnosing food allergy. However, it is a time-consuming procedure and requires onsite medical supervision and resuscitating medicines and devices on hand. The objective of this study was to compare the atopy patch test (APT) with the oral food challenge test (OFC) in children with suspected food allergy-related gastrointestinal (GI) symptoms. A prospective self-controlled study enrolled children with a history of suspected food allergy-related GI symptoms. Skin prick test (SPT) and APT using lyophilized and commercial allergen extracts for cow's milk, egg, wheat, soy, and shrimp were evaluated, and OFC was performed. Thirty-nine patients (25 boys, median age 2.4 yrs) with 76 events of suspected food allergy-related GI symptoms were enrolled. SPT was positive in 11/76 events (14.5%). Sensitivity, specificity, predictive values, and likelihood ratio were calculated related to the food challenge outcome. Of 41 OFC, 30 (73.2%) were positive. APT using lyophilized allergen extracts yielded high sensitivity (80%) and high positive predictive value (85.7%). APT using commercial allergen extracts yielded low sensitivity (30%) but high specificity (90%). The negative predictive value of APT using lyophilized and commercial allergen extracts was 53.8% and 32.2%, respectively. All cases with positive APT using lyophilized allergen extracts together with positive SPT also had positive OFC. In contrast to commercial extracts, APT with lyophilized allergen extracts is reliable, safe, and maybe useful for the diagnosis of suspected food allergy-related GI symptoms in children. OFC is still needed in most of the cases. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. The exploration of medical resources utilization among inguinal hernia repair in Taiwan diagnosis-related groups.

    Science.gov (United States)

    Yan, Yu-Hua; Kung, Chih-Ming; Chen, Yi

    2017-11-09

    This study centered on differences in medical costs, using the Taiwan diagnosis-related groups (Tw-DRGs) on medical resource utilization in inguinal hernia repair (IHR) in hospitals with different ownership to provide suitable reference information for hospital administrators. The 2010-2011 data for three hospitals under different ownership were extracted from the Taiwan National Health Insurance claims database. A retrospective method was applied to analyze the age, sex, length of stay, diagnosis and surgical procedure code, and the change in financial risk of medical costs in IHR cases after introduction of Tw-DRGs. The study calculated the cost using Tw-DRG payment principles, and compared it with estimated inpatient medical costs calculated using the fee-for-service policy. There were 723 IHR cases satisfying the Tw-DRGs criteria. Cost control in the medical care corporation hospital (US$764.2/case) was more efficient than that in the public hospital (US$902.7/case) or nonprofit proprietary hospital (US$817.1/case) surveyed in this study. For IHR, anesthesiologists in the public hospital preferred to use general anesthesia (86%), while those in the two other hospitals tended to administer spinal anesthesia. We also discovered the difference in anesthesia cost was high, at US$80.2/case on average. Because the Tw-DRG-based reimbursement system produces varying hospital costs, hospital administrators should establish a financial risk assessment system as early as possible to improve healthcare quality and financial management efficiency. This would then benefit the hospital, patient, and Bureau of National Health Insurance.

  14. A qualitative signature for early diagnosis of hepatocellular carcinoma based on relative expression orderings.

    Science.gov (United States)

    Ao, Lu; Zhang, Zimei; Guan, Qingzhou; Guo, Yating; Guo, You; Zhang, Jiahui; Lv, Xingwei; Huang, Haiyan; Zhang, Huarong; Wang, Xianlong; Guo, Zheng

    2018-04-23

    Currently, using biopsy specimens to confirm suspicious liver lesions of early hepatocellular carcinoma are not entirely reliable because of insufficient sampling amount and inaccurate sampling location. It is necessary to develop a signature to aid early hepatocellular carcinoma diagnosis using biopsy specimens even when the sampling location is inaccurate. Based on the within-sample relative expression orderings of gene pairs, we identified a simple qualitative signature to distinguish both hepatocellular carcinoma and adjacent non-tumour tissues from cirrhosis tissues of non-hepatocellular carcinoma patients. A signature consisting of 19 gene pairs was identified in the training data sets and validated in 2 large collections of samples from biopsy and surgical resection specimens. For biopsy specimens, 95.7% of 141 hepatocellular carcinoma tissues and all (100%) of 108 cirrhosis tissues of non-hepatocellular carcinoma patients were correctly classified. Especially, all (100%) of 60 hepatocellular carcinoma adjacent normal tissues and 77.5% of 80 hepatocellular carcinoma adjacent cirrhosis tissues were classified to hepatocellular carcinoma. For surgical resection specimens, 99.7% of 733 hepatocellular carcinoma specimens were correctly classified to hepatocellular carcinoma, while 96.1% of 254 hepatocellular carcinoma adjacent cirrhosis tissues and 95.9% of 538 hepatocellular carcinoma adjacent normal tissues were classified to hepatocellular carcinoma. In contrast, 17.0% of 47 cirrhosis from non-hepatocellular carcinoma patients waiting for liver transplantation were classified to hepatocellular carcinoma, indicating that some patients with long-lasting cirrhosis could have already gained hepatocellular carcinoma characteristics. The signature can distinguish both hepatocellular carcinoma tissues and tumour-adjacent tissues from cirrhosis tissues of non-hepatocellular carcinoma patients even using inaccurately sampled biopsy specimens, which can aid early

  15. Under-diagnosis of alcohol-related problems and depression in a family practice in Japan

    Directory of Open Access Journals (Sweden)

    Yamada Kenshi

    2008-09-01

    Full Text Available Abstract Aim The aim of this survey was to assess the accuracy of a family physician's diagnosis of depression and alcoholism. Methods Consecutive new adult patients attending a family practice in Japan between April 2004 and August 2006 were enrolled. Excluded were those with dementia or visual disturbance, and emergency cases. Participants completed a questionnaire regarding their complaints and socio-demographics. A research nurse conducted the Japanese version of the Mini-International Neuropsychiatric Interview (J-MINI in the interview room. The doctor independently performed usual practice and recorded his own clinical diagnoses. A researcher listed the clinical diagnoses and complaints, including J-MINI or clinically-diagnosed alcoholism and depression, using the International Classifications for Primary Care, Second Edition (ICPC-2 and calculated kappa statistics between the J-MINI and clinical diagnoses. Results Of the 120 adult first-visit patients attending the clinics, 112 patients consented to participate in the survey and were enrolled. Fifty-one subjects were male and 61 female, and the average age was 40.7 ± 13.2 years. Eight alcohol-related disorders and five major depressions were diagnosed using the J-MINI, whereas no cases of alcoholism and eight depressions were diagnosed by the physician. Clinically overlooked patients tended to have acute illnesses like a common cold. Concordance between the clinical and research diagnosis was achieved only for three episodes of Major depression, resulting in a kappa statistic of 0.43. Conclusion Although almost half of the major depressions were identified, all alcoholism was missed. A mental health screening instrument might be beneficial in family practice, especially to detect alcoholism.

  16. The exploration of medical resources utilization among inguinal hernia repair in Taiwan diagnosis-related groups

    Directory of Open Access Journals (Sweden)

    Yu-Hua Yan

    2017-11-01

    Full Text Available Abstract Background This study centered on differences in medical costs, using the Taiwan diagnosis-related groups (Tw-DRGs on medical resource utilization in inguinal hernia repair (IHR in hospitals with different ownership to provide suitable reference information for hospital administrators. Methods The 2010–2011 data for three hospitals under different ownership were extracted from the Taiwan National Health Insurance claims database. A retrospective method was applied to analyze the age, sex, length of stay, diagnosis and surgical procedure code, and the change in financial risk of medical costs in IHR cases after introduction of Tw-DRGs. The study calculated the cost using Tw-DRG payment principles, and compared it with estimated inpatient medical costs calculated using the fee-for-service policy. Results There were 723 IHR cases satisfying the Tw-DRGs criteria. Cost control in the medical care corporation hospital (US$764.2/case was more efficient than that in the public hospital (US$902.7/case or nonprofit proprietary hospital (US$817.1/case surveyed in this study. For IHR, anesthesiologists in the public hospital preferred to use general anesthesia (86%, while those in the two other hospitals tended to administer spinal anesthesia. We also discovered the difference in anesthesia cost was high, at US$80.2/case on average. Conclusions Because the Tw-DRG-based reimbursement system produces varying hospital costs, hospital administrators should establish a financial risk assessment system as early as possible to improve healthcare quality and financial management efficiency. This would then benefit the hospital, patient, and Bureau of National Health Insurance.

  17. Appendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

    Science.gov (United States)

    Quentin, Wilm; Scheller-Kreinsen, David; Geissler, Alexander; Busse, Reinhard

    2012-02-01

    As part of the EuroDRG project, researchers from 11 countries (i.e., Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their diagnosis-related groups (DRG) systems deal with appendectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of appendicitis treated with a procedure of appendectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that together comprised at least 97% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify appendectomy patients according to different sets of variables (between two and six classification variables) into diverging numbers of DRGs (between two and 11 DRGs). The most complex DRG is valued 5.1 times more resource intensive than an index case in France but only 1.1 times more resource intensive than an index case in Finland. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the most complex case vignette amount to only 1,005 in Poland but to 12,304 in France. Large variations in the classification of appendectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons and national DRG authorities should consider how other countries' DRG systems classify appendectomy patients in order to optimize their DRG system and to ensure fair and appropriate reimbursement.

  18. Planning processes with integrated evaluation of climate and air; Einbindung und Bewertung von Klima und Luft in Plannungsablaeufe

    Energy Technology Data Exchange (ETDEWEB)

    Katzschner, L. [Kassel Univ. (Gesamthochschule) (Germany). Fachbereich 13 - Stadt- und Landschaftsplanung

    1997-09-01

    More and more often, plannings require climate statements which are suitable to be considered in the weighing of the different factors. The paper makes climate assessment proposals permitting a qualitative and quantitative judgement. Parameters employed are the physiologically equivalent temperature (PET) as well as, increasingly, statements regarding the quality of ventilation. Examples illustrate how space-related planning clues can be derived from climate function maps. The basis for this are climate-geographic surveys (orohydrographic analysis, topographic gradient determination etc.), as well as the analysis of dynamic parameters (air conduction paths and barriers) and thermal parameters (areas warming up excessively, areas of cold and fresh air generation). Linking of these aspects yields a climate function map. It is used to prepare a planning recommendations map which differentiates and evaluates climate-ecological sensitivities. (orig.) [Deutsch] Im Rahmen von Planungsprozessen werden immer haeufiger Klimaaussagen verlangt, die in die Planungsabwaegung Eingang finden koennen. Dazu werden Klimabewertungsvorschlaege fuer eine qualitative und quantitative Beurteilung gemacht. Anwendung finden die bioklimatischen Komplexgroessen und vermehrt Aussagen zur Belueftungsqualitaet. Beispiele verdeutlichen, wie sich aus den Klimafunktionskarten raeumliche Planungshinweise ableiten lassen. Grundlage sind klimageographische Erhebungen (orohydrographische Analyse, topographische Gradientenbestimmung usw.) sowie die Analyse der dynamischen (Luftleitbahnen und Barrieren) und thermischen Parameter (Ueberwaermungsgebiete, Kalt- und Frischluftentstehungsgebiete). In einer Verknuepfung dieser Aspekte wird die Klimafunktionskarte erstellt, aus der die Planungshinweiskarte abgeleitet wird, die klimaoekologische Empfindlichkeiten differenziert und bewertet. (orig.)

  19. Plazentaanatomie und -physiologie mit uteroplazentarem Kreislauf

    NARCIS (Netherlands)

    Engel, N.; Schreiber, J. U.; Kranke, Peter

    2017-01-01

    Die Plazenta besteht neben der Nabelschnur aus parenchymatösem Gewebe, der sog. Eihaut (Amnion) und der Zottenhaut (Chorion). Sie fungiert als Schnittstelle zwischen Mutter und Fetus und ermöglicht den physiologischen Transfer von Gasen, Nährstoffen und Metaboliten. Die Funktion der Plazenta ist als

  20. Hegel und Gorgias

    DEFF Research Database (Denmark)

    Huggler, Jørgen

    Hegel und Gorgias /Jørgen Huggler (University of Aarhus, Denmark) (huggler(at)dpu.dk) Hegels Verständnis des Sophist Gorgias von Leontinoi in den Vorlesungen über die Geschichte der Philosophie gründet auf seine eigene Interpretation der Eleaten, insbesondere Zenon. Aufgrund eigener philosophischer...... „Gründen“, einen echten Beitrag zu dieser Entwicklung des griechischen Denkens geliefert. Vor allen scheint Gorgias die dialektischen Bemühungen der Eleaten fortgesetzt zu haben. Hegels Auslegung des Gorgias kann den lauwarmen Empfang der Sophisten in den deutschen Beiträgen zur Geschichte der Philosophie...... des späten 18. Jahrhunderts (Meiners, Tiedemann, Stäudlin, Buhle und Tennemann) gegenübergestellt werden. In der Tat ist Hegels philosophisches Verständnis ausreichend, um positive Kommentare zu allen Teilen der Diskussion in Gorgias Argument „Über das Nicht-Seiende, oder Über der Natur“ zu geben...

  1. [Correlation of hybrid II capture cytologic exam in diagnosis of cervical lesions related to HPV].

    Science.gov (United States)

    Saturnino, Ana Conceição Ribeiro Dantas; Diniz, Veruska Cassandra; Sisenando, Herbert Ary Arzabe Anteza Costa Nóbrega; de Souza, Eroisa Maria Conceição Oliveira; de Paiva, Magnus Sérgio Martins; de Brito, Maria Helena Marques Fonseca; Ramos, Eleni Souto Nóbrega

    2005-01-01

    The aim of the present study was confront the results of the cytological examination with hybrid capture II in the diagnosis of induced cervical intraepithelial lesion-HPV, correlating the cytological findings with biomoleculares. The research was carried through in a group of 160 sexually active women who had espontaneamente looked its gynecologists for consultation of routine, having been submitted to the collection of cervicovaginal material for cytology and for examination of hybrid capture II in the Centro de Patologia Clínica and the Hospital e Maternidade Promater, in the city of the Natal-RN. The results had shown to relatively high numbers of positive cases for HPV using hybrid capture II (41.87%) and the cytology (23.75%). The agreement between the two studied methods relatively was raised (59.38%). It was evident also that the viruses with high oncogênico potential had presented found in the compatible cytology with Lesion of low risk (11.88%), followed of Lesion of high risk (NIC II and III); already the viruses with low oncogênico potential were more associates the Lesion of low risk (6.25%), followed of Lesion of high risk. The cytology, exactly with its limitations, is an important method in the detention of attributable patologias to the HPV, emphasizing that the molecular method comes to complement it and to consolidate the cytological findings.

  2. Tumour biology of obesity-related cancers: understanding the molecular concept for better diagnosis and treatment.

    Science.gov (United States)

    Teoh, Seong Lin; Das, Srijit

    2016-11-01

    Obesity continues to be a major global problem. Various cancers are related to obesity and proper understanding of their aetiology, especially their molecular tumour biology is important for early diagnosis and better treatment. Genes play an important role in the development of obesity. Few genes such as leptin, leptin receptor encoded by the db (diabetes), pro-opiomelanocortin, AgRP and NPY and melanocortin-4 receptors and insulin-induced gene 2 were linked to obesity. MicroRNAs control gene expression via mRNA degradation and protein translation inhibition and influence cell differentiation, cell growth and cell death. Overexpression of miR-143 inhibits tumour growth by suppressing B cell lymphoma 2, extracellular signal-regulated kinase-5 activities and KRAS oncogene. Cancers of the breast, uterus, renal, thyroid and liver are also related to obesity. Any disturbance in the production of sex hormones and insulin, leads to distortion in the balance between cell proliferation, differentiation and apoptosis. The possible mechanism linking obesity to cancer involves alteration in the level of adipokines and sex hormones. These mediators act as biomarkers for cancer progression and act as targets for cancer therapy and prevention. Interestingly, many anti-cancerous drugs are also beneficial in treating obesity and vice versa. We also reviewed the possible link in the mechanism of few drugs which act both on cancer and obesity. The present review may be important for molecular biologists, oncologists and clinicians treating cancers and also pave the way for better therapeutic options.

  3. Emotionsregulationsstrategien und aggressives Verhalten im Kindergartenalter

    OpenAIRE

    Helmsen, Johanna; Petermann, Franz

    2010-01-01

    In der vorliegenden Studie (N = 193) wurde untersucht, ob sich körperlich und relational aggressive Kinder im Kindergartenalter (mittleres Alter: 55 Monate) in ihren Emotionsregulationsstrategien von ihren unauffälligen Altersgenossen unterscheiden. Zur Erhebung der Emotionsregulation wurde eine strukturierte, videografierte Verhaltensbeobachtung durchgeführt, in der gezielt Frustration ausgelöst wurde. Anschließend wurden Regulationsstrategien in sieben verschiedenen Kategorien ausgewertet. ...

  4. Rudolf Streinz. Meinungs- und Informationsfreiheit zwischen Ost und West / Henn-Jüri Uibopuu

    Index Scriptorium Estoniae

    Uibopuu, Henn-Jüri, 1929-2012

    1983-01-01

    Tutvustus: Streinz, Rudolf. Meinungs- und Informationsfreiheit zwischen Ost und West : Möglichkeiten und Grenzen intersystemarer völkerrechtlicher Garantien in einem systemkonstituierenden Bereich. Ebelsbach : Rolf Gremer, 1981

  5. Zur historischen Aufarbeitung und medialen Vermittlung der Shoah in Italien und Deutschland

    Directory of Open Access Journals (Sweden)

    Peter Kuon

    2016-03-01

    Full Text Available Claudia Müller, Patrick Ostermann und Karl-Siegbert Rehberg, Hrsg., Die Shoah in Geschichte und Erinnerung: Perspektiven medialer Vermittlung in Italien und Deutschland (Bielefeld: transcript, 2015.

  6. Ethik und Sicherheitstechnik. Eine Handreichung

    NARCIS (Netherlands)

    Ammicht-Quinn, Regina; Nagenborg, Michael Herbert; Rampp, Benjamin; Wolkenstein, Andreas F.X.; Ammicht-Quinn, Regina

    2013-01-01

    Mit dem Programm „Forschung für die zivile Sicherheit“ fördert die Bundesregierung im Rahmen der „Hightech-Strategie für Deutschland“ erstmals unmittelbar die Entwicklung von Techniken, die der Schaffung und Bewahrung von ziviler Sicherheit dienen. Bei der Erforschung und Entwicklung von

  7. Work-related stress disorders: variability in clinical expression and pitfalls in psychiatric diagnosis.

    Science.gov (United States)

    Buselli, Rodolfo; Veltri, Antonello; Baldanzi, Sigrid; Bozzi, Silvia; Marino, Riccardo; Chiumiento, Martina; Dell'Osso, Liliana; Cristaudo, Alfonso

    2016-03-24

    Putative occupational stress-related psychiatric disorders are Adjustment Disorders (AD) and Post-Traumatic Stress Disorder (PTSD). Mood Disorders (MD) are not excluded but are unlikely to be identified as occupational diseases. The differential diagnosis between AD and MD is not easy and is based on strict categorical criteria. The aim of this study  was to explore differences in personality and mood spectrum symptoms among workers investigated for occupational stress suffering from AD or MD. Sixty-two patients with AD and 43 with MD were recruited and evaluated by means of rating scales for psychosocial occupational risk and work-related stress (WHS, CDL, OSQ), for sleep disturbances (PSQI), for personality disorders (SCID-II) and for mood spectrum symptoms (MOODS-SR). The diagnostic groups did not differ for WHS, OSQ and PSQI scores. The duration of exposure to stressful/adversative work situations was significantly higher in the MD group (p=0.03). Positive family psychiatric history (p=0.005), personality disorders (p=0.009) and pathological personality traits (p<0.0001) were significantly more frequent in the MD group. The MOODS-SR questionnaire total score (p=0.019) and the manic component score (p=0.001) but not the depressive score were significantly higher in the MD group. The present study suggests that  positive family psychiatric history, pathological personality traits and  spectrum manic symptoms represent markers of vulnerability and low resilience for workers exposed to occupational stress. These characteristics could weaken the etiological relationship between work-related stress and an initial  major depressive episode when it is under investigation as a possible occupational disease.

  8. Bildanalyse in Medizin und Biologie

    Science.gov (United States)

    Athelogou, Maria; Schönmeyer, Ralf; Schmidt, Günther; Schäpe, Arno; Baatz, Martin; Binnig, Gerd

    Heutzutage sind bildgebende Verfahren aus medizinischen Untersuchungen nicht mehr wegzudenken. Diverse Methoden - basierend auf dem Einsatz von Ultraschallwellen, Röntgenstrahlung, Magnetfeldern oder Lichtstrahlen - werden dabei spezifisch eingesetzt und liefern umfangreiches Datenmaterial über den Körper und sein Inneres. Anhand von Mikroskopieaufnahmen aus Biopsien können darüber hinaus Daten über die morphologische Eigenschaften von Körpergeweben gewonnen werden. Aus der Analyse all dieser unterschiedlichen Arten von Informationen und unter Konsultation weiterer klinischer Untersuchungen aus diversen medizinischen Disziplinen kann unter Berücksichtigung von Anamnesedaten ein "Gesamtbild“ des Gesundheitszustands eines Patienten erstellt werden. Durch die Flut der erzeugten Bilddaten kommt der Bildverarbeitung im Allgemeinen und der Bildanalyse im Besonderen eine immer wichtigere Rolle zu. Gerade im Bereich der Diagnoseunterstützung, der Therapieplanung und der bildgeführten Chirurgie bilden sie Schlüsseltechnologien, die den Forschritt nicht nur auf diesen Gebieten maßgeblich vorantreiben.

  9. [Die baltischen Lande im Zeitalter der Reformation und Konfessionalisierung. Livland, Estland, Ösel, Ingermanland, Kurland und Letgallen. Stadt, Land und Konfession 1500-1721. 2. und 3. Teil] / Anti Selart

    Index Scriptorium Estoniae

    Selart, Anti, 1973-

    2012-01-01

    Arvustus: Die baltischen Lande im Zeitalter der Reformation und Konfessionalisierung. Livland, Estland, Ösel, Ingermanland, Kurland und Letgallen. Stadt, Land und Konfession 1500-1721. Hrsg. von Matthias Asche, Werner Buchholz, Anton Schindling. 2. und 3. Teil.

  10. Association of the position of a hospital-acquired condition diagnosis code with changes in medicare severity diagnosis-related group assignment.

    Science.gov (United States)

    Johnson, Tricia; Kane, Jason M; Odwazny, Richard; McNutt, Robert

    2014-11-01

    Incentives to improve quality include paying less for adverse events, including the Centers for Medicare and Medicaid Services' policy to not pay additionally for events classified as hospital-acquired conditions (HACs). This policy is controversial, as variable coding practices at hospitals may lead to differences in the inclusion and position of HACs in the list of codes used for Medicare Severity Diagnosis-Related Group (MS-DRG) assignment. Evaluate changes in MS-DRG assignment for patients with an HAC and test the association of the position of an HAC in the list of International Classification of Diseases, 9th Revision (ICD-9) diagnosis codes with change in MS-DRG assignment. Retrospective analysis of patients discharged from hospital members of the University HealthSystem Consortium's Clinical Data Base between October 2007 and April 2008. Comparisons were made between the MS-DRG assigned when the HAC was not included in the list of ICD-9 diagnosis codes and the MS-DRG that would have been assigned had the HAC code been included in the assignment. Of the 7027 patients with an HAC, 13.8% changed MS-DRG assignment when the HAC was removed. An HAC in the second position versus third position or lower was associated with a 40-fold increase in the likelihood of MS-DRG change. The position of an HAC in the list of diagnosis codes, rather than the presence of an HAC, is associated with a change in MS-DRG assignment. HACs have little effect on reimbursement unless the HAC is in the second position and patients have minor severity of illness. © 2014 Society of Hospital Medicine.

  11. The Relation Between Intellectual Functioning and Adaptive Behavior in the Diagnosis of Intellectual Disability.

    Science.gov (United States)

    Tassé, Marc J; Luckasson, Ruth; Schalock, Robert L

    2016-12-01

    Intellectual disability originates during the developmental period and is characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. In this article, we present a brief history of the diagnostic criteria of intellectual disability for both the DSM-5 and AAIDD. The article also (a) provides an update of the understanding of adaptive behavior, (b) dispels two thinking errors regarding mistaken temporal or causal link between intellectual functioning and adaptive behavior, (c) explains that there is a strong correlational, but no causative, relation between intellectual functioning and adaptive behavior, and (d) asserts that once a question of determining intellectual disability is raised, both intellectual functioning and adaptive behavior are assessed and considered jointly and weighed equally in the diagnosis of intellectual disability. We discuss the problems created by an inaccurate statement that appears in the DSM-5 regarding a causal link between deficits in intellectual functioning and adaptive behavior and propose an immediate revision to remove this erroneous and confounding statement.

  12. [Innovative culture and diagnosis related groups in a high complexity hospital, Colombia].

    Science.gov (United States)

    Gorbanev, Iouri; Agudelo-Londoño, Sandra; Cortes, Ariel; Yepes, Francisco J

    2016-04-01

    Objectives To characterize the perception of Diagnosis-Related Groups (DRGs) as an innovation among physicians, nurses and administrative staff in a hospital in Colombia. Methods A case study of innovative culture in a hospital. Surveys and focus groups were carried out with the medical, nursing and administrative staff. Descriptive statistics were calculated for the perceptions of innovative culture. Comparative analysis was done between professional groups. The results of the focus groups were transcribed and analyzed to deepen the findings of the surveys. Results Significant differences were found in perceptions of the innovative culture. The nursing staff were more enthusiastic than doctors when evaluating the innovative culture and leadership. Physicians felt more autonomy when discussing professional issues. Administrative staff assessed the Hospital's disposition to acquire new medical technologies as higher than that of physicians. The three groups know little about DRG's. Conclusions When implementing a health innovation it is advisable to analyze its effect on the professionals who participate in the implementation. Physicians perceive DRGs as a threat to their professional autonomy, while nurses see it as a pro-innovation force. It is important to involve nursing and administrative staff when implementing this kind of innovation.

  13. Do diagnosis-related group-based payments incentivise hospitals to adjust output mix?

    Science.gov (United States)

    Liang, Li-Lin

    2015-04-01

    This study investigates whether the diagnosis-related group (DRG)-based payment method motivates hospitals to adjust output mix in order to maximise profits. The hypothesis is that when there is an increase in profitability of a DRG, hospitals will increase the proportion of that DRG (own-price effects) and decrease those of other DRGs (cross-price effects), except in cases where there are scope economies in producing two different DRGs. This conjecture is tested in the context of the case payment scheme (CPS) under Taiwan's National Health Insurance programme over the period of July 1999 to December 2004. To tackle endogeneity of DRG profitability and treatment policy, a fixed-effects three-stage least squares method is applied. The results support the hypothesised own-price and cross-price effects, showing that DRGs which share similar resources appear to be complements rather substitutes. For-profit hospitals do not appear to be more responsive to DRG profitability, possibly because of their institutional characteristics and bonds with local communities. The key conclusion is that DRG-based payments will encourage a type of 'product-range' specialisation, which may improve hospital efficiency in the long run. However, further research is needed on how changes in output mix impact patient access and pay-outs of health insurance. Copyright © 2014 John Wiley & Sons, Ltd.

  14. Examination of changes in pathology tests ordered by Diagnosis-Related Group (DRGs) following CPOE introduction.

    Science.gov (United States)

    Vecellio, Elia; Georgiou, Andrew; Toouli, George; Eigenstetter, Alex; Li, Ling; Wilson, Roger; Westbrook, Johanna I

    2013-01-01

    Electronic test ordering, via the Electronic Medical Record (EMR), which incorporates computerised provider order entry (CPOE), is widely considered as a useful tool to support appropriate pathology test ordering. Diagnosis-related groups (DRGs) are clinically meaningful categories that allow comparisons in pathology utilisation by patient groups by controlling for many potentially confounding variables. This study used DRG data linked to pathology test data to examine changes in rates of test ordering across four years coinciding with the introduction of an EMR in six hospitals in New South Wales, Australia. This method generated a list of high pathology utilisation DRGs. We investigated patients with a Chest pain DRG to examine whether tests rates changed for specific test groups by hospital emergency department (ED) pre- and post-EMR. There was little change in testing rates between EDs or between time periods pre- and post-EMR. This is a valuable method for monitoring the impact of EMR and clinical decision support on test order rates.

  15. [Cardiovascular medicine in the German diagnosis-related group--(G-DRG) system 2005].

    Science.gov (United States)

    Fürstenberg, T; Bunzemeier, H; Roeder, N; Reinecke, H

    2005-05-01

    The German diagnosis-related Group (G-DRG) System has recently been published in its third version. From 2005 on, this system will be the definite measure for the budgets of nearly all german hospitals. The preliminary phase with no budget reduction or redistribution being made and in which an inappropriate classification system had no negative impact on reimbursement has, thus, come to an end. At present, many hospitals are struggling in an economic competition about the independence or maintenance of the hospital or several sub-departments. The changes in the classification system with regard to a marked increase in the number of G DRGs, a modified grouping-logic, more properly determined reductions and extra charges for low and high outlier as well as the introduction of further additional charges contribute thereby to a better covering of services and treatments of cardiovascular patients. However, while many of the known problems have been eliminated, there are still weaknesses in the G-DRG System even concerning cardiovascular medicine. The G-DRG System has to be adapted continuously with consultation of the clinical expertise of the respective medical societies. The most important new aspects and changes in the G-DRG System 2005 and the accompanied execution regulations are explained with special view on cardiology.

  16. Cholecystectomy and Diagnosis-Related Groups (DRGs: Patient Classification and Hospital Reimbursement in 11 European Countries

    Directory of Open Access Journals (Sweden)

    Gerli Paat-Ahi

    2014-12-01

    Full Text Available Background As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain compared how their Diagnosis-Related Groups (DRG systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. Results European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England. The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Conclusion Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries’ DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement.

  17. Accuracy of the all patient refined diagnosis related groups classification system in congenital heart surgery.

    Science.gov (United States)

    Parnell, Aimee S; Shults, Justine; Gaynor, J William; Leonard, Mary B; Dai, Dingwei; Feudtner, Chris

    2014-02-01

    Administrative data are increasingly used to evaluate clinical outcomes and quality of care in pediatric congenital heart surgery (CHS) programs. Several published analyses of large pediatric administrative data sets have relied on the All Patient Refined Diagnosis Related Groups (APR-DRG, version 24) diagnostic classification system. The accuracy of this classification system for patients undergoing CHS is unclear. We performed a retrospective cohort study of all 14,098 patients 0 to 5 years of age undergoing any of six selected congenital heart operations, ranging in complexity from isolated closure of a ventricular septal defect to single-ventricle palliation, at 40 tertiary-care pediatric centers in the Pediatric Health Information Systems database between 2007 and 2010. Assigned APR-DRGs (cardiac versus noncardiac) were compared using χ2 or Fisher's exact tests between those patients admitted during the first day of life versus later and between those receiving extracorporeal membrane oxygenation support versus those not. Recursive partitioning was used to assess the greatest determinants of APR-DRG type in the model. Every patient admitted on day 1 of life was assigned to a noncardiac APR-DRG (pDRG (pDRG experienced a significantly increased mortality (pDRG coding has systematic misclassifications, which may result in inaccurate reporting of CHS case volumes and mortality. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Cholecystectomy and Diagnosis-Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

    Science.gov (United States)

    Paat-Ahi, Gerli; Aaviksoo, Ain; Swiderek, Maria

    2014-12-01

    As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England). The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries' DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement.

  19. [Costs of appendicitis treatment by diagnosis-related groups in a third-level pediatric hospital].

    Science.gov (United States)

    Tlacuilo-Parra, Alberto; Hernández-Hernández, Araceli; Venegas-Dávalos, Martha; Gutiérrez-Hermosillo, Violeta; Guevara-Gutiérrez, Elizabeth; Ambriz-González, Gabriela

    2014-01-01

    Diagnosis-related groups (DRGs) are widely used in Europe. They allow performing comparisons in hospitals and incurrent hospital payment systems, defining the payment categories. We undertook this study to classify children who underwent appendectomy according to DRGs. Cross-sectional study. Comorbidities, length of hospitalization, histopathologic classification, and DRG classifications were analyzed. We included 313 patients, 62% males, with an average age of 8 ± 3 years; 91% were referred by another hospital and 67% were treated at night. Average length of hospitalization was 4 ± 3 days. There were comorbidities in 8% and surgical complications in 11%. According to histopathology, appendicitis was edematous (11%), suppurative (36%), gangrenous (22%), perforated (29%), and abscessed (2%). At discharge, 97% of the patients were healthy. Total cost for DRG 343 was $10,470,173.00 (Mexican pesos), DRG 342 was $1,227,592.00 and DRG 340 was $511,521.00. The global amount was $12,209,286.00 (Mexican pesos). The unitary cost for treatment of appendectomy for DRG 343 was $37,935.00, for DRG 342 was $49,103.00 and for DRG 340 was $42,626.00 (Mexican pesos). Because 88% of the cases of appendicitis were uncomplicated, this amount of money could be spent to treat these patients in a second-level hospital, using reimbursement 343 without generating additional expenses.

  20. The value of optical coherence tomography in diagnosis and therapy of age-related degeneration

    International Nuclear Information System (INIS)

    Krebs, I.; Binder, S.; Stolba, U.; Krepler, K.; Glittenberg, C.; Zeiler, F.

    2007-01-01

    The ophthalmologic departments are confronted by the necessity of an increasing number of Fluorescein Angiograms (FA). It should be examined in which cases the FA might be replaced by the Optical Coherence Tomography (OCT). FA and OCT examinations were retrospectively evaluated concerning composition, size and activity of the lesion. Unselected cases with age-related macular degeneration (AMD) who underwent FA within 1 month were retrospectively examined, prior examinations of these patients were also evaluated. According to the results of the FA the patients were assigned to different subgroups. 150 FA and OCT examinations of 50 patients were included. In 12 eyes with non exsudative AMD there was a 100 % consistency of the diagnosis. In 68 examinations of 42 eyes with occult exsudative AMD the consistency concerning lesion composition was 78%, differences were noted in the presence of retinal angiomatous proliferation, minimal classic parts, the presence of fibrosis. The evaluation of the activity showed differences of less than two steps in 97 %. In 24 examinations of 16 eyes treated with antiangiogenetic substances the activity of a lesion was judged to be equal in 75%. In 96 % the indication for re-treatment was identical in both examinations. Both examinations FA and OCT were necessary to evaluate a case concerning composition and activity of a lesion. Measurement of the greatest diameter of the lesion was not possible with the OCT except in predominantly classic lesions. In cases treated with antiangiogenetic substances OCT alone provided enough information to decide whether re-treatment is necessary. (author) [de

  1. Transfusion practice in Helsinki University Central Hospital: an analysis of diagnosis-related groups (DRG).

    Science.gov (United States)

    Syrjälä, M T; Kytöniemi, I; Mikkolainen, K; Ranimo, J; Lauharanta, J

    2001-12-01

    Transfusion data combined with data automatically recorded in hospital databases provides an outstanding tool for blood utilization reporting. When the reporting is performed with an online analytical processing (OLAP) tool, real time reporting can be provided to blood subscribers. When this data is combined with a common patient classification system, Diagnosis-Related Groups (DRG), it is possible to produce statistical results, that are similar in different institutions and may provide a means for international transfusion bench-marking and cost comparison. We use a DRG classification to describe the transfusion practice in Helsinki University Central Hospital. The key indicators include the percentage of transfused patients, the number of transfused units and costs in different DRG groups, as well as transfusion rates per DRG weighted treatment episodes. Ninety-three per cent of all transfusions could be classified into different DRGs. The largest blood-using DRG group was acute adult leukaemia (DRG 473), which accounted for 10.4% of all transfusion costs. The 13 largest blood consuming DRGs accounted for half the total costs in 1998. Currently, there is a lack of an internationally accepted standardized way to report institutional or national transfusion practices. DRG-based transfusion reporting might serve as a means for transfusion benchmarking and thus aid studies of variations in transfusion practice.

  2. [What is the value of pain therapy in the German refined diagnosis-related-groups system?].

    Science.gov (United States)

    Meissner, W; Thoma, R; Bauer, M

    2006-03-01

    The German refined diagnosis-related-groups (G-DRG) system was introduced on 1st January 2003, initially on a voluntary basis and on 1st January 2004 the use of a G-DRG costing for stationary hospital treatment became obligatory. The possibility of a description of acute and chronic pain therapy in the G-DRG system was initially rudimentary and not logically planned and also a fair allotment of proceeds according to resources was not possible. By further development of the G-DRG system, pain therapeutic treatment could be improved in some areas, but in others it still remains unsatisfactory. This article offers a summary of the underlying systematics of the G-DRG system and consideration of chronic and current pain therapy in the G-DRG system 2006. In addition to information on currently available possibilities of a pain therapeutical coding in conformation with the G-DRG system, the tasks which are still outstanding will be outlined.

  3. Evaluation of the performance of diagnosis-related groups and similar casemix systems: methodological issues.

    Science.gov (United States)

    Palmer, G; Reid, B

    2001-05-01

    With the increasing recognition and application of casemix for managing and financing healthcare resources, the evaluation of alternative versions of systems such as diagnosis-related groups (DRGs) has been afforded high priority by governments and researchers in many countries. Outside the United States, an important issue has been the perceived need to produce local versions, and to establish whether or not these perform more effectively than the US-based classifications. A discussion of casemix evaluation criteria highlights the large number of measures that may be used, the rationale and assumptions underlying each measure, and the problems in interpreting the results. A review of recent evaluation studies from a number of countries indicates that considerable emphasis has been placed on the predictive validity criterion, as measured by the R2 statistic. However, the interpretation of the findings has been affected greatly by the methods used, especially the treatment and definition of outlier cases. Furthermore, the extent to which other evaluation criteria have been addressed has varied widely. In the absence of minimum evaluation standards, it is not possible to draw clear-cut conclusions about the superiority of one version of a casemix system over another, the need for a local adaptation, or the further development of an existing version. Without the evidence provided by properly designed studies, policy-makers and managers may place undue reliance on subjective judgments and the views of the most influential, but not necessarily best informed, healthcare interest groups.

  4. Usefulness of gram staining of blood collected from total parenteral nutrition catheter for rapid diagnosis of catheter-related sepsis.

    Science.gov (United States)

    Moonens, F; el Alami, S; Van Gossum, A; Struelens, M J; Serruys, E

    1994-01-01

    The accuracy of Gram staining of blood drawn from catheters used to administer total parenteral nutrition was compared with paired quantitative blood cultures for the diagnosis of catheter-related sepsis. Gram staining was positive in 11 of 18 episodes of catheter-related sepsis documented by quantitative culture (sensitivity, 61%) but in none of the 5 episodes of fever unrelated to catheter infection. Thus, this procedure enabled the rapid presumptive diagnosis and guidance of antimicrobial therapy for total parenteral nutrition catheter sepsis, with a positive predictive value of 100% and a negative predictive value of 42%. PMID:7521359

  5. Diagnosis-related groups for stroke in Europe: patient classification and hospital reimbursement in 11 countries.

    Science.gov (United States)

    Peltola, Mikko; Quentin, Wilm

    2013-01-01

    Diagnosis-related groups (DRGs) are increasingly being used for various purposes in many countries. However, there are no studies comparing different DRG systems in the care of stroke. As part of the EuroDRG project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Sweden and Spain) compared how their DRG systems deal with stroke patients. The study aims to assist clinicians and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of stroke. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually represent at least 1% of stroke cases. In addition, standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify stroke patients according to different sets of variables (between 1 and 7 classification variables) into diverging numbers of DRGs (between 1 and 10 DRGs). In 6 of the countries more than half of the patients are concentrated within a single DRG. The countries' systems also vary with respect to the evaluation of different kinds of stroke patients. The most complex DRG is considered 3.8 times more resource intensive than an index case in Finland. By contrast, in England, the DRG system does not account for complex cases. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only EUR 907 in Poland but to EUR 7,881 in Ireland. Large variations in the classification of stroke patients raise concerns whether all systems rely on the most appropriate classification variables and whether the DRGs adequately reflect differences in the complexity of treating different groups of patients. Learning from other DRG systems may help in improving the national systems. Clinicians and

  6. Depression, pregnancy-related anxiety and parental-antenatal attachment in couples using preimplantation genetic diagnosis.

    Science.gov (United States)

    Winter, C; Van Acker, F; Bonduelle, M; Van Berkel, K; Belva, F; Liebaers, I; Nekkebroeck, J

    2016-06-01

    Do preimplantation genetic diagnosis (PGD) couples experience higher levels of stress during pregnancy and the perinatal period compared with couples who conceive spontaneously (SC) or with ICSI? PGD couples did not experience more psychological stress during pregnancy and beyond than ICSI or SC couples. Previous studies have shown that assisted reproduction technology (ART) couples are more prone to pregnancy-related anxieties than SC couples, but display depressed feelings to an equal or lesser extent. However, only one study has focused on a female PGD sample, which may be a more vulnerable group than other ART groups, due to the potentially complex hereditary background, adverse childhood experiences and losses. In that study, PGD women experienced a reduction in state anxiety, and maternal-antenatal attachment did not differ from normative data. Unfortunately, no data exist on pregnancy-related anxiety, depression and parental-antenatal attachment. Valuable information from both parents (e.g.: couples) is also lacking. For this longitudinal prospective study questionnaire, data from 185 women and 157 men (157 couples) were collected between February 2012 until April 2014. Data were analysed using multilevel analysis. The couples conceiving after PGD, ICSI or SC were followed from the first trimester of the pregnancy until the third month post-partum. A total of 60 PGD, 58 ICSI and 69 SC couples were initially recruited by various departments of Universitair Ziekenhuis Brussel (UZ Brussel). At each trimester (T1: 12-14 weeks, T2: 20-22 weeks, T3: 30-32 weeks) of pregnancy, depression (EPDS), pregnancy-related anxieties (PRAQ) and parental-antenatal attachment (M/PAAS) were recorded. At T4 (3 months post-partum), depression (EPDS) was assessed again. In the first trimester (T1) broad socio-demographic data and at T4 perinatal health data of both mother and child were recorded. Differences between conception groups over time were analysed using multilevel

  7. Knee osteoarthritis related pain: a narrative review of diagnosis and treatment

    Science.gov (United States)

    Alshami, Ali M.

    2014-01-01

    Background Osteoarthritis is a common progressive joint disease, involving not only the joint lining but also cartilage, ligaments, and bone. For the last ten years, majority of published review articles were not specific to osteoarthritis of the knee, and strength of evidence and clinical guidelines were not appropriately summarized. Objectives To appraise the literature by summarizing the findings of current evidence and clinical guidelines on the diagnosis and treatment of knee osteoarthritis pain. Methodology English journal articles that focused on knee osteoarthritis related pain were searched via PubMed (1 January 2002 – 26 August 2012) and Physiotherapy Evidence Database (PEDro) databases, using the terms ‘knee’, ‘osteoarthritis’ and ‘pain’. In addition, reference lists from identified articles and related book chapters were included as comprehensive overviews. Results For knee osteoarthritis, the highest diagnostic accuracy can be achieved by presence of pain and five or more clinical or laboratory criteria plus osteophytes. Some inconsistencies in the recommendations and findings were found between the clinical guidelines and systematic reviews. Generally, paracetamol, oral and topical non-steroidal anti-inflammatory drugs, opioids, corticosteroid injections and physical therapy techniques, such as therapeutic exercises, joint manual therapy and transcutaneous electrical nerve stimulation, can help reduce pain and improve function. Patient education programs and weight reduction for overweight patients are important to be considered. Conclusions Some inconsistencies in the recommendations and findings were found between the clinical guidelines and systematic reviews. However, it is likely that a combination of pharmacological and non-pharmacological treatments is most effective in treating patients with knee osteoarthritis. PMID:24899883

  8. Temperature measurement in practice with resistance thermometers and thermocouples; Temperaturmesspraxis mit Widerstandsthermometern und Thermoelementen

    Energy Technology Data Exchange (ETDEWEB)

    Irrgang, K.; Michalowsky, L (eds.)

