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Sample records for evaluierung und postoperative

  1. Maschinenbau und Verfahrenstechnik Studiengnge und Abschlsse

    E-print Network

    Berns, Karsten

    Maschinenbau und Verfahrenstechnik Studiengänge und Abschlüsse www.uni-kl.de/isgs und www · Maschinenbau mit angewandter Informatik · Energie- und Verfahrenstechnik · Bio- und.mv.uni-kl.de/studium/studiengaenge-und- abschluesse/bachelor studium@uni-kl.de Diplom (Dipl.-Ing.) Maschinenbau und Verfahrenstechnik (Deutsch

  2. Departement Maschinenbau und Verfahrenstechnik

    E-print Network

    Daraio, Chiara

    Departement Maschinenbau und Verfahrenstechnik Bachelor in Maschineningenieurwissenschaften Focus Maschinenbau und Verfahrenstechnik Bachelor in Maschineningenieurwissenschaften Visualization, Simulation

  3. Postoperative Pain Control

    PubMed Central

    Garimella, Veerabhadram; Cellini, Christina

    2013-01-01

    The effective relief of pain is of the utmost importance to anyone treating patients undergoing surgery. Pain relief has significant physiological benefits; hence, monitoring of pain relief is increasingly becoming an important postoperative quality measure. The goal for postoperative pain management is to reduce or eliminate pain and discomfort with a minimum of side effects. Various agents (opioid vs. nonopioid), routes (oral, intravenous, neuraxial, regional) and modes (patient controlled vs. “as needed”) for the treatment of postoperative pain exist. Although traditionally the mainstay of postoperative analgesia is opioid based, increasingly more evidence exists to support a multimodal approach with the intent to reduce opioid side effects (such as nausea and ileus) and improve pain scores. Enhanced recovery protocols to reduce length of stay in colorectal surgery are becoming more prevalent and include multimodal opioid sparing regimens as a critical component. Familiarity with the efficacy of available agents and routes of administration is important to tailor the postoperative regimen to the needs of the individual patient. PMID:24436674

  4. Postoperative Spine Infections

    PubMed Central

    Evangelisti, Gisberto; Andreani, Lorenzo; Girardi, Federico; Darren, Lebl; Sama, Andrew; Lisanti, Michele

    2015-01-01

    Postoperative spinal wound infection is a potentially devastating complication after operative spinal procedures. Despite the utilization of perioperative prophylactic antibiotics in recent years and improvements in surgical technique and postoperative care, wound infection continues to compromise patients’ outcome after spinal surgery. In the modern era of pending health care reform with increasing financial constraints, the financial burden of post-operative spinal infections also deserves consideration. The aim of our work is to give to the reader an updated review of the latest achievements in prevention, risk factors, diagnosis, microbiology and treatment of postoperative spinal wound infections. A review of the scientific literature was carried out using electronic medical databases Pubmed, Google Scholar, Web of Science and Scopus for the years 1973-2012 to obtain access to all publications involving the incidence, risk factors, prevention, diagnosis, treatment of postoperative spinal wound infections. We initially identified 119 studies; of these 60 were selected. Despite all the measures intended to reduce the incidence of surgical site infections in spine surgery, these remain a common and potentially dangerous complication. PMID:26605028

  5. Preventing chronic postoperative pain.

    PubMed

    Reddi, D

    2016-01-01

    Chronic postoperative pain is common. Nerve injury and inflammation promote chronic pain, the risk of which is influenced by patient factors, including psychological characteristics. Interventional trials to prevent chronic postoperative pain have been underpowered with inadequate patient follow-up. Ketamine may reduce chronic postoperative pain, although the optimum treatment duration and dose for different operations have yet to be identified. The evidence for gabapentin and pregabalin is encouraging but weak; further work is needed before these drugs can be recommended for the prevention of chronic pain. Regional techniques reduce the rates of chronic pain after thoracotomy and breast cancer surgery. Nerve-sparing surgical techniques may be of benefit, although nerve injury is not necessary or sufficient for chronic pain to develop. PMID:26620149

  6. Wissenschaftsorganisation Biologie, Chemie und

    E-print Network

    Schmitt, Peter H.

    Wissenschaftsorganisation Bereich I Biologie, Chemie und Verfahrenstechnik 20 Institute KIT-Fakultät Chemieingenieurwesen und Verfahrenstechnik Stand: Februar 2015 Bereich V Physik und Mathematik 21 Institute Bereich IV

  7. Postoperative total parenteral nutrition.

    PubMed

    Waitzberg, D L; Plopper, C; Terra, R M

    1999-06-01

    Surgical trauma induces complex physiologic changes that lead to catabolism and loss of body cell mass. This reaction is usually mild but can be exacerbated by previous malnutrition and postoperative complications. To avoid severe metabolic distress, nutritional therapy may be prescribed, using the enteral route whenever possible. Postoperative total parenteral nutrition (TPN) is indicated for patients already receiving TPN preoperatively, those severely malnourished prior to major surgery, those unable to eat satisfactorily for 7 days, or patients presenting with severe complications. Postoperative TPN should last for at least 7 days. The total energy requirements are between 30 and 35 kcal/kg/day. About 50% to 70% should be provided in the form of carbohydrates, and 20% to 30% in the form of lipids. The optimal input rates for glucose and lipids are 4 to 5 g/kg/day and 80 mg/kg/hr, respectively. The ideal nitrogen administration is 250 to 300 mg/kg/day, and the optimal calorie/nitrogen ratio is 150 to 200. Some specific amino acids can be added as intravenous dipeptides. An adequate follow-up must include clinical and biochemical parameters. Several trials evaluated the impact of TPN in postoperative patients, but further well designed, controlled clinical trials are still necessary to address a great number of unanswered questions. PMID:10227924

  8. Fachbereich Maschinenbau und

    E-print Network

    Berns, Karsten

    Einladung Fachbereich Maschinenbau und Verfahrenstechnik Zum Geleit: Der Fachbereich Maschinenbau und Verfahrenstechnik verfolgt mit seiner ,,Akademischen Jahresfeier" mehrere Ziele: Zum einen möchte-wissenschaftliche Mitarbeiter(innen) und Student(inn)en. #12;Fachbereich Maschinenbau und Verfahrenstechnik EINLADUNG zur

  9. Postoperative pain management

    PubMed Central

    Kolettas, Alexandros; Lazaridis, George; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Kioumis, Ioannis; Pitsiou, Georgia; Papaiwannou, Antonis; Lampaki, Sofia; Karavergou, Anastasia; Pataka, Athanasia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Mpakas, Andreas; Tsakiridis, Kosmas; Fassiadis, Nikolaos; Zarogoulidis, Konstantinos

    2015-01-01

    Postoperative pain is a very important issue for several patients. Indifferent of the surgery type or method, pain management is very necessary. The relief from suffering leads to early mobilization, less hospital stay, reduced hospital costs, and increased patient satisfaction. An individual approach should be applied for pain control, rather than a fix dose or drugs. Additionally, medical, psychological, and physical condition, age, level of fear or anxiety, surgical procedure, personal preference, and response to agents given should be taken into account. The major goal in the management of postoperative pain is minimizing the dose of medications to lessen side effects while still providing adequate analgesia. Again a multidisciplinary team approach should be pursued planning and formulating a plan for pain relief, particularly in complicated patients, such as those who have medical comorbidities. These patients might appear increase for analgesia-related complications or side effects. PMID:25774311

  10. Bibliothek und Dokumentation Bibliothek und Dokumentation

    E-print Network

    Bibliotheks- und Informationsmanage- ment der Hermann von Helmholtz-Gemeinschaft Deutscher Forschungszentren ,,Bibliothek und Dokumentation" sam- melt und beschafft die von den DESY-Mitarbeitern benötigte Fachliteratur erhalten die von ihnen be- nötigten Literaturinformationen aus den Datenban- ken des

  11. Face lift postoperative recovery.

    PubMed

    Mottura, A Aldo

    2002-01-01

    The purpose of this paper is to describe what I have studied and experienced, mainly regarding the control and prediction of the postoperative edema; how to achieve an agreeable recovery and give positive support to the patient, who in turn will receive pleasant sensations that neutralize the negative consequences of the surgery.After the skin is lifted, the drainage flow to the flaps is reversed abruptly toward the medial part of the face, where the flap bases are located. The thickness and extension of the flap determines the magnitude of the post-op edema, which is also augmented by medial surgeries (blepharo, rhino) whose trauma obstruct their natural drainage, increasing the congestion and edema. To study the lymphatic drainage, the day before an extended face lift (FL) a woman was infiltrated in the cheek skin with lynfofast (solution of tecmesio) and the absorption was observed by gamma camera. Seven days after the FL she underwent the same study; we observed no absorption by the lymphatic, concluding that a week after surgery, the lymphatic network was still damaged. To study the venous return during surgery, a fine catheter was introduced into the external jugular vein up to the mandibular border to measure the peripheral pressure. Following platysma plication the pressure rose, and again after a simple bandage, but with an elastic bandage it increased even further, diminishing considerably when it was released. Hence, platysma plication and the elastic bandage on the neck augment the venous congestion of the face. There are diseases that produce and can prolong the surgical edema: cardiac, hepatic, and renal insufficiencies, hypothyroidism, malnutrition, etc. According to these factors, the post-op edema can be predicted, the surgeon can choose between a wide dissection or a medial surgery, depending on the social or employment compromises the patient has, or the patient must accept a prolonged recovery if a complex surgery is necessary. Operative measures which prevent extensive edemas are: avoiding transection of the temporal pedicle, or to realizing platysma plication too tight by using strong aspirative drainage instead of elastic bandages. In the post-op, the manual lymphatic drainage is initiated on the third or fifth day, but must be done by a trained professional, in a method contrary to that specified in the books for non-operated individuals. An aesthetician washes the hair and applies decongestive cold tea on the face the second day, and on the fifth, moisturizes the skin and cosmetically conceals any signs of bruising. The psychological support provided by the staff keeps the patient calm and relaxed. Five years experience with this protocol has enabled us to minimize post-op pain. The edema can be predicted with certain consistency (in which surgery there will be more or less edema) and the proper technique can be selected, permitting the patient to choose the best moment for a FL while the surgeon can avoid intra and postoperative measures that increase the edema. After surgery, the patient receives the daily assistance of the staff, which rapidly and efficiently improves this condition. We can predict and control the post-op recovery and the patient feels fine, unlike the past when recovery was abandoned to its natural evolution. If the patient perceived an intensive, positive support on behalf of the entire staff that kept him or her content, then we have succeeded in doing an excellent marketing. This may encourage others to undergo aesthetic surgery, especially those who are convinced that after surgery they might have to endure considerable suffering. PMID:12140694

  12. Fakultt fr Betriebswirtschaftslehre Kommunikation und

    E-print Network

    Mannheim, Universität

    Akkreditierungen AACSB und EQUIS und agiert seit Jahrzehnten in den nationalen Hochschulrankings im Bereich Betriebswirtschaftslehre der Universität Mannheim ist sie dreifach akkreditiert (AACSB, EQUIS und AMBA) und garantiert

  13. Postoperative fluid management

    PubMed Central

    Kayilioglu, Selami Ilgaz; Dinc, Tolga; Sozen, Isa; Bostanoglu, Akin; Cete, Mukerrem; Coskun, Faruk

    2015-01-01

    Postoperative care units are run by an anesthesiologist or a surgeon, or a team formed of both. Management of postoperative fluid therapy should be done considering both patients’ status and intraoperative events. Types of the fluids, amount of the fluid given and timing of the administration are the main topics that determine the fluid management strategy. The main goal of fluid resuscitation is to provide adequate tissue perfusion without harming the patient. The endothelial glycocalyx dysfunction and fluid shift to extracellular compartment should be considered wisely. Fluid management must be done based on patient’s body fluid status. Patients who are responsive to fluids can benefit from fluid resuscitation, whereas patients who are not fluid responsive are more likely to suffer complications of over-hydration. Therefore, common use of central venous pressure measurement, which is proved to be inefficient to predict fluid responsiveness, should be avoided. Goal directed strategy is the most rational approach to assess the patient and maintain optimum fluid balance. However, accessible and applicable monitoring tools for determining patient’s actual fluid need should be further studied and universalized. The debate around colloids and crystalloids should also be considered with goal directed therapies. Advantages and disadvantages of each solution must be evaluated with the patient’s specific condition. PMID:26261771

  14. Hepatic transplantation: postoperative complications.

    PubMed

    Itri, Jason N; Heller, Matthew T; Tublin, Mitchell E

    2013-12-01

    Advances in surgical techniques and immunosuppression have made orthotopic liver transplantation a first-line treatment for many patients with end-stage liver disease. The early detection and treatment of postoperative complications has contributed significantly to improved graft and patient survival with imaging playing a critical role in detection. Complications that can lead to graft failure or patient mortality include vascular abnormalities, biliary abnormalities, allograft rejection, and recurrent or post-transplant malignancy. Vascular abnormalities include stenosis and thrombosis of the hepatic artery, portal vein, and inferior vena cava, as well as hepatic artery pseudoaneurysm, arteriovenous fistula, and celiac stenosis. Biliary abnormalities include strictures, bile leak, obstruction, recurrent disease, and infection. While imaging is not used to diagnose allograft rejection, it plays an important role in identifying complications that can mimic rejection. Ultrasound is routinely performed as the initial imaging modality for the detection and follow-up of both early and delayed complications. Cholangiography and magnetic resonance cholangiopancreatography are used to characterize biliary complications and computed tomography is used to confirm abnormal findings on ultrasound or for the evaluation of postoperative collections. The purpose of this article is to describe and illustrate the imaging appearances and management of complications associated with liver transplantation. PMID:23644931

  15. [Postoperative care after cataract surgery].

    PubMed

    Cordes, Andreas K; Degenring, Robert F; Schrage, Norbert F

    2012-04-01

    The postoperative treatment of cataract surgery is an important element for success of the surgery. The postoperative therapy primarily aims at the prevention of intraocular bacterial infection by administration of antibiotics. Anti-inflammatory drugs can suppress the operation-related inflammation. In addition to fundamental risks of topical eye drop application, this review article discusses the current therapeutic strategies for the prevention of postoperative bacterial infection and suppression of surgically induced inflammation. PMID:22582516

  16. [Treatment of acute postoperative pain].

    PubMed

    Langlade, A; Kriegel, I

    1997-01-01

    Postoperative pain is a subjective experience involving sensations and perceptions, which may be the result of tissue damage after surgery. Various analgesic drugs and techniques can be used to relief postoperative pain. They must be adapted to the surgery and to the patient. Moreover, adequate management of postoperative pain need to be organized. This include medical attitudes, clinical orientations, disciplinary involvements, consultative protocols and program education. PMID:10868044

  17. Pharmacological management of postoperative ileus.

    PubMed

    Zeinali, Farhad; Stulberg, Jonah J; Delaney, Conor P

    2009-04-01

    The duration of postoperative ileus following abdominal surgery is quite variable, and prolonged postoperative ileus is an iatrogenic phenomenon with important influence on patient morbidity, hospital costs and length of stay in hospital. Adequate treatment for prolonged postoperative ileus is important to improve patient morbidity and clinical efficiency. Both clinical and pharmacological management strategies have improved rapidly over the last decade, and appropriate and timely management using multimodal techniques should be used for optimal care. In this review, we define postoperative ileus, describe the pathogenesis and briefly discuss clinical management before detailing potential pharmacologic management options. PMID:19399212

  18. Postoperative nausea and vomiting

    PubMed Central

    2014-01-01

    Postoperative nausea and vomiting (PONV) is a long-standing issue, not a new concept in anesthesiology. Despite many studies over the last several decades, PONV remains a significant problem due to its complex mechanism. This review presents a summary of the mechanism underlying the pathogenesis of PONV, focusing on preventive treatment, particularly the use of new drugs. In addition, we discuss the latest meta-analysis results regarding correct clinical use of classic drugs. I also summarize the latest trends of postdischarge nausea and vomiting and the pharmacogenetics, which is attracting a great deal of attention from other medical fields in PONV-related studies. Finally, we discuss the drawbacks of existing studies on PONV and suggest a focus for future investigations. PMID:25302092

  19. Physikunterricht und Kalter Krieg

    NASA Astrophysics Data System (ADS)

    Rieß, Falk; Kremer, Armin

    Die Indienstnahme des Physikunterrichts für militaristische und politische Zwecke ist in Deutschland nichts Neues: Die Wurzeln liegen im Kaiserreich und im Faschismus ("Wehrphysik"), und die Praxis im Kalten Krieg stellt hier nichts Außergewöhnliches, sondern lediglich eine auffällige Kontinuität dar.

  20. Postoperative protein sparing.

    PubMed

    Wilmore, D W

    1999-06-01

    Postoperative nitrogen sparing refers to a therapy that decreases net nitrogen loss from the body following an operation. Protein sparing has long been regarded as a surrogate marker for improved outcome, but a critical review of the evidence indicates that this relation is difficult to establish, especially in the short term. Thus, specific endpoints that evaluate outcome are needed to determine the efficacy of a specific therapy that spares protein. Cost effectiveness must also be considered. A variety of therapies were evaluated using protein-sparing, efficiency, and cost criteria. Evidence was reviewed for glucose, amino acids, parenteral nutrition, enteral nutrition, growth hormone, and glutamine administered during the perioperative period. Only three areas could be identified that spared nitrogen and provided efficacy: (1) preoperative total parenteral nutrition (TPN) for 7 to 10 days before operation in a depleted patient (

  1. Bibliothek und Dokumentation Bibliothek und Dokumentation

    E-print Network

    Bibliotheksverband (DBV), im Ar- beitskreis Bibliotheks- und Informationsmanage- ment der Hermann von Helmholtz ,,Bibliothek und Dokumentation" sam- melt die von den DESY-Mitarbeitern benötigte Fachliteratur, insbesondere Wide Web (WWW) zugänglich. Die Gruppe verwaltet auch das Berichts- und Veröffentlichungswesen von DESY

  2. Post-operative cyclizine misuse.

    PubMed

    Woodfield, J; St George, E J

    2013-11-01

    Cyclizine is commonly prescribed as an anti-emetic post-operatively. We report a case of a 51-year-old woman who developed addiction to intravenous cyclizine following regular administration at recommended doses. This is the first report of cyclizine misuse post-operatively. We compare this case to cyclizine abuse reported amongst other populations. Prescribers should be aware of the potential of cyclizine as a drug of abuse. PMID:24215049

  3. KIT-Fakultt Chemieingenieurwesen und

    E-print Network

    Schmitt, Peter H.

    KIT-Fakultät Chemieingenieurwesen und Verfahrenstechnik Stand: März 2014 Vizepräsident für Lehre Scientists (KHYS) Lehre und akademische Angelegenheiten Bereich I Biologie, Chemie und Verfahrenstechnik

  4. Branchen und Unternehmensbereiche

    NASA Astrophysics Data System (ADS)

    Kramer, Regine

    Dieses Kapitel gibt einen Überblick über die Haupteinsatzgebiete von Mathematikern, Informatikern, Naturwissenschaftlern und Ingenieuren in den wichtigsten Wirtschaftsbranchen und Unternehmensbereichen. Dabei werden ausbildungsnahe Aufgabenbereiche ebenso beschrieben wie eher fachferne Tätigkeiten und neben den klassischen Branchen und Berufsbildern auch neue Tätigkeitsfelder für MINT-Fachkräfte beschrieben.

  5. Milch, Milchprodukte, Analoge und Speiseeis

    NASA Astrophysics Data System (ADS)

    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.

  6. Satzung zur nderung der Prfungs-und Studienordnungen der Lehramtsstudiengnge Polnisch Gymnasium und Regionale Schule und

    E-print Network

    Greifswald, Ernst-Moritz-Arndt-Universität

    Gymnasium und Regionale Schule und Russisch Gymnasium und Regionale Schule an der Ernst Polnisch im Lehramtsstudiengang Gymnasium Die Prüfungs- und Studienordnung für den Teilstudiengang Polnisch im Lehramtsstudiengang Gymnasium an der Philosophischen Fakultät der Ernst-Moritz- Arndt

  7. Meteorologie und Klimatologie

    NASA Astrophysics Data System (ADS)

    Malberg, Horst

    Auf der Basis der physikalischen Grundlagen (Strahlung, Luftbewegung, Wolken- und Niederschlagsbildung) sowie der verschiedenen Methoden der Wetterbeobachtung (Boden, Radiosonde, Satelliten, Radar) werden Wettersysteme und Wettervorhersage verständlich erläutert. Die allgemeine atmosphärische Zirkulation verknüpft das kurzlebige Wettergeschehen mit dem großräumigen Klima auf der Erde. Ausführungen über Klimaänderungen, orographische Windsysteme, Stadtklima, Luftverunreinigungen und Wetterbeeinflussung runden die Einführung in den aktuellen Stand der Meteorologie und Klimatologie ab. Für die 3. Aufl. wurde vor allem der Abschnitt 'Zyklonen und Antizyklonen' aktualisiert und erweitert. Darüber hinaus wurde das Lehrbuch um das Kapitel 'Aktuelle Klimaprobleme' ergänzt.

  8. Welt und Wirkungsprinzip

    NASA Astrophysics Data System (ADS)

    Landgraf, Werner

    1997-05-01

    Modell einer kausalen Bewirkung der Welt, und logische, geometrische, physikalische Interprätation dieser Kausalmenge und Fortwirkung der frühsten ihrer sukzessiv als echt Neues bewirkten und durch Vorhandenes oder Späteres nicht darstellbaren oder widerrufbaren Ereignisse als Dimensionen und sie verkörpernde primäre Naturkräfte, mit Korrespondenz zur beobachteten Welt und ihrer grundlegendsten Eigenschaften. Wirklich ist nur was wirkt, wo und wie. Entsprechend ist im Bogenelement statt der Eigenzeit die variante Anzahl Wirkungen relevant, 0 ? 1/h2 dS2 - 1/tpl2 (dt2 - 1/c2 {dq12 + G02/G2 [dq2,32 - ...]}) mit G0 = c4lpl/Epl ? G. Die heutigen Dimensionen und Naturkräfte entstanden in dieser Reihenfolge, haben 'komplementäre' aber gleichwertige statische und dynamische Aspekte, entsprechend ihren Termen in Bogenelement bzw. Vierervektor, aus derem Vergleich sowie mit denen ihrer Nachbarn folgen Grundgleichungen bzw. Erhaltungssätze. Jeweils individuelle Eigenschaften wie ihre Naturkonstante konkretisieren sie und tragen zu gattungsmäßigen wie globale Affinität und Äquivalenzen bei. Ältestes Gebiet oder räumlicher Rand jeder Dimension sind die ersten vom Vorgänger bewirkten Ereignisse, selbst raumzeitlicher Ursprung des Nachfolgers, dort einmalig und ewig maximal rotverschoben fortwirkend und nicht lokalisierbar, um neue Elementareinheiten verschieden und lichtartig mit deren Verhältnis oder dem ihrer globalen Zustandsgrößen als konstanten Anfangsimpuls, Expansion, Längen- oder Ereignisdichte zueinander. Der Übergang vom diskreten Modell weniger Informationen zum Kontinuum und die Korrespondenz zur Physik ist problemlos, Details wie ein kontinuierlicher, abrupter oder ganz fehlender Abfall der Metrik beim ältesten Gebiet sind aber nur durch Beobachtungen entscheidbar. Erörtert werden allgemeine und individuelle Eigenschaften und ihre Konsequenzen der Dimensionen mit ihren Kräften, selbst und im Verhältnis zueinander, etwa ihrer begrenzten Reichweite. Bei Fakten und ihrer Wirkung etwa: Autonomie und Priorität von Selbstwahrnehmung und Eigensystem; etwaige Wahrnehmung durch einen Beobachter und wie sie ihm seinen Kontakt zum Objekt und dessen Darstellbarkeit in seinem Raum wiederspiegelt oder ändert, als nur für ihn relevant; in dessen Dimensionen sichtbare geometrische Bedingungen wegen diskreter Wirkung, oder logische Effekte bei Objekten kleinster Informationsmengen mit unzureichender Lokalisierbarkeit oder ihrer inadäquaten Betrachtung oder Bestimmung dort. Geboten sind genauere Untersuchungen zu Informationsgehalt, Wirkung, deren Reichweite und Gültigkeit bei einzelnen Photonen, mit Emission und durch direkt benachbart hinzukommende Absorption beendetem ereignisartigen Eigensystem, aber für materielle Beobachter unserer Welt und ihre Dimensionen zur vollständigen Lokalisierbarkeit zuwenigen wirksamen Informationen, was dort außer makroskopisch relevanten Projektionen auf Raum und Zeit sowie Lichtartigkeit auch mikroskopisch zwischenliegende Ereignisse wie Wechselwirkung in Medien oder Beugung und Retadierung oder Welleneigenschaften mit Richtungsänderung ganzzahliger Elementar- oder Wellenlängen, mit jeweiliger Kompensation im Bogen; Nichtlokalität; Unschärfen bei Bestimmung komplementärer also auf identischen Information beruhender Größen; und andere Effekte hervorruft. Voran stehen Erfahrungen zur notwendigen Bewirkung von Neuem durch alles Existente als nicht-materielle funktionelle Qualität seiner Individuation und Konkretisierung, und daher Ereignissen und Wirkung als primäre direkt etwas produzierende Naturkraft und Geometrie. Nachgefügt wurde noch eine Gegenüberstellung des Modelles mit kosmogonischen Aussagen der Offenbarungen (nur 2. Auflage).

  9. Departement Maschinenbau und Verfahrenstechnik

    E-print Network

    Daraio, Chiara

    20.04.2015 Departement Maschinenbau und Verfahrenstechnik Bachelor- und Verfahrenstechnik 151-0208-00 P. Jenny D 4 Introduction to Chemical Engineering 151-0942-00 M Verfahrenstechnik 151-0973-00 P. Rudolf von Rohr & C. Müller D 4 Wärmeaustausch: Gestaltung und Optimierung 151

  10. Computed tomography of the postoperative abdominal aorta

    SciTech Connect

    Hilton, S.; Megibow, A.J.; Naidich, D.P.; Bosniak, M.A.

    1982-11-01

    Computed tomography (CT) of the abdomen was performed on 46 patients who had undergone graft replacement of abdominal aortic aneurysms. Twelve post-operative complications were found in nine patients. They included hemorrhage, infection, anastomotic pseudoaneurysms, major vessel occlusion, postoperative pancreatitis, and others. The varied apperance of the normal postoperative graft is also presented. It is concluded that CT is a rapid, sensitive, and noninvasive method for detecting or excluding postoperative complications of abdominal aortic surgery.

  11. Postoperative singultus: an osteopathic approach.

    PubMed

    Petree, Kristie; Bruner, Jonathan

    2015-03-01

    Singultus, or hiccups, is a common medical condition. Despite exponential leaps in medicine, the pathophysiologic cause remains poorly defined. Persistent singultus has been associated with conditions such as pulmonary embolism and myocardial infarction. Singultus is also a well-known postoperative complication. The criterion standard of care for patients with singultus involves ruling out lethal pathologic causes, attempting physical stimulation with Valsava maneuvers or drinking water, and, if no relief has been achieved, administering drugs to ease the symptoms. The authors report a case of a man whose postoperative singultus was successfully managed with osteopathic manipulative treatment. This approach addresses many of the possible underlying neuromechanical causes of the aberrant reflex with minimal potential for adverse effects. Physicians should consider osteopathic manipulative treatment in the care of patients with singultus. PMID:25722363

  12. Naturwissenschaftlich-Technische Fakultt Elektrotechnik und Informatik

    E-print Network

    Blanz, Volker

    ............................................................... 18 Bachelor Lehramt Gymnasium und Berufskolleg.................................................................. 18 Master Lehramt Gymnasium und Berufskolleg............................................................................................................

  13. Unternehmens- und Marktstatistik

    NASA Astrophysics Data System (ADS)

    Grömling, Michael; Scheinost, Ulrich

    Deutschland verfügt über ein gut ausgebautes System amtlicher und nicht amtlicher Unternehmens- und Marktstatistiken, das sich in einem fortwährenden Wandel befindet. Wird es sinnvoll genutzt, können für einzelne Marktteilnehmer wie für die gesamte Gesellschaft kostspielige Fehlentwicklungen vermieden werden. Dazu bedarf es eines sachkundigen Überblicks über die Vielfalt der Statistiken und der zwischen ihnen bestehenden Beziehungen sowie einer ständigen Anpassung an die wirtschaftliche Entwicklung. Als eine mögliche Orientierung kann der auf der Güter- und Faktorebene zu beobachtende Wandel dienen. Einer adäquaten Abbildung der ökonomischen Realität stehen in Deutschland mit seiner starken Verrechtlichung der Statistik jedoch mancherlei Schwierigkeiten im Wege. Teilweise tiefgreifende Reformbestrebungen sind vor allem auf europäischer Ebene im Gange. Als eine ergebnisorientierte Innovation für das Gesamtsystem der Unternehmens- und Marktstatistik wird ein modular aufgebautes System vorgestellt, das auch bei unterschiedlichen und sich wandelnden Rahmenbedingungen schrittweise realisiert werden kann.

  14. Instandhaltung und Normung

    NASA Astrophysics Data System (ADS)

    Rosenkranz-Wuttig, Angela

    Das DIN Deutsches Institut für Normung e.V. ist ein eingetragener Verein mit Sitz in Berlin. Das DIN erarbeitet gemeinsam mit den Experten der interessierten Kreise Normen und Standards als Dienstleistung für Wirtschaft, Staat und Gesellschaft. Die Kenntnis entsprechender Normen, Standards oder Regeln, sowie deren richtiger Einsatz, ist unter den heutigen Marktbedingungen für jedes Unternehmen ein nicht zu unterschätzender wirtschaftlicher Faktor. Normen schaffen Effizienz bei Produktionsabläufen und sorgen durch eine gleichbleibende sowie vergleichbare Produktqualität für Vertrauen bei den Endverbrauchern. Darüber hinaus stehen Normen unter rechtlichen Aspekten für mehr Sicherheit - Hersteller erreichen bei Anwendung und Einhaltung von Normen ein hohes Maß an rechtlicher Absicherung. Das DIN vertritt die deutschen Interessen in den europäischen und weltweiten Normungsorganisationen, siehe Abb. 1. Zuständig für die elektrotechnische Normung in Deutschland sowie als deutscher Repräsentant in den übernationalen Gremien ist die DKE Deutsche Kommission Elektrotechnik Elektronik Informationstechnik im DIN und VDE.

  15. Aufbau und Belastung tribologischer Systeme

    NASA Astrophysics Data System (ADS)

    Schumacher, Jan; Murrenhoff, Hubertus

    Die Tribologie ist laut DIN 50323 die Wissenschaft und Technik von aufeinander einwirkenden Oberflächen in Relativbewegung. Es werden die Teilgebiete Reibung, Verschleiß und Schmierung von ihr behandelt.

  16. Roboter und Zuckerstangen

    NASA Astrophysics Data System (ADS)

    Siebert, Heike

    Bei Produktion und Logistik denkt man sofort an Fabriken, Lagerhallen und Gabelstapler und nicht unbedingt an Zellbiologie. Sieht man etwas genauer hin erscheint dieser Gedankensprung jedoch gar nicht mehr so unpassend. In einer lebenden Zelle laufen eine Vielzahl von Produktions-, Transport- und Regulationsprozessen ab. Soll etwa ein gerade verfügbarer Rohstoff abgebaut werden, muss vielleicht ein Signal ein Gen erreichen, das ein geeignetes Enzym kodiert. Die Aktivierung des Gens führt über mehrere Zwischenstationen zur Produktion des Enzyms, das schließlich noch dahin gelangen muss, wo es gebraucht wird. Ist der Bedarf gedeckt, muss wiederum die Enzymproduktion eingestellt werden.

  17. [Postoperative radiotherapy of prostate cancer].

    PubMed

    Guérif, S; Latorzeff, I; Lagrange, J-L; Hennequin, C; Supiot, S; Garcia, A; François, P; Soulié, M; Richaud, P; Salomon, L

    2014-10-01

    Between 10 and 40% of patients who have undergone a radical prostatectomy may have a biologic recurrence. Local or distant failure represents the possible patterns of relapse. Patients at high-risk for local relapse have extraprostatic disease, positive surgical margins or seminal vesicles infiltration or high Gleason score at pathology. Three phase-III randomized clinical trials have shown that, for these patients, adjuvant irradiation reduces the risk of tumoral progression without higher toxicity. Salvage radiotherapy for late relapse allows a disease control in 60-70% of the cases. Several research in order to improve the therapeutic ratio of the radiotherapy after prostatectomy are evaluate in the French Groupe d'Étude des Tumeurs Urogénitales (Gétug) and of the French association of urology (Afu). The Gétug-Afu 17 trial will provide answers to the question of the optimal moment for postoperative radiotherapy for pT3-4 R1 pN0 Nx patients, with the objective of comparing an immediate treatment to a differed early treatment initiated at biological recurrence. The Gétug-Afu 22 questions the place of a short hormonetherapy combined with image-guided, intensity-modulated radiotherapy (IMRT) in adjuvant situation for a detectable prostate specific antigen (PSA). The implementation of a multicenter quality control within the Gétug-Afu in order to harmonize a modern postoperative radiotherapy will allow the development of a dose escalation IMRT after surgery. PMID:25195116

  18. Postoperative Epidural Hematomas in the Lumbar Spine.

    PubMed

    Schroeder, Gregory D; Kurd, Mark F; Kepler, Christopher K; Arnold, Paul M; Vaccaro, Alexander R

    2015-11-01

    Postoperative epidural hematomas are rare complications following lumbar spine surgery, but if they are not quickly identified and treated they can lead to permanent neurological deficits. Epidural hematomas occur in approximately 0.10%-0.24% of all spine surgeries, and despite the fact that multiple large studies have been performed attempting to identify risk factors for this complication, there is still significant debate about the effect of subfascial drains, postoperative anticoagulation, and antiplatelet medication on the incidence of postoperative hematoma. The purpose of this manuscript is to review the epidemiology, etiology, diagnosis, and treatment of patients who develop a postoperative lumbar epidural hematoma. PMID:26484502

  19. Seminar Methoden der Mustererkennung und Klassifikation Grundlagen der Wahrscheinlichkeitsrechnung und

    E-print Network

    Briesemeister, Linda

    . Jahrhunderts zur¨uck und sind eng mit den Namen der Mathematiker Blaise Pascal und Pierre de Fermat verbunden großer praktischer Bedeutung war und die er vergeblich zu l¨osen versucht hatte, an Pascal und bat um andere p Pascal

  20. Post-operative radiation therapy

    PubMed Central

    Paumier, Amaury

    2013-01-01

    In completely resected non-small-cell lung cancer (NSCLC) patients with pathologically involved mediastinal lymph nodes (N2), administration of adjuvant platinum-based chemotherapy is now considered the standard of care, based on level 1 evidence. The role of post-operative radiotherapy (PORT) in this group of patients remains controversial. In the PORT meta-analysis published in 1998, the conclusions were that if adjuvant radiotherapy was detrimental to patients with early-stage completely resected NSCLC, the role of PORT in the treatment of tumours with N2 involvement was unclear and further research was warranted. Recent retrospective and non-randomized studies as well as subgroup analyses of recent randomized trials evaluating adjuvant chemotherapy, provide evidence of the possible benefit of PORT in patients with mediastinal nodal involvement. The question of PORT indication is also valid for those patients with proven N2 disease who undergo neo-adjuvant chemotherapy followed by surgery. The risk of local recurrence for N2 patients varies between 20% and 60%. Based on currently available data, PORT should be discussed for fit patients with completely resected NSCLC with N2 nodal involvement, within a multidisciplinary setting, preferably after completion of adjuvant chemotherapy or after surgery if patients have had neo-adjuvant chemotherapy. There is need for new randomized evidence to reassess PORT using modern three-dimensional conformal radiation technique, with attention to normal organ sparing, particularly lung and heart, to reduce the possible additional toxicity. Randomized evidence is needed. A new large international multi-institutional randomized trial Lung ART evaluating PORT in this patient population is now underway, as well as a Chinese study comparing postoperative sequential chemotherapy followed by radiotherapy versus adjuvant chemotherapy alone. PMID:25806262

  1. Patentierung und Patentlage

    NASA Astrophysics Data System (ADS)

    Herrmann, Uwe

    Gewerbliche Schutzrechte nehmen in der nationalen Rechts- und Wirtschaftsordnung sowie auch auf internationaler Ebene stetig an Bedeutung zu. Sie dienen dem Schutz geistigen Eigentums und sind für jeden Gewerbetreibenden nicht nur im Hinblick darauf von Bedeutung, eigene Rechte zu sichern, sondern auch insofern von Relevanz, dass ein Verstoß gegen Rechte Dritter zu vermeiden ist. Zu den gewerblichen Schutzrechten gehören unter anderem Kennzeichenrechte, Geschmacksmusterrechte sowie die sogenannten technischen Schutzrechte in Form des Patents sowie des Gebrauchsmusters. Die folgenden Ausführungen befassen sich ausschließlich mit den technischen Schutzrechten und geben eine kurze Einführung in die Voraussetzungen, das Entstehen und den Wegfall sowie in die Wirkungen technischer Schutzrechte. Beleuchtet wird die Situation im Wesentlichen im Hinblick auf nationale technische Schutzrechte, d. h. auf Deutsche Patente und Gebrauchsmuster sowie auf Europäische Patente, die Schutz in Deutschland entfalten. Die Möglichkeit der Erlangung von Schutzrechten im außereuropäischen Ausland wird nur am Rande gestreift.

  2. Management of postoperative spinal infections

    PubMed Central

    Hegde, Vishal; Meredith, Dennis S; Kepler, Christopher K; Huang, Russel C

    2012-01-01

    Postoperative surgical site infection (SSI) is a common complication after posterior lumbar spine surgery. This review details an approach to the prevention, diagnosis and treatment of SSIs. Factors contributing to the development of a SSI can be split into three categories: (1) microbiological factors; (2) factors related to the patient and their spinal pathology; and (3) factors relating to the surgical procedure. SSI is most commonly caused by Staphylococcus aureus. The virulence of the organism causing the SSI can affect its presentation. SSI can be prevented by careful adherence to aseptic technique, prophylactic antibiotics, avoiding myonecrosis by frequently releasing retractors and preoperatively optimizing modifiable patient factors. Increasing pain is commonly the only symptom of a SSI and can lead to a delay in diagnosis. C-reactive protein and magnetic resonance imaging can help establish the diagnosis. Treatment requires acquiring intra-operative cultures to guide future antibiotic therapy and surgical debridement of all necrotic tissue. A SSI can usually be adequately treated without removing spinal instrumentation. A multidisciplinary approach to SSIs is important. It is useful to involve an infectious disease specialist and use minimum serial bactericidal titers to enhance the effectiveness of antibiotic therapy. A plastic surgeon should also be involved in those cases of severe infection that require repeat debridement and delayed closure. PMID:23330073

  3. [Incidence of postoperative complications in geriatric gynecology].

    PubMed

    Rummler, S

    1984-01-01

    The results of a retrospective-study concerning postoperative complications after gynecologic geriatric surgery (506 patients, aged 60 years and over) at the Departement of Gynecology and Obstetrics of the District Hospital Stralsund/GDR are presented. In 106 patients (10,94 per cent) we have registered post-operative complications, in particular anaemia, fever and wound-period (1967 to 1971 = 8,22%, 1977 to 1981 = 13,29%). Gynecologic surgery in the aged requires a carefully clinical management in preoperative diagnostic and an intensive postoperative care. PMID:6475112

  4. Volkszählung und Mikrozensus1

    NASA Astrophysics Data System (ADS)

    Grohmann, Heinz

    Die Volkszählung (Zensus) ist seit langem weltweit eine statistische Erhebung über Bevölkerung und Erwerbstätigkeit. In vielen Ländern wird sie heute in etwa 10jährigem Abstand durchgeführt. In Deutschland wurde sie in den 80er Jahren zum Politikum. Datenschutzängste, verbunden mit politischen Vorgängen (Friedensbewegung), erregten die Menschen, und das Bundesverfassungsgericht steckte neue Grenzen ab. Nach kontroversen Auseinandersetzungen, an denen die Deutsche Statistische Gesellschaft (DStatG) konstruktiv beteiligt war, kam es zur Volkszählung 1987. Den nachfolgenden Paradigmenwechsel hin zu einem registergestützten Zensus 2011 hat die DStatG ebenfalls kreativ mitgestaltet. Im Beitrag wird dieser Weg nachgezeichnet. Das neue Konzept wird vorgestellt und kritisch gewürdigt. Betroffen war auch der Mikrozensus als größte Bevölkerungs- und Arbeitsmarktstichprobe zwischen den Zensen. Nicht zuletzt durch das Wirken eines wissenschaftlichen Beirats, dessen Mitglieder von der DStatG vorgeschlagen wurden, blieb diese Erhebung in ihrem Kern für die Zukunft erhalten.

  5. fr Elektrotechnik und Informationstechnik

    E-print Network

    Noé, Reinhold

    . Felix Gausch Elektrische Messtechnik Prof. Dr.-Ing. Bernd Henning Nachhaltige Energiekonzepte Prof. Dr- gängen in Elektrotechnik, Informatik und Mathematik werden eine Reihe von Oben: Prof. Dr. Dr. h. c. mult

  6. Aerosole und das Klimasystem: Atmosphärenforschung

    NASA Astrophysics Data System (ADS)

    Feichter, Johann

    2003-03-01

    Aerosolpartikel beeinflussen Wetter und Klima. Sie streuen das Sonnenlicht zurück in den Weltraum oder absorbieren es und bewirken damit eine Abkühlung der Erdoberfläche. Man vermutet daher, dass die anthropogen produzierten Aerosole den anthropogen verursachten Treibhauseffekt mildern. Aerosole fungieren auch als Kondensationskerne für Wassertröpfchen und Eiskristalle, womit sie die physikalischen und optischen Eigenschaften von Wolken sowie die Verteilung der Niederschläge beeinflussen. Um die Verteilung des Aerosols realistisch simulieren und mit dem Klimasystem zu koppeln, müssen die Massenverteilung, die chemische Zusammensetzung und die Größenverteilung der Teilchen bekannt sein.

  7. Postoperative ultrasonography of the musculoskeletal system.

    PubMed

    Chun, Kyung Ah; Cho, Kil-Ho

    2015-07-01

    Ultrasonography of the postoperative musculoskeletal system plays an important role in the Epub ahead of print accurate diagnosis of abnormal lesions in the bone and soft tissues. Ultrasonography is a fast and reliable method with no harmful irradiation for the evaluation of postoperative musculoskeletal complications. In particular, it is not affected by the excessive metal artifacts that appear on computed tomography or magnetic resonance imaging. Another benefit of ultrasonography is its capability to dynamically assess the pathologic movement in joints, muscles, or tendons. This article discusses the frequent applications of musculoskeletal ultrasonography in various postoperative situations including those involving the soft tissues around the metal hardware, arthroplasty, postoperative tendons, recurrent soft tissue tumors, bone unions, and amputation surgery. PMID:25971901

  8. Postoperative ultrasonography of the musculoskeletal system

    PubMed Central

    Chun, Kyung Ah; Cho, Kil-Ho

    2015-01-01

    Ultrasonography of the postoperative musculoskeletal system plays an important role in the Epub ahead of print accurate diagnosis of abnormal lesions in the bone and soft tissues. Ultrasonography is a fast and reliable method with no harmful irradiation for the evaluation of postoperative musculoskeletal complications. In particular, it is not affected by the excessive metal artifacts that appear on computed tomography or magnetic resonance imaging. Another benefit of ultrasonography is its capability to dynamically assess the pathologic movement in joints, muscles, or tendons. This article discusses the frequent applications of musculoskeletal ultrasonography in various postoperative situations including those involving the soft tissues around the metal hardware, arthroplasty, postoperative tendons, recurrent soft tissue tumors, bone unions, and amputation surgery. PMID:25971901

  9. [New approach to postoperative delirium treatment].

    PubMed

    Pasechnik, I N; Makhla?, A V; Tepliakova, A N; Guba?dullin, R R; Sal'nikov, P S; Borisov, A Iu; Berezenko, M N

    2015-01-01

    The efficiency of different drugs for sedation was studied in 51 patients after large abdominal operations complicated by postoperative delirium. Diagnosis of postoperative delirium was established according to CAM-ICU criteria. Dexmedetomidine has demonstrated significantly decreased duration of delirium and hospital stay in intensive care unit in comparison with haloperidol. Besides, patients which received dexmedetomidine preserved opportunity for verbal contact. Also these patients interacted better with department's stuff. PMID:26031955

  10. Postoperative hypertension after radical neck dissection.

    PubMed

    Celikkanat, S; Akyol, M U; Koç, C; Olçer, S; Ensari, S; Turgut, S; Ozdem, C

    1997-07-01

    Postoperative hypertension after radical neck dissection was detected in 20.2% of 109 neck dissections in our department between 1989 and 1993. It was probably caused by carotid sinus denervation and appeared after the vasodilation generated by anesthesia had subsided. If postoperative hypertension was encountered after the first operation, the risk of such hypertension after surgery on the contralateral side significantly increased. PMID:9230330

  11. Naproxen premedication reduces postoperative tubal ligation pain.

    PubMed

    Comfort, V K; Code, W E; Rooney, M E; Yip, R W

    1992-04-01

    This study evaluated the effectiveness of naproxen sodium oral premedication in reducing postoperative pain, analgesic requirements and day surgery length of stay in patients undergoing outpatient laparoscopic tubal ligations. We undertook a randomized, double-blind clinical trial on ASA I and ASA II patients undergoing outpatient laparoscopic tubal ligations. The treatment group received two capsules containing naproxen sodium, 275 mg each, and the control group received two identical capsules containing placebo. Postoperative visual analogue pain scores, analgesic requirements, side-effects and length of day surgery stay were studied. Forty-four patients completed the study with 21 patients in the naproxen group and 23 in the placebo group. There was a statistically significant difference between groups in terms of pain score (naproxen group 0.9 +/- 0.2 vs placebo group 3.5 +/- 0.6); patients requiring postoperative opioids (naproxen group 0% vs placebo group 34.8%); and time spent in the day surgery unit (naproxen group 168 +/- 13 min vs placebo group 188 +/- 15 min). There was no difference in the incidence of nausea and vomiting. Only one person developed a side-effect from the naproxen sodium which was minor gastric discomfort. This study shows that naproxen decreased the postoperative tubal ligation pain with less subsequent postoperative analgesic requirements, less time to street fitness and no increase in analgesic side-effects. We recommend the use of this premedication in outpatient laparoscopic tubal ligations. PMID:1348663

  12. Juristische Vorgaben und Problemlagen

    NASA Astrophysics Data System (ADS)

    Knopp, Lothar

    EG-Umwelthaftungsrichtlinie - UmwH-RL (2004) - und deutsches Umweltschadensgesetz - USchadG (2007) - haben zwischenzeitlich eine durchaus beachtliche Fachliteratur provoziert, die sich mit allen Fassetten und Problemlagen beider Regelwerke intensiv auseinandersetzt. Die Betrachtungen beschränken sich nach Inkrafttreten der europäischen Richtlinie dabei nicht nur auf Deutschland, auch die anderen Mitgliedstaaten haben offensichtlich Umsetzungsprobleme bzw. haben erst bis vor kurzem oder gar nicht die UmwH-RL in nationales Recht umgesetzt. Deutschland hat immerhin - wenn auch (wieder einmal) nicht fristgerecht - versucht, dem europäischen Haftungsregime durch Erlass des USchadG Rechnung zu tragen.

  13. Organe der Osmoregulation und Exkretion

    NASA Astrophysics Data System (ADS)

    Møbjerg, Nadja

    Die meisten Schädeltiere sind in der Lage, die Wasser- und Ionenkonzentration ihres Innenmilieus zu regulieren, sind also im Hinblick auf ihren Ionenhaushalt weitgehend unabhängig von der Umgebung. Sie halten die Konzentration von Wasser und anorganischen Ionen in ihren Körperflüssigkeiten (interstitielle Flüssigkeit und Blut) innerhalb enger Grenzen konstant (Osmoregulierer). Schleim aale (Myxinoida) können zwar die Konzentration einzelner anorganischer Ionen regulieren, sind aber insgesamt der hohen Osmolarität des Meerwassers angepasst, also isoosmostisch zu diesem. Isoosmotisch oder leic ht hyperosmostisch zur Umgebung sind auch marine Neoselachier und Latimeria chalumnae (Actinistia), die dazu organische Osmolyte (Harnstoff und Trimethylaminoxid) im Blut akkumulieren (Osmokonformer). Bei anderen aquatischen Schädeltieren sind die Körperflüssigkeiten zur Umgebung hypoosmotisch (im Meerwasser) — sie halten Wasser zurück und scheiden anorganiche Ionen aus — oder hyperosmotisch (im Süßwasser), indem sie Wasser abgeben und anorganische Ionen aufnehmen.