    2004-07-01

    The book addresses students of science and engineering, engineers and practicians in research and industry who are interested in temperature measurements and thermal processes in the temperature range between a few K and over 3200 K. For the first time ever, temperature sensors are classified on the basis of heat transport and heat transfer to the sensor as related to the technological aspects of sensor stress. This includes physical and materials-related fundamentals, materials selection, sensor design and optimisation, error analysis, as well as the analysis of economically relevant applications of electrical temperature measurement in thermal processes. [German] Dieses Buch wendet sich an Studenten der Natur- und Technikwissenschaften, Ingenieure und Hochschulabsolventen in der Forschung und Industrie, die sich mit Temperaturmessungen und thermischen Prozessen im Temperaturbereich von wenigen Kelvin bis zu ueber 3200 K befassen. Der neue Titel wird sich gegenueber bekannten Standards auf diesem Gebiet dadurch auszeichnen, dass eine Klassifizierung der Temperaturfuehler abhaengig vom Waermetransport und den Waermeuebergaengen zum Sensor in Verbindung mit den technologischen Aspekten zu den konkreten Beanspruchungen der Fuehler in der Anwendung vorgenommen wird. Dieser hohe Anspruch schliesst physikalische und werkstoffwissenschaftliche Grundlagen zur Systemloesung, der Werkstoffauswahl, zur Auslegung und Optimierung des Fuehlerdesigns und der notwendigen Fehlerbetrachtung ebenso ein, wie die Analyse volkswirtschaftlich bedeutsamer Anwendungen der elektrischen Temperaturmesstechnik in thermischen Prozessen. (orig.)

  9. To Know or Not to Know: Ethical Issues Related to Early Diagnosis of Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Niklas Mattsson

    2010-01-01

    Full Text Available In Alzheimer's disease (AD, pathological processes start in the brain long before clinical dementia. Biomarkers reflecting brain alterations may therefore indicate disease at an early stage, enabling early diagnosis. This raises several ethical questions and the potential benefits of early diagnosis must be weighted against possible disadvantages. Currently, there are few strong arguments favouring early diagnosis, due to the lack of disease modifying therapy. Also, available diagnostic methods risk erroneous classifications, with potentially grave consequences. However, a possible benefit of early diagnosis even without disease modifying therapy is that it may enable early decision making when patients still have full decision competence, avoiding problems of hypothetical consents. It may also help identifying patients with cognitive dysfunction secondary to other diseases that may be responsive to treatment already today.

  10. Measurement of perfusion using the first-pass dynamic susceptibility-weighted contrast-enhanced (DSC) MRI in neurooncology. Physical basics and clinical applications; Perfusionsmessung mit der T2*-Kontrastmitteldynamik in der Neuroonkologie. Physikalische Grundlagen und klinische Anwendungen

    Energy Technology Data Exchange (ETDEWEB)

    Weber, M.-A.; Giesel, F.L.; Kauczor, H.-U.; Essig, M. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg (Germany). Abteilung Radiologie; Risse, F.; Schad, L.R. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg (Germany). Abteilung Medizinische Physik in der Radiologie

    2005-07-01

    Perfusion imaging in the central nervous system (CNS) is mostly performed using the first-pass dynamic susceptibility-weighted contrast-enhanced (DSC) MRI. The first-pass of a contrast bolus in brain tissue is monitored by a series of T2*-weighted MR images. The susceptibility effect of the paramagnetic contrast agent leads to a signal loss that can be converted, using the principles of the indicator dilution theory, into an increase of the contrast agent concentration. From these data, parameter maps of cerebral blood volume (CBV) and flow (CBF) can be derived. Regional CBF and CBV values can be obtained by region-of-interest analysis. This review article describes physical basics of DSC MRI and summarizes the literature of DSC MRI in neurooncological issues. Studies, all with relatively limited patient numbers, report that DSC MRI is useful in the preoperative diagnosis of gliomas, CNS-lymphomas, and solitary metastases, as well as in the differentiation of these neoplastic lesions from infections and tumor-like manifestations of demyelinating disease. Additionally, DSC MRI is suitable for determining glioma grade and regions of active tumor growth which should be the target of stereotactic biopsy. After therapy, DSC MRI helps better assessing the tumor response to therapy, residual tumor after therapy, and possible treatment failure and therapy-related complications, such as radiation necrosis. The preliminary results show that DSC MRI is a diagnostic tool depicting regional variations in microvasculature of normal and diseased brains. (orig.) [German] Die MRT-Perfusionsmessungen im Zentralnervensystem (ZNS) werden derzeit hauptsaechlich mit der kontrastmittelverstaerkten T2*-Dynamik durchgefuehrt, die die Passage eines schnellen Kontrastmittelbolus mit einer Serie von T2*-gewichteten MRT-Aufnahmen verfolgt und charakterisiert. Dabei wird der Signalabfall, bedingt durch den Suszeptibilitaetseffekt des paramagnetischen Kontrastmittels, mittels geeigneter

  11. Synthese und Charakterisierung wasserfreier Seltenerdmetall-Nitrate, -Acetate und -Oxyacetate

    OpenAIRE

    Heinrichs, Christina

    2013-01-01

    Durch thermische Entwässerung der Seltenerdmetall(SE)-Nitrat-Hydrate und der SE-Acetat-Hydrate im Argon-Strom/Vakuum konnten wasserfreie SE-Nitrate und SE-Nitrat-Monohydrate bzw. wasserfreie SE-Acetate erhalten werden. Es gelang zudem, SE-Oxyacetate durch thermische Zersetzung der SE-Acetate darzustellen. Des Weiteren wurde beim Erhitzen von Praseodym-Carbonat-Hydrat ein Pr-Carbonat-Hydroxid erhalten. Die Verbindungen wurden mittels Röntgenpulverdiffraktometrie und an ausgewählten Beispielen ...

  12. Fetal magnetic resonance imaging of thoracic and abdominal malformations; Fetale Magnetresonanztomographie thorakaler und abdomineller Malformationen

    Energy Technology Data Exchange (ETDEWEB)

    Woitek, R.; Asenbaum, U.; Furtner, J.; Prayer, D. [Medizinische Universitaet Wien, Abteilung fuer Neuroradiologie und Muskuloskelettale Radiologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Brugger, P.C. [Medizinische Universitaet Wien, Zentrum fuer Anatomie und Zellbiologie, Wien (Austria)

    2013-02-15

    Diagnosis and differential diagnosis of fetal thoracic and abdominal malformations. Ultrasound and magnetic resonance imaging (MRI). In cases of suspected pathologies based on fetal ultrasound MRI can be used for more detailed examinations and can be of assistance in the differential diagnostic process. Improved imaging of anatomical structures and of the composition of different tissues by the use of different MRI sequences. Fetal MRI has become a part of clinical routine in thoracic and abdominal malformations and is the basis for scientific research in this field. In cases of thoracic or abdominal malformations fetal MRI provides important information additional to ultrasound to improve diagnostic accuracy, prognostic evaluation and surgical planning. (orig.) [German] Diagnose und Differenzialdiagnose fetaler thorakaler und abdomineller Malformationen. Ultraschall, MRT. MRT zur weiteren Abklaerung und genaueren Differenzierung bei vielen im Ultraschall gestellten Verdachtsdiagnosen. Verbesserte anatomische Darstellung mittels MRT und Darstellung unterschiedlicher Gewebezusammensetzung mittels verschiedener MR-Sequenzen. Die fetale MRT ist bei der angegebenen Fragestellung in die klinische Routine eingegangen und liefert weiterhin die Basis fuer wissenschaftliche Untersuchungen in diesem Bereich. Die fetale MRT liefert beim Vorliegen thorakaler oder abdomineller Malformationen komplementaer zum Ultraschall wichtige Zusatzinformationen, um die diagnostische Genauigkeit zu erhoehen, die Prognoseabschaetzung zu verbessern und ggf. eine bessere chirurgische Planung zu ermoeglichen. (orig.)

  13. Clinical study of syringomyelia. Relation of neurological symptoms and imaging diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Ohga, Ritsu; Konishi, Yoshihiro; Higashi, Yasuto; Kawai, Kingo; Yasuda, Takeshi; Terao, Akira (Kawasaki Medical School, Kurashiki, Okayama (Japan))

    1988-12-01

    We discussed the relationship between neurological symptoms and the locations of syringes observed by CT and MRI (imaging diagnosis) in six cases of syringomyelia admitted to our department during the past five years. Neurological symptoms of the upper cervical and thoracic cords were found in six cases and five cases of them had symmetric distribution. Syringes were found in all cases by delayed CT (D-CT) and MRI. Five cases had laterality. The sites in the spinal cord exhibiting severe involvement of neurological symptoms corresponded with the sites of syringes in imaging diagnosis. The main asymmetric lesions of the syringes were located in the posterior horn. They indicated the relationship with the appearance of the neurological symptoms of the lesion. We compared with the width of the longitudinal level from neurological findings and imaging diagnosis. The rostral level of both corresponded in all cases, but the caudal level corresponded in only one case and neurological symptoms were broader than syringes in imaging diagnosis. It was difficult to identify small syringes when there was complicated scoliosis. The diagnosis of typical cases of syringomyelia is mainly based on such neurological symptoms as a bilateral segmental pattern of dissociated sensory impairment in the past, but imaging diagnosis has recently come to be regarded as very important. (J.P.N.).

  14. Effects of diagnosis-related group payment system on appendectomy outcomes.

    Science.gov (United States)

    Kim, Tae Hyun; Park, Eun-Cheol; Jang, Sung-In; Jang, Suk-Yong; Lee, Sang Ah; Choi, Jae Woo

    2016-12-01

    The voluntary diagnosis-related group (DRG) payment system was introduced in 2002. Since July 2013, the Korean government has mandated DRG participation for all hospitals. The main purpose of this study was to examine the effects of mandatory DRG participation on various outcome metrics for appendectomy patients. We collected inpatient DRG data for 280,062 appendectomy patients between 2007 and 2014 using the Health Insurance Review and Assessment database. We examined patient outcome metrics such as length of stay (LOS), total medical cost, spillover, and readmission rate, according to hospital size. As a result of DRG participation, the average LOS for patients decreased (adjusted ratio: 0.83 [large hospitals], 0.83 [small hospitals]; 95% confidence interval [CI]: 0.82-0.84, 0.82-0.84), the total medical costs of patients increased (adjusted ratio: 1.23 [large hospitals], 1.35 [small hospitals]; 95% CI: 1.22-1.24, 1.34-1.36), the spillover of patients increased (adjusted ratio: 2.10 [large hospitals], 2.30 [small hospitals]; 95% CI: 2.03-2.18, 2.16-2.45), and the readmission rates of appendectomy patients decreased (adjusted ratio: 0.85 [large hospitals], 0.49 [small hospitals]; 95% CI: 0.77-0.94, 0.42-0.57). The mandatory implementation of the DRG payment system in South Korea has led to significant reductions in LOS and readmission rates for appendectomy patients. However, any resulting expansion of outpatient services may result in unnecessary resource usage rather than improving medical quality. Policy makers should consider the various implications reflected by these results when considering DRGs for other diseases. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Childbirth and Diagnosis Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

    Science.gov (United States)

    Bellanger, Martine M; Quentin, Wilm; Tan, Siok Swan

    2013-05-01

    The study compares how Diagnosis-Related Group (DRG) based hospital payment systems in eleven European countries (Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) deal with women giving birth in hospitals. It aims to assist gynaecologists and national authorities in optimizing their DRG systems. National or regional databases were used to identify childbirth cases. DRG grouping algorithms and indicators of resource consumption were compared for those DRGs which account for at least 1% of all childbirth cases in the respective database. Five standardized case vignettes were defined and quasi prices (i.e. administrative prices or tariffs) of hospital deliveries according to national DRG-based hospital payment systems were ascertained. European DRG systems classify childbirth cases according to different sets of variables (between one and eight variables) into diverging numbers of DRGs (between three and eight DRGs). The most complex DRG is valued 3.5 times more resource intensive than an index case in Ireland but only 1.1 times more resource intensive than an index case in The Netherlands. Comparisons of quasi prices for the vignettes show that hypothetical payments for the most complex case amount to only € 479 in Poland but to € 5532 in Ireland. Differences in the classification of hospital childbirth cases into DRGs raise concerns whether European systems rely on the most appropriate classification variables. Physicians, hospitals and national DRG authorities should consider how other countries' DRG systems classify cases to optimize their system and to ensure fair and appropriate reimbursement. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. Editorial: Informationstechnische Bildung und Medienerziehung

    Directory of Open Access Journals (Sweden)

    Annemarie Hauf-Tulodziecki

    2001-10-01

    Full Text Available Die schulische Medienerziehung bzw. die Medienbildung hat ihre derzeit hohe öffentliche Aufmerksamkeit nicht zuletzt der Tatsache zu verdanken, dass gerade die so genannten «Neuen Medien» - heute oft mit den Schlagworten «Multimedia» oder «Internet» abgekürzt - wichtige Erziehungs- und Bildungsmassnahmen erforderlich machen. In der öffentlichen Diskussion gehören inhaltliche Kurzschlüsse zur Tagesordnung: Wenn von «Medienkompetenz» die Rede ist, verbirgt sich dahinter häufig nur ein «Internetführerschein». Diese Beobachtung ärgert nicht nur Medienpädagogen, sondern auch Vertreter einer Informationstechnischen Bildung (1, da berechtigte pädagogische Ansprüche beider Gruppen wenig Beachtung finden. Mittlerweile gibt es eine Reihe von Empfehlungen von BLK und KMK zu diesem Thema, in denen zudem deutlich auf die wechselseitigen Bezüge hingewiesen werden. Die wachsende Bedeutung des Mediums Computer und die weiter zunehmende Digitalisierung traditioneller Medien erfordert sowohl für die Medienerziehung als auch für die Informatische Bildung eine Weiterentwicklung ihrer Ziele und Inhalte. Die Gesellschaft für Informatik e.V. hat 1999 in ihrer Empfehlung «Informatische Bildung und Medienerziehung» aus ihrer Perspektive dargestellt, welche Aufgaben auf die Medienerziehung zukommen, wenn auch die Informations- und Kommunikationstechnologien bzw. die computerbasierten Medien in einer angemessenen Form thematisiert werden sollen. Erste praktische Ansätze, Inhalte aus beiden Bereichen bewusst zusammenzuführen, auch unter einer gemeinsamen Fach- oder Kursbezeichnung, sind häufig additiv und orientieren sich – trotz vorhandener Überschneidungen – an den etablierten medienpädagogischen oder an den informatischen Unterrichtsprinzipien. In dem vorliegenden Themenheft wird aus einer übergeordneten, medienpädagogischen Perspektive die Frage gestellt, wie eine konsistente Weiterentwicklung der Medienerziehung unter angemessener

  17. A standardized CT/HRCT classification for occupational and environmental lung diseases of the German Federal Republic; Standardisierte CT/HRCT-Klassifikation der Bundesrepublik Deutschland fuer arbeits- und umweltbedingte Thoraxerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Hering, K.G. [Radiologische Klinik, Knappschaftskrankenhaus Dortmund (Germany); Tuengerthal, S. [Roentgenabteilung, Thoraxklinik Heidelberg (Germany); Kraus, T. [Institut fuer Arbeitsmedizin, Universitaetsklinikum Aachen (Germany)

    2004-05-01

    High resolution computed tomography (HRCT) plays an indispensable role in the diagnosis of pneumoconiosis and other lung damage arising from inhalation. Till now, however, there has been no agreed standardized convention for the use of the technique, or for documenting results uniformly. A task-group on Diagnostic Radiology in Occupational and Environmental Diseases of the German Radiological Society has produced a coding sheet based on experience gained in production of consultants' clinical reports, experts' examinations of patients seeking compensation for occupational lung disease, and physicians' professional development courses. The coding sheet has been used in a national multicenter study. It has been further developed and tested by an international working group comprising experts from Belgium (P.A. Gevenois), Germany (K.G. Hering, T. Kraus, S. Tuengerthal), Finland (L. Kivisaari, T. Vehmas), France (M. Letourneux), Great Britain (M.D. Crane), Japan (H. Arikawa, Y. Kusaka, N. Suganuma), and the USA (J. Parker). The intention is to standardize documentation of computertomographic findings in occupationally and environmentally related lung and pleural changes, and to facilitate international comparisons of results. Such comparisons were found to be achievable reproducibly with the help of CT/HRCT reference films. The classification scheme is purely descriptive (rather than diagnostic), so that all aspects of occupationally and environmentally related parenchymal and pleural abnormalities may be recorded. Although some of the descriptive terms used are associated with pneumoconiosis (e.g., rounded opacities in silicosis, or, in asbestosis, interlobular septal and intralobular non-septal lines, as well as honeycombing) many overlapping patterns that need to be considered for differential diagnosis are also included in the scheme. (orig.) [German] Die hochaufloesende Computertomographie (HRCT, ''high resolution CT'') ist ein

  18. Recognize and classify pneumoconiosis; Pneumokoniosen erkennen und klassifizieren

    Energy Technology Data Exchange (ETDEWEB)

    Hering, K.G.; Hofmann-Preiss, K. [Klinikum Westfalen, Knappschaftskrankenhaus, Dortmund (Germany)

    2014-12-15

    In the year 2012, out of the 10 most frequently recognized occupational diseases 6 were forms of pneumoconiosis. With respect to healthcare and economic aspects, silicosis and asbestos-associated diseases are of foremost importance. The latter are to be found everywhere and are not restricted to large industrial areas. Radiology has a central role in the diagnosis and evaluation of occupational lung disorders. In cases of known exposure mainly to asbestos and quartz, the diagnosis of pneumoconiosis, with few exceptions will be established primarily by the radiological findings. As these disorders are asymptomatic for a long time they are quite often detected as incidental findings in examinations for other reasons. Therefore, radiologists have to be familiar with the pattern of findings of the most frequent forms of pneumoconiosis and the differential diagnoses. For reasons of equal treatment of the insured a quality-based, standardized performance, documentation and evaluation of radiological examinations is required in preventive procedures and evaluations. Above all, a standardized low-dose protocol has to be used in computed tomography (CT) examinations, although individualized concerning the dose, in order to keep radiation exposure as low as possible for the patient. The International Labour Office (ILO) classification for the coding of chest X-rays and the international classification of occupational and environmental respiratory diseases (ICOERD) classification used since 2004 for CT examinations meet the requirements of the insured and the occupational insurance associations as a means of reproducible and comparable data for decision-making. (orig.) [German] Im Jahr 2012 waren 6 der 10 am haeufigsten anerkannten Berufskrankheiten Pneumokoniosen. Gesundheitspolitisch und oekonomisch stehen dabei die Silikose und asbestassoziierte Erkrankungen im Vordergrund. Insbesondere Letztere treten ubiquitaer auf und sind nicht an grosse Industriestandorte gebunden

  19. Possible use of wild-living rats (Rattus norvegicus) as bioindicators for heavy metal pollution. Part I. Sex and age-related quantification of Al, As, Cd, Co, Cu, Mn, Ni, Pb, Sr, Ti, Tl and Zn in liver, heart, lung, kidney, muscle, brain and bones, and the establishment of distribution patterns; Untersuchungen zur Eignung wildlebender Wanderratten (Rattus norvegicus) als Indikatoren der Schwermetallbelastung. T. I. Alters- und geschlechtsspezifische Quantifizierung der Verteilung von Al, As, Cd, Co, Cu, Mn, Ni, Pb, Sr, Ti, Tl und Zn in den Organen Herz, Leber, Lunge, Niere, Muskulatur, Gehirn und Knochen

    Energy Technology Data Exchange (ETDEWEB)

    Wuenschmann, S. [Internationales Hochschulinstitut Zittau (Germany). Lehrstuhl fuer Umweltverfahrenstechnik; Hochschule fuer Technik, Wirtschaft und Sozialwesen Zittau/Goerlitz (FH), Zittau (Germany). Fachbereich Mathematik/Naturwissenschaften; Oehlmann, J. [J. W. Goethe-Univ. Frankfurt, Zoologisches Inst., Frankfurt/M. (Germany); Delakowitz, B. [Hochschule fuer Technik, Wirtschaft und Sozialwesen Zittau/Goerlitz (FH), Zittau (Germany). Fachbereich Mathematik/Naturwissenschaften; Markert, B. [Internationales Hochschulinstitut Zittau (Germany). Lehrstuhl fuer Umweltverfahrenstechnik

    2001-07-01

    The objective of the current attempt was to investigate the suitability of wild-living rats (Rattus norvegicus) as a passive bioindicator using quantitative determinations of 12 chemical elements in different organs taken from rats which were caught in the Zoological Garden of Zittau. Aside from the determinations of so-called background levels, the focus of interest was with accumulations of certain elements within the organs depending on either sex or age of the rats. There were different affinities of the elements towards certain organs. Because of apparent sex and age-related differences in element concentrations and accumulation features, a well-planned sampling strategy for the use of rats as possible passive bioindicators is indeed required. The consideration of element distribution patterns within the organ system of Rattus norvegicus (based on body burden calculations (in part 2 of this work)) allows an effective use of the rat for purposes of integrative monitoring. (orig.) [German] Durch die Quantifizierung von 12 chemischen Elementen im Organsystem von wildlebenden Ratten (Rattus norvegicus) aus dem Tierpark Zittau (Sachsen) sollte die Eignung dieser Spezies als passiver Bioindikator untersucht werden. Neben der Ermittlung von sogenannten Hintergrundkonzentrationen standen insbesondere Fragen zur geschlechts- und altersspezifischen Akkumulation einzelner Elemente im Organsystem von Rattus norvegicus im Vordergrund. Spezifisch zeigten dabei einzelne Elemente unterschiedliche Affinitaeten zu den entsprechenden Geweben und Organen. Insbesondere die hierbei ermittelten geschlechts- und altersspezifischen Charakteristika einzelner Elemente macht eine detaillierte Ausarbeitung einer Beprobungsstrategie fuer den spaeteren Einsatz als passiver Bioindikator zwingend. Unter Beruecksichtigung des durch die Berechnung des Body Burden (Koerperlast) im 2. Teil der Arbeit ermittelten typischen Verteilungsmusters einzelner Elemente ist Rattus norvegicus zum

  20. Employment status and work-related problems of gastrointestinal cancer patients at diagnosis: a cross-sectional study

    NARCIS (Netherlands)

    de Boer, A. G. E. M.; Bruinvels, D. J.; Tytgat, K. M. A. J.; Schoorlemmer, A.; Klinkenbijl, J. H. G.; Frings-Dresen, M. H. W.

    2011-01-01

    Objective To assess the employment status of patients with gastrointestinal cancer at diagnosis and to examine work-related problems of employed patients. Design New, consecutive patients were included at the Gastrointestinal Oncology Center Amsterdam, a one-stop, rapid access diagnostic assessment

  1. Abdominal polytrauma and parenchymal organs; Abdominelles Polytrauma und Parenchymorgane

    Energy Technology Data Exchange (ETDEWEB)

    Krestan, C.R. [Medizinische Universitaet Wien AKH, Abteilung fuer Allgemeine Radiologie und Kinderradiologie, Klinik fuer Radiologie und Nuklearmedizin, Wien (Austria)

    2014-09-15

    The acute radiological diagnostics of polytrauma patients has become an essential part of the interdisciplinary treatment in the emergency room. The incidence of polytrauma patients with an injury severity score (ISS) > 16 is approximately 450 cases/million inhabitants/year in Europe. Injuries of the parenchymal organs are of utmost importance for the prognosis and treatment of these patients. The injury patterns are complex and a great deal of experience is necessary to be able to obtain the correct diagnosis within minutes. This review article deals with the radiological diagnostics and grading of the severity of injuries to the spleen, liver, pancreas and kidneys. The use of ultrasound for the evaluation of polytraumatized patients will be discussed. The most important trauma-associated findings for the above mentioned organs using multidetector computed tomography (MDCT) will be described and illustrated by dedicated case findings. Ultrasound contrast agents can supply valuable, additional diagnostic information in the evaluation of polytraumatized patients. Computed tomography has become established as the most relevant imaging modality in severe trauma. Innovative organ-adapted and contrast application protocols improve the diagnostic performance of MDCT. The use of focused assessment sonography for trauma (FAST) scanning as a screening tool is in agreement with the other clinical disciplines of the trauma team. The use of MDCT is trauma-dependent and the classification of the severity of the different parenchymal organ injuries is ultimately decisive for further treatment and prognosis of trauma victims. (orig.) [German] Die akute radiologische Diagnostik bei Polytraumapatienten ist in den letzten Jahren unerlaesslicher Bestandteil der interdisziplinaeren Versorgung im Schockraum geworden. Die Inzidenz von Polytraumata mit einem Injury Severity Score (ISS) > 16 betraegt in Europa ca. 450/Mio. Einwohner/Jahr. Verletzungen abdomineller Parenchymorgane sind von

  2. Security and supervision in the telecommunications sector; Sicherheit und Ueberwachung in der Telekommunikation

    Energy Technology Data Exchange (ETDEWEB)

    Fiebig, T.H. [HanseNet Telekommunikation GmbH, Hamburg (Germany)

    1998-03-09

    The contribution summarizes and interprets the laws and regulatory provisions relating to the telecommunications sector in Germany and intended to warrant security and surveillance of installations and services, addressing both technical aspects and legal requirements, which might become of interest in connection with transmission services that might be offered in future by electric power network operators, as a possible, new operational area and expansion of scope of services. (CB) [Deutsch] Der Beitrag gibt eine zusammenfassende und interpretierende Uebersicht ueber die derzeit gueltigen Gesetze und untergeordneten Regelungen, die Sicherheit und Ueberwachungskompetenzen im Telekommunikations-Sektor in Deutschland gewaehrleisten sollen. Es geht um technische Schutzmassnahmen und rechtliche Sicherheitsanforderungen, die im Hinblick auf zur Zeit diskutierte und moegliche kuenftige Dienstleistungen in diesem Bereich seitens der Betreiber von Netzen fuer die Stromuebertragung von Interesse sein koennen. (CB)

  3. GROSSSPRENGUN UND MIKROSEISMIK

    Directory of Open Access Journals (Sweden)

    E. HARDTWIG

    1956-06-01

    Full Text Available Uéber die bei Sprengungen entstelienden Periodenspektren ist noch
    wenig bekannt, trotzdem in jedem Jahre Tausende von Sprengungen
    registriert werden. Die wenigen Arbeiten, die zu diesem Gegenstand erscliienen
    sind, stellen nur erste Versuche dar, den Aufbau der Spektren
    zu erklaren. Wàhrend etwa George Morris (* vorwiegend die bei
    Sprengungen si eh abspielenden Detonationsvorgànge zum Ausgangspunkt
    der Untersuchung macht, ist es bei IT. Menzel (2 die Interferenz von
    Primàrwelle und reflektierter Welle, deren Einfluss auf die Gestalt
    des Spektrums untersucht wird.

  4. Imaging in smoldering (asymptomatic) multiple myeloma. Past, present and future; Bildgebung bei ''smoldering'' (asymptomatischem) multiplem Myelom. Vergangenheit, Gegenwart und Zukunft

    Energy Technology Data Exchange (ETDEWEB)

    Bhutani, M.; Landgren, O. [Center for Cancer Research, National Cancer Institute, National Institutes of Health, Multiple Myeloma Section, Lymphoid Malignancies Branch, Bethesda, MD (United States)

    2014-06-15

    Emerging clinical trial data support treatment of high-risk smoldering multiple myeloma (SMM) upon diagnosis, and not only at the time of progression to symptomatic complications (multiple myeloma). Early detection of bone and/or bone marrow involvement by sensitive imaging modalities may help define SMM patients at a high risk of progression. Current (2011) consensus guidelines recognize skeletal survey as a cornerstone modality for assessment of bone involvement at initial diagnosis and during follow-up of SMM. Skeletal survey has severe limitations related to underdetection of bone lesions and also provides no information on bone marrow abnormalities. Modern imaging strategies such as fluorodeoxyglucose positron-emission tomography/CT (FDG PET/CT) and MRI, in conjunction with functional innovations, provide improved estimates of global abnormalities in the bone marrow and bone compartments. These methods have the potential to objectively quantify early transformation from SMM to multiple myeloma. Although frequently used for staging and risk prognostication in multiple myeloma, modern imaging techniques have only been evaluated to a limited extent in SMM. Scant data in SMM indicate the prognostic value of two or more MRI-detected focal bone marrow abnormalities, which, if present, predict rapid progression to multiple myeloma. Data evaluating the role of FDG PET/CT in detecting early bone marrow abnormalities as an aid to predicting risk or directing treatment in SMM is currently lacking. The superior specificity and sensitivity of modern imaging techniques compared to skeletal survey suggest that these should have a place in standard practice management of patients at a high risk of SMM progression. The model imaging of the future should be an all-in-one strategy offering high diagnostic performance for bone marrow abnormalities and low-volume bone lesions, as well as allowing monitoring by minimizing radiation exposure and the need for contrast agents. Newer

  5. Knee and ankle injuries from playing football; Knie- und Sprunggelenkverletzungen beim Fussballspiel

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, J.; Scheurecker, G. [Roentgeninstitut am Schillerpark, Linz (Austria)

    2010-05-15

    Soccer is the most common sport activity worldwide. Over the last two decades the increase in soccer players has mainly been due to increased interest by females. In general, soccer is a relatively safe sport activity, especially if minor injuries resulting in short periods of absence from playing or training are neglected. However, due to the high number of soccer players severe injuries are also frequent. These are a problem not only for the injured player and the team but may also become problematic for the socio-economic system. In up to 80-90% structures of the lower extremities are injured. For sufficient radiological diagnosis knowledge of the biomechanics of the soccer game and some details about the history of the injury may be of help. To prevent soccer injuries or keep the degree of injury low, special programs had been developed. (orig.) [German] Fussball ist die weltweit am meisten verbreitete Sportart. Der Zuwachs an Fussballspieler(innen) in den letzten beiden Jahrzehnten wird jedoch hauptsaechlich auf das verstaerkte Interesse an weiblichen Spielern zurueckgefuehrt. Das Fussballspiel gilt grundsaetzlich, insbesondere wenn man geringfuegige Verletzungen, die keine therapeutischen Massnahmen notwendig machen, sondern lediglich eine kurzfristige Trainings- oder Spielpause bedingen, als eine relativ sichere Sportart. Auf Grund der Vielzahl an SpielerInnen kommt es allerdings doch zu einer betraechtlichen Anzahl durchaus sehr schwerer Verletzungen. Diese Tatsache stellt ein Problem fuer Spieler und Team dar und mag moeglicherweise auch fuer das soziooekonomische System problematisch werden. Von Verletzungen sind v. a. auf Grund der Natur des Spieles die unteren Extremitaeten betroffen. Zur Durchfuehrung einer suffizienten radiologischen Diagnostik sind Kenntnisse der moeglichen Verletzungsmechanismen und eine Anamneseerhebung von nicht zu unterschaetzendem Wert. Um jedoch derartige Laesionen zu vermeiden bzw. gering zu halten, wurde ueber die Jahre

  6. Pitfalls in diagnostic imaging and assessment of benign asbestos-related thoracic diseases; Fallstricke in der radiologischen Diagnostik und Begutachtung der benignen asbestbedingten Erkrankungen des Thorax

    Energy Technology Data Exchange (ETDEWEB)

    Rehbock, B. [Praxis fuer Diagnostische Radiologie am St.-Hedwig-Krankenhaus Berlin-Mitte, Berlin (Germany). Diagnostische Radiologie; Hofmann-Preiss, K. [Radiologische Gemeinschaftspraxis Erlangen (Germany). Radiologische Diagnostik; Kraus, T. [Universitaetsklinikum der RWTH Aachen (Germany). Inst. fuer Arbeits- und Sozialmedizin

    2012-05-15

    The recognition of asbestos-related diseases of the lung and/or pleura as an occupational disease is of psychosocial, medical and legal importance to the insured person. Radiological imaging is an essential part of the assessment and requires an increasingly high level of competence in the field of radiological diagnosis of pneumoconiosis in interdisciplinary collaboration with occupational medicine and pneumonology. The chest radiogram remains an integral part of basic diagnostic procedures in asbestos-related diseases of the lungs and/or pleura. Its importance lies in the detection of extended pleural changes as well as substantial fibrosis. The inherent low sensitivity and specificity of projection radiography is taken into account by the increasing use of multi-slice high resolution (HR) CT (in low dose technique). Radiological pitfalls in pleural plaque assessment with respect to plain chest X-ray concern all structures that superimpose on the pleural circumference, particularly the anatomical layers of the chest wall (extra-pleural fatty tissue, muscles, thoracic skeleton) as well as other pulmonary findings that can only be reliably assigned using CT. Even if state-of the-art CT is applied, asymmetries and abnormal expression of anatomical structures and variants (e.g. muscles and blood vessels) can lead to false-positive findings. The interstitial fibrosis of asbestosis, manifested as usual interstitial pneumonia (UIP) is non-pathognomonic for asbestosis. Therefore, parietal pleural thickening as a coincident finding to UIP is considered as being the main feature and a highly suggestive indicator of asbestosis in patients with a history of asbestos exposure. (orig.)

  7. Outsourcing. Effects of employment and working relations on the example of mining and energy industries in East Germany; Outsourcing. Effekte auf Beschaeftigung und Arbeitsbeziehungen am Beispiel der Bergbau- und Energiewirtschaft in Ostdeutschland

    Energy Technology Data Exchange (ETDEWEB)

    Bleicher, Andre; Fischer, Joachim; Gensior, Sabine; Steiner, Roald

    2011-07-01

    The authors of the contribution report on the progress and understanding of outsourcing in the Lusatian mining and energy industries in the period from 1991 to 2002. The main themes of this contribution are: (a) The impact of outsourcing on employment and working relations; (b) Conditions and process of outsourcing in East German mining and energy industries; (c) Employment effects of outsourcing in the outsourcing and outsourced companies; (d) Business relationships and networking between outsourcing focal companies and companies to be outsourced: Towards a new industrial middle class in the region; (e) Effects of outsourcing on working relations: opportunities to act of the employee representatives in outsourcing and outsourced companies; (f) outsourcing in East German mining and energy sectors: A model for the West German companies?.

  8. Enterprise Portals und Enterprise Application Integration - Begriffsbestimmung und Integrationskonzeptionen

    OpenAIRE

    Schelp, Joachim; Winter, Robert

    2002-01-01

    Unter den Stichworten »Enterprise Portals« und »Enterprise Application Integration« werden neue Herausforderungen an die Applikationsarchitektur der Unternehmungen gestellt. Bei beiden spielt die Integration vorhandener und das Einfügen neuer Applikationen eine große Rolle. Beiden Themen ist gemein, dass sie die Diskussion bestimmter technischer Konzepte aus den vergangenen Jahren fortsetzen: Portale stellen das moderne Frontend dar, über das die verschiedenen E-Business-Konzepte umgesetzt we...

  9. Fluchen und Flamen, um ein Mann zu sein? Die Verknüpfung von Geschlecht und Sprache durch Vorurteile The Manliness of Swearing and Flaming-On The Role of Stereoptypes in Research on Gender and Language

    Directory of Open Access Journals (Sweden)

    Nicola Döring

    2001-11-01

    Full Text Available Die hier besprochene Monographie der Linguistin Anja Gottburgsen beschäftigt sich theoretisch und empirisch mit sprachbezogenen Geschlechterstereotypen, also mit unseren Vorstellungen darüber, ob und wie Männer und Frauen jeweils in spezifischer und distinkter Weise sprachlich kommunizieren. Im Theorieteil der Arbeit wird der aktuelle Stand der soziolinguistischen und sozialpsychologischen Diskussion zu Geschlecht, Sprachverhalten und Stereotypisierung kritisch referiert und die Bedeutung von sprachbezogenen Geschlechterstereotypen erläutert. Im empirischen Teil berichtet die Autorin die Ergebnisse von drei Fragebogen-Studien mit deutschsprachigen Studierenden. Es zeigt sich, dass bei Studierenden unabhängig von Geschlecht und Geschlechtsrollenorientierung stereotype Vorstellungen über das sprachliche Verhalten von Männern und Frauen verbreitet sind.Linguist Gottburgsen presents both a theoretical and empirical analysis of speech-related gender stereotypes -of common ideas about “male” and “female” ways of speaking. Gottburgsen takes a critical look at current socio-linguistic and social-psychological literature on gender, language behaviour and stereotyping and explains the meaningof language-related gender stereotypes. She furthermore presents the results of three survey studies of German-speaking university students. According to these studies, university students, regardless of sex and of their ideas about gender roles, continue to have quite stereotypical views on “gender-appropriate” language behaviour.

  10. The relative contribution of patient, provider and organizational influences to the appropriate diagnosis and management of diabetes mellitus.

    Science.gov (United States)

    Marceau, Lisa; McKinlay, John; Shackelton, Rebecca; Link, Carol

    2011-12-01

    To estimate the relative contribution of patient attributes, provider characteristics and organizational features of the doctors' workplace to the diagnosis and management of diabetes. In a factorial experimental design doctors (n = 192) viewed clinically authentic vignettes of 'patients' presenting with identical signs and symptoms. Doctor subjects were primary care doctors stratified according to gender and level of experience. During an in-person interview scheduled between real patients, doctors were asked how they would diagnosis and manage the vignette 'patients' in clinical practice. This study considered the relative contribution of patient, doctor and organizational factors. Taken together patient attributes explained only 4.4% of the variability in diabetes diagnosis. Doctor factors explained only 2.0%. The vast majority of the explained variance in diabetes diagnosis was due to organizational factors (14.3%). Relative contributions combined (patient, provider, organizational factors) explained only 20% of the total variance. Attempts to reduce health care variations usually focus on the education/activation of patients, or increased training of doctors. Our findings suggest that shifting quality improvement efforts to the area which contributes most to the creation and amplification of variations (organizational influences) may produce better results in terms of reduced variations in health care associated with diabetes. © 2010 Blackwell Publishing Ltd.

  11. IgG4-related disease: with emphasis on the biopsy diagnosis of autoimmune pancreatitis and sclerosing cholangitis.

    Science.gov (United States)

    Detlefsen, Sönke; Klöppel, Günter

    2018-04-01

    In 2011, chronic fibroinflammatory processes occurring simultaneously or metachronously in various organs and associated with elevated IgG4 serum levels and/or tissue infiltration with IgG4-positive plasma cells have been recognized as manifestations of a systemic disorder called IgG4-related disease (IgG4-RD). The histologic key findings are lymphoplasmacytic infiltration rich in IgG4-positive plasma cells combined with storiform fibrosis and obliterative phlebitis. Among the organs mainly affected by IgG4-RD are the pancreas and the extrahepatic bile ducts. The pancreatic and biliary alterations have been described under the terms autoimmune pancreatitis (AIP) and sclerosing cholangitis, respectively. These diseases are currently more precisely called IgG4-related pancreatitis (or type 1 AIP to distinguish it from type 2 AIP that is unrelated to IgG4-RD) and IgG4-related sclerosing cholangitis (IgG4-related SC). Clinically and grossly, both diseases commonly imitate pancreatic and biliary adenocarcinoma, tumors that are well known for their dismal prognosis. As IgG4-RD responds to steroid treatment, making a resection of a suspected tumor unnecessary, a biopsy is often required to establish the preoperative diagnosis. This review discusses the morphologic spectrum of IgG4-related pancreatitis and IgG4-related SC and focuses on the biopsy relevant histologic features for the diagnosis and differential diagnosis of these diseases.

  12. Hospitalisations for pelvic inflammatory disease temporally related to a diagnosis of Chlamydia or gonorrhoea: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Joanne Reekie

    Full Text Available The presence and severity of pelvic inflammatory disease (PID symptoms are thought to vary by microbiological etiology but there is limited empirical evidence. We sought to estimate and compare the rates of hospitalisation for PID temporally related to diagnoses of gonorrhoea and chlamydia.All women, aged 15-45 years in the Australian state of New South Wales (NSW, with a diagnosis of chlamydia or gonorrhoea between 01/07/2000 and 31/12/2008 were followed by record linkage for up to one year after their chlamydia or gonorrhoea diagnosis for hospitalisations for PID. Standardised incidence ratios compared the incidence of PID hospitalisations to the age-equivalent NSW population.A total of 38,193 women had a chlamydia diagnosis, of which 483 were hospitalised for PID; incidence rate (IR 13.9 per 1000 person-years of follow-up (PYFU (95%CI 12.6-15.1. In contrast, 1015 had a gonorrhoea diagnosis, of which 45 were hospitalised for PID (IR 50.8 per 1000 PYFU, 95%CI 36.0-65.6. The annual incidence of PID hospitalisation temporally related to a chlamydia or gonorrhoea diagnosis was 27.0 (95%CI 24.4-29.8 and 96.6 (95%CI 64.7-138.8 times greater, respectively, than the age-equivalent NSW female population. Younger age, socio-economic disadvantage, having a diagnosis prior to 2005 and having a prior birth were also associated with being hospitalised for PID.Chlamydia and gonorrhoea are both associated with large increases in the risk of PID hospitalisation. Our data suggest the risk of PID hospitalisation is much higher for gonorrhoea than chlamydia; however, further research is needed to confirm this finding.

  13. Cyberbullying und Empathie : affektive, kognitive und medienbasierte Empathie im Kontext von Cyberbullying im Kindes- und Jugendalter

    OpenAIRE

    Pfetsch, Jan; Müller, Christin R.; Ittel, Angela

    2014-01-01

    "Bei medial vermittelter Kommunikation sinkt sowohl die Hemmschwelle für aggressive Verhaltensweisen wie Cyberbullying als auch die Wahrscheinlichkeit empathischer Reaktionen. Im Fokus der vorliegenden Studie mit 979 Schülerinnen und Schülern der 4.-8. Klassen (M=12.01, SD=1.68 Jahre, 55% weiblich) stand die Frage, ob Cyberbullies geringere Ausprägungen für affektive, kognitive und medienbasierte Empathie aufweisen als Unbeteiligte. Empathie wurde im Selbst- und Peerbericht erhoben. Hypothese...

  14. Imaging of demyelinating and neoplastic diseases of the spinal cord; Bildgebung bei demyelinisierenden und tumoroesen Erkrankungen des Rueckenmarks

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Mang, C. [Institut fuer CT und MRT Gaenserndorf, Gaenserndorf (Austria)

    2010-12-15

    The clinical symptoms of myelopathy are variable and non-specific. Demyelinating as well as neoplastic spinal cord diseases can cause paresthesia, progressive sensomotoric deficits and bowel and bladder dysfunction. Imaging of the spine, especially with magnetic resonance imaging (MRI), is an essential component in the diagnostic assessment of myelopathy and makes a substantial contribution to achieving the correct diagnosis. Although intramedullary neoplasms are far less common than demyelinating spinal cord diseases, radiologists should be familiar with the three most common entities, astrocytoma, ependymoma and hemangioblastoma, which represent over 70% of all spinal cord neoplasms. An early diagnosis and therapy is essential with neoplastic and demyelinating spinal cord diseases to hold residual neurological deficits as low as possible. (orig.) [German] Die klinische Symptomatik von Myelopathien ist aeusserst variabel und unspezifisch. Sowohl demyelinisierende als auch tumoroese Rueckenmarkerkrankungen koennen Paraesthesien, progrediente sensomotorische Ausfaelle und eine Sphinkterdysfunktion hervorrufen. Bildgebende Untersuchungen, und hier allen voran die MRT, sind ein unerlaesslicher Bestandteil zur Abklaerung von Myelopathien und tragen wesentlich zur korrekten Diagnose bei. Intramedullaere Tumoren sind zwar weitaus seltener als demyelinisierende Rueckenmarkerkrankungen, dennoch sollte der Radiologe mit den Bildmerkmalen der 3 haeufigsten Tumorarten, dem Astrozytom, Ependymom und Haemangioblastom vertraut sein, die ueber 70% aller Rueckenmarktumoren verursachen. Eine moeglichst fruehe Diagnostik und Therapie sind bei tumoroesen und demyelinisierenden Rueckenmarkerkrankungen essenziell, um bleibende neurologische Defizite moeglichst gering zu halten. (orig.)