  14. Biomarkers of postoperative delirium and cognitive dysfunction

    PubMed Central

    Androsova, Ganna; Krause, Roland; Winterer, Georg; Schneider, Reinhard

    2015-01-01

    Elderly surgical patients frequently experience postoperative delirium (POD) and the subsequent development of postoperative cognitive dysfunction (POCD). Clinical features include deterioration in cognition, disturbance in attention and reduced awareness of the environment and result in higher morbidity, mortality and greater utilization of social financial assistance. The aging Western societies can expect an increase in the incidence of POD and POCD. The underlying pathophysiological mechanisms have been studied on the molecular level albeit with unsatisfying small research efforts given their societal burden. Here, we review the known physiological and immunological changes and genetic risk factors, identify candidates for further studies and integrate the information into a draft network for exploration on a systems level. The pathogenesis of these postoperative cognitive impairments is multifactorial; application of integrated systems biology has the potential to reconstruct the underlying network of molecular mechanisms and help in the identification of prognostic and diagnostic biomarkers. PMID:26106326

  15. Peppermint oil: a treatment for postoperative nausea.

    PubMed

    Tate, S

    1997-09-01

    This paper describes a research study to investigate the efficacy of peppermint oil as a treatment for postoperative nausea. It uses a three-condition experimental design using statistical analysis to compare groups. The Kruskal-Wallis test was used to establish significance and the Mann-Whitney test to differentiate significance between the groups. The control, placebo and experimental groups of gynaecological patients were compared, using variables known to affect postoperative nausea. They were found to be homogeneous for the purposes of the study. A statistically significant differences was demonstrated on the day of operation, using the Kruskal-Wallis test, P = 0.0487. Using the Mann-Whitney test the difference was shown to be between the placebo and experimental group (U = 3; P = 0.02). The experimental group also required less traditional antiemetics and received more opioid analgesia postoperatively. The total cost of the treatment was 48 pence per person. PMID:9378876

  16. Post-operative pulmonary complications after thoracotomy.

    PubMed

    Sengupta, Saikat

    2015-09-01

    Pulmonary complications are a major cause of morbidity and mortality in the post-operative period after thoracotomy. The type of complications and the severity of complications depend on the type of thoracic surgery that has been performed as well as on the patient's pre-operative medical status. Risk stratification can help in predicting the possibility of the post-operative complications. Certain airway complications are more prone to develop with thoracic surgery. Vocal cord injuries, bronchopleural fistulae, pulmonary emboli and post-thoracic surgery non-cardiogenic pulmonary oedema are some of the unique complications that occur in this subset of patients. The major pulmonary complications such as atelectasis, bronchospasm and pneumonia can lead to respiratory failure. This review was compiled after a search for search terms within 'post-operative pulmonary complications after thoracic surgery and thoracotomy' on search engines including PubMed and standard text references on the subject from 2000 to 2015. PMID:26556921

  17. Post-operative pulmonary complications after thoracotomy

    PubMed Central

    Sengupta, Saikat

    2015-01-01

    Pulmonary complications are a major cause of morbidity and mortality in the post-operative period after thoracotomy. The type of complications and the severity of complications depend on the type of thoracic surgery that has been performed as well as on the patient's pre-operative medical status. Risk stratification can help in predicting the possibility of the post-operative complications. Certain airway complications are more prone to develop with thoracic surgery. Vocal cord injuries, bronchopleural fistulae, pulmonary emboli and post-thoracic surgery non-cardiogenic pulmonary oedema are some of the unique complications that occur in this subset of patients. The major pulmonary complications such as atelectasis, bronchospasm and pneumonia can lead to respiratory failure. This review was compiled after a search for search terms within ‘post-operative pulmonary complications after thoracic surgery and thoracotomy’ on search engines including PubMed and standard text references on the subject from 2000 to 2015. PMID:26556921

  18. 8 2. Helium und Tritium in der Geosphre 2. Helium und Tritium in der Geosphre

    E-print Network

    Aeschbach-Hertig, Werner

    8 2. Helium und Tritium in der Geosphäre 2. Helium und Tritium in der Geosphäre 2.1. Spezielle Einheiten und Konstanten An dieser Stelle sollen die speziellen für Helium und Tritium verwendeten Einheiten definiert und dazugehörige Umrechnungen angegeben werden. Die Wahl der Werte einiger für Helium und Tritium

  19. www.gender-und-diversity.fau.de Bro fr Gender und Diversity

    E-print Network

    Gugat, Martin

    www.gender-und-diversity.fau.de Büro für Gender und Diversity Aufgaben und Projekte Büro für Gender und Diversity (BGD) hat es sich in erster Linie zur Aufgabe gemacht, durch vielfältige, einen gender- und diversity- sensiblen Wissenschafts- und Hochschulraum zu stärken, in dem die

  20. Management of postoperative complications: general approach.

    PubMed

    Sanguineti, V Ana; Wild, Jason R; Fain, Mindy J

    2014-05-01

    The goal of postoperative management is to promote early mobility and avoid postoperative complications, recognizing the potentially devastating impact of complications on elderly patients with hip fracture. The recommended approach involves early mobilization; freedom from tethers (indwelling urinary catheters and other devices); effective pain control; treating malnutrition; preventing pressure ulcers; reducing risk for pulmonary, urinary, and wound infections; and managing cognition. This carefully structured and patient-centered management provides older, vulnerable patients their best chance of returning to their previous level of functioning as quickly and safety as possible. PMID:24721365

  1. [Postoperative non-opioid analgesics management].

    PubMed

    Beloeil, Hélène

    2015-06-01

    Morphine, which is known as the reference analgesic, has shown its limits. Reducing morphine consumption and multimodal analgesia are integral parts of a modern management of postoperative pain. Combination of several analgesics aims for improving pain control and the ratio between the analgesic effect and the side effects. Nefopam, paracetamol, non-steroids anti-inflammatory drugs and steroids are the most frequently prescribed non-opioid analgesics in France. They can be administered alone or in combination with or without morphine in the postoperative setting. The analgesic benefit of each of these agents and their associations is variable and described in details in this manuscript. PMID:25744948

  2. Postoperative global amnesia reversed with flumazenil.

    PubMed

    Rinehart, Joseph B; Baker, Brandee; Raphael, Darren

    2012-07-01

    Global postoperative amnesia (profound anterograde and retrograde amnesia) is rare and usually attributed to transient global amnesia-a poorly understood condition with no broadly accepted mechanism. We report an incident of probable transient global amnesia in a patient after endoscopic retrograde cholangiopancreatogram under general anesthesia, which was successfully treated with flumazenil. On the basis of the results of flumazenil administration in this and a previous case report, we would recommend a trial dose of 0.2 mg for cases of global postoperative amnesia, repeated if the first dose seems effective. PMID:22735251

  3. Veroffentlichungen und Vortrage Veroffentlichungen

    E-print Network

    Pensionierung von MinDir Dr. Hermann Schunck M. GR ¨OTSCHEL (TUB, Matheon, ZIB) Mathematik: Schunck.-28.6.2005 Wissenschaftsforum Einstein bei DESY J. MLYNEK (Helmholtz Gesellschaft) A. WAGNER (DESY Hamburg/DE) R. HEUER (DESY) Forschung im Weltraum. D. Dzwonnek (FZJ) Von Politik und Wissenschaftspolitik. 28.10.2005 Festkolloquium anl

  4. Verffentlichungen und Vortrge Verffentlichungen

    E-print Network

    Kontinentalrands mit dem Forschungsschiff ,,Sonne". 20.3.2002 H. RECHENBERG (München/D) Werner Heisenberg und die Elementarteilchenphysik. (Zur Eröffnung der Werner Heisenberg-Jubiläumsausstellung) 10.4.2002 J. BECKER (Jülich/D) Die

  5. Stenting und technische Stentumgebung

    NASA Astrophysics Data System (ADS)

    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].

  6. Arbeitsgestaltung und Mitarbeiterqualifizierung

    NASA Astrophysics Data System (ADS)

    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

  7. Arbeitnehmerschutz und Sicherheit

    NASA Astrophysics Data System (ADS)

    Bölke, Klaus-Peter

    Arbeitnehmerschutz (Arbeitsschutz) bedeutet, auch nach der Definition aus Lexika, die Gesamtheit aller öffentlich-rechtlichen Vorschriften, die dem Schutze des Arbeitnehmers unter Vorgabe von Maßnahmen des Arbeitgebers, die dieser einzuhalten hat, dient. Diese Vorschriften müssen regelmäßig durch öffentliche Stellen (in Deutschland: Gewerbeaufsichtsämter; in Österreich: Arbeitsinspektorate; in der Schweiz: Fabrikinspektion) überwacht und deren Einhaltung z.B. durch Strafandrohungen sichergestellt werden.

  8. Verffentlichungen und Vortrge Verffentlichungen

    E-print Network

    /CH) Space-Born Gamma-Ray Astronomy. 1.6.2004 L. TRENTADUE (CERN/CH) The Running of QED-Alpha. 8.6.2004 F Laser- Physik. 28.4. 2004 H. LANGE (Hamburg/D) PISA und die Folgen ­ Schocktherapie oder längere

  9. Methodik und Qualität statistischer Erhebungen

    NASA Astrophysics Data System (ADS)

    Krug, Walter; Schmidt, Jürgen; Wiegert, Rolf

    Kapitel 8 wirft einen Blick hinter die Kulissen statistischer Arbeit und ihrer Methoden, insbesondere auch hinter die der amtlichen Statistik: Wie kommen die Myriaden von Zahlen zustande, die heute aus statistischen Quellenwerken aller Art und aus Datenbanken abgerufen werden können? Dabei wird deutlich, welche Schwierigkeiten bei Erhebungen, insbesondere bei Stichprobenerhebungen, zu überwinden sind, wie man Antwortverweigerer kooperativer stimmt, wie sich auch aus kleinen Stichproben auf intelligente Weise verlässliche Ergebnisse erzielen lassen und wie Großstichproben auf europäischer Ebene harmonisiert werden. Am Beispiel des Zensus 2011 wird gezeigt, wie sich eine Kombination von Stichproben und Registerauswertungen als Ersatz für eine Volkszählung nutzen lässt. Mitglieder der Deutschen Statistischen Gesellschaft waren daran kooperativ beteiligt.

  10. Aktive und passive Sicherheit

    NASA Astrophysics Data System (ADS)

    Kramer, Florian

    Im Bereich der Fahrzeugsicherheit wird mit dem Begriff "Sicherheit“ eine Situation beschrieben, bei der das erzielbare Risiko kleiner ist als das größte noch vertretbare Risiko (Grenzrisiko) eines bestimmten technischen Vorgangs oder Zustands. Dabei wird das Risiko durch eine Wahrscheinlichkeitsaussage beschrieben, d. h. durch die zu erwartende Häufigkeit des Eintritts eines zum Schaden führenden Ereignisses und das beim Ereigniseintritt zu erwartende Schadensausmaß. Auf Straßenverkehrsunfälle übertragen bedeutet dies beispielsweise die erwartete Häufigkeit von Unfällen nur mit Sachschäden oder die mit Personenschäden. Die Wahrscheinlichkeitsaussage ist die erwartete Häufigkeit von Unfällen und das Schadensausmaß der Sachbzw. der Personenschäden. Es ist nahe liegend, dass das Risiko, einen Unfall mit Sachschaden zu erleiden, ungleich höher ist als das Risiko für Unfälle mit Personenschaden. So wurden im Jahr 2005 in Deutschland insgesamt 1.917.373 Unfälle nur mit Sachschäden, jedoch nur 336.619 Unfälle mit Personenschäden registriert.

  11. Aktive und passive Sicherheit

    NASA Astrophysics Data System (ADS)

    Kramer, Florian

    Im Bereich der Fahrzeugsicherheit wird mit dem Begriff "Sicherheit" eine Situation beschrieben, bei der das erzielbare Risiko kleiner ist als das größte noch vertretbare Risiko (Grenzrisiko) eines bestimmten technischen Vorgangs oder Zustands. Dabei wird das Risiko durch eine Wahrscheinlichkeitsaussage beschrieben, d. h. durch die zu erwartende Häufigkeit des Eintritts eines zum Schaden führenden Ereignisses und das beim Ereigniseintritt zu erwartende Schadensausmaß. Auf Straßenverkehrsunfälle übertragen bedeutet dies beispielsweise die erwartete Häufigkeit von Unfällen nur mit Sachschäden oder die mit Personenschäden. Die Wahrscheinlichkeitsaussage ist die erwartete Häufigkeit von Unfällen und das Schadensausmaß der Sachbzw. der Personenschäden. Es ist nahe liegend, dass das Risiko, einen Unfall mit Sachschaden zu erleiden, ungleich höher ist als das Risiko für Unfälle mit Personenschaden. So wurden im Jahr 2005 in Deutschland insgesamt 1.917.373 Unfälle nur mit Sachschäden, jedoch nur 336.619 Unfälle mit Personenschäden registriert.

  12. Demokrit und die Quantenmechanik

    NASA Astrophysics Data System (ADS)

    Wahsner, Renate

    Es wird gezeigt, daß der antike Atomismus ein auch für die moderne Physik fundamentales Denkprinzip begründete, ein Prinzip, das es in seiner Newtonschen Modifizierung ermöglicht, die Bewegung und das Kontinuum physikalisch zu fassen.Translated AbstractDemocrit and Quantum MechanicsIt is shown that the antique atomisms founded a thought principle which has also a fundamental meaning for modern physics, a principle which in its Newtonian version makes it possible to grasp motion and continuum physically.

  13. Wetter und Klima

    NASA Astrophysics Data System (ADS)

    Frater, Harald

    Diese CD-ROM orientiert sich inhaltlich weitgehend an gängigen Lehrbüchern zum Thema, wobei sie jedoch die Möglichkeiten der elektronischen Medien auf eindrucksvolle Weise nutzt. Unter anderem finden sich Filmbeiträge, Trickfilmsequenzen und Modellierungen. Darüber hinaus enthält die CD auch einige Kapitel, die interaktiv aufbereitet sind. Ein von jeder Stelle der Anwendung anwählbares Hauptmenü, eine Online-Hilfe sowie ein ausführliches Glossar garantieren dem Nutzer dabei höchstmögliche Anwenderfreundlichkeit.

  14. Postoperative Vision Loss after Reverse Shoulder Arthroplasty

    PubMed Central

    Scadden, John

    2014-01-01

    We report a case which highlights the rare but devastating complication of postoperative vision loss (POVL) in orthopaedic surgery. Though documented previously, it has not been reported in shoulder arthroplasty surgery of which we present the first case. The aetiology of POVL is difficult to elucidate due to its elusive nature. We explain the risks associated with regional blocks used for such surgery and how this may be related to POVL. We must be vigilant of the possible causes of POVL as curative treatment is often not possible and hence must take preventative measures which we have recommended. Fortunately, the patient fully recovered at 10 months postoperatively with excellent function of her reverse shoulder arthroplasty. PMID:25610682

  15. Management of Postoperative Abdominal Wall Pain.

    PubMed

    Sharp, Howard T

    2015-12-01

    Postoperative incisional pain is expected after surgery. However, when a patient is complaining of pain months after surgery, this can be a source of frustration and confusion to the patient and the surgeon. Whether the pain is a result of myofascial pain, incisional hernia, or nerve injury, understanding potential sources of abdominal wall pain can simplify this diagnostic dilemma. This chapter will focus on the diagnosis, treatment, and prevention of postsurgical abdominal wall pain. PMID:26512441

  16. [Fat transplantation for postoperative cicatricial pain relief].

    PubMed

    Kjerkegaard, Ulrik Knap; Stolle, Lars Bjørn

    2013-03-25

    This case report presents a successful treatment with fat transplantation to painful scar tissue in the neck and back region after excision of a proliferative myositis (pseudosarcoma) and reconstruction with a trapezius flap in 1983. The patient had chronic pain, social disabilities and a visual analogue scale (VAS) score of 8 preoperatively. At a postoperative control six months later the patient experienced no pain any longer, the VAS score was 1 and he was working full time. PMID:23582893

  17. Postoperative Chemoradiotherapy for Extrahepatic Bile Duct Cancer

    SciTech Connect

    Park, Jin-hong; Choi, Eun Kyung; Ahn, Seung Do; Lee, Sang-wook; Song, Si Yeol; Yoon, Sang Min; Kim, Young Seok; Lee, Yu Sun; Lee, Sung-Gyu; Hwang, Shin; Lee, Young-Joo; Park, Kwang-Min; Kim, Tae Won; Chang, Heung Moon; Lee, Jae-Lyun; Kim, Jong Hoon

    2011-03-01

    Purpose: To evaluate the effect of postoperative concurrent chemoradiotherapy using three-dimensional conformal radiotherapy and to identify the prognostic factors that influence survival in patients with extrahepatic bile duct cancer. Methods and Materials: We retrospectively analyzed the data from 101 patients with extrahepatic bile duct cancer who had undergone postoperative concurrent chemoradiotherapy using three-dimensional conformal radiotherapy. Of the 101 patients, 52 (51%) had undergone complete resection (R0 resection) and 49 (49%) had microscopic or macroscopic residual tumors (R1 or R2 resection). The median radiation dose was 50 Gy. Also, 85 patients (84%) underwent concurrent chemotherapy with 5-fluorouracil. Results: The median follow-up period was 47 months for the surviving patients. The 5-year overall survival rate was 34% for all patients. A comparison between patients with R0 and R1 resection indicated no significant difference in the 5-year overall survival (44% vs. 33%, p = .2779), progression-free survival (35% vs. 22%, p = .3107), or locoregional progression-free survival (75% vs. 63%, p = .2784) rates. An analysis of the first failure site in the 89 patients with R0 or R1 resection indicated isolated locoregional recurrence in 7 patients. Elevated postoperative carbohydrate antigen 19-9 level was an independent prognostic factor for overall survival (p = .001) and progression-free survival (p = .033). A total of 3 patients developed Grade 3 or greater late toxicity. Conclusion: Adjuvant concurrent chemoradiotherapy using three-dimensional conformal radiotherapy appears to improve locoregional control and survival in extrahepatic bile duct cancer patients with R1 resection. The postoperative carbohydrate antigen 19-9 level might be a useful prognostic marker to select patients for more intensified adjuvant therapy.

  18. Optimized imaging of the postoperative spine.

    PubMed

    McLellan, Anne Marie; Daniel, Simon; Corcuera-Solano, Idoia; Joshi, Vivek; Tanenbaum, Lawrence N

    2014-05-01

    Few tasks in imaging are more challenging than that of optimizing evaluations of the instrumented spine. The authors describe how applying fundamental and more advanced principles to postoperative spine computed tomography and magnetic resonance examinations mitigates the challenges associated with metal implants and significantly improves image quality and consistency. Newer and soon-to-be-available enhancements should provide improved visualization of tissues and hardware as multispectral imaging sequences continue to develop. PMID:24792613

  19. Postoperative Autologous Reinfusion in Total Knee Replacement

    PubMed Central

    Crescibene, A.; Martire, F.; Gigliotti, P.; Rende, A.; Candela, M.

    2015-01-01

    Surgeries for total knee replacement (TKR) are increasing and in this context there is a need to develop new protocols for management and use of blood transfusion therapy. Autologous blood reduces the need for allogeneic blood transfusion and the aim of the present study was to verify the safety and the clinical efficacy. An observational retrospective study has been conducted on 124 patients, undergoing cemented total knee prosthesis replacement. Observed population was stratified into two groups: the first group received reinfusion of autologous blood collected in the postoperative surgery and the second group did not receive autologous blood reinfusion. Analysis of data shows that patients undergoing autologous blood reinfusion received less homologous blood bags (10.6% versus 30%; p = 0.08) and reduced days of hospitalization (7.88 ± 0.7 days versus 8.96 ± 2.47 days for the control group; p = 0.03). Microbiological tests were negative in all postoperatively salvaged and reinfused units. Our results emphasize the effectiveness of this procedure and have the characteristics of simplicity, low cost (€97.53 versus €103.79; p < 0.01), and easy reproducibility. Use of autologous drainage system postoperatively is a procedure that allows reducing transfusion of homologous blood bags in patients undergoing TKR. PMID:26442168

  20. Pathophysiology and prevention of postoperative peritoneal adhesions

    PubMed Central

    Arung, Willy; Meurisse, Michel; Detry, Olivier

    2011-01-01

    Peritoneal adhesions represent an important clinical challenge in gastrointestinal surgery. Peritoneal adhesions are a consequence of peritoneal irritation by infection or surgical trauma, and may be considered as the pathological part of healing following any peritoneal injury, particularly due to abdominal surgery. The balance between fibrin deposition and degradation is critical in determining normal peritoneal healing or adhesion formation. Postoperative peritoneal adhesions are a major cause of morbidity resulting in multiple complications, many of which may manifest several years after the initial surgical procedure. In addition to acute small bowel obstruction, peritoneal adhesions may cause pelvic or abdominal pain, and infertility. In this paper, the authors reviewed the epidemiology, pathogenesis and various prevention strategies of adhesion formation, using Medline and PubMed search. Several preventive agents against postoperative peritoneal adhesions have been investigated. Their role aims in activating fibrinolysis, hampering coagulation, diminishing the inflammatory response, inhibiting collagen synthesis or creating a barrier between adjacent wound surfaces. Their results are encouraging but most of them are contradictory and achieved mostly in animal model. Until additional findings from future clinical researches, only a meticulous surgery can be recommended to reduce unnecessary morbidity and mortality rates from these untoward effects of surgery. In the current state of knowledge, pre-clinical or clinical studies are still necessary to evaluate the effectiveness of the several proposed prevention strategies of postoperative peritoneal adhesions. PMID:22147959

  1. [Postoperative pain and methods for its control].

    PubMed

    Capellaro, L; Trompeo, M; Di Laura, I

    1985-02-11

    Research was conducted into post-operative pain and possible means for its control. A total of 66 patients subdivided into 3 groups were studied. In order to document analgesic effectiveness, pain was measured by two subjective methods--Huskisson's Visual Analogue and the "SCORE" index. Patients' anxiety was assessed pre-operatively by a suitably modified tourniquet test. The groups of patients were subdivided according to the analgesic agent used: 1st group (herniectomies, appendicectomies) Baralgina f. 1; 2nd group (cholecystectomies, hysterectomies) Talwin f. 1; 3rd group (cholecystectomies, hysterectomies) Baralgina f. 1 + Talwin f. 1. The latter combination proved to be satisfactory and guaranteed a sufficiently calm post-operative period. On the basis of the data obtained, it is recommended that anaesthesiological procedures include analgesic cover that exploits the action of Phentanyl as an analgesic agent and neurovegetative stabilizer and is to be used at the start of the operation. For operations lasting more than 60 minutes, a combination of Baralgina and Talwin or Buprenorfina may be administered during the post-operative period. PMID:3974929

  2. Aufbau von Beschleunigern und Experimenten Abbildung 110: Geplante Trassenfhrung und Lage des FEL-

    E-print Network

    Aufbau von Beschleunigern und Experimenten Abbildung 110: Geplante Trassenführung und Lage des FEL- Fächers im Bereich Ellerhoop. 250 #12;Aufbau von Beschleunigern und Experimenten Aufbau von Beschleunigern und Experimenten Von der Gruppe ZMEA werden in enger Zusam- menarbeit mit dem M- und F-Bereich die

  3. GEOMETRIE UND KOMBINATORIK VON NASHGLEICHGEWICHTEN

    E-print Network

    Theobald, Thorsten

    wurden Nashs BeitrË? age wie folgt gewË? urdigt (siehe auch [7]). '' John F. Nash introducedGEOMETRIE UND KOMBINATORIK VON NASH­GLEICHGEWICHTEN THORSTEN THEOBALD Institut fË? ur Mathematik, MA Spieltheorie aus den 50er Jahren wurde John Nash (gemeinsam mit John Harsanyi und Reinhard Selten) im Jahr 1994

  4. Leitbilder und Handlungsstrategien für die Raumentwicklung in Deutschland. Entwicklungs-, Umsetzungs- und Fortschreibungsprozess der Bund-Länder-Strategie für Städte und Regionen

    NASA Astrophysics Data System (ADS)

    Issaoui, Mariam; Sinz, Manfred

    2010-09-01

    Die Ministerkonferenz für Raumordnung stellte im Mai 2010 fest, dass sich die „Leitbilder und Handlungsstrategien für die Raumentwicklung in Deutschland“ (2006) bewährt haben und bei der Gestaltung der räumlichen Entwicklung umgesetzt werden. Um die Leitbilder den sich verändernden wirtschaftlichen, sozialen und naturräumlichen Rahmenbedingungen anzupassen und die Erkenntnisse aus dem bisherigen Diskussions- und Umsetzungsprozess in Politik und Praxis einzubeziehen, sind sie zu ergänzen und weiterzuentwickeln. Im Mittelpunkt der Fortschreibung werden die Themen „Partnerschaften und Strategien für Stadtregionen und ländliche Räume“, „Mobilität und Logistik“ sowie „Klimaschutz und Energieversorgung“ stehen.

  5. Chancen und Visionen Der Modernen Mechanik

    NASA Astrophysics Data System (ADS)

    Ehlers, Wolfgang; Wriggers, Peter

    Die Gesellschaft des 21. Jahrhunderts wird ihre Anforderungen an Lebensqualität und Umweltstandards stetig erhöhen. Dies betrifft auch die Anforderungen an Qualität und Vorhersagegenauigkeit bei der Berechnung komplexer Probleme und umfasst insbesondere das Gesamtdesign von Produkten unserer unmittelbaren Umgebung wie Architektur- und Ingenieurbauwerken, aber auch von Industrieprodukten, die wir in unseremtäglichen Leben einsetzen.

  6. Bildanalyse in Medizin und Biologie

    NASA Astrophysics Data System (ADS)

    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.

  7. Dynamische Motorvermessung mit verschiedenen Methoden und Modellen

    NASA Astrophysics Data System (ADS)

    Schreiber, Alexander

    Die stark zunehmenden gesetzlichen und wirtschaftlichen Vorgaben zur Senkung von Kraftstoffverbrauch und Abgasemissionen stellen große Anforderungen an die weitere Entwicklung von Benzin- und Dieselmotoren. Hierbei sind grundlegende Fortschritte durch Konstruktion und auslegungsbedingte Maßnahmen im Bereich der Einspritzung, Gemischaufbereitung, Aufladung, Brennverfahren und Abgasnachbehandlung zu erreichen. Ein wesentlicher Teil dieser Verbesserungen wird jedoch durch eine Zunahme von Variabilitäten erreicht wie z.B. verstellbaren Vor-, Haupt- und Nacheinspritzungen, variablem Raildruck, variablen Nockenwellensteuerwinkeln, Ventilhüben, Drall-/Tumbleklappen sowie verstellbaren Abgasturbinen, Abgasrückführströmen und Abgasnachbehandlungssystemen. Dadurch steigt die Zahl der Stellglieder (Aktoren) stark an. Hinzu kommen zusätzliche Sensoren wie z.B. für Luftzahl, NOx, Brennraumdruck, Abgastemperatur und Abgasdruck. Deshalb nimmt der Umfang der Steuerungs-, Regelungs- und Diagnosefunktionen in der Motorelektronik (ECU) stark zu. Bild 7-1 zeigt als Beispiel den Signalfluss für die gesteuerten und geregelten Größen eines Dieselmotors in einer beispielhaften Prüfstandsumgebung.

  8. Pyropheophorbide und a as a catabolite of ethylene-induced chlorophyll und a degradation

    SciTech Connect

    Shimokawa, Keishi; Hashizume, Akihito ); Shioi, Yuzo )

    1990-05-01

    An enzyme extract prepared from ethylene-induced degreening Citrus fruits contains chlorophyll (Chl) degrading enzymes. The fate of Chl carbons during an enzymatic degradation was investigated using Chl {und a}-{sup 14}C. Accompanying the disappearance of labelled Chl {und a}, pheophorbide {und a} and pyropheophorbide {und a} appeared and accumulation of pyropheophorbide {und a} was observed. HydroxyChl {und a} was also detected, but this is thought to be an artifact during chromatography. Unlike ethylene-induced Citrus fruits (in vivo), further degradation of pyropheophorbide {und a} did not occur in vitro enzyme system. This suggests that there is a lack of enzyme(s) and/or cofactor(s) for further degradation. It is concluded that Chl {und a} degraded enzymatically by the following order: Chl {und a}, chlorophyllide {und a}, pheophorbide {und a} and pyropheophorbide {und a}.

  9. Hinweise zu Prfungsvoraussetzungen und Teilnahmevoraussetzungen im 4. und 5. Semester Biologie Bachelor

    E-print Network

    Ulm, Universität

    Hinweise zu Prüfungsvoraussetzungen und Teilnahmevoraussetzungen im 4. und 5. Semester Biologie des 4. Semesters Voraussetzungen: - Grundlagen der Biologie - Physiologie I mit Tierphysiologie Biologie - Physiologie I mit Tierphysiologie, Pflanzenphysiologie und Einf. i.d. Biochemie - Mikrobiologie

  10. Unfallaufnahme und Datenerhebung

    NASA Astrophysics Data System (ADS)

    Brösdorf, Klaus-Dieter; Moser, Andreas; Burg, Jürgen

    Unfälle ereignen sich in unterschiedlichen Schweregraden. Man unterscheidet zwischen Unfälle mit nur Sachschaden und in Unfälle mit Personenschaden. Gemäß Statistik [1] machten in Deutschland im Jahr 2005 Unfälle mit Personenschaden (336.619) etwa 15 % der Gesamtanzahl der polizeilich erfassten Unfälle (2.253.992) aus. In den amtlichen Statistiken sind nur polizeilich erfasste Unfälle enthalten. Eine größere Zahl von Unfällen, insbesondere leichtere Unfälle, wird offensichtlich polizeilich nicht gemeldet. Mit den Daten der Versicherungswirtschaft wird die Anzahl der Kfz-Schäden pro Jahr in Deutschland mit 8.673.000 angegeben [2].

  11. The Postoperative Pain Assessment Skills pilot trial

    PubMed Central

    McGillion, Michael; Dubrowski, Adam; Stremler, Robyn; Watt-Watson, Judy; Campbell, Fiona; McCartney, Colin; Victor, J Charles; Wiseman, Jeffrey; Snell, Linda; Costello, Judy; Robb, Anja; Nelson, Sioban; Stinson, Jennifer; Hunter, Judith; Dao, Thuan; Promislow, Sara; McNaughton, Nancy; White, Scott; Shobbrook, Cindy; Jeffs, Lianne; Mauch, Kianda; Leegaard, Marit; Beattie, W Scott; Schreiber, Martin; Silver, Ivan

    2011-01-01

    BACKGROUND/OBJECTIVES: Pain-related misbeliefs among health care professionals (HCPs) are common and contribute to ineffective postoperative pain assessment. While standardized patients (SPs) have been effectively used to improve HCPs’ assessment skills, not all centres have SP programs. The present equivalence randomized controlled pilot trial examined the efficacy of an alternative simulation method – deteriorating patient-based simulation (DPS) – versus SPs for improving HCPs’ pain knowledge and assessment skills. METHODS: Seventy-two HCPs were randomly assigned to a 3 h SP or DPS simulation intervention. Measures were recorded at baseline, immediate postintervention and two months postintervention. The primary outcome was HCPs’ pain assessment performance as measured by the postoperative Pain Assessment Skills Tool (PAST). Secondary outcomes included HCPs knowledge of pain-related misbeliefs, and perceived satisfaction and quality of the simulation. These outcomes were measured by the Pain Beliefs Scale (PBS), the Satisfaction with Simulated Learning Scale (SSLS) and the Simulation Design Scale (SDS), respectively. Student’s t tests were used to test for overall group differences in postintervention PAST, SSLS and SDS scores. One-way analysis of covariance tested for overall group differences in PBS scores. RESULTS: DPS and SP groups did not differ on post-test PAST, SSLS or SDS scores. Knowledge of pain-related misbeliefs was also similar between groups. CONCLUSIONS: These pilot data suggest that DPS is an effective simulation alternative for HCPs’ education on postoperative pain assessment, with improvements in performance and knowledge comparable with SP-based simulation. An equivalence trial to examine the effectiveness of deteriorating patient-based simulation versus standardized patients is warranted. PMID:22184553

  12. [Postoperative alkaline reflux gastritis (author's transl)].

    PubMed

    Rothmund, M; Neher, M

    1977-02-25

    Postoperative alkaline reflux gastritis is a distinct clinical entity occuring after operations enlarging, bypassing or resecting the pylorus. Reflux of alkaline duodenal content into the stomach is the causative factor. Primarily bile acids have an aggressive effect and lead to a destruction of the gastric mucosal barrier. Epigastric pain, fullness after meals and bile vomiting are the main symptoms. Gastroscopy with biopsy reveals a severe chronic atrophic gastritis and bile reflux. In most cases an achlorhydria that can be histamin-resistant is present. For adequate treatment surgical procedures diverting the bile flow from the stomach should be performed. PMID:836529

  13. [Intravitreal injection. Monitoring to avoid postoperative complications].

    PubMed

    Meyer, C H; Ziemssen, F; Heimann, H

    2008-02-01

    Intravitreal injection is generally regarded as safe. Many of the potential complications caused by this procedure are extremely rare and can be avoided by careful inspection beforehand and proper performance of the injection. In rare cases, however, the administered drugs may cause various pharmacological side effects. This article summarizes the safety profiles of Macugen and Lucentis from the drug approval studies and describes initial findings on possible or observed side effects after intravitreal administration of Avastin. In addition, important points to observe in order to avoid intra- and postoperative complications are provided. PMID:18256842

  14. PRFERLISTE DER FAKULTT FR PHYSIK UND ASTRONOMIE Sommersemester 2015

    E-print Network

    Heermann, Dieter W.

    PRÜFERLISTE DER FAKULTÄT FÜR PHYSIK UND ASTRONOMIE Sommersemester 2015 *** I. DIPLOMSTUDIENGANG hierzu, siehe Studienplan.) #12;PRÜFERLISTE DER FAKULTÄT FÜR PHYSIK UND ASTRONOMIE im Jahr 2015 *** II Prüfungssekretariat der Fakultät für Physik und Astronomie per Aushang veröffentlicht. Anmeldefristen und -modalitäten

  15. Predictive Factors of Postoperative Pain and Postoperative Anxiety in Children Undergoing Elective Circumcision: A Prospective Cohort Study

    PubMed Central

    Tsamoudaki, Stella; Ntomi, Vasileia; Yiannopoulos, Ioannis; Christianakis, Efstratios; Pikoulis, Emmanuel

    2015-01-01

    Background Although circumcision for phimosis in children is a minor surgical procedure, it is followed by pain and carries the risk of increased postoperative anxiety. This study examined predictive factors of postoperative pain and anxiety in children undergoing circumcision. Methods We conducted a prospective cohort study of children scheduled for elective circumcision. Circumcision was performed applying one of the following surgical techniques: sutureless prepuceplasty (SP), preputial plasty technique (PP), and conventional circumcision (CC). Demographics and base-line clinical characteristics were collected, and assessment of the level of preoperative anxiety was performed. Subsequently, a statistical model was designed in order to examine predictive factors of postoperative pain and postoperative anxiety. Assessment of postoperative pain was performed using the Faces Pain Scale (FPS). The Post Hospitalization Behavior Questionnaire study was used to assess negative behavioral manifestations. Results A total of 301 children with a mean age of 7.56 ± 2.61 years were included in the study. Predictive factors of postoperative pain measured with the FPS included a) the type of surgical technique, b) the absence of siblings, and c) the presence of postoperative complications. Predictive factors of postoperative anxiety included a) the type of surgical technique, b) the level of education of mothers, c) the presence of preoperative anxiety, and d) a history of previous surgery. Conclusions Although our study was not without its limitations, it expands current knowledge by adding new predictive factors of postoperative pain and postoperative anxiety. Clearly, further randomized controlled studies are needed to confirm its results. PMID:26495079

  16. Postoperative Alterations in Taste and Smell

    PubMed Central

    Elterman, Kelly Galina; Mallampati, Seshagiri Rao; Kaye, Alan David; Urman, Richard Dennis

    2014-01-01

    Context: Alterations in taste and smell, including but not limited to anosmia, ageusia, hypogeusia, and dysgeusia, have been described in association with various medications, including anesthetic agents. Frequently, these symptoms occur 1-2 weeks after medication administration and last several months. While such a phenomenon is a rare occurrence, it nonetheless can significantly impact patients’ satisfaction and quality of life. Evidence Acquisition: The methodology consisted of a thorough literature search using the MEDLINE and Cochrane databases utilizing keywords such as anosmia, ageusia, olfactory disorders, postoperative, and anesthesia. Results: Our results yielded several previously published case report, and were not limited to a specific type of anesthesia. Based on available literature, we review the physiology of taste and smell as well as the medications associated with loss of these senses. We describe perioperative agents that could lead to postoperative complications associated with anosmia and and ageusia. Conclusions: Based on available literature recommendations for anesthesiologists caring for patients at risk for this occurrence are presented in this review. The symptoms are usually temporary as in the majority of the patients the sensory receptor cells are able to regenerate themselves after injury. Anesthesia providers need to aware of this phenomenon to be able to reassure patients and possibly avoid anesthetic techniques associated with anosmia and ageusia. PMID:25599025

  17. Immediate postoperative complications in transsphenoidal pituitary surgery: A prospective study

    PubMed Central

    Chowdhury, Tumul; Prabhakar, Hemanshu; Bithal, Parmod K.; Schaller, Bernhard; Dash, Hari Hara

    2014-01-01

    Background: Considering the important role of pituitary gland in regulating various endocrine axes and its unique anatomical location, various postoperative complications can be anticipated resulting from surgery on pituitary tumors. We examined and categorized the immediate postoperative complications according to various tumor pathologies. Materials and Methods: We carried out a prospective study in 152 consecutive patients and noted various postoperative complications during neurosurgical intensive care unit stay (within 48 hrs of hospital stay) in patients undergoing transsphenoidal removal of pituitary tumors. Results: In our series, various groups showed different postoperative complications out of which, cerebrospinal fluid leak was the commonest followed by diabetes insipidus, postoperative nausea and vomiting, and hematoma at operation site. Conclusion: Various immediate postoperative complications can be anticipated in transsphenoidal pituitary surgery even though, it is considered to be relatively safe. PMID:25191182

  18. Comprehensive Postoperative Management After Endoscopic Skull Base Surgery.

    PubMed

    Tien, Duc A; Stokken, Janalee K; Recinos, Pablo F; Woodard, Troy D; Sindwani, Raj

    2016-02-01

    To maximize outcomes from endoscopic skull base surgery, careful early postoperative management is critically important. Standardized postoperative regimens are lacking. The type of reconstruction and presence and type of cerebrospinal fluid leak dictate management. If a leak is encountered intraoperatively, patients should avoid maneuvers that increase intracranial pressures for at least 1 month. Early postoperative care focuses on minimizing and managing nasal crusting. This article reviews the evidence in the literature on postoperative management, complications, and quality of life after surgery, and outlines our experience in the management of patients after endoscopic skull base surgery. PMID:26614842

  19. Regelung ausgewählter Hybridtopologien: parallel und leistungsverzweigt

    NASA Astrophysics Data System (ADS)

    Zetina, Siegfried Saenger; Scholt, Torsten; Neiß, Konstantin

    Hybridfahrzeuge gewinnen zunehmend an Bedeutung, vor allem wegen der Möglichkeit zur Kraftstoffeinsparung, aber auch wegen ihrer zusätzlichen Agilität aufgrund der kurzfristig erreichbaren erhöhten Drehmomente. Durch die flexible Gestaltung von elektrischen Maschinen, Batterien und Nebenaggregaten lassen sich unter Beibehaltung des Standardbauraums verschiedene Antriebsstrangkonzepte realisieren. Um diese steuern und regeln zu können, ist eine bibliothekenbasierte und flexible Software-Architektur notwendig. In diesem Beitrag werden anhand zweier Praxisbeispiele die Gemeinsamkeiten, die Komplexität und die Unterschiede bei der Steuerung und Regelung von zwei zunächst verschiedenen Hybridantriebssträngen, parallel-mild Hybrid und leistungsverzweigt-voll Hybrid, vorgestellt.

  20. [Postoperative radiotherapy of breast cancer and cardiotoxicity].

    PubMed

    Nagykálnai, Tamás; Nagy, A Csaba; Landherr, László

    2014-06-01

    Cardiac complications may present a particular problem following radiation treatment applied to the mediastinum and thoracic wall (and especially to the left breast). Exposure of the heart during radiotherapy increases the risk of ischemic heart disease occurring generally years after the treatment. The incidence of radiation cardiotoxicity depends on various factors related to oncological therapies and the patient (details of radiotherapy, age, gender, comorbidities, smoking habits, etc.). Until recently the majority of clinical studies reported increased cardiac morbidity in patients receiving radiation treatment of the chest wall and the breast. Due to modern methods, however, postoperative chest wall and left breast irradiation is much safer today than previously. In order to avoid cardiotoxicity, adherence to clinical practice guidelines for chemo- and targeted therapy of breast cancer, use of the most advanced irradiation procedures, regular monitoring of patients, and close cooperation between cardiologists and oncologists are all recommended. PMID:24880968

  1. Hair Transplantation: Preventing Post-operative Oedema.

    PubMed

    Gholamali, Abbasi; Sepideh, Pojhan; Susan, Emami

    2010-05-01

    Swelling or oedema of forehead or eyelids is a common consequence of hair transplantation surgery. However, this results in increased morbidity and absence from work due to unaesthetic appearance. To study various physical and therapeutic modalities to reduce or completely prevent the occurrence of such oedema. Three hundred forty hair transplant patients were recruited in the study and were categorized into 8 groups depending upon the intervention employed. There were 32 dropouts in the study due to various reasons. Patients who were administered steroid with tumescent solution had the highest number of patients without oedema, with only 3 out of 117 patients developing oedema. Physical measures like position of head during sleeping, application of occlusion bands or ice packs did not show satisfactory results. Addition of triamcinolone to tumescent anaesthetic solution is a very effective technique of preventing post-operative swelling. PMID:21031066

  2. Nefopam and Ketamine Comparably Enhance Postoperative Analgesia

    PubMed Central

    Kapfer, Barbara; Alfonsi, Pascal; Guignard, Bruno; Sessler, Daniel I.; Chauvin, Marcel

    2005-01-01

    Summary Opioids alone sometimes provide insufficient postoperative analgesia. Co-administration of drugs may reduce opioid use and to improve opioid efficacy. We therefore tested the hypothesis that administration of ketamine or nefopam, to postoperative patients with pain only partly alleviated by morphine, limits the amount of subsequent opioid necessary to produce adequate analgesia. Patients (n=77) recovering from major surgery were given up to 9 mg intravenous morphine. Those still suffering from pain were randomly assigned to blinded administration of: 1) isotonic saline (Control, n=21); 2) ketamine 10 mg (Ketamine, n=22); or, 3) nefopam 20 mg (Nefopam, n=22). Three-mg morphine boluses were subsequently given at 5-minute intervals until adequate analgesia was obtained, or 60 minutes elapsed after the beginning of the study drug administration, or ventilation became insufficient (respiratory rate < 10 breath/minute or saturation by pulse oxymetery < 95%). Supplemental morphine (i.e., after test drug administration) requirements were significantly greater in the Control group [17 ± 10 (SD) mg] than in the Nefopam (10 ± 5 mg, P < 0.005) or Ketamine (9 ± 5 mg, P < 0.001) groups. Morphine titration was successful in all Ketamine and Nefopam patients, but failed in four Control patients (two from respiratory toxicity and two from persistent pain). Tachycardia and profuse sweating were more frequent in patients given nefopam and sedation was greater with ketamine; however, the incidence of other potential complications did not differ between groups. Implications We conclude that ketamine 10 mg and nefopam 20 mg comparably potentiate opioid analgesia, each reducing opioid need by approximately 40%. Ketamine administration was associated with sedation whereas nefopam produced tachycardia and sweating. However, none of the side effects was serious. Either drug can thus be used to potentiate opioid analgesia. PMID:15616073

  3. S. Phleps LMU SS09: Galaxien und Galaxienhaufen im Universum 1 Galaxien und Galaxienhaufen im Universum

    E-print Network

    Boehringer, Hans

    S. Phleps LMU SS09: Galaxien und Galaxienhaufen im Universum 1 Galaxien und Galaxienhaufen im Population von Galaxienhaufen I LMU SS 2009 #12;S. Phleps LMU SS09: Galaxien und Galaxienhaufen im Universum Semesters eine Klausur schreiben. 2 #12;S. Phleps LMU SS09: Galaxien und Galaxienhaufen im Universum Agenda

  4. S. Phleps LMU SS09: Galaxien und Galaxienhaufen im Universum 1 Galaxien und Galaxienhaufen im Universum

    E-print Network

    Boehringer, Hans

    S. Phleps LMU SS09: Galaxien und Galaxienhaufen im Universum 1 Galaxien und Galaxienhaufen im Population von Galaxienhaufen I LMU SS 2009 #12;S. Phleps LMU SS09: Galaxien und Galaxienhaufen im Universum function 2 #12;S. Phleps LMU SS09: Galaxien und Galaxienhaufen im Universum Fundamental questions

  5. Diagnosis, prevention and management of postoperative pulmonary edema.

    PubMed

    Bajwa, Sj Singh; Kulshrestha, A

    2012-07-01

    Postoperative pulmonary edema is a well-known postoperative complication caused as a result of numerous etiological factors which can be easily detected by a careful surveillance during postoperative period. However, there are no preoperative and intraoperative criteria which can successfully establish the possibilities for development of postoperative pulmonary edema. The aims were to review the possible etiologic and diagnostic challenges in timely detection of postoperative pulmonary edema and to discuss the various management strategies for prevention of this postoperative complication so as to decrease morbidity and mortality. The various search engines for preparation of this manuscript were used which included Entrez (including Pubmed and Pubmed Central), NIH.gov, Medknow.com, Medscape.com, WebMD.com, Scopus, Science Direct, MedHelp.org, yahoo.com and google.com. Manual search was carried out and various text books and journals of anesthesia and critical care medicine were also searched. From the information gathered, it was observed that postoperative cardiogenic pulmonary edema in patients with serious cardiovascular diseases is most common followed by noncardiogenic pulmonary edema which can be due to fluid overload in the postoperative period or it can be negative pressure pulmonary edema (NPPE). NPPE is an important clinical entity in immediate post-extubation period and occurs due to acute upper airway obstruction and creation of acute negative intrathoracic pressure. NPPE carries a good prognosis if promptly diagnosed and appropriately treated with or without mechanical ventilation. PMID:23439791

  6. Diagnosis, Prevention and Management of Postoperative Pulmonary Edema

    PubMed Central

    Bajwa, SJ Singh; Kulshrestha, A

    2012-01-01

    Postoperative pulmonary edema is a well-known postoperative complication caused as a result of numerous etiological factors which can be easily detected by a careful surveillance during postoperative period. However, there are no preoperative and intraoperative criteria which can successfully establish the possibilities for development of postoperative pulmonary edema. The aims were to review the possible etiologic and diagnostic challenges in timely detection of postoperative pulmonary edema and to discuss the various management strategies for prevention of this postoperative complication so as to decrease morbidity and mortality. The various search engines for preparation of this manuscript were used which included Entrez (including Pubmed and Pubmed Central), NIH.gov, Medknow.com, Medscape.com, WebMD.com, Scopus, Science Direct, MedHelp.org, yahoo.com and google.com. Manual search was carried out and various text books and journals of anesthesia and critical care medicine were also searched. From the information gathered, it was observed that postoperative cardiogenic pulmonary edema in patients with serious cardiovascular diseases is most common followed by noncardiogenic pulmonary edema which can be due to fluid overload in the postoperative period or it can be negative pressure pulmonary edema (NPPE). NPPE is an important clinical entity in immediate post-extubation period and occurs due to acute upper airway obstruction and creation of acute negative intrathoracic pressure. NPPE carries a good prognosis if promptly diagnosed and appropriately treated with or without mechanical ventilation. PMID:23439791

  7. [Post-operative pain therapy of a chronic pain patient].

    PubMed

    Pawlik, Michael T; Ittner, Karl Peter

    2006-11-01

    Post-operative pain therapy of chronic pain patients poses a challenge. Here we report the perioperative management of a 39-year-old male under chronic therapy with oxycodon, gabapentin and tolperison. Particular the pharmacointeractions regarding premedication and postoperative dose finding of opioids with intravenous PCIA are discussed. PMID:17151986

  8. Welt und Wirkungsprinzip (2nd Aufl.)

    NASA Astrophysics Data System (ADS)

    Landgraf, Werner

    2010-03-01

    Modell einer kausalen Bewirkung der Welt, und logische, geometrische, physikalische Interprätation dieser Kausalmenge und Fortwirkung der frühsten ihrer sukzessiv als echt Neues bewirkten und durch Vorhandenes oder Späteres nicht darstellbaren oder widerrufbaren Ereignisse als Dimensionen und sie verkörpernde primäre Naturkräfte, mit Korrespondenz zur beobachteten Welt und ihrer grundlegendsten Eigenschaften. Wirklich ist nur was wirkt, wo und wie. Entsprechend ist im Bogenelement statt der Eigenzeit die variante Anzahl Wirkungen relevant, 0 ? 1/h2 dS2 - 1/tpl2 (dt2 - 1/c2 {dq12 + G02/G2 [dq2,32 - ...]}) mit G0 = c4lpl/Epl ? G. Die heutigen Dimensionen und Naturkräfte entstanden in dieser Reihenfolge, haben 'komplementäre' aber gleichwertige statische und dynamische Aspekte, entsprechend ihren Termen in Bogenelement bzw. Vierervektor, aus derem Vergleich sowie mit denen ihrer Nachbarn folgen Grundgleichungen bzw. Erhaltungssätze. Jeweils individuelle Eigenschaften wie ihre Naturkonstante konkretisieren sie und tragen zu gattungsmäßigen wie globale Affinität und Äquivalenzen bei. Ältestes Gebiet oder räumlicher Rand jeder Dimension sind die ersten vom Vorgänger bewirkten Ereignisse, selbst raumzeitlicher Ursprung des Nachfolgers, dort einmalig und ewig maximal rotverschoben fortwirkend und nicht lokalisierbar, um neue Elementareinheiten verschieden und lichtartig mit deren Verhältnis oder dem ihrer globalen Zustandsgrößen als konstanten Anfangsimpuls, Expansion, Längen- oder Ereignisdichte zueinander. Der Übergang vom diskreten Modell weniger Informationen zum Kontinuum und die Korrespondenz zur Physik ist problemlos, Details wie ein kontinuierlicher, abrupter oder ganz fehlender Abfall der Metrik beim ältesten Gebiet sind aber nur durch Beobachtungen entscheidbar. Erörtert werden allgemeine und individuelle Eigenschaften und ihre Konsequenzen der Dimensionen mit ihren Kräften, selbst und im Verhältnis zueinander, etwa ihrer begrenzten Reichweite. Bei Fakten und ihrer Wirkung etwa: Autonomie und Priorität von Selbstwahrnehmung und Eigensystem; etwaige Wahrnehmung durch einen Beobachter und wie sie ihm seinen Kontakt zum Objekt und dessen Darstellbarkeit in seinem Raum wiederspiegelt oder ändert, als nur für ihn relevant; in dessen Dimensionen sichtbare geometrische Bedingungen wegen diskreter Wirkung, oder logische Effekte bei Objekten kleinster Informationsmengen mit unzureichender Lokalisierbarkeit oder ihrer inadäquaten Betrachtung oder Bestimmung dort. Geboten sind genauere Untersuchungen zu Informationsgehalt, Wirkung, deren Reichweite und Gültigkeit bei einzelnen Photonen, mit Emission und durch direkt benachbart hinzukommende Absorption beendetem ereignisartigen Eigensystem, aber für materielle Beobachter unserer Welt und ihre Dimensionen zur vollständigen Lokalisierbarkeit zuwenigen wirksamen Informationen, was dort außer makroskopisch relevanten Projektionen auf Raum und Zeit sowie Lichtartigkeit auch mikroskopisch zwischenliegende Ereignisse wie Wechselwirkung in Medien oder Beugung und Retadierung oder Welleneigenschaften mit Richtungsänderung ganzzahliger Elementar- oder Wellenlängen, mit jeweiliger Kompensation im Bogen; Nichtlokalität; Unschärfen bei Bestimmung komplementärer also auf identischen Information beruhender Größen; und andere Effekte hervorruft. Voran stehen Erfahrungen zur notwendigen Bewirkung von Neuem durch alles Existente als nicht-materielle funktionelle Qualität seiner Individuation und Konkretisierung, und daher Ereignissen und Wirkung als primäre direkt etwas produzierende Naturkraft und Geometrie. Nachgefügt wurde noch eine Gegenüberstellung des Modelles mit kosmogonischen Aussagen der Offenbarungen (nur 2. Auflage).

  9. Physik gestern und heute Das Eiskalorimeter

    NASA Astrophysics Data System (ADS)

    Heering, P.

    2003-07-01

    Kalorimetrische Messungen gehören heute zum experimentellen Standardrepertoire im Bereich der Thermodynamik und der physikalischen Chemie. Das erste Gerät für derartige Messungen entwickelten Ende des 18. Jahrhunderts die französischen Wissenschaftler Antoine Laurent Lavoisier und Pierre Simon de Laplace.

  10. Ressourceneinsatzplanung In der Energie- und Verfahrenstechnik

    NASA Astrophysics Data System (ADS)

    Engell, Sebastian; Handschin, Edmund; Rehtanz, Christian; Schultz, Rüdiger

    Der ökologisch nachhaltige, wirtschaftlich effiziente und politisch faire Umgang mit den Ressourcen der Erde ist eine der größten Herausforderungen an die Menschheit im 21. Jahrhundert und impliziert Paradigmenwechsel in allen Bereichen des gesellschaftlichen Lebens. Energie- und Verfahrenstechnik sind traditionell Bereiche, in denen der optimale Umgang mit kostbaren und beschränkt verfügbaren Ressourcen von erstrangiger Bedeutung ist. Zur Lösung der damit verbundenen komplexen Entscheidungsprobleme sind mathematische Methoden schon seit längerem im Einsatz. Hierbei können aber noch längst nicht alle bislang aufgetretenen Probleme fundiert angegangen werden. Der wachsende wirtschaftliche und ökologische Druck auf die Effizienz der Produktions-und Versorgungssysteme sowie stärkere Schwankungen von Angebot und Nachfrage führen zu neuen Herausforderungen, für die neue mathematische Methoden und Algorithmen entwickelt werden müssen.

  11. Post-Operative Psychosocial Predictors of Outcome in Bariatric Surgery

    PubMed Central

    Sheets, Carrie S.; Peat, Christine M.; Berg, Kelly C.; White, Emily K.; Bocchieri-Ricciardi, Lindsey; Chen, Eunice Y.; Mitchell, James E.

    2015-01-01

    Although there are several recent reviews of the pre-operative factors that influence treatment outcome for bariatric surgery, commensurate efforts to identify and review the predictive validity of post-operative variables are lacking. This review describes the post-operative psychosocial predictors of weight loss in bariatric surgery. Results suggest empirical support for post-operative binge eating, uncontrolled eating/grazing, and presence of a depressive disorder as negative predictors of weight loss outcomes; whereas, adherence to dietary and physical activity guidelines emerged as positive predictors of weight loss. With the exception of depression, psychological comorbidities were not consistently associated with weight loss outcomes. Results highlight the need for post-operative assessment of disordered eating and depressive disorder, further research on the predictive value of post-operative psychosocial factors, and development of targeted interventions. PMID:25381119

  12. Villafranca Die Kabinete und die Revolutionen.

    E-print Network

    Wagner, Stephan

    Villafranca oder Die Kabinete und die Revolutionen. von Sir John Retcliffe (Verfasser des Romans (Nachtrag zu »Magenta und Solferino.«) Dritter Abschnitt. Ein Provisorium! DIE VILLA AM SEE. Die Folge der Schlacht bei Magenta war die völlige Räumung der Lombardei und das Zurückgehen der österreichischen Armee

  13. FAUST: Entwicklung von Fahrerassistenz- und autonomen Systemen

    NASA Astrophysics Data System (ADS)

    Pareigis, Stephan; Schwarz, Bernd; Korf, Franz

    Der Beitrag beschreibt ein Ausbildungs- und Entwicklungsprojekt am Department Informatik der Hochschule für Angewandte Wissenschaften (HAW) Hamburg. Auf verschiedenen Fahrzeugplattformen werden Fahrerassistenz- und autonome Systeme entwickelt. Die zu erarbeitenden Inhalte umfassen die Themen verteilte Echtzeitsysteme, Sensordatenverarbeitung und Bildverarbeitung. Aus didaktischer Sicht wird durch die geforderte Teamarbeit ein hohes Motivationspotential der Studierenden erreicht, durch das neben den technologischen Kenntnissen auch Softskills vermittelt werden.

  14. Organe und Gremien Organe der Stiftung

    E-print Network

    Organe und Gremien Organe der Stiftung und weitere Gremien Verwaltungsrat Vertreter der Juli 1999) Prof. Dr. B. H. Wiik (Vorsitzender) (verstorben am 26. Februar 1999) 13 #12;Organe und Organization for Particle Physics CERN, Genf (CH) Prof. Dr. V. Metag Gesellschaft für Schwerionenforschung GSI

  15. Anfrageoptimierung in Volcano und Bjorn Scheuermann

    E-print Network

    Mannheim, Universität

    Anfrageoptimierung in Volcano und Cascades Bj¨orn Scheuermann Vortrag im Rahmen des Seminars Datenbanken, WS 03/04 Anfrageoptimierung in Volcano und Cascades ­ p.1/23 #12;Zielsetzung Entwicklung von ¨angig von konkretem Datenmodell Anfrageoptimierung in Volcano und Cascades ­ p.2/23 #12;Volcano

  16. Mol-Gastronomie Von Kristallen und Zellwänden

    NASA Astrophysics Data System (ADS)

    Vilgis, Thomas A.

    2004-05-01

    Erdbeerzeit! Die leuchtend roten und saftigen Früchte verführen zum heftigsten Naschen, und die zu kurze Saison der Vitaminbomben wirft immer wieder die Frage auf, ob dieser Genuss durch moderne Technik verlängert werden kann. Der Versuch, Erdbeeren als ganze Früchte einzufrieren und diese aus der Kühltruhe in alter Frische hervorzuzaubern ist zwar bestechend, aber zum Scheitern verurteilt.

  17. Die Entwicklung vor Leibniz und Newton

    E-print Network

    Nejdl, Wolfgang

    Professor in Cam- bridge und dort Lehrer von 46 Seite an Seite blicken Isaac Newton und Gottfried WilhelmDie Entwicklung vor Leibniz und Newton Einige Fragen, die wir heute der Infinitesimalrechung zu verfolgten. So wusste etwa Fermat schon vor 1640, wie man die Funktion xn integriert. In Isaac Barrows Buch

  18. Kosmologie und Teilchenphysik.

    NASA Astrophysics Data System (ADS)

    Appenzeller, I.

    This book is a selection of 17 articles published in the journal "Spektrum der Wissenschaft". The original English versions of the papers were first published in "Scientific American". Contents: 1. Einführung (I. Appenzeller). 2. Sehr große Strukturen im Universum (J. O. Burns). 3. Die großräumigen Eigenbewegungen der Galaxien (A. Dressler). 4. Dunkle Materie im Universum (L. M. Krauss). 5. Der doppelte Beta-Zerfall (M. K. Moe, S. P. Rosen). 6. Quark-Lepton Familien (D. B. Cline). 7. Beschleunigerexperimente testen kosmologische Theorien (D. N. Schramm, G. Steigman). 8. Das Rätsel der kosmologischen Konstanten (L. Abbott). 9. Das Higgs-Boson (M. J. G. Veltman). 10. Die Suche nach dem Protonenzerfall (J. M. LoSecco, F. Reines, D. Sinclair). 11. Das inflationäre Universum (A. H. Guth, P. J. Steinhardt). 12. Die fünfte Dimension (E. Schmutzer). 13. Die verborgenen Dimensionen der Raumzeit (D. Z. Freedman, P. van Nieuwenhuizen). 14. Ist die Natur supersymmetrisch? (H. E. Haber, G. L. Kane). 15. Schwerkraft und Antimaterie (T. Goldman, R. J. Hughes, M. M. Nieto). 16. Superstrings (M. B. Green). 17. Kosmische Strings (A. Vilenkin).

  19. Postoperative thrombocytosis: An unusual case report.

    PubMed

    Madaan, Garima Baweja; Jairajpuri, Zeeba S; Hajini, Farooq F; Jetley, Sujata

    2015-01-01

    Thrombocytosis is often an incidental finding seen in 35-50% of cases and the cause determination creates a diagnostic challenge. Extreme thrombocytosis is rare and seen in 2-5.8% patients only. Among the various causes of increased platelet count, surgical procedures have attracted much attention in both experimental and clinical domain. The appearance of thrombocytosis after surgery needs to be diagnosed to establish the type of thrombocytosis (clonal or reactive), as treatment and prognosis are quite different between them. This case report is vital because of two reasons: First, the increase in platelet count is difficult to rationalize than many of the other thrombocytoses, such as those related to primary augmentation of the function of the bone marrow; second, the association of platelets with the clotting process has led to the belief that their increase after a surgical procedure is connected with the occurrence of postoperative thrombosis. This case presents an interesting finding from a patient who has undergone major abdominal surgery and has shown an unexpected perpetual increase in platelet count. PMID:26539380

  20. Pterygia: Single-fraction postoperative beta irradiation

    SciTech Connect

    Beyer, D.C. )

    1991-02-01

    A retrospective evaluation was performed with records of 128 patients with 146 eyes that underwent applications of strontium-90 after pterygium excisions performed between 1982 and 1988. With a median follow-up of 13 months, 135 eyes were evaluable. Most pterygia (127 of 135) were treated with a single postoperative application of Sr-90 that delivered 3,000 cGy of beta radiation in one fraction. The actuarial freedom from relapse was 87%; all recurrences occurred within the first 18 months, and 46% of these within the first 3 months. Of the 13 recurrences, 10 have been re-treated with surgery and a second course of beta irradiation with excellent results. All eight eyes for which follow-up was available had no evidence of disease. The ultimate control rate was 96.3% for the series. Correlation of various treatment parameters, including age, bilaterality, prior recurrence, and interval from surgery to irradiation, was performed, and no statistically significant difference was seen. No serious complications have developed. Transient conjunctivitis and photophobia were almost universally seen, with five cases lasting beyond 5 months. The authors conclude that a single application of Sr-90 after surgery is effective and safe in managing pterygia.

  1. Bile reflux in postoperative alkaline reflux gastritis.

    PubMed

    Cabrol, J; Navarro, X; Sancho, J; Simo-Deu, J; Segura, R

    1990-02-01

    This study evaluates enterogastric reflux (EGR) levels in patients with and without symptoms of postoperative alkaline reflux gastritis (PARG) after gastric surgery. The bile acids (BA) present in the gastric juice were quantified by thin-layer chromatography and spectrofluorometry. The mean BA concentration for controls was 2.25 mumol reflux/hour, for 15 asymptomatic patients 47.94 and for 15 patients with symptoms of PARG 125.79. After biliary diversion by a Roux-en-Y anastomosis in the latter, their BA in 13 of these patients after surgery, and relapsed in only one during a 4-year follow-up. The remaining two patients had the lowest preoperative BA levels in this group. These results indicate that EGR is increased after gastric surgery more markedly indicated that EGR is increased after gastric surgery more markedly in patients with symptoms of PARG, and that patients who have high levels of EGR (more than 80 mumol BA reflux/hour) clearly benefit from biliary diversion. PMID:2302001

  2. The spectrum of postoperative scleral necrosis.

    PubMed

    Doshi, Rishi R; Harocopos, George J; Schwab, Ivan R; Cunningham, Emmett T

    2013-01-01

    An otherwise healthy 62-year-old woman developed necrotizing scleritis 23 years following pterygium excision with adjunctive beta-radiation. Surgically induced necrotizing scleritis (SINS) was diagnosed, but the scleritis progressed despite anti-inflammatory therapy, and 10 weeks after presentation the patient developed a hypopyon and decreased vision. After cultures revealed no growth at 72 hours, immunosuppressive therapy was escalated, with a subsequent deterioration in the patient's clinical course. Scedosporium superinfection was eventually cultured and found on histological examination of the enucleated globe. In reported cases, infectious scleral necrosis occurs most commonly following pterygium (71.4%) and scleral buckling (97.2%) surgery. Hypopyon is uncommon (10.0%) in patients with postoperative scleral necrosis, but when present is a strong predictor of infection (odds ratio, 21.2; 95% confidence interval, 2.9-157.5). Rates of underlying autoimmune disease are generally low (0.0-12.5%) except following cataract and lens procedures, where the occurence of SINS heralds systemic illness in 42.9% of cases. PMID:23410842

  3. Bile reflux in postoperative alkaline reflux gastritis.

    PubMed Central

    Cabrol, J; Navarro, X; Sancho, J; Simo-Deu, J; Segura, R

    1990-01-01

    This study evaluates enterogastric reflux (EGR) levels in patients with and without symptoms of postoperative alkaline reflux gastritis (PARG) after gastric surgery. The bile acids (BA) present in the gastric juice were quantified by thin-layer chromatography and spectrofluorometry. The mean BA concentration for controls was 2.25 mumol reflux/hour, for 15 asymptomatic patients 47.94 and for 15 patients with symptoms of PARG 125.79. After biliary diversion by a Roux-en-Y anastomosis in the latter, their BA in 13 of these patients after surgery, and relapsed in only one during a 4-year follow-up. The remaining two patients had the lowest preoperative BA levels in this group. These results indicate that EGR is increased after gastric surgery more markedly indicated that EGR is increased after gastric surgery more markedly in patients with symptoms of PARG, and that patients who have high levels of EGR (more than 80 mumol BA reflux/hour) clearly benefit from biliary diversion. PMID:2302001

  4. [Patient-controlled analgesia and postoperative pain].

    PubMed

    Langlade, A; Briard, C; Bouguet, D; Blanchard, F; Conan, F

    1994-01-01

    Patient controlled analgesia improves titration of analgesic drugs, minimizing individual pharmacodynamic differences between patients, during the postoperative period. We describe the efficacy and the safety of intravenous PCA, based on the follow-up of 300 patients, recovering from upper and lower abdominal surgery. Successful use of PCA requires the choice of two important parameters: the PCA bolus and the lock-out period. In our experience, we only prescribed morphine, with a PCA bolus of 0.5 or 1 mg and a lock-out period of 5 or 10 minutes. Nurses were educated to change the syringes and to assess analgesia and the respiratory function. Patients were mostly hospitalized in surgical wards and only 16% of patients were treated in an intensive care unit. Patient's acceptance proved to be excellent and only 4 patients were not satisfied with PCA therapy. The incidence of respiratory depression was low (0.02%) and only one patient required naloxone. The side effects were dysphoria, nausea, pruritus and urinary retention; their incidence was low. PMID:8087635

  5. Grundlagen der Nieren- und Leberdialyse

    NASA Astrophysics Data System (ADS)

    Schreiber, Christian; Al-Chalabi, Ahmed N. Ar.; Tanase, Oana; Kreymann, Bernhard

    Die Dialyse ist ein künstliches Blutreinigungsverfahren, das sowohl mit der Nachahmung physiologischer Vorgänge als auch mit der Benutzung bestimmter physikalisch- chemischer Gesetze arbeitet. Ihre technische Umsetzung in einer Dialysemaschine sowie chirurgische und internistische Interventionen gehören zu dem Zusammenspiel unterschiedlicher Disziplinen, die eine Dialyse ermöglichen. Die Grundlagen des Dialyseverfahrens, die Maschine und die Unterschiede von Nieren- und Leberdialyse sollen im Folgenden erklärt werden. Heute besteht in der Bundesrepublik Deutschland bei ca. 55.000 Patienten ein chronisch dialysepflichtiges Nierenversagen (Stand 2005). Das Leben dieser Patienten kann mit der Dialyse um Jahrzehnte verlängert werden. Damit ist die Nierendialyse eines der erfolgreichsten medizintechnischen Verfahren. Bei der Leberdialyse sind ebenbürtige Erfolge noch nicht erzielt worden. Umso wichtiger ist es, hier neue Wege zu finden, um auch für Leberpatienten ein effizientes Dialyseverfahren zu etablieren.

  6. Postoperative Therapy for Chronic Thumb Carpometacarpal (CMC) Joint Dislocation.

    PubMed

    Wollstein, Ronit; Michael, Dafna; Harel, Hani

    2016-01-01

    Surgical arthroplasty of thumb carpometacarpal (CMC) joint osteoarthritis is commonly performed. Postoperative therapeutic protocols aim to improve range of motion and function of the revised thumb. We describe a case in which the thumb CMC joint had been chronically dislocated before surgery, with shortening of the soft-tissue dynamic and static stabilizers of the joint. The postoperative protocol addressed the soft tissues using splinting and exercises aimed at lengthening and strengthening these structures, with good results. It may be beneficial to evaluate soft-tissue tension and the pattern of thumb use after surgery for thumb CMC joint osteoarthritis to improve postoperative functional results. PMID:26709434

  7. Remote Postoperative Epidural Hematoma after Brain Tumor Surgery

    PubMed Central

    Chung, Ho-Jung; Park, Jae-Sung; Jeun, Sin-Soo

    2015-01-01

    A postoperative epidural hematoma (EDH) is a serious and embarrassing complication, which usually occurs at the site of operation after intracranial surgery. However, remote EDH is relatively rare. We report three cases of remote EDH after brain tumor surgery. All three cases seemed to have different causes of remote postoperative EDH; however, all patients were managed promptly and showed excellent outcomes. Although the exact mechanism of remote postoperative EDH is unknown, surgeons should be cautious of the speed of lowering intracranial pressure and implement basic procedures to prevent this hazardous complication of brain tumor surgery. PMID:26605271

  8. Strahlen-und kinetische Waffen: Neue Waffentechniken und Rüstungskontrolle

    NASA Astrophysics Data System (ADS)

    Neuneck, Götz

    Laserstrahlen, Mikrowellen oder elektromagnetische Beschleuniger lassen sich nicht nur für zivile, sondern für militärische Zwecke einsetzen. Die Aufgabe einer vorbeugenden Rüstungskontrolle wäre es, diese wie andere künftige Waffentechnologien auf ihren destabilisierenden Charakter hin zu untersuchen und ihre Stationierung zu beschränken oder zu verhindern.

  9. Synthese und Charakterisierung neuer Nickel-und Eisenkomplexe als Modelle

    E-print Network

    Osterloh, Frank

    (II) complexes bound to an [Fe4S4] cluster via bridging thiolates: synthesis and crystal structures, Chem. Commun., 1996, 777-778. Unidentate and Bidentate Binding of Nickel(II) Complexes to an Fe4S4: Übergangsmetalle in der Biologie und ihre Koordinationschemie": Funktionalisierung von Fe4S4-Clustern, Bosen

  10. Lineare und verzweigte Blockcopolymere aus Polypeptiden und synthetischen Polymeren

    NASA Astrophysics Data System (ADS)

    Kukula, Hildegard

    2001-07-01

    Die vorliegende Arbeit beschäftigt sich mit der Synthese und den Eigenschaften von linearen und verzweigten amphiphilen Polypeptid-Blockcopolymeren. Die Frage nach dem Einfluss der Topologie und Konformation der Blockcopolymere auf die supramolekularen und kolloidalen Eigenschaften bildete einen wichtigen Aspekt bei den Untersuchungen. Die Blockcopolymere wurden nach einem mehrstufigen Reaktionsschema durch Kombination von anionischer und ringöffnender Polymerisation von Aminosäuren-N-Carboxyanhydriden (NCA) synthetisiert. Die Untersuchung der Polypeptid-Blockcopolymere hinsichtlich ihres Aggregationsverhaltens in fester Phase sowie in verdünnter wässriger Lösung erfolgte mittels Streumethoden (SAXS, WAXS, DLS) sowie abbildender Methoden (TEM). Durch Einsatz der Blockcopolymere als polymere Stabilisatoren in der Emulsionspolymerisation wurden Oberflächen funktionalisierte Latizes erhalten. Als Beispiel für eine pharmazeutische Anwendung wurden bioverträgliche Polypeptid-Blockcopolymere als Wirkstoff-Trägersysteme in der Krebstherapie eingesetzt. This work describes the synthesis and characterization of linear and branched polypeptide block copolymers having amphiphilic character. The studies focused on the impact of the block copolymers' conformation and architecture on the supramolecular and colloidal properties. The polypeptide block copolymers were prepared in a multi-step process involving the anionic synthesis of (poly)amino-functional polymers (polystyrene and polybutadiene) which where used as macroinitiators for the ring-opening polymerization of N-carboxyanhydrides (NCA) of protected a-aminoacids. Supramolecular structures of the block copolymers in the solid state as well as in diluted aqueous solution were investigated using scattering (SAXS, WAXS, DLS) and microscopic (TEM) methods. Both linear and branched polypeptide block copolymers were used as polymeric stabilizers in the emulsion polymerization of styrene to yield polypeptide-decorated latexes. Biocompatible block copolymers were used as drug-delivery systems in lymphatic cancer therapy.

  11. Incidence of Postoperative Ptosis Following Trabeculectomy With Mitomycin C

    PubMed Central

    Naruo-Tsuchisaka, Asako; Arimoto, Go; Goto, Hiroshi

    2015-01-01

    Purpose: To prospectively investigate the incidence of postoperative ptosis following trabeculectomy by comparing preoperative and postoperative margin reflex distance (MRD), and to analyze the clinical factors associated with ptosis. Patients and Methods: Patients who underwent trabeculectomy with mitomycin C in unilateral eye between 2010 and 2012 were enrolled. MRD was measured before and 3 and 6 months after trabeculectomy. The MRD is the distance between the light reflex at central cornea and the upper eyelid margin when the patient gazed at a pen light placed 50 cm away straightly. Postoperative ptosis was defined as a decrease in MRD?2 mm from preoperative level. The correlation among ?MRD (difference between preoperative and 6 mo postoperative MRD) and clinical factors comprising age, spherical equivalent, preoperative MRD, 6-month postoperative intraocular pressure (IOP), and IOP reduction (difference between preoperative and 6 mo postoperative IOP) was analyzed. Results: Thirty-six patients (36 eyes) were analyzed. Preoperative median MRD was not different between the operated eye and nonoperated fellow eye (both 4.0 mm, P=0.65). The 3- and 6-month postoperative MRD in the operated eye were significantly reduced compared with preoperative MRD (3.0 mm, P=0.04 and 2.5 mm, P=0.01, respectively). The 3- and 6-month postoperative MRD in the nonoperated eye were not different from preoperative MRD (4.0 mm, P=0.81 and 4.0 mm, P=0.85, respectively). The incidence of ptosis at 6 months after operation was 19% (7 of 36 eyes). The IOP was significantly decreased at 3 and 6 months after operation (both P<0.01). No correlation was observed between ?MRD and all the factors analyzed. Conclusions: Ptosis is a major complication following trabeculectomy with mitomycin C, with an incidence of 19% at 6 months after operation. PMID:25318575

  12. Comparison of methods to facilitate postoperative bowel function.

    PubMed

    Crainic, Christina; Erickson, Kathie; Gardner, Janet; Haberman, Sheri; Patten, Pam; Thomas, Pat; Hays, Victoria

    2009-01-01

    Improving postoperative return of bowel function after abdominal surgery is an important nursing and medical goal. One promising intervention to achieve this goal is to have patients chew gum several times per day in the early postoperative period to stimulate the cephalic-vagal reflex and bowel peristalsis. A study to determine if return of gastrointestinal function after abdominal surgery could be hastened by the simple intervention of chewing gum or sucking on hard candy three times per day is described. PMID:20552850

  13. Predicting postoperative total calcium requirements after parathyroidectomy in secondary hyperparathyroidism

    PubMed Central

    Kang, Byung Heon; Hwang, Soon Young; Kim, Jeong Yeop; Hong, Yu Ah; Jung, Mi Yeon; Lee, Eun Ah; Lee, Ji Eun; Lee, Jae Bok; Ko, Gang Jee; Pyo, Heui Jung; Kwon, Young Joo

    2015-01-01

    Background/Aims: To prevent hypocalcemia after parathyroidectomy (PTX), parenteral calcium is required in addition to oral calcitriol and calcium. After switching to oral calcium, patients can be discharged from the hospital. The aim of this study was to analyze the clinical characteristics and outcomes of PTX performed at a single Korean center and to investigate the associated laboratory factors used to analyze the total amount of postoperative calcium required. Methods: We enrolled 91 hemodialysis patients undergoing PTX from November 2003 to December 2011. We collected clinical and laboratory data preoperatively, 12 and 48 hours postoperatively, at discharge, and 3 and 6 months postoperatively. Results: In total, 59 patients underwent PTX with autotransplantation (AT), 6 underwent total PTX without AT, 11 underwent subtotal PTX, and 15 underwent limited PTX. Total PTX without AT showed the lowest recurrence rate. At all postoperative time points, the mean levels of serum calcium, phosphorus, and intact parathyroid hormone (iPTH) decreased significantly, compared with preoperative levels; however, alkaline phosphatase (ALP) increased significantly from 48 hours postoperatively to discharge (p < 0.001). On multiple linear regression analysis, the total amount of injected calcium during hospitalization showed a significant correlation with preoperative ALP (p < 0.001), preoperative iPTH (p = 0.037), and ?phosphorus at 48 hours (p < 0.001). We developed an equation for estimating the total calcium requirement after PTX. Conclusions: Preoperative ALP, preoperative iPTH, and ?phosphorus at 48 hours may be significant factors in estimating the postoperative calcium requirement. The formula for postoperative calcium requirement after PTX may help to predict the duration of postoperative hospitalization. PMID:26552461

  14. Wiki und die schnelle Lehre

    E-print Network

    Pfeifer, Holger

    Wiki und die schnelle Lehre Hochschulen debattieren über Open Educational Resources 28 DEUTSCHE UNIVERSITÄTS ZEITUNG 11 23.10.2015 | EUR 7,90 Offensive Schluss mit dem Technikwahn. Ein Plädoyer für die Skepsis der Geisteswissenschaftler 20 Bauchlandung Die neue Bildungsstrategie in Frankreich formuliert

  15. Schmerzen und Schmerztherapie in der Dermatologie.

    PubMed

    Beiteke, Ulrike; Bigge, Stefan; Reichenberger, Christina; Gralow, Ingrid

    2015-10-01

    Eine Prävalenzrate von 23 Millionen Deutschen mit chronischen Schmerzen ist anzunehmen. In einer aktuellen Erhebung waren 30 % der chronischen Schmerzpatienten mit ihrer Schmerztherapie nicht zufrieden. Des Weiteren leiden fünf Millionen Deutsche an neuropathischen Schmerzen, wovon 20 % nicht ausreichend therapiert sind. Schmerz ist auch ein Symptom vieler dermatologischer Krankheitsbilder. Die zumeist somatischen Schmerzen sind vielfach als milde Schmerzen einzustufen. Eine zunehmende Forschung zur Lebensqualität zeigt jedoch eine deutliche Beeinträchtigung der Lebensqualität durch moderate Schmerzen, u.a. bei Psoriasis vulgaris et arthropathica. Starke Schmerzen treten bei Herpes zoster, Ulcus cruris und Pyoderma gangraenosum auf. Als Grundlagen werden Schmerzklassifikation und im kurzen Exzerpt Schmerzleitung und -modulation dargestellt. Der Einsatz standardisierter Skalen zur Erhebung und Verlaufsbeobachtung der Schmerzstärke wird empfohlen, um Therapieoptimierungen zu gewährleisten und interdisziplinär auf gleicher Basis zu kommunizieren. Die Weiterbildung in der Dermatologie sieht den Erwerb von Kenntnissen, Erfahrungen und Fertigkeiten in der allgemeinen Schmerztherapie vor. Bezogen darauf werden grundlegende Behandlungskonzepte in Anlehnung an das erweiterte WHO-Schema, ein stufenweises Vorgehen sowie Kombinationstherapien dargestellt. Der Fokus dieser Arbeit liegt auf der Schmerztherapie o. g. konservativ zu behandelnder stark schmerzhafter Dermatosen. Neben gängigen Therapeutika und aktuellen Therapiestandards werden, soweit vorhanden, leitlinienbasiert spezifische Optionen erörtert. Der Wissensstand zum peri- und postoperativen Schmerzmanagement wird kurz umrissen. Dieser Artikel vermittelt: ? Grundlagen zur Klassifikation und Neurophysiologie von Schmerzen, ? Standards für die Schmerzdokumentation bei Kindern und Erwachsenen, ? allgemeine Standards für eine medikamentöse Schmerztherapie, ? aktuelle spezifische Therapieoptionen für Zosterneuralgie, Ulcus cruris, Pyoderma gangraenosum im Zusammenhang mit dem erweiterten WHO-Schema. PMID:26408456

  16. ATK4 -Computer-und Mediensicherheit FHS Hagenberg

    E-print Network

    )man in the middle" t¨auschen k¨onnte. Berechnen Sie dazu alle Nachrichten, die Eve erzeugen und verschicken muss und Sie wieder alle versandten Nachrichten und den gemeinsamen Schl¨ussel. (6) Berechnen Sie den diskreten

  17. ATK4 -Computer-und Mediensicherheit FHS Hagenberg

    E-print Network

    unterschiedlichen Nachrichten m1 und m2 vom gleichen Sender. Die Parameter p = 6238469 und g = 2431 sind (als Teil des public-key) bekannt. Die beiden Nachrichten m1 und m2 sind ebenfalls bekannt, somit auch ihre

  18. Fakultt Elektrotechnik und Informationstechnik Prof. Steinbach / Heike Roth

    E-print Network

    Kuehnlenz, Kolja

    Fakultät Elektrotechnik und Informationstechnik Prof. Steinbach / Heike Roth Infoveranstaltung der Hörsaal 0602 #12;Fakultät Elektrotechnik und Informationstechnik Prof. Steinbach / Heike Roth 2 · Ansprechpartner · Links Übersicht #12;Fakultät Elektrotechnik und Informationstechnik Prof. Steinbach / Heike Roth

  19. Klinik fr Psychosomatik und Psychotherapie PD Dr. Peter Angerer

    E-print Network

    Manstein, Dietmar J.

    Klinik für Psychosomatik und Psychotherapie 6.11.2008 PD Dr. Peter Angerer Dr. Mechthild Heinmüller. Harald Gündel Medizinische Hochschule Hannover Klinik für Psychosomatik und Psychotherapie Dr. Heribert, Psychotherapie und Medizinische Psychologie Betriebliche Gesundheitsförderung am Beispiel der Studie: Prävention

  20. Zweite Satzung zur nderung der Studien-und Prfungsordnung der Universitt Stuttgart fr die Masterstudiengnge Energietechnik; Fahrzeug-und Motorentechnik;

    E-print Network

    Reyle, Uwe

    ; Verfahrenstechnik und Medizintechnik Vom 08. August 2014 Aufgrund von §§ 19 Abs. 1 Nr. 9 und 32 Abs. 3 Satz 1 des; Mechatronik; Technische Kybernetik; Technologiemanagement; Verfahrenstechnik und Medizintechnik vom 24. August

  1. fr die Verarbeitung personenbezogener Daten von Studienbewerberinnen und Studienbewerbern und von Mitgliedern sowie

    E-print Network

    Steinhoff, Heinz-Jürgen

    ORDNUNG für die Verarbeitung personenbezogener Daten von Studienbewerberinnen und Studienbewerbern und von Mitgliedern sowie Angehörigen der Universität Osnabrück, die nicht in einem Dienst- oder-Kraft-Treten..................................................................................................................... 8 #12;3 § 1 Allgemeines (1) Die Universität kann von Studienbewerberinnen/ Studienbewerbern und von

  2. S. Phleps LMU SS09: Galaxien und Galaxienhaufen im Universum 1 Galaxien und Galaxienhaufen im Universum

    E-print Network

    Boehringer, Hans

    S. Phleps LMU SS09: Galaxien und Galaxienhaufen im Universum 1 Galaxien und Galaxienhaufen im Universum http://www.xray.mpe.mpg.de/theorie/cluster/SS09/Lecture.html Stefanie Phleps, MPE Tel: 30000 Galaxien und Galaxienhaufen 12.Entwicklung der Population von Galaxienhaufen II LMU SS 2009 #12;S. Phleps

  3. S. Phleps LMU SS09: Galaxien und Galaxienhaufen im Universum 1 Galaxien und Galaxienhaufen im Universum

    E-print Network

    Boehringer, Hans

    S. Phleps LMU SS09: Galaxien und Galaxienhaufen im Universum 1 Galaxien und Galaxienhaufen im Universum http://www.xray.mpe.mpg.de/theorie/cluster/SS09/Lecture.html Stefanie Phleps, MPE Tel: 30000 Galaxien und Galaxienhaufen 12. Entwicklung der Population von Galaxienhaufen II LMU SS 2009 #12;S. Phleps

  4. Aufbau und Anpassung der Motorsteuerungs-Software für Otto- und Dieselmotoren

    NASA Astrophysics Data System (ADS)

    Stuhler, Harald; Ricken, Volker; Diener, René

    Die Erfüllung steigender Kundenansprüche und strenger gesetzlicher Vorgaben hinsichtlich der Verringerung des Kraftstoffverbrauchs, der Reduzierung von Schadstoffemissionen, der Erhöhung von Fahrsicherheit, Fahrleistung und Fahrkomfort ist untrennbar mit dem Einzug elektronischer Systeme in moderne Kraftfahrzeuge verbunden. Die elektronischen Systeme bestimmen zunehmend den Kundennutzen und werden für die Differenzierung der Automobilhersteller untereinander immer wichtiger. Daher sind sie ein wesentlicher Erfolgsfaktor moderner Kraftfahrzeuge.

  5. Preoperative cerebrospinal fluid ?-Amyloid/Tau ratio and postoperative delirium

    PubMed Central

    Xie, Zhongcong; Swain, Celeste A; Ward, Sarah A P; Zheng, Hui; Dong, Yuanlin; Sunder, Neelakantan; Burke, Dennis W; Escobar, Diana; Zhang, Yiying; Marcantonio, Edward R

    2014-01-01

    Objective The neuropathogenesis of postoperative delirium remains unknown. Low cerebrospinal fluid (CSF) ?-amyloid protein (A?) and high CSF Tau levels are associated with Alzheimer's disease. We, therefore, assessed whether lower preoperative CSF A?/Tau ratio was associated with higher incidence and greater severity of postoperative delirium. Methods One hundred and fifty-three participants (71 ± 5 years, 53% men) who had total hip/knee replacement under spinal anesthesia were enrolled. CSF was obtained during initiation of spinal anesthesia. The incidence and severity of postoperative delirium were determined by Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS) on postoperative day 1 and 2. A?40, A?42, and Tau levels in the CSF were measured by enzyme-linked immunosorbent assay. The relationships among these variables were determined, adjusting for age and gender. Results Participants in the lowest quartile of preoperative CSF A?40/Tau and A?42/Tau ratio had higher incidence (32% vs. 17%, P = 0.0482) and greater symptom severity of postoperative delirium (A?40/Tau ratio: 4 vs. 3, P = 0.034; A?42/Tau ratio: 4 vs. 3, P = 0.062, the median of the highest MDAS score) as compared to the combination of the rest of the quartiles. The preoperative CSF A?40/Tau or A?42/Tau ratio was inversely associated with MDAS score (A?40/Tau ratio: ?0.12 ± 0.05, P = 0.014, adj. ?0.12 ± 0.05, P = 0.018; A?42/Tau ratio: ?0.65 ± 0.26, P = 0.013, adj. ?0.62 ± 0.27, P = 0.022). Interpretation Lower CSF A?/Tau ratio could be associated with postoperative delirium, pending confirmation of our preliminary results in further studies. These findings suggest potential roles of A? and/or Tau in postoperative delirium neuropathogenesis. PMID:24860840

  6. A Qualitative Report of Patient Problems and Postoperative Instructions

    PubMed Central

    Atchison, Kathryn A.; Black, Edward E.; Leathers, Richard; Belin, Thomas R.; Abrego, Mirna; Gironda, Melanie W.; Wong, Daniel; Shetty, Vivek; DerMartirosian, Claudia

    2014-01-01

    Purpose While surgery related stress may interfere with the patient's ability to concentrate on instructions, language difficulty or low health literacy may also impede appropriate doctor/patient communication. The purpose of this study is to understand from a sample of minority patients the types of problems encountered during healing and the level of information regarding elements of postoperative instructions they recalled receiving at an inner-city safety net hospital. We initiated a qualitative study to understand the care sequence process and provision of informed consent and postoperative instruction. Methods African American or Latino patients, 18 years of age or older, who had third molars removed under general anesthesia or received treatment for a mandibular fracture were recruited to participate in a focus group to discuss their treatment. Patients described their problem and any informed consent given about treatment risks and benefits and postoperative information they recalled. Results A total of 137 former patients were approached, 57 agreed to participate (42%) and 34 of those (60%) completed the interview. Subjects included 14 females and 20 males. Five categories of patient problems were reported: physical, eating, treatment-related, psychosocial, and other problems. People reported 5 categories of coping strategies: medication use, physical treatments, dietary solutions, rest, and clinical assistance. Twenty people recalled being given informed consent, and 5 participants recalled no elements of informed consent. Overall, 14 participants recalled elements of postoperative instruction. Conclusion Gaps in patient understanding of postoperative care suggest room for improvement in postoperative instructions. Additional research is necessary to design and test high-quality postoperative instructions for surgical treatment and recovery in populations with limited health related literacy. PMID:15789315

  7. Symmetriebrechung und Emergenz in der Kosmologie.

    NASA Astrophysics Data System (ADS)

    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.

  8. PCR und Real-Time PCR

    NASA Astrophysics Data System (ADS)

    Konrad, Regina; Busch, Ulrich

    Die vielfältigen Anwendungsmöglichkeiten der Polymerasekettenreaktion (polymerase chain reaction, PCR) machen sie zu einer der wichtigsten und am häufigsten eingesetzten Methoden in der molekularbiologischen Forschung und Diagnostik. Für diese Technologie wurde der Erfinder der Methode, Kary Mullis, 1993 mit dem Nobelpreis ausgezeichnet. Die PCR erlaubt einen hochsensitiven und spezifischen in-vitro-Nachweis von Desoxyribonukleinsäuren (DNA), da im Zuge der Reaktion Sequenzabschnitte gezielt vermehrt werden. Innerhalb weniger Stunden können aus einem einzigen Zielmolekül 1012 identische Moleküle entstehen [1].

  9. Gekrümmter Raum und verbogene Zeit. Einsteins Vermächtnis.

    NASA Astrophysics Data System (ADS)

    Thorne, K. S.

    This book is a German translation, by D. Gerstner and S. Khan, of the American original "Black holes and time warps. Einstein's outrageous legacy" published in 1994 (see 61.003.008). Contents: 1. Die Relativität von Raum und Zeit. 2. Die Krümmung von Raum und Zeit. 3. Schwarze Löcher werden entdeckt und verworfen. 4. Das Geheimnis der Weißen Zwerge. 5. Der Kollaps ist unvermeidlich. 6. Was folgt nach dem Kollaps? 7. Das goldene Zeitalter. 8. Die Suche. 9. Glückliche Zufälle. 10. Kräuselungen der Raumzeit. 11. Was ist wirklich? 12. Schwarze Löcher verdampfen. 13. Im Innern Schwarzer Löcher. 14. Wurmlöcher und Zeitmaschinen.

  10. Kosmische Katastrophen und der Ursprung der Religion.

    NASA Astrophysics Data System (ADS)

    Hoyle, F.

    This book is a German translation, by V. Delavre, from the English original "The origin of the Universe and the origin of religion", published in 1993. Contents: E. Sens: Die unterbrochene Musikstunde. Einleitung zur deutschen Ausgabe. C. Ryskamp: Einführung. R. N. Anshen: Vorwort. F. Hoyle: Kosmische Katastrophen und der Ursprung der Religion - Die Folgen der Respektabilität; Eiszeiten und Kometen; Die allgemeine Situation in den Nacheiszeiten; Kometen und der Ursprung der Religionen; Der Übergang zu Mittelalter und Neuzeit. Diskussionsbeiträge: Ruth Nanda Anshen, Freeman Dyson, Paul Oscar Kristeller, John Archibald Wheeler, James Schwartz, Roger Shinn, Milton Gatch, Philip Solomon, Norman Newell. F. Hoyle: Schlußwort. A. Tollmann: Nachwort zur deutschen Ausgabe.

  11. Mittelwert- und Arbeitstaktsynchrone Simulation von Dieselmotoren

    NASA Astrophysics Data System (ADS)

    Zahn, Sebastian

    Getrieben durch die immer restriktiveren Anforderungen an das Emissions- und Verbrauchsverhalten moderner Verbrennungsmotoren steigt die Komplexität von Motormanagementsystemen mit jeder Modellgeneration an. Damit geht nicht nur eine Zunahme des Softwareumfangs von Steuergeräten sondern zugleich ein deutlicher Anstieg des Applikations-, Vermessungs- und Testaufwandes einher. Zur Effizienzsteigerung des Software- und Funktionsentwicklungsprozesses haben sich daher in der Automobilindustrie sowie in Forschungsinstituten verschiedene modell- und simulationsbasierte Methoden wie die Model-in-the-Loop (MiL) Simulation, die Software-in-the-Loop (SiL) Simulation, das Rapid Control Prototyping (RCP) sowie die Hardware-in-the-Loop (HiL) Simulation etabliert.

  12. Early Postoperative Pain After Keyless Abdominal Rope-Lifting Surgery

    PubMed Central

    Hüsey?no?lu, Ürfettin; Ç?çek, Melek

    2015-01-01

    Background and Objectives: Keyless abdominal rope-lifting surgery is a novel, gasless, single-incision laparoscopic surgical technique. In this study we aimed to compare the postoperative pain from keyless abdominal rope-lifting surgery with carbon dioxide laparoscopy performed for benign ovarian cysts. Methods: During a 20-month period, 77 women underwent surgery for a benign ovarian cyst. Keyless abdominal rope-lifting surgery and conventional carbon dioxide laparoscopy techniques were used for the operations in 32 women and 45 women, respectively. The 2 operative techniques were compared with regard to demographic characteristics; preoperative, intraoperative, and postoperative data including early postoperative pain scores; and frequency of shoulder pain and analgesic requirements. Results: Data regarding demographic characteristics, preoperative findings, cyst diameters and rupture rates, intra-abdominal adhesions, intraoperative blood loss, and postoperative hospital stay did not differ between groups (P > .05). However, the mean operative and abdominal access times were significantly longer in the keyless abdominal rope-lifting surgery group (P < .05). Visual analog scale pain scores at initially and at the second, fourth, and 24th hours of the postoperative period were significantly lower in the keyless abdominal rope-lifting surgery group (P < .05). Similarly, keyless abdominal rope-lifting surgery caused significantly less shoulder pain and additional analgesic use (P < .05). Conclusion: Keyless abdominal rope-lifting surgery seems to cause less pain in the management of benign ovarian cysts in comparison with conventional carbon dioxide laparoscopy. PMID:25848177

  13. Association of Comorbidities With Postoperative In-Hospital Mortality

    PubMed Central

    Kork, Felix; Balzer, Felix; Krannich, Alexander; Weiss, Björn; Wernecke, Klaus-Dieter; Spies, Claudia

    2015-01-01

    Abstract The purpose of this article is to evaluate the American Society of Anesthesiologists Physical Status (ASA PS) and the Charlson comorbidity index (CCI) for the prediction of postoperative mortality. The ASA PS has been suggested to be equally good as the CCI in predicting postoperative outcome. However, these scores have never been compared in a broad surgical population. We conducted a retrospective cohort study in a German tertiary care university hospital. Predictive accuracy was compared using the area under the receiver-operating characteristic curves (AUROC). In a post hoc approach, a regression model was fitted and cross-validated to estimate the association of comorbidities and intraoperative factors with mortality. This model was used to improve prediction by recalibrating the CCI for surgical patients (sCCIs) and constructing a new surgical mortality score (SMS). The data of 182,886 patients with surgical interventions were analyzed. The CCI was superior to the ASA PS in predicting postoperative mortality (AUROCCCI 0.865 vs AUROCASAPS 0.833, P?postoperative mortality especially well in patients never admitted to an intensive care unit. The newly constructed SMS provides a good estimate of patient's risk of death after surgery. It is capable of identifying those patients at especially high risk and may help reduce postoperative mortality. PMID:25715258

  14. Postoperative sleep disruptions: a potential catalyst of acute pain?

    PubMed

    Chouchou, Florian; Khoury, Samar; Chauny, Jean-Marc; Denis, Ronald; Lavigne, Gilles J

    2014-06-01

    Despite the substantial advances in the understanding of pain mechanisms and management, postoperative pain relief remains an important health care issue. Surgical patients also frequently report postoperative sleep complaints. Major sleep alterations in the postoperative period include sleep fragmentation, reduced total sleep time, and loss of time spent in slow wave and rapid eye movement sleep. Clinical and experimental studies show that sleep disturbances may exacerbate pain, whereas pain and opioid treatments disturb sleep. Surgical stress appears to be a major contributor to both sleep disruptions and altered pain perception. However, pain and the use of opioid analgesics could worsen sleep alterations, whereas sleep disruptions may contribute to intensify pain. Nevertheless, little is known about the relationship between postoperative sleep and pain. Although the sleep-pain interaction has been addressed from both ends, this review focuses on the impact of sleep disruptions on pain perception. A better understanding of the effect of postoperative sleep disruptions on pain perception would help in selecting patients at risk for more severe pain and may facilitate the development of more effective and safer pain management programs. PMID:24074687

  15. Dezocine Prevents Postoperative Hyperalgesia in Patients Undergoing Open Abdominal Surgery

    PubMed Central

    Yu, Fang; Zhou, Jie; Xia, Suyun; Xu, Huan; Wang, Xiangrui

    2015-01-01

    Objective. Postoperative hyperalgesia is very frequent and hard to treat. Dezocine is widely used and has a modulatory effect for thermal hyperalgesia in animal models. So, this study was designed to investigate the potential role of dezocine in decreasing postoperative hyperalgesia for patients undergoing open abdominal surgery. Methods. This is a randomized, double-blinded, and placebo-controlled trial. 50 patients for elective open gastrectomy were randomly allocated to either a true treatment group (0.15?mg/kg intravenous dezocine at the end of surgery) or a sham treatment group (equivalent volume of saline) in a 1?:?1 ratio. Patients were followed up for 48 hours postoperatively and pain threshold to Von Frey filaments, pain scores, PCIA consumption, rescue analgesics use, sedation score, and occurrence of postoperative nausea and vomiting were recorded. Results. Patients in the true treatment group experienced statistically significantly higher pain threshold on forearm and smaller extent of peri-incisional hyperalgesia than the sham treatment group. Rescue analgesic use, cumulative PCIA consumption, and pain scores were statistically significantly decreased in the true treatment group compared to the sham treatment group. Conclusions. Dezocine offers a significant antihyperalgesic and analgesic effect in patients undergoing elective open gastrectomy for up to 48 hours postoperatively. PMID:26170890

  16. Wissen und Handeln der Mathematiker Philosophische Analyse und Betrachtung ihrer Relevanz für die Industrie

    NASA Astrophysics Data System (ADS)

    Riss, Uwe V.; Schmidt, Vasco A.