  15. Scoping review of nursing-related dissemination and implementation research in German-speaking countries: Mapping the field / Scoping Review zum Stand der pflegebezogenen Disseminations- und Implementierungsforschung in deutschsprachigen Ländern: eine Bestandsaufnahme

    Directory of Open Access Journals (Sweden)

    Hoben Matthias

    2014-12-01

    Full Text Available Evidenzbasierte Innovationen in die Pflegepraxis zu implementieren, ist eine Herausforderung. International steht ein wachsender Fundus an Arbeiten der Disseminations- und Implementierungsforschung (DI-Forschung zur Verfügung, die versuchen, DI-Prozesse besser zu verstehen, zu optimieren und damit die Versorgungsqualität zu verbessern. Über die Zahl und den Fokus von DI-Forschungsarbeiten in deutschsprachigen Pflegesettings ist hingegen wenig bekannt. Dieses scoping Review untersucht daher diesen Forschungsstand, diskutiert diesen vor dem Hintergrund der internationalen DI-Forschung und gibt Empfehlungen für künftige Forschungsaktivitäten. Durchsucht wurden internationale Datenbanken (Web of Knowledge einschließlich Medline, CINAHL PsycInfo und GeroLit, sechs deutschsprachige Pflegezeitschriften sowie die Literaturlisten der eingeschlossenen Quellen. Insgesamt wurden 186 Publikationen eingeschlossen, die 140 Forschungsprojekte repräsentierten. Die Studienqualität wurde mittels fünfinternational bewährter Checklisten eingeschätzt. Die Qualität der Studien war tendenziell gering. 94 Forschungsprojekte evaluierten DI-Strategien, 67 erforschten Einflussfaktoren auf DI-Prozesse, 64 untersuchten Auswirkungen, Merkmale oder Verläufe von DI-Prozessen und 5 berichteten über die Entwicklung oder Validierung von Erhebungsinstrumenten für DI-Variablen. Methodologische Fragen der DI-Forschung oder die Entwicklung und Testung von DI-Theorien wurden in keiner der eingeschlossenen Studien thematisiert. Künftige pflegewissenschaftliche DI-Forschung im deutschsprachigen Raum sollte sich vor allem den letztgenannten Themen verstärkt widmen. Dabei wird es insbesondere darauf ankommen, die internationalen DI-Befunde zur Kenntnis zu nehmen, systematisch zu berücksichtigen, darauf aufzubauen und diese ggf. zu erweitern.

  16. Sleep quality among relatively younger patients with initial diagnosis of hypertension: dippers versus non-dippers.

    Science.gov (United States)

    Yilmaz, Mehmet Birhan; Yalta, Kenan; Turgut, Okan Onur; Yilmaz, Ahmet; Yucel, Oguzhan; Bektasoglu, Gokhan; Tandogan, Izzet

    2007-01-01

    Sleep is a basic physiological process. Normal sleep yields decrease in sympathetic activity, blood pressure (BP) and heart rate. Those, who do not have expected decrease in their BP are considered "non-dippers". We aimed to determine if there was any association between the non-dipping status and sleep quality, designed a cross-sectional study, and enrolled and evaluated the sleep quality of relatively young patients with an initial diagnosis of hypertension. Seventy-five consecutive patients, diagnosed to have stage 1 hypertension by their primary physicians, were referred to our study. Patients had newly diagnosed with stage 1 hypertension. Patients with a prior use of any anti-hypertensive medication were not included. Eligible patients underwent the Pittsburgh Sleep Quality Index (PSQI), which has an established role in evaluating sleep disturbances. All patients underwent ambulatory BP monitoring. There were 42 non-dipper patients (mean age = 47.5+/-11.9 years, 24 male/18 female), as a definition, 31 dipper hypertensive patients (mean age = 48.5+/-12.8 years, 21 male/10 female) and two with white coat hypertension. Daytime systolic and diastolic mean BPs were not significantly different between the two groups. Night-time mean systolic and diastolic BPs were significantly higher in non-dippers compared with dippers. PSQI scores, globally, were significantly higher in non-dippers compared with dippers. Total PSQI score was not correlated with body mass index. It was noticed that, individually, sleep quality, sleep efficiency and sleep disturbance scores were significantly higher in non-dippers. Being a poor sleeper in terms of high PSQI score (total score>5) was associated with 2.955-fold increased risk of being a non-dipper (95% confidence interval 1.127-7.747). We showed that the risk of having non-dipping hypertension, a risk factor for poor cardiovascular outcomes among hypertensive individuals, was tripled (odds ratios) among poor sleepers. We think that

  17. Jung und Alt im Dialog

    Directory of Open Access Journals (Sweden)

    Caroline Baetge

    2012-04-01

    Full Text Available Rezension zu: Kupser, Thomas, und Ida Pöttinger, Hrsg. 2011. Mediale Brücken: Generationen im Dialog durch aktive Medienarbeit. Gesellschaft - Altern - Medien 3. München: kopaed.

  18. Frauen in Philosophie und Wissenschaft

    Directory of Open Access Journals (Sweden)

    Regina Harzer

    2006-03-01

    Full Text Available Der von Brigitte Doetsch herausgegebene Band präsentiert die aktuelle Feministische Philosophie und sammelt Beiträge, die Einblick geben in den gegenwärtigen Forschungsstand, wie ihn „Philosophinnen im dritten Jahrtausend“ erreicht haben. Insgesamt neun, zum Teil interdisziplinär ausgerichtete Arbeiten werden vorgestellt. Das Themenspektrum ist weit: Geschichte der Philosophie; Politische Philosophie und Naturphilosophie; Epistemologie; Biopolitik und Bioethik als Bereiche praktischer Philosophie; Forschung über Geschlechterverhältnisse. Alle Beiträge gehen zurück auf eine Vortragsreihe des Braunschweiger Zentrums für Gender Studies (www.genderzentrum.de. Leser/-innen erhalten einen guten Überblick über die aktuelle Frauenforschung aus der Sicht theoretischer und praktischer Philosophie.

  19. Gesundheit und Pflege im Alter

    OpenAIRE

    Pfaff, Martin

    1989-01-01

    Gesundheit und Pflege im Alter : d. Gesundheitsreformgesetz (GRG) ; Möglichkeiten, Grenzen u. weitere Vorschläge / Martin Pfaff ; Klaus Deimer. - In: Expertengespräch "Pflege in der Familie". - Augsburg, 1989. - Getr. Zählung

  20. Diagnosis of animal diseases using nuclear and related techniques: Developments and trends

    International Nuclear Information System (INIS)

    Anderson, J.; McKay, J.A.

    1991-01-01

    Nuclear techniques such as radioimmune precipitation, radioimmunoassay, DNA cloning and amino acid sequencing have led to a greater understanding of protein structure and function, antigenic variation and the immune response to infection. Knowledge gained from the use of this technology has led to the development of improved diagnostic assays. Although radioimmunoassay has been used for animal disease diagnosis for many years, more recently it has been replaced by the enzyme linked immunosorbent assay (ELISA). The ELISA offers advantages in speed of reading and longer reagent shelf life and obviates the use of radiochemicals. This is particularly important in developing countries, which may have no facilities for storage, handling and disposal of radioactive materials. In the case of rinderpest diagnosis, taken as an example, the virus neutralization test was replaced by a simple indirect ELISA for seromonitoring throughout the Pan-African Rinderpest Campaign. In the near future, this will be replaced by a competitive ELISA using a rinderpest specific monoclonal antibody, which will offer significant advantages in sensitivity and specificity. In the future it may be possible to replace the rinderpest antigen with vector expressed proteins or synthetic polypeptides. More recent developments such as the 'amplified' ELISA and the use of fluorogenic and bioluminescent substrates may further improve disease diagnosis. The knowledge gained from the use of modern technology is essential to the development of improved diagnostic assays which in turn will lead to improved disease diagnosis and control. (author). 9 refs

  1. Socioeconomic disparities in breast cancer survival: relation to stage at diagnosis, treatment and race

    Directory of Open Access Journals (Sweden)

    Yu Xue

    2009-10-01

    Full Text Available Abstract Background Previous studies have documented lower breast cancer survival among women with lower socioeconomic status (SES in the United States. In this study, I examined the extent to which socioeconomic disparity in breast cancer survival was explained by stage at diagnosis, treatment, race and rural/urban residence using the Surveillance, Epidemiology, and End Results (SEER data. Methods Women diagnosed with breast cancer during 1998-2002 in the 13 SEER cancer registry areas were followed-up to the end of 2005. The association between an area-based measure of SES and cause-specific five-year survival was estimated using Cox regression models. Six models were used to assess the extent to which SES differences in survival were explained by clinical and demographical factors. The base model estimated the hazard ratio (HR by SES only and then additional adjustments were made sequentially for: 1 age and year of diagnosis; 2 stage at diagnosis; 3 first course treatment; 4 race; and 5 rural/urban residence. Results An inverse association was found between SES and risk of dying from breast cancer (p Conclusion Stage at diagnosis, first course treatment and race explained most of the socioeconomic disparity in breast cancer survival. Targeted interventions to increase breast cancer screening and treatment coverage in patients with lower SES could reduce much of socioeconomic disparity.

  2. Integrative review of factors related to the nursing diagnosis nausea during antineoplastic chemotherapy.

    Science.gov (United States)

    Moysés, Aline Maria Bonini; Durant, Lais Corsino; Almeida, Ana Maria de; Gozzo, Thais de Oliveira

    2016-10-10

    to identify factors related to the nursing diagnosis nausea among cancer patients undergoing chemotherapy. integrative review conducted in four electronic databases (PUBMED, EMBASE, CINAHL and LILACS) using the key words: neoplasia, antineoplastic agents and nausea. only 30 out of 1,258 papers identified met the inclusion criteria. The most frequent related factors were: being younger than 50 years old, motion sickness, being a woman, emetogenic potential of the chemotherapy, anxiety, conditioned stimulus, and expecting nausea after treatment. this review's findings, coupled with the incidence of nausea among cancer patients undergoing chemotherapy, reveal an important difference between evidence found and that used by NANDA International, Inc. Even though it provides an appropriate definition of related factors, it does not mention chemotherapy, despite the various studies addressing the topic using different designs and presenting various objectives and outcomes. identificar os fatores relacionados ao diagnóstico de enfermagem náusea entre pacientes oncológicos durante o tratamento quimioterápico. revisão integrativa de quatro bases eletrônicas de dados (PUBMED, EMBASE, CINAHL e LILACS) com as palavras-chaves neoplasia, agentes antineoplásicos e náusea. dos 1258 artigos identificados, somente 30 atenderam aos critérios de inclusão. Os fatores relacionados mais frequentes foram: idade abaixo de 50 anos, doença do movimento, sexo feminino, potencial emético do quimioterápico, ansiedade, estímulo condicionado e expectativa de náuseas depois do tratamento. diante dos resultados encontrados e da incidência de náusea entre os pacientes oncológicos em tratamento quimioterápico, observa-se diferença importante entre as evidências encontradas e as utilizadas pela NANDA International, Inc. Apesar da definição estar adequada entre os fatores relacionados, não há menção à quimioterapia mesmo com inúmeros estudos, com diferentes delineamentos

  3. Editorial: Computerspiele und Videogames in formellen und informellen Bildungskontexten

    Directory of Open Access Journals (Sweden)

    Johannes Fromme

    2008-01-01

    Full Text Available Computer- und Videospiele sind heute ein selbstverständlicher Bestandteil der Lebenswelt vieler Kinder und Jugendlicher, aber auch von (jüngeren Erwachsenen, die mit diesen neuen Medien aufgewachsen sind. Lange Zeit haben elektronische Bildschirmspiele allenfalls sporadische Beachtung gefunden. Weder in der Medienforschung oder Medienpädagogik noch in der breiteren Öffentlichkeit waren sie ein Gegenstand von breiterem Interesse.* In den letzten knapp zehn Jahren sind Video- und Computerspiele allerdings zunehmend in den Fokus der Aufmerksamkeit gerückt. Dabei sind in der massenmedial vermittelten Öffentlichkeit vor allem Amokläufe in Schulen in einen direkten Zusammenhang mit den Vorlieben (der Täter für bestimmte Computerspiele gebracht worden. Die auch von prominenten Politikern aufgegriffene These lautete, dass gewalthaltige Spiele wie der First Person Shooter «Counterstrike» ein virtuelles Trainingsprogramm für das Töten und daher als wesentliche Ursache solcher Schulmassaker anzusehen seien. Auf der Basis dieser kausalen Wirkungsannahmen bzw. der unterstellten negativen Lern- und Trainingseffekte werden seither immer wieder Forderungen nach einem Verbot solcher «Killerspiele» oder gar nach der Verbannung aller Bildschirmmedien aus den Kinderzimmern abgeleitet. Neben solcher skandalisierter Thematisierung ist aber zunehmend auch eine nüchterne wissenschaftliche Auseinandersetzung zu konstatieren. So haben sich seit Beginn des neuen Jahrtausends die «digital game studies» als interdisziplinäres Forschungsfeld etabliert. Im Jahr 2000 wurde innerhalb der Gesellschaft für Medienwissenschaft z.B. die AG Games gebildet, die sich zu einem wichtigen deutschsprachigen Forum für die wissenschaftliche Beschäftigung mit Computerspielen entwickelt hat, und im Jahr 2002 entstand die internationale Digital Games Research Association (DiGRA, die im September 2009 ihre vierte grosse Konferenz nach 2003, 2005 und 2007 durchgeführt hat

  4. Werte, existentielle Schuld und Hilfsbereitschaft gegenüber Indios und landlosen Bauern in Paraguay

    OpenAIRE

    Schmitt, Manfred; Behner, Robert; Müller, Lothar; Montada, Leo

    1992-01-01

    Die Untersuchung ist eine Replikation vorangegangener Studien zur psychologischen Verarbeitung eigener Bevorteilung in Relation zur Benachteiligung anderer. 80 paraguayischen Studierenden wurden Benachteiligungsepisoden von landlosen Bauern (Campesinos) und Indianern geschildert. Die Probanden sollten anhand vorgegebener Reaktionsmöglichkeiten angeben, wie sie die geschilderten Benachteiligungen beurteilen (z.B. als wie ungerecht), welche Emotionen diese bei ihnen auslösen (z.B. Schuldgefühle...

  5. Professionalisierung und Doping im Sport

    OpenAIRE

    Wüterich, Christoph

    2004-01-01

    Der Beitrag untersucht Zusammenhänge zwischen der zunehmenden Professionalisierung des Sports und dem Anstieg von Dopingvergehen. Er zeigt, dass im historischen Vergleich beide Phänomene nicht neu sind, dass sich die Probleme aufgrund der steigenden Bedeutung des Leistungssports aber zugespitzt haben. Ausgehend von einer juristischen und sozioökonomischen Analyse der Anreize zu Doping werden Lösungsvorschläge entwickelt. The author analyzes the interdependencies between a growing commercia...

  6. Pepsi und Coca ewige Rivallen

    OpenAIRE

    POLJAKOW ANDREJ; POLJAKOW WLADIMIR

    2016-01-01

    Fast jeder kennt Pepsi und Coca. Man kann sie treffen praktisch in jedem Geschaeft. Dennoch nicht alle wissen, dass diese Firmen Erzrivallen sind und das ihre Rivallitaet sich seit Ewigkeit dauert. In meinem Artikel, welches ich in der Zusammenarbeit mit meinem Vater schrieb versuchte ich den Weg beider Firmen von der Gruendung bis heutigen Tagen zu beschreiben. Auf diesem Weg trafen sich technologische Aenderungen, Gerichtsverhandlungen, sowie geschickte Tricks. Wichtige Rolle spielt auch Ma...

  7. Tax Shield, Insolvenz und Zinsschranke

    OpenAIRE

    Arnold, Sven; Lahmann, Alexander; Schwetzler, Bernhard

    2010-01-01

    Dieser Beitrag analysiert den Wertbeitrag fremdfinanzierungsbedingter Steuervorteile (Tax Shield) unter realistischen Bedingungen (keine Negativsteuer; mögliche Insolvenz) für unterschiedliche Finanzierungspolitiken. Zusätzlich wird der Effekt der sogenannten Zinsschranke auf den Wert des Tax Shield ermittelt. Die Bewertung des Tax Shield mit und ohne Zinsschranke findet im einperiodigen Fall auf der Basis von Optionspreismodellen und im mehrperiodigen Fall auf der Basis von Monte Carlo Simul...

  8. Diagnosis and differential diagnosis of hydrocephalus in adults

    International Nuclear Information System (INIS)

    Langner, Soenke; Mensel, Birger; Kuehn, Jens Peter; Kirsch, Michael; Fleck, Steffen; Baldauf, Joerg

    2017-01-01

    Hydrocephalus is caused by an imbalance of production and absorption of cerebrospinal fluid (CSF) or obstruction of its pathways, resulting in ventricular dilatation and increased intracranial pressure. Imaging plays a crucial role in the diagnosis, differential diagnosis and planning of treatment. This review article presents the different types of hydrocephalus und their typical imaging appearance, describes imaging techniques, and discusses differential diagnoses of the different forms of hydrocephalus. Imaging plays a central role in the diagnosis of hydrocephalus. While magnetic resonance (MR) imaging is the first-line imaging modality, computed tomography (CT) is often the first-line imaging test in emergency patients.

  9. Influence of region and site-specific factors on the degree of general validity of ecological and primary-energy-related assessments of biogas; Einfluss regionaler und standortspezifischer Faktoren auf die Allgemeingueltigkeit oekologischer und primaerenergetischer Bewertungen von Biogas

    Energy Technology Data Exchange (ETDEWEB)

    Dressler, Daniela

    2015-11-01

    As described in this publication, since the early 1990s numerous studies based on the life cycle assessment methodology have been dedicated to assessments of different kinds of bioenergy in comparison with fossil energy resources in terms of their energy balance and environmental impact. On reviewing the results of these studies one finds a strikingly wide range of variation. One major factor of influence on the results of life cycle assessments, besides methodological factors such as the choice of allocation method, is the representativeness of the data used. Thus, widely varying results are also obtained when balance calculations and assessments are performed on energy crops with due consideration to regional and site-specific factors. To address this problem the present study endeavoured to identify region and site-specific factors and assess them in terms of their influence on the life cycle assessment of the cultivation and conversion to biogas of different kinds of energy crops. For this purpose the following questions were explored: What influence do region, site and equipment-specific factors have on the results of ecological and primary-energy-related assessments; and how large are the differences in results between region and site-specific assessments on the one hand and assessments based on general assumptions on the other? It transpires that the results of region and site-specific assessments differ from one another in terms of both the assessment of energy cropping and the assessment of the entire process chain of biogas production and conversion to electricity.

  10. Neuropathological and neuroradiological aspects of acute disseminated encephalomyelitides (ADEM); Neuropathologische und neuroradiologische Aspekte akuter disseminierter Enzephalomyelitiden (ADEM)

    Energy Technology Data Exchange (ETDEWEB)

    Niedermayer, I.; Feiden, W. [Universitaet des Saarlandes, Homburg/Saar (Germany). Abt. fuer Neuropathologie; Deinzer, M. [Universitaet des Saarlandes, Homburg/Saar (Germany). Abt. Neuroradiologie; Moringlane, J.R. [Universitaet des Saarlandes, Homburg/Saar (Germany). Neurochirurgische Klinik

    2000-11-01

    Among non-neoplastic lesions of the central nervous system, demyelinating pseudotumors of the group of acute disseminated encephalomyelitis (ADEM) most frequently occasion neurosurgical intervention for purposes of definitive diagnosis and thus enter the domain of the surgical pathologist. Typically, ADEM presents with multifocal, bilateral lesions in an asymmetrical distribution. Especially monolocular manifestations may be diagnostically challenging. Due to the acuteness of clinical symptoms and the expansive, space-occupying character of the lesions a diffuse glioma, a metastatic disease, a primary cerebral Non-Hodgkin's lymphoma, brain abscess, a parasitosis or an ischemic brain tissue necrosis may be suspected. This impression is supported by uptake of contrast-medium most pronounced at the periphery of the lesion and the subcortical location. The histomorphologic feature of relative axonal preservation in areas with acute myelin breakdown and lymphocytic infiltrates make the diagnosis of an acute primary demyelinating disease probable. A diagnosis of glioma may be prompted by the florid, cytologically atypical astrogliosis especially in intraoperative request. Based on a series of 14 cases of radiologically and bioptically documented cases of ADEM typical examples will be demonstrated and discussed. (orig.) [German] Demyelinisierende Pseudotumoren aus dem Formenkreis akuter disseminierter Enzephalomyelitiden (ADEM-Gruppe) gehoeren zu den haeufigsten nichtneoplastischen Laesionen, die zumal in der bildgebenden neuroradiologischen Diagnostik das Bild einer Neoplasie vortaeuschen koennen. Typischerweise handelt es sich bei der ADEM um multifokale, bilaterale asymmetrische Laesionen. Differenzialdiagnostisch sind v.a. seltene monolokulaere Manifestationen bedeutsam, bei denen aufgrund der akuten klinischen Symptomatik sowie des expansiven raumfordernden Chrakters der Laesionen klinisch-radiologisch nicht selten ein hirneigener glialer Tumor, eine

  11. Determination of the agricultural and process-related boundary conditions for the use of rapeseed oil and its refinery products as motor fuel. Final report; Ermittlung der landwirtschaftlichen, prozesstechnischen und verfahrenstechnischen Rahmenbedingungen fuer die Verwendung von Rapsoel und seiner Umwandlungsprodukte als Kraftstoff. Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Schliephake, D; Hacker, C M

    1994-11-01

    The use of rapeseed oil as a motor fuel is viewed from various angles: Production aspects; environmental aspects; marketing aspects in agriculture; business management aspects in the Federal Republic of Germany; production and refining of rapeseed oil; use of rapeseed oil methyl ester as diesel fuel and in mineral oil processing plants; engine performance. (orig./SR) [Deutsch] In dem vorliegenden Bericht wird der Einsatz von Rapsoel als Kraftstoff aus verschiedenen Blickwinkeln betrachtet: Produktionsaspekte, Umweltaspekte, marktwirtschaftliche Aspekte in der Landwirtschaft; betriebswirtschaftliche Aspekte in der Bundesrepublik Deutschland; Herstellung und Raffination von Rapsoel; Einsatz von Rapsoelmethylester als Dieselkraftstoff und in Anlagen der Mineraloelverarbeitung; Motortechnische Untersuchungsergebnisse. (orig./SR)

  12. Neue Shandite und Parkerite. Darstellung und röntgenographische Charakterisierung

    OpenAIRE

    Anusca, Irina

    2009-01-01

    Das Ziel dieser Arbeit war es, neue Verbindungen mit Shandit- und Parkeritstruktur zu darstellen und mittels röntgenographischen Methoden (Pulverdiffraktometrie und Einkristallanalyse), das thermische Verhalten durch DTA / DSC - Messungen und Elektronenmikroskopische Untersuchungen (REM, EDX) zu charakterisieren. Die vorliegende Arbeit ist wie folgt im zwei Themen gegliedert: Shandite und Parkerite. Der ersten Teil dieser Arbeit befaßt sich mit metallreichen ternären Chalkogeniden M3A2X2, ...

  13. Molekulargenetische Studie zur Verbreitung und Interaktion von PCV-2 bei Haus- und Wildschweinen

    OpenAIRE

    Bronnert, Bastian Balthasar Marcel

    2014-01-01

    Im Rahmen der vorliegenden Arbeit wurden Wild- und Hausschweingewebeproben aus den Jahren 2005 bis 2008 mittels nested PCR auf das Vorkommen von PCV-2 untersucht und die positiv getesteten Proben mittels Realtime PCR quantifiziert. Zusätzlich wurden die Proben im Institut für Pathologie der Justus-Liebig-Universität histologisch und immunhistologisch untersucht (Dissertation Hohloch). Ziel war es das Vorkommen von PCV-2 und die Häufigkeit von PCV-2 assoziierter Erkankungen bei Haus- und Wilds...

  14. Vom Stabilitäts- und Wachstumsgesetz zum Wohlstands- und Nachhaltigkeitsgesetz

    OpenAIRE

    Koll, Willi

    2016-01-01

    Das Stabilitäts- und Wachstumsgesetz wird bald 50 Jahre alt. Neue Herausforderungen erfordern eine Wirtschaftspolitik, die weit über die Ziele des Gesetzes hinausweist. Sie muss wirtschaftliches Wachstum und Stabilität mit den Zielen fiskalischer, sozialer und ökologischer Nachhaltigkeit auf nationaler und europäischer Ebene verbinden. Der Autor gibt einen Über blick über solche umfassenden Zielsysteme und leitet daraus ab, wie eine derart erweiterte wirtschaftspolitische Agenda in ein Wohlst...

  15. Interconnectedness und digitale Texte

    Directory of Open Access Journals (Sweden)

    Detlev Doherr

    2013-04-01

    Full Text Available Zusammenfassung Die multimedialen Informationsdienste im Internet werden immer umfangreicher und umfassender, wobei auch die nur in gedruckter Form vorliegenden Dokumente von den Bibliotheken digitalisiert und ins Netz gestellt werden. Über Online-Dokumentenverwaltungen oder Suchmaschinen können diese Dokumente gefunden und dann in gängigen Formaten wie z.B. PDF bereitgestellt werden. Dieser Artikel beleuchtet die Funktionsweise der Humboldt Digital Library, die seit mehr als zehn Jahren Dokumente von Alexander von Humboldt in englischer Übersetzung im Web als HDL (Humboldt Digital Library kostenfrei zur Verfügung stellt. Anders als eine digitale Bibliothek werden dabei allerdings nicht nur digitalisierte Dokumente als Scan oder PDF bereitgestellt, sondern der Text als solcher und in vernetzter Form verfügbar gemacht. Das System gleicht damit eher einem Informationssystem als einer digitalen Bibliothek, was sich auch in den verfügbaren Funktionen zur Auffindung von Texten in unterschiedlichen Versionen und Übersetzungen, Vergleichen von Absätzen verschiedener Dokumente oder der Darstellung von Bilden in ihrem Kontext widerspiegelt. Die Entwicklung von dynamischen Hyperlinks auf der Basis der einzelnen Textabsätze der Humboldt‘schen Werke in Form von Media Assets ermöglicht eine Nutzung der Programmierschnittstelle von Google Maps zur geographischen wie auch textinhaltlichen Navigation. Über den Service einer digitalen Bibliothek hinausgehend, bietet die HDL den Prototypen eines mehrdimensionalen Informationssystems, das mit dynamischen Strukturen arbeitet und umfangreiche thematische Auswertungen und Vergleiche ermöglicht. Summary The multimedia information services on Internet are becoming more and more comprehensive, even the printed documents are digitized and republished as digital Web documents by the libraries. Those digital files can be found by search engines or management tools and provided as files in usual formats as

  16. Increased relative risk of subsequent affective disorders in patients with a hospital diagnosis of obesity

    DEFF Research Database (Denmark)

    Thomsen, A F; Kvist, T K; Andersen, P K

    2006-01-01

    OBJECTIVE: To investigate the risk of clinical affective disorders of patients who were hospitalized because of obesity in the study period 1 January 1977 to 31 December 1999. METHOD: Using data from Danish hospital registers, three study cohorts were identified by their diagnoses at discharge from...... discharged with an index diagnosis was identified. In total, 1081 events occurred in the observation period. An index diagnosis of obesity was associated with an increased risk of affective-disorders hospitalization when compared with patients with osteoarthritis (Rate ratio: 1.35 (95% CI: 1.......09-1.67)) and tended to be associated with an increased risk when compared to patients with non-toxic goiter (Rate ratio: 1.23 (95% CI: 0.99-1.53)). Patients with obesity diagnoses who did not have additional hospital diagnoses of substance- or alcohol abuse had a risk of affective disorders that was 1.55 (95% CI: 1...

  17. Work related physical activity and risk of a hospital discharge diagnosis of atrial fibrillation or flutter

    DEFF Research Database (Denmark)

    Frost, L; Frost, P; Vestergaard, P

    2005-01-01

    of atrial fibrillation or flutter associated with sedentary work in a standing position, light workload, or heavy workload in men or women. CONCLUSION: No evidence was found of an association between physical activities during working hours and risk of a hospital discharge diagnosis of atrial fibrillation......, Cancer, and Health Study. The physical strain during working hours was categorised as sedentary, light, or heavy, and analysed using proportional hazard models. Subjects were followed up in the Danish National Registry of Patients and in the Danish Civil Registration System. RESULTS: During follow up...... (mean 5.7 years) a hospital discharge diagnosis of atrial fibrillation or flutter occurred in 305 men and 113 women. When using the risk of atrial fibrillation or flutter associated with sedentary work at a sitting position as a reference, no excess risk (unadjusted as well as adjusted) was found...

  18. Synthesis and characterization of nanometer sized thermoelectric lead-antimony-silver-tellurium compounds and related materials; Synthese und Charakterisierung nanoskaliger Thermoelektrika der LAST (Lead-Antimony-Silver-Tellurium)-Familie und verwandter Verbindungen

    Energy Technology Data Exchange (ETDEWEB)

    Petri, Denis

    2012-09-10

    The present dissertation deals with different variants of synthesis and processing of nanocrystalline composites of various thermoelectric compounds based on lead telluride including LAST-m (AgPb{sub m}SbTe{sub m+2}), LASTT-m-x (AgPb{sub m-x}Sn{sub x}SbTe{sub m+2}), LABST-m-x (AgPb{sub m}Sb{sub 1-x}Bi{sub x}Te{sub m+2}), doped LAST-m and (PbTe){sub m}(M{sup 15}{sub 2}Te{sub 3}) and the characterization thereof. A new route of manufacturing nanocrystalline composites was developed. The so called co-ball milling-route includes the synthesis of bi- or multinary compounds by conventional solid state melting methods followed by combined milling of appropriate amounts in a planetary ball mill; a process related to the widely used mechanical alloying of elemental powders. The as produced powders were shortly annealed for one hour and a.erwards compacted either at room temperature followed by pressureless sintering or combined application of high pressure and elevated temperatures via spark-plasma-sintering or short-term-sintering. The ball milling yielded micron-sized agglomerates consisting of crystallites with diameters ranging from 10 to 50 nm. These crystallites exhibited complicated internal nanostructures severe crystal defects as a consequence of the high energy processing. During short-term annealing some grain coarsening occured and the crystal defects partly healed, which was confirmed by TEM and HRTEM investigations as well as profile analysis of XRD powder pattern. Local EDX-analysis showed different compositions at every point as a consequence of synthesis and decomposition of the compounds. Measurements of thermopower, electrical and thermal conductivity were carried out and the values of the figure of merit ZT and the powerfactor were calculated. In general the compounds exhibited larger thermopower than corresponding bulk materials, which might be attributed to energy filtering of charge carriers at partly oxidized grain boundaries. Due to enhanced phonon

  19. Gosvig und das Problem der Geschichte

    DEFF Research Database (Denmark)

    Wentzer, Thomas Schwarz

    2016-01-01

    Der Essay geht der Frage nach, wieso so viele philosophische Bücher, insbesondere innerhalb der sogenannten 'kontinentalen' Philosophie des 20. Jhs, einen Titel tragen, der durch die Struktur 'x und y' gekennzeichnet ist. Hat Heideggers 'Sein und Zeit' auch hier Schule gemacht? Wenn ja, wie so? U...... These, dass die Iteration des 'und' tatsächlich und in Kontrast zur Genetivkonstruktion der Idealisten ('Phänomenologie des Geistes') die Geschichtlichkeit im Zeitalter postsubjektivistischen Denkens reflektiert....

  20. INTELLECTUAL AND ACADEMIC PERFORMANCE OF CHILDREN WITH CONGENITAL HYPOTHYROIDISM IN RELATION TO TIME OF DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    Madhava Vijaya Kumar

    2016-12-01

    Full Text Available BACKGROUND Context- Congenital hypothyroidism is an important cause of preventable mental retardation in children. Since, neonatal screening is not done routinely in India, many cases are diagnosed late. Earlier, the diagnosis and initiation of treatment, better will be the outcome. The aim of the study is to assess the effect of time of onset of treatment in intellectual and scholastic performances in children with congenital hypothyroidism. MATERIALS AND METHODS Children were classified into 3 groups. Group 1 were diagnosed and treatment initiated within one month of birth. Group 2, between 1 and 6 months and group 3 after 6 months. General intelligence and IQ were assessed by Malin’s intelligence scale for Indian children. Scholastic performance were evaluated by academic evaluation scale for slow learners and ADHD were diagnosed by DSM-IV criteria. Settings and Design- The study was done in the Paediatric Endocrinology Clinic of Institute of Maternal and Child Health, Department of Paediatrics, Government Medical College, Kozhikode. Study population included children of age group 6-9 years with congenital hypothyroidism. Statistical Methods Used- Statistical analysis was done with SPSS software version 16. The statistical analysis was done by ANOVA test. RESULTS IQ and intellectual outcomes were better in group 1 where treatment was initiated within one month. Similarly, poor academic abilities and increased incidence of ADHD were noted in children in whom diagnosis was made late. CONCLUSION Later the diagnosis more will be the intellectual and scholastic backwardness in children underscoring the importance of universal newborn screening.

  1. Diffuse and vascular hepatic diseases; Diffuse und vaskulaere Lebererkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Kreimeyer, S.; Grenacher, L. [Universitaetsklinikum Heidelberg, Abteilung Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)

    2011-08-15

    In addition to focal liver lesions, diffuse and vascular disorders of the liver represent a wide spectrum of liver diseases which are from the radiological point of view often difficult or nearly impossible to diagnose. Classical diagnostic methods are computed tomography and magnetic resonance imaging in addition to ultrasound. Diffuse parenchymal damage caused by diseases of various etiologies is therefore difficult to evaluate because it often lacks characteristic morphological features. For hepatic steatosis, hemochromatosis/siderosis as an example of a diffuse storage disease and sarcoidosis and candidiasis as infectious/inflammatory diseases, an image-based diagnosis is appropriate in some cases. For most diffuse liver diseases, however only nonspecific changes are visualized. Vascular pathologies of the liver, such as the Budd-Chiari syndrome and portal vein thrombosis, however, can usually be diagnosed very clearly using radiology and there is also a very effective interventional radiological treatment. Chronic diseases very often culminate in liver cirrhosis which is highly associated with an increased risk of liver cancer. (orig.) [German] Neben den fokalen Leberlaesionen stellen diffuse und vaskulaere Lebererkrankungen ein weites Spektrum an Erkrankungen der Leber dar, die radiologisch oft schwer oder gar nicht diagnostizierbar sind. Klassische diagnostische Verfahren sind dabei neben dem Ultraschall die Computertomographie und die Magnetresonanztomographie. Diffuse Parenchymschaeden, bedingt durch Erkrankungen unterschiedlichster Aetiologie, sind deshalb schwierig evaluierbar, weil haeufig charakteristische bildmorphologische Merkmale fehlen. Die Steatosis hepatis, die Haemochromatose/Siderose als Beispiel der Speicherkrankheiten sowie die Sarkoidose und die Candidose als infektioes-entzuendliche Erkrankungen sind einer bildbasierten Diagnosestellung z. T. zugaenglich, bei den meisten diffusen Lebererkrankungen jedoch zeigen sich lediglich unspezifische

  2. Mensch und Maschine in Übersetzungsprozessen

    DEFF Research Database (Denmark)

    Hansen, Gyde

    2014-01-01

    gebrauchstauglich sein. In meinem empirischen Projekt zur Erforschung notwendiger Kompetenzen, zum Übersetzen, Revidieren und zum Pre- und Post-Editing, TraREdit, arbeite ich mit den Sprachen Deutsch, Dänisch und Englisch. Trotz offensichtlicher Mängel von Maschinenübersetzungen muss man erkennen, dass diese besser...

  3. Sprachvermittlung und Spracherwerb in Afrika. Deutsch nach ...

    African Journals Online (AJOL)

    erlernende Fremdsprache richtig und auf hohem Niveau sprechen zu lernen. Lehrende sollten alles daransetzen zu verhindern, dass die Lernenden in dieser Vereinfachungsphase stehen bleiben und ihre Sprache fossilieren. Die Bewusstmachung der Ähnlichkeiten von Zulu und. Deutsch kann dazu beitragen, indem man ...

  4. Zustand und Perspektiven der Kapitalmarktfinanzierung in Deutschland

    DEFF Research Database (Denmark)

    Beck, Thorsten; Kaserer, Christoph; Rapp, Marc Steffen

    2016-01-01

    Die Autoren haben sich im Rahmen des durch das Bundesministerium für Wirtschaft und Energie (BMWi) in Auftrag gegebenen Forschungsprojekts „Beteiligungs- und Kapitalmarktfinanzierung im deutschen Finanzsystem: Zustand und Entwicklungsperspektiven“ (Dienstleistungsprojekt I C 4 -27/14) mit dem Zus...

  5. Data Science und Analytics in Bibliotheken

    Directory of Open Access Journals (Sweden)

    José Luis Preza

    2017-09-01

    Full Text Available Bibliotheken sind in einer priviligierten Situation: Sie verwalten riesige Mengen von Daten und Informationen. Data Science und Analytics-Methoden ermöglichen es Bibliotheken, den Inhalt, den sie verwalten, voll auszunutzen, um den Nutzern bessere Informationen, Suche und Empfehlungen zu bieten.

  6. "Morphology is a witness which doesn't lie": diagnosis by similarity relation and analogical inference in clinical forensic medicine.

    Science.gov (United States)

    Rees, Gethin

    2011-09-01

    In this paper, I utilise semi-structured interviews with Forensic Medical Examiners (FMEs) in Scotland in order to investigate their diagnostic work. Drawing upon classic medical sociological work on diagnosis (for instance, the work of Paul Atkinson and Michael Bloor), my understanding of diagnosis is as a subjective, but socially-constructed activity whereby medical practitioners are taught to identify (in this case) injury types, initially by ostension, then also by examination. I then extend the analysis postulated within the classic studies by outlining a mechanistic method for the actual cognitive process of diagnosis, drawn from a sociologically informed reading of the historian of science, Thomas Kuhn. It is argued that diagnosis is achieved by similarity relation (comparing new cases to those previously observed), and analogical reasoning (drawing inferences based on the analogy with previous cases). Given that new cases subtly alter the individual FME's classificatory schema, resulting in potential differences in diagnoses, the FME community are required to conduct much reparative work in order to construct their evidence as consensual and factual, as is required by law. The paper will conclude with some brief comments on the future of forensic medical examinations, particularly concerning the fact/opinion distinction. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. [Relation of psychological distress after diagnosis of gastric cancer at a cancer screening center with psychological support from public health nurses and family members].

    Science.gov (United States)

    Fukui, Sakiko; Ozawa, Harumi

    2003-07-01

    The objectives of this study were to examine the degree of psychological distress during the first 6 months after diagnosis of gastric cancer and investigate the relation to psychological support from public health nurses and family members. One hundred and five patients with stomach, colorectal, or esophagus cancer were mailed a questionnaire. They were asked questions concerning the level of shock on the day of diagnosis, at 1-week after the diagnosis, and at 6 months post diagnosis. In addition, their physical and psychological status was assessed at the 6-month time point. They were also asked about perceived psychological support from public health nurses and family members. The relation between psychological distress and such psychological support was then assessed using multiple regression analyses. The levels of shock on the day of diagnosis and after 1-week were both significantly related to the psychological support from public health nurses. Physical and psychological status at 6 months post diagnosis was significantly related to the level of psychological support from the patient's family members. The study revealed that psychological support from public health nurses improves the level of patient psychological distress during the first 1 week after the cancer diagnosis. Psychological support from family members facilitates the physical and psychological adjustment at 6 months post diagnosis. The results indicate that psychological support is important just after cancer diagnosis and for longer term adjustment, pointing to a major role of health care professionals alleviating problems associated with cancer diagnosis.

  8. The development of "Diagnosis Related Groups" - DRGs, a methodology for classifying hospital patients

    OpenAIRE

    Noronha, Marina F.; Veras, Cláudia T.; Leite, Iuri C.; Martins, Monica S.; Braga Neto, Francisco; Silver, Lynn

    1991-01-01

    É descrito o processo de desenvolvimento do sistema de classificação de pacientes internados em hospitais que atendem casos agudos, denominada Diagnosis Relatd Group - DRGs, desenvolvido e difundido por pesquisadores da Universidade de Yale, USA. Esse sistema vem a ser um instrumento que permite a mensuração do produto hospitalar, principalmente sob o ponto de vista gerencial. São apresentadas considerações acerca do que é entendido como produto hospitalar, seguindo nos meandros do desenvolvi...

  9. Patient's lung cancer diagnosis as a cue for relatives' smoking cessation: evaluating the constructs of the teachable moment.

    Science.gov (United States)

    McBride, Colleen M; Blocklin, Michelle; Lipkus, Isaac M; Klein, William M P; Brandon, Thomas H

    2017-01-01

    To understand whether patient-reported experiences with lung cancer may create teachable moments (TM) for their relatives as evidenced by shifts in their risk perceptions, affective response, and self-image and in turn, motivation to quit smoking. Patients at a comprehensive cancer center (n = 152) completed a survey within 6 months of lung cancer diagnosis to assess their cancer-related symptoms and openness and enumerated relatives who were smokers. Relative smokers (n = 218) then completed a survey assessing their risk perceptions, affective response, and self-image as a smoker related to the patient's diagnosis (TM mechanisms), and their motivation to quit smoking. Cross-sectional mediation and moderation analyses were conducted to explore the links between patient-reported experiences, and relatives' TM mechanisms, and motivation to quit smoking. Relative-reported affect was a significant mediator of the association between patient-reported symptoms and relative smoker's desire to quit. Relatives' self-image was a significant moderator of the association between patient-reported symptoms and relative smoker's desire to quit, such that patients' reported symptoms were associated with relatives' desire to quit only when the relative smoker reported a generally positive self-image as a smoker. No evidence was found for moderated mediation. However, the link between symptoms and negative affect was moderated by perceptions of risk. Whether smokers experience a family member's lung cancer as a TM is influenced by multiple interrelated cognitive and affective factors that warrant further exploration. Clearer understanding of these factors could inform how to re-invigorate and sustain this motivation to promote concrete actions toward smoking cessation. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  10. Overall and peripheral lung function assessment by spirometry and forced oscillation technique in relation to asthma diagnosis and control.

    Science.gov (United States)

    Heijkenskjöld Rentzhog, C; Janson, C; Berglund, L; Borres, M P; Nordvall, L; Alving, K; Malinovschi, A

    2017-12-01

    Classic spirometry is effort dependent and of limited value in assessing small airways. Peripheral airway involvement, and relation to poor control, in asthma, has been highlighted recently. Forced oscillation technique (FOT) offers an effort-independent assessment of overall and peripheral lung mechanics. We studied the association between lung function variables, obtained either by spirometry or multifrequency (5, 11 and 19 Hz) FOT, and asthma diagnosis and control. Spirometry measures, resistance at 5 (R5) and 19 Hz (R19), reactance at 5 Hz (X5), resonant frequency (f res ), resistance difference between 5-19 Hz (R5-R19) and Asthma Control Test scores were determined in 234 asthmatic and 60 healthy subjects (aged 13-39 years). We used standardized lung function variables in logistic regression analyses, unadjusted and adjusted for age, height, gender and weight. Lower FEV 1 /FVC (OR [95% CI] 0.47 [0.32, 0.69]) and FEF 50 (0.62 [0.46, 0.85]) per standard deviation increase, and higher R5 (3.31 [1.95, 5.62]) and R19 (2.54 [1.65, 3.91]) were associated with asthma diagnosis. Independent predictive effects of FEV 1 /FVC and R5 or R19, respectively, were found for asthma diagnosis. Lower FEV 1 /FVC and altered peripheral FOT measures (X5, f res and R5-R19) were associated with uncontrolled asthma (P-values < .05). Resistance FOT measures were equally informative as spirometry, related to asthma diagnosis, and, furthermore, offered additive information to FEV 1 /FVC, supporting a complementary role for FOT. Asthma control was related to FOT measures of peripheral airways, suggesting a potential use in identifying such involvement. Further studies are needed to determine a clinical value and relevant reference values in children, for the multifrequency FOT measurements. © 2017 John Wiley & Sons Ltd.