    Die grundlegende Frage, mit der wir uns im Folgenden beschäftigen wollen, ist, welches die charakteristischen Fähigkeiten von Mathematikern sind und warum diese für die Industrie interessant erscheinen. Allgemein schreibt das Berufe-Lexikon über das Berufsbild des Mathematikers: "Mathematiker befassen sich mit der Entwicklung und Weiterentwicklung mathematischer Formeln, Methoden und Theorien und übertragen diese auf praxisbezogene Fragestellungen aus Naturwissenschaften, Medizin, Ingenieur- oder Wirtschaftswissenschaften. Das Berufsbild des Mathematikers variiert sehr stark in Abhängigkeit vom Einsatzfeld. Die meisten Mathematiker übernehmen eine Lehrtätigkeit an Schulen oder Hochschulen. Weiterhin arbeiten Mathematiker in Wirtschaftsbranchen, die mathematische Grundsätze für ihre Entscheidungsfindung nutzen. Hervorzuheben sind hier insbesondere Versicherungen, Kreditinstitute, Unternehmensberatungen, Software-Unternehmen und Pharmahersteller."

  17. Georg Faustus – Leben und Legende

    E-print Network

    Baron, Frank

    2009-01-01

    ) 12. November 2009 (english version?) * 1466 (?) in Helmstadt, † um 1540; Astrologe, Wahrsager und Bezugsperson der Faustlegende, oft als Johann Faust bezeichnet 1. Kurzbiografie Es existieren nur wenige verlässliche Quellen über den... einzugehen. Mit der Erfindung lateinischer Namen, die sein Profil als Magier oder Astrologe fördern konnten, folgte Faustus einer verbreiteten humanistischen Tendenz. Sabellicus wies darauf hin, dass er aus dem Land der Sabiner kam, bekannt für Zauberei...

  18. Kosmologie und Gravitation. Eine Einführung.

    NASA Astrophysics Data System (ADS)

    Berry, M.

    This textbook is a German translation of the English original "Principles of cosmology and gravitation" first published in 1976 (18.003.033) and reprinted in 1989 (49.003.004). Contents: 1. Einleitung. 2. Kosmographie. 3. Physikalische Grundlagen der allgemeinen Relativitätstheorie. 4. Die gekrümmte Raumzeit und die physikalische Mathematik der allgemeinen Relativitätstheorie. 5. Die allgemeine Relativitätstheorie in der Umgebung massereicher Körper. 6. Kosmische Kinematik. 7. Kosmische Dynamik. 8. Am Anfang.

  19. [Postoperative computed tomography control of allogeneic vascular prostheses].

    PubMed

    Zwicker, C; Langer, M; Cordes, M; Langer, R; Hepp, W; Felix, R

    1989-03-01

    33 CT-studies of 26 patients with alloplastic vascular prostheses were evaluated and compared with postoperative digital subtraction-angiography in 16 cases. 13 patients had no pathologic findings confirmed by further clinical development. In 4 cases bypass infection was diagnosed, which CT findings were perigraft gas (2/4), perigraft fluid (4/4), cm-enhancement (4/4) and fistulas (2/4). 10-21 d. post.-op. sterile hematomas were found in 3 patients. Further 3 cases had 5 weeks-2 post.-op. perigraft seromas. CT was method of first choice for diagnostic of perivascular alterations after bypass surgery. DSA was complementary to CT and should be performed to detect vascular complications. PMID:2706889

  20. Cerebrospinal Fluid A? to Tau Ratio and Postoperative Cognitive Change

    PubMed Central

    Xie, Zhongcong; McAuliffe, Sayre; Swain, Celeste A.; Ward, Sarah A. P.; Crosby, Catherine A.; Zheng, Hui; Sherman, Janet; Dong, Yuanlin; Zhang, Yiying; Sunder, Neelakantan; Burke, Dennis; Washicosky, Kevin J.; Tanzi, Rudolph E.; Marcantonio, Edward R.

    2013-01-01

    Objective Determination of biomarker and neuropathogenesis of postoperative cognitive change (POCC) or postoperative cognitive dysfunction. Background POCC is one of the most common postoperative complications in elderly patients. Whether preoperative cerebrospinal fluid (CSF) ?-amyloid protein (A?) to tau ratio, an Alzheimer disease biomarker, is a biomarker for risk of POCC remains unknown. We therefore set out to assess the association between preoperative CSF A?42 or A?40 to tau ratio and POCC. Methods Patients who had total hip/knee replacement were enrolled. The CSF was obtained during the administration of spinal anesthesia. Cognitive tests were performed with these participants at 1 week before and at 1 week and 3 to 6 months after the surgery. Z scores of the changes from preoperative to postoperative on several key domains of the cognitive battery were determined. We then examined the association between preoperative CSF A?42/tau or A?40/tau ratio and the outcome measures described earlier, adjusting for age and sex. Results Among the 136 participants (mean age = 71 ± 5 years; 55% men), preoperative CSF A?42/tau ratio was associated with postoperative Hopkins Verbal Learning Test Retention [Z score 8.351; age, sex-adjusted (adj.) P = 0.003], and the Benton Judgment of Line= Orientation (Z score 1.242; adj. p = 0.007). A?40/tau ratio was associated with Brief Visuospatial Memory Test Total Recall (Z score = 1.045; adj. P = 0.044). Conclusions Preoperative CSF A?/tau ratio is associated with postoperative changes in specific cognitive domains. The presence of the Alzheimer's disease biomarker, specifically the A?/tau ratio, may identify patients at higher risk for cognitive changes after surgery. PMID:23732272

  1. Association of Preoperative Biliary Drainage With Postoperative Outcome Following Pancreaticoduodenectomy

    PubMed Central

    Povoski, Stephen P.; Karpeh, Martin S.; Conlon, Kevin C.; Blumgart, Leslie H.; Brennan, Murray F.

    1999-01-01

    Objective To determine whether preoperative biliary instrumentation and preoperative biliary drainage are associated with increased morbidity and mortality rates after pancreaticoduodenectomy. Summary Background Data Pancreaticoduodenectomy is accompanied by a considerable rate of postoperative complications and potential death. Controversy exists regarding the impact of preoperative biliary instrumentation and preoperative biliary drainage on morbidity and mortality rates after pancreaticoduodenectomy. Methods Two hundred forty consecutive cases of pancreaticoduodenectomy performed between January 1994 and January 1997 were analyzed. Multiple preoperative, intraoperative, and postoperative variables were examined. Pearson chi square analysis or Fisher’s exact test, when appropriate, was used for univariate comparison of all variables. Logistic regression was used for multivariate analysis. Results One hundred seventy-five patients (73%) underwent preoperative biliary instrumentation (endoscopic, percutaneous, or surgical instrumentation). One hundred twenty-six patients (53%) underwent preoperative biliary drainage (endoscopic stents, percutaneous drains/stents, or surgical drainage). The overall postoperative morbidity rate after pancreaticoduodenectomy was 48% (114/240). Infectious complications occurred in 34% (81/240) of patients. Intraabdominal abscess occurred in 14% (33/240) of patients. The postoperative mortality rate was 5% (12/240). Preoperative biliary drainage was determined to be the only statistically significant variable associated with complications (p = 0.025), infectious complications (p = 0.014), intraabdominal abscess (p = 0.022), and postoperative death (p = 0.037). Preoperative biliary instrumentation alone was not associated with complications, infectious complications, intraabdominal abscess, or postoperative death. Conclusions Preoperative biliary drainage, but not preoperative biliary instrumentation alone, is associated with increased morbidity and mortality rates in patients undergoing pancreaticoduodenectomy. This suggests that preoperative biliary drainage should be avoided whenever possible in patients with potentially resectable pancreatic and peripancreatic lesions. Such a change in current preoperative management may improve patient outcome after pancreaticoduodenectomy. PMID:10450725

  2. Intravenous Paracetamol for Postoperative Analgesia in Laparoscopic Cholecystectomy

    PubMed Central

    Gousheh, Sayed Mohamadreza; Nesioonpour, Sholeh; Javaher foroosh, Fatemeh; Akhondzadeh, Reza; Sahafi, Sayed Ali; Alizadeh, Zeinab

    2013-01-01

    Background Although opioids are the main choice for acute postoperative pain control, many side effects have been reported for them. NSAIDs and paracetamol have been used extensively as alternatives, and it seems that they are more effective for minor to moderate pain control postoperatively when have been used alone or in combination with opioids. As laparoscopic cholecystectomy poses moderate pain postoperatively, this study was planned to assess whether paracetamol is able to provide effective analgesia as a sole analgesic at least in the first few hours post operatively. Objectives We evaluated the effect of intravenous Paracetamol on postoperative pain in patients undergoing laparoscopic cholecystectomy. Patients and Methods This is a randomized double- blind clinical trial study. 30 patients ASA class I, aged 18 to 50 years, candidate for laparoscopic cholecystectomy were recruited, and randomly divided into two equal groups. Group A (paracetamol group) received 1 gr paracetamol and group B received placebo ten minutes after the induction of anesthesia. 0.1 mg/Kg Morphine was administered intravenously based on patients compliant and pain score >3. Pain score and the opioids consumption were recorded in the first six hours postoperative. Patient's pain was measured by the VAS (Visual Analog Scale). Results The pain score was lower in group A (P= 0.01), but the morphine consumption showed no significant difference between the groups (P= 0.24) during the first 6 hours postoperatively. Conclusions Although paracetamol (1gr) has caused a better pain relief quality but it is not a suitable analgesic for moderate pain control in acute phase after surgery alone. PMID:24223365

  3. Optimising postoperative pain management in the ambulatory patient.

    PubMed

    Shang, Allan B; Gan, Tong J

    2003-01-01

    Over 60% of surgery is now performed in an ambulatory setting. Despite improved analgesics and sophisticated drug delivery systems, surveys indicate that over 80% of patients experience moderate to severe pain postoperatively. Inadequate postoperative pain relief can prolong recovery, precipitate or increase the duration of hospital stay, increase healthcare costs, and reduce patient satisfaction. Effective postoperative pain management involves a multimodal approach and the use of various drugs with different mechanisms of action. Local anaesthetics are widely administered in the ambulatory setting using techniques such as local injection, field block, regional nerve block or neuraxial block. Continuous wound infusion pumps may have great potential in an ambulatory setting. Regional anaesthesia (involving anaesthetising regional areas of the body, including single extremities, multiple extremities, the torso, and the face or jaw) allows surgery to be performed in a specific location, usually an extremity, without the use of general anaesthesia, and potentially with little or no sedation. Opioids remain an important component of any analgesic regimen in treating moderate to severe acute postoperative pain. However, the incorporation of non-opioids, local anaesthetics and regional techniques will enhance current postoperative analgesic regimens. The development of new modalities of treatment, such as patient controlled analgesia, and newer drugs, such as cyclo-oxygenase-2 inhibitors, provide additional choices for the practitioner. While there are different routes of administration for analgesics (e.g. oral, parenteral, intramuscular, transmucosal, transdermal and sublingual), oral delivery of medications has remained the mainstay for postoperative pain control. The oral route is effective, the simplest to use and typically the least expensive. The intravenous route has the advantages of a rapid onset of action and easier titratibility, and so is recommended for the treatment of acute pain.Non-pharmacological methods for the management of postoperative pain include acupuncture, electromagnetic millimetre waves, hypnosis and the use of music during surgery. However, further research of these techniques is warranted to elucidate their effectiveness in this indication. Pain is a multifactorial experience, not just a sensation. Emotion, perception and past experience all affect an individual's response to noxious stimuli. Improved postoperative pain control through innovation and creativity may improve compliance, ease of delivery, reduce length of hospital stay and improve patient satisfaction. Patient education, early diagnosis of symptoms and aggressive treatment of pain using an integrative approach, combining pharmacotherapy as well as complementary technique, should serve us well in dealing with this complex problem. PMID:12678572

  4. Villafranca Die Kabinete und die Revolutionen.

    E-print Network

    Prodinger, Helmut

    Villafranca oder Die Kabinete und die Revolutionen. von Sir John Retcliffe Zweiter Abschnitt: 10 Jahre! Historisch politischer Roman aus der Gegenwart Erster Band. Die Tricoloren! F�R DEN LESER! Die »Zehn Jahre« bilden die Fortsetzung und Vollendung des Romans »Villafranca«, dessen Stoff unter der Hand

  5. Prfungstermine und -rume Sommersemester 2015 -Wiederholungsprfungen Master -

    E-print Network

    Vollmer, Heribert

    -173710- 174000 Financial Management (Asset Management und Risk Management) 19 I-301 (zusammen mit 171604) Finance.05.15 12:30 - 14:00 173310-173710- 174000 Financial Management (Asset Management und Risk Management) 19 I) 8 I-301 (zusammen mit 170604) Banking and Insurance Mi 27.05.15 14:00 - 15:30 173700 Banking

  6. Institut fr Public Health und Pflegeforschung

    E-print Network

    Institut für Public Health und Pflegeforschung Geschäftsstelle Fachbereich 11 Human- und) 218 ­ 68980/-68880 eMail health@uni-bremen.de www www.ipp.uni-bremen.de Das Institut für Public Health Informationstechnologie, bei entsprechender Vorerfahrung auch aus den Bereichen Public Health, Pflege oder Psychologie

  7. Reduktion und Revision Aspekte des nichtmonotonen

    E-print Network

    Schubart, Christoph

    -Maximilians-Universit¨at M¨unchen Seminar f¨ur Philosophie, Logik und Wissenschaftstheorie Referenten Prof. Dr. Dr. Wolfgang Stegm¨uller Prof. Dr. Wolfgang Spohn Oktober 1988 #12;c Hans Rott, 2007 Diese elektronische Fassung ist Wittgenstein Symposiums (1988), hrsg. v. Paul Weingartner und Gerhard Schurz, Wien: H

  8. Isabel Krebs Erzeugung und Analyse von

    E-print Network

    Weinfurter, Harald

    Isabel Krebs Erzeugung und Analyse von Hyperentanglement mit einem Michelson-Interferometer Bachelorarbeit #12;#12;Bachelorarbeit Erzeugung und Analyse von Hyperentanglement mit einem Michelson-Interferometer An der Fakultät für Physik der Ludwig-Maximilians-Universität München Vorgelegt am 10. Mai 2010 von

  9. Spindephasierung und kohrente Kontrolle eines Ensembles von

    E-print Network

    Anders, Frithjof

    Spindephasierung und kohärente Kontrolle eines Ensembles von Quantenpunkten Spindephasing and coherent control of an ensemble of quantum dots Master-Thesis von Andre Jovchev April 2012 Institut für Festkörperphysik AG Grewe #12;Spindephasierung und kohärente Kontrolle eines Ensembles von Quantenpunkten

  10. Aufbau von Beschleunigern und Experimenten Aufbau von Beschleunigern

    E-print Network

    Aufbau von Beschleunigern und Experimenten Aufbau von Beschleunigern und Experimenten Von der, wurde von ZMEA eine Hebe- und Verschie- bevorrichtung für das etwa 15 m lange und 3000 kg schwere kalte: In DORIS wurden im Quadranten SL zwei Kicker gewechselt. PETRA: Für die geplante Nutzung von PETRA als

  11. Correlation of early postoperative blood glucose levels with postoperative complications, hospital costs, and length of hospital stay in patients with gastrointestinal malignancies.

    PubMed

    Huang, Pei-ying; Lin, Ming-zhu; Wen, Jun-ping; Li, Xue-jun; Shi, Xiu-lin; Zhang, Hui-jie; Chen, Ning; Li, Xiao-ying; Yang, Shu-yu; Chen, Gang

    2015-02-01

    Early postoperative hyperglycemia in non-diabetic patients is an important risk factor affecting postoperative complications and mortality. This study aimed at investigating the effects of early postoperative hyperglycemia on postoperative complications, hospital costs, and length of hospital stay in non-diabetic patients with gastrointestinal malignancies; data of 1,015 non-diabetic patients with gastrointestinal malignancies, who underwent surgical intervention between January 2010 and January 2012, were retrospectively evaluated. Records on fasting plasma glucose (FPG), liver function, and kidney function were collected before and one day after surgery. Correlation of early postoperative FPG levels with postoperative complications, hospital costs, and length of hospital stay was further assessed in non-diabetic patients with gastrointestinal malignancies. One day after surgery, FPG results were significantly increased compared to preoperative values. FPG levels greater than or equal to 9.13 mmol/L (or 164.34 mg/dL) were associated with significant increases in the incidence of postoperative complications, length of hospital stay, and hospital costs. An association is shown between FPG and postoperative hyperglycemia in non-diabetic patients undergoing surgery for gastrointestinal malignancies. Significant increases in postoperative complications among these patients suggest that measurement of early postoperative FPG levels is critical to identify patients with postoperative hyperglycemia. PMID:24853883

  12. Is Crystallised Intelligence Preserved in Post-Operative Delirium? 

    E-print Network

    Ferner, Harriet S.

    2008-06-27

    .5 years, SD = 7.3 years) completed both pre- and post-operative testing sessions (S1 and S2). Tests consisted of two parts; a “Cognitive Test Battery”, comprising of the NART, as a measure of Gc, and Digit Span, Verbal Fluency and the Victoria Stroop Test...

  13. Pancreaticoduodenectomy: expected post-operative anatomy and complications

    PubMed Central

    Lavelle, L P; Hoare, S M; O'Neill, A C; Awan, F N; Malone, D E; Ryan, E R; McCann, J W; Heffernan, E J

    2014-01-01

    Pancreaticoduodenectomy is a complex, high-risk surgical procedure performed for tumours of the pancreatic head and other periampullary structures. The rate of perioperative mortality has decreased in the past number of years but perioperative morbidity remains high. This pictorial review illustrates expected findings in early and late post-operative periods, including mimickers of pathology. It aims to familiarize radiologists with the imaging appearances of common and unusual post-operative complications. These are classified into early non-vascular complications such as delayed gastric emptying, post-operative collections, pancreatic fistulae and bilomas; late non-vascular complications, for example, biliary strictures and hepatic abscesses; and vascular complications including haemorrhage and ischaemia. Options for minimally invasive image-guided management of vascular and non-vascular complications are discussed. Familiarity with normal anatomic findings is essential in order to distinguish expected post-operative change from surgical complications or recurrent disease. This review summarizes the normal and abnormal radiological findings following pancreaticoduodenectomy. PMID:25026968

  14. Laser Acupuncture for Postoperative Pain Management in Cats

    PubMed Central

    Marques, Virgínia I.; Cassu, Renata N.; Nascimento, Felipe F.; Tavares, Rafaela C. P.; Crociolli, Giulliane C.; Guilhen, Rafael C.; Nicácio, Gabriel M.

    2015-01-01

    The aim of this study was to evaluate laser acupuncture as an adjuvant for postoperative pain management in cats. Twenty cats, undergoing ovariohysterectomy, were sedated with intramuscular (IM) ketamine (5?mg?kg?1), midazolam (0.5?mg?kg?1), and tramadol (2?mg?kg?1). Prior to induction of anaesthesia, the subjects were randomly distributed into two groups of 10 cats: Laser: bilateral stomach 36 and spleen 6 acupoints were stimulated with infrared laser; Control: no acupuncture was applied. Anaesthesia was induced using intravenous propofol (4?mg?kg?1) and maintained with isoflurane. Postoperative analgesia was evaluated by a blinded assessor for 24?h following extubation using the Dynamic Interactive Visual Analogue Scale and Multidimensional Composite Pain Scale. Rescue analgesia was provided with IM tramadol (2?mg?kg?1), and the pain scores were reassessed 30?min after the rescue intervention. If the analgesia remained insufficient, meloxicam (0.2?mg?kg?1 IM, single dose) was administered. Data were analyzed using t-tests, the Mann-Whitney test, and the Friedman test (P < 0.05). The pain scores did not differ between groups. However, postoperative supplemental analgesia was required by significantly more cats in the Control (5/10) compared with the Laser group (1/10) (P = 0.038). Laser acupuncture reduced postoperative analgesic requirements in cats undergoing ovariohysterectomy. PMID:26170879

  15. Cataract surgery and postoperative complications in diabetic patients.

    PubMed

    Ivanci?, Dorotea; Mandi?, Zdravko; Bara?, Josip; Kopi?, Mirta

    2005-01-01

    Diabetes mellitus influences the function and morphology of the eye lens. The cataract is the second most common complication of diabetes mellitus on the eye. A hundred patients with cataract were examined in the prospective study. The patients were divided into two groups. The first group consisted of 50 patients with cataract who had not suffered from a system or local disease. The second group consisted of 50 patients with cataract and diabetes mellitus that had lasted for at least five years. In both groups the patients underwent identical cataract extra capsular extraction with intraocular PMMA (polymethylmethacrylate) lens implantation in camera posterior. The objective of this study was to compare the two groups of patients in order to find out the most common intraoperative or postoperative complications in diabetics. The most common postoperative complications in patients suffering from diabetes were inflammatory reactions and bleeding: postoperative keratopathy, uveitis anterior serous and uveitis anterior fibrinous with posterior sinechia and opacity of the posterior lens capsule as results. Postoperative visual acuity was worse in the patients in group II on the seventh day and six months after operation. It was diabetic retinopathy and its progression that caused deterioration of visual acuity. Diabetic retinopathy and its progression, as well as maculopathy were found only in patients who were not treated with photocoagulation before the operation. PMID:16193678

  16. Determinants of adverse reaction following postoperative T-tube cholangiogram.

    PubMed Central

    Dellinger, E P; Kirshenbaum, G; Weinstein, M; Steer, M

    1980-01-01

    The incidence, nature, and mechanisms of adverse reaction following postoperative T-tube cholangiogram have received little attention in the medical literature. This paper presents the experience at one hospital over a 30-month period (1975--1977) covering 139 patients who had 170 cholangiograms. Factors examined included intraoperative and postoperative cultures of bile, the use of antibiotics prior to the performance of the cholangiogram, the technique of cholangiography, the interval between operation and cholangiogram. Eleven (6.5%) cholangiograms were followed by an adverse reaction. Two of these reactions were severe, manifested by signs of septic shock. The administration of antibiotics was not associated with a reduction in adverse reactions. The cholangiographic technique of gravity infusion of dye, which effectively limits the amount of pressure generated during the study, was associated with a significant reduction in adverse reactions. No severe reactions occurred following any study performed by the gravity technique. There was no significant correlation between the age of the patient or the number of days postoperative with adverse reaction. A review of the literature suggests that the mechanism for these severe reactions is cholangiovenous reflux. The avoidance of high intraductal pressures (above 25 cm of water) during the performance of postoperative T-tube cholangiogram should significantly reduce the incidence of adverse reactions. PMID:7369805

  17. Postoperative colonic decompression: eight years' experience of a new technique.

    PubMed

    Rickett, J W; Parivar, F; Benfield, J E

    1986-07-01

    Fifty-one patients undergoing left colon and rectal resection were selected for being at considerable risk of anastomotic dehiscence. They were treated postoperatively by colonic decompression using the Balloon Colostomy instead of a loop colostomy. The results of this technique are reported and discussed. PMID:3789607

  18. Postoperative colonic decompression: eight years' experience of a new technique.

    PubMed Central

    Rickett, J. W.; Parivar, F.; Benfield, J. E.

    1986-01-01

    Fifty-one patients undergoing left colon and rectal resection were selected for being at considerable risk of anastomotic dehiscence. They were treated postoperatively by colonic decompression using the Balloon Colostomy instead of a loop colostomy. The results of this technique are reported and discussed. PMID:3789607

  19. Epidural nalbuphine for postoperative analgesia in orthopedic surgery

    PubMed Central

    Chatrath, Veena; Attri, Joginder Pal; Bala, Anju; Khetarpal, Ranjana; Ahuja, Deepti; Kaur, Sawinder

    2015-01-01

    Background: The challenging task of postoperative pain relief comes within the realm of the anesthesiologist. Combined spinal epidural (CSE) anesthesia can be used as the sole technique for carrying out surgical procedures and managing postoperative pain using various drug regimes. Epidural administration of opioids in combination with local anesthetic agents in low dose offers new dimensions in the management of postoperative pain. Aims: Comparative evaluation of bupivacaine hydrochloride with nalbuphine versus bupivacaine with tramadol for postoperative analgesia in lower limb orthopedic surgeries under CSE anesthesia to know the quality of analgesia, incidence of side effects, surgical outcome and level of patient satisfaction. Settings and Design: A prospective, randomized and double-blind study was conducted involving 80 patients of American Society of Anesthesiologists physical status I and II coming for elective lower limb orthopedic surgeries carried under spinal anesthesia. Materials and Methods: Anesthesia was given with 0.5% of 2.5 ml bupivacaine intrathecally in both the groups. Epidurally 0.25% bupivacaine along with 10 mg nalbuphine (group A) or tramadol 100 mg (group B) diluted to 2 ml to make a total volume of 10 ml was administered at sensory regression to T10. Statistical Analysis: The data were collected, compiled and statistically analyzed with the help of MS Excel, EPI Info 6 and SPSS to draw the relative conclusions. Results and Conclusions: The mean duration of analgesia in group A was 380 ± 11.49 min and in group B was 380 ± 9.8 min. The mean sedation score was found to be more in group B than group A. The mean patient satisfaction score in group A was 4.40 ± 0.871 and in group B was 3.90 ± 1.150 which was found to be statistically significant (P < 0.05). We concluded that the addition of nalbuphine with bupivacaine was effective for postoperative analgesia in terms of quality of analgesia and patient satisfaction score as compared to tramadol. PMID:26712968

  20. Predictors of Postoperative Complications After Trimodality Therapy for Esophageal Cancer

    SciTech Connect

    Wang, Jingya; Wei, Caimiao; Tucker, Susan L.; Myles, Bevan; Palmer, Matthew; Hofstetter, Wayne L.; Swisher, Stephen G.; Ajani, Jaffer A.; Cox, James D.; Komaki, Ritsuko; Liao, Zhongxing; Lin, Steven H.

    2013-08-01

    Purpose: While trimodality therapy for esophageal cancer has improved patient outcomes, surgical complication rates remain high. The goal of this study was to identify modifiable factors associated with postoperative complications after neoadjuvant chemoradiation. Methods and Materials: From 1998 to 2011, 444 patients were treated at our institution with surgical resection after chemoradiation. Postoperative (pulmonary, gastrointestinal [GI], cardiac, wound healing) complications were recorded up to 30 days postoperatively. Kruskal-Wallis tests and ?{sup 2} or Fisher exact tests were used to assess associations between continuous and categorical variables. Multivariate logistic regression tested the association between perioperative complications and patient or treatment factors that were significant on univariate analysis. Results: The most frequent postoperative complications after trimodality therapy were pulmonary (25%) and GI (23%). Lung capacity and the type of radiation modality used were independent predictors of pulmonary and GI complications. After adjusting for confounding factors, pulmonary and GI complications were increased in patients treated with 3-dimensional conformal radiation therapy (3D-CRT) versus intensity modulated radiation therapy (IMRT; odds ratio [OR], 2.018; 95% confidence interval [CI], 1.104-3.688; OR, 1.704; 95% CI, 1.03-2.82, respectively) and for patients treated with 3D-CRT versus proton beam therapy (PBT; OR, 3.154; 95% CI, 1.365-7.289; OR, 1.55; 95% CI, 0.78-3.08, respectively). Mean lung radiation dose (MLD) was strongly associated with pulmonary complications, and the differences in toxicities seen for the radiation modalities could be fully accounted for by the MLD delivered by each of the modalities. Conclusions: The radiation modality used can be a strong mitigating factor of postoperative complications after neoadjuvant chemoradiation.

  1. Portable single port 23-gauge vitrectomy in postoperative endophthalmitis

    PubMed Central

    Höhn, Fabian; Kretz, Florian TA; Sheth, Saumil; Natarajan, S; Singh, Pankaj; Koch, Frank H; Koss, Michael J

    2015-01-01

    Aim To evaluate the safety and effectiveness of the Intrector® for treating postoperative endophthalmitis. Materials and methods In a retrospective multicenter study, patients who received a single port 23-gauge core pars plana vitrectomy and isovolumetric injection of vancomycin, ceftazidime, and dexamethasone/amphotericin B using the Intrector® for postoperative endophthalmitis of intermediate severity (grade II or III vitreous inflammation and best-corrected visual acuity between hand movements and 0.3 logMAR [logarithm of the minimum angle of resolution]) were evaluated. Improvement in visual acuity, resolution of intraocular inflammation, the need for additional surgical procedures, and the development of complications were evaluated at a 1-month follow-up examination. Results Fifteen patients (mean age 55.6±7.2 years) underwent treatment with the Intrector®. The mean vitreous volume aspirated was 0.78±0.22 mL. The vitreous samples indicated positive microorganism culture results in six of the 15 cases, but the samples were positive when analyzed by real-time polymerase chain reaction in all cases (15/15). The mean best-corrected visual acuity improved significantly (P=0.01) from 0.88±0.29 (logMAR) to 0.32±0.28. Each patient demonstrated at least three lines of visual improvement. No additional medical or surgical interventions were required, and the complete resolution of intraocular inflammation was noted in all patients at the 1-month follow-up examination. No procedure-related complications were observed. Conclusion The Intrector® may be a safe and effective treatment option for infectious postoperative endophthalmitis. Larger studies comparing the outcomes of the Intrector® to the traditional treatments for postoperative endophthalmitis need to be conducted before its role in the treatment of postoperative endophthalmitis can be properly defined. PMID:26316685

  2. Factors Associated with Postoperative Pain in Endodontic Therapy

    PubMed Central

    Sadaf, Durre; Ahmad, Muhammad Zubair

    2014-01-01

    Objective: To assess postoperative pain in endodontic therapy and its association with clinical factors such as gender, age, tooth type, pulpal diagnosis, and preoperative pain, length of obturation and sealer extrusion. Study Design: Cross-Sectional study. Place and Duration of Study: Dental section of the Aga khan university hospital, Karachi, Pakistan from January to December 2009. Methodology: One hundred and forty patients (140) requiring endodontic therapy for molar and premolar teeth were included in this study. Local Anesthesia (2% Lidocain with 1:80,000 Epinephrine) was administered. The tooth was isolated with rubber dam. Access cavity was prepared with the help of round carbide No. 2 bur. Canal preparation was completed using crown-down technique. Access was sealed with sterile dry cotton pallet and restored temporarily with double layer of Glass ionomer cement and Cavit. After one week patients were recalled and access was re-opened, obturation was done using cold lateral condensation technique. Ca(OH)2 based sealer was used. Postoperative radiographs were taken. Patients were recalled after 24 hours and postobturation pain was recorded using Visual analogue scale (VAS).Data was obtained on a structured Performa. ?2 test was used for statistical analysis. Results: Pain was present in 42.9% of patients. Females more frequently experienced pain (65%) than males (35%). Preoperative pain was found to be significantly associated with postoperative pain (p value < 0.001). Obturation length was not found to be significantly associated with postoperative pain (p value 1.0). Sealer extrusion was not found to be significantly associated with postoperative (P value 0.547). PMID:25598754

  3. Risk Factors for Postoperative Fibrinogen Deficiency after Surgical Removal of Intracranial Tumors

    PubMed Central

    Wei, Naili; Jia, Yanfei; Wang, Xiu; Zhang, Yinian; Yuan, Guoqiang; Zhao, Baotian; Wang, Yao; Zhang, Kai; Zhang, Xinding; Pan, Yawen; Zhang, Jianguo

    2015-01-01

    Higher levels of fibrinogen, a critical element in hemostasis, are associated with increased postoperative survival rates, especially for patients with massive operative blood loss. Fibrinogen deficiency after surgical management of intracranial tumors may result in postoperative intracranial bleeding and severely worsen patient outcomes. However, no previous studies have systematically identified factors associated with postoperative fibrinogen deficiency. In this study, we retrospectively analyzed data from patients who underwent surgical removal of intracranial tumors in Beijing Tiantan Hospital date from 1/1/2013to12/31/2013. The present study found that patients with postoperative fibrinogen deficiency experienced more operative blood loss and a higher rate of postoperative intracranial hematoma, and they were given more blood transfusions, more plasma transfusions, and were administered larger doses of hemocoagulase compared with patients without postoperative fibrinogen deficiency. Likewise, patients with postoperative fibrinogen deficiency had poorer extended Glasgow Outcome Scale (GOSe), longer hospital stays, and greater hospital expenses than patients without postoperative fibrinogen deficiency. Further, we assessed a comprehensive set of risk factors associated with postoperative fibrinogen deficiency via multiple linear regression. We found that body mass index (BMI), the occurrence of postoperative intracranial hematoma, and administration of hemocoagulasewere positively associated with preoperative-to-postoperative plasma fibrinogen consumption; presenting with a malignant tumor was negatively associated with fibrinogen consumption. Contrary to what might be expected, intraoperative blood loss, the need for blood transfusion, and the need for plasma transfusion were not associated with plasma fibrinogen consumption. Considering our findings together, we concluded that postoperative fibrinogen deficiency is closely associated with postoperative bleeding and poor outcomes and merits careful attention. Practitioners should monitor plasma fibrinogen levels in patients with risk factors for postoperative fibrinogen deficiency. In addition, postoperative fibrinogen deficiency should be remediated as soon as possible to reduce postoperative bleeding, especially when postoperative bleeding is confirmed. PMID:26658430

  4. Zwischen Web 2.0, virtuellen Welten und Game-based Learning - Einsatzszenarien und Prototypen im Hochschulumfeld

    NASA Astrophysics Data System (ADS)

    Pongratz, Hans

    Web 2.0, virtuelle Welten und Game-based Learning werden als Allheilmittel moderner Wissensvermittlung an Hochschulen genannt. Dieser Artikel beschreibt nach einer Einführung in die Thematik Einsatzszenarien und Prototypen im Hochschulumfeld anhand ausgewählter Web 2.0-Dienste, der virtuellen Welt Second Life, eines an der TUM entwickelten Frameworks für Gamebased Learning Applikationen und eines Lernspiels. Diese werden anhand von konkreten Lehr- und Lernszenarien vorgestellt und anhand der bisherigen Erfahrungen in diesem Bereich kritisch beleuchtet.

  5. Tycho Brahe - Instrumentenbauer und Meister der Beobachtungstechnik

    NASA Astrophysics Data System (ADS)

    Wolfschmidt, Gudrun

    Vor der Erfindung des Fernrohrs war der dänische Astronom Tycho Brahe (1546 - 1601) der bedeutendste beobachtende Astronom. Von seinem Observatorium Uraniborg auf der - damals dänischen - Insel Hven ist heute noch der Grundriß erkennbar, von Stjerneborg sind die Fundamente erhalten, die Kuppeln in den 1950er Jahren ergänzt. In der Astronomie-Ausstellung im Deutschen Museum gibt es ein Modell der Sternwarte Uraniborg und der zugehörigen Instrumente (Maßstab 1:10); das größere Modell wurde dem Technischen Museum in Malmö geschenkt. Die Instrumente, die er in den Observatorien Uraniborg und Stjerneborg benutzte, sind nicht erhalten. Aber es gibt gute Beschreibungen der Instrumente (Halbkreis, Quadranten, Sextanten, Armillarsphären, Triquetrum, Himmelsglobus) in seinem Buch Astronomiae instauratae mechanica (Wandsbek 1598). Eine Nachbildung des großen hölzernen Quadranten kann man im Runden Turm in Kopenhagen sehen. Zwei Sextanten, hergestellt für Tycho um 1600 von Jost Bürgi und Erasmus Habermel, gibt es noch im Nationalmuseum für Technik in Prag. Ähnlichkeiten von Tychos Instrumenten mit Groß-Instrumenten aus dem islamischen Kulturkreis sind auffällig. Tycho Brahes Meßgeräte markieren einen großen Fortschritt in der Entwicklung astronomischer Instrumente und Meßtechniken und bilden die Grundlage für den weiteren Fortschritt der Positionsastronomie und der damit verbundenen Tabellenwerke. Die Nachwirkungen sind bis ins 17. und 18. Jahrhundert nachweisbar.

  6. 20 Kombination von C++ und Java 20-1(368) 20 Kombination von C++ und Java

    E-print Network

    Arndt, Holger

    20 Kombination von C++ und Java 20-1(368) 20 Kombination von C++ und Java Inhalt 20.1 Java Native Interface (JNI) 20.1.1 C++-Funktionen aus Java aufrufen 20.1.2 Java-Funktionen aus C++ aufrufen 20.2 gcj und das Compiled Native Interface (CNI) 20.2.1 C++-Funktionen aus Java aufrufen 20.2.2 Java-Funktionen aus

  7. 20 Kombination von C++ und Java 20-1 20 Kombination von C++ und Java

    E-print Network

    Arndt, Holger

    20 Kombination von C++ und Java 20-1 20 Kombination von C++ und Java Inhalt 20.1 Java Native Interface (JNI) 20.1.1 C++-Funktionen aus Java aufrufen 20.1.2 Java-Funktionen aus C++ aufrufen 20.2 gcj und das Cygnus Native Interface (CNI) 20.2.1 C++-Funktionen aus Java aufrufen 20.2.2 Java-Funktionen aus C

  8. Universitt Konstanz Algorithmen und Datenstrukturen Fachbereich Informatik & Informationswissenschaft WS 2009/2010

    E-print Network

    Brandes, Ulrik

    Verwendung einer Hashta- belle den Schnitt AB von A und B berechnet. Geben Sie asymptoti- sche Schranken für Needleman und Wunsch. Skiz- zieren Sie die verwendete Matrix D und den Verlauf des Algorithmus und geben Sie

  9. Diagnose und Therapie einer Depression im höheren Lebensalter – Einflüsse von Patienten- und Arztmerkmalen

    PubMed Central

    von dem Knesebeck, Olaf; Bönte, Markus; Siegrist, Johannes; Marceau, Lisa; Link, Carol; McKinlay, John

    2013-01-01

    Zusammenfassung Studienergebnissee aus dem englischsprachigen Raum zeigen, dass diagnostische und therapeutische Entscheidungen von Hausärzten bei der Versorgung von depressiven Patienten systematischen Einflüssen unterliegen, und dass sowohl Merkmale des Arztes als auch des Patienten unabhängig vom Krankheitsbild Einfluss auf diese Entscheidungen haben. In der vorliegenden Arbeit werden Ergebnisse einer deutschen Studie präsentiert, in der die Einflüsse von Patienten- und Arztmerkmalen auf diagnostische und therapeutische ärztliche Entscheidungen bei einer Depression untersucht wurden. Unter Anwendung eines faktoriellen Experimentaldesigns spielten professionelle Schauspieler in Videofilmen die Rolle von Patienten, die Symptome für eine depressive Erkrankung äußern. In den Videofilmen, die alle auf einem identischen Skript basieren, wurden systematisch die Patientenmerkmale Alter (55 vs. 75 Jahre), Geschlecht und sozialer Status (Hausmeister vs. Lehrer) variiert. Die randomisierte Ärztestichprobe wurde nach dem Arztgeschlecht und professioneller Erfahrung (< 5 vs. > 15 Jahre) geschichtet. Der Videofilm wurde insgesamt 128 niedergelassenen Ärzten für Allgemeinmedizin und hausärztlich tätigen Internisten in ihrer Praxis vorgespielt. Danach wurden die Ärzte zu unterschiedlichen Aspekten von Diagnose und Therapie befragt. Es wurde erhoben, ob der Arzt dem Patienten über das gezeigte Gespräch hinausgehende Fragen stellen würde, welche Diagnosen er für wahrscheinlich hält, wie sicher er sich mit seiner Diagnose ist, welche diagnostischen Tests er anordnen würde, ob er den Patienten überweisen würde oder ob er Medikamente verordnen oder ihm Empfehlungen zur Änderung seines Lebensstils geben würde. Die Ergebnisse weisen darauf hin, dass sowohl die Diagnose als auch die Therapie einer Depression durch niedergelassene Hausärzte in Deutschland nur geringfügig durch die untersuchten Merkmale der Patienten und der behandelnden Ärzte beeinflusst wird. PMID:19274607

  10. Postoperative fungal endophthalmitis caused by Trichosporon asahii treated with voriconazole.

    PubMed

    Gonul, Saban; Gedik, Sansal; Ozturk, Banu Turgut; Bakbak, Berker; Koktekir, Bengu Ekinci; Okudan, Suleyman; Dag?, Hatice Turk

    2015-01-01

    Postoperative fungal endophthalmitis is a rare but devastating complication of cataract surgery. Vitrectomy and intravitreal amphotericin B injection as well as administration of systemic antifungal agents have been suggested as optimal treatments for fungal endophthalmitis. However, this therapy may fail to eliminate fungal species resistant to current antifungal agents. The saprophytic fungus Trichosporon asahii is frequently observed as a cause of endogenous endophthalmitis in immunosuppressed patients. We report a case of postoperative endophthalmitis caused by T. asahii, resistant to amphotericin B. To the best of our knowledge, this is the first report of T. asahii endophthalmitis successfully treated with intravitreal and systemic voriconazole, pars plana vitrectomy, and removal of the intraocular lens and entire lens capsule. PMID:26375343

  11. Intraoperative Dexmedetomidine Promotes Postoperative Analgesia in Patients After Abdominal Colectomy

    PubMed Central

    Ge, Dong-Jian; Qi, Bin; Tang, Gang; Li, Jin-Yu

    2015-01-01

    Abstract Surgery-induced acute postoperative pain may lead to prolonged convalescence. The present study was designed to investigate the effects of intraoperative dexmedetomidine on postoperative analgesia following abdominal colectomy surgeries. Eighty patients scheduled for abdominal colectomy surgery under general anesthesia were divided into 2 groups, which were maintained using propofol/remifentanil/dexmedetomidine (PRD) or propofol/remifentanil/saline (PRS). During surgery, patients in the PRD group had a lower bispectral index (BIS) value, which indicated a deeper anesthetic state, and a higher sedation score right after extubation than patients in the PRS group. During the first 24?hours post surgery, PRD patients consumed less morphine in patient-controlled analgesia (PCA) and had a lower score in the visual analog scale (VAS) testing than their controls from the PRS group. Intraoperative administration of dexmedetomidine appears to promote the analgesic property of morphine-based PCA in patients after abdominal colectomy. PMID:26376397

  12. Cohort study of intracameral moxifloxacin in postoperative endophthalmitis prophylaxis.

    PubMed

    Galvis, Virgilio; Tello, Alejandro; Sánchez, Mary Alejandra; Camacho, Paul Anthony

    2014-01-01

    We conducted a cohort study to evaluate post-cataract surgery endophthalmitis rates in relation to prophylactic intracameral moxifloxacin administration. A total of 2332 patients (2674 eyes) who underwent phacoemulsification by a single surgeon from January 2007 through December 2012 were included in the study. A total of 1056 eyes did not receive intracameral prophylactic moxifloxacin and the antibiotic was injected in 1618 eyes. The incidence of presumed postoperative endophthalmitis in the 2 groups was calculated. The rate of presumed infectious endophthalmitis after cataract surgery between January 2007 and June 2009 (without intracameral moxifloxacin) was 0.094%. The rate in the second period, from July 2009 to December 2012 (with prophylactic intracameral moxifloxacin), was 0%. In our patients, a decline in the incidence of presumed infectious postoperative endophthalmitis appeared to be associated with the application of intracameral moxifloxacin. PMID:24526838

  13. Cohort Study of Intracameral Moxifloxacin in Postoperative Endophthalmitis Prophylaxis

    PubMed Central

    Galvis, Virgilio; Tello, Alejandro; Sánchez, Mary Alejandra; Camacho, Paul Anthony

    2014-01-01

    We conducted a cohort study to evaluate post-cataract surgery endophthalmitis rates in relation to prophylactic intracameral moxifloxacin administration. A total of 2332 patients (2674 eyes) who underwent phacoemulsification by a single surgeon from January 2007 through December 2012 were included in the study. A total of 1056 eyes did not receive intracameral prophylactic moxifloxacin and the antibiotic was injected in 1618 eyes. The incidence of presumed postoperative endophthalmitis in the 2 groups was calculated. The rate of presumed infectious endophthalmitis after cataract surgery between January 2007 and June 2009 (without intracameral moxifloxacin) was 0.094%. The rate in the second period, from July 2009 to December 2012 (with prophylactic intracameral moxifloxacin), was 0%. In our patients, a decline in the incidence of presumed infectious postoperative endophthalmitis appeared to be associated with the application of intracameral moxifloxacin. PMID:24526838

  14. A Case of Incus Vibroplasty: Postoperative Changes in Residual Hearing

    PubMed Central

    Roh, Kyung Jin; Lee, Eun Jung; Choi, Byung Il

    2015-01-01

    In patients with mild to severe hearing loss, conventional hearing aids offer limited benefits and several problems with feedback and cosmesis. Middle ear implants are a feasible option for patients with moderate to severe hearing loss who are unable to achieve adequate benefit from or cannot tolerate hearing aids for various reasons. Here we present a case of middle ear implant surgery using Vibrant Soundbridge with incus vibroplasty technique, and describe the hearing changes during postoperative follow-up. PMID:26185793

  15. Population-based analysis of tonsil surgery and postoperative hemorrhage.

    PubMed

    Mueller, J; Boeger, D; Buentzel, J; Esser, D; Hoffmann, K; Jecker, P; Mueller, A; Radtke, G; Geißler, K; Bitter, T; Guntinas-Lichius, O

    2015-12-01

    Although tonsil surgery is one of the most frequent otorhinolaryngological procedures, not many population-based regional or country-wide studies are published on the incidence of postoperative bleeding and its risk factors. 2,216 patients underwent tonsil surgery in 2012 in Thuringia, a federal state in Germany. Most frequent indications were recurrent tonsillitis (44 % of all cases), tonsillar abscess (27 %), and tonsillar hyperplasia (20 %). 29 % of the patients were <10 years of age. Most frequent methods of surgery were tonsillectomy (73 %) and tonsillotomy (19 %). 215 patients (10 %) had 221 events of a postoperative hemorrhage. Re-surgery for hemostasis was necessary in 137 patients (6 %). The interval to re-surgery was 4.4 ± 4.6 days. The re-surgery rate was 8, 0.2, and 15 % after tonsillectomy, tonsillotomy, and radical tonsillectomy, respectively. In cases of recurrent tonsillitis, male gender (p < 0.001), age >24.78 years (median; (p = 0.018), and waiving of perioperative antibiotics (p = 0.029) were independent factors associated with hemorrhage. In cases of tonsillar hyperplasia tonsillectomy instead of tonsillotomy, the only significant risk factor was postoperative hemorrhage (p = 0.005). The overall incidence of tonsillar surgery was 87.6/100,000. The highest incidence was seen for patients 3-4 years of age with 862.7/100,000. In children <10 years, the incidence was always higher for boys than for girls. Throughout all age groups, a reverse gender relation was only seen, if surgery was indicated for recurrent tonsillitis. We recommend establishing national guidelines for indication of tonsil surgery, especially of tonsillectomy, including recommendations for perioperative care to decrease variations in tonsil surgery rates and minimize postoperative complications. PMID:25502742

  16. Prior infection exacerbates postoperative cognitive dysfunction in aged rats.

    PubMed

    Hovens, Iris B; van Leeuwen, Barbara L; Nyakas, Csaba; Heineman, Erik; van der Zee, Eddy A; Schoemaker, Regien G

    2015-07-15

    Older patients may experience persisting postoperative cognitive dysfunction (POCD), which is considered to largely depend on surgery-induced (neuro)inflammation. We hypothesize that inflammatory events before surgery could predispose patients to POCD. When part of our aged rats developed Mycoplasma pulmonis, this presented the unique opportunity to investigate whether a pulmonary infection before surgery influences surgery-induced neuroinflammation and POCD. Male 18-mo-old Wistar rats that had recovered from an active mycoplasma infection (infection) and control rats (healthy) were subjected to abdominal surgery and jugular vein catheterization under general anesthesia (surgery) or remained naïve (control). In postoperative week 2, behavioral tests were performed to assess cognitive performance and exploratory behavior. The acute systemic inflammatory response was investigated by measuring plasma IL-6 and IL-12. In the hippocampus, prefrontal cortex and striatum, microglial activity, neurogenesis, and concentrations of IL-6, IL-12, IL1B, and brain-derived neurotropic factor on postoperative day 14 were determined. Rats still showed signs of increased neuroinflammatory activity, as well as cognitive and behavioral changes, 3 wk after the symptoms of infection had subsided. Rats that had experienced infection before surgery exhibited a more generalized and exacerbated postoperative cognitive impairment compared with healthy surgery rats, as well as a prolonged increase in systemic cytokine levels and increased microglial activation in the hippocampus and prefrontal cortex. These findings support the hypothesis that an infection before surgery under general anesthesia exacerbates POCD. Future studies are necessary to determine whether the found effects are aging specific and to investigate the magnitude and time course of this effect in a controlled manner. PMID:25972458

  17. Multilobed uveal melanoma masquerading as postoperative choroidal detachment.

    PubMed

    Shields, J A; Leonard, B C; Sarin, L V

    1976-05-01

    A case of multilobed malignant melanoma with a haemorrhagic retinal detachment which mimicked a postoperative choroidal detachment is described. Because the lesion showed no resolution six weeks after cataract surgery a tumour evaluation was undertaken. The diagnosis was established with a positive radioactive phosphorus uptake (32P) test and biopsy of the intraocular mass. A suggested approach to the diagnosis in such difficult cases is proposed. PMID:952810

  18. Association between intraoperative electroencephalographic suppression and postoperative mortality‡

    PubMed Central

    Willingham, M.; Ben Abdallah, A.; Gradwohl, S.; Helsten, D.; Lin, N.; Villafranca, A.; Jacobsohn, E.; Avidan, M.; Kaiser, H.