  11. Marktkonstitution und Regulierung der unabhängigen Film- und Fernsehproduktion : Staat, Verbände und Gewerkschaften im deutsch-britischen Vergleich

    OpenAIRE

    Elbing, Sabine; Voelzkow, Helmut

    2006-01-01

    "In einem internationalen Vergleich von Deutschland und Großbritannien wird untersucht, welche Beiträge die staatliche Politik und die Wirtschafts- und Sozialpartner (Wirtschafts- und Arbeitgeberverbände sowie Gewerkschaften) zur Förderung der unabhängigen Film- und Fernsehproduktion leisten. Es wird gezeigt, dass die britische Medienpolitik die Position der unabhängigen Film- und Fernsehproduktion gegenüber den Fernsehsendern gestärkt hat. In Deutschland hat die Medienpolitik darauf verzicht...

  12. The role of dual diagnosis in health-related quality of life among treatment-seeking patients in Spain.

    Science.gov (United States)

    Daigre, Constanza; Grau-López, Lara; Rodríguez-Cintas, Laia; Ros-Cucurull, Elena; Sorribes-Puertas, Marta; Esculies, Oriol; Bones-Rocha, Katia; Roncero, Carlos

    2017-12-01

    The comorbidity of any substance use disorder and another mental disorder is defined as dual diagnosis. Dual diagnosis is very common and clinical and therapeutic consequences have been described. This cross-sectional study aimed to analyse health-related quality of life (HRQoL) according to clinical characteristics and psychiatric comorbidities in patients with substance dependence. A total of 1276 substance-dependent patients seeking treatment were recruited. HRQoL was evaluated by the Short-Form 36 (SF-36) questionnaire. The SCID-I, SCID-II and Conners' adult ADHD diagnostic interview were used to evaluate dual diagnosis. A visual analogue scale was used to measure craving. Bivariate and multivariate analyses were performed, and correction for multiple tests was conducted. Substance-dependent patients had impaired quality of life, especially in the mental component. SF-36 physical and mental component scores were 47.7 ± 10.9 and 36.1 ± 14.1, respectively. Furthermore, 65% of the patients had dual diagnosis, 51% had an Axis I DSM-IV-TR mental disorder and 35% had some personality disorder. Impaired physical quality of life was independently associated with medical condition, age, being female, depressive disorder and anxiety disorder. Depression disorder, any personality disorder, active consumption last month, Attention deficit hyperactivity disorder, anxiety disorder, suicide attempt were independently associated with worse mental quality of life. These findings emphasize the significance of dual diagnosis in the impairment of HRQoL in substance-dependent patients, particularly with regard to mental component. In addicted patients with low scores on SF-36, psychiatric comorbidity should be evaluated and treated in an integrated approach.

  13. [Die baltischen Lande im Zeitalter der Reformation und Konfessionalisierung : Livland, Estland, Ösel, Ingermanland, Kurland und Lettgallen : Stadt, Land und Konfession 1500-1721. Teil 4. Hrsg. von Matthias Asche, Werner Buchholtz und Anton Schindlin

    Index Scriptorium Estoniae

    Maasing, Madis, 1984-

    2013-01-01

    Arvustus: Die baltischen Lande im Zeitalter der Reformation und Konfessionalisierung : Livland, Estland, Ösel, Ingermanland, Kurland und Lettgallen : Stadt, Land und Konfession 1500-1721. Teil 4. (Katholisches Leben und Kirchenreform im Zeitalter der Glaubensspaltung, 72). Hrsg. von Matthias Asche, Werner Buchholtz und Anton Schindling. Verlag Aschendorff. Münster 2012

  14. Investigation of relation between operator's mental workload and information flow in accident diagnosis tasks of nuclear power plant

    International Nuclear Information System (INIS)

    Ha, Chang Hoon; Kim, Jong Hyun; Seong, Poong Hyun

    2004-01-01

    In the main control room (MCR) of a nuclear power plant (NPP), there are lots of dynamic information sources for MCR operator's situation awareness. As the human-machine interface in MCR is advanced, operator's information acquisition, information gathering and decision-making is becoming an important part to maintain the effective and safe operation of NPPs. Diagnostic task in complex and huge systems like NPP is the most difficult and mental effort-demanding for operators. This research investigates the relation between operator's mental workload and information flow in accident diagnosis tasks. The amount of information flow is quantified, using information flow model and Conant's model, a kind of information theory. For the mental workload measure, eye blink rate, blink duration, fixation time, number of fixation, and gaze direction are measured during accident diagnosis tasks. Subjective methods such as NASA-Task Load Index (NASA-TLX) and Modified Cooper-Harper (MCH) method are also used in the experiment. It is shown that the operator's mental workload has significant relation to information flow of diagnosis task. It makes possible to predict the mental workload through the quantity of the information flow of a system

  15. Acute myocardial infarction and diagnosis-related groups: patient classification and hospital reimbursement in 11 European countries.

    Science.gov (United States)

    Quentin, Wilm; Rätto, Hanna; Peltola, Mikko; Busse, Reinhard; Häkkinen, Unto

    2013-07-01

    As part of the diagnosis related groups in Europe (EuroDRG) project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with patients admitted to hospital for acute myocardial infarction (AMI). The study aims to assist cardiologists and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a primary diagnosis of AMI. Diagnosis-related group classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify AMI patients according to different sets of variables into diverging numbers of DRGs (between 4 DRGs in Estonia and 16 DRGs in France). The most complex DRG is valued 11 times more resource intensive than an index case in Estonia but only 1.38 times more resource intensive than an index case in England. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only €420 in Poland but to €7930 in Ireland. Large variation exists in the classification of AMI patients across Europe. Cardiologists and national DRG authorities should consider how other countries' DRG systems classify AMI patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement.

  16. GIS und Fernerkundung für Landschaftsmonitoring und Landschaftsplanung

    Science.gov (United States)

    Blaschke, Thomas

    2002-09-01

    Der Beitrag beleuchtet die Rolle der Geographischen Informationsverarbeitung hinsichtlich der Aufgaben in der Umweltüberwachung. Dabei wird über etablierte "sektorale" Umweltbeobachtungssysteme (Boden, Wasser, Luft) hinaus zunehmend der Bedarf an einer integrativen Betrachtung der Landschaft deutlich, insbesondere in mittleren bis kleinen Maßstäben. Wie verändern sich ganze Landschaften in Deutschland, in Europa? Welches sind Bereiche kritischer Abnahme landschaftlicher Diversität? Wie können landschaftliche Vielfalt und Eigenart erhalten beziehungsweise deren Erhalt überwacht werden? Diese und weitere Fragen drängen sich vor allem bei der Erstellung langfristiger Szenarien der Veränderung ganzer Landschaften und in der Nachhaltigkeitsdiskussion auf.

  17. Possible Age-Related Progression of Attentional Impairment in ADHD and Its Attenuation by Past Diagnosis and Treatment.

    Science.gov (United States)

    Ben-Sheetrit, Joseph; Tasker, Hanan; Avnat, Lee; Golubchik, Pavel; Weizman, Abraham; Manor, Iris

    2017-12-01

    The aim of the study is to evaluate attentional impairment in different age groups with ADHD. In all, 58 children, 73 adolescents, and 104 adults with ADHD were evaluated using the Test of Variables of Attention (TOVA). Subjects with comorbidities or psychotropic treatment were not included. Considering Response Time Variability (RTV), adults were 10.6 and 4.0 times more likely to be severely impaired (standard score impaired (standard scoreimpaired participants were adults. Age predicted impairment in Attention Performance Index (API), RTV, and d', but not Omissions or Commissions. Past treatment with stimulants predicted less impairment in d', past diagnosis predicted less impairment in RTV, and each predicted less impairment in Omissions and API. Adults had more attentional impairment than children and adolescents. Past diagnosis and treatment were associated with less ADHD-related attentional impairment.

  18. Redefining diagnosis-related groups (DRGs) for palliative care - a cross-sectional study in two German centres.

    Science.gov (United States)

    Vogl, Matthias; Schildmann, Eva; Leidl, Reiner; Hodiamont, Farina; Kalies, Helen; Maier, Bernd Oliver; Schlemmer, Marcus; Roller, Susanne; Bausewein, Claudia

    2018-04-05

    Hospital costs and cost drivers in palliative care are poorly analysed. It remains unknown whether current German Diagnosis-Related Groups, mainly relying on main diagnosis or procedure, reproduce costs adequately. The aim of this study was therefore to analyse costs and reimbursement for inpatient palliative care and to identify relevant cost drivers. Two-center, standardised micro-costing approach with patient-level cost calculations and analysis of the reimbursement situation for patients receiving palliative care at two German hospitals (7/2012-12/2013). Data were analysed for the total group receiving hospital care covering, but not exclusively, palliative care (group A) and the subgroup receiving palliative care only (group B). Patient and care characteristics predictive of inpatient costs of palliative care were derived by generalised linear models and investigated by classification and regression tree analysis. Between 7/2012 and 12/2013, 2151 patients received care in the two hospitals including, but not exclusively, on the PCUs (group A). In 2013, 784 patients received care on the two PCUs only (group B). Mean total costs per case were € 7392 (SD 7897) (group A) and € 5763 (SD 3664) (group B), mean total reimbursement per case € 5155 (SD 6347) (group A) and € 4278 (SD 2194) (group B). For group A/B on the ward, 58%/67% of the overall costs and 48%/53%, 65%/82% and 64%/72% of costs for nursing, physicians and infrastructure were reimbursed, respectively. Main diagnosis did not significantly influence costs. However, duration of palliative care and total length of stay were (related to the cost calculation method) identified as significant cost drivers. Related to the cost calculation method, total length of stay and duration of palliative care were identified as significant cost drivers. In contrast, main diagnosis did not reflect costs. In addition, results show that reimbursement within the German Diagnosis-Related Groups system does not

  19. Current role of MDCT in the diagnosis of coronary artery disease (2011). A clinical guideline of the Austrian Societies of Cardiology and Radiology; Aktueller Stellenwert der MSCTA in der Koronargefaessdiagnostik (2011). Klinischer Leitfaden der Oesterreichischen Gesellschaften fuer Kardiologie und Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Hergan, K. [Salzburger Landeskliniken, Paracelsus Medizinische Privatuniv. (Austria). Universitaetsinst. fuer Radiologie; Globits, S. [Landesklinikum St. Poelten (Austria). 3. Medizinische Abt./Kardiologie; Loewe, C. [Medizinische Univ. Wien (AT). Universitaetsklinik fuer Radiodiagnostik] (and others)

    2011-10-15

    The clinical guideline of the Austrian Societies for Cardiology and Radiology on the actual role of MDCT in the diagnosis of coronary artery diseases includes the following issues: CT calcium scoring; CT angiography (CTA) of the coronaries; actually recommended application of MDCR; generally inappropriate use of the technique for specific patients; radiation exposure; structural and organizational framework.

  20. [Tubulointerstitial nephritis with uveitis (TINU) syndrome. A relatively rare rheumatological differential diagnosis with unexplained uveitis].

    Science.gov (United States)

    Häusler, U; Guminski, B; Helmchen, U; Kisters, K; Heinz, C; Braun, J

    2013-05-01

    The tubulo-interstitial nephritis and uveitis (TINU) syndrome, first described in 1975, is a rare disease most probably of autoimmune origin that is characterized by unilateral or bilateral uveitis and tubulointerstitial nephritis. Most patients are adolescents and it is sometimes associated with other autoimmune diseases, such as spondyloarthritis, rheumatoid arthritis and hyperthyroidosis. This article reports the case of a 43-year-old female patient who presented with refractory recurrent bilateral uveitis despite therapy with high doses of corticosteroids in combination with cyclosporin. When the patient was referred to this hospital for rheumatological examination after almost 1 year of therapy, mild renal insufficiency and proteinuria were found. The kidney biopsy revealed interstitial nephritis, partly crescent-shaped and partly chronic. A diagnosis of TINU syndrome was made and treatment with adalimumab in combination with methotrexate was started. The favorable clinical outcome indicated that tumor necrosis factor (TNF) alpha may play an important role in the pathogenesis of TINU syndrome.

  1. Anticipating issues related to increasing preimplantation genetic diagnosis use: a research agenda.

    Science.gov (United States)

    Klitzman, Robert; Appelbaum, Paul S; Chung, Wendy; Sauer, Mark

    2008-01-01

    Increasing use of preimplantation genetic diagnosis (PGD) poses numerous clinical, social, psychological, ethical, legal and policy dilemmas, many of which have received little attention. Patients and providers are now considering and using PGD for a widening array of genetic disorders, and patients may increasingly seek 'designer babies.' In the USA, although governmental oversight policies have been discussed, few specific guidelines exist. Hence, increasingly, patients and providers will face challenging ethical and policy questions of when and for whom to use PGD, and how it should be financed. These issues should be better clarified and addressed through collection of data concerning the current use of PGD in the USA, including factors involved in decision making about PGD use, as well as the education of the various communities that are, and should be, involved in its implementation. Improved understanding of these issues will ultimately enhance the development and implementation of future clinical guidelines and policies.

  2. Tic disorders in the differential diagnosis of chronic cough in children in relation to four cases.

    Science.gov (United States)

    Karakaya, Işık; Şişmanlar, Şahika Gülen

    2015-09-01

    Chronic cough is a frequent reason for medical referrals in childhood. In patients who do not have signs or symptoms of an underlying respiratory system disease and who do not respond to experimental treatment, psychogenic cough should be considered. In this paper, four patients who were referred to our department with a prediagnosis of psychogenic cough, found to have tic disorder as a result of the assessments performed and improved with antipsychotic medication are presented. The differantial diagnosis of chronic cough in children should include tic disorders as well as psychogenic cough. Tic disorders can be diagnosed easily with detailed history and their response to medical treatment is rather satisfactory. Recognition of these disorders by pediatricians will minimize erroneous diagnoses and inappropriate therapies in children with a complaint of chronic cough.

  3. Ethik, Recht und Theologie. Reproduktionstechnologien in Polen

    Directory of Open Access Journals (Sweden)

    Susanne Lettow

    2006-03-01

    Full Text Available Die bisherigen Debatten um Stammzellforschung, Klonen und Reproduktionstechnologien wurden in Deutschland weitgehend im nationalstaatlichen Rahmen und mit Blick auf Entwicklungen im angelsächsischen Raum geführt. Dabei sind diese Forschungsrichtungen und Technologien kein genuin „westliches“ Phänomen – immerhin wurde das erste Retortenkind in Polen bereits 1987 geboren. Heidi Hofmann lässt in ihrem Band polnische Philosoph/-innen, Jurist/-innen und Politikerinnen zu Wort kommen und öffnet den Blick dafür, dass die Art und Weise, in der Reproduktionstechnologien gesellschaftlich problematisiert werden, in Polen durch ganz andere politische, kulturelle und historische Konstellationen geprägt ist als in Deutschland.

  4. Restaurierung von Seen und Renaturierung von Seeufern

    Science.gov (United States)

    Grüneberg, Björn; Ostendorp, Wolfgang; Leßmann, Dieter; Wauer, Gerlinde; Nixdorf, Brigitte

    Süßwasserseen haben als ökosysteme und Lebensraum für Pflanzen und Tiere eine herausragende Bedeutung für die Artenvielfalt auf der Erde und prägen als Landschaftselemente unsere natürliche Umwelt. Seen fungieren als natürliche Stoffsenken, vor allem für Kohlenstoff und Nährstoffe, aber auch als Senken für in ihren Einzugsgebieten emittierte gelöste und feste Schadstoffe. Darüber hinaus ist Wasser eine wichtige Naturressource. Süßwasserseen stellen in den meisten Regionen der Erde lebenswichtige Quellen für die Versorgung mit Trinkwasser und tierischem Eiweiß (Fischfang) dar. Sie dienen als Wasserspeicher für die landwirtschaftliche und industrielle Nutzung. Auch für Erholungsaktivitäten des Menschen kommt ihnen eine große Bedeutung zu.

  5. Rapid-prenatal diagnosis through fluorescence in situ hybridization for preventing aneuploidy related birth defects.

    Science.gov (United States)

    Fauzdar, Ashish; Chowdhry, Mohit; Makroo, R N; Mishra, Manoj; Srivastava, Priyanka; Tyagi, Richa; Bhadauria, Preeti; Kaul, Anita

    2013-01-01

    Women with high-risk pregnancies are offered prenatal diagnosis through amniocentesis for cytogenetic analysis of fetal cells. The aim of this study was to evaluate the effectiveness of the rapid fluorescence in situ hybridization (FISH) technique for detecting numerical aberrations of chromosomes 13, 21, 18, X and Y in high-risk pregnancies in an Indian scenario. A total of 163 samples were received for a FISH and/or a full karyotype for prenatal diagnosis from high-risk pregnancies. In 116 samples both conventional culture techniques for getting karyotype through G-banding techniques were applied in conjunction to FISH test using the AneuVysion kit (Abbott Molecular, Inc.), following standard recommended protocol to compare the both the techniques in our setup. Out of 116 patients, we got 96 normal for the five major chromosome abnormality and seven patients were found to be abnormal (04 trisomy 21, 02 monosomy X, and 01 trisomy 13) and all the FISH results correlated with conventional cytogenetics. To summarize the results of total 163 patients for the major chromosomal abnormalities analyzed by both/or cytogenetics and FISH there were 140 (86%) normal, 9 (6%) cases were abnormal and another 4 (2.5%) cases were suspicious mosaic and 10 (6%) cases of culture failure. The diagnostic detection rate with FISH in 116 patients was 97.5%. There were no false-positive and false-negative autosomal or sex chromosomal results, within our established criteria for reporting FISH signals. Rapid FISH is a reliable and prompt method for detecting numerical chromosomal aberrations and has now been implemented as a routine diagnostic procedure for detection of fetal aneuploidy in India.

  6. E-Government und E-Banking: Aktueller Stand, Evaluation und Erfolgsfaktoren

    OpenAIRE

    Bayer, Tobias

    2002-01-01

    Zu Max Webers Zeiten entsprach die Bürokratie noch ganz dem Vorbild des preussischen Militärs " klare Hierarchien und klare Aufgabenbereiche schlugen sich nieder in Effizienz und Effektivität. Heute ist das Bild getrübt und Worte wie "Erstarrung", "Überreglementierung" und "Verwaltungskultur" machen die Runde. Neben den gestiegenen Erwartungen der Bürger, die sich in Zeiten des E-Banking und E-Commerce nicht mehr in lange Warteschlangen einreihen wollen und auf die rigiden Öffnungszeiten der ...

  7. Personen- und Güterverkehr

    Science.gov (United States)

    Flämig, Heike; Gertz, Carsten; Mühlhausen, Thorsten

    Im Jahr 2010 war in Deutschland der Verkehrssektor für fast 20 % der energiebedingten Treibhausgase verantwortlich. Das Klima hat sich bereits so weit verändert, dass zur Sicherung der Funktion der Verkehrssysteme auch Anpassungsmaßnahmen notwendig sind. Diese Maßnahmen müssen durch verkehrsreduzierende bzw. -beeinflussende Maßnahmen ergänzt werden. Ausgehend von den Emissionen im Verkehrssektor und möglichen Minderungen schlägt das Kapitel den Bogen zu Optionen der Anpassung an den Klimawandel, die ausführlich und konkret dargestellt werden. Besonders betrachtet werden die mannigfaltigen Gefahren der Rückkopplung sowie die vielfältigen Wechselwirungen mit anderen Themengebieten und Sektoren.

  8. A protocol for a new methodological model for work-related shoulder complex injuries: From diagnosis to rehabilitation.

    Science.gov (United States)

    Setuain, Igor; Gonzalez-Izal, Miriam; Paularena, Ainara; Luque, Jose Luis; Andersen, Lars L; Izquierdo, Mikel

    2017-02-07

    Work-related injuries of the shoulder complex represent a challenge for clinicians because of the large variety of clinical entities involved and the broad anatomic structures that can be affected. Furthermore, commonly performed orthopedic tests have demonstrated limited accuracy for diagnosing the injury despite considerable research efforts. The aim of this study protocol is therefore to describe a comprehensive approach integrating both a clinical- and functional status-based pathology and an adapted rehabilitation prescription. A longitudinal cohort study will be performed at the Department of Rehabilitation and Medical Assistance of a mutual insurance society for work-related injury management in Spain (Mutua Navarra, Pamplona, Navarra Spain). Patients will be attended by an occupational physician who specializes in work-related injuries and is part of the project team that will systematically visit all the participants. After the medical diagnosis and any requested supplementary evaluations (i.e., radiological examinations), the patients will be referred to the rehabilitation service. Before the physiotherapeutic rehabilitation program is initiated, the patients will undergo a comprehensive functional screening at the biomechanics laboratory. Using a decision-making scheme, the identified functional deficits will be used to customize the individual rehabilitation plan. The proposed objective criteria-based shoulder diagnosis and rehabilitation model could be a new effective strategy for minimizing the time required to regain functional capacity and recover from symptoms among patients with work-related shoulder injuries. The study protocol has been registered on Clinical Trials.gov as NCT02732002 (April 10 th 2016).

  9. Osteoporose und Genetik des Knochenstoffwechsels

    Directory of Open Access Journals (Sweden)

    Obermayer-Pietsch B

    2002-01-01

    Full Text Available Osteoporose ist in hohem Maß genetisch determiniert. Neue Wege der molekularbiologischen Forschung haben sich in den letzten Jahren auf diesem Gebiet etabliert. "Gene mapping" mit polymorphen genetischen Markern auf der Suche nach Phänotyp-assoziierten Genen ist ein aufwendiges, aber vielversprechendes Verfahren und wird durch die Erkenntnisse des Human Genome Projects beschleunigt. So wurde jüngst u. a. das Low-density Lipoprotein 5-Gen als wichtig für den Knochenstoffwechsel identifiziert. Kandidaten-gene wie Hormonrezeptor-, Cytokin- oder Kollagen-Gene werden hinsichtlich ihrer Gen-Gen- und Gen-Umwelt- Interaktionen untersucht und erlauben neue funktionelle Einsichten in Erkrankungen des Knochenstoffwechsels. Mutationen der Kollagen-Gene sind bei einigen seltenen Erkrankungen, wie dem Osteoporose-Pseudogliom-Syndrom oder der Osteogenesis imperfecta gefunden worden, könnten aber auch für häufige Varianten von Bindegewebsstörungen wie der congenitalen Hüftdysplasie verantwortlich sein, die etwa 10 % der weiblichen kaukasischen Bevölkerung in unterschiedlichem Ausmaß betrifft. Osteoporose am Schenkelhals und erhöhte Gelenkslaxizität sowie andere generalisierte Veränderungen des Knochen- und Kollagenstoffwechsels können hier möglicherweise ebenfalls durch Störungen des Kollagen I alpha 1-Gens erklärt werden. In Summe können wir zahlreiche neue Einsichten in die Pathophysiologie des Skelettsystems erwarten, die uns auch neue Zugangswege für Diagnostik und Therapie unserer Patienten ermöglichen werden.

  10. CLILiG und Musikunterricht

    Directory of Open Access Journals (Sweden)

    Merle Jung

    2015-10-01

    Full Text Available Der Einsatz von Musik und Liedern im Sprachunterricht ist seit der Entwicklung der kommunikativen Methoden ein beliebtes Thema in der Fremdsprachendidaktik. Musik und Sprache haben Ähnlichkeiten bei den kognitiven Verarbeitungsprozessen und der gedächtnisstützende Einfluss der Musik und ihr Nutzen für das Sprachenlernen sind allgemein bekannt. Dieser Nutzen wird aber meistens nur aus der (fremdsprachlichen Perspektive gezogen, die musikalische Erziehung der Lernenden bleibt im Hintergrund. Dabei bietet der bilinguale Musikunterricht mit der klaren Ausrichtung auf die musikalischen Ziele eine gute Möglichkeit, diese zwei Bereiche – Musik und Sprache – gleichwertig miteinander zu verbinden. Das Ziel des vorliegenden Beitrags ist es, die Vorteile des bilingualen Musikunterrichts zu erörtern und an einem Beispielmodul zum Thema Wetter im Herbst zu verdeutlichen. The use of music and songs in language teaching has been a popular topic in foreign language didactics since the development of communicative methods. Music and language have similarities in cognitive processing and the memory supporting influence of music and its beneficial effect on language learning are generally known. However, this benefit will usually be drawn only from the (foreign language perspective, the musical education of the learners remains in the background. Yet bilingual music education with a clear focus on the musical goals provides a great opportunity to connect these two areas - music and language - equally to each other. The aim of this paper is to discuss the advantages of bilingual music education and to present an example based on the bilingual module Weather in Autumn.

  11. Benign chordoma of the sacral bone. Radiologic appearance and differential dignosis; Benignes Chordom des Os Sacrum. Radiologische Morphologie und differential-diagnostische Aspekte

    Energy Technology Data Exchange (ETDEWEB)

    Pegios, W. [Strahlenklinik und Poliklinik, Freie Univ. Berlin (Germany); Vogl, T.J. [Strahlenklinik und Poliklinik, Freie Univ. Berlin (Germany); Rausch, M. [Strahlenklinik und Poliklinik, Freie Univ. Berlin (Germany); Klein, U. [Strahlenklinik und Poliklinik, Freie Univ. Berlin (Germany); Balzer, J.O. [Strahlenklinik und Poliklinik, Freie Univ. Berlin (Germany); Hammerstingl, R. [Strahlenklinik und Poliklinik, Freie Univ. Berlin (Germany); Mack, M.G. [Strahlenklinik und Poliklinik, Freie Univ. Berlin (Germany); Felix, R. [Strahlenklinik und Poliklinik, Freie Univ. Berlin (Germany)

    1994-12-31

    Chordomas constitute 3-4% of all primary bony tumors [17, 20] and they arise from remnants of the notochord [4]. They can occur anywhere along the skull base and spine, where the notochord extends. 50% arise in the sacrum, 35% in the clivus and 15% in the vertebrae [17, 20]. Chordomas usually occur after the second decade with the highest incidence between the fifth and seventh decade. There is a male predominance, with roughly a 2 to 1 male-to-female ratio. Children are rarely affected [5, 25, 34]. In this article a case of a patient with a Chordoma of the sacrum is presented. After a fall on the coccyx the patient complained of recurrent and altogether increasing pain for some years. The clinical diagnosis was fracture of the coccyx with consecutive formation of callus. Finally the MRI showed a characteristically increased signal intensity in the T2-weighted spin-echo sequence (SE). With the help of MRI guided biopsy the diagnosis of a benign highly differentiated chordoma could be confirmed. (orig.) [Deutsch] Chordome stellen 3 bis 4% aller primaeren Knochentumoren dar [17, 20] und gehen von den Resten der primitiven Chorda dorsalis aus [4]. Sie koennen ueberall dort auftreten, wo embryonale Reste des Chordagewebes vorhanden sind: 50% im Sacrum, 35% im Clivus und mit 15% an den Wirbelkoepern [17, 20]. Chordome werden in der Regel nach der zweiten Lebensdekade beobachtet und erreichen ihre hoechste Inzidenz zwischen der fuenften und der siebten Lebensdekade. Sie zeigen eine Praeferenz fuer das maennliche Geschlecht mit eine Relation von ungefaehr 2:1. Kinder sind seltener betroffen [5, 25, 34]. Im folgenden soll ein Patient mit einem Chordom des Os Sacrum vorgestellt werden. Nach Sturz auf das Steissbein klagte der Patient jahrelang ueber rezidivierende und insgesamt zunehmende Schmerzsymptomatik. Die klinische Diagnose lautete Zustand nach Steissbeinfraktur mit Kallusbildung. Die schliesslich durchgefuehrte MRT zeigte eine charakteristische erhoehte

  12. Carola Bauschke-Urban, Marion Kamphans, Felizitas Sagebiel (Hg.: Subversion und Intervention. Wissenschaft und Geschlechter(unordnung. Opladen u.a.: Verlag Barbara Budrich 2010.

    Directory of Open Access Journals (Sweden)

    Tina Jung

    2011-12-01

    Full Text Available Inwieweit sind die tradierten Geschlechterverhältnisse in Wissenschaft und Hochschule in Unordnung geraten? Neben empirischen Befunden, theoretischen Reflexionen und Praxisansätzen ist der vorliegende Sammelband mit biographischem Material und Würdigungen der Wissenschaftlerin Sigrid Metz-Göckel angereichert. Der Band gibt Einblicke in die Frauen- und Geschlechterforschung als nach wie vor umkämpftes Terrain in der Wissenschaftslandschaft sowie in die Universität als Arbeitsplatz, der (Karriere-Fallen und Hürden bereithält. Wissenschaft wird aber auch als Ort intellektueller und politischer Leidenschaft und (potentieller Teil eines guten Lebens begriffen. Hier schließt die Frage nach Leitorientierungen über bloß formale Geschlechtergerechtigkeit hinaus an, wie sie exemplarisch in einem Beitrag formuliert wird: Brot und Rosen!To what extent have the traditional gender relations in science and university become out of order? Besides empirical findings, theoretical reflections, and practical approaches, this anthology is enriched with biographical material and evaluations by the scientist Sigrid Metz-Göckel. The volume offers insights into women’s and gender studies as a still contested territory within the scientific community and within the university as a workplace, which holds both (career pitfalls and obstacles. However, science is also seen as a place for intellectual and political passion and a (potential part of a good life. Here, the question for a guiding orientation beyond mere formal gender equality connects as it is exemplarily formulated in one of the articles: bread and roses!

  13. Patients' perception of DED and its relation with time to diagnosis and quality of life: an international and multilingual survey.

    Science.gov (United States)

    Labetoulle, Marc; Rolando, Maurizio; Baudouin, Christophe; van Setten, Gysbert

    2017-08-01

    To improve understanding of patients' experience and perception of dry eye disease (DED) and its impact on quality of life (QoL). This survey was observational, non-interventional and cross-sectional. The survey was conducted online on 706 patients with DED from five European countries (France, Germany, Italy, Spain and the UK). All patients met the following inclusion criteria: 40 years or older with DED diagnosed by a healthcare professional (HCP), not wearing contact lenses and using tear substitutes daily for at least 6 months. The survey (performed in the five native languages) included 9 screening questions (inclusion criteria) and 26 complementary questions about patients' demography, disease history, DED diagnosis, use of relief treatments, perceptions of DED condition and its impact on QoL. Overall, 218 of 706 (31%) patients perceived DED as a 'disease' or even a 'handicap', and 468 of 706 (66%) as a 'discomfort'. High impact of DED on patients' QoL was associated with negative perception, delay in diagnosis, visits to more than one HCP before diagnosis and high frequency of treatment use. This survey also provided us with a list of language-specific keywords that patients used most frequently to spontaneously describe their condition. Findings showed that negative perception of DED, delayed diagnosis and high frequency of treatment use were inter-related, and that all have a negative impact on patients' QoL. The generated language-specific keywords used to describe DED could serve as the basis for a comprehensive QoL questionnaire to be used in clinical settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Strategische Beschaffung: Grundlagen, Planung und Umsetzung eines integrierten Supply Management

    NARCIS (Netherlands)

    van Weele, A.J.; Eßig, M.

    2017-01-01

    Dieses Buch bietet – erstmalig in deutscher Übersetzung – eine umfassende und sehr anschauliche Darstellung zu Grundlagen, Planung und Umsetzung einer modernen Beschaffungsfunktion. Beschaffung und Supply Management werden dabei als wesentliches Bindeglied innerhalb des Managementsystems eines

  15. Theoriebedingte Wörterbuchform- probleme und wörterbuch ...

    African Journals Online (AJOL)

    zunehmend mehr neue Elemente der Wörterbuchform im Vorspann, im Wörterverzeichnis und im. Nachspann ...... tur und -architektur aufweisen und sich nur quantitativ bei den überdachten ...... modernen Printwörterbüchern. Lexikos 18: ...

  16. Emil Fahrenkamp : Bauten und Projekte für Berlin

    NARCIS (Netherlands)

    Jacob, B.

    2006-01-01

    Thema der vorliegenden Arbeit ist die umfassende Aufarbeitung und Dokumentation der Bauten und Projekte Emil Fahrenkamps (*1885, 1966) in Berlin und Potsdam-Babelsberg sowie die kritische Einordnung seiner Arbeiten in den Kontext der Baugeschichte des 20. Jahrhunderts. Den zentralen

  17. [Preussen und Livland im Zeichen der Reformation] / Anti Selart

    Index Scriptorium Estoniae

    Selart, Anti, 1973-

    2015-01-01

    Arvustus: Preussen und Livland im Zeichen der Reformation. Hrsg. von Arno Mentzel-Reuters und Klaus Neitmann. (Tagungsberichte der Historischen Kommission für ost- und westpreussische Landesforschung, 28). Fibre Verlag. Osnabrück 2014

  18. Pre-diagnosis employment status and financial circumstances predict cancer-related financial stress and strain among breast and prostate cancer survivors.

    Science.gov (United States)

    Sharp, Linda; Timmons, Aileen

    2016-02-01

    Cancer may have a significant financial impact on patients, but the characteristics that predispose patients to cancer-related financial hardship are poorly understood. We investigated factors associated with cancer-related financial stress and strain in breast and prostate cancer survivors in Ireland, which has a complex mixed public-private healthcare system. Postal questionnaires were distributed to 1373 people diagnosed with cancer 3-24 months previously identified from the National Cancer Registry Ireland. Outcomes were cancer-related financial stress (impact of cancer diagnosis on household ability to make ends meet) and financial strain (concerns about household financial situation since cancer diagnosis). Modified Poisson regression was used to estimate relative risks (RR) for factors associated with cancer-related financial stress and strain. Seven hundred forty survivors participated (response rate = 54 %). Of the respondents, 48 % reported cancer-related financial stress and 32 % cancer-related financial strain. Compared to those employed at diagnosis, risk of cancer-related financial stress was significantly lower in those not working (RR = 0.71, 95 % CI 0.58-0.86) or retired (RR = 0.48, 95 % CI 0.34-0.68). It was significantly higher in those who had dependents; experienced financial stress pre-diagnosis; had a mortgage/personal loans; had higher direct medical out-of-pocket costs; and had increased household bills post-diagnosis. For cancer-related financial strain, significant associations were found with dependents, pre-diagnosis employment status and pre-diagnosis financial stress; risk was lower in those with higher direct medical out-of-pocket costs. Cancer-related financial stress and strain are common. Pre-diagnosis employment status and financial circumstances are important predictors of post-diagnosis financial wellbeing. These findings could inform development of tools to identify patients/survivors most in need of financial

  19. Optimizing the molecular diagnosis of CDKL5 gene-related epileptic encephalopathy in boys.

    Science.gov (United States)

    Mei, Davide; Darra, Francesca; Barba, Carmen; Marini, Carla; Fontana, Elena; Chiti, Laura; Parrini, Elena; Dalla Bernardina, Bernardo; Guerrini, Renzo

    2014-11-01

    Mutations involving the cyclin-dependent kinase-like 5 (CDKL5) gene cause an early onset epileptic encephalopathy (EE) with severe neurologic impairment and a skewed 12:1 female-to-male ratio. To date, 18 mutations have been described in boys. We analyzed our cohort of boys with early onset EE to assess the diagnostic yield of our molecular approach. We studied 74 boys who presented early onset severe seizures, including infantile spasms and developmental delay, in the setting of EE, using Sanger sequencing, next-generation sequencing (NGS) and multiplex ligation-dependent probe amplification (MLPA). We identified alterations involving CDKL5 in four boys (5.4%) using NGS in one and MLPA in three. Three of four mutations were indicative of somatic mosaicism. CDKL5 gene mutations accounted for 5.4% of boys with early onset EE. Somatic mosaic mutations might be even more represented than germline mutations, probably because their less deleterious effect enhances viability of the male embryo. The molecular approach used for CDKL5 screening remarkably influences the diagnostic yield in boys. Diagnosis is optimized by Sanger sequencing combined with array-based methods or MLPA; alternatively, NGS targeted resequencing designed to also detect copy number alterations, may be performed. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  20. Best practice guidelines for the molecular genetic diagnosis of Type 1 (HFE-related hereditary haemochromatosis

    Directory of Open Access Journals (Sweden)

    Barton David E

    2006-11-01

    Full Text Available Abstract Background Hereditary haemochromatosis (HH is a recessively-inherited disorder of iron over-absorption prevalent in Caucasian populations. Affected individuals for Type 1 HH are usually either homozygous for a cysteine to tyrosine amino acid substitution at position 282 (C282Y of the HFE gene, or compound heterozygotes for C282Y and for a histidine to aspartic acid change at position 63 (H63D. Molecular genetic testing for these two mutations has become widespread in recent years. With diverse testing methods and reporting practices in use, there was a clear need for agreed guidelines for haemochromatosis genetic testing. The UK Clinical Molecular Genetics Society has elaborated a consensus process for the development of disease-specific best practice guidelines for genetic testing. Methods A survey of current practice in the molecular diagnosis of haemochromatosis was conducted. Based on the results of this survey, draft guidelines were prepared using the template developed by UK Clinical Molecular Genetics Society. A workshop was held to develop the draft into a consensus document. The consensus document was then posted on the Clinical Molecular Genetics Society website for broader consultation and amendment. Results Consensus or near-consensus was achieved on all points in the draft guidelines. The consensus and consultation processes worked well, and outstanding issues were documented in an appendix to the guidelines. Conclusion An agreed set of best practice guidelines were developed for diagnostic, predictive and carrier testing for hereditary haemochromatosis and for reporting the results of such testing.

  1. Contribution of double-labelling scintigraphy to the diagnosis of chronic pancreatitis (relative to 50 observations)

    International Nuclear Information System (INIS)

    Palmas, Jacques.

    1975-01-01

    This study, after a short anatomical and anatomo-pathological survey, outlines the main stages in the discovery of the pancreatic label and attempts to define the practical problems encountered in the application of scintigraphic methods. The choice of pancreatic indicator is shown to have been very difficult and the substance used, after much research, is still imperfect: Se75-labelled methionine. To offset the defects of this tracer some remarkable techniques have been developed, for example electronic subtraction to cut out the liver image. The equipment used is then described, together with the working procedure adopted at the Angers U.H.C. The results obtained on 50 observations are given in table form. In the discussion the following points are dealt with in turn: scintigraph interpretation criteria, the diagnostic contribution of scintigraphy, the place of this examination in the positive diagnosis of chronic pancreatitis. Examination of a limited number of observations leads to certain conclusions in agreement with those formulated by many authors. The scintigram is first and foremost a 'function of the active parenchyma mass'. According to LEGER it is limited by the fact that the scintigraph cannot distinguish between different pathological processes. Nevertheless this examination is considered to have real diagnostic value in pancreatic diseases, especially when all abnormal images exist [fr

  2. Spectral characteristics of caries-related autofluorescence spectra and their use for diagnosis of caries stage

    Science.gov (United States)

    Son, Sung-Ae; Jung, Kyeong-Hoon; Ko, Ching-Chang; Kwon, Yong Hoon

    2016-01-01

    The purpose of the present study was to identify factors useful for diagnosis of the caries stage from laser-induced autofluorescence (AF) spectra. Affected teeth were accurately staged and allocated to four groups: sound, stage II, stage III, or stage IV. A 405-nm laser was used to produce AF spectra. The spectrum factors analyzed were spectrum slope at 550 to 600 nm, spectral area from 500 and 590 nm, and intensity ratio of peaks 625 and 667 nm (625/667 nm). DIAGNOdent was used as control measurement. AF spectra of sound teeth had a peak near 500 nm followed by a smooth decline to 800 nm. As caries progressed, some specimens in stages II to IV showed one or two peak(s) near 625 and 667 nm. Slopes at 550 to 600 nm and areas under the curve at 500 to 590 nm were significantly different (p<0.001) for each stage. Two-peak ratios were also significantly different (p<0.001) except for stage III and stage IV. DIAGNOdent readings for sound and stage II and stage III and IV were not significantly different. Among the studied factors, the spectrum slope at 550 to 600 nm and area under curve at 500 to 590 nm could be useful treatment decision-making tools for carious lesions.

  3. A web-based knowledge management system integrating Western and Traditional Chinese Medicine for relational medical diagnosis.

    Science.gov (United States)

    Herrera-Hernandez, Maria C; Lai-Yuen, Susana K; Piegl, Les A; Zhang, Xiao

    2016-10-26

    This article presents the design of a web-based knowledge management system as a training and research tool for the exploration of key relationships between Western and Traditional Chinese Medicine, in order to facilitate relational medical diagnosis integrating these mainstream healing modalities. The main goal of this system is to facilitate decision-making processes, while developing skills and creating new medical knowledge. Traditional Chinese Medicine can be considered as an ancient relational knowledge-based approach, focusing on balancing interrelated human functions to reach a healthy state. Western Medicine focuses on specialties and body systems and has achieved advanced methods to evaluate the impact of a health disorder on the body functions. Identifying key relationships between Traditional Chinese and Western Medicine opens new approaches for health care practices and can increase the understanding of human medical conditions. Our knowledge management system was designed from initial datasets of symptoms, known diagnosis and treatments, collected from both medicines. The datasets were subjected to process-oriented analysis, hierarchical knowledge representation and relational database interconnection. Web technology was implemented to develop a user-friendly interface, for easy navigation, training and research. Our system was prototyped with a case study on chronic prostatitis. This trial presented the system's capability for users to learn the correlation approach, connecting knowledge in Western and Traditional Chinese Medicine by querying the database, mapping validated medical information, accessing complementary information from official sites, and creating new knowledge as part of the learning process. By addressing the challenging tasks of data acquisition and modeling, organization, storage and transfer, the proposed web-based knowledge management system is presented as a tool for users in medical training and research to explore, learn and

  4. Analysis of data related to the updating of diagnosis reference levels in radiology and nuclear medicine. Assessment 2007-2008

    International Nuclear Information System (INIS)

    2010-01-01

    This report presents the results of the analysis of 'patient' dosimetric data which radiology and nuclear medicine establishments must supply every year to the IRSN (the French Radioprotection and Nuclear Safety Institute) according to a decree related to diagnosis reference levels in radiology and nuclear medicine. The analysed dosimetric data concern assessments performed during 2007 and 2008. For the different concerned practices (radiology, scanography, nuclear medicine), the report proposes a presentation and a discussion of global data, and then a presentation of data either for different types of examination on adults and on children, or for the different parts of the body

  5. The effect of financing hospital health care providers through updated Diagnosis Related Groups. Case studies: the municipal hospitals in Romania

    Directory of Open Access Journals (Sweden)

    Emil OLTEANU

    2014-11-01

    Full Text Available In our scientific approach we tried to develop a model with which to highlight the effect of financing hospital health care providers using the hospital 's Diagnosis Related Groups (DRG and Mean Relative Values (MRV. The econometric model used is simple linear regression model form. Development of the model was performed by using the EViews 7 to the municipal hospitals in Romania during 2010 - 2012, being considered DRG dependent variable and independent variables: C and MRV. Analyzing in detail the results recorded by providers following simple regression model is observed that there are units which, although recorded low values in the number of patients discharged, they were able to achieve a relatively high VRM or to contract a level of TAC over average of the entire sample.