    2014-01-01

    Background Low bispectral index values frequently reflect EEG suppression and have been associated with postoperative mortality. This study investigated whether intraoperative EEG suppression was an independent predictor of 90 day postoperative mortality and explored risk factors for EEG suppression. Methods This observational study included 2662 adults enrolled in the B-Unaware or BAG-RECALL trials. A cohort was defined with >5 cumulative minutes of EEG suppression, and 1:2 propensity-matched to a non-suppressed cohort (?5 min suppression). We evaluated the association between EEG suppression and mortality using multivariable logistic regression, and examined risk factors for EEG suppression using zero-inflated mixed effects analysis. Results Ninety day postoperative mortality was 3.9% overall, 6.3% in the suppressed cohort, and 3.0% in the non-suppressed cohort {odds ratio (OR) [95% confidence interval (CI)]=2.19 (1.48–3.26)}. After matching and multivariable adjustment, EEG suppression was not associated with mortality [OR (95% CI)=0.83 (0.55–1.25)]; however, the interaction between EEG suppression and mean arterial pressure (MAP) <55 mm Hg was [OR (95% CI)=2.96 (1.34–6.52)]. Risk factors for EEG suppression were older age, number of comorbidities, chronic obstructive pulmonary disease, and higher intraoperative doses of benzodiazepines, opioids, or volatile anaesthetics. EEG suppression was less likely in patients with cancer, preoperative alcohol, opioid or benzodiazepine consumption, and intraoperative nitrous oxide exposure. Conclusions Although EEG suppression was associated with increasing anaesthetic administration and comorbidities, the hypothesis that intraoperative EEG suppression is a predictor of postoperative mortality was only supported if it was coincident with low MAP. Clinical trial registration NCT00281489 and NCT00682825. PMID:24852500

  19. Foot and hand massage as an intervention for postoperative pain.

    PubMed

    Wang, Hsiao-Lan; Keck, Juanita F

    2004-06-01

    Physiological responses to pain create harmful effects that prolong the body's recovery after surgery. Patients routinely report mild to moderate pain even though pain medications have been administered. Complementary strategies based on sound research findings are needed to supplement postoperative pain relief using pharmacologic management. Foot and hand massage has the potential to assist in pain relief. Massaging the feet and hands stimulates the mechanoreceptors that activate the "nonpainful" nerve fibers, preventing pain transmission from reaching consciousness. The purpose of this pretest-posttest design study was to investigate whether a 20-minute foot and hand massage (5 minutes to each extremity), which was provided 1 to 4 hours after a dose of pain medication, would reduce pain perception and sympathetic responses among postoperative patients. A convenience sample of 18 patients rated pain intensity and pain distress using a 0 to 10 numeric rating scale. They reported decreases in pain intensity from 4.65 to 2.35 (t = 8.154, p <.001) and in pain distress from 4.00 to 1.88 (t = 5.683, p <.001). Statistically significant decreases in sympathetic responses to pain (i.e., heart rate and respiratory rate) were observed although blood pressure remained unchanged. The changes in heart rate and respiratory rate were not clinically significant. The patients experienced moderate pain after they received pain medications. This pain was reduced by the intervention, thus supporting the effectiveness of massage in postoperative pain management. Foot and hand massage appears to be an effective, inexpensive, low-risk, flexible, and easily applied strategy for postoperative pain management. PMID:15297952

  20. Organe und Gremien Organe der Stiftung

    E-print Network

    European Organization for Particle Physics CERN, Geneva (CH) Dr. A. Wrulich Paul Scherrer Institut ) Johann-Wolfgang Goethe Universität, Frankfurt am Main (D) und die Mitglieder des Wissenschaftlichen Rates

  1. Bundesrepublik Deutschland Deutsches Patent-und Markenamt

    E-print Network

    Dietz, Nikolaus

    1/12 ß (19) Bundesrepublik Deutschland Deutsches Patent- und Markenamt *DE4211741B420060921* (10 drei Monaten nach Veröffentlichung der Patenterteilung kann nach § 59 Patentgesetz gegen das Patent Ein

  2. Efficacy of Postoperative Prophylactic Antibiotic Therapy in Third Molar Surgery

    PubMed Central

    Reddy B, Praveen

    2014-01-01

    Introduction: Surgical extraction of mandibular third molar is the most frequently performed procedure in oral surgery. This procedure is associated with significant postoperative sequelae such as trismus, swelling, pain and infection. The need of antibiotic therapy during the removal of mandibular third molar has been a contentious issue. Method: This study investigated a regimen by using amoxycillin and metronidazole in one group and without using antibiotics in the other. Both the groups were assessed postoperatively on the 1st, 2nd, 5th, 7th and 10th days by the same observer for post operative mouth opening (interincisal distance), presence of a purulent discharge at the site of surgery, pain and swelling. Result: Overall, no statistically significant difference was seen between both the treatment groups when interincisal distance, pain, swelling and purulent discharge were considered. Conclusion: The results of this study failed to show any advantage which was associated with the routine postoperative use of antibiotics in asymptomatic third molar surgeries. PMID:24995236

  3. Remote postoperative epidural hematoma after subdural hygroma drainage.

    PubMed

    Paiva, Wellingson Silva; Oliveira, Arthur Maynart Pereira; de Andrade, Almir Ferreira; Brock, Roger Schmidt; Teixeira, Manoel Jacobsen

    2010-01-01

    Objective. Subdural hygroma is reported to occur in 5%-20% of all patients with closed head trauma, the treatment is controversial and in symptomatic cases surgical drainage is need. We report on a new case with remote acute epidural hematoma (AEH) after subdural hygroma drainage. Case Presentation. A 38-year-old man suffered blunt head trauma and had diffuse axonal injury grade III in CT scan. A CT scan that was late performed showed an increasing subdural fluid collection with mild mass effect and some effacement of the left lateral ventricle. We perform a trepanation with drainage of a hypertensive subdural collection with citrine aspect. Postoperative tomography demonstrated a large left AEH. Craniotomy and evacuation of the hematoma were performed. Conclusion. The mechanism of remote postoperative AEH formation is unclear. Complete reliance on neurologic monitoring, trust in an early CT scan, and a relative complacency after an apparently successful initial surgery for hygroma drainage may delay the diagnosis of this postoperative AEH. PMID:20671987

  4. Alternative Therapies for the Prevention of Postoperative Nausea and Vomiting.

    PubMed

    Stoicea, Nicoleta; Gan, Tong J; Joseph, Nicholas; Uribe, Alberto; Pandya, Jyoti; Dalal, Rohan; Bergese, Sergio D

    2015-01-01

    Postoperative nausea and vomiting (PONV) is a complication affecting between 20 and 40% of all surgery patients, with high-risk patients experiencing rates of up to 80%. Recent studies and publications have shed light on the uses of alternative treatment for PONV through their modulation of endogenous opioid neuropeptides and neurokinin ligands. In addition to reducing PONV, hypnosis was reported to be useful in attenuating postoperative pain and anxiety, and contributing to hemodynamic stability. Music therapy has been utilized to deepen the sedation level and decrease patient anxiety, antiemetic and analgesic requirements, hospital length of stay, and fatigue. Isopropyl alcohol and peppermint oil aromatherapy have both been used to reduce postoperative nausea. With correct training in traditional Chinese healing techniques, acupuncture (APu) at the P6 acupoint has also been shown to be useful in preventing early PONV, postdischarge nausea and vomiting, and alleviating of pain. Electro-acupuncture (EAPu), as with APu, provided analgesic and antiemetic effects through release and modulation of opioid neuropeptides. These non-pharmacological modalities of treatment contribute to an overall patient wellbeing, assisting in physical and emotional healing. PMID:26734609

  5. Postoperative constipation risk assessment in Turkish orthopedic patients.

    PubMed

    ?endir, Merdiye; Büyük?ylmaz, Funda; A?t?, Türkinaz; Gürp?nar, ?engül; Yazgan, ?lknur

    2012-01-01

    This descriptive, correlational study was conducted to describe constipation risk assessment and the affecting factors of constipation risk of patients who have undergone major orthopedic surgery. Data were collected using a patient information form and the Constipation Risk Assessment Scale (CRAS) on the second postoperative day. Data were analyzed using the SPSS version 11.5 for Windows. The mean age of the 83 patients studied was 53.75 ± 21.29 years. Subjects were hospitalized in the orthopedic wards for 14.39 ± 15.17 days, and their current bowel habit was 2.18 ± 1.80 stools per week. Of the sample, 63.9% were female, 69.9% of the patients had a history of previous surgery, 45.8% had hip/knee arthroplasty surgery, and 55.4% had bowel problems during the hospitalization period. Patients had a medium risk for constipation according to the CRAS subscale (gender, mobility, and pharmacological agents). Total CRAS score was 12.73 ± 4.75 (medium risk) on the second postoperative day. In addition, age, marital status, educational level, having a history of surgery, and bowel elimination problems did have a significant effect on constipation risk. On the basis of the findings from this study, nurses must learn the postoperative constipation risk of orthopedic patients to implement safe and effective interventions. PMID:22472670

  6. Preoperative Statin Use and Postoperative Acute Kidney Injury

    PubMed Central

    Brunelli, Steven M.; Waikar, Sushrut S.; Bateman, Brian T.; Chang, Tara I.; Lii, Joyce; Garg, Amit X.; Winkelmayer, Wolfgang C.; Choudhry, Niteesh K.

    2013-01-01

    BACKGROUND Acute kidney injury is a frequent postoperative complication that confers increased mortality, morbidity, and costs. The purpose of this study was to evaluate whether preoperative statin use is associated with a decreased risk of postoperative acute kidney injury. METHODS We assembled a retrospective cohort of 98,939 patients who underwent a major open abdominal, cardiac, thoracic, or vascular procedure between 2000 and 2010. Statin users were pair-matched to nonusers on the basis of surgery type, baseline kidney function, days from admission until surgery, and propensity score based on demographics, comorbid conditions, and concomitant medications. Acute kidney injury was defined based on changes in serum creatinine measurements applying Acute Kidney Injury Network and Risk-Injury-Failure staging systems, and on the need for renal replacement therapy. Associations between statin use and acute kidney injury were estimated by conditional logistic regression. RESULTS Across various acute kidney injury definitions, statin use was consistently associated with a decreased risk: adjusted odds ratios (95% confidence intervals) varied from 0.74 (0.58–0.95) to 0.80 (0.71–0.90). Associations were similar among diabetics and nondiabetics, and across strata of baseline kidney function. The protective association of statins was most pronounced among patients undergoing vascular surgery and least among patients undergoing cardiac surgery. CONCLUSIONS Preoperative statin use is associated with a decreased risk of postoperative acute kidney injury. Future randomized clinical trials are needed to determine causality. PMID:23062398

  7. Role of spinal cyclooxygenase in human postoperative and chronic pain

    PubMed Central

    Eisenach, James C.; Curry, Regina; Rauck, Richard; Pan, Peter; Yaksh, Tony L.

    2010-01-01

    Background Nonsteroidal anti-inflammatory drugs are commonly used to treat postoperative and chronic pain. Animal studies suggest these drugs act in part by blocking prostaglandin production in the spinal cord. We tested intrathecal ketorolac in patients with chronic or postoperative pain. Methods Following Institutional Review Board and Food and Drug Administration approval, 3 clinical studies were performed. First, 15 patients receiving chronic intrathecal morphine received intrathecal ketorolac, 0.5 – 2.0 mg. Second, 12 patients receiving chronic intrathecal morphine received, in a double blinded, randomized, cross over design, intrathecal saline or ketorolac, 2.0 mg, with pain intensity as the primary outcome measure. Third, 30 patients undergoing total vaginal hysterectomy received, in a double blinded, randomized, controlled design, intrathecal saline or ketorolac, 2.0 mg with bupivacaine with time to first morphine dose after surgery as the primary outcome measure. Results Chronic pain patients had many symptoms prior to intrathecal injection, without worsening of these symptoms from ketorolac. Pain intensity was reduced by intrathecal ketorolac, but this did not differ from placebo. In the first study, pain was reduced by intrathecal ketorolac in patients with high cerebrospinal fluid prostaglandin E2 concentrations, but not in those with normal concentrations. Intrathecal ketorolac did not alter time to first morphine after surgery. Conclusions Intrathecal ketorolac did not relieve chronic pain or extend anesthesia or analgesia from intrathecal bupivacaine administered at the beginning of surgery. Under the conditions of these studies, spinal cylcooxygenase activity appears not contribute to chronic or postoperative pain. PMID:20395820

  8. Alternative Therapies for the Prevention of Postoperative Nausea and Vomiting

    PubMed Central

    Stoicea, Nicoleta; Gan, Tong J.; Joseph, Nicholas; Uribe, Alberto; Pandya, Jyoti; Dalal, Rohan; Bergese, Sergio D.

    2015-01-01

    Postoperative nausea and vomiting (PONV) is a complication affecting between 20 and 40% of all surgery patients, with high-risk patients experiencing rates of up to 80%. Recent studies and publications have shed light on the uses of alternative treatment for PONV through their modulation of endogenous opioid neuropeptides and neurokinin ligands. In addition to reducing PONV, hypnosis was reported to be useful in attenuating postoperative pain and anxiety, and contributing to hemodynamic stability. Music therapy has been utilized to deepen the sedation level and decrease patient anxiety, antiemetic and analgesic requirements, hospital length of stay, and fatigue. Isopropyl alcohol and peppermint oil aromatherapy have both been used to reduce postoperative nausea. With correct training in traditional Chinese healing techniques, acupuncture (APu) at the P6 acupoint has also been shown to be useful in preventing early PONV, postdischarge nausea and vomiting, and alleviating of pain. Electro-acupuncture (EAPu), as with APu, provided analgesic and antiemetic effects through release and modulation of opioid neuropeptides. These non-pharmacological modalities of treatment contribute to an overall patient wellbeing, assisting in physical and emotional healing.

  9. Effectiveness of various medications on postoperative pain following complete instrumentation.

    PubMed

    Torabinejad, M; Cymerman, J J; Frankson, M; Lemon, R R; Maggio, J D; Schilder, H

    1994-07-01

    The root canals of 588 consecutive nonsurgical patients with varying levels of pain were completely instrumented in 10 endodontic practices and 4 endodontic graduate programs. The participants were sequentially assigned to one of nine medications and a placebo. The severity of pain was assessed by the visual analog scale for 72 h following instrumentation. Among all of the parameters studied, three factors (preoperative pain, apprehension, and types of medication) were found to be significant in determining postinstrumentation pain. An association was found between the intensity of pre-and postoperative pain. As the intensity of preoperative pain increased, the chances for more severe postoperative pain increased (p < 0.0001). In addition, an association between the presence of apprehension before any treatment and postoperative pain was also noted (between 0.012 < p < 0.047). Examination of the time-effect curves for various medications in patients with no mild pain showed no statistical significant difference between the effectiveness of different medications and placebo. However, a multiple comparison of the effectiveness of various medications and placebo on patients in moderate and severe preoperative pain showed that ibuprofen, ketoprofen, erythromycin base, penicillin, and methylprednisolone plus penicillin were more effective than placebo within the first 48 h following complete instrumentation. PMID:7996097

  10. [Preemptive analgesia in postoperative pain for children in otolaryngological department].

    PubMed

    Przeklasa-Muszy?ska, Anna; Nosek-Kozdra, Klaudia; Muszy?ski, Tomasz; Kocot-Kepska, Magdalena; Podziorny, Henryk; Ole?, Krzysztof; Dobrogowski, Jan; Wordliczek, Jerzy a; Dardzi?ski, Wiktor

    2006-01-01

    Although much more about the safe and effective management of pain in children is now known, this knowledge has not been widely or effectively translated into routine clinical practice. Pain in children is still a big problem even thought available many possibilities to cure it. Malpractice during postoperative period influence not only for recovery, but also causes long lasting consequences (emotional changes). The most common applied method for treatment postoperative pain in children is still pharmacotherapy. One of the most effective form of it is preemptive analgesia. Specifically, preemptive analgesia may be defined as an antinociceptive treatment that prevents establishment of altered central processing of afferent input from sites of injury. The most important conditions for establishment of effective preemptive analgesia are the establishment of an effective level of antinociception before injury, and the continuation of this effective analgesic level well into the post-injury period to prevent central sensitization during the inflammatory phase. Although single-agent therapy may attenuate the central nociceptive processing, multi-modal therapy is more effective, and may be associated with fewer side effects compared with the high-dose, single-agent therapy. Practical in the pediatric patients in laryngological ward seems to be one of the most effective method of pain therapy in postoperative period. Laryngological procedures in children cause a severe pain. The most common procedure in children in laryngological practice is adenotomy. There is a pressing need for further research and clinical development in the management of pain in children. PMID:17348410

  11. Objektorientierte Modellierung Zur Simulation und Regelung von Energiewandlungsprozessen

    NASA Astrophysics Data System (ADS)

    Abel, Dirk

    In allen Ingenieursdisziplinen hat die mathematische Modellierung technischer Systeme und Prozesse ihren festen Platz gefunden — nicht zuletzt getrieben durch die Ausführbarkeit auf leistungsfähigen Digitalrechnern, die zur Simulation, zur Analyse und zum Entwurf eingesetzt werden. Beflügelt wird dies durch neuere Entwicklungen im Bereich der Modellierungssprachen und Rechnerwerkzeuge, die mit modernen objektorientierten Konzepten und algebraisch/symbolischen Rechenfähigkeiten aufwarten. Anhand zweier aktueller Forschungsprojekte zur Energiewandlung — stellvertretend für die Bereiche Kraftwerkstechnik und Verbrennungsmotoren — werden der Zugang zur objektorientierten Modellierung und deren Potential gegenüber konventionellen Ansätzen aus der Ingenieurssicht, speziell aus dem Blickwinkel der Regelungstechnik, aufgezeigt.

  12. Rückwärtsintegration - Zu den Verhältnissen Gymnasium, Hochschule und Arbeitswelt

    NASA Astrophysics Data System (ADS)

    Schmid, Gerhard; Heppner, Winfried; Focht, Eva

    In seiner 2007 erschienen Sammlung von Vorträgen und Essays beschäftigt sich Wolfgang Frühwald, mit der Frage "Wieviel Wissen brauchen wir?“ [1] Die Kernproblematik moderner Wissenschaft und Forschung sieht der Autor, emeritierter Ordinarius für Neuere Deutsche Literaturwissenschaft und von 1992 bis 1997 Präsident der Deutschen Forschungsgemeinschaft, einerseits in der zunehmenden Spezialisierung der Wissenschaftsbereiche, andererseits in der Gefahr der Abkoppelung der Naturwissenschaften von den Geisteswissenschaften. Wiederholt plädiert er dafür, über der rasanten Entwicklung beispielsweise in der Biologie und Physik, die historische, gesellschaftliche und besonders die ethische Dimension der Forschung nicht zu übersehen und fordert eine übergeordnete Theorie der Wissenschaft, die nur im Dialog zwischen den einzelnen Fachgebieten zu entwickeln sei.

  13. Differenzialdiagnosen, Simulatoren und ungewöhnliche Formen des Kontaktekzems.

    PubMed

    Kränke, Birger; Schuster, Christian

    2015-11-01

    Wie alle Ekzemkrankheiten sind sowohl das irritative als auch das allergische Kontaktekzem primär über ihr morphologisches Erscheinungsbild "Ekzem" definiert. Zusätzlich gilt aber als unabdingbar für die Diagnosestellung, dass sie als spezifisches Reaktionsmuster an Haut (und Schleimhaut) erst durch den direkten oder indirekten Kontakt mit einem Allergen oder Irritans ausgelöst werden. In der Theorie und im Lehrbuch lassen sich die für ein Ekzem typischen Charakteristika einfach beschreiben, doch in der täglichen Praxis können die Erscheinungsbilder vielfältig und durchaus uncharakteristisch sein: Kontaktreaktionen können auch lichenoid, lymphomatoid, granulomatös, pigmentiert, purpurisch oder multiforme-artig auftreten und somit das eigentlich typische "Ekzembild" vermissen lassen. Dadurch wird der Kreis der zu berücksichtigenden Differenzialdiagnosen deutlich erweitert. Komplizierend kommt hinzu, dass eine signifikante Zahl an Auslösern, die nicht über einen Kontaktmechanismus krankheitsauslösend wirken, unerwünschte Reaktionen entsprechend der Morphologie eines Ekzems und dem Verteilungsmuster eines Kontaktekzems auslösen können. In diesem Zusammenhang sind vor allem Medikamente und hier besonders die zunehmend in der Onkologie verwendeten Kinaseblocker zu nennen. Die Kenntnis dieser Zusammenhänge ist essentiell für die adäquate diagnostische wie auch therapeutische Betreuung eines Patienten mit vermeintlichem oder tatsächlichem Kontaktekzem. PMID:26513064

  14. Improving the recognition of post-operative acute kidney injury

    PubMed Central

    Trotter, Nicola; Doherty, Cal; Tully, Vicki; Davey, Peter; Bell, Samira

    2014-01-01

    The National Institute for Health and Care Excellence (NICE) state that acute kidney injury (AKI) is seen in 13–18% of all people being admitted to hospital and that other patients will further go on to develop AKI during their time in hospital, with around 30–40% being in the operative setting. AKI has an estimated inpatient mortality of 20-30% in the UK and can lead to long-term morbidities like chronic kidney disease.[2] AKI is under-recognised and badly managed despite its prevalence and seriousness, with NCEPOD report stating that only 50% of patients with AKI received good care, that there was poor assessment of risk factors for AKI, and there was an unacceptable delay in recognising post-admission AKI in 43% of patients.[4] Baseline data collected on the urology ward in Ninewells Hospital, showed that only five of 22 (23%) patients undergoing urological surgery had post-operative creatinine measured on the ward within 48 hours (the primary method for detecting AKI). Excluding patients who were discharged the same day 5/16 (31%) received the blood test. The aim of the project was to increase the number of patients returning to ward 9 post-surgery who receive a serum creatinine measurement within two days of their urological surgery, excluding daycases. Specifically, we wanted the reliability of this measurement to be 95% or over in ward 9 by 30 July 2014. This was to be done by raising awareness around AKI on ward 9 and changing protocol so that every patient staying on ward 9 beyond their day of surgery should receive a post-operative creatinine. This would be tested for a set amount of time to see if patients with AKI were being missed. Despite not being able to implement a set protocol, the percentage of patients receiving post-operative creatinine measurements on ward 9 after a urological surgery still increased significantly. By interacting with the urology team and presenting our data, the knowledge and comprehension of the problem was altered. This lead to a change in culture and a significant increase in the number of post-operative creatinine measurements being taken. Through building relationships on the ward and sharing our data and knowledge there was an increase from 27% of patients receiving post-op creatinine in our first week of collecting data, to 87% in our last week on ward 9. However, without a set tool or change in protocol this change appears to have not been sustainable as the percentage dropped to 42% two weeks later.

  15. Herstellung von Chitosan und einige Anwendungen

    NASA Astrophysics Data System (ADS)

    Struszczyk, Marcin Henryk

    2001-05-01

    1. Die Deacetylierung von crabshell - Chitosan führte gleichzeitig zu einem drastischen Abfall der mittleren viscosimetrischen Molmasse ( Mv), insbesondere wenn die Temperatur und die Konzentration an NaOH erhöht werden. Diese Parameter beeinflussten jedoch nicht den Grad der Deacetylierung (DD). Wichtig ist jedoch die Quelle des Ausgangsmaterials: Chitin aus Pandalus borealis ist ein guter Rohstoff für die Herstellung von Chitosan mit niedrigem DD und gleichzeitig hoher mittlerer Mv, während Krill-Chitin (Euphausia superba) ein gutes Ausgangsmaterial zur Herstellung von Chitosan mit hohem DD und niedrigem Mv ist. Chitosan, das aus Insekten (Calliphora erythrocephala), unter milden Bedingungen (Temperatur: 100°C, NaOH-Konzentration: 40 %, Zeit: 1-2h ) hergestellt wurde, hatte die gleichen Eigenschaften hinsichtlich DD und Mv wie das aus Krill hergestellte Chitosan. Der Bedarf an Zeit, Energie und NaOH ist für die Herstellung von Insekten-Chitosan geringer als für crabshell-Chitosan vergleichbare Resultaten für DD und Mv. 2. Chitosan wurde durch den Schimmelpilz Aspergillus fumigatus zu Chitooligomeren fermentiert. Die Ausbeute beträgt 25%. Die Chitooligomere wurden mit Hilfe von HPLC und MALDI-TOF-Massenspektrmetrie identifiziert. Die Fermentationsmischung fördert die Immunität von Pflanzen gegen Bakterien und Virusinfektion. Die Zunahme der Immunität schwankt jedoch je nach System Pflanze-Pathogen. Die Fermentation von Chitosan durch Aspergillus fumigatus könnte eine schnelle und billige Methode zur Herstellung von Chitooligomeren mit guter Reinheit und Ausbeute sein. Eine partiell aufgereinigte Fermentationsmischung dieser Art könnte in der Landwirtschaft als Pathogeninhibitor genutzt werden. Durch kontrollierte Fermentation, die Chitooligomere in definierter Zusammensetzung (d.h. definierter Verteilung des Depolymerisationsgrades) liefert, könnte man zu Mischungen kommen, die für die jeweilige Anwendung eine optimale Bioaktivität besitzen. 3. Die aus Chitosan-Dispersionen hergestellten MCChB-Filme weisen bessere mechanische Eigenschaften (Bruchfestigkeit, Dehnung) und eine höhere Wasseraufnahmefähigkeit auf als Filme, die nach herkömmlichen Methoden aus sauerer Lösung hergestellt werden. Die Einführung von Proteinen ändert die mechanischen Eigenschaften der MCChB-Filme abhängig von der Art, der Proteine sowie des DD und der Mv des eingesetzte Chitosan. Die Zugabe von Protein beschleunigt den biologischen Abbau der MCChB-Filme. Aus den untersuchten MCChB-Filmen mit Proteinzusatz können leichte, reißfeste und dennoch elastische Materialen hergestellt werden. 4. Mit Hilfe von MCChB-Dispersion kann Papier modifiziert werden. Dadurch werden die mechanischen Eigenschaften verbessert und die Wasseraufnahme wird verringert. Die Zugabe von Proteinen verringert das Wasseraufnahmevermögen noch weiter. Ein geringes Wasseraufnahmevermögen ist der bedeutendste Faktor bei der Papierherstellung. Auch Papier, das mit einem MCChB-Protein-Komplexe modifiziert wurde, zeigt gute mechanische Eigenschaften. 5. Wird Chitosan durch unmittelbare Einführung von MCChB auf Cellulose-Fasern aufgebracht, so erhält man eine netzartige Struktur, während durch Ausfällung aufgebrachtes Chitosan eine dünne Schicht auf den Cellulose-Fasern bildet. Die netzartige Struktur erleichtert die Bioabbaubarkeit, während die Schichtstruktur diese erschwert. 6. Die guten mechanischen Eigenschaften, die geringe Wasseraufnahmefähigkeit und die mit Cellulose vergleichbare Bioabbaubarkeit von Papier, das mit MCChB modifiziert wurde, lassen MCChB für die Veredlung von Papier nützlich erscheinen. 1. Deacetylation of the crustacean chitosan causes drastically decrease in the Mv with increasing reaction temperature and time as well as the concentration of sodium hydroxide. However, the DD are relatively less affected. Pandalus borealis is a good source for production of chitosan having high Mv and low DD, whereas chitosan of medium to low Mv can ideally be prepared using krill chitin. Insect chitosan is prepared under milder condition a

  16. Zwischen Physik und Philosophie Ino Weber, Carl Friedrich von Weizscker, Ein Leben zwischen Physik und Philosophie

    E-print Network

    Falge, Eva

    Zwischen Physik und Philosophie Ino Weber, Carl Friedrich von Weizsäcker, Ein Leben zwischen Physik Philosoph? Die Einordnung Carl Friedrich von Weizsäckers in klassische Kategorien fällt schwer, denn sein zur Quantenphysik. Die noch junge Quantenmechanik der 1920er-Jahre warf ganz neue methodische und

  17. ATK4 -Computer-und Mediensicherheit FHS Hagenberg

    E-print Network

    unterschiedlichen Nachrichten m1 und m2 vom glei- chen Sender. Der public key des Senders ist (p, g, A) = (6238469, 2431, 4696879). Die beiden Nachrichten m1 und m2 sind ebenfalls bekannt, somit k¨onnen Sie ihre

  18. Bachelor-, Master-und Doktorandenseminar des Instituts fr Informatik

    E-print Network

    Zachmann, Gabriel

    wird. Die Wahl fällt dabei auf die Integration von CMMI-DEV und ITIL bzw. ITIL Service Design. Zur Schnittstellenbereiche vorgestellt, an denen sich Prozessgebiete von CMMI-DEV und ITIL Service Design berühren. Daraufhin

  19. Zentralbung zur Vorlesung ,,Einfhrung in die Informatik: Programmierung und Softwareentwicklung"

    E-print Network

    Programmierung und Softwareentwicklung Aufgabe 1: Typkonversion (I) Ein netter Bankangestellter verspricht Ihnen: Typkonversion (II) Ein netter Bankangestellter verspricht Ihnen für Ihr Sparkonto einen Zinssatz von 25%. Er in die Informatik Programmierung und Softwareentwicklung Aufgabe 1: Typkonversion (III) Ein netter

  20. Forschungskolloquium fr Israel-und Nahoststudien Wintersemester 2015/ 16

    E-print Network

    Heermann, Dieter W.

    Forschungskolloquium für Israel- und Nahoststudien Wintersemester 2015/ 16 Dienstag, 27.Oktober. Januar: Shimon Stein, Botschafter des Staates Israel a.D. Das Ende von Oslo? Die Gegenwart der israelisch zusätzliche Blocksitzungen zur Forschungsliteratur der Israel- und Nahoststudien. Veranstaltungsort

  1. Rudolf Lindau Die Freundschaft, welche Wilson und Irwing ver-

    E-print Network

    Prodinger, Helmut

    chinesischen Seidenver- käufer, die gleichzeitig die Hauptkäufer von indischem Opium und englischen Meilen weit in das Innere, um dort Opium und Waffen gegen Seide einzutauschen. Es war eine kurze Zeit, wo

  2. Regelungen im Verkehr mit Lebensmitteln und Bedarfsgegenständen in Deutschland

    NASA Astrophysics Data System (ADS)

    Thomas, Gundula; Freund, Astrid; Gründig, Friedrich

    Im Zuge der Globalisierung von Produktion und Handel ändert sich auch der Charakter der Vorschriften im Lebensmittelrecht. Zunehmend treten internationale Rechtsbestimmungen, Abkommen, Standards und andere Normen an die Stelle nationaler Regelungen.

  3. n Einfhrung Albert Einstein: Der Mensch, Wissenschaftler und Weltbrger

    E-print Network

    Pfeifer, Holger

    1915­2015 n Einführung Albert Einstein: Der Mensch, Wissenschaftler und Weltbürger Prof. Dr Einsteins Allgemeine Relativitätstheorie die Welt veränderte Prof. Dr. Günther Hasinger, Institute Allgemeine Relativitätstheorie Schwarze Löcher und GPS: Wie Einsteins Allgemeine Relativitätstheorie die Welt

  4. Fakultt fr Physik und Astronomie Ruprecht-Karls-Universitt Heidelberg

    E-print Network

    Aeschbach-Hertig, Werner

    Studiengang Physik vorgelegt von Katja Träumner aus Karl-Marx-Stadt 2005 #12;2 Inbetriebnahme, Tests und erste1 Fakultät für Physik und Astronomie Ruprecht-Karls-Universität Heidelberg Diplomarbeit im

  5. Prfungs-und Studienordnung fr den weiterbildenden Masterstudiengang ,,Community Medicine

    E-print Network

    Greifswald, Ernst-Moritz-Arndt-Universität

    1 Prüfungs- und Studienordnung für den weiterbildenden Masterstudiengang ,,Community Medicine für den weiterbildenden Masterstudiengang ,,Community Medicine and Epidemiologic Research Masterstudiengang ,,Community Medicine and Epidemiologic Research". Im Übrigen gilt für alle weiteren Studien- und

  6. Physik-Nobelpreis 2003 Pioniere in der Supraleiter- und Supraflüssigkeitsforschung

    NASA Astrophysics Data System (ADS)

    Huebener, Rudolf

    2003-11-01

    Die Königlich Schwedische Akademie der Wissenschaften vergab in diesem Jahr den Physik-Nobelpreis zu gleichen Teilen an Aleksej Abrikossow, Witalij Ginsburg und Anthony Leggett für ihre pionierhaften Beiträge zur Theorie der Supraleiter und Supraflüssigkeiten.http://www.nobel.se

  7. FAKULTT FR PHYSIK UND ASTRONOMIE RUHR-UNIVERSITT BOCHUM

    E-print Network

    Gerwert, Klaus

    FAKULTÄT FÜR PHYSIK UND ASTRONOMIE RUHR-UNIVERSITÄT BOCHUM Programm Mini-Frühstücksbuffet ab 10 antreibt (und was das mit Spielzeug zu tun hat) PD Dr. Enno Middelberg (Astronomie, RUB) weitere Termine

  8. Mol-Gastronomie Granulare Fleischgerichte und molekulares Kleben

    NASA Astrophysics Data System (ADS)

    Vilgis, Thomas A.

    2005-09-01

    Buletten, Fleischküchle oder Kebabs, Köstlichkeiten aus gehacktem Fleisch bestimmter Körnung, finden sich in allen Kulturen. Physikalisch ein großes Problem, denn zu Tisch dürfen diese Gebilde nicht auseinander brechen und zerfallen. Für ausreichend Bindung und Klebung muss also gesorgt werden.

  9. A Comparative Clinical Evaluation of the Effect of Preoperative and Postoperative Antimicrobial Therapy on Postoperative Sequelae after Impacted Mandibular Third Molar Extraction

    PubMed Central

    Gbotolorun, Olalekan Micah; Ibikunle, Adebayo Aremu; Emeka, Christian Ibezi; Arotiba, Godwin Toyin; Akinwande, Jelili Adisa

    2014-01-01

    ABSTRACT Objectives To compare the effect of preoperative and postoperative antibiotics therapy on postoperative sequelae after impacted mandibular third molar extractions. Material and Methods This was a prospective study conducted at Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospitalon consecutive patients with impacted third molar extractions for a 12 month period. Group I (n = 31) had administration of 1 gram of oral metronidazole and 1 gram of amoxicillin capsules 30 minutes preoperative and Group II (n = 31) had 500 milligrams of amoxicillin capsule 8 hourly and 400 milligrams of metronidazole tablets administered post operatively for 5 days. Pain, facial swelling and mouth opening assessment were done postoperatively and on days 1, 3 and 7. Results The general pattern of postoperative pain, regardless of antimicrobial use revealed that pain increased from day 1 to day 3 postoperatively and began to decrease in intensity subsequently up to the seventh day. There was however a statistically significant difference (P = 0.0001) between the two groups on the 7th postoperative day with the subjects in Group I showing lower pain intensity. The mean difference of the facial width on days 1 and 3 was significant (P = 0.04 and P = 0.0001 respectively) with subjects in Group II having a reduced facial width compared to those in Group I. Conclusions This study suggested that the administration of preoperative or postoperative antibiotics showed no marked differences in the degree of postoperative sequaele that occur after impacted mandibular third molar extractions. PMID:25089174

  10. Neurokinin-1 Receptor Antagonists in Preventing Postoperative Nausea and Vomiting

    PubMed Central

    Liu, Meng; Zhang, Hao; Du, Bo-Xiang; Xu, Feng-Ying; Zou, Zui; Sui, Bo; Shi, Xue-Yin

    2015-01-01

    Abstract Newly developed neurokinin-1 receptor (NK-1R) antagonists have been recently tried in the prevention of postoperative nausea and vomiting (PONV). This systematic review and meta-analysis was conducted to explore whether NK-1R antagonists were effective in preventing PONV. The PRISMA statement guidelines were followed. Randomized clinical trials (RCTs) that tested the preventive effects of NK-1R antagonists on PONV were identified by searching EMBASE, CINAHL, PubMed, and the Cochrane Library databases followed by screening. Data extraction was performed using a predefined form and trial quality was assessed using a modified Jadad scale. The primary outcome measure was the incidence of PONV. Meta-analysis was performed for studies using similar interventions. Network meta-analysis (NMA) was conducted to compare the anti-vomiting effects of placebo, ondansetron, and aprepitant at different doses. Fourteen RCTs were included. Meta-analysis found that 80?mg of aprepitant could reduce the incidences of nausea (3 RCTs with 224 patients, pooled risk ratio (RR)?=?0.60, 95% confidence interval (CI)?=?0.47 to 0.75), and vomiting (3 RCTs with 224 patients, pooled RR?=?0.13, 95% CI?=?0.04 to 0.37) compared with placebo. Neither 40?mg (3 RCTs with 1171 patients, RR?=?0.47, 95% CI?=?0.37 to 0.60) nor 125?mg (2 RCTs with 1058 patients, RR?=?0.32, 95% CI?=?0.13 to 0.78) of aprepitant showed superiority over 4?mg of ondansetron in preventing postoperative vomiting. NMA did not find a dose-dependent effect of aprepitant on preventing postoperative vomiting. Limited data suggested that NK-1R antagonists, especially aprepitant were effective in preventing PONV compared with placebo. More large-sampled high-quality RCTs are needed. PMID:25984662

  11. Transperineal Management for Postoperative and Radiation Rectourethral Fistulas

    PubMed Central

    Voelzke, Bryan B.; McAninch, Jack W.; Breyer, Benjamin N.; Glass, Allison S.; Garcia-Aguilar, Julio

    2013-01-01

    Purpose The rectal sphincter preserving transperineal approach has been increasingly used successfully. We analyzed our experience with this surgical approach. A secondary aim was to evaluate the surgical outcome of energy ablative rectourethral fistulas without a concomitant interposition muscle flap. Materials and Methods We identified all patients with rectourethral fistula who underwent rectal sphincter preserving transperineal repair from 1998 to 2011. Re-approximation of the urethral mucosa, posterior anastomotic urethroplasty or partial/total prostatectomy with urethrovesical anastomosis was performed for urinary closure. The fistula cohort was divided into 2 groups, including postoperative and energy ablative fistulas, respectively. Success after perineal rectourethral fistula repair was defined as resolution after the first attempt at repair. Results A total of 23 patients underwent rectal sphincter preserving, transperineal rectourethral fistula repair. In the postoperative fistula cohort the fistula was successfully resolved in all 10 patients. A dartos interposition muscle flap was used in 2 of 10 patients. In the energy ablative cohort the fistula was successfully closed in 8 of 13 patients. An interposition muscle flap was not placed in 8 patients with an energy ablative fistula, of whom success was achieved in 5. Two of the 5 patients with an energy ablative fistula and a successful outcome without a concomitant interposition muscle flap had urinary extravasation, necessitating temporary catheterization. Conclusions Rectal sphincter preserving transperineal repair is a successful surgical method to repair postoperative and energy ablative rectourethral fistulas. An interposition muscle flap should be considered in the setting of energy ablative rectourethral fistulas to increase successful outcomes. PMID:23009867

  12. Incidence of postoperative wound infections after open tendo Achilles repairs

    PubMed Central

    Marican, Mohd Mizan; Fook-Chong, Stephanie Man Chung; Rikhraj, Inderjeet Singh

    2015-01-01

    INTRODUCTION Tendo Achilles (TA), which is the confluence of the gastrocnemius and soleus muscles, is one of the most commonly injured tendons. The surgical repair of TA ruptures is associated with a significant risk of infection. This study examined several factors (i.e. gender, age, body mass index, history of diabetes mellitus, steroid use, acute or chronic TA injuries, type of surgical incision and type of sutures used) that may be associated with postoperative wound infection after open TA repair. METHODS This was a retrospective study involving 60 patients who underwent open TA repair over an 18-month period. Patients who had prior TA surgery or open TA injuries, or who needed soft tissues flaps were excluded. RESULTS Among the patients, 7 (11.7%) developed superficial wound infections that were successfully treated with oral antibiotics, while 3 (5.0%) developed deep wound infections that required at least one debridement procedure. No significant association was found between the risk of postoperative wound infection and gender, age, the presence of diabetes mellitus, acute or chronic ruptures, site of surgical incision and type of deep or superficial sutures used. CONCLUSION While diabetes mellitus and age did not appear to be associated with postoperative wound infections after open TA repair, obese patients were found to be two times more likely to develop a wound infection than normal-weight patients. The incidence of superficial wound infections in this study was similar to previously published results (11.7% vs. 8.2%–14.6%), but the incidence of deep infections was higher (5% vs. 1%–2%). PMID:26512146

  13. Magnesium and Ketamine Gargle and Postoperative Sore Throat

    PubMed Central

    Teymourian, Houman; Mohajerani, Seyed Amir; Farahbod, Alireza

    2015-01-01

    Background: Postoperative sore throat is one of the most common complications after endotracheal intubation. Both Ketamine and magnesium can block N-methyl-D-aspartic acid (NMDA) receptors and provide central and local analgesia. Objectives: To compare the effect of magnesium sulfate and ketamine gargle on the incidence and severity of postoperative sore throat. Patients and Methods: A total of 100 patients candidate for emergency acute appendicitis surgery were enrolled in the study. Patients in ketamine group received ketamine gargle (0.5 mg/kg) and magnesium group received magnesium sulfate gargle (20 mg/kg up to 30 mL dextrose water 20%) 15 minutes before the operation. Patient complaint of postoperative sore throat, and its severity measured by visual analogue scale (VAS) were recorded at baseline in recovery room, and then 2, 4, and 24 hours after operation. Results: There were no significant differences between age, sex, and body mass index (BMI) between two groups of patients. Hemodynamics of patients, including blood pressure, respiratory rate, oxygen saturation %, and conscious state were not significantly different (P > 0.05). Number of patients with sore throat were significantly lower in magnesium group compared to ketamine group at 2 (P = 0.032), 4 (P = 0.02), and 24 hours (P = 0.01) after the operation. Sore throat pain score (VAS) was significantly lower in magnesium group compared to ketamine group at 2 (P = 0.019), 4 (P = 0.028), and 24 hours (P = 0.014) after the operation. Conclusions: Magnesium at low dose decreases sore throat and pain severity more effectively compared to ketamine gargle. PMID:26161316

  14. Is day-1 postoperative review necessary after pars plana vitrectomy?

    PubMed

    Alexander, P; Michaels, L; Newsom, R

    2015-11-01

    PurposeThis study aimed to determine the proportion of patients requiring alteration in management based on the findings of the day-1 postoperative visit after pars plana vitrectomy, and to identify clinical characteristics that predict the need for unexpected intervention.Patients and methodsA retrospective case note review was conducted of all patients who underwent pars plana vitrectomy and who then attended for review on the first postoperative day. All patients received routine prophylactic anti-glaucoma medication.ResultsTwo hundred and seventy-three patients examined on day 1 following vitrectomy were studied. Indications for surgery included retinal detachment, epiretinal membrane, macular hole, vitreous haemorrhage, diabetic eye disease, and floaters. Twenty-gauge (20G) vitrectomy was performed in 124 eyes (45%); 23-gauge (23G) vitrectomy was performed in 149 eyes (55%). Phacoemulsification was performed concurrently in 51/273 (19%) eyes. Ten patients (3.7%) required unexpected intervention on day 1 owing to intraocular pressure (IOP) >30 (2/273), IOP <6 (5/273), or unexpected return to theatre for anterior chamber washout (3/273). There was no difference in intervention rate or day-1 IOP between 20G and 23G cases. Hypotony was less common if gas tamponade was used (?(2)-test, P<0.001). Patients undergoing combined phacoemulsification and 20G vitrectomy were significantly more likely to require intervention on day 1 than patients undergoing 20G vitrectomy alone (15.0 vs 1.9%, P=0.029, Fisher's exact test) but this was not the case for patients undergoing 23G vitrectomy (0 vs 4.2%, Fisher's exact test, P=0.58).ConclusionsThe intervention rate on the first day after vitrectomy is low and day-1 postoperative review can be safely omitted in the majority of patients undergoing vitrectomy. PMID:26315702

  15. Postoperative outcomes following pancreaticoduodenectomy: how should age affect clinical practice?

    PubMed Central

    2013-01-01

    Background Pancreaticoduodenectomy is an increasingly common procedure performed for both benign and malignant disease. There are conflicting data regarding the safety of pancreatic resection in older patients. Potentially modifiable perioperative risk factors to improve outcomes in older patients have yet to be determined. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database for 2008 to 2009 was used for this retrospective analysis. Patients undergoing pancreaticoduodenectomy were identified and divided into those above and below the age of 65. Preoperative risk factors and postoperative morbidity and mortality were evaluated. Results Among 2,045 patients included in this analysis, 994 patients were >65 years (48.6%) while 1,051 were (less than or equal to) 65 years (51.4%). Thirty-day mortality was higher in the older age group compared to the younger age group 3.6% vs. 1.9% respectively, P = 0.017, odds ratio 1.94. Older patients had a higher incidence of unplanned intubation, ventilator support >48 h and septic shock compared with younger patients. On multivariate logistic regression, after adjusting for other 30-day postoperative occurrences (significant at the P <0.1 level) only septic shock was independently associated with a higher odds of mortality, unplanned intubation, and ventilator support >48 h in older patients compared with younger patients. Conclusions This report from a population-based database is the first to highlight postoperative sepsis as an independent risk factor for mortality and morbidity in older patients undergoing pancreatic resection. Careful perioperative management addressing this issue is essential for patients over the age of 65. PMID:23742036

  16. Predictors of Postoperative Finger Stiffness in Unstable Proximal Phalangeal Fractures

    PubMed Central

    Onishi, Tadanobu; Shimizu, Takamasa; Fujitani, Ryotaro; Shigematsu, Koji; Tanaka, Yasuhito

    2015-01-01

    Background: The purpose of this study was to determine the risk factors for postoperative finger stiffness after open reduction and internal fixation of unstable proximal phalangeal fractures using a low-profile plate and/or screw system. We hypothesized that dorsal plate placement is a risk factor for postoperative finger stiffness. Methods: Seventy consecutive patients (50 men, 20 women; average age, 40 years) with 75 unstable proximal phalangeal fractures were treated with titanium plates and/or screws and evaluated at a minimum follow-up of 1 year. Thirty-six comminuted fractures and 24 intra-articular fractures were included, and 16 fractures had associated soft-tissue injuries. Plate fixation was performed in 59 fractures, and the remaining 16 were fixed with screws only. The implants were placed in a dorsal location in 33 fractures and in a lateral or volar location in 42 fractures. Finger stiffness was defined as a total active range of finger motion <80% for the treated finger. Univariate and multivariate analyses were performed on 8 variables: patient characteristics (age and sex), fracture characteristics (fracture comminution, joint involvement, and associated soft-tissue injury), and surgical characteristics (type and location of implants and removal of the implants). Results: Postoperative finger stiffness occurred in 38 fractures. The multivariate analysis indicated that plate fixation (odds ratio, 5.9; 95% confidence interval, 1.5–24.0; P = 0.01) and dorsal placement (odds ratio, 3.0; 95% confidence interval, 1.1–8.3; P = 0.03) were independent risk factors for finger stiffness. Conclusion: We recommend the use of screw fixation as much as possible for unstable proximal phalangeal fractures using a midlateral approach. PMID:26180732

  17. INSTITUT FR GESCHICHTE DER MEDIZIN, NATURWISSENSCHAFT UND TECHNIK

    E-print Network

    Rossak, Wilhelm R.