  6. [Geisteswissenschaft und Publizistik im Baltikum des 19. und frühen 20. Jahrhunderts] / Manfred von Boetticher

    Index Scriptorium Estoniae

    Boetticher, Manfred von, 1947-

    2012-01-01

    Arvustus: Geisteswissenschaft und Publizistik im Baltikum des 19. und frühen 20. Jahrhunderts (Schriften der Baltischen Historischen Kommission, 17; Baltische Biographische Forschungen, 1). Hrsg. von Norbert Angermann, Wilhelm Lenz und Konrad Maier. (Berlin: LIT-Varlag, 2011)

  7. PATHOPHYSIOLOGY, DIAGNOSIS AND TREATMENTOF DUMPING SYNDROME AND ITS RELATION TO BARIATRIC SURGERY.

    Science.gov (United States)

    Chaves, Yasmin da Silva; Destefani, Afrânio Côgo

    The dumping syndrome is frequent in bariatric surgery. It is probably the most common syndrome following partial or complete gastrectomy. Its prevalence in partial gastrectomy can reach up to 50%, thus it can be a significant complication arising from some types of bariatric surgeries. Critical analysis on dumping syndrome, its pathophysiology, diagnosis and treatment. A literature review was performed using the key words: 'dumping syndrome', 'bariatric surgery' and 'rapid dumping syndrome'. Inclusion criteria were: books, original works, case reports and meta-analyzes, and the exclusion criterion was literature review. Concerning the publication time, articles were screened between 1960 and May 2015. The dumping syndrome is complication arising from obesity surgeries, but also can be a result of vagus nerve damage. Diagnosis is done primarily through the use of questionnaires based on scores. The Sigstad score and Arts survey are valid means for assessing the dumping syndrome. Initial therapy consists in the adoption of dietary measures, short acting drugs administration. A síndrome de dumping é frequente após operações bariátricas. É, provavelmente, a mais comum das síndromes que sucedem gastrectomias parciais ou completas. Sua prevalência, em gastrectomias parciais pode chegar a até 50%, tornando-se assim complicação significante em alguns tipos de operações bariátricas. Realizar análise crítica sobre a síndrome de dumping em sua fisiopatologia, diagnóstico e tratamento. Foi realizada revisão bibliográfica utilizando os descritores: 'síndrome de dumping', 'cirurgia bariátrica' e 'síndrome do esvaziamento rápido'. Os critérios de inclusão foram: livros, trabalhos originais, relatos de caso e metanálises; excluíram-se as revisões bibliográficas. Quanto ao tempo de publicação, foram selecionados artigos entre 1960 e maio de 2015. A síndrome de dumping é complicação gastrointestinal oriunda de operações para obesidade, mas tamb

  8. Age at diagnosis in women with non-metastatic breast cancer: Is it related to prognosis?

    International Nuclear Information System (INIS)

    Alieldin, N.H.; Abo-Elazm, O.M.; Bilal, D.; Ibrahim, A.S.; Salem, S.E.; Gouda, E.; Elmongy, M.

    2014-01-01

    Objective: Primary objective was to verify whether breast cancer patients aged less than 40 years at diagnosis have poorer prognosis than older patients. Secondary to assess prognostic factors influencing disease free survival. Methods: 941 women were diagnosed with non-metastatic breast cancer at NCI, Cairo in 2003. Epidemiologic, clinico-pathological characteristics, treatment modalities and disease free survival were compared among the two age groups. Prognostic factors were evaluated for association with disease-free survival. Results: One hundred-eighty-one patients (19.2%) were younger than 40 years and 760 (80.8%) were older. Older women presented with higher rates of comorbidities and younger women presented with more hormone non-responsive tumors. Young women presented with larger tumors pT4 = 13.8% compared to 8.6% in older women, yet not significant. Young women were treated with more conservative surgery, more adjuvant chemotherapy and radiotherapy while older women with more radical mastectomies and more hormonal treatment. Recurrence rates were significantly higher among young women 44,2% compared to 34.5% in older women. Five year disease free survival in young women was 38.9% ± 4.6% compared to 48.6% ± 2.5% with adjusted hazard ratio of 1.22 95% Cl (0.91-1.64),p = 0.19. Multivariate analyses identified positive axillary lymph nodes (pN2-pN3), larger tumor size (pT3-pT4), hypertension, lobular carcinoma type and lack of adjuvant systemic treatment as independent factors associated with poor DFS. Conclusion: Young women were not found to have poorer prognosis, yet they presented with more ER negative tumors. Most of women presented with advanced stage and young women had higher recurrence rates.

  9. Benzodiazepine prescription in relation to psychiatric diagnosis and patient characteristics: A pilot study

    Directory of Open Access Journals (Sweden)

    Marić Nađa P.

    2015-01-01

    Full Text Available Introduction: Benzodiazepines are widely used drugs which are often misused. Analysis of psychotropic drugs prescription in Serbia showed high prescription rate of benzodiazepines in the psychiatric patient population, with an increasing trend. Potential association between psychiatric diagnostic categories (organic brain syndrome, psychotic disorders, bipolar disorder, unipolar depression, anxiety disorder, personality disorder, or the sociodemographic characteristics of patients (gender, age, education, marital state and benzodiazepine prescribing practice was not thoroughly tested. Aim: By analyzing routine practice of the university clinic, the aim of this study was to examine whether there is an association between clinical or socio-demographic characteristics of the patients and benzodiazepine prescribing practice. Material and methods: This study was carried out by retrospective analysis of the patient's medical charts after hospital discharge (n=102. Data analysis included descriptive statistics, testing the difference between groups and correlation analysis. Results: At the discharge, 94.1% of patients had benzodiazepines prescribed, with an average dose of 4.6 ± 3.2mg lorazepam dose equivalents. It is shown that female patients were prescribed with higher doses of benzodiazepines than male patients (p=0.018, that the average dose was higher for patients treated with an overall larger number of psychiatric drugs (p = 0.013, as well as that hospital inpatients had higher doses compared to day hospital-treated patients (p = 0.011. Patients with a diagnosis of personality disorder had a slight upward trend of benzodiazepine dose (p=0.078. Conclusion: Current research provided a clear insight into the actual practice of benzodiazepine prescription at local university center. Similarly to our region, indications for prescribing benzodiazepines appear to be quite broad and not specific enough worldwide. This is why it is important to

  10. Radiographic diagnosis of mechanical obstruction in dogs based on relative small intestinal external diameters.

    Science.gov (United States)

    Finck, Cyrielle; D'Anjou, Marc-André; Alexander, Kate; Specchi, Swan; Beauchamp, Guy

    2014-01-01

    Mechanical obstruction is a frequent cause of acute vomiting in dogs requiring prompt diagnosis to improve patient management and prognosis. The purpose of this retrospective study was to compare small intestinal radiographic characteristics in dogs with versus without mechanical intestinal obstruction. Fifty dogs with gastrointestinal clinical signs and abdominal radiographs were recruited from hospital record archives and assigned to groups (group 1, obstructive, n = 25; group 2, nonobstructive n = 25). Abdominal radiographs were randomized and independently interpreted by three examiners who were unaware of group status. Intestinal dilation was subjectively scored based on distribution (segmental, regional or diffuse), and severity (absent, mild, moderate or severe). Small intestinal maximal diameter (SImax), L5 vertebral body height, small intestinal minimal diameter (SImin), and an estimated average of small intestinal diameters (SIave) were measured and three ratios were calculated: SImax/L5, SImax/SImin, and SImax/SIave. Segmental dilation was more prevalent in obstructed dogs for all examiners (P ≤ 0.03) and most nonobstructed dogs had no dilation (P ≤ 0.05). All ratios were higher in obstructed dogs (P dogs with SImax/L5 ≤ 1.4, SImax/SImin ≤ 2, and SImax/SIave ≤ 1.3 values are very unlikely to be mechanically obstructed; dogs with SImax/L5 ≥ 2.4, SImax/SImin ≥ 3.4 and SImax/SIave ≥ 1.9 are very likely obstructed, particularly if segmental dilation (less than 25% of the small intestine) is present. Dogs with ratios falling between these thresholds may need further testing unless other signs justify surgical exploration or endoscopy. © 2014 American College of Veterinary Radiology.

  11. Entwicklung und Anwendung neuer NMR-Methoden: Orientierungsmedien zur Strukturbestimmung mit anisotropen Parametern und Metabonomics

    OpenAIRE

    Büchler, Silke

    2014-01-01

    Das Ziel dieser Arbeit war die Entwicklung und Anwendung neuer Orientierungsmedien zur Strukturbestimmung mit anisotropen Parametern, sowie die Etablierung von Metabonomics-Studien an Flüssigzellkulturen und Reispflanzen.

  12. Using clinician text notes in electronic medical record data to validate transgender-related diagnosis codes.

    Science.gov (United States)

    Blosnich, John R; Cashy, John; Gordon, Adam J; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Fine, Michael J

    2018-04-04

    Transgender individuals are vulnerable to negative health risks and outcomes, but research remains limited because data sources, such as electronic medical records (EMRs), lack standardized collection of gender identity information. Most EMR do not include the gold standard of self-identified gender identity, but International Classification of Diseases (ICDs) includes diagnostic codes indicating transgender-related clinical services. However, it is unclear if these codes can indicate transgender status. The objective of this study was to determine the extent to which patients' clinician notes in EMR contained transgender-related terms that could corroborate ICD-coded transgender identity. Data are from the US Department of Veterans Affairs Corporate Data Warehouse. Transgender patients were defined by the presence of ICD9 and ICD10 codes associated with transgender-related clinical services, and a 3:1 comparison group of nontransgender patients was drawn. Patients' clinician text notes were extracted and searched for transgender-related words and phrases. Among 7560 patients defined as transgender based on ICD codes, the search algorithm identified 6753 (89.3%) with transgender-related terms. Among 22 072 patients defined as nontransgender without ICD codes, 246 (1.1%) had transgender-related terms; after review, 11 patients were identified as transgender, suggesting a 0.05% false negative rate. Using ICD-defined transgender status can facilitate health services research when self-identified gender identity data are not available in EMR.

  13. Acute myocardial infarction and diagnosis-related groups: patient classification and hospital reimbursement in 11 European countries

    Science.gov (United States)

    Quentin, Wilm; Rätto, Hanna; Peltola, Mikko; Busse, Reinhard; Häkkinen, Unto

    2013-01-01

    Aims As part of the diagnosis related groups in Europe (EuroDRG) project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with patients admitted to hospital for acute myocardial infarction (AMI). The study aims to assist cardiologists and national authorities to optimize their DRG systems. Methods and results National or regional databases were used to identify hospital cases with a primary diagnosis of AMI. Diagnosis-related group classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify AMI patients according to different sets of variables into diverging numbers of DRGs (between 4 DRGs in Estonia and 16 DRGs in France). The most complex DRG is valued 11 times more resource intensive than an index case in Estonia but only 1.38 times more resource intensive than an index case in England. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only €420 in Poland but to €7930 in Ireland. Conclusions Large variation exists in the classification of AMI patients across Europe. Cardiologists and national DRG authorities should consider how other countries' DRG systems classify AMI patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement. PMID:23364755

  14. Does awareness of diagnosis influence health related quality of life in north Indian patients with lung cancer ?

    Science.gov (United States)

    Aggarwal, Ashutosh Nath; Singh, Navneet; Gupta, Dheeraj; Behera, Digambar

    2016-05-01

    Several patients with cancer in India are not aware of their diagnosis. We evaluated the impact of awareness of cancer diagnosis on health-related quality of life (HRQL) in newly diagnosed patients with lung cancer. A total of 391 treatment-naïve patients with lung cancer, seen at the Lung Cancer Clinic of a tertiary care hospital in north India, were categorized into those aware of their diagnosis (group A) and those not aware (group B). All patients answered Hindi versions of abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref) and European Organization for Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ-C30), and its lung cancer module, EORTC QLQ-LC13. Various domain scores were computed and compared between the two groups. Analysis of covariance was used to determine significance of differences after adjustment for potential confounding factors. Only 117 (29.9%) patients were aware of their diagnosis. Of all, 302 (77.2%) patients had non-small cell lung cancer, and 301 (77.0%) had advanced disease. All HRQL domain scores were similar between the two groups, except that group B patients had significantly poorer median (interquartile range) Physical [39.3 (28.6-50.0) vs 46.4 (28.6-57.1)] and Environment [46.9 (40.6-56.3) vs 53.1 (0.6-65.6)] domain scores of WHOQOL-Bref, and p0 hysical function [60.0 (40.0-73.3) vs 66.7 (46.7-80.0)] and Fatigue [66.7 (55.6-77.8) vs 66.7 (44.4-66.7)] scores of QLQ-C30. After adjusting for gender, age, education, family income, and tumour extent, these differences were not significant. Disclosure of cancer diagnosis, or lack of it, had no significant impact on HRQL in patients with lung cancer after adjustment of potential confounders.

  15. Does awareness of diagnosis influence health related quality of life in north Indian patients with lung cancer ?

    Directory of Open Access Journals (Sweden)

    Ashutosh Nath Aggarwal

    2016-01-01

    Full Text Available Background & objectives: Several patients with cancer in India are not aware of their diagnosis. We evaluated the impact of awareness of cancer diagnosis on health-related quality of life (HRQL in newly diagnosed patients with lung cancer. Methods: A total of 391 treatment-naïve patients with lung cancer, seen at the Lung Cancer Clinic of a tertiary care hospital in north India, were categorized into those aware of their diagnosis (group A and those not aware (group B. All patients answered Hindi versions of abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref and European Organization for Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ-C30, and its lung cancer module, EORTC QLQ-LC13. Various domain scores were computed and compared between the two groups. Analysis of covariance was used to determine significance of differences after adjustment for potential confounding factors. Results: Only 117 (29.9% patients were aware of their diagnosis. Of all, 302 (77.2% patients had non-small cell lung cancer, and 301 (77.0% had advanced disease. All HRQL domain scores were similar between the two groups, except that group B patients had significantly poorer median (interquartile range Physical [39.3 (28.6-50.0 vs 46.4 (28.6-57.1] and Environment [46.9 (40.6-56.3 vs 53.1 (0.6-65.6] domain scores of WHOQOL-Bref, and p0 hysical function [60.0 (40.0-73.3 vs 66.7 (46.7-80.0] and Fatigue [66.7 (55.6-77.8 vs 66.7 (44.4-66.7] scores of QLQ-C30. After adjusting for gender, age, education, family income, and tumour extent, these differences were not significant. Interpretation & conclusions: Disclosure of cancer diagnosis, or lack of it, had no significant impact on HRQL in patients with lung cancer after adjustment of potential confounders.

  16. Klimaanpassung in Land- und Forstwirtschaft: Ergebnisse eines Workshops der Ressortforschungsinstitute FLI, JKI und Thünen-Institut

    OpenAIRE

    Schimmelpfennig, Sonja; Heidecke, Claudia; Beer, Holger; Bittner, Florian; Klages, Susanne; Krengel, Sandra; Lange, Stefan

    2018-01-01

    Das Working Paper stellt die Ergebnisse einer Umfrage und eines Workshops zusammen, die von Wissenschaftlern und Wissenschaftlerinnen der Ressortforschungsinstitute Thünen-Institut, Julius Kühn-Institut (JKI) und Friedrich-Loeffler-Institut (FLI) im Herbst 2016 zusammengetragen und diskutiert worden sind. Ziel des Workshops und der Umfrage war, den Stand des Wissens zu Klimaanpassungsthemen in der Ressortforschung des BMEL und die zukünftigen Herausforderungen einer Anpassung an den Klimawand...

  17. Geschmackspapillendichte und Geschmackswahrnehmung bei Jugendlichen mit Essstörungen und einer gesunden Kontrollgruppe

    OpenAIRE

    Kaltenhofer, Alice

    2009-01-01

    Fragestellung Die Schmeckwahrnehmung wird u.a. über Lernprozesse, kognitive Vorgänge, genetische und biochemische Faktoren reguliert. Ess- und Diätverhalten werden durch sie beeinflusst. Den anatomisch und physiologisch ersten Abschnitt der Schmeckwahrnehmung bilden die fungiformen Geschmackspapillen. In den Geschmackspapillen liegen die Geschmacksknopsen, mit deren Hilfe die Schmeckstoffe aufgenommen und in Form von Aktionspotentialen zum Thalamus, dem limbischen System,dem Gyrus postzentral...

  18. Kontrolle des Verwaltungsrates : eine Untersuchung der internen und externen Kontrollinstitutionen, -instrumente und -mechanismen

    OpenAIRE

    Reust, Dominik

    2014-01-01

    Eine wichtige Erkenntnis dieser Arbeit ist, dass eine effiziente und effektive Kontrolle des Verwaltungsrates nur über das Zusammenspiel der internen körperschaftlichen Kontrollinstitutionen und -instrumente mit den externen Kontrollinstitutionen und Kontrollmechanismen des Marktes erreicht wird. Die Vorschriften der VegüV betreffend transparente Entschädigungspolitik und unabhängige Stimmrechtsvertreter sowie die in der Aktienrechtsrevision angestrebte Stärkung der Informations-, Mitwirk...

  19. Recht und Rechtssystem als globale Struktur und Medium der Verhaltensorientierung / Raul Narits

    Index Scriptorium Estoniae

    Narits, Raul, 1952-

    2008-01-01

    Äratr.: Multiple Modernität, Globalisierung der Rechtsordnung und Kommunikationsstruktur der Rechtssysteme : Internationales Symposium zur Theorie der Rechtskommunikation an der Universität Tartu im April 2006 ; II. Sonderheft Estland. Berlin, 2008, lk. 219-238. - (Rechtstheorie : Zeitschrift für Logik und Juristische Methodenlehre, Rechtsinformatik, Kommunikationsforschung, Normen- und Handlungstheorie, Soziologie und Philosophie des Rechts ; Bd. 38, 2007, H. 2/3)

  20. Das Sabbatjahr für Lehrerinnen und Lehrer: Wer profitiert und in welcher Form?

    OpenAIRE

    Rothland, Martin

    2013-01-01

    Das Sabbatjahr für Lehrerinnen und Lehrer wird programmatisch als Maßnahme der Belastungsreduktion, der Regeneration sowie der Ressourcenstärkung diskutiert. Empirische Belege für die erwarteten Effekte finden sich jedoch kaum. Im Rahmen einer Längsschnittstudie mit drei Erhebungszeitpunkten vor, während und nach dem Sabbatjahr werden die Entwicklung der Belastungswahrnehmung, des Gesundheitszustands und allgemeiner sowie arbeitsbezogener Emotionen (Berufs- und Lebenszufriedenheit) auf der Ba...

  1. Referenzmodelle im Mobile Business: Analyse und Entwicklung neuer Rollen, Szenarien und Geschäftsmodelle

    OpenAIRE

    Hufenbach, Yvonne

    2016-01-01

    Das digitale Zeitalter ist charakterisiert durch sich stetig wandelnde Märkte, Techniken und wirtschaftliche Voraussetzungen. Klassische Wertschöpfungsketten brechen auf und wandeln sich zu Wertschöpfungsnetzen. Dabei findet eine Neuzuordnung zwischen Wertschöpfungstätigkeiten und Marktteilnehmern statt. Diese digitale Welt ist zudem durch hohe Interdependenzen wirtschaftlicher, informationstechnischer und rechtlicher Fragestellungen gekennzeichnet. Vor diesem Hintergrund verfolgt die Arb...

  2. EVALUATION OF THE IMPORTANCE OF BIOCHEMICAL PARAMETERS IN RELATION TO ULTRASONOGRAPHIC FINDING IN ECTOPIC PREGNANCY DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    Dragan Lončar

    2011-09-01

    Full Text Available The implantation of the fertilized egg outside the uterine cavity leads to the development of ectopic pregnancy. The incidence of ectopic pregnancy is 1/100 births. The most common place of ectopic implantation of the fertilized ovum is the oviduct (98% with predilection for the ampullar part of the Fallopian tube. The aim of this study was to determine the predictive importance of beta-hCG and progesterone concentration compared to ultrasonographic finding in the ectopic pregnancy diagnosis.We examined 24 patients with ectopic pregnancies which we divided according to the days of amenorrhea into two groups: the first group with the total of 28 patients from 16–42 days and another group of 8 patients with amenorrhea longer than 42 days. The control group was comprised of 20 patients with vital intrauterine pregnancy, gestational age of 42-52 days. Blood samples for quantitative determination of hormones were collected on three occasions after 48 hours in the forenoon time in the examined and control group of pregnant women. Ultrasonographic examinations of all pregnant women were carried out immediately after blood sampling, with the trans-vaginal approach using "make loop" option, and measurements with an accuracy of 0.1 mm.Mean values for beta-hCG range from 698-1774 mlU/ml in the first group of pregnant women, and in the second group of 1896 mlU/ml to 4410 mlU/ml with a statistically significant difference compared to the values in the control group (p <0.001. The concentration of progesterone in the first group of women ranging from 41-70 nmol/l, and in the second group of 76-94 nmol/l which is also the statistically significant difference compared to the control group (p<0.002. We have shown that ultrasonographic finding with its parameters reliably predicts the values of biochemical parameters both in normal intrauterine pregnancy and in the case of ectopic pregnancy.Embryo viability and implantation place condition the values of

  3. Arbeitszeitflexibilisierung in der westdeutschen Metall- und Elektroindustrie und die Verbandsstrategien - Eine vergleichende Analyse der arbeitszeitpolitischen Strategien des Arbeitgeberverbandes Gesamtmetall und der Industriegewerkschaft Metall

    OpenAIRE

    Altun, Ufuk

    2005-01-01

    Arbeitszeitpolitik und Arbeitszeitgestaltung haben seit dem Tarifkompromiss im Jahre 1984 in der Metall-, und Elektroindustrie in der politischen und wissenschaftlichen Diskussion einen immensen Bedeutungszuwachs erfahren. Die Forderungen nach einer flexibleren Arbeitszeitgestaltung haben zeitgleich sowohl aus der Globalisierungsdiskussion und der Debatte um die Wettbewerbsfähigkeit des "Wirtschaftsstandorts Deutschland" heraus wie auch aus beschäftigungspolitischen Gründen neuen Auftrieb bek...

  4. Sewage sludge volumes and disposal strategies in Germany and Europe today; Aktuelle Klaerschlammmengen und Ihre Entsorgung in Deutschland und Europa

    Energy Technology Data Exchange (ETDEWEB)

    Esch, B.; Loll, U.

    2001-07-01

    This report presents the latest data published by the Federal Statistical Authority on the quantities of sewage sludges in Germany and their disposal. It also shows the quantities and their relation to the population. In addition to the quantities of sewage sludge, their qualities are also shown. The report is completed by data from the European Union. With brief explanations and clear graphics, the statistical key data can help anybody to achieve an extensive overview of the subject. The report also gives ideas for in-debth studies. [German] In vorliegendem Bericht werden die aktuellsten Daten des Statistischen Bundesamtes zum Anfall und Entsorgung der Klaerschlaemme in Deutschland vorgestellt. Es wird weiterhin dargestellt, wie sich die Mengen im Verhaeltnis zwischen Einwohner und Einwohnergleichwerten verhalten. Neben den Klaerschlammmengen werden auch die Klaerschlammqualitaeten dargestellt. Ergaenzt wird dieser Bericht durch Daten aus der Europaeischen Union. Mit kurzen Erlaeuterungen und anschaulichen Grafiken koennen die Eckdaten der Statistik jedem zu einem umfassenden Ueberblick verhelfen. Fuer vertiefende Studien werden Anhaltspunkte und Anregungen gegeben. (orig.)

  5. Osteopetrose - aktuelle Diagnostik und Therapie

    Directory of Open Access Journals (Sweden)

    Schulz AS

    2008-01-01

    Full Text Available Unter dem Begriff Osteopetrose wird eine heterogene Gruppe von Krankheiten zusammengefasst, die durch eine pathologisch vermehrte Knochenmasse charakterisiert ist. Diese Osteosklerose basiert in den meisten Fällen auf einem Defekt in der Knochenresorption durch Osteoklasten. Beim Menschen können mehrere Typen unterschieden und nach dem Vererbungsmodus, dem Manifestationsalter, der Schwere der klinischen Symptomatik und nach assoziierten Symptomen klassifiziert werden. Hauptformen sind die infantile "maligne" autosomal rezessive Osteopetrose (ARO, intermediäre autosomal rezessive Formen (IARO und milder verlaufende autosomal dominante Subtypen (ADO. In den letzten Jahren konnten mehrere zur Osteopetrose führende Genveränderungen identifiziert werden. Alle diese Genveränderungen bei humaner Osteopetrose betreffen Proteine, die an der Differenzierung oder Funktion der Osteoklasten beteiligt sind. Da die Osteoklasten sich aus der hämatopoietischen Stammzelle differenzieren, ist die hämatopoietische Stammzelltransplantation eine kurative Therapieoption bei schweren Osteopetroseformen. Allerdings ist diese Therapie mit erheblichen Risiken verbunden. Darüber hinaus sind bestimmte Subtypen der Osteopetrose mit schweren neurologischen Veränderungen assoziiert, die durch eine Stammzelltransplantation nicht positiv beeinflusst werden können. Ein genaues Verständnis der Pathogenese der humanen Osteopetrose ist daher wichtig für die Wahl der richtigen Therapie und gewährt darüber hinaus einen tieferen Einblick in die Physiologie and andere Pathologien des Knochens.

  6. Natur und Moderne um 1900

    DEFF Research Database (Denmark)

    , nordeuropäischen Vergleich widmen sich die Beiträge den medialen Repräsentationen von Natur (in Literatur, Philosophie, Film, Foto) ebenso wie der Kolonisierung des Raumes (in Tourismus, Reisen, Sport, Natur- und Heimatschutz). Der Band bietet damit auch Impulse für die neuen theoretisch-methodischen Ansätze der...

  7. Dynamic magnetic resonance defecography in the diagnosis of combined pelvic floor disorders in proctology; Dynamische MR-Defaekographie zur Diagnostik kombinierter Beckenbodenfunktionsstoerungen in der Proktologie

    Energy Technology Data Exchange (ETDEWEB)

    Paetzel, C.; Strotzer, M.; Lenhart, M.; Feuerbach, S. [Klinikum der Univ. Regensburg (Germany). Inst. fuer Roentgendiagnostik; Fuerst, A.; Rentsch, M. [Klinikum der Univ. Regensburg (Germany). Chirurgische Klinik und Poliklinik

    2001-05-01

    Evaluation of magnetic resonance defecography in the diagnosis of pelvic floor disorders were examined prospectively. MRI was performed on a 1.5 T scanner. The rectum was opacified with 200 ml of ultrasound transmission gel. A sagittal single section T2-weighted gradient echo sequence with a temporal resolution of 1.1 second was performed. Changes of the anorectal angle and the position of the pelvic organs in relation to the pubococcygeal line were registered at rest, during straining, and during evacuation of the rectum. Results: Patients with obstructed defecation (n = 15) showed prolapse of the rectal mucosa (n = 5), anterior rectocele (n = 8), pelvic floor descent (n = 5), enterocele (n = 2), and anorectal dyscoordination (n = 3). Individuals with stool incontinence (n = 15) had an anterior rectocele (n = 10), pelvic floor descent (n = 11), enterocele (n = 2), prolapse of rectal mucosa (n = 1), and a puborectal insufficiency (n = 1). Urine incontinence was associated with cystocele (n = 10) or normal findings (n = 4). In patients with unspecific symptoms (n = 6), anorectal dyscoordination (n = 4) and prolapse of the rectal mucosa (n = 2) were found. MRI was superior for the detection of enteroceles, cystoceles and pelvic floor descent compared with clinical investigation. Conclusion: Dynamic MR imaging supplies complex information in anorectal disease and thus improves protoscopy. (orig.) [German] Ziel dieser Studie war die Evaluierung der dynamischen MRT in der proktologischen Diagnostik. Patienten und Methode: in einer prospektiven Studie wurden 36 Patienten (27 Frauen, 9 Maenner) mit Beckenbodenfunktionsstoerungen an einem 1.5-T-Geraet konsekutiv untersucht. Das Rektum wurde mit 200 ml Ultraschallgel kontrastiert. Verwendet wurde eine T{sub 2}-gewichtete Gradientenechoseqenz mit einer zeitlichen Aufloesung von 1,1 Sekunden in Einzelschichttechnik. Aus den Ergebnissen von MRT und proktologischer Untersuchung wurde eine Konsensdiagnose erstellt, die die

  8. Technique and radiation dose of conventional X-rays and computed tomography of the sacroiliac joint; Technik und Strahlendosis konventioneller Roentgenaufnahmen und Computertomographie des Sakroiliakalgelenks

    Energy Technology Data Exchange (ETDEWEB)

    Jurik, A.G. [Department of Radiology R, Aarhus Kommunehospital (Denmark)

    2004-03-01

    Anterior-posterior (a.p.) or posterior-anterior X-rays of the sacroiliac joint, sometimes supplemented by a transverse view, have been the method of choice for diagnosis of patients suspected of having sacroiliitis. The sensitivity and specificity of conventional X-rays are relatively low, which can delay the diagnosis of sacroiliitis. Computed tomography (CT) is superior to conventional X-rays for diagnosis of sacroiliitis, but does emit a relatively higher dose of radiation. For this reason, particularly for females, CT should be optimized by employing semi-coronal planes, which require a lower radiation dose than axial planes. CT in a semi-coronal plane causes minimal radiation to the ovaries, and the effective radiation dose for women might even be lower than with conventional AP X-rays. Therefore, for suspected sacroiliitis in young women, CT in the semi-coronal plane is the preferred imaging method with respect to diagnostics and radiation protection when magnetic resonance imaging (MRI) is not available. Male gonads can be protected from radiation doses in conventional X-rays, and CT as the primary imaging method can only be justified in these cases because of its better diagnostic capabilities. Due to the lack of inherent risk factors, MRI is superior to CT for diagnostics since it provides images of inflammatory signs in addition to joint destruction. Thus, when available, MRI should be given preference for diagnosis of sacroiliitis. (orig.) [German] Roentgenaufnahmen des Sakroiliakalgelenks im anterior-posterioren bzw. posterior-anterioren Strahlengang, gelegentlich ergaenzt durch die Schraegaufnahme, sind seit vielen Jahren die Methode der Wahl fuer die Diagnostik bei Patienten mit Verdacht auf Sakroiliitis. Die Sensitivitaet und Spezifitaet des konventionellen Roentgens sind relativ niedrig, was die Diagnose der Sakroiliitis verzoegern koennte. Die Computertomographie (CT) ist dem konventionellen Roentgen fuer die Diagnostik der Sakroiliitis ueberlegen

  9. Magnetic resonance tomography and ultrasound in rheumatology; MRT und Sonographie in der Rheumatologie

    Energy Technology Data Exchange (ETDEWEB)

    Kainberger, F. [Universitaetsklinik fuer Radiodiagnostik, Ludwig-Boltzmann-Inst. fuer Physikalische und Radiologische Tumordiagnostik, Wien (Austria); Czerny, C. [Universitaetsklinik fuer Radiodiagnostik, Ludwig-Boltzmann-Inst. fuer Physikalische und Radiologische Tumordiagnostik, Wien (Austria); Trattnig, S. [Universitaetsklinik fuer Radiodiagnostik, Ludwig-Boltzmann-Inst. fuer Physikalische und Radiologische Tumordiagnostik, Wien (Austria); Lack, W. [Universitaetsklinik fuer Orthopaedie, Wien (Austria); Machold, K. [Universitaetsklinik fuer Innere Medizin III, Wien (Austria). Abt. fuer Rheumatologie; Graninger, W. [Universitaetsklinik fuer Innere Medizin III, Wien (Austria). Abt. fuer Rheumatologie

    1996-08-01

    Technical innovations and software improvements in magnetic resonance imaging (MRI) and high-resolution sonography (US) have definitely influenced the diagnostic imaging of rheumatic diseases. For MRI, improvements in surface coils, dedicated low-field systems (0.2 T), and software improvements (shorter acquisition times and refinements of fat suppressing techniques) must be mentioned. For sonography, the main innovations concern the development of higher transducer frequencies (7-15 Mhz) and power Doppler imaging. Clinical evaluations have shown that MRI and US are most useful in cases of suspected rheumatic disease with negative plain film radiographs and for documenting the course of the disease, diagnosing of early rheumatoid arthritis, making a differential diagnosis in clinically unclear rheumatic diseases, investigating vascularization, and quantifying pannus formation. In order to improve diagnostic efficacy the role of MRI and US in the management of patients with rheumatic disease should be reconsidered. (orig.) [Deutsch] Technische Innovationen in Hard- und Software von Magnetresonanztomographie (MRT) und Sonographiegeraeten haben die bildgebende Diagnostik in der Rheumatologie massgeblich beeinflusst (Verbesserungen der Oberflaechenspulen mit hohen Gradientenfeldern, dedizierte Niederfeldgeraete, Softwareverbesserungen in Form von kuerzeren Aquisitionszeiten und Verfeinerungen in der Fettunterdrueckung, hoehere Transducerfrequenzen zwischen 7 und 15 Mhz, Powerdopplerverfahren). Fuer die klinische Anwendung bedeutet dies, dass MRT und Sonographie als bildgebende Zusatzverfahren nach der Anfertigung konventioneller Roentgenaufnahmen anzuwenden sind, wenn diese unauffaellige Resultate ergeben oder spezielle Fragen zur Schwere des Krankheitsprozesses bzw. von Folgeerscheinungen zu beantworten sind. Im besonderen betrifft dies den Nachweis der Frueharthritis, die Differentialdiagnose klinisch nicht klar einzuordnender Krankheitsbilder und die Bestimmung des

  10. Prenatal diagnosis of Zellweger syndrome and related disorders: impaired degradation of phytanic acid

    NARCIS (Netherlands)

    Poulos, A.; van Crugten, C.; Sharp, P.; Carey, W. F.; Robertson, E.; Becroft, D. M.; Saudubray, J. M.; Poll-The, B. T.; Christensen, E.; Brandt, N.

    1986-01-01

    Normal amniocytes and chorionic villous cells in culture are able to produce 14CO2 from exogenous [1-14C] phytanic acid. In contrast, cells from four fetuses at risk for the cerebro-hepato-renal (Zellweger) syndrome and related disorders showed a greatly reduced activity, indicating a block in

  11. Value of scintigraphy in the diagnosis of infections related to continuous ambulatory peritoneal dialysis (CAPD)

    International Nuclear Information System (INIS)

    Soriano, A.; G-Vicence, A.M.; Torre, M. de la; Rodado, S.; Poblete, V.M.; Alcazar, R.

    2002-01-01

    Full text: Complications related to CAPD result in temporary or permanent discontinuation of CAPD. Approximately a 20 % of the patients on peritoneal dialysis are transferred to hemodialysis due to different complications, chief among these is peritonitis. Other complications are exit-site infections, catheter-related problems, hernias, poor ultrafiltration or clearance, etc. Although peritonitis remains the major cause of transfer to hemodialysis the accurate identification and localization the other infectious complications is necessary for their appropriate treatment. The aim of this study is to assess prospectively the value of scintigraphic with 99mTc-HMPAO labeled white blood cells (WBC) in-patients on CAPD with suspicious of infectious complications. From 1997 to 2000, 27 scintigraphies with 99mTc HMPAO labeled WBC were performed in 17 patients with suspicious of catheter related abdominal wall infection, assessed by Twardowski scale, or peritonitis. In five patients we carried out study of control after the onset of therapy to assess response. The procedure for radiolabeling WBC with 99mTc-HMPAO in our department is similar to the ISORBE consensus protocol. Planar images were obtained 30 minutes, 2 hours, and in some cases at 24 hours, after administration of 740-925 MBq of labeled WBC. Four patients with clinical evidence of peritonitis showed a diffuse uptake, in two of them we carried out scintigraphy after antibiotic therapy and we did not find abnormalities. From 18 scintigraphies with catheter-related local infection 6 showed focal uptake in patients with positive culture and pericatheter exudate. All patients with negative culture had normal scintigraphies. In 3 of them after antibiotic therapy and negative culture did not find pathologic abnormalities. Peritoneal and wall abdominal scintigraphy with WBC radiolabeling with 99mTc-HMPAO is useful method for evaluation of several CAPD-related infectious complications. (author)

  12. O desenvolvimento dos "Diagnosis Related Groups"- DRGs. Metodologia de classificação de pacientes hospitalares The development of "Diagnosis Related Groups" - DRGs, a methodology for classifying hospital patients

    Directory of Open Access Journals (Sweden)

    Marina F. Noronha

    1991-06-01

    Full Text Available É descrito o processo de desenvolvimento do sistema de classificação de pacientes internados em hospitais que atendem casos agudos, denominada Diagnosis Relatd Group - DRGs, desenvolvido e difundido por pesquisadores da Universidade de Yale, USA. Esse sistema vem a ser um instrumento que permite a mensuração do produto hospitalar, principalmente sob o ponto de vista gerencial. São apresentadas considerações acerca do que é entendido como produto hospitalar, seguindo nos meandros do desenvolvimento dos primeiros DRGs, até a mais recente revisão do sistema. É descrita sua utilização em alguns países e diversos usos potenciais desse sistema, que abrangem desde o uso para pagamento a instrumento de controle de qualidade.The history of Diagnosis Related Groups (DRG's, a system for classifying patients in acute care hospitals, developed by researchers at Yale University, USA, is reviewed. DRGs are an instrument for measuring the hospital product, primarily from a management viewpoint. Starting with a review of the definitions of hospital product, the article follows the course from the first DRGs through the most recent revision, providing a summary of potential and current applications of the system in several countries, which range from payment mechanism to uses in quality control.

  13. In vitro-Permeationsstudien von hydrophilen und lipophilen Arzneistoffen an okularen Geweben und Zellkulturen

    OpenAIRE

    Scholz, Martina

    2003-01-01

    Da die Arzneistoffpermeation durch okulare Gewebe einen entscheidenden Einfluss auf die Heilung vieler Augenleiden hat, wurde die in vitro-Permeation hydrophiler und lipophiler Arzneistoffe durch okulare Gewebe und Zellkulturen in dieser Arbeit untersucht. Die Dissertation befasst sich vorrangig mit der Permeation des hydrophilen Modellarzneistoffs Pilocarpinhydrochlorid (P-HCl) durch isolierte Schweinecornea (SC), Schweinesklera, Kaninchenkonjunktiva und corneale bzw. konjunktivale Kan...

  14. Philologie im Horizont der Geschichtlichkeit von Sprache und Text: zum Tagungsband von Wulf Oesterreicher und Maria Selig

    Directory of Open Access Journals (Sweden)

    Olaf Müller

    2016-03-01

    Full Text Available Wulf Oesterreicher und Maria Selig, Hrsg., Geschichtlichkeit von Sprache und Text: Philologien – Disziplingenese – Wissenschaftshistoriographie (Paderborn: Wilhelm Fink, 2014, 332 S.

  15. Environmental Information System Baden-Wuerttemberg, RIPS 2016. Spatial information and planning system; Umweltinformationssystem Baden-Wuerttemberg. Konzeption RIPS 2016. Raeumliches Informations- und Planungssystem

    Energy Technology Data Exchange (ETDEWEB)

    Weissenbach, Kurt; Czommer, Olaf; Ellmenreich, Bastian (eds.)

    2016-04-21

    The Spatial Information and Planning System (RIPS), as the overarching component of the Environmental Information System Baden-Wuerttemberg (UIS BW), implements the environmental and nature conservation-specific geoinformation-related requirements taking into account applicable framework conditions. To this end, RIPS offers tailor-made services on the basis of a standardized and in transnational cooperation developed technical kit for the areas of geodata processing and management as well as the development and provision of software components with geo-functions and geodata services as part of the technical and information procedures. The coordination and steering takes place via project development offices, working groups and committees in close coordination with the departments of environmental and nature conservation administration as well as further cooperation and in coordination with other specialist administrations. Taking into account changed framework conditions and new geo-referenced requirements in UIS BW, the present RIPS concept focuses on future-oriented geofunction and geodata management in the field of environmental and nature conservation management as well as the provision of geo-specialized environmental and nature conservation data for policy makers, administrators and the public on innovative technologies Applications and Services. [German] Das Raeumliche Informations- und Planungssystem (RIPS) setzt als uebergreifende Komponente des Umweltinformationssystems Baden-Wuerttemberg (UIS BW) die umwelt- und naturschutzspezifischen geoinformationsbezogenen Anforderungen unter Beruecksichtigung geltender Rahmenbedingungen um. Hierzu bietet RIPS massgeschneiderte Dienstleistungen auf der Basis eines standardisierten und in laenderuebergreifenden Kooperationen entwickelten technischen Baukastens fuer die Bereiche Geodatenverarbeitung und -management sowie die Entwicklung und Bereitstellung von Softwarekomponenten mit Geofunktionen und Geodatendiensten

  16. History of stress-related health changes: a cue to pursue a diagnosis of latent primary adrenal insufficiency.

    Science.gov (United States)

    Yamamoto, Toshihide

    2014-01-01

    Routine delays in the diagnosis of primary adrenal insufficiency (PAI) are well known and conceivably attributable to the absence of cues, other than anti-adrenal autoantibodies, to pursue subclinical PAI. Subclinical PAI is latent unless the afflicted patient encounters stress such as an acute illness, surgery, psychosocial burden, etc. It remains to be demonstrated whether a history of stress-related health changes is a useful cue to pursue a diagnosis of latent PAI. The patients were selected for a history of recurrent symptoms, i.e., gastrointestinal symptoms, fatigue, or lassitude, aggravated by stress and alleviated by the removal of stress, and signs, i.e., weight loss, hypotension, and hyperpigmentation. As the early morning cortisol levels were low or low-normal and the adrenocorticotropic hormone (ACTH) levels were within the reference ranges, provocation tests, i.e., insulin-induced hypoglycemia tests and low-dose (1 μg) corticotropin tests (LDTs), were used to estimate the hypothalamus-pituitary-adrenal (HPA) axis status. Patients with the HPA axis dysfunction on two provocation tests were supplemented with physiologic doses of glucocorticoids (GCs). The effects of GC supplementation on stress-related health changes were observed. The ACTH levels after insulin-induced hypoglycemia were higher and the cortisol levels were lower in the patients than in the control subjects. The cortisol levels in the patients were increased less significantly by LDT than those observed in the control subjects. Stress-related health changes ceased to recur and signs, i.e., a low body weight, hypotension, and hyperpigmentation, were ameliorated following GC supplementation. A history of stress-related health changes is useful as a cue to pursue latent PAI in patients with low or low-normal early morning cortisol levels.

  17. Zoophilie in Zoologie und Roman: Sex und Liebe zwischen Mensch und Tier bei Plutarch, Plinius dem Älteren, Aelian und Apuleius

    Directory of Open Access Journals (Sweden)

    Judith Hindermann

    2011-09-01

    Full Text Available Die Bedeutung von Zoophilie in der antiken Literatur wurde bislang – mit Ausnahme des Mythos – kaum untersucht. Überblickt man die überlieferten literarischen Texte, fällt auf, dass Zoophilie ausserhalb des Mythos vor allem in zwei literarischen Gattungen auftritt : Einerseits in den zoologischen Schriften von Plutarch, Plinius dem Älteren und Aelian, andererseits im antiken Roman, d.h. in den Metamorphosen des Apuleius und im pseudo-lukianischen Onos. In diesem Beitrag soll untersucht werden, welche Funktion Zoophilie in den beiden literarischen Gattungen hat und wie die Autoren die sexuelle Praktik bewerten, die weder nach griechischem noch römischen Recht strafbar war. Da Vorstellungen über Tiere eng mit Gender und Geschlechterhierarchien verbunden sind, soll insbesondere die Frage berücksichtigt werden, inwiefern männliche und weibliche Verhaltens- und Rollenzuschreibungen bei der Darstellung zoophiler Akte wirksam werden.

  18. Changes of Diagnosis Criteria for Gambling-Related Disorders and Psychoactive and Behavioral Addictions

    Directory of Open Access Journals (Sweden)

    Iwona Niewiadomska

    2017-01-01

    Full Text Available Autorki poruszają kwestię zmian w kryteriach diagnostycznych dotyczących zaburzeń związanych z hazardem oraz uzależnień chemicznych i czynnościowych w literaturze przedmiotu. Prezentują też krótki przegląd kolejnych edycji podręczników międzynarodowych klasyfikacji, zarówno Diagnostics and Statistical Manual of Mental Disorders – DSM, jak i The International Statistical Classification of Diseases and Related Health Problems – ICD. W artykule przedstawiona jest również dyskusja badaczy na temat umiejscowienia zaburzeń związanych z hazardem w klasyfikacjach diagnostycznych. DSM-V umiejscawia zaburzenie hazardowe w kategorii „zaburzenia używania substancji i nałogów” (ang. Substance-Related and Addictive Disorders, DSM-V, w podkategorii „zaburzenia niezwiązane z substancjami” (ang. Non-Substace Related Disorders, DSM-V. Natomiast według nadal obowiązującego ICD-10, zaburzenie hazardowe pozostaje w obszarze zaburzeń kontroli i impulsów, pod nazwą „hazard patologiczny”.

  19. Rapid Diagnosis of 83 Patients with Niemann Pick Type C Disease and Related Cholesterol Transport Disorders by Cholestantriol Screening

    Directory of Open Access Journals (Sweden)

    Janine Reunert

    2016-02-01

    Full Text Available Niemann Pick type C (NP-C is a rare neurodegenerative disorder caused by an impairment of intracellular lipid transport. Due to the heterogeneous clinical phenotype and the lack of a reliable blood test, diagnosis and therapy are often delayed for years. In the cell, accumulating cholesterol leads to increased formation of oxysterols that can be used as a powerful screening parameter for NP-C. In a large scale study, we evaluated the oxysterol cholestane-3β,5α,6β-triol (c-triol as potential biomarker for a rapid diagnosis of NP-C. Using GC/MS, c-triol has been analyzed in 1902 plasma samples of patients with the suspicion for NP-C. Diagnosis in patients with elevated oxysterols was confirmed by genetic analysis. 71 new NP-C patients (69 NP-C1 and two NP-C2 and 12 Niemann Pick type A/B patients were identified. 24 new mutations in NPC1, one new mutation in NPC2 and three new mutations in the SMPD1 gene were found. Cholestane-3β,5α,6β-triol was elevated in Niemann Pick type C1, type C2, type A/B and in CESD disease. No other study has ever identified so many NP-C patients, proving that c-triol is a rapid and reliable biomarker to detect patients with NP-C disease and related cholesterol transport disorders. It should replace the filipin test as the first-line diagnostic assay.

  20. Recht und soziales Kapital im Wohlfahrtsstaat

    OpenAIRE

    Karstedt, Susanne

    1997-01-01

    'Das Konzept des sozialen Kapitals spielt eine zentrale Rolle in der Diskussion um den Um- und Abbau des Wohlfahrtsstaates. Zerstört der Wohlfahrtsstaat soziales Kapital? Können staatliche Sozialleistungen durch das soziale Kapital in Familien, Nachbarschaften und Gemeinden umstandslos ersetzt werden, und individuelle Rechtsansprüche als Forderungen an diese sozialen Netzwerke zurückverwiesen werden? Kann die angestrebte 'Verantwortungsgesellschaft' (Etzioni) die Leistungen übernehmen, mit de...

  1. Variationen und ihre Kompensation in CMOS Digitalschaltungen

    OpenAIRE

    Baumann, Thomas

    2010-01-01

    Variationen bei der Herstellung und während des Betriebs von CMOS Schaltungen beeinflussen deren Geschwindigkeit und erschweren die Verifikation der in der Spezifikation zugesicherten Eigenschaften. In dieser Arbeit wird eine abstraktionsebenenübergreifende Vorgehensweise zur Abschätzung des Einflusses von Prozess- und betriebsbedingten Umgebungsvariationen auf die Geschwindigkeit einer Schaltung vorgestellt. Neben Untersuchungen der Laufzeitsensitivität in low-power CMOS Technologien von...

  2. Von Medien, Übertragungen und Automaten

    Directory of Open Access Journals (Sweden)

    Alessandro Barberi

    2013-12-01

    Full Text Available Im Zuge der Debatten zum Medialen Habitus wurde vielfach betont, dass die >Theorie der Praxispraxeologischen Medientheorie< des Medialen Habitus avant la lettre gesprochen werden kann. Dieser Artikel untersucht – ausgehend von den Debatten zur "Medienkompetenz" – wie Bourdieu Sprache, Sprechen und Diskurs, sowie Akteure, Felder und Habitus als Medien begreift und betont dabei die Nützlichkeit der Bourdieuschen Bildungssoziologie im Rahmen einer sozialwissenschaftlichen Grundlegung der Medienpädagogik.

  3. Verletzungen und Fehlbeanspruchungen im leistungsorientierten Rudersport

    OpenAIRE

    Bussian, Marc Robert

    2004-01-01

    Die Stellung der Breitensportart Rudern als gesundheitsfördernde Sportform ist in der Literatur gleichlautend positiv beschrieben. Im leistungsorientierten Rudersport müssen neben den Verletzungen und Fehlbeanspruchungen der eigentlichen Sportart die unabdingbaren Nebentrainingsformen berücksichtigt werden. In den neunziger Jahren vollzog sich ein trainingsmethodischer Wandel, die Einführung eines erschwinglichen Rudersimulators und eine technische Weiterentwicklung im Boots- und Ruderbau. Ei...

  4. Pflege und Beruf: ungleiche Chancen der Vereinbarkeit

    OpenAIRE

    Keck, Wolfgang

    2011-01-01

    Die Vereinbarkeit von Beruf und Pflege wird in der Öffentlichkeit zu wenig thematisiert. Pflegende in einkommensschwachen Familien können sich keine zusätzlichen Pflegedienste leisten und müssen häufiger Einschnitte im Beruf in Kauf nehmen. Beschäftigte in unteren Hierarchieebenen können Beruf und Pflege nur schwer vereinbaren, da sie flexible Arbeitszeitregelungen seltener nutzen können.

  5. Polnische qualitative Soziologie: Entwicklung und Hauptthemen

    OpenAIRE

    Konecki, Krzysztof T.; Kacperczyk, Anna M.; Marciniak, Lukasz T.

    2005-01-01

    In dem vorliegenden Beitrag wird die Entwicklung der qualitativen Soziologie in Polen rekonstruiert, indem deren wesentliche intellektuelle Wurzeln und einige Hauptthemen der polnischen Soziologie vorgestellt werden. Romantizismus und die induktive Methode sind essenzielle Elemente für die Entwicklung der Disziplin in Polen gewesen und Charakteristika ihrer Besonderheit. Die Bedeutung von Florian ZNANIECKI für die Entstehung der polnischen qualitativen Soziologie wird gewürdigt. URN: urn:n...

  6. Bedeutung von Umwelt- und Organismusfaktoren bei Autoaggressionen

    OpenAIRE

    Rohmann, Ulrich H.; Elbing, Ulrich; Hartmann, Hellmut

    1988-01-01

    In der vorliegenden Arbeit werden übergeordnete Hypothesen zu autoaggressiven Verhaltensweisen formuliert, wobei prozeßhafte Abläufe von umweltbezogenen und organischen Variablen angenommen werden. Eine solche dynamische Beziehung hat ihre Bedeutung sowohl für verursachende als auch aufrechterhaltende Faktoren. In einer Querschnittuntersuchung lassen sich Korrelationen von Tageszeit- und Tätigkeitscharakteristiken (umweltbezogene Variablen) zur Autoaggressionshäufigkeit und Pulsfrequenz (Orga...

  7. Long-term catheterization: current approaches in the diagnosis and treatment of port-related infections

    Directory of Open Access Journals (Sweden)

    Bustos C

    2014-02-01

    Full Text Available Cesar Bustos,1 Aitziber Aguinaga,1 Francisco Carmona-Torre,2 Jose Luis Del Pozo1,3 1Department of Clinical Microbiology, 2Department of Internal Medicine, 3Division of Infectious Diseases, Clinica Universidad de Navarra, Pamplona, Spain Abstract: Since the first description in 1982, totally implanted venous access ports have progressively improved patients' quality of life and medical assistance when a medical condition requires the use of long-term venous access. Currently, they are part of the standard medical care for oncohematologic patients. However, apart from mechanical and thrombotic complications, there are also complications associated with biofilm development inside the catheters. These biofilms increase the cost of medical assistance and extend hospitalization. The most frequently involved micro-organisms in these infections are gram-positive cocci. Many efforts have been made to understand biofilm formation within the lumen catheters, and to resolve catheter-related infection once it has been established. Apart from systemic antibiotic treatment, the use of local catheter treatment (ie, antibiotic lock technique is widely employed. Many different antimicrobial options have been tested, with different outcomes, in clinical and in in vitro assays. The stability of antibiotic concentration in the lock solution once instilled inside the catheter lumen remains unresolved. To prevent infection, it is mandatory to perform hand hygiene before catheter insertion and manipulation, and to disinfect catheter hubs, connectors, and injection ports before accessing the catheter. At present, there are still unresolved questions regarding the best antimicrobial agent for catheter-related bloodstream infection treatment and the duration of concentration stability of the antibiotic solution within the lumen of the port. Keywords: catheter-related infection, bacteremia, biofilm

  8. Risk markers of all-cause and diagnosis-specific disability pension--a prospective cohort study of individuals sickness absent due to stress-related mental disorders

    DEFF Research Database (Denmark)

    Ishtiak-Ahmed, Kazi; Perski, Aleksander; Mittendorfer-Rutz, Ellenor

    2014-01-01

    BACKGROUND: Stress-related mental disorders rank among the leading causes of sickness absence in several European countries. The aim of this study was to investigate predictors of all-cause and diagnosis-specific disability pension in sickness absentees with stress-related mental disorders. METHO....... The variation in the effect of risk markers with regard to age and diagnosis of disability pension speaks in favour of the importance of a person-centered approach in treatment and rehabilitation....

  9. A categorical view toward diagnosis and classification of war-related psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Abhari SA

    1993-04-01

    Full Text Available Documented war experiences have provided early descriptions of different group of psychiatric features. A combat soldier with palpitation and chest pains was felt to have a functional cardiac disturbance, called soldier's heart. Anxiety and other symptoms indicating increased arousal were called shell shock and were thought to be related to lesions in the central nervous system (CNS. Describing analytically war events could operate with an enormous emotional intensity breaking through the ego defences and flooding it with an uncontrollable anxiety. Post traumatic stress disorder (PTSD delineates a syndrome developing after a discrete traumatic event in a stress setting. Diagnostic conceptualization which tie PTSD to stress and trauma invariably involve two different approaches from two different theoretical bases: the concepts dealing with trauma on the one hand (which could effect on CNS and those dealing with stress-response theory on the other. Author emphasizes on viewing the patients who complain of war psychiatric effects in three categories: (1 Non PTSD diagnoses that the patient ought to be treated accordingly (2 Traumatic neurosis which has overwhelming war stress related emotional aspects and is occurred in predisposed individuals. This category is suggested to be classified as post war stress disorder specifically, to be differentiated from other post traumatic psychiatric categories. (3 Author also suggests the third category as post traumatic war stress syndrome which is thought to have organic origin. Symptoms such as hyperacusis, hyperirritability, tinnitus and particular type of head aches which are mostly refractory to treatment confirm the hypothesis.

  10. Bisphosphonate-Related Osteonecrosis of the Jaw Bone: Radiological Pattern and the Potential Role of CBCT in Early Diagnosis

    Directory of Open Access Journals (Sweden)

    James Olutayo

    2010-04-01

    Full Text Available Objectives: To systematize the clinico-radiological symptoms and course of bisphosphonate-related osteonecrosis of jaw bone and to evaluate the diagnostic potential of various radiological techniques to detect mild osteonecrosis in each stage of the disease.Material and Methods: The sample consisted of 22 patients previously diagnosed with extraoral malignant disease. Diagnosis was based on a clinical examination in conjunction to digital panoramic radiography and cone beam computed tomography (CBCT. Two dentomaxillofacial radiologists reviewed all images.Results: Twenty patients showed mandibular involvement clinically, while two others had a maxillary involvement. Four stages of the disease were proposed based on the clinico-radiological findings. Subclinical cortical and lamina dura thickening was detected with only three-dimensional CBCT and periapical images, while ulceration and cortical bone thickening was detected only by three-dimensional CBCT. Mixed sclerotic, lytic bone destruction involving alveolar and basal bone with or without encroachment on the mandibular canal, pathological mandibular fractures were detected by two-dimensional panoramic and three-dimensional CBCT images. Other findings are non healing extraction sockets, periapical radiolucencies, osteolysis, sequestra, oroantral fistula, and periosteal new bone formation.Conclusions: The present study showed that bisphosphonate-related osteonecrosis of jaw bone occurs in four distinct clinico-radiological stages. For mild cases, panoramic image diagnosis was much less obvious, whereas cone beam computed tomography was able to fully characterise the bony lesions and describe their extent and involvement of neighbouring structures in all cases. Thus cone beam computed tomography might better contribute to the prevention of bisphosphonate-related osteonecrosis of jaw bone as well to the disease management.

  11. Rechtspopulistische Einstellungen in Ost- und Westdeutschland

    Directory of Open Access Journals (Sweden)

    Beate Küpper

    2017-12-01

    Full Text Available Während sich die Mehrheit der Deutschen für Demokratie, Vielfalt und Gleichwertigkeit positioniert, sind zugleich rechtspopulistische Einstellungen lauter geworden. Der Beitrag berichtet über Befunde der Mitte-Studie der Friedrich-Ebert-Stiftung 2016 zu der Verbreitung rechtspopulistischer und rechtsextreme Einstellungen, wirft einen besonderen Blick auf potentielle Wähler_innen der AfD und diskutiert am Ende mögliche Erklärungen für die gefundenen Unterschiede zwischen Ost- und Westdeutschen.

  12. Relative value of computed tomography and hypocycloidal tomography in the diagnosis of pituitary microadenoma

    International Nuclear Information System (INIS)

    Bonafe, A.; Sobel, D.; Manelfe, C.

    1981-01-01

    The relative value of a second generation CT scanner and complex motion polytomography are compared in 36 patients undergoing transphenoidal surgery due to clinical and biological evidence of pituitary hypersecretion. CT findings of focal glandular hypodensity in 17 patients and upward convexity of the sellar contens in 15 patients suggested the presence of a pituitary microadenoma. Complex motion tomographic findings suggesting a microadenoma were found in 21 of 32 cases and included bulging of the sellar floor or localized thinning of the lamina dura. Selective transsphenoidal adenomectomy was performed on 34 of the 36 patients and the preoperative location based on CT scanning data was positively correlated with surgical results in 75% of the cases. When there is a strong clinical suspicion of pituitary hypersecretion both CT and polytomography may suggest the existence and location of a microadenoma. CT should be the radiographic technique of choice since it produces accurate information as to the size and density of the pituitary gland. (orig.)

  13. Features of the Diagnosis and Treatment of Acid-Related Disease in Patients with Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    S.M. Tkach

    2016-09-01

    Full Text Available The article considers the problem of the combined course of acid-related disorder of the gastrointestinal tract and diabetes mellitus (DM. The attention is paid to the fact that in most cases the treatment of gastroesophageal reflux disease and peptic ulcers in patients with diabetes mellitus should be carried out not as a proton pump inhibitor monotherapy, but as a comprehensive and differentiated treatment, taking into account etiological and pathogenetic features of the disease. When choosing the components of triple or quadruple therapy for the eradication of H.pylori in patients with DM among the group of proton pump inhibitors, it is desirable to give preference to pantoprazole (Zovanta. Pantoprazole does not interact with clarithromycin — basic antibiotic of H.pylori therapy. H.pylori therapy based on pantoprazole reduces the likelihood of side effects and increases the effectiveness of treatment.

  14. Ultrasonographic diagnosis of fatty liver and relations with body index, serum lipid, and serum triglyceride

    International Nuclear Information System (INIS)

    Jang, Young Deog; Lee, S. H.; Lee, H. K.; Kim, D. H.; Kwon, K. H.; Kim, K. C.

    1989-01-01

    Hepatic fatty infiltration appears as an area of increased echogenicity. And many factors concerned to fatty infiltration. With 65 cases of fatty liver and 42 cases of normal group, we analyzed fatty liver with grading and attempt to find relations between grade of fatty liver and levels of body index, serum triglyceride, and serum lipid. And compared fatty liver with normal control group. Patients with fatty liver are higher percentage of supra-normal value in body index, serum lipid, and serum triglyceride than normal control group. As fatty infiltration progressed, serum lipid, serum trig-lyceride and body index are also increased. Conclusively ultrasonographic examination of liver with serum triglyceride, serum lipid, and body index are simple method, useful follow-up examination of fatty liver, and preventive routine check-up of chronic liver disease

  15. Diagnosis and treatment of sleep related breathing disorders in children: 2007 to 2011.

    LENUS (Irish Health Repository)

    Walsh, A

    2015-03-01

    Sleep related breathing disorders (SRBD) have historically been under-recognised and under-treated. Obstructive sleep apnoea (OSA) affects approximately 3% of children. In line with the increased recognition of SRBD there has been an increase in demand for diagnostic services. We determined the awareness of SRBD amongst Irish paediatricians, examined the provision of sleep services to children throughout the country between 2007 and 2011 and audited diagnostic sleep services in a tertiary centre in 2011. Amongst respondents there was an awareness of SRBD but a poor understanding of diagnostic evaluation with 31\\/46 (67) referring to inappropriate services. There has been a sharp increase in both diagnostic sleep tests (433-1793 [414]) and in the use of non-invasive ventilation (NIV) (31-186 [627]) for treatment of SRBD between 2007 and 2011. Paediatric sleep services are organized in an ad-hoc manner nationally with significant service variation. The use of domiciliary overnight oximetry reduced the requirement for more formal polysomnography by 70%.

  16. Severe IgG4-Related Disease in a Young Child: A Diagnosis Challenge

    Directory of Open Access Journals (Sweden)

    Susana Corujeira

    2015-01-01

    Full Text Available Immunoglobulin G4-related disease (IgG4-RD is an increasingly recognized syndrome that can appear with multiple organ involvement, typically with tumor-like swelling, lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, and elevated serum IgG4 concentrations. We report the case of a 22-month-old female child with failure to thrive and recurrent respiratory tract infections since 8 months of age. Physical examination was normal except for pulmonary auscultation with bilateral crackles and wheezes. Laboratory tests revealed elevated erythrocyte sedimentation rate, and elevated serum IgG and IgG4 with polyclonal hypergammaglobulinemia. Thoracic CT and MRI showed multiple mediastinal lymphadenopathies and a nodular posterior mediastinal mass in right paratracheal location with bronchial compression. Initial fine needle aspiration biopsy was compatible with reactive lymphadenopathy but after clinical worsening a thoracoscopic partial resection of the mass was performed and tissue biopsy revealed lymphoplasmacytic infiltrate and increased number of IgG4-positive plasma cells and a ratio of IgG4/IgG positive cells above 40%. Glucocorticoids therapy was started with symptomatic improvement, reduction in the size of the mass, and decrease of serum IgG4 levels after 6 weeks. There are very few reports of IgG4-RD in children. Long-term follow-up is necessary to monitor relapses and additional organ involvement.

  17. Interdisciplinary consensus on diagnosis and treatment of testicular germ cell tumors. Results of an update conference based on evidence-based medicine (EBM); Interdisziplinaerer Konsensus zur Diagnostik und Therapie von Hodentumoren. Ergebnisse einer Update-Konferenz auf Grundlage evidenzbasierter Medizin (EBM)

    Energy Technology Data Exchange (ETDEWEB)

    Souchon, R. [Deutsche Gesellschaft fuer Radioonkologie (DEGRO) (Germany); Arbeitsgemeinschaft Radiologische Onkologie (ARO), Strahlenklinik AKH Hagen (Germany); Krege, S. [Deutsche Gesellschaft fuer Urologie (DGU) (Germany); Essen Univ. (Gesamthochschule) (Germany). Klinik und Poliklinik fuer Urologie; Schmoll, H.J. [Arbeitsgemeinschaft Internistische Onkologie (AIO), Zentrum fuer innere Medizin IV der Martin-Luther-Univ. Halle-Wittenberg (Germany); Albers, P. [Bonn Univ. (Germany). Urologische Klinik; Beyer, J. [Marburg Univ. (Germany). Medizinisches Zentrum fuer Innere Medizin; Bokemeyer, C. [Tuebingen Univ. (Germany). Abt. fuer Innere Medizin 2; Classen, J. [Tuebingen Univ. (Germany). Medizinisches Strahleninstitut und Roentgenabteilung; Dieckmann, K.P. [Albertinen-Krankenhaus, Hamburg (Germany). Urologische Abt.; Hartmann, M. [Bundeswehrkrankenhaus, Hamburg (Germany). Urologische Abt.; Heidenreich, A. [Marburg Univ. (Germany). Urologische Klinik; Hoeltl, W. [Kaiser-Franz-Josef-Spital Wien (Austria). Urologische Klinik; Kliesch, S. [Muenster Univ. (Germany). Klinik fuer Urologie; Koehrmann, K.U. [Urologische Klinik des Klinikums der Stadt Mannheim (Germany); Kuczyk, M. [Medizinische Hochschule Hannover (Germany). Klinik fuer Urologie; Schmidberger, H. [Goettingen Univ. (Germany). Klinik fuer Strahlentherapie und Radioonkologie; Weinknecht, S. [Krankenhaus am Urban Berlin (Germany). Urologische Abt.; Winter, E. [Klinikum Schwerin (Germany). Urologische Klinik; Wittekind, C. [Leipzig Univ. (Germany). Inst. fuer Pathologie; Bamberg, M. [Tuebingen Univ. (Germany). Abt. fuer Strahlentherapie

    2000-09-01

    An 'Interdisciplinary Update Consensus Statement' summarizes and defines the diagnostic and therapeutic standards according to the current scientific practices in testicular cancer. For 21 separate areas scientifically based decision criteria are suggested. For treatment areas where more than one option exist without a consensus being reached for a preferred strategy, such as in seminoma in clinical Stage I or in non-seminoma Stages CS I or CS IIA/B, all acceptable alternative strategies with their respecitve advantages and disadvantages are presented. This 'Interdisciplinary Update Consensus' was presented at the 24th National Congress of the German Cancer Society on March 21st and subsequently evaluated and approved by the various German scientific medical societies. (orig.) [German] Der zu 21 Themenkomplexen anhand wissenschaftlich begruendeter Entscheidungskriterien erarbeitete 'Interdisziplinaere Update-Konsensus' praezisiert und definiert diagnostische und therapeutische Standards entsprechend dem aktuellen Wissensstand ueber die Tumorentitaet. Fuer Therapiesituationen, bei denen mehrere Optionen bestehen und kein Konsens ueber die favorisierte Strategie erzielt wurde wie beim Seminom im klinischen Stadium I oder beim Nichtseminom in den Stadien CS I bzw. CS IIA/B, wurden jeweilige Alternativen mit deren Vor- und Nachteilen dargestellt. Der 'Interdisziplinaere Update-Konsensus' wurde beim 24. Deutschen Krebskongress am 21.3.2000 vorgestellt, nachfolgend von den daran beteiligten wissenschaftlichen Fachgesellschaften geprueft und gebilligt. (orig.)

  18. Retrofit MHB Hamm. Process-related optimization of the combustion air system MHB Hamm; Retrofit MHB Hamm. Prozess- und verfahrenstechnische Optimierung des Verbrennungsluftsystems MHB Hamm

    Energy Technology Data Exchange (ETDEWEB)

    Schumacher, Frank [SC Schumacher Consulting handelnd fuer Xervon Energy GmbH, Ritterhude (Germany); Lindke, Carsten [MHB Hamm Betriebsfuehrungsgesellschaft mbH, Hamm (Germany); Auel, Werner [Xervon Energy GmbH, Duisburg (Germany)

    2012-11-01

    The authors of the contribution under consideration report on a process-related optimization of the combustion air system of the waste incinerator Hamm. Subsequently to the historical aspects of this waste incinerator and the development of its calorific values, the authors describe the tender Retrofit, its implementation as well as the first practical experiences.

  19. Freiheit und Geschlecht im neoliberalen Kontext Freedom and Equality in a Neoliberal Context

    Directory of Open Access Journals (Sweden)

    Irene Dölling

    2008-11-01

    Full Text Available Freiheit und Gleichheit gehören in modernen Gesellschaften zu den gleichermaßen positiven wie unbestimmten Grundwerten. Die Autorinnen untersuchen in ihren Beiträgen, die in vier Schwerpunkte – Staat, Markt, Recht/Eigentum und Liebe/Sexualität – gegliedert sind, wie ‚Freiheit‘ im Kontext neoliberaler Transformationen auf eine im Vergleich mit der fordistisch organisierten Gesellschaft neue Weise diskursiviert, institutionalisiert und reguliert wird und wie sich dabei das Verhältnis von Freiheit und Geschlecht neu figuriert. Neben den Veränderungen in Geschlechterverhältnissen und praktizierten Geschlechterarrangements stehen die Möglichkeiten feministischer geschlechterpolitischer Interventionen im Mittelpunkt des Interesses.In modern societies freedom and equality belong to those core values that are positive as well as vague. The authors examine how, in the context of neoliberal transformations, ‘freedom’ becomes discursive, institutionalized, and regulated in new ways in comparison to those societies organized according to Fordism and how this reconfigures the relationship between freedom and equality. The contributions are divided into four themes: state, market, law/ownership, and love/sexuality. Of central interest to the study are the transformations in gender relations and gender arrangements in practice as well as the possibilities for feminist gender-political interventions.

  20. Barbara Becker-Cantarino: Genderforschung und Germanistik. Perspektiven von der Frühen Neuzeit bis zur Moderne. Berlin: Weidler Buchverlag 2010.

    Directory of Open Access Journals (Sweden)

    Sahra Dornick

    2011-07-01

    Full Text Available Die Grundlage der literaturhistorischen Untersuchung bilden literarische und religiöse Texte von der Frühen Neuzeit bis zur Moderne – Romane, Dramen und Briefe sowie Ego-Dokumente, philosophische Schriften und bildliche Darstellungen. Die Autorin konzentriert sich auf die Rekonstruktion der in den Primärtexten auffindbaren Geschlechterverhältnisse und -rollen und auf die kritische Beleuchtung ihrer Produktions- und Rezeptionsbedingungen in einem grundlegend patriarchalisch strukturierten literarischen Feld. Damit gelingt es ihr, einerseits anschaulich vorzuführen, inwiefern Geschlecht als strukturierende Struktur in literarische und religiöse Texte eingeschrieben ist, und andererseits zu zeigen, welche Lücke aufgrund der Demarkierung weiblicher Autorschaft und weiblichen Schreibens bis heute in der literaturhistorischen Forschung klafft.Literary and religious texts from the Early Modern era to Modernity – novels, plays, and letters as well as ego documents, philosophical writings, and visual material are the basis for this literary-historical analysis. The author focuses on the reconstruction of the gender relations and roles that can be found in the primary texts as well as on a critical analysis of the conditions for production and reception in a literary field that was fundamentally patriarchally structured. In doing so, she succeeds both in clearly illustrating to what extent gender is encoded as a structuring pattern in literary and religious texts and in showing the gap, which, due to the demarcation of female authorship and female writing, is still gaping in literary-historical research until today.

  1. European and Russian interests between the poles of rapprochement and alienation. The energy policy relations between the European Union and Russia from 2000 to 2007; Die energiepolitischen Beziehungen zwischen der Europaeischen Union und Russland 2000-2007. Europaeische und russische Interessen im Spannungsfeld zwischen Annaeherung und Entfremdung

    Energy Technology Data Exchange (ETDEWEB)

    Rippert, Sebastian

    2008-07-01

    Energy mix, security of supply, climate change, renewable energies, Nabucco project and North Stream pipeline are all buzzwords that have only recently gained public currency. Russia is an important partner to the European Union in its energy strategy. On the one hand it has abundant energy raw material resources, while on the other it needs foreign capital and external investors for their development. Different intents thus stand face to face in this strategic partnership. The EU stands for market economy principles and economic efficiency, while Russia relies on governmental control extending also into the energy economy and the management of its energy resources. This book, which was submitted as a master thesis of the Rhenish Friedrich-Wilhelm University of Bonn, offers a detailed description of the energy political relations between the EU and Russia at the start of the 21st century, analysing the different interests of the players involved. It gives a comprehensive factual overview, accompanied by an assessment from the viewpoint of political science, of European energy policy, developments in Russia under Vladimir Putin and the already existing instruments of cooperation.

  2. Editorial 01/2013 Normen und Normierungen

    Directory of Open Access Journals (Sweden)

    Christian Swertz

    2013-03-01

    Full Text Available Auf unterschiedlichsten Ebenen werden die Diskussionen und Forschungen der Medienpädagogik von normativ aufgeladenen Begriffen durchzogen: so, wenn es um Standards in der Medienbildung geht, wenn beispielsweise diskutiert wird, welche Inhalte in welcher Form vermittelt werden sollen; so auch wenn zur Debatte steht, wie Medienpädagogik institutionalisiert werden sollte und welche Voraussetzungen gegeben sein müssen, um einen geplanten Bildungsprozess zu lenken oder anzuleiten.Derartige Norm(ierungen wurden bereits mit der Konzeptualisierung des Begriffs Medienkompetenz und im Blick auf die Emanzipation des Menschen kritisch beleuchtet, womit auch Kritik an gesellschaftlichen Herrschafts- und Machtstrukturen verbunden war. Die Orientierung an der sozialwissenschaftlich verstandenen Emanzipation des Menschen ist allerdings in anderen pädagogischen Disziplinen durchaus umstritten. Gleichzeitig ist zu beobachten, dass die gesellschaftskritische Perspektive im medienpädagogischen Diskurs über die Orientierung von Medienkompetenz und Medienbildung eine immer geringere Rolle spielt. Deshalb hat sich die Redaktion der MEDIENIMPULSE entschlossen, dem Thema Normen und Normierungen eine eigene Ausgabe zu widmen.Dabei sollten folgende Fragen behandelt werden:Wie sieht es mit Norm(ierungen im Bereich der Mediendidaktik aus? Wie sind die mit aktuellen Medienkompetenz- und Medienbildungsbegriffen verbundenen Normen epistemologisch und (medientheoretisch abgestützt? Wie lassen sich – nur scheinbar paradox formuliert – wissenschaftlich begründbare medienpädagogische Normen finden, die sich den genannten Normierungen widersetzen und entziehen? Inwiefern führt die Einführung von Laptopklassen oder Smartboards im schulischen Bereich oder die Gestaltung von Videospielprojekten in der außerschulischen Medienbildung zu einer unreflektierten Sozialdisziplinierung, die als illegitime Form(atierung des Menschen verstanden werden kann? Der Schwerpunktteil

  3. Proteinuria in preeclampsia: Not essential to diagnosis but related to disease severity and fetal outcomes.

    Science.gov (United States)

    Dong, Xin; Gou, Wenli; Li, Chunfang; Wu, Min; Han, Zhen; Li, Xuelan; Chen, Qi

    2017-04-01

    Preeclampsia is a leading cause of maternal and perinatal morbidity and mortality globally and proteinuria can be one of the cardinal features of this disease. However, studies about the association of the amount of proteinuria and the severity of preeclampsia, and perinatal outcomes are limited. Data on 239 women with preeclampsia were retrospectively collected from a university teaching hospital from September 2011 to June 2013 and analysed. Data included all clinical parameters and proteinuria in a 24h urine collection. In cases of severe preeclampsia, significantly fewer patients had proteinuria levels 0.3g/L, but there was no difference in cases of severe preeclampsia when proteinuria levels were >0.3g/L. Furthermore, when proteinuria levels were >0.3g/L, the frequency of severe preeclampsia in each group was significantly higher than the frequency of mild pre-eclampsia cases. Time of onset was significantly earlier in patients with proteinuria >3g/L in a 24h urine collection, but time between the onset of preeclampsia and delivery was not correlated with the amount of proteinuria. The birth weight was significantly lower in patients with proteinuria >3g/L. The incidence of fetal growth restriction or stillbirth was significantly higher in patients with proteinuria >5g/L. Our data demonstrate that the amount of proteinuria is not associated with the severe of preeclampsia, once proteinuria is detected, but is related to the severity of preeclampsia. The adverse fetal outcomes appear to be the function of prematurity rather than proteinuria itself. Copyright © 2017 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

  4. Analysis of data relative to the update of diagnosis reference levels in radiology and nuclear medicine. Situation 2004-2006

    International Nuclear Information System (INIS)

    2008-01-01

    This report presents the results of the analysis of patients dosimetry data the radiology and nuclear medicine institutions have to transmit yearly to I.R.S.N. in application of the 12. february decree disposal relative to the diagnosis reference levels in radiology and nuclear medicine. The analysed dosimetry data concern the evaluations realised between the date of decree publication, the 16. march 2004 and 31. december 2006. The so considered results have to allow to the Nuclear Safety Authority to define the evolution needs of the regulation. Particularly, the analysis of delivered doses in radiology and the activities given in nuclear medicine lead to propositions on the possible update of reference values of some examination types. (N.C.)

  5. Diagnosis of ventricular drainage-related bacterial meningitis by broad-range real-time polymerase chain reaction

    DEFF Research Database (Denmark)

    Deutch, Susanna; Dahlberg, Daniel; Hedegaard, Jesper

    2007-01-01

    OBJECTIVE: To compare a broad-range real-time polymerase chain reaction (PCR) diagnostic strategy with culture to evaluate additional effects on the etiological diagnosis and the quantification of the bacterial load during the course of ventricular drainage-related bacterial meningitis (VR......-BM). METHODS: We applied a PCR that targeted conserved regions of the 16S ribosomal ribonucleic acid gene to cerebrospinal fluid (CSF) samples from patients with external ventricular drainage or a ventriculoperitoneal shunt during the course of VR-BM. We compared the PCR results with CSF cultures. A total...... of 350 routine CSF samples were consecutively collected from 86 patients. The CSF deoxyribonucleic acid was automatically purified and subjected to PCR. Amplicons from the PCR samples that were positive for VR-BM were subsequently deoxyribonucleic acid sequenced for final identification. Clinical data...

  6. Development of a claim review and payment model utilizing diagnosis related groups under the Korean health insurance.

    Science.gov (United States)

    Shin, Y S; Yeom, Y K; Hwang, H

    1993-02-01

    This paper describes the development of a claim review and payment model utilizing the diagnosis related groups (DRGs) for the fee for service-based payment system of the Korean health insurance. The present review process, which examines all claims manually on a case-by-case basis, has been considered to be inefficient, costly, and time-consuming. Differences in case mix among hospitals are controlled in the proposed model using the Korean DRGs. They were developed by modifying the US-DRG system. An empirical test of the model indicated that it can enhance the efficiency as well as the credibility and objectivity of the claim review. Furthermore, it is expected that it can contribute effectively to medical cost containments and to optimal practice pattern of hospitals by establishing a useful mechanism in monitoring the performance of hospitals. However, the performance of this model needs to be upgraded by refining the Korean DRGs which play a key role in the model.

  7. Trialling diagnosis-related groups classification in the Iranian health system: a case study examining the feasibility of introducing casemix.

    Science.gov (United States)

    Ghaffari, S; Doran, C; Wilson, A; Aisbett, C

    2010-05-01

    This paper examines the quality of routinely collected information in an Iranian hospital in a trial of casemix classification. Australian Refined Diagnosis Related Groups (AR-DRG) were used to classify patient episodes. There were 327 DRGs identified, of which 20% had only 1 case. The grouper program identified invalid records for 4% of total separations. Approximately 4.5% of cases were classified into error DRGs and 3.4% were ungroupable. No complication and comorbidity effects were identified with 93% of total cases. R2 (variance in length of stay explained) was 44% for untrimmed cases, increasing to 63%, 57% and 58% after trimming by L3H3, IQR and 10th-95th percentile methods respectively.

  8. Medienpädagogik und die Digitale Gesellschaft im Spannungsfeld von Regulierung und Teilhabe

    Directory of Open Access Journals (Sweden)

    Stefan Iske

    2014-12-01

    Full Text Available Vor 25 Jahren stellte Tim Berners-Lee sein Konzept eines World Wide Web (WWW vor und legte damit einen der bedeutendsten Grundsteine der digitalen Vernetzung. Was ursprünglich zum Austausch von Informationen und Daten unter Forschenden entworfen wurde, hat sich zu einem umfassenden Kultur- und Bildungsraum entwickelt und ist ein universaler und zentraler Dienst des Internet geworden. Dieser gegenwärtige Status des Internet und des World Wide Web ist der vorläufige Zwischenstand einer historischen Entwicklung, der sowohl Transformationen und Veränderungen als auch Konstanten zugrunde liegen. Nicht erst zum diesjährigen Geburtstag des World Wide Web wird deutlich, dass durch digitale und vernetzte Technologien zentrale Kategorien wie Bildung, Erziehung und Sozialisation berührt werden. Beispielhaft kann auf die aktuellen Debatten über Regulierungsmechanismen im Internet wie auch auf die Enthüllungen Edward Snowdens hingewiesen werden. Aus dem Vorangehenden lassen sich medienpädagogische Fragestellungen ableiten, die zum Beispiel die Handlungsautonomie von Subjekten sowie Möglichkeitsräume der Mitgestaltung von und Teilhabe an Gesellschaft (Winter 2012, Swertz 2014 thematisieren. Zudem sind es Fragen der Mediensozialisation und der Konstruktion von Identität in digital vernetzten Räumen (Jörissen/Marotzki 2008, die sowohl bei der Theoriebildung als auch im Rahmen medienpädagogischer Praxis eine hohe Relevanz besitzen.

  9. Combining macula clinical signs and patient characteristics for age-related macular degeneration diagnosis: a machine learning approach.

    Science.gov (United States)

    Fraccaro, Paolo; Nicolo, Massimo; Bonetto, Monica; Giacomini, Mauro; Weller, Peter; Traverso, Carlo Enrico; Prosperi, Mattia; OSullivan, Dympna

    2015-01-27

    To investigate machine learning methods, ranging from simpler interpretable techniques to complex (non-linear) "black-box" approaches, for automated diagnosis of Age-related Macular Degeneration (AMD). Data from healthy subjects and patients diagnosed with AMD or other retinal diseases were collected during routine visits via an Electronic Health Record (EHR) system. Patients' attributes included demographics and, for each eye, presence/absence of major AMD-related clinical signs (soft drusen, retinal pigment epitelium, defects/pigment mottling, depigmentation area, subretinal haemorrhage, subretinal fluid, macula thickness, macular scar, subretinal fibrosis). Interpretable techniques known as white box methods including logistic regression and decision trees as well as less interpreitable techniques known as black box methods, such as support vector machines (SVM), random forests and AdaBoost, were used to develop models (trained and validated on unseen data) to diagnose AMD. The gold standard was confirmed diagnosis of AMD by physicians. Sensitivity, specificity and area under the receiver operating characteristic (AUC) were used to assess performance. Study population included 487 patients (912 eyes). In terms of AUC, random forests, logistic regression and adaboost showed a mean performance of (0.92), followed by SVM and decision trees (0.90). All machine learning models identified soft drusen and age as the most discriminating variables in clinicians' decision pathways to diagnose AMD. Both black-box and white box methods performed well in identifying diagnoses of AMD and their decision pathways. Machine learning models developed through the proposed approach, relying on clinical signs identified by retinal specialists, could be embedded into EHR to provide physicians with real time (interpretable) support.

  10. Early results of pediatric appendicitis after adoption of diagnosis-related group-based payment system in South Korea

    Directory of Open Access Journals (Sweden)

    Moon SB

    2015-11-01

    Full Text Available Suk-Bae MoonDepartment of Surgery, Kangwon National University Hospital, Kangwon National School of Medicine, Kangwon National University, Chuncheon, South KoreaPurpose: As an alternative to the existing fee-for-service (FFS system, a diagnosis-related group (DRG-based payment system has been suggested. The aim of this study was to investigate the early results of pediatric appendicitis treatment under the DRG system, focusing on health care expenditure and quality of health care services.Patients and methods: The medical records of 60 patients, 30 patients before (FFS group, and 30 patients after adoption of the DRG system (DRG, were reviewed retrospectively.Results: Mean hospital stay was shortened, but the complication and readmission rates did not worsen in the DRG. Overall health care expenditure and self-payment decreased from Korean Won (KRW 2,499,935 and KRW 985,540, respectively, in the FFS group to KRW 2,386,552 and KRW 492,920, respectively, in the DRG. The insurer’s payment increased from KRW 1,514,395 in the FFS group to KRW 1,893,632 in the DRG. For patients in the DRG, calculation by the DRG system yielded greater overall expenditure (KRW 2,020,209 vs KRW 2,386,552 but lower self-payment (KRW 577,803 vs KRW 492,920 than calculation by the FFS system.Conclusion: The DRG system worked well in pediatric patients with acute appendicitis in terms of cost-effectiveness over the short term. The gradual burden on the national health insurance fund should be taken into consideration.Keywords: appendicitis, child, fee-for-service plans, diagnosis-related groups, quality of health care, health care expenditures

  11. Steueroasen und Regulierungsoasen – Auswirkungen auf die Stabilität des Finanzmarkts und politische Implikationen

    Directory of Open Access Journals (Sweden)

    Michaela Schmidt

    2012-12-01

    Full Text Available In diesem Beitrag wird dargelegt, dass Steuer- und Regulierungsoasen nicht nur Steuerausfälle und Kapitalflucht ermöglichen, sondern auch eine Hauptursache für die Finanzkrise 2007/2008 waren und weiterhin die Stabilität des Finanzmarkts gefährden. Sie haben den Boden bereitet für das Aufkommen nicht regulierter Finanzinstitutionen, sogenannter Schattenbanken. Regulierungsoasen ermöglichen Finanzmarktakteuren eine Umgehung von Regulierungs- und Aufsichtsvorschriften und heizen den Wettbewerb um niedrige Regulierungsvorschriften maßgeblich an. Jeder Schritt zu einer finanzpolitischen Re-Regulierung von Steuer- und Regulierungsoasen sowie Schattenbanken ist ein aktiver Schritt zur Krisenvorbeugung und damit zum Schutz der ArbeitnehmerInnen vor den gewaltigen volkswirtschaftlichen Kosten von Finanzkrisen.

  12. Technology images and concepts of technology in transition. An analysis in the philosophy of technology and general technology; Technikbilder und Technikkonzepte im Wandel. Eine technikphilosophische und allgemeintechnische Analyse

    Energy Technology Data Exchange (ETDEWEB)

    Banse, G. [Forschungszentrum Karlsruhe GmbH Technik und Umwelt (DE). Inst. fuer Technikfolgen-Abschaetzung und Systemanalyse (ITAS); Meier, B. [Potsdam Univ. (Germany). Inst. fuer Arbeitslehre/Technik; Wolffgramm, H. (eds.)

    2002-02-01

    This volume contains contributions resulting from an expert discussion on 'Technology Images and Concepts of Technology in Transition - an analysis in the philosophy of technology and general technology. This expert discussion took place on 6 October 2000 at the State Pedagogical Institute Brandenburg in Ludwigsfelde-Struveshof and was conceived and organized co-operatively by the Forschungszentrum Karlsruhe, Institute for Technology Assessment and Systems Analysis, the University of Potsdam, Institute for the Theory of Work/Technology and Professor Horst Wolffgramm, Frankfurt (Oder). It was the aim of the expert discussion to compile, compare and relate the various positions in the philosophy of technology, general technology science, the history of technology and the didactics of technology of the 'conceptualisation' of technology as a basis for generally understanding technology or for a scientifically based 'image of technology' to each other, and then to make them accessible for curricula within a framework of conceiving general technical education at all school levels. The contributions are grouped according to the two main foci of the event: On the one hand they are concerned with determining a contemporary concept of technology ('Image of technology'). One of the aims is to characterize technological change from the historical-genetic perspective and in this way to access technology as a work of mankind, as an important element of our culture. At the same time it is necessary to forecast future developments or to make future paths of development visible to enable the indication of change by basic innovations. Second, on this basis and supported by educational theory, conclusions are drawn for future-oriented technical general education for all students. The main focus in this is on the linkage between goals, content and subject-specific methods. In order to enable the determination of competence of any individual

  13. Erfahrungen an der Schnittstelle von Medienarbeit und Praxisforschung

    Directory of Open Access Journals (Sweden)

    Peter Holzwarth

    2007-11-01

    Full Text Available Der Beitrag reflektiert die Verbindung von praktischer Medienarbeit und Forschung am Beispiel eines internationalen EU-Forschungsprojekts zum Thema Medien und Migration. Neben didaktischen Prinzipien und Konzepten für die aktive Medienarbeit im Forschungskontext geht es um die Kooperation von medienpädagogischer Begleitung (MB und wissenschaftlicher Begleitung (WB sowie um deren spezifische Kompetenzen.

  14. Leitung und Kooperation in wissenschaftlichen Bibliotheken Berlins - eine empirische Untersuchung

    OpenAIRE

    Paul, Gerhard

    1998-01-01

    Die vorliegende Arbeit greift ein im bibliotheks- und IuK-wissenschaftlichen sowie im fachprofessionellen Diskurs bisher weitgehend vernachlässigtes, aber immer bedeutsameres Thema auf: das vertikale soziale Geschehen in der Arbeitsorganisation ?wissenschaftliche Bibliothek". Die Absicht der Untersuchung lag darin, einen Zusammenhang zwischen dem Interaktionsverhalten der Leitungspersonen einerseits und der Mobilisierung von Leistungs- und Innovationspotentialen bei den Mitarbeiterinnen und M...