    INSTITUT FÜR GESCHICHTE DER MEDIZIN, NATURWISSENSCHAFT UND TECHNIK Ernst-Haeckel-Haus | Jena AKADEMISCHETRAUERFEIER|GEDÄCHTNISSYMPOSIUM INSTITUT FÜR GESCHICHTE DER MEDIZIN, NATURWISSENSCHAFT UND TECHNIK Ernst-Haeckel und Technik, Ernst-Hae- ckel-Haus, bis zu seinem Tod am 22. Juli 2014. Von 1998 bis 2010 war Olaf

  18. Mol-Gastronomie Von Weihnachtsplätzchen und anderen granularen Backwerken

    NASA Astrophysics Data System (ADS)

    Vilgis, Thomas

    2003-11-01

    Weihnachten steht vor der Tür, und aus den Backöfen duften die ersten Plätzchen als Vorboten. Die isst man auch bei Physikers so gern, dass kaum ein Krumen übrig bleibt. Dabei sind die Krümel besonders interessant, denn sie zeigen eine Vielzahl von Merkmalen und lassen auf die verschiedenen Teigarten schließen, deren Reiz nicht nur im Geschmack, sondern auch in Herstellungsweise und Teigklasse liegt.

  19. Incidence of stroke and acute renal failure in patients of postoperative atrial fibrillation after myocardial revascularization

    PubMed Central

    Barbieri, Lucas Regatieri; Sobral, Marcelo Luiz Peixoto; Gerônimo, Glaucio Mauren da Silva; dos Santos, Gilmar Geraldo; Sbaraíni, Evandro; Dorfman, Fabio Kirzner; Stolf, Noedir Antônio Groppo

    2013-01-01

    Introduction Postoperative atrial fibrillation is the most common arrhythmia in cardiac surgery, its incidence range between 20% and 40%. Objective Quantify the occurrence of stroke and acute renal insufficiency after myocardial revascularization surgery in patients who had atrial fibrillation postoperatively. Methods Cohort longitudinal bidirectional study, performed at Portuguese Beneficent Hospital (SP), with medical chart survey of patients undergoing myocardial revascularization surgery between June 2009 to July 2010. From a total of 3010 patients were weaned 382 patients that presented atrial fibrillation preoperatively and/or associated surgeries. The study was conducted in accordance with national and international following resolutions: ICH Harmonized Tripartite Guidelines for Good Clinical Practice - 1996; CNS196/96 Resolution, and Declaration of Helsinki. Results The 2628 patients included in this study were divided into two groups: Group I, who didn't show postoperative atrial fibrillation, with 2302 (87.6%) patients; and group II, with 326 (12.4%) who developed postoperative atrial fibrillation. The incidence of stroke in patients was 1.1% without postoperative atrial fibrillation vs. 4% with postoperative atrial fibrillation (P<0.001). Postoperative acute renal failure was observed in 12% of patients with postoperative atrial fibrillation and 2.4% in the group without postoperative atrial fibrillation (P<0.001), that is a relation 5 times greater. Conclusion In this study there was a high incidence of stroke and acute renal failure in patients with postoperative atrial fibrillation, with rates higher than those reported in the literature. PMID:24598947

  20. Single dose oral diclofenac for acute postoperative pain in adults

    PubMed Central

    Derry, Philip; Derry, Sheena; Moore, R Andrew; McQuay, Henry J

    2014-01-01

    Background Diclofenac is a non-steroidal anti-inflammatory drug (NSAID), available as a potassium salt (immediate-release) or sodium salt (delayed-release). This review updates an earlier review published in The Cochrane Database of Systematic Reviews (Issue 2, 2004) on ‘Single dose oral diclofenac for postoperative pain’. Objectives To assess single dose oral diclofenac for the treatment of acute postoperative pain. Search methods Cochrane CENTRAL, MEDLINE, EMBASE, Biological Abstracts, the Oxford Pain Relief Database, and reference lists of articles were searched; last search December 2008. Selection criteria Randomised, double-blind, placebo-controlled clinical trials of single dose, oral diclofenac (sodium or potassium) for acute postoperative pain in adults. Data collection and analysis Two review authors independently assessed studies for inclusion and quality, and extracted data. The area under the pain relief versus time curve was used to derive the proportion of participants with at least 50% pain relief over 4 to 6 hours, using validated equations. Relative benefit (risk) and number needed to treat to benefit (NNT) were calculated. Information on adverse events, time to remedication, and participants needing additional analgesia was also collected. Main results Fifteen studies (eight additional studies) with 1512 participants more than doubled the information available at each dose. Overall 50% to 60% of participants experienced at least 50% pain relief over 4 to 6 hours at any dose with diclofenac, compared to 10 to 20% with placebo, giving NNTs of about 2.5 for doses of 25 mg to 100 mg (similar to earlier review); no dose response was demonstrated. At 50 mg and 100 mg, NNTs for diclofenac potassium (2.1 (1.8 to 2.4) and 1.9 (1.7 to 2.2)) were significantly lower (better) than for diclofenac sodium (6.7 (4.2 to 17) and 4.5 (3.2 to 7.7)). The median time to use of rescue medication was 2 hours for placebo, 4.3 hours for diclofenac 50 mg and 4.9 hours for diclofenac 100 mg. Adverse events were reported at a similar rate to placebo, with no serious events. Authors’ conclusions Oral diclofenac is an effective single-dose treatment for moderate to severe postoperative pain. Significantly more participants experienced at least 50% pain relief over 4 to 6 hours with diclofenac potassium than with diclofenac sodium. There was no significant difference between diclofenac and placebo in the incidence of adverse events. PMID:19370609

  1. Single dose oral ibuprofen for acute postoperative pain in adults

    PubMed Central

    Derry, Christopher J; Derry, Sheena; Moore, R Andrew; McQuay, Henry J

    2014-01-01

    Background This review updates a 1999 Cochrane review showing that ibuprofen at various doses was effective in postoperative pain in single dose studies designed to demonstrate analgesic efficacy. New studies have since been published. Ibuprofen is one of the most widely used non-steroidal anti-inflammatory (NSAID) analgesics both by prescription and as an over-the-counter medicine. Ibuprofen is used for acute and chronic painful conditions. Objectives To assess analgesic efficacy of ibuprofen in single oral doses for moderate and severe postoperative pain in adults. Search methods We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies to May 2009. Selection criteria Randomised, double blind, placebo-controlled trials of single dose orally administered ibuprofen (any formulation) in adults with moderate to severe acute postoperative pain. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Pain relief or pain intensity data were extracted and converted into the dichotomous outcome of number of participants with at least 50% pain relief over 4 to 6 hours, from which relative risk and number-needed-to-treat-to-benefit (NNT) were calculated. Numbers of participants using rescue medication over specified time periods, and time to use of rescue medication, were sought as additional measures of efficacy. Information on adverse events and withdrawals were collected. Main results Seventy-two studies compared ibuprofen and placebo (9186 participants). Studies were predominantly of high reporting quality, and the bulk of the information concerned ibuprofen 200 mg and 400 mg. For at least 50% pain relief compared with placebo the NNT for ibuprofen 200 mg (2690 participants) was 2.7 (2.5 to 3.0) and for ibuprofen 400 mg (6475 participants) it was 2.5 (2.4 to 2.6). The proportion with at least 50% pain relief was 46% with 200 mg and 54% with 400 mg. Remedication within 6 hours was less frequent with higher doses, with 48% remedicating with 200 mg and 42% with 400 mg. The median time to remedication was 4.7 hours with 200 mg and 5.4 hours with 400 mg. Sensitivity analysis indicated that pain model and ibuprofen formulation may both affect the result, with dental impaction models and soluble ibuprofen salts producing better efficacy estimates. Adverse events were uncommon, and not different from placebo. Authors’ conclusions The very substantial amount of high quality evidence demonstrates that ibuprofen is an effective analgesic in treating postoperative pain. NNTs for 200 mg and 400 mg ibuprofen did not change significantly from the previous review even when a substantial amount of new information was added. New information is provided on remedication. PMID:19588326

  2. A Radiobiological Analysis of Multicenter Data for Postoperative Keloid Radiotherapy

    SciTech Connect

    Flickinger, John C.

    2011-03-15

    Purpose: To identify factors significantly affecting recurrence rates after postoperative external beam radiotherapy (XRT) of keloids, and to delineate any radiation dose response and effects of radiation dose per fraction. Methods and Materials: A comprehensive literature review was performed to compile a database of 2,515 resected keloids (36.9% earlobe). Postoperative XRT was 45- to 100-kV X-rays in 27.0% or 120- to 250-kV X-rays in 11.1%, Co-60 in 1.9%, Sr-90 in 4.7%, 1.5- to 9-MeV electrons in 26.5%, and no XRT in 28.8%. In the 1,791 irradiated patients, the median radiation parameters were as follows: total dose, 15 Gy (range, 6-30 Gy); dose per fraction, 5.0 Gy (range, 2-15 Gy); fractions, 3 (range, 1-10); and time, 7 days (range, 0-33 days). Results: Multivariate stepwise logistic regression correlated decreased keloid recurrence with earlobe location (p = 1.98E-10; odds ratio, 0.34), biologically effective dose (p = 1.01E-27), and treatment with electron beam or Co-60 vs. other techniques (p = 0.0014; odds ratio, 0.72). Different radiobiological models calculated values of {alpha}/{beta} = 1.12 to 2.86 (mean, 2.08) and time (repopulation) correction factors for biologically effective dose from 0.98 to 2.13 Gy per day (mean, 1.34) starting 10 days after surgery. Different models (with {alpha}/{beta} = 2.08) predicted that doses needed for 90% and 95% control with 3 fractions of postoperative electron beam were 16.0 to 16.2 Gy and 18.3 to 19.2 Gy, respectively, in less than 10 days for earlobe keloids and 21.5 to 22.2 Gy and 23.4 to 24.8 Gy, respectively, in less than 10 days for other sites. Conclusions: Postoperative keloid radiotherapy requires moderately high doses and optimal technique to be effective. The relatively low {alpha}/{beta} ratio indicates that radiotherapy with a limited number of fractions and high doses per fraction is the best strategy.

  3. [Laparoscopic cholecystectomy: 100 consecutive cases without postoperative morbidity].

    PubMed

    Klaiber, C; Metzger, A; Leepin, H; Saager, C

    1991-06-15

    100 consecutive patients underwent laparoscopic cholecystectomy for symptomatic gallbladder stones. We report our results and the management of choledocholithiasis. In two cases the laparoscopic procedure had to be converted into open cholecystectomy due to bleeding. There were no complications postoperatively. The results show that laparoscopic cholecystectomy is a safe procedure with real benefits. The main advantages are greater comfort for the patient, better cosmetic results, shortening of hospital stay and earlier return to full activity. We feel that, with a proper indication, laparoscopic removal of the gallbladder will establish itself as the procedure of choice in stone disease. PMID:1830401

  4. [Postoperative total parenteral feeding with a carbohydrate mixture (autor's transl)].

    PubMed

    Dutz, R; Greiner, E; Kersting, K H; Mast, D; Peter, K; Schaub, P

    1976-11-12

    After gastric operations, patients were fed completely by the parenteral route. Aminoacids, caloric nutrients and electrolytes were infused simultaneously and continuously 24 hours daily until the fourth postoperative day. The daily supply of aminoacids amounted to 80 g. Glucose, fructose and xylite in equal proportions were used to supply calories. The total daily amount was 605 g. The important electrolytes were contained in the infusion solutions in amounts corresponding to basic requirement. The results of the investigation confirmed that patients can be successfully nourished parenterally after extensive operations with the combined daily additives we have selected. PMID:825769

  5. Supraleitung und Interkontinentalraketen „On-line computing“ zwischen Militär, Industrie und Wissenschaft

    NASA Astrophysics Data System (ADS)

    Knolle, Johannes; Joas, Christian

    Der zweite Weltkrieg und der Kalte Krieg veränderten nicht nur das Verhältnis zwischen Militär, Industrie und Wissenschaft, sondern auch die wissenschaftliche Praxis von Physikern und anderen Wissenschaftlern. In den 1950er Jahren stellte die Entwicklung von Interkontinentalraketen die Auftragnehmer des Militärs in der Industrie vor komplexe Fragestellungen, zu deren Lösung sie auf die Expertise von Wissenschaftlern angewiesen waren. Industrieunternehmen gründeten eigene Forschungseinheiten zur Lösung technischer und wissenschaftlicher Probleme.

  6. Ökophysik: Plaudereien über das Leben auf dem Land, im Wasser und in der Luft

    NASA Astrophysics Data System (ADS)

    Nachtigall, W.

    Prof. em. Dr. rer. nat. Werner Nachtigall, geb. 1934, war als Zoophysiologe und Biophysiker Leiter des Zoologischen Instituts der Universität des Saarlandes in Saarbrücken. In Forschung und Ausbildung hat er sich insbesondere mit Aspekten der Technischen Biologie und Bionik befasst und mit seinen Forschergruppen viele Basisdaten insbesondere zur Ökologie, Physiologie und Physik des Fliegens und Schwimmens aber auch zur Stabilität beispielsweise der Gräser erarbeitet. Lebewesen überraschen immer wieder durch ihre "Biodiversität", ihre hochspezifischen Ausgestaltungen und Anpassungen.

  7. The effects of early postoperative radiation on vascularized bone grafts

    SciTech Connect

    Evans, H.B.; Brown, S.; Hurst, L.N. )

    1991-06-01

    The effects of early postoperative radiation were assessed in free nonvascularized and free vascularized rib grafts in the canine model. The mandibles of one-half of the dogs were exposed to a cobalt 60 radiation dose of 4080 cGy over a 4-week period, starting 2 weeks postoperatively. The patency of vascularized grafts was confirmed with bone scintigraphy. Histological studies, including ultraviolet microscopy with trifluorochrome labeling, and histomorphometric analyses were performed. Osteocytes persist within the cortex of the vascularized nonradiated grafts to a much greater extent than in nonvascularized, nonradiated grafts. Cortical osteocytes do not persist in either vascularized or nonvascularized grafts subjected to radiation. New bone formation is significantly retarded in radiated grafts compared with nonradiated grafts. Periosteum and endosteum remained viable in the radiated vascularized grafts, producing both bone union and increased bone turnover, neither of which were evident to any significant extent in nonvascularized grafts. Bone union was achieved in vascularized and non-vascularized nonradiated bone. In the radiated group of dogs, union was only seen in the vascularized bone grafts.

  8. Post-operative pulmonary complications after non-cardiothoracic surgery

    PubMed Central

    Kelkar, Kalpana Vinod

    2015-01-01

    Post-operative pulmonary complications (PPCs) occur in 5–10% of patients undergoing non-thoracic surgery and in 22% of high risk patients. PPCs are broadly defined as conditions affecting the respiratory tract that can adversely influence clinical course of the patient after surgery. Prior risk stratification, risk reduction strategies, performing short duration and/or minimally invasive surgery and use of anaesthetic technique of combined regional with general anaesthesia can reduce the incidence of PPCs. Atelectasis is the main cause of PPCs. Atelectasis can be prevented or treated by adequate analgesia, incentive spirometry (IS), deep breathing exercises, continuous positive airway pressure, mobilisation of secretions and early ambulation. Pre-operative treatment of IS is more effective. The main reason for post-operative pneumonia is aspiration along the channels formed by longitudinal folds in the high volume, low pressure polyvinyl chloride cuffs of the endotracheal tubes. Use of tapered cuff, polyurethane cuffs and selective rather than the routine use of nasogastric tube can decrease chances of aspiration. Acute lung injury is the most serious PPC which may prove fatal. PMID:26556919

  9. Influence of postoperative enteral nutrition on postsurgical infections.

    PubMed Central

    Beier-Holgersen, R; Boesby, S

    1996-01-01

    BACKGROUND: This study was undertaken to test the hypothesis that early enteral nutrition might reduce the incidence of serious complications after major abdominal surgery. METHODS: In a randomised double blind prospective trial 30 patients received Nutri-drink and 30 patients received placebo through a nasoduodenal feeding tube. On the day of operation the patients were given median 600 ml of either nutrition or placebo, 60 ml per hour. On the first postoperative day the patients received either 1000 ml (median) of nutrition or placebo, on day 2 1200 ml (median) nutrition, 1400 ml placebo, on day 3 1000 ml (median) nutrition, 1150 ml placebo, and on day 4 1000 ml (median) nutrition, 800 ml placebo. All patients were followed up for 30 days by the same investigator. RESULTS: The two groups were similar with regard to nutritional status and type of operation. The rate of postoperative infectious complications was significantly lower in the nutrition group, two of 30 compared with 14 of 30 in the placebo group (p = 0.0009). CONCLUSION: Early enteral nutrition given to patients after major abdominal surgery results in an important reduction in infectious complications. PMID:9038665

  10. The chain of postoperative complications after laparoscopic cholecystectomy.

    PubMed

    Karabulut, Mehmet; Gönenç, Murat; Al??, Halil

    2014-01-01

    Bile duct injuries are among the most dreadful complications of cholecystectomy. As laparoscopic cholecystectomy has become increasingly popular, the incidence of this complication increased and has remained unchanged in spite the learning curve being completed. A 50-year-old female underwent elective laparoscopic cholecystectomy for gallstone disease. A complicated bile duct injury occurred during the procedure. As the injury was immediately recognized, it was treated with concomitant hepaticojejunostomy. In the postoperative period, biliary fistula, which was assumed to be the result of an anastomotic leak, was encountered. Diagnostic and therapeutic percutaneous transhepatic biliary drainage was considered. It revealed that the anastomosis was intact and the source of biliary leak was an aberrant right posterior sectorial branch. A severe bleeding through the biliary catheter occurred due to transmigration of the catheter into the portal vein. Bleeding was controlled with embolization by the interventional radiologist. The patient thereafter was re-operated, and the leakage was sealed by ligation of the aberrant right posterior sectorial branch. The postoperative period was uneventful. As long as cholecystectomy is performed, bile duct injuries will always exist. Therefore, every abdominal surgeon should be aware of possible consequences of complications related to this procedure. PMID:25931907

  11. Effect of Pregabalin and Dexamethasone on Postoperative Analgesia after Septoplasty

    PubMed Central

    Demirhan, Abdullah; Akkaya, Akcan; Tekelioglu, Umit Yasar; Apuhan, Tayfun; Bilgi, Murat; Yurttas, Veysel; Bayir, Hakan; Yildiz, Isa; Gok, Uzeyir; Kocoglu, Hasan

    2014-01-01

    Objectives. The aim of this study was to explore effect of a combination of pregabalin and dexamethasone on pain control after septoplasty operations. Methods. In this study, 90 patients who were scheduled for septoplasty under general anesthesia were randomly assigned into groups that received either placebo (Group C), pregabalin (Group P), or pregabalin and dexamethasone (Group PD). Preoperatively, patients received either pregabalin 300?mg one hour before surgery, dexamethasone 8?mg intravenously during induction, or placebo according to their allocation. Postoperative pain treatment included tramadol and diclofenac sodium 30 minutes before the end of the operation. Numeric rating scale (NRS) for pain assessment, side effects, and consumption of tramadol, pethidine, and ondansetron were recorded. Results. The median NRS score at the postoperative 0 and the 2nd?h was significantly higher in Group C than in Group P and Group PD (P ? 0.004 for both). The 24?h tramadol and pethidine, consumptions were significantly reduced in Groups P and PD compared to Group C (P < 0.001 and P < 0.001). The incidence of blurred vision was significantly higher in Group PD compared to Group C within both 0–2?h and 0–24?h periods (P = 0.002 and P < 0.001, resp.). Conclusions. We conclude that administration of 300 mg pregabalin preoperatively may be an adequate choice for pain control after septoplasty. Addition of dexamethasone does not significantly reduce pain in these patients. PMID:24876957

  12. Children's postoperative pain at home: family interview study.

    PubMed

    Kankkunen, Päivi M; Vehviläinen-Julkunen, Katri M; Pietilä, Anna-Maija K

    2002-02-01

    The purpose of this study was to: (i) describe the methods that are used in the identification and management of postoperative pain in children aged 1-7 years after minor outpatient surgery at home; (ii) to identify parents' perceptions regarding children's pain and pain medication; and (iii) to examine parents' perceptions of discharge advice. Family interviews with inductive content analysis were used to gather information from families of 17 Finnish children undergoing minor outpatient surgery at a university hospital in Finland. Versatile methods were employed by the parents in the identification and management of children's postoperative pain subsequent to discharge from the hospital. The children expressed that they had experienced pain relief through the administration of pain medication, eating ice-cream and playing. The results indicate a need for further research in order to identify what elements of parents' perceptions of children's pain and pain medication should receive additional attention. In addition, the content, methods of providing and timing of discharge advice need to be developed in order to help parents with their efforts to achieve maximum pain relief in children after surgery. PMID:11831425

  13. Preemptive Analgesia Does Not Reduce Pain or Improve Postoperative Functioning

    PubMed Central

    Grube, Jennifer O.; Damme-Sorenen, Jesse

    2004-01-01

    Objectives: To examine the effectiveness of preemptive analgesia in gynecologic laparoscopy patients. Methods: A double-blinded, randomized trial was performed from June 2000 to June 2001. Preoperatively, patients were randomly assigned to 0.25% bupivicaine or normal saline control. Following anesthetic induction, the study drug or a placebo was injected prior to the proposed incisions. Results: Of the 164 patients enrolled, 85 were randomized to the study group and 79 to the control. Age, surgery indication, and estimated blood loss did not vary significantly between groups. Overall mean pain score (± standard error of the mean) for study and control groups did not differ at 4 hours (3.2±0.3 vs 3.2±0.3) or at 24 hours (4.2±0.3 vs 4.2±0.3). Incisional pain scores also did not differ at 4 hours (3.0±0.3 vs 2.7±0.3) or at 24 hours (3.6±0.3 vs 3.6±0.3). Both groups were similar in activity limitation at 24 hours and oral narcotic consumption within 24 hours postoperatively. After stratifying surgery type for level of complexity, no difference was noted between groups. Multiple logistic regression analysis also noted no difference in outcomes. Conclusion: Preemptive analgesia in patients undergoing gynecologic laparoscopy does not reduce postoperative pain or decrease the time to return of normal activities. PMID:14974656

  14. Congenital Cataract: Progress in Surgical Treatment and Postoperative Recovery of Visual Function.

    PubMed

    Wang, Mingyue; Xiao, Wei

    2015-03-01

    Congenital cataract is a common cause of childhood low vision or blindness worldwide. Early surgery should be performed in sensitive vision development period to avoid vision deprivation in cases of strabismus and nystagmus development. Postoperative recovery of visual function is of great significance for these patients and should include proper postoperative aphakia correction by the application of a contact lens and secondary implantation of an intraocular lens (IOL). Patients should receive amblyopic training after surgery to improve their postoperative visual acuity. Although recent advances in surgery techniques and materials have brought better postoperative visual acuity and less complications, a few postoperative complications can still hamper vision condition and vision development, including posterior capsule opacification and secondary glaucoma. Surgery in early infancy are risk factors for these two complications. Life-long follow-up is essential for these patients. Further study will continue to address the surgery timing issue and methods that prevent postoperative complications. PMID:26390798

  15. Single dose oral paracetamol (acetaminophen) for postoperative pain in adults

    PubMed Central

    Toms, Laurence; McQuay, Henry J; Derry, Sheena; Moore, R Andrew

    2014-01-01

    Background This is an updated version of the original Cochrane review published in Issue 1, 2004 - this original review had been split from a previous title on ‘Single dose paracetamol (acetaminophen) with and without codeine for postoperative pain’. The last version of this review concluded that paracetamol is an effective analgesic for postoperative pain, but additional trials have since been published. This review sought to evaluate the efficacy and safety of paracetamol using current data, and to compare the findings with other analgesics evaluated in the same way. Objectives To assess the efficacy of single dose oral paracetamol for the treatment of acute postoperative pain. Search methods We searched The Cochrane Library, MEDLINE, EMBASE, the Oxford Pain Relief Database and reference lists of articles to update an existing version of the review in July 2008. Selection criteria Randomised, double-blind, placebo-controlled clinical trials of paracetamol for acute postoperative pain in adults. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Area under the “pain relief versus time” curve was used to derive the proportion of participants with paracetamol or placebo experiencing at least 50% pain relief over four to six hours, using validated equations. Number-needed-to-treat-to-benefit (NNT) was calculated, with 95% confidence intervals (CI). The proportion of participants using rescue analgesia over a specified time period, and time to use, were sought as measures of duration of analgesia. Information on adverse events and withdrawals was also collected. Main results Fifty-one studies, with 5762 participants, were included: 3277 participants were treated with a single oral dose of paracetamol and 2425 with placebo. About half of participants treated with paracetamol at standard doses achieved at least 50% pain relief over four to six hours, compared with about 20% treated with placebo. NNTs for at least 50% pain relief over four to six hours following a single dose of paracetamol were as follows: 500 mg NNT 3.5 (2.7 to 4.8); 600 to 650 mg NNT 4.6 (3.9 to 5.5); 975 to 1000 mg NNT 3.6 (3.4 to 4.0). There was no dose response. Sensitivity analysis showed no significant effect of trial size or quality on this outcome. About half of participants needed additional analgesia over four to six hours, compared with about 70% with placebo. Five people would need to be treated with 1000 mg paracetamol, the most commonly used dose, to prevent one needing rescue medication over four to six hours, who would have needed it with placebo. Adverse event reporting was inconsistent and often incomplete. Reported adverse events were mainly mild and transient, and occurred at similar rates with 1000 mg paracetamol and placebo. No serious adverse events were reported. Withdrawals due to adverse events were uncommon and occurred in both paracetamol and placebo treatment arms. Authors’ conclusions A single dose of paracetamol provides effective analgesia for about half of patients with acute postoperative pain, for a period of about four hours, and is associated with few, mainly mild, adverse events. PMID:18843665

  16. Elektronische Citizen Cards in Deutschland und Europa

    NASA Astrophysics Data System (ADS)

    Kowalski, Bernd

    Meine sehr geehrten Damen und Herren, der Bedarf an elektronischen Identitäten entsteht durch die wachsende Mobilität der Gesellschaft bei einem gleichzeitig steigenden Bedarf an Onlinepräsenz. Diese elektronischen Identitäten machen natürlich auch vor den staatlichen Ausweisen nicht halt, wie zum Beispiel dem Reisepass, aber auch dem Personalausweis und weiteren Ausweisdokumenten. Wobei es bei den staatlich herausgegebenen oder kontrollierten Ausweisen immer um zwei verschiedene Dinge geht: Einmal um die hoheitliche Funktion, wie zum Beispiel beim Reisepass. Hier geht es zum Beispiel darum, in einem Europa mit gefallenen Grenzen und bei freiem Reiseverkehr für alle Personen, die in diesem Raum wohnen, insbesondere auch im Schengener Raum, die Möglichkeit zu schaffen, auch künftig noch Personenkontrollen durchzuführen. Auch der Reiseverkehr über die europäischen Grenzen hinaus ist insofern ein Problem, da die Identitätenprüfung an den Grenzkontrollen immer schwieriger wird. Deswegen braucht man an dieser Stelle Möglichkeiten, um eine Personenüberprüfung durchzuführen, um feststellen zu können, dass diese Person auch zum Dokument gehört.

  17. Intelligent produzieren - Prozesse verstehen und mit innovativen Werkzeugen verbessern

    NASA Astrophysics Data System (ADS)

    Kress, Dieter

    Im Umfeld der stetig fortschreitenden Globalisierung und der damit verbundenen Verlagerung von Produktionsstätten und dem Transfer bekannter Technologien ist eine stetige Weiterentwicklung der Fertigungstechnik unumgänglich, um auch zukünftig am Standort Deutschland einen Technologievorsprung zu halten und Produkte zu fertigen, die weltweit konkurrenzfähig sind. Die Notwendigkeit zur permanenten Innovation ist unbestritten. Das Ziel muss es dabei sein, die Produktivität zu erhöhen, die Qualität der Produkte auf stets hohem Niveau zu halten bzw. die Qualität noch weiter zu steigern und gleichzeitig die Kosten stetig zu senken. Dies erfordert intelligente und innovative Werkzeugkonzepte für die Hochleistungsfertigung.

  18. Modellgestützte Ladedruck- und Abgasrückführ-Regelung von Dieselmotoren

    NASA Astrophysics Data System (ADS)

    von Pfeil, Karl

    Zur Erfüllung der Abgasgesetzgebung bei gleichzeitiger hoher Fahrleistung und Beschleunigung sind moderne Pkw-Dieselmotoren mit externer Abgasrückführung (AGR) und mit Abgasturbolader mit variabler Turbinengeometrie (VTG) ausgestattet, siehe Bild 10-1. Der über ein Ventil stellbare AGR-Massenstrom wird zur Senkung der Stickoxidemissionen eingesetzt und der Turbolader wird hauptsächlich zur Steigerung des Ladedrucks und damit zur Leistungssteigerung verwendet. Mittels VTG wird der Turbolader an den Motorbetriebspunkt angepasst. Hierzu wird über einen elektrisch oder pneumatisch betätigten Aktor die Turbinenleitschaufelstellung und damit die wirksame Turbinenströmung verstellt.

  19. Am 02. Februar 2015 wurden das Promotionsprogramm "Religion -Conflict -Reconciliation" und das Promotionsprogramm der Fakultt fr Mathematik und Informatik durch den Rat der Akademie in die Jenaer

    E-print Network

    Rossak, Wilhelm R.

    Am 02. Februar 2015 wurden das Promotionsprogramm "Religion - Conflict - Reconciliation" und das-Akademie und wählen ihre Vertreter in den Rat der Akademie. Das Promotionsprogramm "Religion - Conflict

  20. Haptische Modellierung und Deformation einer Kugelzelle

    NASA Astrophysics Data System (ADS)

    Schippritt, Darius; Wiemann, Martin; Lipinski, Hans-Gerd

    Haptische Simulationsmodelle dienen in der Medizin in erster Linie dem Training operativer Eingriffe. Sie basieren zumeist auf physikalischen Gewebemodellen, welche eine sehr genaue Simulation der biomechanischen Eigenschaften des betreffenden Gewebes erlauben, aber gleichzeitig sehr rechenintensiv und damit zeitaufwändig in der Ausführung sind. Die menschliche Wahrnehmung kann allerdings auch eine ungenaue haptische Modellierung psychooptisch ausgleichen. Daher kann es sinnvoll sein, haptische Simulationen auch mit nicht vollständig physikalisch definierten Deformationsmodellen durchzuführen. Am Beispiel der haptischer Simulation einer in-vitro Fertilisation wird gezeigt, dass durch die Anwendung eines geometrischen Deformationsmodells eine künstliche Befruchtung unter realistischen experimentellen Bedingungen in Echtzeit haptisch simuliert und damit trainiert werden kann.

  1. Impact of surgical approach on postoperative delirium in elderly patients undergoing gastrectomy: laparoscopic versus open approaches

    PubMed Central

    Shin, Young-Hee; Jeong, Hee-Joon

    2015-01-01

    Background Postoperative delirium is a frequent complication in elderly patients undergoing major abdominal surgery and is associated with a poor outcome. We compared postoperative delirium in elderly patients following laparoscopic gastrectomy (LG) versus open gastrectomy (OG). Methods In total, 130 patients aged ? 65 years with gastric cancer undergoing LG and OG were enrolled prospectively. Postoperative delirium and cognitive status were assessed daily using the Confusion Assessment Method (CAM) and Mini-Mental Status Examination (MMSE), respectively, for 3 days postoperatively. For CAM-positive patients, delirium severity was then assessed using the Delirium Index (DI). Results In total, 123 subjects (LG, n = 60; OG, n = 63) were included in the analysis. In both groups, the overall incidences of postoperative delirium were similar: 31.6% (19/60) in the LG group and 41.2% (26/63) in the OG group. When considering only those with delirium, the severity, expressed as the highest DI score, was similar between the groups. A decline in cognitive function (reduction in MMSE ? 2 points from baseline) during 3 days postoperatively was observed in 23 patients in the LG group (38.3%) and 27 patients in the OG group (42.9%) (P = 0.744). In both groups, postoperative cognitive decline was significantly associated with postoperative delirium (P < 0.001). Conclusions We found that, compared with traditional open gastrectomy, laparoscopic gastrectomy did not reduce either postoperative delirium or cognitive decline in elderly patients with gastric cancer. PMID:26257851

  2. The importance of the postoperative anesthetic visit: do repeated visits improve patient satisfaction or physician recognition?

    PubMed

    Zvara, D A; Nelson, J M; Brooker, R F; Mathes, D D; Petrozza, P H; Anderson, M T; Whelan, D M; Olympio, M A; Royster, R L

    1996-10-01

    This study evaluates whether repeated postoperative visits by the anesthesiologist improve patient ability to recall the anesthesiologist's name and the patient's perception of and satisfaction with anesthesia services. In a randomized, prospective trial, 144 patients with an anticipated postoperative length of stay of at least three days were enrolled in three groups: Group A patients (n = 48) had one postoperative visit, Group B (n = 48) had two postoperative visits, and Group C (n = 48) had three postoperative visits. All postoperative visits were performed by the attending anesthesiologist on consecutive postoperative days. Patients were contacted two days after their last postoperative visit to complete a study questionnaire. Patients were able to recall the anesthesiologist's name significantly less frequently than the surgeon's name, and there was no difference in name recall among groups. Recall was not affected by patient age, sex, or ASA physical status; the mode of contact (telephone versus personal visit); the anesthesiologist's gender; the presence of preoperative medication; or the identity of the preoperative evaluator. Patients could identify the anesthesiologist's gender approximately 85% of the time, regardless of group, and were more likely to identify female anesthesiologists (P = 0.026, odds ratio 3.3). Patient evaluation of hospital, surgical, and anesthesia care was favorable in all groups and did not vary with group. Increasing the number of postoperative visits does not improve patient name recognition of the anesthesiologist or increase patient satisfaction with or perception of anesthesia services. PMID:8831323

  3. The use of music during the immediate postoperative recovery period.

    PubMed

    Heiser, R M; Chiles, K; Fudge, M; Gray, S E

    1997-04-01

    The most effective approach to managing patients' pain in the immediate postoperative period may include a combination of pharmacologic agents and noninvasive, nonpharmacologic interventions. In this study, nurse researchers evaluated the effect of music on pain and anxiety levels and selected physiologic parameters of two groups of patients who were emerging and recovering from anesthesia. Patients in the treatment group listened to music through head-phones during the last 30 minutes of their surgical procedures and during the first hour in the postanesthesia care unit (PACU). Patients in the control group had identical surgical procedures, received the same preoperative medications, and were managed with the same anesthesia protocol but did not listen to music in the OR or PACU. No differences existed between the two patient groups in the variables measured; however, patients in the treatment group stated that music helped them relax and functioned as a distracter. PMID:9093740

  4. Perioperative fluid management and postoperative hyponatremia in children.

    PubMed

    Oh, Gia J; Sutherland, Scott M

    2016-01-01

    Intravenous (IV) fluids are used ubiquitously when children undergo surgical procedures. Until recently, Holliday and Segar's guidelines for calculating maintenance fluids dictated fluid management strategies in postoperative pediatric patients. An increased recognition of hospital-acquired hyponatremia and its associated morbidity has led to a critical re-examination of IV fluid management in this population. Postsurgical patients are at high risk of developing hyponatremia due to the presence of non-osmotic stimuli for antidiuretic hormone release. Recent studies have established that, as they are administered in current practice, hypotonic maintenance fluids are associated with increased rates of hyponatremia. The best available data demonstrate that administration of isotonic fluid reduces hyponatremic risk. In this review, we discuss the collective data available on the subject and offer guidelines for fluid management and therapeutic monitoring. PMID:25784018

  5. Postoperative Submandibular Gland Swelling following Craniotomy under General Anesthesia.

    PubMed

    Nakanishi, Haruka; Tono, Tetsuya; Ibusuki, Shoichiro

    2015-01-01

    Objective. Reporting of a rare case of postoperative submandibular gland swelling following craniotomy. Case Report. A 33-year-old male underwent resection for a brain tumor under general anesthesia. The tumor was resected via a retrosigmoid suboccipital approach and the patient was placed in a lateral position with his face down and turned to the right. Slight swelling of the right submandibular gland was observed just after the surgery. Seven hours after surgery, edematous change around the submandibular gland worsened and he required emergent reintubation due to airway compromise. The cause of submandibular gland swelling seemed to be an obstruction of the salivary duct due to surgical positioning. Conclusion. Once submandibular swelling and edematous change around the submandibular gland occur, they can worsen and compromise the air way within several hours after operation. Adequate precaution must be taken for any predisposing skull-base surgery that requires strong cervical rotation and flexion. PMID:26697254

  6. [Lymphotherapy of early postoperative period in intraocular cataract correction].

    PubMed

    Bocharov, V E; Varnakov, S I; Makarov, I A; Mel'nikova, M V

    1999-01-01

    Potentialities of lymphotropic method of drug administration for arresting inflammation after intraocular cataract correction were studied in 60 patients aged 48-63 years. Extracapsular cataract extraction with implantation of posterior-chamber Alexeev's intraocular lens (IOL) was carried out in all of them. Patients with complications of surgery and a history of inflammations in the operated eye were not included in the study. For assessing lymphotherapy effect on drug concentration in the blood, bloodflow aggregation gradient in the bulbar conjunctiva venules was estimated in the operated on eye. The data indicate that lymphotherapy is an effective method for treating early postoperative inflammations after IOL implantation, shortening the treatment terms in comparison with traditional therapy. PMID:10207315

  7. POSTOP: Postbuckled open-stiffener optimum panels, user's manual

    NASA Technical Reports Server (NTRS)

    Biggers, S. B.; Dickson, J. N.

    1984-01-01

    The computer program POSTOP developed to serve as an aid in the analysis and sizing of stiffened composite panels that may be loaded in the postbuckling regime, is intended for the preliminary design of metal or composite panels with open-section stiffeners, subjected to multiple combined biaxial compression (or tension), shear and normal pressure load cases. Longitudinal compression, however, is assumed to be the dominant loading. Temperature, initial bow eccentricity and load eccentricity effects are included. The panel geometry is assumed to be repetitive over several bays in the longitudinal (stiffener) direction as well as in the transverse direction. Analytical routines are included to compute panel stiffnesses, strains, local and panel buckling loads, and skin/stiffener interface stresses. The resulting program is applicable to stiffened panels as commonly used in fuselage, wing, or empennage structures. The capabilities and limitations of the code are described. Instructions required to use the program and several example problems are included.

  8. Postoperative Submandibular Gland Swelling following Craniotomy under General Anesthesia

    PubMed Central

    Nakanishi, Haruka; Tono, Tetsuya; Ibusuki, Shoichiro

    2015-01-01

    Objective. Reporting of a rare case of postoperative submandibular gland swelling following craniotomy. Case Report. A 33-year-old male underwent resection for a brain tumor under general anesthesia. The tumor was resected via a retrosigmoid suboccipital approach and the patient was placed in a lateral position with his face down and turned to the right. Slight swelling of the right submandibular gland was observed just after the surgery. Seven hours after surgery, edematous change around the submandibular gland worsened and he required emergent reintubation due to airway compromise. The cause of submandibular gland swelling seemed to be an obstruction of the salivary duct due to surgical positioning. Conclusion. Once submandibular swelling and edematous change around the submandibular gland occur, they can worsen and compromise the air way within several hours after operation. Adequate precaution must be taken for any predisposing skull-base surgery that requires strong cervical rotation and flexion. PMID:26697254

  9. Postoperative Delayed Duodenum Perforation following Elective Laparoscopic Cholecystectomy.

    PubMed

    Jing, Kong; Shuo-Dong, Wu

    2014-01-01

    Background. Duodenum injury is extremely rare complication of laparoscopic cholecystectomy with potentially fatal consequences. Methods. Over the past 13-year period, 3000 laparoscopic cholecystectomies were performed in our institution. Duodenum injury only occurred in one patient recently who had undergone gastrectomy owing to duodenal diverticulum. The diagnosis and management of this rare complication of laparoscopic cholecystectomy are described, and the literature is reviewed. Results. We present this case of duodenum injury on the fourth postoperative day after selective laparoscopic cholecystectomy was treated successfully by percutaneous needle aspiration and catheter drainage. The hospital stay was 26 days. No abscess recurred during the follow-up period. Conclusion. Duodenum injuries are extremely rare complications of laparoscopic cholecystectomy with potentially fatal consequences if not promptly recognized and treated. Sonographically guided percutaneous needle aspiration and catheter drainage can be used to treat the intraperitoneal abscess. Billroth II subtotal gastrectomy and gastrojejunostomy were beneficial for the treatment. PMID:24790609

  10. Postoperative Delayed Duodenum Perforation following Elective Laparoscopic Cholecystectomy

    PubMed Central

    Jing, Kong; Shuo-Dong, Wu

    2014-01-01

    Background. Duodenum injury is extremely rare complication of laparoscopic cholecystectomy with potentially fatal consequences. Methods. Over the past 13-year period, 3000 laparoscopic cholecystectomies were performed in our institution. Duodenum injury only occurred in one patient recently who had undergone gastrectomy owing to duodenal diverticulum. The diagnosis and management of this rare complication of laparoscopic cholecystectomy are described, and the literature is reviewed. Results. We present this case of duodenum injury on the fourth postoperative day after selective laparoscopic cholecystectomy was treated successfully by percutaneous needle aspiration and catheter drainage. The hospital stay was 26 days. No abscess recurred during the follow-up period. Conclusion. Duodenum injuries are extremely rare complications of laparoscopic cholecystectomy with potentially fatal consequences if not promptly recognized and treated. Sonographically guided percutaneous needle aspiration and catheter drainage can be used to treat the intraperitoneal abscess. Billroth II subtotal gastrectomy and gastrojejunostomy were beneficial for the treatment. PMID:24790609

  11. The efficacy of benorylate in postoperative dental pain.

    PubMed

    Moore, U; Seymour, R A; Williams, F M; Nicholson, E; Rawlins, M D

    1989-01-01

    The efficacy of a single pre-operative dose of benorylate (4 g) was determined in a double-blind, randomized, placebo-controlled parallel study in patients undergoing removal of a single impacted lower third molar. Patients treated with benorylate 4 g reported significantly less pain between 3-6 h after dosage than those treated with placebo. Overall pain scores at 6 h were significantly less in the benorylate group than the placebo group. However, overall pain scores at 12 h did not differ significantly between treatment groups. It is concluded from this study that a single dose of benorylate 4 g given immediately prior to the removal of an impacted lower third molar provides limited pain control during the postoperative period. PMID:2563688

  12. [Pleural hernia of an esophageal graft--late postoperative complication].

    PubMed

    Grabowski, K; Lewandowski, A; Moro?, K; Struty?ska-Karpi?ska, M; B?aszczuk, J; Macha?a, R

    1997-01-01

    Pleural hernia of the oesophageal substitute from pedicled intestinal segment is one of the late postoperative complications. 13 cases of patients with oesophagus reconstructed because of lye ingestion stenosis are presented. Problems concerning diagnosis and treatment of pleural hernia are analysed. Eight patients with minor symptoms were treated conservatively. Five patients were operated, two of them from acute necrosis of the substitute. Necrosis was caused by incarceration of the bowel and torsion of the mesentery. Elective operative treatment consisted of reduction of hernia sac contents, closing of the hernia orifice, chest drainage and temporary gastronomy. In patient operated as an emergency cases necrotic part of substitute was removed. This resulted in oesophageal exclusion in the neck, creating gastronomy. Chest drainage was also performed. PMID:9446380

  13. Diagnosis of varicocele and postoperative evaluation using inguinal ultrasonography.

    PubMed Central

    Orda, R; Sayfan, J; Manor, H; Witz, E; Sofer, Y

    1987-01-01

    Ultrasonographic real-time imaging and measurements of spermatic veins in the inguinal canal were evaluated in two groups of patients: 20 young men with varicocele and 18 controls. Examinations were performed with the patient in an upright relaxed position, and performing the Valsalva maneuver. The increase in diameter of the main vein during Valsalva maneuver was considered to quantitatively represent venous reflux. The data obtained were correlated with pre- and postoperative clinical findings. This method of evaluation proved to be a useful noninvasive diagnostic modality for detecting varicocele and for assessing treatment results. On the basis of venous diameters and reflux values, a classification of varicocele is proposed. Such an objective method of grading would eliminate the subjective impression and interpretation factors of the examiner. Images Fig. 1. PMID:3300579

  14. Management of postoperative nausea and vomiting: focus on palonosetron

    PubMed Central

    Muchatuta, Neil A; Paech, Michael J

    2009-01-01

    Postoperative nausea and vomiting (PONV) remains a significant problem in modern anesthetic practice, with an incidence in high-risk groups of up to 80%. In addition to being unpleasant and distressing for the patient, PONV has the potential to adversely affect patient and surgical outcomes. Advances in PONV prophylaxis over recent years include using non-pharmacological means to reduce baseline risk, a change to less emetogenic anesthetic techniques and the combination of multiple antiemetic drugs. The 5-hydroxytryptamine-3 (5-HT3) antagonists have proven a particularly valuable addition to the armamentarium against PONV. Palonosetron is a second-generation 5-HT3 antagonist that has recently been approved for prophylaxis against PONV. It has unique structural, pharmacological and clinical properties that distinguish it from other agents in its class. This review summarizes current evidence on PONV prophylaxis, reviews the 5-HT3 antagonists in particular and focuses on the established and future roles of palonosetron. PMID:19436621

  15. TGF?-Smad signalling in postoperative human lens epithelial cells

    PubMed Central

    Saika, S; Miyamoto, T; Ishida, I; Shirai, K; Ohnishi, Y; Ooshima, A; McAvoy, J W

    2002-01-01

    Aims: To localise Smads3/4 proteins in lens epithelial cells (LECs) of fresh and postoperative human specimens. Smads3/4 are involved in signal transduction between transforming growth factor ? (TGF?) cell surface receptors and gene promoters. Nuclear localisation of Smads indicates achievement of endogenous TGF? signalling in cells. Methods: Three circular sections of the anterior capsule, one lens, and 17 capsules undergoing postoperative healing were studied. Immunohistochemistry was performed for Smads3/4 in paraffin sections of the specimens. The effect of exogenous TGF?2 on Smad3 subcellular localisation was examined in explant cultures of extracted human anterior lens epithelium. Results: The cytoplasm, but not the nuclei, of LECs of uninjured lenses was immunoreactive for Smads3/4. In contrast, nuclear immunoreactivity for Smads3/4 was detected in LECs during capsular healing. Nuclei positive for Smads3/4 were observed in monolayered LECs adjacent to the regenerated lens fibres of Sommerring’s ring. Interestingly, the nuclei of LECs that were somewhat elongated, and appeared to be differentiating into fibre-like cells, were negative for Smads3/4. Fibroblast-like, spindle-shaped lens cells with nuclear immunoreactivity for nuclear Smads3/4 were occasionally observed in the extracellular matrix accumulated in capsular opacification. Exogenous TGF? induced nuclear translocation of Smad3 in LECs of anterior capsule specimens in explant culture. Conclusions: This is consistent with TGF? induced Smad signalling being involved in regulating the behaviour of LECs during wound healing after cataract surgery. PMID:12446380

  16. Postoperative ureteral obstruction after endoscopic treatment for vesicoureteral reflux

    PubMed Central

    Chung, Jae Min; Park, Chang Soo

    2015-01-01

    Purpose We undertook this study to evaluate the incidence, risk factors, management, and outcome of postoperative ureteral obstruction after endoscopic treatment for vesicoureteral reflux (VUR). Materials and Methods Ninety patients undergoing endoscopic treatment for VUR were retrospectively reviewed and classified into two groups according to ureteral obstruction: the nonobstruction group (83 cases, 122 ureters; mean age, 7.0±2.8 years) and the obstruction group (7 cases, 10 ureters; mean age, 6.2±8.1 years). We analyzed the following factors: age, sex, injection material, laterality, voiding dysfunction, constipation, renal scarring, preoperative and postoperative ultrasound findings, endoscopic findings, injection number, and injection volume. Additionally, we reviewed the clinical manifestations, natural course, management, and outcome of ureteral obstruction after endoscopic treatment. Results The incidence of ureteral obstruction after endoscopic treatment was 7.6% (10/132 ureters). The type of bulking agent used and injection volume tended to be associated with ureteral obstruction. However, no significant risk factors for obstruction were identified between the two groups. Three patients showed no symptoms or signs after the onset of ureteral obstruction. Most of the patients with ureteral obstruction experienced spontaneous resolution within 1 month with conservative therapy. Two patients required temporary ureteral stents to release the ureteral obstruction. Conclusions In our experience, the incidence of ureteral obstruction was slightly higher than in previous reports. Our study identified no predictive risk factors for developing ureteral obstruction after endoscopic treatment. Although most of the ureteral obstructions resolved spontaneously within 1 month, some cases required drainage to relieve symptoms or to prevent renal function deterioration. PMID:26175873

  17. Effects of sugammadex on the prevention of postoperative peritoneal adhesions.

    PubMed

    ?ahin, Hasan; Toman, Hüseyin; Kiraz, Hasan Ali; ?im?ek, Tuncer; Erba?, Mesut; Özkul, Faruk; Ar?k, Muhammet Kas?m; Hanc?, Volkan

    2015-09-01

    Many materials and techniques have been used to prevent and repair intra-abdominal adhesions, but an effective solution has not been found. The aim of this study is to research the effect of sugammadex on intra-abdominal adhesions in an experimentally induced intra-abdominal adhesion model. Twenty-four female Wistar albino rats were included in the study. The experimental animals were randomly divided into three groups: the sugammadex group (Group SX, n = 8), the control group (Group C, n = 8), and the sham group (Group S, n = 8). After starvation for 1 night, the rats were injected with a 50 mg/kg intramuscular dose of ketamine and a 5 mg/kg intramuscular dose of xylazine for anesthesia. The rats in the SX group were given 3 mL sugammadex into the peritoneal cavity, while rats in the control group were given 3 mL 0.9% sodium chloride. In the sham group, the peritoneal cavity was opened, but no chemicals were administered. All rats were sacrificed on the 10(th) postoperative day. The adhesions were staged as 0, 1, 2, and 3 according to Evans et al.'s model. Our evaluation of macroscopic adhesion intensity found statistically significant differences between the groups. The sugammadex group was observed to have fewer adhesions in a statistically significant manner compared with the control group (p < 0.05). In our experimental intra-abdominal adhesion model in rats, we observed that sugammadex prevented postoperative intra-abdominal adhesions. PMID:26362958

  18. High Rates of Postoperative Wound Infection Following Elective Implant Removal

    PubMed Central

    Backes, M; Schep, N.W.L; Luitse, J.S.K; Goslings, J.C; Schepers, T

    2015-01-01

    Introduction : Metal implants placed during fracture surgery are often removed for various reasons (i.e. pain, prominent material, patients request). The removal of implants is considered a ‘clean’ procedure and as low risk surgery. The incidence of wound infections following implant removal has received little attention in the literature. The aim of the current study was to assess the incidence and risk factors of postoperative wound infections (POWIs) following implant removal. Material and Methods : All consecutive adult patients in a Level 1 and Level 2 Trauma Center who had their implants removed during a 6.5 years period were included. Exclusion criteria were removal of implants because of an ongoing infection or fistula and removal followed by placement of new implants. Primary outcome measure was a POWI as defined by the US Centers for Disease Control and Prevention. Patient characteristics and peri-operative characteristics were collected from the medical charts. Results : A total of 452 patients were included (512 procedures). The overall POWI rate was 11.6% (10% superficial, 1.6% deep). A total of 403 procedures (78.7%) comprised of implant removal below the knee joint with a 12.2% POWI rate. A POWI following initial fracture treatment was associated with a higher rate of POWI following implant removal (p=0.012). A POWI occurred more often in younger patients (median age 36 versus 43 years; p=0.004). Conclusion : The overall incidence of postoperative wound infection was 11.6% with 10% superficial and 1.6% of deep infections in patients with elective implant removal. A risk factor for POWI following implant removal was a previous wound infection. PMID:26401166

  19. Post-operative bilateral adrenal haemorrhage: A case report

    PubMed Central

    McNicol, R.E.; Bradley, A.; Griffin, J.; Duncan, G.; Eriksen, C.A.; Guthrie, G.J.K.

    2014-01-01

    INTRODUCTION Bilateral adrenal haemorrhage is a rare, but serious, illness carrying an estimated 15% mortality.1,2 The majority of cases occur in patients with acute, stressful illness, however the exact mechanism underlying adrenal haemorrhage remains unclear. This medical emergency carries significant diagnostic difficulty4 with non-specific clinical symptoms and variations in electrolyte abnormalities. Timely treatment is important as it prevents both the acute and long-term sequelae of adrenal failure. PRESENTATION OF CASE This report describes a medical emergency in a surgical patient following emergency surgery for intra-abdominal sepsis. The patient reported non-specific symptoms of confusion, mild pyrexia and vague abdominal pain during the post-operative phase, with subtle electrolyte abnormalities and a low serum cortisol suggestive of adrenal crisis. Timely medical treatment, with intravenous hydrocortisone and intensive monitoring, and appropriate medical follow-up with addition of long-term fludrocortisone resulted in a satisfactory outcome. DISCUSSION This report describes a potentially life-threatening complication of intra-abdominal sepsis with adrenal crisis secondary to bilateral adrenal haemorrhage. In particular, this case highlights the diagnostic difficulty in such surgical patients due to vague symptoms and, in this case, the presence of a presentation variant with acute hyponatraemia and normal potassium. CONCLUSION This case highlights the importance of awareness of both the symptoms and signs and variation in electrolyte profile when assessing surgical patients post-operatively. In addition, this case highlights the benefit of early recognition and initiation of treatment and the importance of follow-up as long-term medical management is often required to prevent further relapse. PMID:25437659

  20. Universitat Konstanz Fachbereich Mathematik und Statistik

    E-print Network

    Dreher, Michael

    bezeichnen wir mit lim inf n xn, lim sup n xn den kleinsten bzw. gr¨o�ten H¨aufungspunkt dieser Folge (limes inferior bzw. limes superior). Finden Sie zwei beschr¨ankte Folgen (an)nN und (bn)nN reeller Zahlen mit lim

  1. Universitat Konstanz Fachbereich Mathematik und Statistik

    E-print Network

    Dreher, Michael

    lim inf n xn, lim sup n xn den kleinsten bzw. gr¨o�ten H¨aufungspunkt dieser Folge (gesprochen: limes inferior bzw. limes superior). Finden Sie zwei beschr¨ankte Folgen (an)nN und (bn)nN reeller Zahlen mit lim

  2. infos und akzente 1/2001 schwerpunkt

    E-print Network

    Steiner, Daniel

    's fit to print», steht oben über der Titelseite der New York Times ­ «Alle Nachrichten, die würdig sind nicht. Information, Nachrichten, Journalismus ­ was meinen wir heute in unserer Welt mit diesen das ganze Sendevolumen minus Unterhaltung, «fiction» und Werbung. Konkreter: Nachrichten, Magazine

  3. Digitale Gedchtnisse fr Menschen und Objekte

    E-print Network

    Siekmann, Jörg H.

    Gedächtnisses Memex-Vision von Vannevar Bush: Mikrofilme als Speichermedium Zeitlinie verfolgen durch abspielen Leben in einem ,,Lifelog" digital zu konservieren. Quellen: [Bush, 1945], [Wikipedia, 2012b], [Google Quelle: [Bush, 1945] #12;Digitale Gedächtnisse für Menschen und Objekte · 13. August 2012 · 9© DFKI Gmb

  4. Projektbericht Marina Shvalova und Oliver Bestmann

    E-print Network

    Parallelrechnerevaluation PySpank: Python Interface zu SPANK Betreuer: Julian Kunkel Wissenschaftliches Rechnen Department-ins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2.3 SPANK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 3 PySPANK 10.1 Motivation und Zielsetzung Im Rahmen dieser Arbeit wird ein Python Interface PySPANK zu einer Plug-in Schnitt

  5. Greifswalder Beitrge zur Hochschullehre Elektronische Prfungsformen und

    E-print Network

    Greifswald, Ernst-Moritz-Arndt-Universität

    . Die Verantwortung für den Inhalt dieser Veröffentlichung liegt beim Autor. #12;5 InhaltsverzeEktronischE PrüfungsformEn und E-lEarning-untErstützung für PolyvalEntE lEhrE sind der schwerpunkt des vierten Bandes der

  6. Nobelpreistrger STATION UND WISSENSCHAF TLICHE HEIMAT

    E-print Network

    Just, Armin

    -LUDWIGS-UNIVER SITÄT #12;Heinrich Otto Wieland, 1927 NOBELPREIS FÜR CHEMIE Adolf Otto Reinhold Windaus, 1928 NOBELPREIS-LUDWIGS-UNIVERSITÄT FREIBURG HEINRICH OTTO WIELAND, * 1877 in Pforzheim, 1957 in München 1927 Nobelpreis für Chemie "Für seine Forschungen über die Zusammensetzung der Gallensäure und verwandter Substanzen" ADOLF OTTO REINHOLD WINDAUS

  7. Nobelpreistrger STATION UND WISSENSCHAF TLICHE HEIMAT

    E-print Network

    Just, Armin

    -LUDWIGS-UNIVER SITÄT #12;Heinrich Otto Wieland, 1927 NOBELPREIS FÜR CHEMIE Adolf Otto Reinhold Windaus, 1928 NOBELPREIS-LUDWIGS-UNIVERSITÄT FREIBURG HEINRICH OTTO WIELAND, * 1877 in Pforzheim, 1957 in München 1927 Nobelpreis für Chemie ,,Für seine Forschungen über die Zusammensetzung der Gallensäure und verwandter Substanzen" ADOLF OTTO

  8. Mol-Gastronomie Vinaigrettes und Benetzung

    NASA Astrophysics Data System (ADS)

    Vilgis, Thomas

    2005-03-01

    Dass wir Salatblätter mit einer Vinaigrette übergießen, hat natürlich einen kulinarischen Grund: Die Kombination von Essig und Öl verleiht Salat erheblich an Geschmack. Nicht nur durch deren Eigengeschmack, sondern auch durch die Lösungseigenschaften von Geschmacksstoffen. Allerdings liefern Salatsaucen auch einen physikalischen Grund für ihre Beliebtheit: die Benetzungsfähigkeit der Blätter.

  9. Studienjahr 2015/2016 | Medizin -Modellstudiengang HannibaL | MHH | Psychiatrie und Psychotherapie

    E-print Network

    Manstein, Dietmar J.

    Studienjahr 2015/2016 | Medizin - Modellstudiengang HannibaL | MHH | Psychiatrie und Psychotherapie Krankheitsbilder; Übersicht über therapeutische Strategien in Psychiatrie und Psychotherapie; Unterscheidung des Folgetertials Literatur: z. B. Möller et al.: Psychiatrie und Psychotherapie. Thieme-Verlag (Duale

  10. Angebotsspezifische Prfungsordnung fr das Weiterbildungsprogramm ,,Softwareentwicklung und Software Engineering" an der Universitt Bremen

    E-print Network

    Diekmann, Martin

    Software Engineering" an der Universität Bremen mit dem Weiterbildenden Studium ,,Softwareentwicklung und Software Engineering" mit Zertifikatsabschluss und Weiterbildungskursen im Bereich ,,Softwareentwicklung und Software Engineering" mit Zertifikatsabschluss vom 29. Oktober 2014 Der Fachbereichsrat 3

  11. Nr. 052 // 2014 // 27. Mrz 2014 Zukunftsforum ,Recht und Moral` am 4.4.14

    E-print Network

    Schittkowski, Klaus

    Himmel ­ Über das Verhältnis von Regeln und Moral im Sport` referieren. Die Juristin und ehemalige Leistungssportlerin war eine der Ersten, die Doping im Radsport anprangerte und sich durch ihr beherztes Vorgehen

  12. The Importance of Pre and Postoperative Physical Activity Counseling in Bariatric Surgery

    PubMed Central

    King, Wendy C; Bond, Dale S

    2012-01-01

    There is increasing evidence that physical activity (PA) can enhance weight loss and other outcomes after bariatric surgery. However, most preoperative patients are insufficiently active, and without support, fail to make substantial increases in their PA postoperatively. This review provides the rationale for PA counseling in bariatric surgery and describes how to appropriately tailor strategies to pre- and postoperative patients. PMID:22710705

  13. Comparison of Linear and Non-linear Soft Tissue Models with Post-operative CT Scan

    E-print Network

    Payan, Yohan

    Comparison of Linear and Non-linear Soft Tissue Models with Post-operative CT Scan in Maxillofacial on a qualitative and quantitative comparison of the simulations with a post-operative CT scan is detailed many models were proposed in the literature, few works propose satisfying validation procedures

  14. A case of adolescent giant parathyroid adenoma presenting multiple osteolytic fractures and postoperative hungry bone syndrome

    PubMed Central

    Ebina, Kosuke; Miyoshi, Yuji; Izumi, Shinji; Hashimoto, Jun; Naka, Norifumi; Tsukamoto, Yasunori; Kashii, Masafumi; Kaito, Takashi; Yoshikawa, Hideki

    2015-01-01

    Key Clinical Message Primary hyperparathyroidism (PHPT) and postoperative hungry bone syndrome are very rare conditions in adolescents, and may be frequently misdiagnosed as a metastatic bone tumor. However, delay in diagnosis may lead to a fatal preoperative hypercalcemia and postoperative hypocalcemia. PHPT is a differential diagnosis of adolescent hypercalcemia and osteolytic fractures. PMID:26509019

  15. Serum thrombomodulin as a newly identified biomarker for postoperative lung injury: a prospective observational study.

    PubMed

    Maeda, Sumiko; Takahashi, Satomi; Sato, Masami

    2012-01-01

    Postoperative lung injury after lung cancer resection is still a difficult problem to be solved. Thrombomodulin (TM) is a membrane-bound glycoprotein of endothelial cells, and its serum level is elevated in patients with acute lung injury or acute respiratory distress syndrome. In fact, TM is abundant in the pulmonary capillary vessels. Lung resection reduces the volume of pulmonary capillary vessels; however, the change in the serum levels of TM after lung resection remains to be investigated. We therefore analyzed the postoperative changes in the serum TM levels in 60 patients who underwent thoracotomy without lung resection (n = 3), partial resection of the lung (n = 15), or lobectomy (n = 42). Preoperative and postoperative day-1 laboratory data including the serum levels of TM and KL-6, a sialylated carbohydrate antigen (a biomarker for pulmonary fibrosis), and oxygenation index were collected. Unexpectedly, the postoperative serum levels of TM were lower than preoperative values in lobectomy group, whereas they remained unchanged after thoracotomy without lung resection and after partial resection of the lung. In addition, the serum TM level decreased proportional to the resected lung volume. Eight out of 42 patients with lobectomy presented high postoperative serum levels of TM, and 3 out of these 8 patients presented postoperative impaired oxygenation. Postoperative impaired oxygenation occurred only in patients with elevated TM levels; namely, an increase of serum TM is associated with impaired oxygenation after lung resection. In conclusion, serum TM is a possible biomarker for predicting the occurrence of postoperative lung injury. PMID:22990590

  16. Comparative study between paracetamol and two different doses of pregabalin on postoperative pain in laparoscopic cholecystectomy

    PubMed Central

    Esmat, Ibrahim M.; Farag, Hanan M.

    2015-01-01

    Background: Postoperative pain is the primary reason for prolonged hospital stay after laparoscopic cholecystectomy. This study compared the effect of a single oral preoperative administration of paracetamol (1 g) with 2 different doses of pregabalin (150 or 300 mg) for attenuating postoperative pain and analgesic consumption. Materials and Methods: Seventy-five patients, aged 18-60 years, American Society of Anesthesiologists’ physical status I and II undergoing elective laparoscopic cholecystectomy were included in this randomized controlled study. Patients were divided into three groups, 25 each to receive either oral paracetamol 1 g (group I, control group) or pregabalin 150 (group II) or 300 mg (group III), 2 h before surgery. Postoperative pain was evaluated based on visual analog scale over a period of 6 h and 1st time for rescue analgesia. Postoperative sedation, hemodynamic changes, serum cortisol level, and side effects were also evaluated. Results: There was a significant decrease in mean heart rate, mean systolic blood pressure, sedation score, pain score, and delayed the first request for analgesics postoperatively in group (II) and group (III) compared to group (I) 2 h postoperatively. There was no significant difference in group (III) compared to group (II) postoperatively. The incidence of postoperative side effects was more in group (III). Conclusion: The single oral preoperative dose administration of pregabalin had significant opioid-sparing effect in the first 6 h after surgery, whereas side effects were more common with administration of pregabalin 300 mg. PMID:26543452

  17. CLINICAL ASPECTS OF ACUTE POST-OPERATIVE PAIN MANAGEMENT & ITS ASSESSMENT

    PubMed Central

    Gupta, Anuj; Kaur, Kirtipal; Sharma, Sheeshpal; Goyal, Shubham; Arora, Saahil; Murthy, R.S.R

    2010-01-01

    Management of postoperative pain relieve suffering and leads to earlier mobilization, shortened hospital stay, reduced hospital costs, and increased patient satisfaction. An effective postoperative management is not a standardized regime rather is tailored to the needs of the individual patient, taking into account medical, psychological, and physical condition; age; level of fear or anxiety; surgical procedure; personal preference; and response to therapeutic agents given. The major goal in the management of postoperative pain is to minimize the dose of medications to lessen side effects & provide adequate analgesia. Postoperative pain is still under managed due to obstacles in implementation of Acute Pain Services due to insufficient education, fear of complications associated with available analgesic drugs, poor pain assessment and inadequate staff. This review reflects the clinical aspects of postoperative pain & its assessment & management with an emphasis on research for new analgesic molecules & delivery system. PMID:22247838

  18. Bench-to-bedside review: Routine postoperative use of the nasogastric tube – utility or futility?

    PubMed Central

    Tanguy, Michèle; Seguin, Philippe; Mallédant, Yannick

    2007-01-01

    This article provides a summary of current information on rational postoperative use of the nasogastric tube, based on a review of literature related to postoperative gastrointestinal discomfort and management with the nasogastric tube. Routine gastric decompression after major surgery neither hastens the return of bowel function nor diminishes the incidence of postoperative nausea and vomiting. The multimodal postoperative rehabilitation programme is a modern and more efficient approach. Omission of nasogastric tube decompression does not increase the incidence of anastomotic leakage or wound dehiscence. Conversely, early enteral feeding is feasible and safe, favours local immunity and gut integrity, and improves nutritional status. With the objective to feeding, nasogastric tube could be used in selected patients. To conclude, use of the nasogastric tube to prevent or limit postoperative gastrointestinal discomfort must be challenged. In contrast to gastric decompression, early gastric feeding must be considered within the new concept of fast track surgery. PMID:17214909

  19. Prediction of Post-Operative Liver Dysfunction by Serum Markers of Liver Fibrosis in Hepatocellular Carcinoma

    PubMed Central

    Shen, Yinghao; Shi, Guoming; Huang, Cheng; Zhu, Xiaodong; Chen, Si; Sun, Huichuan; Zhou, Jian; Fan, Jia

    2015-01-01

    Aim To investigate the role of biomarkers in predicting postoperative liver dysfunction in patients with hepatocellular carcinoma (HCC). Methods A total of 200 patients operated from July 2009 to June 2010 at Zhongshan Hospital, Fudan University for pathologically confirmed HCC were retrospectively analyzed for clinical data, HBD DNA level and serum biochemical markers for liver fibrosis. The patients were followed up to observersation end point. Correlation of the monitored parameters with postoperative liver dysfunction and patient survival was statistically analyzed. Results Preoperative hepatitis B virus (HBV) DNA level, serum prealbumin (PA) hyaluronic acid (HA), and laminin (LN) levels correlated with postoperative liver dysfunction. A predictive model was generated using these 4 parameters and validated in 89 HCC patients with sensitivity and specificity of 0.625 and 0.912, respectively. However, no correlation was identified between postoperative liver function and overall survival. Conclusion Liver fibrosis markers could be preoperatively used in predicting postoperative liver dysfunction in HCC patients. PMID:26501145

  20. Methods for the postoperative management of the thoracic oncology patients: lessons from the clinic.

    PubMed

    Leuzzi, Giovanni; Facciolo, Francesco; Pastorino, Ugo; Rocco, Gaetano

    2015-12-01

    Oncological thoracic surgery comprises challenging procedures not only from a surgical point of view but also regarding the postoperative management. The most significant procedures performed for malignancy are those requiring resection of the lung, the pleura, the esophagus, mediastinal structures, the chest wall and airways. Especially after major procedures, postoperative complications occur frequently and usually require a multidisciplinary approach involving thoracic surgeons, anesthesiologists, pulmonologist, physiotherapists and oncologists. Thus, a proper postoperative management is as important as the surgical procedure to achieve the best outcome following surgery. In this article, we provide an overview of the basic principles for management of postoperative imaging and drain system and review the main postoperative complications following thoracic surgery, focusing also on new strategies to prevent them. PMID:26536136

  1. Post-operative cognitive function following general versus regional anesthesia, a systematic review

    PubMed Central

    Davis, Nicholas; Lee, Melissa; Lin, Albert Y.; Lynch, Lisa; Monteleone, Matthew; Falzon, Louise; Ispahany, Nighat; Lei, Susan

    2014-01-01

    The effect of anesthetic technique on post-operative outcomes remains in question. This systematic review compares the role of regional versus general anesthesia, with a particular focus on post-operative cognitive function. Potentially relevant articles were identified by searching publicly available computerized databases for this systematic review. Any surgical procedure was accepted with the exception of cardiac, carotid, and neurosurgical procedures. Any regional anesthetic technique was accepted unless combined with a general anesthetic or in conjunction with propofol as a sedative. Any measure of post-operative cognitive function was accepted as long as it was performed no sooner than seven days post-operatively. Sixteen studies met inclusion criteria and were included in the final analysis. Three studies showed some difference in cognitive function between regional and general anesthesia, while the remaining thirteen showed no difference between regional and general anesthesia on postoperative cognitive function. PMID:25144505

  2. A Retrospective Analysis of the Management of Postoperative Discitis: A Single Institutional Experience

    PubMed Central

    Lakshmi, K.

    2015-01-01

    Study Design Retrospective study. Purpose The aim of the study was to study the impact and outcome of conservative management and surgical intervention in cases of postoperative discitis. Overview of Literature Postoperative discitis is a rare but often misdiagnosed cause of failed back syndrome. There is paucity of literature regarding management guidelines of postoperative discitis. Methods The study was carried out over a period of 6 years. Eighteen patients with postoperative discitis were included in the study. Results Conservative management with antibiotics, analgesics and bed rest were started in all the study cases. Posterior transpedicular fixation after re-exploration debridement and curettage of disc space granulation tissue was conducted in five patients in whom conservative management failed. Conclusions Early diagnosis and appropriate management is the key to effective treatment of postoperative discitis. Conservative management leads to excellent results in majority of cases. Surgical intervention with posterior interbody fusion and debridement is helpful when conservative treatment fails. PMID:26240715

  3. Day case laparoscopy: a survey of postoperative pain and an assessment of the value of diclofenac.

    PubMed

    Edwards, N D; Barclay, K; Catling, S J; Martin, D G; Morgan, R H

    1991-12-01

    A randomised, controlled study was undertaken to assess the postoperative pain and side effects experienced by patients undergoing day case diagnostic laparoscopy and laparoscopic sterilisation, and to evaluate the effectiveness in these patients of peroperative diclofenac. Patients undergoing laparoscopic sterilisation had significantly higher pain scores at one hour postoperatively, and at discharge, than patients undergoing diagnostic laparoscopy (p less than 0.01) but there were no significant differences in pain scores 24 hours after discharge. The incidence of postoperative side effects following discharge from hospital was high, but there were no significant differences between the groups. Diclofenac had no significant effect in either group on the severity of postoperative pain, or the incidence of postoperative side effects. PMID:1838235

  4. Schönheit und andere Provokationen - Eine neue evolutionsbiologische Theorie der Kunst

    NASA Astrophysics Data System (ADS)

    Junker, Thomas

    Die Evolution hat viele spektakuläre Phänomene hervorgebracht - von der Eleganz des Vogelflugs über die gigantischen Körper der Dinosaurier und die farbenprächtige Vielfalt der Korallenriffe bis hin zu ihrem jüngsten Geniestreich - der menschlichen Kunst. Die schönen Künste - Malerei, Bildhauerei und Architektur, Theater, Tanz, Oper und Filmkunst, Musik und Literatur - Produkte der Evolution? Diese Vorstellung mutet vielen Menschen fremd an, aber wie könnte es anders sein? Denn wenn Charles Darwin recht hat, dann sind nicht nur die körperlichen Merkmale der Menschen als Antworten auf die Erfordernisse des Lebens entstanden, sondern auch ihre geistigen Fähigkeiten und Verhaltensweisen. Im Jahr 1859 hatte er auf den letzten Seiten seines berühmten Buches über die Entstehung der Arten eine kühne Prophezeiung gemacht: Durch die Evolutionstheorie werde es "zu einer bemerkenswerten Revolution in der Naturwissenschaft kommen […]. Die Psychologie wird auf die neue Grundlage gestellt, dass jede geistige Kraft und Fähigkeit notwendigerweise durch graduelle Übergänge erworben wird“ (Darwin 1859, S. 484, 488; Junker 2008).

  5. Dekanat der Sozial-und Wirtschaftswissenschaftlichen Fakultt Johannes Kepler Universitt Linz, Altenberger Strae 69, 4040 Linz

    E-print Network

    Hochreiter, Sepp

    Dekanat der Sozial- und Wirtschaftswissenschaftlichen Fakultät Johannes Kepler Universität Linz Institut für angewandte Statistik an der Johannes Kepler Universität Linz an und übernahm im April 2014 die

  6. Analysis of risk factors for postoperative pancreatic fistula following pancreaticoduodenectomy

    PubMed Central

    Liu, Qi-Yu; Zhang, Wen-Zhi; Xia, Hong-Tian; Leng, Jian-Jun; Wan, Tao; Liang, Bin; Yang, Tao; Dong, Jia-Hong

    2014-01-01

    AIM: To explore the morbidity and risk factors of postoperative pancreatic fistula (POPF) following pancreaticoduodenectomy. METHODS: The data from 196 consecutive patients who underwent pancreaticoduodenectomy, performed by different surgeons, in the General Hospital of the People’s Liberation Army between January 1st, 2013 and December 31st, 2013 were retrospectively collected for analysis. The diagnoses of POPF and clinically relevant (CR)-POPF following pancreaticoduodenectomy were judged strictly by the International Study Group on Pancreatic Fistula Definition. Univariate analysis was performed to analyze the following factors: patient age, sex, body mass index (BMI), hypertension, diabetes mellitus, serum CA19-9 level, history of jaundice, serum albumin level, blood loss volume, pancreatic duct diameter, pylorus preserving pancreaticoduodenectomy, pancreatic drainage and pancreaticojejunostomy. Multivariate logistic regression analysis was used to determine the main independent risk factors for POPF. RESULTS: POPF occurred in 126 (64.3%) of the patients, and the incidence of CR-POPF was 32.7% (64/196). Patient characteristics of age, sex, BMI, hypertension, diabetes mellitus, serum CA19-9 level, history of jaundice, serum albumin level, blood loss volume, pylorus preserving pancreaticoduodenectomy and pancreaticojejunostomy showed no statistical difference related to the morbidity of POPF or CR-POPF. Pancreatic duct diameter was found to be significantly correlated with POPF rates by univariate analysis and multivariate regression analysis, with a pancreatic duct diameter ? 3 mm being an independent risk factor for POPF (OR = 0.291; P = 0.000) and CR-POPF (OR = 0.399; P = 0.004). The CR-POPF rate was higher in patients without external pancreatic stenting, which was found to be an independent risk factor for CR-POPF (OR = 0.394; P = 0.012). Among the entire patient series, there were three postoperative deaths, giving a total mortality rate of 1.5% (3/196), and the mortality associated with pancreatic fistula was 2.4% (3/126). CONCLUSION: A pancreatic duct diameter ? 3 mm is an independent risk factor for POPF. External stent drainage of pancreatic secretion may reduce CR-POPF mortality and POPF severity. PMID:25516663

  7. Dexmedetomidine in Postoperative Analgesia in Patients Undergoing Hysterectomy

    PubMed Central

    Ren, Chunguang; Chi, Meiying; Zhang, Yanwei; Zhang, Zongwang; Qi, Feng; Liu, Zhong

    2015-01-01

    Abstract Both dexmedetomidine and sufentanil modulate spinal analgesia by different mechanisms, and yet no human studies are available on their combination for analgesia during the first 72 hours after abdominal hysterectomy. This CONSORT-prospective, randomized, double-blinded, controlled trial sought to evaluate the safety and efficacy of the combination of dexmedetomidine and sufentanil in intravenous patient-controlled analgesia (PCA) for 72 hours after abdominal hysterectomy. Ninety women undergoing total abdominal hysterectomy were divided into 3 equal groups that received sufentanil (Group C; 0.02??g/kg/h), sufentanil plus dexmedetomidine (Group D1; 0.02??g/kg/h, each), or sufentanil (0.02??g/kg/h) plus dexmedetomidine (0.05??g/kg/h) (Group D2) for 72 hours after surgery in this double-blinded, randomized study. The primary outcome measure was the postoperative sufentanil consumption, whereas the secondary outcome measures were pain intensity (visual analogue scale), requirement of narcotic drugs during the operation, level of sedation, Bruggrmann comfort scale, and concerning adverse effects. The postoperative sufentanil consumption was significantly lower in Groups D1 and D2 than in Group C during the observation period (P?

  8. Predictors of Delayed Postoperative Respiratory Depression Assessed From Naloxone Administration

    PubMed Central

    Weingarten, Toby N.; Herasevich, Vitaly; McGlinch, Maria C.; Beatty, Nicole C.; Christensen, Erin D.; Hannifan, Susan K.; Koenig, Amy E.; Klanke, Justin; Zhu, Xun; Gali, Bhargavi; Schroeder, Darrell R.; Sprung, Juraj

    2015-01-01

    Background To identify patient and procedural characteristics associated with postoperative respiratory depression or sedation that required naloxone intervention. Methods We identified patients who received naloxone to reverse opioid-induced respiratory depression or sedation within 48 hours after discharge from anesthetic care (transfer from the post anesthesia care unit, or transfer from the operating room to postoperative areas) between July 1, 2008 and June 30, 2010. Patients were matched to two controls based on age, sex, and exact type of procedure performed during the same year. A chart review was performed to identify patient, anesthetic and surgical factors that may be associated with risk for intervention requiring naloxone. In addition, we identified all patients who developed adverse respiratory events [hypoventilation, apnea, oxyhemoglobin desaturation, pain/sedation mismatch] during Phase I anesthesia recovery. We performed conditional logistic regression taking into account the 1:2 matched set case-control study design to assess patient and procedural characteristics associated with naloxone use. Results We identified 134 naloxone administrations, 58% within 12 hours of discharge from anesthesia care, with incidence of 1.6 per 1,000 (95% CI 1.3 – 1.9) anesthetics. Presence of obstructive sleep apnea (odds ratio = 2.45, 95%CI 1.27-4.66, P = 0.008), and diagnosis of adverse respiratory event in postanesthesia recovery room (odds ratio = 5.11, 95%CI 2.32-11.27, P < 0.001) were associated with increased risk for requiring naloxone to treat respiratory depression or sedation following discharge from anesthesia care. Following discharge from anesthesia care, patients administered naloxone used a greater median dose of opioids (10 [interquartile range 0, 47.1] vs. 5 [0, 24.8] intravenous morphine equivalents, P = 0.020) and more medications with sedating side effects (N = 41 [31%] vs. 24 [9%], P<0.001). Conclusion Obstructive sleep apnea and adverse respiratory events in recovery room are harbingers of increased risk for respiratory depression or sedation requiring naloxone after discharge from anesthesia care. Also, patients administered naloxone received more opioids and other sedating medications after discharge from anesthetic care. Our findings suggest that these patients may benefit from more careful monitoring after being discharged from anesthesia care. PMID:25993390

  9. Prfungsordnung fr den Bachelor-Studiengang kologie und Umweltschutz

    E-print Network

    Wolkenhauer, Olaf

    1 Prüfungsordnung für den Bachelor-Studiengang �kologie und Umweltschutz an der Babe folgenden Dokumenten der Babe-Bolyai-Universität und der Fakultät für Biologie und Geologie der Babe Senatul Universitii "Babe-Bolyai" în edina 14.04.2003 (Verordnung über Lehrveranstaltungen auf Grundlage

  10. Von Donuts und Zucker: Mit Neutronen biologische Makromoleküle erforschen

    NASA Astrophysics Data System (ADS)

    May, Roland P.

    2003-05-01

    Für die Erforschung von Biomolekülen bieten Neutronen einzigartige Eigenschaften. Vor allem ihre unterschiedliche Wechselwirkung mit dem natürlichen Wasserstoff und seinem schweren Isotop Deuterium ermöglicht tiefe Einblicke in Struktur, Funktion und Dynamik von Proteinen, Nukleinsäuren und Biomembranen. Bei vielen Fragestellungen zur Strukturaufklärung gibt es kaum oder keine Alternative zum Neutron. Das Institut Laue-Langevin trägt Bahnbrechendes zum Erfolg der Neutronen-Methoden in der Biologie bei.

  11. Effect of body mass index on operative time, hospital stay, stone clearance, postoperative complications, and postoperative analgesic requirement in patients undergoing percutaneous nephrolithotomy

    PubMed Central

    Shohab, Durre; Ayub, Ramsha; Alam, Muhammad Umar; Butt, Amna; Sheikh, Sanam; Assad, Salman; Akhter, Saeed

    2015-01-01

    Objective To compare the effect of body mass index (BMI) on operative time, hospital stay, stone clearance, postoperative complications, and postoperative analgesic requirement in patients undergoing percutaneous nephrolithotomy (PCNL) by comparing three BMI groups. Material and methods This is a retrospective analysis of 129 patients who underwent PCNL from January 2010 to August 2013. All the patients underwent PCNL by a standard technique. The patients were divided into three groups: patients having a BMI ?24 kg/m2 were included in the normal group, those having a BMI of 24.1–30.0 kg/m2 were included in the overweight group, and those having a BMI >30 kg/m2 were included in the obese group. Three groups were compared for operative time, hospital stay, stone clearance, postoperative complications, and postoperative analgesic requirement. Results A total of 129 patients including 44 females and 85 males were included with a mean age of 45.00±1.44 years. The mean age in the normal group was 43.29±1.69 years, 47.08±1.29 years in the overweight group, and 43.61±1.25 years in the obese group. The mean stone size in the normal group was 25.46±8.92 mm, 28.01±8.40 mm in the overweight group, and 26.84±7.41 mm in the obese group. Our results showed no statistically significant difference with respect to mean operative time, mean hospital stay, and stone clearance in the normal, obese, and overweight patients undergoing PCNL. Postoperative complications and analgesia requirement were also similar in all the three groups. Conclusion There was no effect of BMI on operative time, hospital stay, stone clearance, postoperative complications, and postoperative analgesic requirement in patients undergoing PCNL. PCNL is a safe and effective procedure for the removal of renal stones in obese patients. PMID:26623145

  12. The influence of postoperative epidural analgesia on postoperative pain and stress response after major spine surgery--a randomized controlled double blind study.

    PubMed

    Servicl-Kuchler, Darja; Maldini, Branka; Borgeat, Alain; Bili?, Nada; Kosak, Robert; Mavcic, Blaz; Novak-Jankovic, Vesna

    2014-06-01

    Major spinal surgery is associated with severe postoperative pain and stress response, bowel dysfunction, and a potential for chronic pain development. Epidural analgesia has been shown to be advantageous compared to intravenous analgesia alone. The aim of the study was to investigate whether postoperative addition of epidural levobupivacaine to intravenous opioid analgesia offers advantage over intravenous opioid analgesia alone. Eighty-one patients scheduled for spinal fusion were enrolled in the study and randomized into two groups. Postoperatively, group A received 0.125% epidural levobupivacaine and group B received saline. Both groups also received intravenous piritramide as a rescue analgesic. Pain intensity, rescue analgesic consumption, blood glucose, cholesterol and cortisol levels, postoperative blood loss, paresthesia, time to first postoperative defecation, and length of hospital stay were recorded. Sixty-eight patients completed the study. The visual analog scale score (mean 2 vs. 4, p = 0.01), consumption ofpiritramide (25 mg vs. 51.5 mg, p = 0.01) and metamizole (1400 vs. 1875 mg, p < 0.01), incidence of nausea (6% vs. 28% p = 0.02) and blood loss (450 mL vs. 650 mL, p < 0.05) were significantly lower in group A. Bowel recovery and first postoperative defecation also occurred earlier in group A (6% vs. 45%, p < 0.01). Blood cortisol, glucose and cholesterol levels and the incidence of paresthesia did not differ between the groups. In conclusion, after spinal fusion, postoperative epidural administration of levobupivacaine provides better analgesia and fewer side effects with no impact on stress response. PMID:25163233

  13. Frstin der Wissenschaft Ein Leben fr Mathematik und Emanzipation

    E-print Network

    , Physiologie bei Hermann von Helmholtz und Chemie bei Robert Bunsen. #12;2. Studienjahre in Heidelberg Auf Tschebyschow Sofja Kowalewskaja Hermann Schwarz #12;Sofja Kowalewskaja Mathematikerin, Schriftstellerin

  14. Zentralbung zur Vorlesung ,,Einfhrung in die Informatik: Programmierung und Softwareentwicklung"

    E-print Network

    Programmierung und Softwareentwicklung Ein netter Bankangestellter verspricht Ihnen für Ihr Sparkonto einen: Typkonversion (II) Ein netter Bankangestellter verspricht Ihnen für Ihr Sparkonto einen Zinssatz von 25%. Er

  15. Expertise bewerben und finden im Social Semantic Web

    NASA Astrophysics Data System (ADS)

    Polleres, Axel; Mochol, Malgorzata

    Im vorliegenden Beitrag diskutieren wir Rahmenbedingungen zur Kombination, Wiederverwendung und Erweiterung bestehender RDFVokabulare im Social Semantic Web. Hierbei konzentrieren wir uns auf das Anwendungsszenario des Auffindens und Bewerbens von Experten im Web oder Intranet. Wir präsentieren, wie RDF-Vokabulare einerseits und de facto Standardformate andererseits, die von täglich verwendeten Applikationen benutzt werden (z. B. vCard, iCal oder Dublin Core), kombiniert werden können, um konkrete Anwendungsfälle der Expertensuche und zum Management von Expertise zu lösen. Unser Fokus liegt darauf aufzuzeigen, dass für praktische Anwendungsszenarien nicht notwendigerweise neue Ontologien entwickelt werden müssen, sondern der Schlüssel vielmehr in der Integration von bestehenden, weit verbreiteten und sich ergänzenden Formaten zu einem kohärenten Netzwerk von Ontologien liegt. Dieser Ansatz garantiert sowohl direkte Anwendbarkeit von als auch niedrige Einstiegsbarrieren in Semantic Web-Technologien sowie einfache Integrierbarkeit in bestehende Applikationen. Die im Web verfügbaren und verwendeten RDFFormate decken zwar einen großen Bereich der Aspekte zur Beschreibung von Personen und Expertisen ab, zeigen aber auch signifikante Überlappungen. Bisher gibt es wenig systematische Ansätze, um diese Vokabulare zu verbinden, sei es in Form von allgemeingültigen Praktiken, die definieren, wann welches Format zu benutzen ist, oder in Form von Regeln, die Überlappungen zwischen einzelnen Formaten formalisieren. Der vorliegende Artikel analysiert, wie bestehende Formate zur Beschreibung von Personen, Organisationen und deren Expertise kombiniert und, wo nötig, erweitert werden können. Darüber hinaus diskutieren wir Regelsprachen zur Beschreibung von Formatüberlappungen sowie deren praktische Verwendbarkeit zur Erstellung eines Ontologie-Netzwerks zur Beschreibung von Experten.

  16. Modellgestützte Fehlererkennung und Diagnose für Common-Rail-Einspritzsysteme

    NASA Astrophysics Data System (ADS)

    Clever, Sebastian

    Moderne Pkw-Dieselmotoren sind mit verschiedensten komplexen mechatronischen Komponenten ausgestattet. So kommen neben Abgasrückführsystemen zur Minderung der Stickoxidemissionen und Turboladern zur Steigerung der Leistungsdichte insbesondere elektronisch gesteuerte Mehrfach-Einspritzsysteme zum Einsatz. Deshalb erhöht sich die Bedeutung einer umfassenden Fehlererkennung und Diagnose, zusätzlich zu den bekannten OBD- und EOBD-Vorgaben, im Rahmen steigender Anforderungen an die Zuverlässigkeit und Verfügbarkeit. Um diese Anforderungen zu erfüllen, bieten sich modellbasierte Verfahren an. Ihr Stand in verschiedenen Gebieten wird zum Beispiel in [1-6] beschrieben. Mit dem Einsatz modellgestützter Fehlererkennungsverfahren bei Verbrennungsmotoren beschäftigen sich beispielsweise [7-18].

  17. Einstein und die Folgen - Teil II: Zum Weltjahr der Physik

    NASA Astrophysics Data System (ADS)

    Kiefer, Claus

    2005-03-01

    Nach der Quantentheorie sind Schwarze Löcher nicht wirklich schwarz. Sie verhalten sich wie thermodynamische Systeme, besitzen also eine Temperatur und eine Entropie. Folglich strahlen sie Energie ab, verlieren an Masse und können dadurch vergehen. Kommt dabei die Information über den Stern, aus dem das Schwarze Loch ursprünglich entstand, wieder zurück? Nach dem klassischen Keine-Haare-Theorem würde man erwarten, dass alle Information verloren geht: Das Loch ist durch seine Masse, seinen Drehimpuls und seine (eventuelle) elektrische Ladung vollständig charakterisiert. Diese und andere Fragen, etwa zur Entropie, wird nur eine Theorie der Quantengravitation endgültig beantworten können. Ihre Konstruktion bleibt auch im 21. Jahrhundert eine der größten Herausforderungen der Physik.

  18. Severity and predicted outcome of postoperative Pseudomonas aeruginosa infections.

    PubMed

    Kodama, T; Yokoyama, T; Takesue, Y; Okita, M; Nakamitsu, A; Hiyama, E; Imamura, Y; Santo, T; Murakami, Y; Tsumura, H

    1995-01-01

    The severity and predicted outcome of postoperative Pseudomonas aeruginosa (P. aeruginosa) infections (PPAI) was evaluated using a severity scoring system based on a simplification and modification of the APACHE II system. A total of 86 patients in whom P. aeruginosa was isolated from various sources were examined. PPAI developed in 50 patients, resulting in an overall mortality rate of 24%. An increased severity score (SS) correlated with an increased risk of developing PPAI. Thus, PPAI developed in 33% of the patients with an SS of 0-1, in 66.7% of those with an SS of 2-3, and in 100% of those with an SS of 6 or higher. Moreover, the mortality rate of the patients with an initial score of 6 or higher was 50%. The mean (+/- SD) initial severity score was 5.4 +/- 2.9 for survivors and 2.9 +/- 2.6 for nonsurvivors (P < 0.01). In the patients who subsequently died, the SS remained high throughout the clinical course despite therapy, whereas in the survivors the SS decreased progressively, reflecting a favorable clinical course. These results suggest that our severity scoring system was useful for predicting outcome and monitoring the response of PPAI to therapy. PMID:8520159

  19. Management of Delayed Onset Postoperative Hemorrhage after Anastomotic Urethroplasty

    PubMed Central

    Bertrand, L. A.; Elliott, S. P.; Breyer, B. N.; Erickson, B. A.

    2015-01-01

    Excision with primary anastomosis (EPA) urethroplasty is generally the preferred method for short strictures in the bulbar urethra, given its high success rate and low complication rate compared to other surgical interventions. Bleeding is a presumed risk factor for any surgical procedure but perioperative hemorrhage after an EPA requiring hospitalization and/or reintervention is unreported with no known consensus on the best course for management. Through our experience with three separate cases of significant postoperative urethral hemorrhage after EPA, we developed an algorithm for treatment beginning with conservative management and progressing through endoscopic and open techniques, as well as consideration of embolization by interventional radiology. All the three of these cases were managed successfully though they did require multiple interventions. We theorize that younger patients with more robust corpus spongiosum and more vigorous spontaneous erections, patients that have undergone fewer prior urethral procedures and therefore have more prominent vasculature, and those patients managed with a two-layer closure of the ventral urethra without ligation of the transected bulbar arteries are at a higher risk for this complication. PMID:26635991

  20. Percutaneous Management of Postoperative Duodenal Stump Leakage with Foley Catheter

    SciTech Connect

    Oh, Jung Suk Lee, Hae Giu Chun, Ho Jong; Choi, Byung Gil; Lee, Sang Hoon; Hahn, Seong Tai; Ohm, Joon Young

    2013-10-15

    Purpose: This study was designed to evaluate retrospectively the safety and efficacy of the percutaneous management of duodenal stump leakage with a Foley catheter after subtotal gastrectomy. Methods: Ten consecutive patients (M:F = 9:1, median age: 64 years) were included in this retrospective study. The duodenal stump leakages were diagnosed in all the patients within a median of 10 days (range, 6-20). At first, the patients underwent percutaneous drainage on the day of or the day after confirmation of the presence of duodenal stump leakage, and then the Foley catheters were replaced at a median of 9 days (range, 6-38) after the percutaneous drainage. Results: Foley catheters were placed successfully in the duodenal lumen of all the patients under a fluoroscopic guide. No complication was observed during and after the procedures in all the patients. All of the patients started a regular diet 1 day after the Foley catheter placement. The patients were discharged at a median of 7 days (range, 5-14) after the Foley catheter placement. The catheters were removed in an outpatient clinic 10-58 days (median, 28) after the Foley catheter placement. Conclusions: Fluoroscopy-guided percutaneous Foley catheter placement may be a safe and effective treatment option for postoperative duodenal stump leakage and may allow for shorter hospital stays, earlier oral intake, and more effective control of leakage sites.