  15. [Sascha Möbius. Das Gedähtnis der Reichsstadt. Unruhen und Kriege in der lübeckischen Chronistik und Kriege und Erinnerungskultur des späten mittelalters und der frühen Neuzeit

    Index Scriptorium Estoniae

    Hormuth, Dennis

    2012-01-01

    Arvustus: Sascha Möbius. Das Gedähtnis der Reichsstadt. Unruhen und Kriege in der lübeckischen Chronistik und Kriege und Erinnerungskultur des späten mittelalters und der frühen Neuzeit. (Göttingen, 2011)

  16. MR of the muskuloskeletal system: A review; MR-Tomographie (MRT) des Skeletts, der peripheren Weichteile und der Gelenke - aktuelle Uebersicht

    Energy Technology Data Exchange (ETDEWEB)

    Bohndorf, K. [Zentralklinikum Augsburg (Germany). Klinik fuer Diagnostische und Neuroradiologie; Kretschmer, K.H. [Zentralklinikum Augsburg (Germany). Klinik fuer Diagnostische und Neuroradiologie

    1996-05-01

    The skeleton, the peripheral soft tissues, and the joints have become important indications to use MRI routinely. About 25-35% of daily examinations focus on these anatomic sites. Superior contrast resolution, the option of different imaging planes, and the unsurpassed visualization of bone marrow, fibrous and hyaline cartilage, ligaments, and tendons are the reasons for the overwhelming success of this imaging method. MRI often provides the direct way to diagnosis. More and more the so-called `step by step` approach to diagnosis by imaging methods is being abandoned in favor of the primary use of MRI. The present survey summarizes the main indications for MRI in the field of the musculoskeletal system, in adults as well as in children. Special topics like tumors, inflammation, ischemia, and trauma are discussed. Some anatomic sites like the carpal joint, the shoulder, and the knee are presented in more detail. (orig.) [Deutsch] Eine Vielzahl von Fragestellungen zu wesentlichen Indikationen der MR-Tomographie am Skelett, den peripheren Weichteilen und den Gelenken haben sich in der taeglichen Praxis entwickelt. Durchschnittlich 25-35% der taeglichen Untersuchungen betreffen diesen Themenkreis. Ueberlegene Kontrastaufloesung, die Darstellung in beliebig waehlbaren Ebenen und die unuebertroffene Visualisierung von Strukturen wie Knochenmark, fibroesem und hyalinem Knorpel, Ligamenten und Sehnen, sind die Ursache der raschen Verbreitung der Methode. Die MRT stellt haeufig den direkten Weg zur Diagnose dar und ersetzt zunehmend die sog. `Stufendiagnostik` und damit Methoden wie die Computertomographie, Arteriographie oder auch Skelettszintigraphie. In der vorliegenden Uebersicht werden wesentliche, heute als gesichert anzusehenden Anwendungsgebiete der MRT bei Kindern und Erwachsenen zusammengefasst. Die Arbeit gibt einen Ueberblick ueber spezielle Fragestellungen bei Tumoren, Entzuendungen, Ischaemie und traumatischen Fragestellungen. Eine Reihe von anatomischen

  17. Mammography and radiation risk; Mammographie und Strahlenrisiko

    Energy Technology Data Exchange (ETDEWEB)

    Jung, H. [Hamburg Univ. (Germany). Inst. fuer Biophysik und Strahlenbiologie

    1998-10-01

    Breast cancer is the most frequent malignant neoplasia among women in Germany. The use of mammography as the most relevant diagnostic procedure has increased rapidly over the last decade. Radiation risks associated with mammography may be estimated from the results of numerous epidemiological studies providing risk coefficients for breast cancer in relation to age at exposure. Various calculations can be performed using the risk coefficients. For instance, a single mammography examination (bilateral, two views of each breast) of a women aged 45 may enhance the risk of developing breast cancer during her lifetime numerically from about 12% of 12.0036%. This increase in risk is lower by a factor of 3,300 as compared to the risk of developing breast cancer in the absence of radiation exposure. At the age of 40 or more, the benefit of mammography exceeds the radiation risk by a factor of about 100. At higher ages this factor increases further. Finally, the dualism of individual risk and collective risk is considered. It is shown that the individual risk of a patient, even after multiple mammography examinations, is vanishingly small. Nevertheless, the basic principle of minimising radiation exposure must be followed to keep the collective risk in the total population as low as reasonably achievable. (orig.) [Deutsch] Das Mammakarzinom ist in Deutschland die haeufigste Krebserkrankung der Frau, und entsprechend oft wird die Mammographie als das derzeit wichtigste Diagnoseverfahren eingesetzt. Zur Beurteilung des mit einer mammographischen Untersuchung verbundenen Strahlenrisikos liegen die Resultate einer groesseren Anzahl strahlenepidemiologischer Studien vor. Diese liefern den Risikokoeffizienten fuer Brustkrebs in Abhaengigkeit vom Lebensalter bei Strahlenexposition und ermoeglichen somit die Berechnung des altersabhaengigen Strahlenrisikos. Beispielsweise wird durch eine einmalige Mammographie-Untersuchung (bilateral, je zwei Aufnahmen in zwei Ebenen) bei einer 45

  18. Assessment of patient's pain-related behavior at physical examination may allow diagnosis of recent osteoporotic vertebral fracture.

    Science.gov (United States)

    Postacchini, Roberto; Paolino, Michela; Faraglia, Silvia; Cinotti, Gianluca; Postacchini, Franco

    2013-09-01

    Although innumerable studies have analyzed the multiple aspects of osteoporotic vertebral fractures, no study has focused on the clinical features related to spine pain in patients with recent osteoporotic vertebral compression fractures (VCFs). To determine whether the assessment of pain-related behavior (P-RB) of patients with osteoporotic VCFs of recent onset may allow the fracture to be strongly suspected, or even diagnosed, at physical examination. Pain-related behavior of elderly patients attending an outpatient spine clinic was evaluated on the basis of six consecutive movements made on the examining table. Fifty-six patients complaining only of lumbar or thoracic pain. The fractured patients (FPs), representing the fracture group (FG), were the 19 who had a recent VCF, whereas the control group (CG) consisted of the remaining 37 patients. Assessment of P-RB was based on six parameters: grimacing, sighing, clenching or blocking eyelids, gaping or strongly tightening the lips, need for help to take positions, and extreme difficulty to turn in the prone position. A score of 1 or a decimal was assigned to each parameter, the final score to each patient being 0 to 6. Three types of injury, acute (I), subacute (II), or chronic (III), were identified on the basis of the time elapsed from the probable occurrence of the fracture. The diagnosis of recent fracture was based on magnetic resonance images. Patients were videotaped during their movements. An examiner, unaware of the clinical history and diagnosis, gave a P-RB score to all patients and indicated whether they had to be placed in FG or CG, and also their presumable type of fracture. Subsequently, a DVD with the videotapes of all patients was given to three independent examiners, not specifically expert of spine conditions, who were asked to make the same evaluations as the first examiner. The mean scores for P-RB given by the first examiner were 4.6 to FG and 0.7 to CG (pPain-related behavior evaluation of

  19. Further development of the methodology for the realization of safety analyses concerning the controllability of operational malfunctions and accidents. Report on the working package 1. Review and development of safety-related assessment for final repositories for wastes with negligible heat generation and the provision of the necessary set of tools using the example of the final repository Konrad; Weiterentwicklung der Methodik fuer die Durchfuehrung von Sicherheitsanalysen zur Beherrschung von Betriebsstoerungen und Stoerfaellen. Bericht zum Arbeitspaket 1. Untersuchung und Entwicklung von sicherheitstechnischen Bewertungen fuer Endlager fuer Abfaelle mit vernachlaessigbarer Waermeentwicklung und Bereitstellung des notwendigen Instrumentariums am Beispiel des Endlagers Konrad

    Energy Technology Data Exchange (ETDEWEB)

    Hartwig-Thurat, Eva; Uhlmann, Stephan

    2015-09-15

    In the research project on the ''Review and development of safety-related assessments of disposal facilities with negligible heat generation; development and provision of the necessary set of tools, using the example of the Konrad disposal facility'' (Untersuchung und Entwicklung von sicherheitstechnischen Bewertungen fuer Endlager fuer Abfaelle mit vernachlaessigbarer Waermeentwicklung; Entwicklung und Bereitstellung des notwendigen Instrumentariums am Beispiel des Endlagers Konrad - Forschungsvorhaben 3612R03410), the state of the art in science and technology of the safety-related assessments and sets of tools for building a safety case was examined. The reports pertaining to the two work packages described the further development of the methodology for accident analyses (WP 1) and of building a safety case (WP 2); also, comparisons were drawn on a national and international scale with the methods applied in the licensing procedure of the Konrad disposal facility. As part of the project, the report of Work Package 1 depicts the methodology of the operating safety analysis in order to control malfunctions and incidents (accident analysis) using the example of the Konrad mine accident analysis. Set of criteria in this connection is the state-of-the-art international and national comprehensive body of legislation identifying the incident requirements. In extracts complementary safety analysis procedures of other countries are presented where applicable. It becomes apparent, that the majority of the investigated countries use a deterministic accident analyses to identify incidents. Here, common international practice is to com-plement the deterministic accident analysis by a probabilistic analysis. This procedure acts on the IAEA (International Atomic Energy Agency) terms of reference using both deterministic and probabilistic methods for the determination of facility hazard potentials. Based on the Konrad mine method, aspects of incident

  20. Important theories of the 20th century. Relativity, cosmology, quantum mechanics and chaos theory. 3. corr. ed.; Bedeutende Theorien des 20. Jahrhunderts. Relativitaetstheorie, Kosmologie, Quantenmechanik und Chaostheorie

    Energy Technology Data Exchange (ETDEWEB)

    Kinnebrock, Werner [Fachhochschule Rheinland-Pfalz (Germany)

    2011-07-01

    The past century changed the classical, scientific way of view enormously. The quantum theory broke with the imagination of continuity of all dynamical processes and gave space to completely new, nearly revolutionary approaches of thinking. Einstein's relativity theory put the absoluteness of time and space as well as the general validity of the Euclidean geometry in question. The absolute calculability, as it was formulated by Laplace, was by the influence of chaos theory proven as illusion. Computers made by the Mandelbrot set the presentation of new esthetic and never seen structures. Hilbert's century program of a complete formalization of mathematics failed because of the famous law of Goedel. It is the demand of this book to present all these theories and conclusions easily understandably and entertainingly.

  1. Radiation-related caries. Etiology and possible preventive strategies. What should the radiotherapist know?; Radiogene Karies. Aetiologie und Moeglichkeiten der Praevention. Was sollte der Strahlentherapeut wissen?

    Energy Technology Data Exchange (ETDEWEB)

    Schweyen, R.; Hey, J. [Martin-Luther-Univ., Halle-Wittenberg (Germany). Universitaetspoliklinik fuer Prothetik; Fraenzel, W. [Martin-Luther-Univ., Halle-Wittenberg (Germany). Inst. fuer Physik; Vordermark, D. [Martin-Luther-Univ., Halle-Wittenberg (Germany). Universitaetsklinik und Poliklinik fuer Strahlentherapie; Hildebrandt, G.; Kuhnt, T. [Universitaetsklinikum Rostock (Germany). Universitaetsklinik und Poliklinik fuer Strahlentherapie

    2012-01-15

    After radiation treatment of head-and-neck cancer, the impairment of patient's quality of life still remains an issue. After completion of the treatment course, a substantial number of patients develop so-called radiation caries. In addition, almost 50% of all cases of infectious osteoradionecrosis (iORN) of the jaws are directly associated with radiation caries. This review addresses our current knowledge on the etiology and pathogenesis of radiation caries including possible preventive strategies. Materials and methods A PubMed search using the terms ''radiation caries'' (''radiation related caries'', ''radiation related damage to dentition'') and ''radiogenic caries'' (''postradiation caries'', ''dental complications and radiotherapy'') was performed. The analysis of its content focused on the etiology, the pathogenesis, and the available knowledge on prophylaxis as well as treatment of radiation caries. Results For this review, 60 publications were selected. As main causal factors for radiogenic caries, either indirect impairment, resulting from alterations in the oral environment (e.g., radiation-induced xerostomia) or direct radiation-induced damage in teeth hard tissues are discussed. Radiation caries remains a lifelong threat and, therefore, requires permanent prevention programs. Conclusion To enable optimal medical care of the patients during the time course of radiotherapy as well as afterwards, close interdisciplinary cooperation between radiotherapists, oral surgeons, otorhinolaryngologists, and dentists is absolutely essential. (orig.)

  2. Variants in adjacent oxytocin/vasopressin gene region and associations with ASD diagnosis and other autism related endophenotypes

    Directory of Open Access Journals (Sweden)

    Sunday M. Francis

    2016-05-01

    Full Text Available Background: There has been increasing interest in oxytocin (peptide: OT, gene: OXT as a treatment pathway for neurodevelopmental disorders such as Autism Spectrum Disorder (ASD. Neurodevelopmental disorders affect functional, social, and intellectual abilities. With advances in molecular biology, research has connected multiple gene regions to the clinical presentation of ASD. Studies have also shown that the neuropeptide hormones OT and arginine vasopressin (AVP influence mammalian social and territorial behaviors and may have treatment potential for neurodevelopmental disorders. Published data examining molecular and phenotypic variation in ASD, such as cognitive abilities, are limited. Since most studies have focused on the receptors in the OT-AVP system, we investigated genetic variation within peptide genes for association with phenotypic ASD features that help identify subgroups within the spectrum.Methods: In this study, TDT analysis was carried out utilizing FBAT in 207 probands (156 trios and a European Ancestry (EA subsample (108 trios. The evolutionarily related and adjacent genes of OXT and AVP were studied for associations between the tagged single nucleotide polymorphisms and ASD diagnosis, social abilities, restrictive and repetitive behaviors, and IQ for cognitive abilities. Additionally, relationships with whole blood serotonin (WB5HT were explored because of the developmental relationships connecting plasma levels of OT and WB5HT within ASD.Results: Results indicate significant association between OXT rs6084258 (p=0.001 and ASD. Associations with several intermediate phenotypes were also noted: OXT rs6133010 was associated with IQ (full scale IQ, p=0.008; nonverbal IQ, p=0.010, verbal IQ, p=0.006; and OXT rs4813625 and OXT rs877172 were associated with WB5HT levels (EA, p=0.027 and p=0.033, respectively. Additionally, we measured plasma OT (pOT levels in a subsample (N=54. Results show the three polymorphisms, OXT rs6084258

  3. Variants in Adjacent Oxytocin/Vasopressin Gene Region and Associations with ASD Diagnosis and Other Autism Related Endophenotypes.

    Science.gov (United States)

    Francis, Sunday M; Kistner-Griffin, Emily; Yan, Zhongyu; Guter, Stephen; Cook, Edwin H; Jacob, Suma

    2016-01-01

    There has been increasing interest in oxytocin (peptide: OT, gene: OXT) as a treatment pathway for neurodevelopmental disorders such as Autism Spectrum Disorder (ASD). Neurodevelopmental disorders affect functional, social, and intellectual abilities. With advances in molecular biology, research has connected multiple gene regions to the clinical presentation of ASD. Studies have also shown that the neuropeptide hormones OT and arginine vasopressin (AVP) influence mammalian social and territorial behaviors and may have treatment potential for neurodevelopmental disorders. Published data examining molecular and phenotypic variation in ASD, such as cognitive abilities, are limited. Since most studies have focused on the receptors in the OT-AVP system, we investigated genetic variation within peptide genes for association with phenotypic ASD features that help identify subgroups within the spectrum. In this study, TDT analysis was carried out utilizing FBAT in 207 probands (156 trios) and a European Ancestry (EA) subsample (108 trios).The evolutionarily related and adjacent genes of OXT and AVP were studied for associations between the tagged single nucleotide polymorphisms and ASD diagnosis, social abilities, restrictive and repetitive behaviors, and IQ for cognitive abilities. Additionally, relationships with whole blood serotonin (WB5HT) were explored because of the developmental relationships connecting plasma levels of OT and WB5HT within ASD. RESULTS indicate significant association between OXT rs6084258 (p = 0.001) and ASD. Associations with several endophenotypes were also noted: OXT rs6133010 was associated with IQ (full scale IQ, p = 0.008; nonverbal IQ, p = 0.010, verbal IQ, p = 0.006); and OXT rs4813625 and OXT rs877172 were associated with WB5HT levels (EA, p = 0.027 and p = 0.033, respectively). Additionally, we measured plasma OT (pOT) levels in a subsample (N = 54). RESULTS show the three polymorphisms, OXT rs6084258, OXT rs11697250, and OXT rs877172

  4. Politisches „Milieu“, Familienwirklichkeit und Rechtsreform. Katholische und sozialdemokratische Positionen in der Weimarer Republik Political “Milieu,” Family Reality, and Legal Reform: Catholic and Social Democratic Positions in the Weimar Republic

    Directory of Open Access Journals (Sweden)

    Arne Duncker

    2005-03-01

    Full Text Available Bei der verdienstvollen und materialreichen Arbeit Heinemanns handelt es sich um die gekürzte und überarbeitete Fassung einer an der Universität Augsburg 2002 abgeschlossenen Dissertation. Literatur ist bis einschließlich 2002 eingearbeitet. Mit Katholizismus und Sozialdemokratie hat die Arbeit zwei der bedeutendsten politischen und kulturellen Bewegungen – und auch “Milieus“ (S. 13 f. – Deutschlands in der Zeit der Weimarer Republik zum Gegenstand. In der Arbeit werden Fragen der historischen Familienforschung, Sozialgeschichte und Parteiengeschichte behandelt. Sie enthält darüber hinaus – ausbaufähige – rechtshistorische, frauengeschichtliche, parlamentsgeschichtliche und ehephilosophische Abschnitte sowie ein Schwerpunktkapitel (S. 213–292 zur Bevölkerungspolitik.Heinemann’s work, deserving and rich in material, is a shortened and revised version of a dissertation submitted to the University of Augsburg in 2002. Literature published up to the year 2002 is included in the text. The work has made as its focus two of the most important political and cultural movements—as well as “Milieus” (page 13 and following—of Germany during the time of the Weimar Republic: Catholicism and social democracy. Questions relating to historical family research, social history, and party history are dealt with in the work. It also includes sections, which could be expanded upon, on legal history, the history of women, parliamentary history, and the philosophy of marriage, as well as a central chapter focusing on the politics of demographics (213–292.

  5. Heat management in motor vehicles 3. Development methods and innovations in heat management in passenger cars and industrial vehicles; Waermemanagement des Kraftfahrzeugs 3. Entwicklungsmethoden und Innovationen der Kfz- und Nfz-Waermetechnik

    Energy Technology Data Exchange (ETDEWEB)

    Deussen, N. (ed.) [Fachhochschule Koeln (Germany). Labor fuer Verbrennungsmotoren und Applikation

    2002-07-01

    The proceedings volume outlines problem solutions, development strategies and design methods relating to heat management in motor vehicles. The focus is on utilisation, supply, transmission and release of heat in passenger cars and industrial vehicles. The complete state of the art is reviewed, with the focus on the following subjects: The potential of heat management in terms of performance and comfort; Future strategies for optimisation of thermal processes; Expert knowledge in component and system innovations; Status and perspectives of user software; Engine cooling, vehicle air conditioning, heat protection; Methodology; Numeric fluid mechanics; Heat transfer; Practical applications of thermal engineering, Heat management in engines; Thermal system optimisation; CFD; Future numeric methods in heat transfer and fluid mechanics; Methods of measurement and instrumentation. [German] Der Tagungsband informiert in einem aktuellen Ueberblick ueber Problemloesungen, Entwicklungsstrategien und Auslegungsmethoden im Umfeld des Kraftfahrzeug-Waermemanagements. Dabei wird insbesondere auf die Optimierung der Nutzung, Bereitstellung, Uebertragung und Abgabe von Waerme fokussiert. Der Inhalt umfasst dabei Anwendungen bei Automobilen und Nutzfahrzeugen. Der Leser erhaelt einen konkreten Ueberblick ueber die Trends auf neuestem Stand der Technik. Besondere Schwerpunkte sind: Potenzial des Waermemanagements bezueglich Leistung und Kundennutzen - Zukunftsweisende Strategien zur Optimierung waermetechnischer Prozesse - Kompaktes Fachwissen bei Bauteil- und System-Innovationen - Stand der Technik und Zukunftsperspektive bei Anwendersoftware. Inhalt: Motorkuehlung - Fahrzeugklimatisierung - Hitzeschutz - Methoden der Waermetechnik - Numerische Stroemungsmechanik - Waermeuebertragung - Anwendungsbeispiele der Waermetechnik - Motor-Thermomanagement - Waermetechnische Systemoptimierung - CFD - Zukuenftige numerische Methoden der Waermeuebertragung und Stroemungsmechanik - Messtechnik

  6. Comparison of three methods for gastrointestinal nematode diagnosis determination in grazing dairy cattle in relation to milk production.

    Science.gov (United States)

    Mejía, M E; Perri, A F; Licoff, N; Miglierina, M M; Cseh, S; Ornstein, A M; Becu-Villalobos, D; Lacau-Mengido, I M

    2011-12-29

    Development of resistance to anthelmintic drugs has motivated the search for diagnostic methods to identify animals for targeted selective treatments. We compared three methods for the diagnosis of nematode infection in relation to milk production in a fully grazing dairy herd of 150 cows in the humid Pampa (Argentina). Animals had feces, blood and milk sampled during the first postpartum month for EPG, pepsinogen and anti-Ostertagia antibody determination, respectively. With the results obtained two groups of cows, divided in high and low parasite burden, were conformed for each method, and milk production was then compared between groups. When cows were separated by the EPG method (EPG=0 (N=106) vs. EPG>0 (N=44)) a difference of nearly 800 l of milk per cow per lactation was found (P 1000) or by anti-Ostertagia (ODR ≤ 0.5 vs. ODR > 0.5) results did not differ. Interestingly, proportion of cows in each group differed between methods (P<0.0001), and the anti-Ostertagia method yielded significantly more cows in the high index group compared to results using the EPG or Pepsinogen method. No correlations were found between parasite indexes determined by the different methods. High parasite burden estimation found may be ascribed to the production system, fully grazing all year round, and to the sampling time, at the beginning of lactation with cows in negative energy balance and depressed immunity. The fact that the cows were born and reared outside, on pasture with continuous nematode larvae exposure, may also account for the results obtained. In conclusion, EPG counting during the first postpartum month may be a useful tool for the diagnosis of production impairment induced by high nematode burden in adult grazing dairy cows. The anthelmintic treatment of only the EPG-positive recently calved cows would improve milk production, while reducing selective pressure on nematode population for the development of resistance. Copyright © 2011 Elsevier B.V. All rights

  7. Nachhaltiger Lebensmittelkonsum gestern, heute und morgen

    DEFF Research Database (Denmark)

    Aschemann-Witzel, Jessica

    2013-01-01

    Die Weltgemeinschaft sieht sich mit steigendem Bevölkerungswachstum und Zielkonflikten der Nutzung von Land und Agrarrohstoffen konfrontiert. Dies wirft die Frage auf, wie nachhaltiger Lebensmittelkonsum in der Zukunft auszusehen hat. Der Beitrag diskutiert die Frage aus Sicht der Konsumverhaltens...

  8. Ruhende Flüssigkeiten und Gase

    Science.gov (United States)

    Heintze, Joachim

    Das mechanische Verhalten von Flüssigkeiten und Gasen ist dadurch gekennzeichnet, dass sie keine statische Schubfestigkeit besitzen, andernfalls würden sie nicht beginnen, zu fließen. In ruhenden Flüssigkeiten und Gasen können daher keine Schubspannungen bestehen:

  9. Handlung und Kommunikation als Grundbegriffe der Soziologie

    NARCIS (Netherlands)

    Martens, W.P.M.; Albert, H.; Greshoff, R.; Schützeichel, R.

    2010-01-01

    Handlung und Kommunikation gelten in der Soziologie manchmal als alternative, konkurrierende Grundbegriffe für die Beschreibung und Erklärung sozialer Zusammenhänge (siehe u.a. Luhmann 1984; 1990; Schneider 1994; Stichweh 2000; Greshoff 1999; Schwinn 2001; Albert et. al. 2003). Eine Soziologie,

  10. Die Gestalten und das Gestalten der Welt

    NARCIS (Netherlands)

    Ierna, Carlo; Höfer, Ulf; Valent, Juta

    2017-01-01

    In seiner Kosmogonie bespricht Ehrenfels den Ursprung, die Entwicklung, und das endgültige Schicksal des Universums: die Gestalt der Welt. Einerseits ist sie ein Kosmos, ein Geschöpf des Ordnungsprinzips, andererseits ein Chaos, als Resultat des Prinzips des Zufalls und der Entropie. Diese beiden

  11. Systeme im Einsatz. Lernmanagement, Kompetenzmanagement und PLE

    NARCIS (Netherlands)

    Kalz, Marco; Schön, Sandra; Lindner, Martin; Roth, Detlev; Baumgartner, Peter

    2011-01-01

    Kalz, M., Schön, S., Lindner, M., Roth, D., & Baumgartner, P. (2011). Systeme im Einsatz. Lernmanagement, Kompetenzmanagement und PLE. In M. Ebner, & S. Schön (Eds.), L3T - Lerhbuch für Lernen und Lehren mit Technologie (pp. 111-118). Graz, Austria: Uni Graz. Available at

  12. Global environmental policy strategies. ''Environment and development'' in north-south relations. Strategien globaler Umweltpolitik. ''Umwelt und Entwicklung'' in den Nord-Sued-Beziehungen

    Energy Technology Data Exchange (ETDEWEB)

    Bruckmeier, K

    1994-01-01

    Global environmental policy has hardly made headway after the United Nations World Conference on Environment and Development (UNCED) in Rio in June 1992, despite there being no shortage of programmes, institutions, and actors. Obviously, formal structures for political action based on the system of institutions of the United Nations do not suffice. Global environmental policy strategies must reach further, overcoming system-immanent obstacles to sustainable development. This necessitates analyzing the causes of environmental destruction and making a critical evaluation of the relations between the societies of the North and South that received their imprint from development policies. Only after such a preliminary elucidation by interdisciplinary approaches in the light of political and ecological economy and human ecology does an empirical analysis of politically controlled processes in environmental and development policy make sense. The analysis points to strategies for this international political field that rely on non-governmental actors and social movements, and question the traditional European model of an environmental policy determined by government institutions. (orig./UA)

  13. Zwischen Aufbegehren und bürgerlicher Rolle: die Lebensgemeinschaft von Helene Lange und Gertrud Bäumer The partnership of Helene Lange und Gertrud Bäumer: a both rebellious and domestic way of life

    Directory of Open Access Journals (Sweden)

    Mechthilde Vahsen

    2001-07-01

    Full Text Available Die Forschungsarbeiten analysieren private weibliche Beziehungsformen und ihre Bedeutung für die erste deutsche Frauenbewegung. Im Zentrum der Betrachtung steht eines der wichtigsten Führungspaare dieser Zeit: Helene Lange und Gertrud Bäumer. Die Dissertation von Göttert liefert einen wichtigen Beitrag zur Netzwerkforschung, Schaser beschäftigt sich in ihrer innovativen Studie mit der Lebensgemeinschaft der beiden Frauen, die sie in die frauenbewegten und politischen Kontexte einordnet.These studies analyse the private aspects of female relationship and their significance for the first wave of the German women’s movement. The focus is on the leading couple at that particular time: Helene Lange and Gertrud Bäumer. The dissertation by Göttert contributes an important piece to the network research, whereas Schaser describes in her innovative study the partnership of the two women, which is strongly related to the feminist and political context.

  14. Schaulust und Horror Soziokulturelle - Perspektiven auf PEEPING TOM

    Directory of Open Access Journals (Sweden)

    Thomas Ballhausen

    2010-09-01

    Full Text Available Die Geschichte des Kinos und des Films ist mindestens ebenso sehr eine Geschichte des Schreckens (und der damit verbundenen Schaulust wie sie eine Geschichte des Dokumentarischen zu sein scheint. Es sind die außergewöhnlichen Körper und deren Bewegungen, die das Publikum zu allen Zeiten faszinierten, schockierten und zum Schauen und Sehen lockten. Besonders das Genre des Horrorfilms ist mit diesem zentralen Aspekt des Kinos besonders deutlich verbunden.

  15. Automation of ultrasonic testing, instrumentation and rules for application and evaluation. Proceedings; Automatisierung der Ultraschallpruefung, Geraetetechnik und Regeln zur Anwendung und Auswertung. Vortraege des Seminars

    Energy Technology Data Exchange (ETDEWEB)

    Wuestenberg, H. [comp.

    1997-12-31

    The proceedings volume contains 18 lectures of the seminar addressing the following (selected) aspects: Requirements to be met by PC cards for US testing applications, defined by producers and appliers; digital technology and its impact on multichannel US testing instruments; the ALOK and array systems combined into one very efficient testing system (SAPHIR); a testing system combining US radiation source arrays and the pulsed eddy current method by means of highly integrated microelectronics (ASICs); regulatory standards and specifications for automated US testing; requirements for automated US testing in compliance with nuclear engineering codes; state of the art in standardisation for definition of required properties of US testing systems; critical review of the proposed standard relating to the TOFD method; automated evaluation shown with the example of US testing of pipelines. (orig./CB) [Deutsch] Dieser Band enthaelt 18 Vortraege mit folgenden Themen (Auswahl): Anforderungen an Ultraschall-PC-Karten aus der Sicht von Hersteller und Betreiber; Einfluss der Digitaltechnik auf Mehrkanal-Ultraschall-Pruefanlagen; Vereinigung der ALOK- und der Gruppenstrahler-Technik in einem leistungsfaehigen Pruefsystem (SAPHIR); Ein kombiniertes Pruefsystem fuer die Ultraschall-Gruppenstrahler- und Impuls-Wirbelstrom-Technik auf der Basis von hochintegrierter Mikroelektronik (ASICs); Regelwerke und Spezifikationen fuer die automatisierte Ultraschallpruefung; Anforderungen der kerntechnischen Regelwerke an die automatisierte Ultraschallpruefung; Stand der Normung bei der Charakterisierung der Eigenschaften von Ultraschall-Pruefsystemen; Kritische Bewertung des Normungsvorschlages zur Beugungslaufzeittechnik (TOFD); und Automatisierte Auswertung am Beispiel der Ultraschallpruefung von Fernrohrleitungen. (orig.)

  16. Quantitative Analyse und Visualisierung der Herzfunktionen

    Science.gov (United States)

    Sauer, Anne; Schwarz, Tobias; Engel, Nicole; Seitel, Mathias; Kenngott, Hannes; Mohrhardt, Carsten; Loßnitzer, Dirk; Giannitsis, Evangelos; Katus, Hugo A.; Meinzer, Hans-Peter

    Die computergestützte bildbasierte Analyse der Herzfunktionen ist mittlerweile Standard in der Kardiologie. Die verfügbaren Produkte erfordern meist ein hohes Maß an Benutzerinteraktion und somit einen erhöhten Zeitaufwand. In dieser Arbeit wird ein Ansatz vorgestellt, der dem Kardiologen eine größtenteils automatische Analyse der Herzfunktionen mittels MRT-Bilddaten ermöglicht und damit Zeitersparnis schafft. Hierbei werden alle relevanten herzphysiologsichen Parameter berechnet und mithilfe von Diagrammen und Graphen visualisiert. Diese Berechnungen werden evaluiert, indem die ermittelten Werte mit manuell vermessenen verglichen werden. Der hierbei berechnete mittlere Fehler liegt mit 2,85 mm für die Wanddicke und 1,61 mm für die Wanddickenzunahme immer noch im Bereich einer Pixelgrösse der verwendeten Bilder.

  17. Sowjetunion und Völkerrecht 1962-1973 / Henn-Jüri Uibopuu

    Index Scriptorium Estoniae

    Uibopuu, Henn-Jüri, 1929-2012

    1980-01-01

    Tutvustus: Sowjetunion und Völkerrecht 1962-1973 : Bibliographie und analyse / hrsg. Boris Meissner, Dietrich Frenzke und Erika Chilicki. Köln : Wissenschaft und Politik, 1979 [t.p. incorrectly: 1977

  18. Age-related differences in the rate and diagnosis of 30-day readmission after hospitalization for acute ischemic stroke.

    Science.gov (United States)

    Hirayama, Atsushi; Goto, Tadahiro; Faridi, Mohammad K; Camargo, Carlos A; Hasegawa, Kohei

    2018-01-01

    Background Little is known about the association between age and readmission within 30 days after hospitalization for acute ischemic stroke. Aim To examine the age-related differences in rate and principal reason of 30-day readmissions in patients hospitalized for acute ischemic stroke. Methods In this retrospective, population-based cohort study using State Inpatient Databases from eight US states, we identified all adults hospitalized for acute ischemic stroke. We grouped the patients into four age categories: readmission within 30 days of discharge from the index hospitalization for acute ischemic stroke and the principal diagnosis of 30-day readmission. Results We identified 620,788 hospitalizations for acute ischemic stroke. The overall 30-day readmission rate was 16.6% with an increase with advanced age. Compared to patients aged readmission rate was significantly higher in age 65-74 years (OR 1.19; 95% CI 1.16-1.21), in age 75-84 years (OR 1.29; 95% CI 1.27-1.31), and in ≥ 85 years (OR 1.24; 95% CI 1.22-1.27; all Preadmission rate association between men and women (P interaction  readmissions were assigned stroke-related conditions or rehabilitation care. Compared to younger adults, older adults were more likely to present with non-stroke-related conditions (46.1% in readmission rate after acute ischemic stroke. Compared with younger adults, older adults were more likely to be readmitted for non-stroke-related conditions.

  19. Coronary artery bypass grafts and diagnosis related groups: patient classification and hospital reimbursement in 10 European countries

    Science.gov (United States)

    2014-01-01

    Background The prospective reimbursement of hospitals through the grouping of patients into a finite number of categories (Diagnosis Related Groups, DRGs), is common to many European countries. However, the specific categories used vary greatly across countries, using different characteristics to define group boundaries and thus those characteristics which result in different payments for treatment. In order to assist in the construction and modification of national DRG systems, this study analyses the DRG systems of 10 European countries. Aims To compare the characteristics used to categorise patients receiving a coronary artery bypass graft (CABG) surgery into DRGs. Further, to compare the structure into which DRGs are placed and the relative price paid for patients across Europe. Method Patients with a procedure of CABG surgery are analysed from Austria, England, Estonia, Finland, France, Germany, Ireland, Poland, Spain and Sweden. Diagrammatic algorithms of DRG structures are presented for each country. The price in Euros of seven typical case vignettes, each made up of a set of a hypothetical patient’s characteristics, is also analysed for each country. In order to enable comparisons across countries the simplest case (index vignette) is taken as baseline and relative price levels are calculated for the other six vignettes, each representing patients with different combinations of procedures and comorbidities. Results European DRG payment structures for CABG surgery vary in terms of the number of different DRGs used and the types of distinctions which define patient categorisation. Based on the payments given to hospitals in different countries, the most resource intensive patient, relative to the index vignette, ranges in magnitude from 1.37 in Poland to 2.82 in Ireland. There is also considerable variation in how much different systems pay for particular circumstances, such as the occurrence of catheterisation or presence of comorbidity. Conclusion Past

  20. Bewegung bei Vorschulkindern: Empfehlungen und Wirklichkeit

    Directory of Open Access Journals (Sweden)

    Graf C

    2011-01-01

    Full Text Available Bewegung und körperliche Aktivität spielen insbesondere in der ganzheitlichen Entwicklung von Kindern eine wichtige Rolle. Heutzutage ist der kindliche Lebensstil allerdings von Bewegungsarmut und der Nutzung audiovisueller Medien geprägt. Bereits Kindergartenkinder sind überwiegend inaktiv bzw. verbringen viel Zeit mit Fernsehen. Eine mögliche Folge von mangelnder Bewegung können motorische Defizite darstellen. In eigenen Kollektiven schneiden mindestens 45 % der Kinder unterdurchschnittlich in den motorischen Hauptbeanspruchungsformen Koordination, Kraft und Schnelligkeit ab. Inwiefern sich dies langfristig auf die gesunde körperliche, aber auch geistige und emotionale Entwicklung der Kinder auswirkt, kann derzeit noch nicht beantwortet werden. Sicherlich unterstützen aber motorische Defizite ein Meidungsverhalten und den weiteren Rückzug aus der Bewegung sowie die Entwicklung von Übergewicht und Adipositas. Allgemein wird für Kinder in dieser Altersgruppe mindestens 2 Stunden tägliche Bewegungszeit sowie eine Reduktion der Fernsehzeit auf maximal 30 Min. empfohlen. Um diese Ziele zu erreichen bzw. zu unterstützen, sind effektive präventive Programme in den verschiedenen Lebensräumen der Kinder, Kindergärten, aber auch pädiatrischen Praxen etc. vonnöten. Bislang ist kein gesundheitsförderlicher/ präventiver „Königsweg“ bekannt, insbesondere nicht für Risikofamilien mit einem geringen sozioökonomischen Status und/oder Migrationshintergrund. Wichtig erscheinen aber die Förderung der intersektoralen Zusammenarbeit und ein Schwerpunkt in der Planung und Umsetzung auf Qualitätssicherung und Projektmanagement, um auch nachhaltig die Gesundheit der Kinder zu unterstützen.

  1. Der Einfluss von sozialer Ungleichheit und kulturellen Unterschieden auf die Wahrnehmung von finanziellen und Arbeitsplatzrisiken: Überlegungen zur Risikogesellschaft

    OpenAIRE

    Abbott, David; Quilgars, Deborah; Jones, Anwen

    2006-01-01

    Der vorliegende Artikel beruht auf Daten einer Studie, die sich mit der Frage beschäftigt, wie verschiedene soziale und kulturelle Gruppen die Risiken von Einkommens- und Arbeitsplatzverlust wahrnehmen und darauf reagieren. Autoren wie LASH, DOUGLAS und LUPTON betonten die Bedeutung von Gruppenzugehörigkeit und sozialen Kategorien für die Strukturierung der Reaktionsweisen auf verschiedene Risikoarten. Sie sprechen daher lieber von Risikokulturen als von der Risikogesellschaft. Trotzdem erken...

  2. Planning and operating energy efficient factories; Energieeffiziente Fabriken planen und betreiben

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Egon; Strauch, Joerg [Technische Univ. Chemnitz (Germany). Professur fuer Fabrikplanung und Fabrikbetrieb; Engelmann, Joerg [Volkswagen Sachsen GmbH, Zwickau (Germany). Werktechnik / Umweltplanung; Loeffler, Thomas [Technische Univ. Chemnitz (Germany). Professur fuer Fabrikplanung und Fabrikbetrieb; IREGIA e.V., Chemnitz (Germany)

    2009-07-01

    This book presents systematic approaches to developing energy saving potentials in the planning and operation of factories. The authors describe the drivers of the current energy debate and the state of the art in making factories energy efficient. They explain important principles that must be observed in considering factories as a system and in order to understand questions relating to energy. They have developed methods for finding appropriate energy-efficient solutions in factory planning. Detailed explanations are given on energy-relevant installations which require planning such as drives, compressed air systems or ventilation systems. The book presents methods and instruments for the analysis and evaluation of energy consumption which can be used for assessment purposes during the initial planning as well as for monitoring and influencing energy consumption during normal operation. Selected practical examples, notably from the automotive industry, serve to illustrate the material presented. The book is intended primarily for planning and production engineers in the piece goods industry as well as for students in related fields. [German] Das Buch zeigt auf, wie beim Planen und Betreiben von Fabriken systematisch Potenziale fuer Energieeinsparungen erschlossen werden koennen. Die Autoren beschreiben die Treiber der aktuellen Energiedebatte und den Status Quo der ''Energieeffizienten Fabrik''. Sie erlaeutern wichtige Grundlagen, um die Fabrik als System und energetische Zusammenhaenge zu verstehen. Eine von ihnen entwickelte Methodik hilft, bereits bei der Planung von Fabriken adaequate energieeffiziente Loesungen zu finden. Energierelevante Planungsobjekte wie elektrische Antriebe, Druckluft- oder Lueftungssysteme werden naeher erlaeutert. Fuer die Analyse und Bewertung des Energieverbrauchs werden Methoden und Instrumente vorgestellt, mit denen sowohl die Ausgangsituation bei der Planung beurteilt als auch der Energieverbrauch im

  3. The Ethnic Politics of Coup Avoidance: Evidence from Zambia and Uganda Ethnopolitik und die Vermeidung von Militärputschen: Sambia und Uganda im Vergleich

    Directory of Open Access Journals (Sweden)

    Stefan Lindemann

    2011-01-01

    Full Text Available Though military interventions seem endemic in sub-Saharan Africa, more than a third of all countries have been able to avoid military coups. To solve this puzzle, this article relates the likelihood of military coups to the degree of ethnic congruence between civilian and military leaders, arguing that coup avoidance is most likely when government and army either exhibit the same ethnic bias or are both ethnically balanced. This argument is illustrated by a comparison of the diverging experiences of Zambia and Uganda. While Zambia is among Africa’s coup-free countries, Uganda’s vulnerability to military intervention has varied over time – with four coups under Obote and the Uganda National Liberation Front (UNLF but no coups under Amin and Museveni. Drawing on original longitudinal data on the ethnic distribution of political and military posts, the article shows that the absence of military coups in Zambia goes back to the balanced composition of government and army. In Uganda, coup avoidance under Amin and Museveni can be linked to the fact that government and army exhibited the same ethnic bias, whereas the coups against the Obote and UNLF regimes reflected either ethnic incongruence between civilian and military leaders or the destabilising combination of a similarly polarised government and army.Politische Interventionen von Militärs scheinen im subsaharischen Afrika allgegenwärtig zu sein. In mehr als einem Drittel der afrikanischen Staaten kam es jedoch bislang nicht zu einem Militärputsch. Der Autor dieses Beitrags vermutet eine Verbindung zwischen dem Grad ethnischer Kongruenz in der zivilen und der militärischen Führung eines Staates und der Wahrscheinlichkeit von Militärinterventionen; er argumentiert, dass ein Putsch immer dann vermieden werden kann, wenn Regierung und militärische Führung entweder von der gleichen ethnischen Gruppe dominiert werden oder wenn beide ethnisch ausgewogen zusammengesetzt sind. Dieser Erkl

  4. Performance evaluation of inpatient service in Beijing: a horizontal comparison with risk adjustment based on Diagnosis Related Groups.

    Science.gov (United States)

    Jian, Weiyan; Huang, Yinmin; Hu, Mu; Zhang, Xiumei

    2009-04-30

    The medical performance evaluation, which provides a basis for rational decision-making, is an important part of medical service research. Current progress with health services reform in China is far from satisfactory, without sufficient regulation. To achieve better progress, an effective tool for evaluating medical performance needs to be established. In view of this, this study attempted to develop such a tool appropriate for the Chinese context. Data was collected from the front pages of medical records (FPMR) of all large general public hospitals (21 hospitals) in the third and fourth quarter of 2007. Locally developed Diagnosis Related Groups (DRGs) were introduced as a tool for risk adjustment and performance evaluation indicators were established: Charge Efficiency Index (CEI), Time Efficiency Index (TEI) and inpatient mortality of low-risk group cases (IMLRG), to reflect respectively work efficiency and medical service quality. Using these indicators, the inpatient services' performance was horizontally compared among hospitals. Case-mix Index (CMI) was used to adjust efficiency indices and then produce adjusted CEI (aCEI) and adjusted TEI (aTEI). Poisson distribution analysis was used to test the statistical significance of the IMLRG differences between different hospitals. Using the aCEI, aTEI and IMLRG scores for the 21 hospitals, Hospital A and C had relatively good overall performance because their medical charges were lower, LOS shorter and IMLRG smaller. The performance of Hospital P and Q was the worst due to their relatively high charge level, long LOS and high IMLRG. Various performance problems also existed in the other hospitals. It is possible to develop an accurate and easy to run performance evaluation system using Case-Mix as the tool for risk adjustment, choosing indicators close to consumers and managers, and utilizing routine report forms as the basic information source. To keep such a system running effectively, it is necessary to

  5. Model remediation of contaminated sites as illustrated by the example of the TNT-remediation project Stadtallendorf, Hessen, Germany. Part 1: Final report; Part 2: Documentation and balancing of the measures; Part 3: Documentation of citizens' participation and public relations activities in Stadtallendorf; Modellhafte Sanierung von Altlasten am Beispiel des TNT-Sanierungsprojektes Stadtallendorf/Hessen. T. 1: Abschlussbericht. T. 2: Dokumentation und Bilanzierung von Auswirkungen der Sanierung. T. 3: Dokumentation der Buergerbeteiligung und Oeffentlichkeitsarbeit in Stadtallendorf

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-07-01

    The project comprised the following stages: 1. Development of a technology for purification of soils contaminated with explosives. The process comprised soil washing, hot steam treatment, and thermal treatment of residues; 2. Projecting, construction and two years of operation of a soil purification plant with a rated throughput of 20 t/h and a total throughput of 130,000 t; 3. Remediation of two representative sites on DAG terrain (TNT production chain and filling stations); 4. Verification of the findings in an accompanying scientific programme. The site under investigation was formerly occupied by the Dynamit AG (DAG) Stadtallendorf, where TNT, contaminated waste water and acids were produced, and contamination levels were high in several areas. Today, the area is a residential area. In addition to the investigations described here, the waste water discharge system of the DAG was modernized. [German] Das FuE-Vorhaben Stadtallendorf wurde mit folgender Zielsetzung begonnen: (1) Entwicklung einer geeigneten und moeglichst umweltvertraeglichen Technik zur Reinigung von Boeden mit sprengstoffspezifischen Kontaminationen; hierzu wurde in Anlehnung an die Ausschreibung des Bundes ein kombiniertes Bodenbehandlungsverfahren vorgesehen, das aus folgenden Komponenten bestand: - Bodenwaesche, - Heissdampfbehandlung, - Thermische Reststoffbehandlung. (2) Planung, Bau und zweijaehriger Betrieb einer entsprechenden grosstechnischen Bodenreinigungsanlage (Nenndurchsatz von 20 t/Stunde; Gesamtdurchsatz 130.000 t). (3) Bodensanierung von zwei repraesentativen Arealen im DAG-Gelaende (TNT-Produktionskette und Fuellstellenbetrieb). (4) Absicherung der Ergebnisse in einem wissenschaftlichen Begleitprogramm. Gegenstand der Phase 2 des Vorhabens war der vollstaendige Prozess der Planung und Umsetzung der Sanierung eines (Teils eines) Planungsraumes des Ruestungsaltstandortes Dynamit AG (DAG) Stadtallendorf. Es handelte sich dabei um einen Bereich, der als Standort fuer TNT

  6. Public relations in risk communication: risk pr. The importance of public relations for risk communication; Public Relations in der Risikokommunikation: Risiko-PR. Die Bedeutung von Public Relations fuer die Risikokommunikation

    Energy Technology Data Exchange (ETDEWEB)

    Lehmann, K.

    2001-07-01

    Risks have become a central problem of our time, as is reflected in concepts like 'society at risk' and 'anti-technological attitude', in group protest against risks and against those who cause them, and last but not least in the critical attitude of the media. Against this background, organisations must needs enter the public discussion and be able to communicate professionally and convincingly in order to ensure their own success and further existence. The book describes the basic problems of risk research and risk communications and discusses inhowfar, and how, public relations strategies and instruments can help here. [German] Risiken werden verstaerkt zum Problem unserer Zeit. Das belegen nicht nur Begriffe wie 'Risikogesellschaft' und 'Technikfeindlichkeit', die in letzter Zeit an Bedeutung gewonnen haben, sondern auch und vor allem nachhaltige Proteste von engagierten Gruppierungen gegen Risiken und deren Verursacher oder auch die kritische Berichterstattung der Medien. Vor diesem Hintergrund ist es fuer Organisationen erforderlich, in die oeffentliche Auseinandersetzung um Risiken einzusteigen und hier professionell und ueberzeugend zu kommunizieren, um den Organisationserfolg und Organisationsbestand zu sichern. Die vorliegende Arbeit beschreibt die Grundprobleme der Risikoforschung und Risikokommunikation und diskutiert, ob und inwieweit Public Relations bei der Loesung dieser Probleme helfen koennen, da insbesondere Public Relations gezielt Strategien und Instrumente nutzen, um beispielsweise den Wissensstand der Oeffentlichkeit zu verbessern und den Dialog mit relevanten Teiloeffentlichkeiten zu foerdern. (orig.)

  7. Genetic variants in telomerase-related genes are associated with an older age at diagnosis in glioma patients: evidence for distinct pathways of gliomagenesis.

    Science.gov (United States)

    Walsh, Kyle M; Rice, Terri; Decker, Paul A; Kosel, Matthew L; Kollmeyer, Thomas; Hansen, Helen M; Zheng, Shichun; McCoy, Lucie S; Bracci, Paige M; Anderson, Erik; Hsuang, George; Wiemels, Joe L; Pico, Alexander R; Smirnov, Ivan; Molinaro, Annette M; Tihan, Tarik; Berger, Mitchell S; Chang, Susan M; Prados, Michael D; Lachance, Daniel H; Sicotte, Hugues; Eckel-Passow, Jeanette E; Wiencke, John K; Jenkins, Robert B; Wrensch, Margaret R

    2013-08-01

    Genome-wide association studies have implicated single nucleotide polymorphisms (SNPs) in 7 genes as glioma risk factors, including 2 (TERT, RTEL1) involved in telomerase structure/function. We examined associations of these 7 established glioma risk loci with age at diagnosis among patients with glioma. SNP genotype data were available for 2286 Caucasian glioma patients from the University of California, San Francisco (n = 1434) and the Mayo Clinic (n = 852). Regression analyses were performed to test for associations between "number of risk alleles" and "age at diagnosis," adjusted for sex and study site and stratified by tumor grade/histology where appropriate. Four SNPs were significantly associated with age at diagnosis. Carrying a greater number of risk alleles at rs55705857 (CCDC26) and at rs498872 (PHLDB1) was associated with younger age at diagnosis (P = 1.4 × 10(-22) and P = 9.5 × 10(-7), respectively). These SNPs are stronger risk factors for oligodendroglial tumors, which tend to occur in younger patients, and their association with age at diagnosis varied across tumor subtypes. In contrast, carrying more risk alleles at rs2736100 (TERT) and at rs6010620 (RTEL1) was associated with older age at diagnosis (P = 6.2 × 10(-4) and P = 2.5 × 10(-4), respectively). These SNPs are risk factors for all glioma grades/histologies, and their association with age at diagnosis was consistent across tumor subgroups. Carrying a greater number of risk alleles might be expected to decrease age at diagnosis. However, glioma susceptibility conferred by variation in telomerase-related genes did not follow this pattern. This supports the hypothesis that telomerase-related mechanisms of telomere maintenance are more associated with gliomas that develop later in life than those utilizing telomerase-independent mechanisms (ie, alternative lengthening of telomeres).

  8. Combined functional and morphological imaging of sarcomas. Significance for diagnostics and therapy monitoring; Kombinierte funktionelle und morphologische Bildgebung bei Sarkomen. Stellenwert fuer Diagnostik und Therapiemonitoring

    Energy Technology Data Exchange (ETDEWEB)

    Schramm, N.; Rist, C.; Reiser, M.F.; Berger, F. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Schlemmer, M.; Issels, R. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Medizinische Klinik und Poliklinik III, Muenchen (Germany)

    2010-04-15

    {sup 18}F-fluorodeoxyglucose positron-emission tomography (FDG-PET) and especially hybrid FDG-PET/CT is becoming more and more accepted for the clinical management of adult and pediatric patients with sarcomas. By integrating the CT component the specificity in particular but also the sensitivity of the modality are improved further. With PET/CT a complete staging including the detection of lung metastases is feasible in a single examination. For patients with primary bone and soft tissue sarcomas FDG-PET/CT is utilized for diagnosis, staging and restaging, metabolic tumor grading, guidance of biopsies, detection of tumor recurrence and therapy monitoring. Furthermore, it has been demonstrated that FDG uptake of the tumor prior to treatment and changes of FDG uptake after therapy significantly correlate with histopathologic response and survival of patients. Therefore, PET and PET/CT have a prognostic value. In the future new perspectives of hybrid PET/CT imaging will arise by introducing novel radiotracers and combined functional imaging of tumor metabolism and perfusion. High resolution MRI is essential for local evaluation of the primary tumor and preoperative planning with assessment of possible infiltration of vascular or neural structures. Contrast-enhanced MRI remains a key tool in the diagnosis of recurrent disease, especially in tumors which are not hypermetabolic. Dynamic contrast-enhanced MR sequences can significantly contribute to therapy monitoring. More research is necessary to prospectively compare dynamic contrast-enhanced MRI and FDG-PET/CT for evaluation of local and recurrent diseases. (orig.) [German] Die {sup 18}F-Fluordeoxyglukose-Positronenemissionstomographie (FDG-PET) und insbesondere die Hybridbildgebung als FDG-PET/CT gewinnen beim klinischen Management erwachsener und paediatrischer Sarkompatienten zunehmend an Bedeutung. Durch die CT-Komponente werden v. a. die Spezifitaet, aber auch die Sensitivitaet des Verfahrens weiter gesteigert

  9. Ein überfälliger Dialog. Wie Frauen- und Geschlechterforschung und Soziologie miteinander ins Gespräch kommen können

    Directory of Open Access Journals (Sweden)

    Heike Kahlert

    2007-03-01

    Full Text Available Die Monographie von Brigitte Aulenbacher zum Zusammenhang von Rationalisierung, Geschlecht und Gesellschaft ist in gegenstandsbezogener und methodologischer Hinsicht ambitioniert, überzeugend und lesenswert. Die Studie stellt eine solide, manchmal auch etwas zu weitschweifige und detailreiche Grundlage für weiterführende Diskussionen zwischen der (sozialwissenschaftlichen Frauen- und Geschlechterforschung und der Soziologie, genauer der Gesellschaftstheorie in zeitdiagnostischer Perspektive, Arbeits-, Industrie-, Organisations- und Techniksoziologie, dar.

  10. A Challenging Diagnosis of IgG4-Related Disease When Understanding Limitations of Laboratory Testing Was Pivotal

    Directory of Open Access Journals (Sweden)

    Victoria Y. Y. Xu

    2017-01-01

    Full Text Available A 76-year-old man was incidentally found on a CT scan to have lymphadenopathy and bilateral kidney enlargement suggestive of infiltrative renal disease. He was largely asymptomatic but had bilateral salivary and lacrimal gland enlargement. A grossly elevated serum IgG (>70 g/L with concomitant suppression of other immunoglobulins, a small IgG restriction, and a parotid biopsy revealing lymphoplasmacytic infiltrate with slight kappa light chain excess all suggested a lymphoproliferative disorder (LPD. The diagnostic workup was further confounded by a normal serum IgG4 concentration. Moreover, bone marrow and renal biopsies did not reveal evidence of LPD. Discussion with the laboratory not only clarified that the markedly increased total IgG could not be accounted for by the small IgG restriction, but also identified a discrepancy in the IgG4 measurement. Repeat analysis of a follow-up sample revealed an elevated IgG4 of 5.94 (reference interval: 0.039–0.864 g/L, which prompted a repeat parotid biopsy that showed predominant IgG4+ lymphocytic infiltrates. Despite the deluding presentations, a final diagnosis of IgG4-related disease (IgG4-RD was made based on elevated serum IgG4 concentrations and histopathological findings. This case highlights the importance of recognizing limitations of laboratory testing and the benefit of close communications among clinical subspecialties and the laboratory.

  11. A comparison of survival of patients treated for AIDS-related central nervous system lymphoma with and without tissue diagnosis

    International Nuclear Information System (INIS)

    Kaufmann, Thomas; Nisce, Lourdes Z.; Coleman, Morton

    1996-01-01

    Purpose: This is a retrospective review of the treatment outcome of radiation therapy (RT) in acquired immunedeficiency syndrome (AIDS) patients with presumed primary central nervous system (CNS) non-Hodgkin's lymphoma (NHL), with and without tissue verification. Methods and Materials: Twenty-seven patients with AIDS-related CNS NHL were treated between 1986 and 1992. They were divided into two groups. Group 1 consisted of nine patients with a positive histology for NHL. They were treated with dexamethasone (DXM) and whole brain RT. Group 2 consisted of 18 patients who, because of unique circumstances, were treated without histologic confirmation of NHL. Rapid clinical and/or radiologic response to DXM and whole-brain RT was interpreted as NHL. Results: For group 1, the response rate was 87.5%, mean survival 6.1 months, and median survival 4.5 months. For group 2, the response rate was 72.2%, mean survival 5.2 months, and median survival 4.5 months. The overall response rate was 76.9%, mean survival 5.8 months, and median survival 4.5 months. Conclusions: In instances where a tissue diagnosis cannot be established, a positive response to an empiric trial of DXM and RT to 20 Gy may constitute presumptive evidence of NHL

  12. How did market competition affect outpatient utilization under the diagnosis-related group-based payment system?

    Science.gov (United States)

    Kim, Seung Ju; Park, Eun-Cheol; Kim, Sun Jung; Han, Kyu-Tae; Jang, Sung-In

    2017-06-01

    Although competition is known to affect quality of care, less is known about the effects of competition on outpatient health service utilization under the diagnosis-related group payment system. This study aimed to evaluate these effects and assess differences before and after hospitalization in South Korea. Population-based retrospective observational study. We used two data set including outpatient data and hospitalization data from National Health Claim data from 2011 to 2014. Participants who were admitted to the hospital for hemorrhoidectomy were included. A total of 804 884 hospitalizations were included in our analysis. The outcome variables included the costs associated with outpatient examinations and the number of outpatient visits within 30 days before and after hospitalization. High-competition areas were associated with lower pre-surgery examination costs (rate ratio [RR]: 0.88, 95% confidence interval [CI]: 0.88-0.89) and fewer outpatient visits before hospitalization (RR: 0.98, 95% CI: 0.98-0.99) as well as after hospitalization compared with moderate-competition areas. Our study reveals that outpatient health service utilization is affected by the degree of market competition. Future evaluations of hospital performance should consider external factors such as market structure and hospital location. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  13. [Diagnosis-related groups as an instrument to develop suitable case-based lump sums in hematology and oncology].

    Science.gov (United States)

    Thalheimer, Markus

    2011-01-01

    In 2003 a new reimbursement system was established for German hospitals. The approximately 17 million inpatient cases per year are now reimbursed based on a per-case payment regarding diagnoses and procedures, which was developed from an internationally approved system. The aim was a better conformity of costs and efforts in in-patient cases. In the first 2 years after implementation, the German diagnosis-related group (DRG) system was not able to adequately represent the complex structures of treatment in hematological and oncological in-patients. By creating new diagnoses and procedures (International Classification of Diseases 10 (ICD-10) and Surgical Operations and Procedures Classification System (OPS) catalogues), generating new DRGs and better splitting of existing ones, the hematology and oncology field could be much better described in the following years. The implementation of about 70 'co-payment structures' for new and expensive drugs and procedures in oncology was also crucial. To reimburse innovations, an additional system of co-payments for innovations was established to bridge the time until innovations are represented within the DRG system itself. In summary, hematological and oncological in-patients, including cases with extraordinary costs, are meanwhile well mapped in the German reimbursement system. Any tendencies to rationing could thereby be avoided, as most of the established procedures and costly drugs are adequately represented in the DRG system. Copyright © 2011 S. Karger AG, Basel.

  14. Systematically evaluating the impact of diagnosis-related groups (DRGs) on health care delivery: a matrix of ethical implications.

    Science.gov (United States)

    Fourie, Carina; Biller-Andorno, Nikola; Wild, Verina

    2014-04-01

    Swiss hospitals were required to implement a prospective payment system for reimbursement using a diagnosis-related groups (DRGs) classification system by the beginning of 2012. Reforms to a health care system should be assessed for their impact, including their impact on ethically relevant factors. Over a number of years and in a number of countries, questions have been raised in the literature about the ethical implications of the implementation of DRGs. However, despite this, researchers have not attempted to identify the major ethical issues associated with DRGs systematically. To address this gap in the literature, we have developed a matrix for identifying the ethical implications of the implementation of DRGs. It was developed using a literature review, and empirical studies on DRGs, as well as a review and analysis of existing ethics frameworks. The matrix consists of the ethically relevant parameters of health care systems on which DRGs are likely to have an impact; the ethical values underlying these parameters; and examples of specific research questions associated with DRGs to illustrate how the matrix can be applied. While the matrix has been developed in light of the Swiss health care reform, it could be used as a basis for identifying the ethical implications of DRG-based systems worldwide and for highlighting the ethical implications of other kinds of provider payment systems (PPS). Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Impact of the Korean Diagnosis-Related Groups payment system on the outcomes of adenotonsillectomy: A single center experience.

    Science.gov (United States)

    Kwak, Sang Hyun; Kim, Ji Hoon; Kim, Da Hee; Kim, Jung Min; Byeon, Hyung Kwon; Kim, Won Shik; Koh, Yoon Woo; Kim, Se-Heon; Choi, Eun Chang

    2018-06-01

    To report outcomes with regard to clinical aspects and medical costs of adenotonsillectomy and tonsillectomy at a single institution before and after implementation of the Diagnosis-Related Groups (DRG) payment system in Korea. We retrospectively reviewed the records of patients treated with adenotonsillectomy or tonsillectomy between July 2012 and June 2014. The Korean DRG payment system was applied to seven groups of specific diseases and surgeries including adenotonsillectomy and tonsillectomy from July 2013 at all hospitals in Korea. We divided patients into four groups according whether the fee-for-service (FFS) or DRG payment system was implemented and operation type (FFS-adenotonsillectomy (AT), DRG-AT, FFS-tonsillectomy (T), and DRG-T). A total of 1402 patients were included (485 FFS-AT, 490 DRG-AT, 203 FFS-T, and 223 DRG-T). The total medical cost of the DRG-AT group was significantly lower than that of the FFS-AT group (1191±404 vs. 1110±279 USD, PDRG system for adenotonsillectomy and tonsillectomy reduced medical costs and clinical outcomes were not significantly altered by the adoption of the DRG system. 4. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Metastatic pattern and DNA ploidy in stage IV breast cancer at initial diagnosis. Relation to response and survival.

    Science.gov (United States)

    De Lena, M; Romero, A; Rabinovich, M; Leone, B; Vallejo, C; Machiavelli, M; Cuevas, M; Rodriguez, R; Lacava, J; Perez, J

    1993-06-01

    Sixty-nine patients with metastatic breast cancer (MBC) at initial diagnosis were analyzed to verify if metastatic pattern and clinical outcome are related to DNA ploidy determined by flow cytometry (FCM). Characteristics of 55 fully evaluable patients were as follows: median age: 61 years; postmenopausal: 75%; bone-only metastases (BM): 60%; extraosseous-only metastases (EM): 40%. Overall response rates (CR + PR) obtained with different chemotherapies and/or hormonal therapies were 58% and 68% for patients with BM and EM, respectively. Sixty percent of specimens resulted aneuploid, and the mean coefficient of variation of the complete series was 5.1%. In the whole group of patients DNA ploidy of primary tumor did not predict the metastatic pattern and had no influence upon response to treatment, duration of response, time to progression, and overall survival. When analyses were carried out according to metastatic pattern, those patients with BM showed similar results. However, within the group with EM, those with diploid tumors presented a significantly better survival (median 18 vs 13 months, p = .04). FCM-DNA analysis seems to identify a subgroup of patients with poor prognosis constituted by those who had aneuploid primary tumors and metastases to extraosseous sites.

  17. Evaluation of optical coherence tomography in the diagnosis of age related macula degeneration compared with fluorescence angiography

    Directory of Open Access Journals (Sweden)

    Fröschl, Barbara

    2007-02-01

    Full Text Available Background: In industrialised nations age-related macular degeneration (AMD is the most common cause of blindness and severe visual impairment. AMD is a disease of the retina characterized by the accumulation of metabolic products in the macula. In early stages drusen and pigment disorders occur, in late stages a dry form is distinguished from the exsudative form with choroidal neovascularisation. AMD causes vision disorders such as blurred vision of the central part of the visual field, leading finally to a dark spot. Several therapies are available for the exsudative form, however an exact diagnosis is partially essential. The gold standard for the diagnosis of AMD is fluorescein angiography (FA, an invasive investigation with intravenous application of a dye. Optical coherence tomography (OCT is a more recent non-invasive procedure. Objectives: The aim of this HTA report is to investigate the efficacy and efficiency of OCT compared to FA. Ethical, societal and legal aspects are also considered. Methods: A systematic literature search was performed in 34 international databases which yielded 2324 articles. Eight publications were included for assessment, according to predefined selection criteria. Results: The number of studies investigating OCT compared to FA in patients with AMD is presently very limited and the quality of the studies is generally low. The number of investigated patients is below 35 in four publications and in only one publication it is above 100. Moreover in most of the articles very selected patient groups are studied. Economic studies concerning the efficiency of OCT compared to FA cannot be identified. DiscussionEven though the patient groups investigated and the objectives of the studies are very heterogenous, all publications uniformly show that OCT cannot replace FA. However, OCT yields additional diagnostic findings and may verify unclear findings of FA. Therefore the application of OCT in addition to FA is useful in

  18. Sustainable development - theory and practice of environmental consulting. Proceedings of a seminar of Zentrale Informationsstelle Umweltberatung Bayern. Vol. 11; Nachhaltige Entwicklung - Theorie und Praxis fuer die Umweltberatung. Seminarband der Zentralen Informationsstelle Umweltberatung Bayern. Bd. 11

    Energy Technology Data Exchange (ETDEWEB)

    Koller, U.; Behling, G.; Klemmer, A.; Haury, H.J. [comps.

    1998-12-31

    On 25/26 November, 1997, Zentrale Informationsstelle, Umweltberatung Bayern held its 11th seminar under the title ``Sustainable development - theory and practice of environmental consulting. Subjects related to the Agenda 21 were discussed in lectures and workshops. [Deutsch] Am 25. und 26. November 1997 veranstaltete die Zentrale Informationsstelle, Umweltberatung Bayern ihr elftes Seminar mit dem Thema ``Nachhaltige Entwicklung- Theorie und Praxis fuer die Umweltberatung``. In Fachvortraegen und Workshops wurden Themen zur Agenda 21 behandelt. (ABI)

  19. Bakteriochlorophyllvorstufen und Pigment-Protein-Komplexe in Rhodospirillum rubrum ST3 und GN11

    OpenAIRE

    Hammel, Jörg U.

    2006-01-01

    In der vorliegenden Arbeit wurden zwei Mutanten des Alpha-Proteobakteriums Rhodospirillum rubrum untersucht, die im Bakteriochlorophyll-Biosyntheseweg unterbrochen sind, um einen Beitrag zum genaueren Verständnis der Biosynthese dieser Moleküle und der einzelnen daran beteiligten Schritte zu liefern. Von den beiden Stämmen ST3 und GN11 wurden die ins Kulturmedium ausgeschiedenen Pigmente aufgereinigt und spektroskopisch analysiert. Ebenfalls wurden sowohl von ST3, als auch von GN11 die in int...

  20. Computerspielgewalt und Aggression: Längsschnittliche Untersuchung von Selektions- und Wirkungseffekten

    OpenAIRE

    Staude-Müller, Frithjof

    2011-01-01

    Auf Grundlage sozialkognitiver Aggressionsmodelle wurde die Beziehung zwischen Computerspielgewohnheiten und der Aggressionsneigung sowie Verzerrungen in der sozialen Informationsverarbeitung untersucht. Dazu wurden 499 Schüler/innen weiterführender Schulen (6.-8. Kl. Gymnasium, Haupt- und Realschule) in zwei Erhebungen mit einem Intervall von einem Jahr befragt. Mit hierarchischen Regressionsanalysen wurden Wirkungs- und Selektionseffekte geprüft, wobei relevante Drittvariablen (Monitoring u...

  1. Zu den Grundlagen der visuellen Soziologie: Wahrnehmen und Sehen, Beobachten und Betrachten

    OpenAIRE

    Bachleitner, Reinhard; Weichbold, Martin

    2015-01-01

    In diesem Beitrag werden die visuellen Modi des Wahrnehmens – das Sehen, Beobachten und Betrachten – in ihrem Wesen skizziert, und die doppelte Theorieabhängigkeit von Wahrnehmungsprozessen wird thematisiert. Dabei zeigt sich, dass mehrere offene methodologische und erkenntnistheoretische Fragen durch die Differenzierung des Wahrnehmungsvorgangs in drei Stufen (reines Sehen, kognitive Repräsentation, Transformation des Perzepts in Worte) sowie die Differenzierung der Wahrnehmungsmodi in jewei...

  2. Intermediale Synchronisation zwischen Volltext und Film und ihre Realisierung in Hybrideditionen

    OpenAIRE

    Bülow, Gilles

    2017-01-01

    Diese Arbeit behandelt die theoretische Erfassung und prototypische Erzeugung komplexer Musterdokumente mit synchronisiertem »Volltext« und »Bewegtbild«. Dabei werden wesentliche Randbedingungen für die Dokumentengliederung ermittelt. Diese Randbedingungen erlauben es dann, unterhalb der Plattformebene (des »reinen« Buchs und des »reinen« Films) neue multimediale Hybrideditionen auf Basis elektronischer Publikationsformate als Ausgabeplattform »sinnvoll« zu generieren. Empirisch wird der F...

  3. Hospital payment systems based on diagnosis-related groups: experiences in low- and middle-income countries

    Science.gov (United States)

    Wittenbecher, Friedrich

    2013-01-01

    Abstract Objective This paper provides a comprehensive overview of hospital payment systems based on diagnosis-related groups (DRGs) in low- and middle-income countries. It also explores design and implementation issues and the related challenges countries face. Methods A literature research for papers on DRG-based payment systems in low- and middle-income countries was conducted in English, French and Spanish through Pubmed, the Pan American Health Organization’s Regional Library of Medicine and Google. Findings Twelve low- and middle-income countries have DRG-based payment systems and another 17 are in the piloting or exploratory stage. Countries have chosen from a wide range of imported and self-developed DRG models and most have adapted such models to their specific contexts. All countries have set expenditure ceilings. In general, systems were piloted before being implemented. The need to meet certain requirements in terms of coding standardization, data availability and information technology made implementation difficult. Private sector providers have not been fully integrated, but most countries have managed to delink hospital financing from public finance budgeting. Conclusion Although more evidence on the impact of DRG-based payment systems is needed, our findings suggest that (i) the greater portion of health-care financing should be public rather than private; (ii) it is advisable to pilot systems first and to establish expenditure ceilings; (iii) countries that import an existing variant of a DRG-based system should be mindful of the need for adaptation; and (iv) countries should promote the cooperation of providers for appropriate data generation and claims management. PMID:24115798

  4. Diagnosis and laparoscopic management of a rare endometriosis-related peritoneal mass with rapid growth in early pregnancy.

    Science.gov (United States)

    Di Donato, Nadine; Facchini, Chiara; Leggieri, Concetta; Caprara, Giacomo; Seracchioli, Renato

    2015-08-01

    Herein is described the diagnosis, clinical management and laparoscopic removal of a rapid growing retro-uterine mass in a pregnant woman. After laparoscopic removal of the pelvic mass, diagnosis of peritoneal endometriotic cyst was made on histology. The patient was asymptomatic and no history of endometriosis was reported. The laparoscopic management of the peritoneal mass was safe and effective and to our knowledge this is the first case report describing a decidualized endometriotic lesion in the absence of a pre-pregnancy endometriosis diagnosis. © 2015 The Authors Journal of Obstetrics and Gynaecology Research © 2015 Japan Society of Obstetrics and Gynecology.

  5. Die Kunst des Intavolierens: Gebundenheit und Freiheit

    Directory of Open Access Journals (Sweden)

    Ring, Johannes

    2003-12-01

    Full Text Available A big part of 16th century keyboard repertory was intabulated vocal music; arrangements of motets, sets of masses and chansons. Marcant and sometimes little known examples show the different functions of intabulations: repertoire for the organists (liturgical function, music of delight and pedagogical functions. As a part of Ars Organistum intabulations were the basis of professional musical studies, learning to improvise organ music and to compose music. Masters like H. Scheidemann, the both Gabrielis, J. de Lublin, P. Philips, the both Cabezóns, some English and French anonym composers demonstrate that intabulations are much more than keyboard reductions - artful arrangements with their own life and character on the way to artful paraphrases. The intentions of the composers / arrangers in connection with the possibilities of the keyboard instruments definite the character and the step of transforming a vocal set in a (new piece of keyboard music.

    [de] Ein großer Teil des Musikrepertoires für Tasteninstrumente im 16. Jahrhundert bestand aus intavolierter Vokalmusik - Bearbeitungen von Motetten, Messsätzen und Chansons. Markante und teilweise wenig bekannte Beispiele zeigen verschiedene Funktionen der Intavolierungen. Zu nennen sind das Organistenrepertoire (liturgisches Umfeld, die Musik zur Erbauung und Unterhaltung und die pädagogische Funktion. Als Bestandteil der Ars Organistum waren Intavolierungen wichtig um professionell das Improvisieren von Musik und das Komponieren zu erlernen. Exemplarisch dokumentieren besonders H. Scheidemann, die beiden Gabrielis, J. de Lublin, P. Philips, die beiden Cabezóns und einige anonyme Komponisten aus England und Frankreich, dass ihre Kunst des Intavolierens weit über den Übertragungsmodus hinausgeht, bis hin zum virtuosen Arrangement und zur kunstvollen Paraphrase. Die Intentionen der Komponisten in Verbindung mit den Möglichkeiten der Tasteninstrumente pr

  6. Kommunikation und Lernen in partizipativen kulturellen und medialen Räumen

    Directory of Open Access Journals (Sweden)

    Elke Zobl

    2012-12-01

    Full Text Available Eine der interessantesten Transformationen in der Jugendkultur seit den 1990er-Jahren ist die steigende Zahl vor allem an Mädchen und jungen Frauen, die zu aktiven kulturellen Produzentinnen wurden. In diesem Artikel wird argumentiert, dass sie mit ihren eigenen kulturellen Produktionen und Netzwerken neue soziale und mediale Räume öffnen, die durch eine partizipative Kultur, selbst-organisiertes Lernen in informellen Kontexten und lokale, transnationale und virtuelle Vernetzung und Kommunikation geprägt sind. Ziel dieses Artikels ist es, das Kommunizieren und Lernen in partizipativen kulturellen (bzw. sozialen und medialen Räumen am Beispiel queer-feministischer Festivals – sogenannter „Ladyfeste“ – darzustellen und ihre Bedeutung in (medien-pädagogischen Kontexten zu diskutieren.One of the most interesting transformations in youth culture since the 1990s is the growing number of girls and young women as active cultural producers. By creating their own cultural productions and networks, this article argues, that they open up new cultural (i. e. social and media spaces which are characterized by a participatory culture, self-organised learning and local, transnational and virtual networks and communication. Taking the example of queer-feminist festivals (so called “Ladyfests”, the aim of this article is to discuss communication and learning in participatory cultural and media spaces and their meaning in the context of (media-pedagogy.

  7. PHP und MySQL der Web-Baukasten fur Einsteiger und Individualisten

    CERN Document Server

    Damaschke, Giesbert

    2015-01-01

    Sie haben schon eigene Webseiten gebaut und mochten diese nun mit Funktionen ausstatten, fur die Sie PHP und MySQL benotigen? Giesbert Damaschke zeigt Ihnen in diesem Buch, wie Sie das schaffen. Schritt fur Schritt erlernen Sie die benotigten Programmier- und Datenbankgrundlagen - immer im Rahmen von typischen dynamischen Anwendungen. So erheben und speichern Sie zum Beispiel mit Formularen Kontaktdaten, prufen Benutzereingaben, erstellen Menus, richten einen Besucherzahler ein, verschicken E-Mails mit PHP oder entwickeln sogar einen eigenen Blog. Alle Codebeispiele werden ausfuhrlich erklart,

  8. Wirkungen eines Bifidojoghurts mit Laktulose und eines konventionellen Joghurts auf Darmphysiologie und bakterielle Metaboliten als Risikomodulatoren der Kolonkarzinogenese sowie Darmflora und Blutlipide bei gesunden Erwachsenen

    OpenAIRE

    Gerlach, Stefanie

    2007-01-01

    Hintergrund: Probiotische und synbiotische Milchprodukte zählen zu den "funktionellen Lebensmitteln", denen im Vergleich zu herkömmlichen Produkten ein gesundheitsfördernder Zusatznutzen zugeschrieben wird. Dabei wird diskutiert, ob die Gesundheit bereits gesunder Personen noch optimierbar ist, ob und in welcher Weise die Darmflora gezielt "günstig" modifiziert werden kann und/oder ob diese Manipulation zu messbaren gesundheitsfördernden Veränderungen metabolischer und systemischer Biomarker ...

  9. Patient and parent perceptions of the diagnosis and management of cystic fibrosis-related diabetes

    Directory of Open Access Journals (Sweden)

    Kate Millington

    2014-09-01

    Conclusions: Health care professionals caring for patients with CFRD should be informed of the specific challenges that arise in CFRD. Education in advance of CFRD diagnosis may facilitate management.

  10. Electromagnetic converters and sensors. Fundamentals, fieldnumerical calculation of electromagnetic fields and application in mechatronics. 2. new rev. and enl. ed.; Elektromagnetische Wandler und Sensoren. Grundlagen, feldnumerische Berechnung elektromagnetischer Felder und Anwendungen in der Mechatronik

    Energy Technology Data Exchange (ETDEWEB)

    Cassing, W.; Stanek, W.; Erd, L.; Huebner, K.D.; Koch, J.; Dukart, A.

    2002-07-01

    Electrodynamic theories and calculation methods are discussed with particular regard to permanent electromagnetic circuits in mechatronics. Design strategies and computer calculation methods are explained by examples and applied to magnetic sensors, e.g. in automotive, electrically switched permanent magnet systems and actuators. The theoretical background is based primarily on the complete Maxwell's equations with their interdisciplinary related fields and up to compact formulations for use in relativistic quantum electrodynamics. [German] In diesem Fachbuch werden elektrodynamische Theorien und verschiedene Berechnungsverfahren unter besonderer Beruecksichtigung dauerelektromagnetischer Kreise in der Mechatronik behandelt. An ausgewaehlten Berechnungsbeispielen werden die wichtigsten Entwurfsstrategien und computerorientierten Rechenverfahren erlaeutert und auf magnetische Sensoren u.a. aus dem Bereich Automotive, elektrisch schaltbare Dauermagnetsysteme und Aktuatoren angewendet. Der theoretische Hintergrund hierfuer sind vorrangig die kompletten Maxwell'schen Gleichungen mit interdisziplinaeren Nachbargebieten bis hin zu kompakten Formulierungen fuer die relativistische Quantenelektrodynamik. (orig.)

  11. Michael Jäckel, Julia Derra, Cornelia Eck: SchönheitsAnsichten. Geschlechterbilder in Werbeanzeigen und ihre Bewertung. Baden-Baden: Nomos Verlag 2009.

    Directory of Open Access Journals (Sweden)

    Waltraud Posch

    2010-11-01

    Full Text Available Michael Jäckel, Julia Derra, and Cornelia Eck’s cross-generational study answers the question as to which concepts of beauty are presented in magazine advertisements and how recipients react to these concepts. The book provides an important basis for Media Studies and Gender Sociology particularly because it also shows medial constructions of gender that are initially invisible and because it shows gender related illustrations of physicality and beauty.In einer generationenübergreifenden Studie gehen Michael Jäckel, Julia Derra und Cornelia Eck der Frage nach, welche Schönheitsbilder in der Zeitschriftenwerbung präsentiert und wie diese von Rezipient/-innen aufgenommen werden. Das Buch liefert eine wichtige Basis für Medienforschung und Soziologie der Geschlechter, zumal es auch vordergründig nicht sichtbare mediale Konstruktionen von Geschlecht und die geschlechtsbezogene Darstellung von Körperlichkeit und Schönheit aufzeigt.

  12. Editorial: Theoriebildung in Mediendidaktik und Wissensmanagement

    Directory of Open Access Journals (Sweden)

    Michael Kerres

    2002-10-01

    Full Text Available Das Internet trägt massgeblich zur Entstehung einer neuen Lern- und Wissenskultur bei und ist mittlerweile Gegenstand einer ganzen Reihe von Projekten in der Erziehungswissenschaft. So wird zum Beispiel der Frage nachgegangen, welche Möglichkeiten der Strukturierung und Gestaltung von Lernmaterialien am besten geeignet sind, um Lernprozesse anzuregen, wie die interpersonale Kommunikation im Internet durch didaktische Gestaltungsmassnahmen gefördert werden können oder wie die entfernte Betreuung von Lernenden über das Netz funktioniert. Zunehmend wird dabei auch der Übergang bedeutsam zwischen didaktisch aufbereiteten Lernangeboten, wie sie die Mediendidaktik traditionell beschäftigt, und dem Austausch von nicht didaktisch aufbereiteten Informationen in Organisationen, wie es im Bereich des Wissensmanagements diskutiert wird. In diesen Projekten werden vielfach Detailfragen behandelt, und isoliert, ohne Bezug zu grundlegenden Theoriefragen untersucht. Es mangelt an einer genuin mediendidaktischen Theoriediskussion, die einen übergreifenden Bezugsrahmen aus erziehungswissenschaftlicher Perspektive liefert. In der Vergangenheit ist die Mediendidaktik von Seiten einer «kritischen» Medienpädagogik zeitweise skeptisch beäugt und in ihrer Existenz grundlegend infrage gestellt worden. In der aktuellen Diskussion wird gerne auf lerntheoretische Ansätze zurückgegriffen, die Lernen als aktiven Vorgang der individuellen und kooperativen Wissenskonstruktion begreifen. Doch Wissens- und Lerntheorien ersetzen keine mediendidaktische Modell- und Theoriebildung, die Perspektiven für eine Gestaltung zukünftiger Lernwelten liefert und dabei zum Beispiel sowohl bildungstheoretische Überlegungen als auch Konzepte des instructional design einbezieht. In dem ersten Teil dieser Ausgabe geht es um theoretische Perspektiven der Mediendidaktik. So diskutiert der Artikel von Michael Kerres und Claudia de Witt den Beitrag der Positionen von Behaviorismus

  13. Symmetriebrechung und Emergenz in der Kosmologie.

    Science.gov (United States)

    Mainzer, K.

    Seit der Antike wird der Aufbau des Universums mit einfachen und regulären (symmetrischen) Grundstrukturen verbunden. Diese Annahme liegt selbst noch den Standardmodellen der relativistischen Kosmologie zugrunde. Demgegenüber läßt sich die Emergenz neuer Strukturen von den Elementarteilchen über Moleküle bis zu den komplexen Systemen des Lebens als Symmetriebrechung verstehen. Symmetriebrechung und strukturelle Komplexität bestimmen die kosmische Evolution. Damit zeichnet sich ein fachübergreifendes Forschungsprogramm von Physik, Chemie und Biologie ab, in dem die Evolution des Universums untersucht werden kann.

  14. Die Ware Buch und die Philologie

    Directory of Open Access Journals (Sweden)

    Bernhard Hurch

    2017-10-01

    Full Text Available Die im 19. Jahrhundert sich verändernden Produktionsbedingungen für Druckwerke (Buchdruck, Satz, Papier, Bindung wirkten katalysierend auf die Fachkonstitution und Institutionalisierung der Philologien. Hier steht der tatsächliche Buchmarkt im Vordergrund der Darstellung, das Käuferpublikum und die Voraussetzungen des Vertriebs. Dazu gehören auch die Rezension als entstehende Textsorte und die rasch arbeitenden Rezensionsorgane. F.-R. Hausmann wurde in den letzten Jahren unentbehrlicher Mitarbeiter dieses im Rahmen des Grazer Schuchardt-Projekts "Netzwerk des Wissens" angesiedelten Ansatzes.

  15. Fluchen und Flamen, um ein Mann zu sein? Die Verknüpfung von Geschlecht und Sprache durch Vorurteile

    Directory of Open Access Journals (Sweden)

    Nicola Döring

    2001-11-01

    Full Text Available Die hier besprochene Monographie der Linguistin Anja Gottburgsen beschäftigt sich theoretisch und empirisch mit sprachbezogenen Geschlechterstereotypen, also mit unseren Vorstellungen darüber, ob und wie Männer und Frauen jeweils in spezifischer und distinkter Weise sprachlich kommunizieren. Im Theorieteil der Arbeit wird der aktuelle Stand der soziolinguistischen und sozialpsychologischen Diskussion zu Geschlecht, Sprachverhalten und Stereotypisierung kritisch referiert und die Bedeutung von sprachbezogenen Geschlechterstereotypen erläutert. Im empirischen Teil berichtet die Autorin die Ergebnisse von drei Fragebogen-Studien mit deutschsprachigen Studierenden. Es zeigt sich, dass bei Studierenden unabhängig von Geschlecht und Geschlechtsrollenorientierung stereotype Vorstellungen über das sprachliche Verhalten von Männern und Frauen verbreitet sind.

  16. [Das Bild und die Wahrnehmung der Stadt und der städtischen Gesellschaft im Hanseraum im Mittelalter und in der frühen Neuzeit] / Juhan Kreem

    Index Scriptorium Estoniae

    Kreem, Juhan

    2009-01-01

    Arvustus: Das Bild und die Wahrnehmung der Stadt und der städtischen Gesellschaft im Hanseraum im Mittelalter und in der frühen Neuzeit. hrsg. v. Roman Czaja. Torun, 2004. Torunis 2002. aastal toimunud konverentsi materjalid. Projekti "Pilt ja linn" raames ilmunud publikatsioonide loendit saab näha aadressil http://www.historiaurbium.org/english/attivita_images_en.html.

  17. Infectious spondylitis and its differential diagnosis; Spondylitis und ihre Differenzialdiagnosen

    Energy Technology Data Exchange (ETDEWEB)

    Erlemann, Rainer [Helios St. Johannes Klinik, Duisburg (Germany). Inst. fuer Radiologie; Hoogeveen, Anja [AKH Viersen (Germany)

    2012-06-15

    Infectious spondylitis can be diagnosed early and reliably by MRI, given that the most important diagnostic criteria are present. These criteria are bone marrow edema adjacent to two contiguous vertebral end plates, disk space of high signal intensity and enhancement of bone adjacent to two contiguous vertebral end plates and of the disk space. If not all of these criteria are present, diagnostic accuracy decreases. Erosive osteochondritis, spondylarthritis, osteoporotic fractures of two contiguous vertebral end plates, active Schmorl's nodes as well as neuropathic spine may mimic an infectious spondylitis. This paper presents typical and atypical morphologic patterns of infectious spondylitis as well as the differentiation criteria from the above mentioned diseases. (orig.)

  18. Use of the clinical microbiology laboratory for the diagnosis and management of infectious diseases related to the oral cavity

    Directory of Open Access Journals (Sweden)

    Dewa Made Sukrama

    2016-06-01

    Full Text Available Our knowledge regarding the pathogenesis of infections relative to the oral cavity is rapidly expanding, similar to our overall understanding of how infectious diseases impact our daily lives. The complexity of the flora within the oral cavity is quite unique and often makes diagnosis difficult; however, it is becoming more apparent that accurate diagnostic testing is important from the standpoint of focusing appropriate therapy on pathogens within this crucial body site, and avoiding overuse of antimicrobial agents in settings of infection where they have no demonstrated benefit.Infections of the oral mucosa, teeth (caries and root canal infections and their supporting structures (periodontitis, dento-alveolar abscess are polymicrobial, although usually associated with a characteristic microbiota linked to the site of infection. However, identification of the relevant oral pathogens is not commonly undertaken in diagnostic clinical microbiology laboratories due to lack of expertise in handling fastidious oral microbes and interpretation of the findings. When specimens from oral diseases are processed, they are frequently reported as ‘mixed oral flora’. This type of reporting is unhelpful both to clinicians and to epidemiologists collating data for disease and anti-microbial susceptibility trends. This probably reflec