  1. The Relation between Nonverbal IQ and Postoperative CI Outcomes in Cochlear Implant Users: Preliminary Result

    PubMed Central

    Park, Mina; Song, Jae-Jin; Oh, Seo Jin; Shin, Min-Sup; Lee, Jun Ho; Oh, Seung Ha

    2015-01-01

    Objectives. This study assessed the correlation between performance intelligence and the postoperative cochlear implant (CI) outcome in Korean-speaking children. In addition, the relationship between the performance intelligence subscales and the post-CI speech outcome was evaluated. Materials and Methods. Thirteen pediatric CI users (five males, eight females; median age at implantation 6.2 (range 1.3–14.2) years; median age at intelligence test 9.3 (range 5–16) years) who were tested using the Korean Educational Development Institute-Wechsler Intelligence Scale for children were studied. The correlations between the intelligence scores and 1-2 years postoperative Categories of Auditory Performance (CAP) scores and between subscales of performance and 1-2 years postoperative CAP scores were analyzed. Results. There was no correlation between the categories of verbal intelligence quotient (IQ) and performance IQ for “mentally retarded” and “average,” respectively (Spearman's rho = 0.42, P = 0.15). There was a strong correlation between performance IQ and the postoperative CAP scale (Spearman's rho = 0.8977, P = 0.0008). “Picture arrangement” and “picture completion,” reflecting social cognition, were strongly correlated with the postoperative CAP scales. Conclusion. Performance intelligence, especially social cognition, was strongly related to the postoperative CI outcome of cochlear implant users. Therefore, auditory rehabilitation, including social rehabilitation, should maximize the postoperative CI outcomes. PMID:26236723

  2. Effect of Sugammadex on Postoperative Bleeding and Coagulation Parameters After Septoplasty: A Randomized Prospective Study

    PubMed Central

    Ta?, Nilay; Korkmaz, Hakan; Ya?an, Özgür; Korkmaz, Mukadder

    2015-01-01

    Backround Sugammadex is a reversal agent with well known advantages but it’s effects on haemostasis and bleeding have been a topic of interest. Septoplasty is a common surgical procedure with postoperative respiratory complications and bleeding. The aim of this study is to investigate the effects of sugammadex on postoperative coagulation parameters and bleeding after septoplasty procedure. Material/Methods In this randomized controlled study, fifty patients were grouped into two groups; neostigmine (Group N) vs. sugammadex (Group S). For the evaluation of PT, aPTT and INR, blood samples were taken for at the postoperative 120th minutes and alteration of these values with respect to preoperative values were documented. Postoperative bleeding was measured by evaluating the amount of blood absorbed on the nasal tip dressing during 3 hours postoperatively. Results Postoperative bleeding amount was significantly higher in the Group S compared to Group N (p=0.013). No significant difference was observed between two groups according to coagulation parameters (PT; p=0.953, aPTT; p=0.734, INR; p=0.612). Conclusions Sugammadex was associated with higher amount of postoperative bleeding than neostigmine in septoplasty patients. In surgical procedures having high risk of bleeding the safety of sugammadex need to be verified. PMID:26271275

  3. Role of Ketamine in Acute Postoperative Pain Management: A Narrative Review

    PubMed Central

    Radvansky, Brian M.; Shah, Khushbu; Parikh, Anant; Sifonios, Anthony N.; Le, Vanny; Eloy, Jean D.

    2015-01-01

    Objectives. The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. Design. A literature search was performed using the phrases “ketamine” and “postoperative pain.” The authors analyzed the studies that involved testing ketamine's effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS) pain scores, and persistent postoperative pain at long-term follow-up. Results. While many different administration protocols were evaluated, delivering ketamine both as a pre- or perioperative bolus and postoperative infusion for up to 48 hours appeared to be the most effective. These effects are dose-dependent. However, a number of studies analyzed showed no benefit in using ketamine versus placebo for controlling postoperative pain. While ketamine is a safe and well-tolerated drug, it does have adverse effects, and there are concerns for possible neurotoxicity and effects on memory. Conclusions. In a number of limited situations, ketamine has shown some efficacy in controlling postoperative pain and decreasing opioid consumption. More randomized controlled trials are necessary to determine the surgical procedures and administrations (i.e., intravenous, epidural) that ketamine is best suited for. PMID:26495312

  4. Effects of ketoprofen for prevention of postoperative cognitive dysfunction in aged rats.

    PubMed

    Kawano, Takashi; Takahashi, Tetsuya; Iwata, Hideki; Morikawa, Akihiro; Imori, Satoko; Waki, Sayaka; Tamura, Takahiko; Yamazaki, Fumimoto; Eguchi, Satoru; Kumagai, Naoko; Yokoyama, Masataka

    2014-12-01

    Postoperative cognitive dysfunction is a common geriatric complication that may be associated with increased mortality. Here, we investigated the effects of postoperative analgesia with ketoprofen on cognitive functions in aged animals and compared its effectiveness to morphine. Rats were randomly allocated to one of four groups: isoflurane anesthesia without surgery (group C), isoflurane anesthesia with laparotomy (group IL), and isoflurane anesthesia with laparotomy plus postoperative analgesia with ketoprofen or morphine. There was no difference in postoperative locomotor activity among groups. In group IL, postoperative pain levels assessed by the Rat Grimace Scale significantly increased until 8 h after surgery, which was similarly inhibited by both ketoprofen and morphine. Cognitive function was assessed using radial arm maze testing for 12 consecutive days from postoperative day 3. Results showed that the number of memory errors in group IL were significantly higher than those in goup C. However, both ketoprofen and morphine could attenuate the increase in memory errors following surgery to a similar degree. Conversely, ketoprofen showed no effect on cognitive function in the nonsurgical rats that did not experience pain. Our findings suggest that postoperative analgesia with ketoprofen can prevent the development of surgery-associated memory deficits via its pain-relieving effects. PMID:24676769

  5. Suchmaschinen und Informationsqualität: Status quo, Problemfelder, Entwicklungstendenzen

    NASA Astrophysics Data System (ADS)

    Maaß, Christian; Gräfe, Gernot

    Das Thema Informationsqualität wird in den vorangegangenen Beiträgen umfangreich betrachtet. Die dabei geführte Diskussion zielt vordergründig auf organisatorische Dimensionen der Datenqualität, die strukturierte Datenanalyse oder Datenmanagementprozesse im Unternehmen ab. Dabei liegt ein Großteil der zur Unterstützung von Entscheidungsprozessen herangezogenen Informationen in Datenbanksystemen bzw. in einem Data Warehouse vor. Auf Basis verschiedener Analysetools (z. B. Online-Analytical-Processing) lassen sich diese Informationen dann systematisch auswerten. Allerdings können Entscheidungen nicht allein aufgrund der unternehmensintern vorliegenden Informationen getroffen werden. Vielmehr gilt es auch die aus der Unternehmensumwelt relevanten Informationen zu verarbeiten, die zum Teil über das Internet zugänglich sind. Im Gegensatz zu unternehmensinternen Datenbanksystemen handelt es sich beim Internet um ein schwach strukturiertes und offenes Netzwerk, weshalb die im Unternehmenskontext eingesetzten Analysetools kaum weiterhelfen, um Informationen mit hoher Qualität herauszufiltern. In dieser Situation spielen Suchmaschinen eine wichtige Rolle, um Informationen zu identifizieren und anhand verschiedener Kriterien in Form einer Suchergebnisseite zu sortieren.

  6. Darwin, Engels und die Rolle der Arbeit in der biologischen und kulturellen Evolution des Menschen

    NASA Astrophysics Data System (ADS)

    Reichholf, Josef H.

    Im Jahre 1876, 5 Jahre nach Erscheinen von Darwins Buch über die Evolution des Menschen und die sexuelle Selektion (Darwin 1871), veröffentlichte Friedrich Engels den berühmt gewordenen Essay "Anteil der Arbeit an der Menschwerdung des Affen“ (Engels 1876). Die Kernfrage darin lautet in Kurzform: Warum hat der Mensch eigentlich ein Bedürfnis nach Arbeit? Engels Antwort wird nachfolgend näher betrachtet und vom gegenwärtigen Kenntnisstand aus beurteilt. Wie sich zeigen wird, beantworten seine Überlegungen die Frage nicht wirklich. Sie ist weiterhin offen. Es können lediglich einige zusätzliche Anhaltspunkte zur Diskussion gestellt werden. Angesichts des drängenden Problems millionenfacher Arbeitslosigkeit und der Forderungen nach einem "Grundrecht auf Arbeit“ kommt den Überlegungen zum möglichen Ursprung des Bedürfnisses nach Arbeit mehr als nur akademisches Interesse zu.

  7. Schwingungsspektren und Normalkoordinatenanalysen sterisch überladener Silane: Tetrakis(trimethylsilyl)silan und Hexakis(trimethylsilyl)disilan

    NASA Astrophysics Data System (ADS)

    Schenzel, Karla; Hassler, Karl; Bauer, Günther

    1997-12-01

    ZusammenfassungThe infrared and Raman vibrational spectra of (Me 3Si) 4Si and (Me 3Si) 3SiSi(SiMe 3) 3 as well as of their perdeuterated derivatives have been measured and assigned with the aid of normal coordinate analyses. SiSi force constants were calculated for these strained molecules. They are considerably smaller than force constants of disilanes or trisilanes. Zusammenfassung Die Infrarot- und Ramanspektren von (Me 3Si) 4Si und (Me 3Si) 3SiSi(SiMe 3) 3 sowie ihrer perdeuterierten Derivate wurden aufgenommen und mit Hilfe von Normalkoordinatenanalysen zugeordnet. Die für diese gespannten Moleküle errechneten SiSi-Valenzkraftkonstanten sind deutlich kleiner als jene von Disilanen oder Trisilanen.

  8. Einstellung und Wissen von Lehramtsstudierenden zur Evolution - ein Vergleich zwischen Deutschland und der Türkei

    NASA Astrophysics Data System (ADS)

    Graf, Dittmar; Soran, Haluk

    Es wird eine Untersuchung vorgestellt, in der Wissen und Überzeugungen von Lehramtsstudierenden aller Fächer zum Thema Evolution an zwei Universitäten in Deutschland und der Türkei erhoben worden sind. Die Befragung wurde in Dortmund und in Ankara durchgeführt. Es stellte sich heraus, dass ausgeprägte Defizite im Verständnis der Evolutionsmechanismen herrschen. Viele Studierende, insbesondere aus der Türkei, sind nicht von der Faktizität der Evolution überzeugt. Dies gilt sowohl für Studierende mit Fach Biologie als auch für Studierende mit anderen Fächern. Näher untersucht worden sind die Faktoren, die die Überzeugungen zur Evolution beeinflussen können, was ja in Anbetracht der hohen Ablehnungsrate der Evolution von besonderem Interesse ist. Das Vertrauen in die Wissenschaft spielt hierbei eine besondere Rolle: Wer der Wissenschaft vertraut, ist auch eher von der Evolution überzeugt, als diejenigen, die skeptisch gegenüber der Wissenschaft sind.

  9. Ubungszettel Lineare Algebra und Analytische Geometrie II

    E-print Network

    C des R 2 und #11;; #12; 2 R, soda#25; #27;(v; w) = #11; v 1 w 1 + #12;v 2 w 2 fur v; w 2 R 2 mit v durch fv 2 R 2 : #27;(v; v) = 1g dargestellt? 3. Fur A 2 M(2 #2; 2; C ) #12;nde man T 2 GL(2; C ), soda

  10. Recurrent Postoperative Spinal Epidural Hematoma in a Patient with Protein S Deficiency

    PubMed Central

    Anno, Masato; Yamazaki, Takashi; Hara, Nobuhiro; Hayakawa, Keishi

    2015-01-01

    A 71-year-old man underwent cervical laminectomy and developed two symptomatic epidural hematomas during the acute postoperative period. On both occasions, drain obstruction was the predominant cause. Congenital Protein S deficiency was diagnosed postoperatively. Protein S is a vitamin K-dependent natural anticoagulant and is essential for inhibiting thrombosis in microcirculation. We assume that Protein S deficiency followed by perioperative bed-rest and surgical invasiveness led to severe hypercoagulability and subsequent drain obstruction. The present findings suggest that both bleeding disorders and hypercoagulability are risk factors for postoperative symptomatic epidural hematoma. PMID:26236521

  11. Indications and postoperative treatment for Ex-PRESS® insertion in Japanese patients with glaucoma: comparison with standard trabeculectomy

    PubMed Central

    Kato, Noriko; Takahashi, Genichiro; Kumegawa, Koichi; Kabata, Yoshiaki; Tsuneoka, Hiroshi

    2015-01-01

    Background We investigated indications and early postoperative treatment for Ex-PRESS® insertion for glaucoma by comparing postoperative outcomes with those for standard trabeculectomy. Methods Ex-PRESS insertion was performed in 21 eyes and standard trabeculectomy (TLE) in 22 eyes. Mean intraocular pressure (IOP) in the 6 months after surgery, success rate for postoperative IOP decline, postoperative complications, postoperative treatment, filtering blebs, and indications were then retrospectively investigated. Results Mean postoperative IOP did not differ significantly between the groups at any observation time for 6 months after surgery. Further, it did not differ between either the groups of patients with primary open-angle glaucoma (POAG) and neovascular glaucoma (NTG), or the patients with primary open-angle glaucoma and NTG in the Ex-PRESS group. Comparison of success rates in reduction of postoperative IOP between the groups under the following four survival conditions showed no significant differences: postoperative IOP <30% of the preoperative IOP, complete success (no additional ophthalmic solution), and qualified success (ophthalmic solution required); 5 mmHg ? postoperative IOP ?21 mmHg, complete success (no additional ophthalmic solution), and qualified success (ophthalmic solution required). With regard to postoperative complications and postoperative treatment, the incidence of hyphema was significantly lower in the Ex-PRESS group, but no other significant intergroup differences were seen. The height of the filtering bleb was lower in the Ex-PRESS group. Conclusion Postoperative outcomes in the Ex-PRESS and TLE groups were comparable. The incidence of hyphema was significantly lower in the Ex-PRESS group. Ex-PRESS insertion appears to be useful in patients with NTG and in those prone to postoperative bleeding. There were no significant intergroup differences in postoperative treatment. Assessment of outcome after Ex-PRESS insertion was difficult in some patients. Postoperative treatment should be developed to suit the specific requirements of Ex-PRESS insertion. PMID:26316691

  12. [Transfer managment of postoperative acute pain therapy to outpatient aftercare].

    PubMed

    Tank, C; Lefering, R; Althaus, A; Simanski, C; Neugebauer, E

    2014-10-01

    The significance of postoperative pain management for patients in the hospital is well known and has been a focus of research for several years. The ambulatory care after hospital discharge, however, is not well investigated. A prospective observational study was therefore conducted to study the transfer management from in-hospital patients to ambulatory care. A patient questionnaire was developed and patients were asked to fill it out at different time points after the operation: during the time in the hospital, then at 2 weeks and 6 months after hospital discharge. In addition, the responsible family doctor was approached and interviewed. The main focus of the questionnaire was the measurement of post-surgical pain (numeric rating scale NRS), patient satisfaction (Cologne patient questionnaire), and quality of life (SF 12). Of a total of 128 patients 72.9% described moderate to severe pain after the orthopaedic operations in the hospital. 90.8% of the patients had pain directly after discharge from the hospital; in 67.4% of the cases pain was ?3 and in 23.4% of the cases pain was ?6. Six months after discharge pain was significant in 29.4% of the patients, 60.8% of the patients were satisfied with the transfer to the home setting. 16% were not satisfied at all and 23.2% were neutral. Important factors for dissatisfaction with the transfer management were, according to stepwise logistic regeression analysis, sex (female patients), young age, a poor bodily constitution at the hospital and thereafter, and the pain management in the hospital and after discharge. The study shows the significance of the acute pain therapy not only during the hospital stay but also after discharge. There are very few data on pain therapy after discharge from the hospital. Based on the significance of the chronification of acute pain it is of the utmost importance to close this gap. PMID:24452431

  13. Foot massage: effectiveness on postoperative pain in breast surgery patients.

    PubMed

    Ucuzal, Meral; Kanan, Nevin

    2014-06-01

    The aim of this study was to determine the effect of foot massage on pain after breast surgery, and provide guidance for nurses in nonpharmacologic interventions for pain relief. This was a quasiexperimental study with a total of 70 patients who had undergone breast surgery (35 in the experimental group and 35 in the control group). Patients in the control group received only analgesic treatment, whereas those in the experimental group received foot massage in addition to analgesic treatment. Patients received the first dose of analgesics during surgery. As soon as patients came from the operating room, they were evaluated for pain severity. Patients whose pain severity scored ?4 according to the Short-Form McGill Pain Questionnaire were accepted into the study. In the experimental group, pain and vital signs (arterial blood pressure, pulse, and respiration) were evaluated before foot massage at the time patients complained about pain (time 0) and then 5, 30, 60, 90, and 120 minutes after foot massage. In the control group, pain and vital signs were also evaluated when the patients complained about pain (time 0) and again at 5, 30, 60, 90, and 120 minutes, in sync with the times when foot massage was completed in the experimental group. A patient information form was used to collect descriptive characteristics data of the patients, and the Short-Form McGill Pain Questionnaire was used to determine pain severity. Data were analyzed for frequencies, mean, standard deviation, chi-square, Student t, Pillai trace, and Bonferroni test. The results of the statistical analyses showed that patients in the experimental group experienced significantly less pain (p ? .001). Especially notable, patients in the experimental group showed a decrease in all vital signs 5 minutes after foot massage, but patients in the control group showed increases in vital signs except for heart rate at 5 minutes. The data obtained showed that foot massage in breast surgery patients was effective in postoperative pain management. PMID:24882025

  14. Unplanned Reoperations in Neurosurgical Patients Due to Postoperative Bleeding

    PubMed Central

    Zheng, Xin-Rui; Chen, Tao; Yang, Yue-Fan; Rao, Wei; Wang, Guan-Ying; Zhang, Shan-Hong; Fei, Zhou

    2015-01-01

    Abstract The aim of this study is to investigate the incidence of unplanned reoperations from all causes due to bleeding in neurosurgical patients. The medical records of patients who received neurosurgical procedures at our hospital were retrospectively reviewed and data of patients who received reoperations were extracted and summarized. A literature review was conducted of the Medline, Cochrane, EMBASE, and Google Scholar databases up to November 2013. The main outcome measure was the rate of unplanned reoperations due to bleeding. At our hospital, 68 patients with a mean age of 41.5?±?21.5 years (range, 7 months to 76 years) received an unplanned reoperation. More than 70% of the patients were older than 18 years, 64.7% were males, and 94.1% had cranial surgery. Almost 60% of the patients received >1 blood transfusion (58.8%) after the first surgery. Of the 68 patients, 35 (51.5%) received a second operation due to bleeding. Univariate logistic regression analysis only showed that an increasing time interval between the first and second surgery was associated with a decreased chance of the reoperation being performed due to bleeding (odds ratio [OR]?=?0.843, 95% confidence interval [CI]: 0.720–0.987; P?=?.033). Of 229 studies identified, 5 retrospective reports with a total of 1375 patients were included in the analysis. The rate of reoperations for bleeding in the 5 studies ranged from 4.2% to 31.5%. Employing measures to reduce postoperative bleeding may help reduce the rate of unplanned neurosurgical reoperations. PMID:26061301

  15. Efficiency of a new radiant heater for postoperative rewarming.

    PubMed

    Weyland, W; Weyland, A; Hellige, G; Fritz, U; Neumann, H; Martens, S; Crozier, T; Braun, U

    1994-08-01

    Effective rewarming devices have only become available recently. This investigation compares the efficiency of an new overhead radiant heater (ARAGONA Thermal Ceilings TM, CTCX, 1000 W) with that of an electric blanket (50 W) or a standard hospital blanket. 35 patients undergoing postoperative assisted ventilation and continued sedation were randomly assigned to one of the treatments. Shivering, oxygen uptake, heart rate and invasive blood pressure were measured and the increase in total body heat minus body heat production was calculated as heat balance. Results are given as medians (range). Subcutaneous temperatures were taken to calculate the mean skin temperature. The evaluation was undertaken for an oesophageal temperature interval of 35 degrees to 37 degrees C. All groups exhibited a similar mean oxygen uptake i.e. thermogenesis (3.5 (2.7-4.0) ml.kg-1.min-1, 3.3 (2.7-4.9) ml.kg-1.min-1;3.2 (2.4-5.1) ml.kg-1. min-1) which correspond to a resting energy expenditure. The time of rewarming of the radiant heat treated group (n = 12) (100 (76-143) min) for this interval was significantly reduced in comparison to both other groups (183 (116-320) min; 231 (115-340) min). A slightly positive heat balance was only achieved in the group treated by radiant heat, indicating that all metabolic heat was conserved or heat losses were compensated by transfer of external heat. Shivering was significantly reduced in the radiant heater group whereas the rate pressure product was insignificantly higher. We did not find any significant effect for the electric heating blanket in comparison to the control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7976152

  16. The effect of music on postoperative pain and anxiety.

    PubMed

    Allred, Kelly D; Byers, Jacqueline F; Sole, Mary Lou

    2010-03-01

    The purpose of this study was to determine if listening to music or having a quiet rest period just before and just after the first ambulation on postoperative day 1 can reduce pain and/or anxiety or affect mean arterial pressure, heart rate, respiratory rate, and/or oxygen saturation in patients who underwent a total knee arthroplasty. Fifty-six patients having a total knee arthroplasty were randomly assigned to either a music intervention group or a quiet rest group. A visual analog scale was used to measure pain and anxiety. Physiologic measures, including blood pressure, heart rate, oxygen saturation, and respiratory rate, were also obtained. Statistical findings between groups indicated that the music group's decrease in pain and anxiety was not significantly different from the comparison rest group's decrease in pain (F = 1.120; p = .337) or anxiety (F = 1.566; p = .206) at any measurement point. However, statistical findings within groups indicated that the sample had a statistically significant decrease in pain (F = 6.699; p = .001) and anxiety (F = 4.08; p = .013) over time. Results of this research provide evidence to support the use of music and/or a quiet rest period to decrease pain and anxiety. The interventions pose no risks and have the benefits of improved pain reports and decreased anxiety. It potentially could be opioid sparing in some individuals, limiting the negative effects from opioids. Nurses can offer music as an intervention to decrease pain and anxiety in this patient population with confidence, knowing there is evidence to support its efficacy. PMID:20207324

  17. Thermography as a quantitative imaging method for assessing postoperative inflammation

    PubMed Central

    Christensen, J; Matzen, LH; Vaeth, M; Schou, S; Wenzel, A

    2012-01-01

    Objective To assess differences in skin temperature between the operated and control side of the face after mandibular third molar surgery using thermography. Methods 127 patients had 1 mandibular third molar removed. Before the surgery, standardized thermograms were taken of both sides of the patient's face using a Flir ThermaCam™ E320 (Precisions Teknik AB, Halmstad, Sweden). The imaging procedure was repeated 2 days and 7 days after surgery. A region of interest including the third molar region was marked on each image. The mean temperature within each region of interest was calculated. The difference between sides and over time were assessed using paired t-tests. Results No significant difference was found between the operated side and the control side either before or 7 days after surgery (p > 0.3). The temperature of the operated side (mean: 32.39 °C, range: 28.9–35.3 °C) was higher than that of the control side (mean: 32.06 °C, range: 28.5–35.0 °C) 2 days after surgery [0.33 °C, 95% confidence interval (CI): 0.22–0.44 °C, p < 0.001]. No significant difference was found between the pre-operative and the 7-day post-operative temperature (p > 0.1). After 2 days, the operated side was not significantly different from the temperature pre-operatively (p = 0.12), whereas the control side had a lower temperature (0.57 °C, 95% CI: 0.29–0.86 °C, p < 0.001). Conclusions Thermography seems useful for quantitative assessment of inflammation between the intervention side and the control side after surgical removal of mandibular third molars. However, thermography cannot be used to assess absolute temperature changes due to normal variations in skin temperature over time. PMID:22752326

  18. Therapeutic suggestion has not effect on postoperative morphine requirements.

    PubMed

    van der Laan, W H; van Leeuwen, B L; Sebel, P S; Winograd, E; Baumann, P; Bonke, B

    1996-01-01

    This study was designed to confirm the effect of therapeutic intraoperative auditory suggestion on recovery from anesthesia, to establish the effect of preoperative suggestion, and to assess implicit memory for intraoperative information using an indirect memory task. Sixty consenting unpremedicated patients scheduled for elective gynecologic surgery were randomly divided into three equal groups: Group 1 received a tape of therapeutic suggestions preoperatively, and the story of Robinson Crusoe intraoperatively; Group 2 heard the story of Peter Pan preoperatively and therapeutic suggestions intraoperatively; Group 3 heard the Crusoe story preoperatively and the Peter Pan story intraoperatively. A standardized anesthetic technique was used with fentanyl, propofol, isoflurane, and nitrous oxide. After surgery, all patients received patient-controlled analgesia (PCA) with a standardized regimen. In the 24 h postsurgery, morphine use was recorded every 6 h and at 24 h an indirect memory test (free association) was used to test for memory of the stories. Anxiety scores were measured before surgery and at 6 and 24 h postsurgery. There were no significant differences between groups for postoperative morphine use, pain or nausea scores, anxiety scores, or days spent in hospital after surgery. Seven of 20 patients who heard the Pan story intraoperative gave a positive association with the word "Hook," whereas 2 of 20 who did not hear the story gave such an association. Indirect memory for the Pan story was established using confidence interval (CI) analysis. (The 95% CI for difference in proportion did not include zero). No indirect memory for the Crusoe story could be demonstrated. This study did not confirm previous work which suggested that positive therapeutic auditory suggestions, played intraoperatively, reduced PCA morphine requirements. In contrast, a positive implicit memory effect was found for a story presented intraoperatively. PMID:8712392

  19. Checkliste: ERASMUS+ Personalmobilitt zu Fort-und Weiterbildungszwecken

    E-print Network

    Meise, Reinhold

    Checkliste: ERASMUS+ Personalmobilität zu Fort- und Weiterbildungszwecken weiß = Schritte des IO (-12238)V:\\Dezernat 1\\Dezernat 1.3\\Erasmus\\Personalmobilität\\Personalmobilität_STT_14_15\\Personalmobilität_Fort_Weiterbildung_Checkliste/-in IO und gastgebende Institution Mobility Agreement #12;Checkliste: ERASMUS+ Personalmobilität zu Fort

  20. Das PRSIDIUM, die FORSCHUNGSKOMMISSION, die KOMMISSION FR FRAUENFRDERUNG UND GLEICHSTELLUNG

    E-print Network

    Manstein, Dietmar J.

    Das PRÄSIDIUM, die FORSCHUNGSKOMMISSION, die KOMMISSION FÜR FRAUENFÖRDERUNG UND GLEICHSTELLUNG und die GLEICHSTELLUNGSBEAUFTRAGTE DER MHH laden ein zum FÖRDERKOLLOQUIUM 24. NOVEMBER 2005 HÖRSAAL G 16 familiärem Status" DR. KATHARINA WAGNER MHH Hämatologie/Onkologie ,,Die Rolle von C/EBPalpha für die

  1. Bergische Universitt Wuppertal Fachbereich C -Mathematik und Naturwissenschaften

    E-print Network

    Arndt, Holger

    -Teilnehmer senden möchte. Der Server schickt die Nachrichten der Nutzer und Statusmeldungen in jeweils einer Zeile. Der Einfachheit halber werden alle Nachrichten an alle Clients verschickt. Beispiel: Der Nutzer Max Nachrichten zu verwalten. Informieren Sie sich dafür über die Methoden offer und take. · Die Methode flush der

  2. Bergische Universitt Wuppertal Fachbereich C Mathematik und Naturwissenschaften

    E-print Network

    Arndt, Holger

    ­Teilnehmer senden möchte. Der Server schickt die Nachrichten der Nutzer und Statusmeldungen in jeweils einer Zeile. Der Einfachheit halber werden alle Nachrichten an alle Clients verschickt. Beispiel: Der Nutzer Max Nachrichten zu verwalten. Informieren Sie sich dafür über die Methoden offer und take. . Die Methode flush der

  3. Zentralbung zur Vorlesung ,,Einfhrung in die Informatik: Programmierung und Softwareentwicklung"

    E-print Network

    Programmierung und Softwareentwicklung Aufgabe 1: Typkonversion (I) Ein netter Bankangestellter verspricht Ihnen: Typkonversion (II) Ein netter Bankangestellter verspricht Ihnen für Ihr Sparkonto einen Zinssatz von 25%. Er in die Informatik Programmierung und Softwareentwicklung Aufgabe 1: Typkonversion (III) Ein netter

  4. Zentralbung zur Vorlesung ,,Einfhrung in die Informatik: Programmierung und Softwareentwicklung"

    E-print Network

    : Einführung in die Informatik Programmierung und Softwareentwicklung Aufgabe 1: Typkonversion (I) Ein netter Softwareentwicklung Aufgabe 1: Typkonversion (II) Ein netter Bankangestellter verspricht Ihnen für Ihr Sparkonto einen: Einführung in die Informatik Programmierung und Softwareentwicklung Aufgabe 1: Typkonversion (III) Ein netter

  5. Forschungskolloquium fr Israel-und Nahoststudien Wintersemester 2015/ 16

    E-print Network

    Heermann, Dieter W.

    Forschungskolloquium für Israel- und Nahoststudien Wintersemester 2015/ 16 Dienstag, 27.Oktober on the Zionist project Donnerstag, 28. Januar: Shimon Stein, Botschafter des Staates Israel a.D. Das Ende von Forschungsliteratur der Israel- und Nahoststudien. Veranstaltungsort: Hochschule für Jüdische Studien Heidelberg (Hf

  6. Vergleich der Exposition der Bevölkerung durch digitale und analoge Rundfunksender

    NASA Astrophysics Data System (ADS)

    Schubert, M.; Bornkessel, C.; Wuschek, M.; Schmidt, P.

    2007-06-01

    Dieser Beitrag fasst die Ergebnisse eines Projektes zusammen, das vom Bundesamt für Strahlenschutz und dem Ministerium für Umwelt, Naturschutz und Reaktorsicherheit (BMU) im Rahmen des Deutschen Mobilfunk Forschungsprogramms (DMF) gefördert wurde. Hintergrund der Studie ist die Untersuchung der Auswirkung der Umstellung von der analogen auf die digitale terrestrische Rundfunkübertragung in Deutschland auf die Exposition der Bevölkerung.

  7. Validierung von UML-Modellen und OCL-Bedingungen

    E-print Network

    Gogolla, Martin - Fachbereich 3

    Validierung von UML-Modellen und OCL-Bedingungen Mark Richters and Martin Gogolla Universität ein allgemein akzeptierter Standard für die Modellierung von Software- Systemen und wird als solcher von einer groÿen Anzahl von CASE-Tools unterstützt. Oft weisen UML-Werkzeuge nur wenig Unterstützung

  8. JKU goes GENDER Frauen und Mnner an der

    E-print Network

    Hochreiter, Sepp

    JKU goes GENDER Frauen und Männer an der Johannes Kepler Universität Linz #12;2 JKU goes GENDER #12;3 JKU goes GENDER JKU goes GENDER Frauen und Männer an der Johannes Kepler Universität Linz #12;4 JKU goes GENDER IMPRESSUM Herausgeber: o.Univ.Prof. DI Dr. Richard Hagelauer, Rektor Johannes Kepler

  9. Physik gestern und heute: Fragwürdiges beim Millikan-Versuch

    NASA Astrophysics Data System (ADS)

    Heering, Peter

    2006-09-01

    Robert A. Millikan erhielt 1923 als erster amerikanischer Physiker den Nobelpreis für Physik. Geehrt wurde er für seine Präzisionsmessungen zum Photoeffekt und zur experimentellen Bestimmung der elektrischen Elementarladung. Millikans Experimente zur Elementarladung sind auch heute noch ein Standardthema im schulischen Physikunterricht, gleichzeitig werfen sie aber eine Reihe von wissenschaftstheoretischen und ethisch relevanten Fragen auf.

  10. Black-Scholes, marktkonsistente Bewertung und Risikomae Thomas Knispela

    E-print Network

    Weber, Stefan

    in ihrer modernen Form von Fischer Black, Robert Merton und Myron Scholes in den frühen 70er Jahren mathematischen Techniken wurde Anfang der 70er Jahre am MIT von Fischer Black (*1938 - 1995), Myron S. ScholesBlack-Scholes, marktkonsistente Bewertung und Risikomaße Thomas Knispela Gerhard Stahlb Stefan

  11. Regelsysteme 1 10. Tutorial LQ Regulator und Kalman Filter

    E-print Network

    Lygeros, John

    Regelsysteme 1 10. Tutorial LQ Regulator und Kalman Filter Dave Ochsenbein Institut f¨ur Automatik ETH Z¨urich HS 2014 Dave Ochsenbein Regelsysteme 1 HS 2014 #12;10. Tutorial LQ Regulator und Kalman Filter Gliederung 10.1. Varia 10.2. LQ-Regulator 10.3. Kalman-Bucy Filter 10.4. Eigenschaften des

  12. Berufsziel Lehrer in der Sekundarstufe I und im Gymnasium

    E-print Network

    Heermann, Dieter W.

    Berufsziel Lehrer ­ in der Sekundarstufe I und im Gymnasium Neue Strukturen und Möglichkeiten Lehramtsausbildung - 3 Ausbildungsphasen Staatsprüfung für die Laufbahn des höheren Schuldienstes Sek I / GymnasiumVO-KM § 6, Abs. 1 Lehramt Gymnasium Der Studienumfang für das Lehramt Gymnasium wird allgemein wie folgt

  13. Patient-specific semi-supervised learning for postoperative brain tumor segmentation.

    PubMed

    Meier, Raphael; Bauer, Stefan; Slotboom, Johannes; Wiest, Roland; Reyes, Mauricio

    2014-01-01

    In contrast to preoperative brain tumor segmentation, the problem of postoperative brain tumor segmentation has been rarely approached so far. We present a fully-automatic segmentation method using multimodal magnetic resonance image data and patient-specific semi-supervised learning. The idea behind our semi-supervised approach is to effectively fuse information from both pre- and postoperative image data of the same patient to improve segmentation of the postoperative image. We pose image segmentation as a classification problem and solve it by adopting a semi-supervised decision forest. The method is evaluated on a cohort of 10 high-grade glioma patients, with segmentation performance and computation time comparable or superior to a state-of-the-art brain tumor segmentation method. Moreover, our results confirm that the inclusion of preoperative MR images lead to a better performance regarding postoperative brain tumor segmentation. PMID:25333182

  14. Postoperative pain in Sprague Dawley rats after liver biopsy by laparotomy versus laparoscopy.

    PubMed

    Préfontaine, Liette; Hélie, Pierre; Vachon, Pascal

    2015-05-01

    Laparoscopic surgery offers advantages for both animal welfare and quality of experimental data. Compared with laparotomy, laparoscopy is associated with less postoperative pain and faster recuperation in humans and is also associated with less postoperative pain in dogs. Postoperative pain associated with laparotomy and laparoscopy has not been compared in rodents, however. The authors used a validated pain grimace scale to evaluate postoperative pain in male Sprague Dawley rats after liver biopsy by laparotomy or laparoscopy. Rats that underwent laparoscopy showed fewer recognized signs of pain than did rats that underwent laparotomy. The authors suggest that laparoscopy could be used for repeated biopsies in rats, minimizing the number of animals used in pharmacological and toxicological studies. PMID:25897938

  15. Liver Planning Software Accurately Predicts Postoperative Liver Volume and Measures Early

    E-print Network

    Miga, Michael I.

    Liver Planning Software Accurately Predicts Postoperative Liver Volume and Measures Early or remnant liver volume (RLV) after hepatic resection is a critical predictor of perioperative outcomes. This study investigates whether the accuracy of liver surgical plan- ning software for predicting

  16. Xylitol Gum Chewing to Achieve Early Postoperative Restoration of Bowel Motility After Laparoscopic Surgery.

    PubMed

    Gong, Yunhui; Zhang, Qianwen; Qiao, Lin; Lv, Donghao; Ruan, Jiaying; Chen, Hongqin; Gong, Junming; Shi, Gang

    2015-08-01

    Our objective was to evaluate the effects of postoperative xylitol gum chewing on gastrointestinal functional recovery after laparoscopy. Altogether, 120 patients undergoing elective gynecologic laparoscopy were randomly divided into 2 groups of 60 each (final numbers: 53 controls, 56 patients). Controls underwent a routine postoperative regimen. Starting 6 hour after surgery, study patients chewed mint-flavored, sugarless xylitol gum until flatus occurred thrice a day. Other postoperative management was routine. First bowel sounds, first flatus, first bowel movement, and discharge times were recorded. Symptoms included abdominal distension, nausea, and vomiting. First flatus and first bowel sounds occurred significantly (P<0.001) earlier in the study patients. No significant differences were found for first defecation time, hospitalization duration, or mild/severe intestinal obstruction (all P>0.05). Thus, xylitol gum chewing after laparoscopy can effectively shorten the time to first flatus and helps with postoperative gastrointestinal functional recovery. It is simple, convenient, and well tolerated. PMID:26121546

  17. COST-EFFECTIVENESS OF INTRAVENOUS NICARDIPINE VERSUS SODIUM NITROPRUSSIDE FOR POSTOPERATIVE HYPERTENSION AFTER CARDIAC SURGERY.

    E-print Network

    Barnes, Brian Joseph

    2010-11-23

    Postoperative hypertension after cardiac surgery is common and associated with substantial morbidity. Both sodium nitroprusside (SNP) and nicardipine (NIC) are effective in its management. SNP is inexpensive, but associated with labile blood...

  18. Histology of the postoperative stomach before and after diversion of bile.

    PubMed Central

    Watt, P C; Sloan, J M; Spencer, A; Kennedy, T L

    1983-01-01

    Gastric biopsy specimens were taken in 33 patients before and after procedures to divert bile (construction of Roux loop in 19, closure of gastrojejunostomy in 14). Each biopsy specimen was assessed for dysplasia, intestinal metaplasia, atrophy, and gastritis, each variable being given a score ranging from 0 to 6. Patients were given preoperative and postoperative scores for each of these variables based on the average score of all preoperative or postoperative specimens. Comparison between preoperative and postoperative histology showed that there was no difference for gastritis, atrophy, or intestinal metaplasia. Patients who underwent closure of a gastrojejunostomy showed improvement in dysplasia that was not statistically significant. There was, however, a significant improvement in dysplasia in patients in whom a Roux loop was fashioned (p = 0.006) and in all patients taken together (p = 0.002). It was concluded that procedures that divert bile improve dysplasia but not other histological abnormalities in the stomach postoperatively. PMID:6416436

  19. Rectal indomethacin for postoperative pain in orthopaedic surgery. A double-blind study.

    PubMed

    Twiston-Davies, C W; Goodwin, M I; Baxter, P J

    1990-05-01

    We report a double-blind study of the effectiveness of indomethacin suppositories in the relief of postoperative pain and the reduction in demand for opiate analgesia following orthopaedic procedures. PMID:1971275

  20. Sonderforschungsbereich 950 ,,Manuskriptkulturen in Asien, Afrika und Europa" 3. TAG DER OFFENEN TR

    E-print Network

    Hamburg,.Universität

    Sonderforschungsbereich 950 ,,Manuskriptkulturen in Asien, Afrika und Europa" 3. TAG DER in Asien, Afrika und Europa" zum dritten Mal zu einem TAG DER OFFENEN TÜR ein und stellt am Beispiel von Asien, Afrika und Europa. Allerdings haben die Forscher ihre Fühler schon längst in weitere

  1. -Theorie und asymptotisches Verhalten der Storungsenergie bei einem Navier-Stokes-System im

    E-print Network

    Grunau, Hans-Christoph

    von Christian Ernst Meister geboren am 14.5.1969 in Frankfurt a. M. 1. Gutachter: Prof. Dr. Wolf von Kolloquiums: 22. Oktober 2001 #12;#12;DU MUSST VERSTEHN! AUS EINS MACH ZEHN, UND ZWEI LASS GEHN, UND DREI MACH GLEICH, SO BIST DU REICH. VERLIER DIE VIER! AUS F ¨UNF UND SECHS- SO SAGT DIE HEX- MACH SIEBEN UND ACHT

  2. Aufbau von Beschleunigern und Experimenten Abbildung 128: Einbau eines Beschleunigermoduls im TTF-Tunnel.

    E-print Network

    Aufbau von Beschleunigern und Experimenten Abbildung 128: Einbau eines Beschleunigermoduls im TTF-Tunnel. 262 #12;Aufbau von Beschleunigern und Experimenten Aufbau von Beschleunigern und Experimenten Von der. Beschleuniger HERA Die vorbereitenden Arbeiten für die Luminositätser- höhung von HERA und den Einbau von

  3. Gerd Wechsung: Die spaten Jahre 1990 bis 2004 (Verfat von Harald Hempel und Jorg Rothe)

    E-print Network

    Rothe, Jörg

    Gerd Wechsung: Die sp¨aten Jahre ­ 1990 bis 2004 (Verfaßt von Harald Hempel und J¨org Rothe) Anfang der 90er Jahre verschrieb sich Gerd fast vollst¨andig der demokratischen Erneuerung und der Universit¨at erlahmten Gerds wissenschaftliche Schaffenskraft und sein Einsatz f¨ur Studenten und

  4. Vorlesungsverzeichnis Frauen-und Geschlechterforschung JGU SoSe 2013 (Stand Januar 2013)

    E-print Network

    Kaus, Boris

    und Konzepte von Gleichheit und Differenz, Diversität und Ungleichheit Axel Rüdiger Ebel Mi, 17. Apr und Ungleichheit Axel Rüdiger Ebel Mi, 17. Apr. 2013 [10:15] - Mi, 17. Jul. 2013 [10:15] Seminar / Online Kommunikation: Sexualität im Internet Richard Lemke Do, 18. Apr. 2013 [12:00] - Do, 18. Jul. 2013

  5. Fish Oil and Post-Operative Atrial Fibrillation – Results of the Omega-3 Fatty Acids for Prevention of Post-Operative Atrial Fibrillation (OPERA) Trial

    PubMed Central

    Mozaffarian, Dariush; Marchioli, Roberto; Macchia, Alejandro; Silletta, Maria G.; Ferrazzi, Paolo; Gardner, Timothy J.; Latini, Roberto; Libby, Peter; Lombardi, Federico; O’Gara, Patrick T.; Page, Richard L.; Tavazzi, Luigi; Tognoni, Gianni

    2013-01-01

    Context Post-operative atrial fibrillation/flutter (AF) is one of the most common complications of cardiac surgery and significantly increases morbidity and healthcare utilization. A few small trials have evaluated whether long-chain n-3-polyunsaturated fatty acids (PUFA) reduce post-op AF, with mixed results. Objective To determine whether peri-operative n-3-PUFA supplementation reduces post-op AF. Design Randomized, double-blind, placebo-controlled, multinational, clinical trial. Patients A total of 1,516 patients scheduled for cardiac surgery across 28 centers in the US, Italy, and Argentina, enrolled between Aug 2010 and Jun 2012. Inclusion criteria were broad; the main exclusions were regular use of fish oil or absence of sinus rhythm at enrollment. Forty-eight percent of screened patients and 94% of eligible patients were enrolled. Intervention Patients were randomized to receive fish oil (1 g capsules containing ?840 mg n-3-PUFA as ethyl esters) or placebo, with pre-operative loading of 10g over 3-5 days (or 8g over 2 days) followed post-operatively by 2g/d until hospital discharge or post-op day10, whichever first. Main Outcome Measures The primary endpoint was occurrence of post-op AF >30 sec. We also evaluated post-op AF lasting >1hr, resulting in symptoms, or treated with cardioversion; other secondary post-op AF endpoints; other tachyarrhythmias; hospital utilization; and major adverse cardiovascular events, 30-day mortality, bleeding, and other adverse events. All endpoints and analyses plans were prespecified. Results At enrollment, mean±SD age was 64±13 years, 72.2% were male, and 51.8% had planned valvular surgery. The primary endpoint occurred in 233 (30.7%) and 227 (30.0%) patients assigned to placebo and n-3-PUFA, respectively (OR=0.96, 95%CI=0.77-1.20; P=0.74). None of the secondary endpoints were significantly different, including post-op AF that was sustained, symptomatic, or treated (n=231 [30.5%] vs. n=224 [29.6%], P=0.70) or number of post-op AF episodes per patient (1 episode: n=220 [29.0%] vs. n=217 [28.6%]; 2 episodes: n=156 [20.6%] vs. n=157 [20.7%]; 3+ episodes: n=18 [2.4%] vs. n=21 [2.8%]; P=0.73). n-3-PUFA was generally well-tolerated, with no evidence for increased risk of bleeding or serious adverse events. Conclusions In this large multinational trial among patients undergoing cardiac surgery, peri-operative supplementation with n-3-PUFA, compared to placebo, did not reduce the risk of post-operative AF. PMID:23128104

  6. Magnesium Versus Bupivacaine Infiltration in Controlling Postoperative Pain in Inguinal Hernia Repair

    PubMed Central

    Razavi, Seyed Sajad; Peyvandi, Hasan; Badrkhani Jam, Ali Reza; Safari, Farhad; Teymourian, Houman; Mohajerani, Seyed Amir

    2015-01-01

    Background: Postoperative pain is one of the most common problems after hernia repair. Decrease in postoperative pain accelerates functional recovery, decreases duration of hospital stay and postoperative morbidity. Objectives: To compare postoperative analgesic effect of infiltration of magnesium versus bupivacaine into incision of inguinal hernia repair. Patients and Methods: In a double blind clinical trial, 80 patients’ candidates for elective inguinal hernia repair were enrolled. Right before closure of incision, in Bupivacaine group 5 mL Bupivacaine 0.5% added to 5 mL normal saline and in Magnesium group, 10 mL Magnesium sulfate 20% was infused subcutaneously. Pain score was measured using numeric rating score (NRS) at 1, 3, 6, 12 and 24 hours postoperatively. If NRS was above 3, 1 mg morphine was administered as rescue analgesic until patient felt comfortable or NRS < 3. Results: Postoperative pain scores at 1 and 3 hours were not significantly different between bupivacaine and magnesium groups (P = 0.21, 0.224; respectively). However, at 6 (P = 0.003), 12 (P = 0.028) and 24 (P = 0.022) hours postoperative, pain score (NRS) was significantly lower in bupivacaine group. Number of patients needed at least 1 dose of rescue morphine (P = 0.001), mean number of episodes asked for morphine during next 24 hours (P = 0.001) and total dose of morphine requirement (P = 0.01) were significantly lower in bupivacaine group. Conclusions: Magnesium infiltration did not decrease total dose and number of episodes needed for morphine rescue analgesic. Bupivacaine infiltration into surgical site was more effective than magnesium sulfate infiltration in postoperative pain control. PMID:26705525

  7. Percutaneous CT-guided drainage of a postoperative intra-abdominal abscess in a combat environment.

    PubMed

    Plackett, Timothy P; Naeem, Mohammad

    2015-03-01

    Combat medical care results in limited resource availability, which can prompt creativity in treatment of otherwise common conditions. A postoperative intra-abdominal abscess is not an uncommon occurrence following traumatic hollow viscous injury in the deployed environment, but treatment is often limited to surgical drainage only. Herein, we describe a novel use of a dual-lumen central venous catheter to obtain percutaneous drainage of a postoperative intra-abdominal abscess. PMID:25735034

  8. Postoperative statin use and risk of biochemical recurrence following radical prostatectomy: Results from the SEARCH database

    PubMed Central

    Allott, Emma H.; Howard, Lauren E.; Cooperberg, Matthew R.; Kane, Christopher J.; Aronson, William J.; Terris, Martha K.; Amling, Christopher L.; Freedland, Stephen J.

    2014-01-01

    Objective • To investigate the effect of postoperative statin use on biochemical recurrence (BCR) in PC patients treated with radical prostatectomy (RP) who never used statins before surgery. Patients and Methods • We conducted a retrospective analysis of 1,146 RP patients within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. • Multivariable Cox proportional hazards analyses were used to examine differences in risk of BCR between postoperative statin users versus nonusers. • To account for varying start dates and duration of statin use during follow-up, postoperative statin use was treated as a time-dependent variable. • In secondary analysis, models were stratified by race to examine the association of postoperative statin use with BCR among black and non-black men. Results • After adjusting for clinical and pathological characteristics, postoperative statin use was significantly associated with 36% reduced risk of BCR (HR 0.64; 95%CI 0.47-0.87; p=0.004). • Postoperative statin use remained associated with reduced risk of BCR after adjusting for preoperative serum cholesterol levels. • In secondary analysis, following stratification by race, this protective association was significant in non-black (HR 0.49; 95%CI 0.32-0.75; p=0.001) but not black men (HR 0.82; 95%CI 0.53-1.28; p=0.384). Conclusion • In this retrospective cohort of men undergoing RP, postoperative statin use was significantly associated with reduced risk of BCR. • Whether the association between postoperative statin use and BCR differs by race requires further study. • Given these findings, coupled with other studies suggesting that statins may reduce risk of advanced PC, randomized controlled trials are warranted to formally test the hypothesis that statins slow PC progression. PMID:24588774

  9. Herschel und die Zukunft der Fern-Infrarot-Astronomie

    NASA Astrophysics Data System (ADS)

    Linz, Hendrik

    2015-06-01

    Schon lange ist die beobachtende Astronomie den engen Grenzen des optisch Sichbaren entwachsen und hat fast alle Bereiche des elektromagnetischen Spektrums für sich dienstbar gemacht. Im sogenannten nahen und mittleren Infrarot (Wellenlängen zwischen 1-30 ?m) sowie im Millimeter- und Radio-Regime (Wellenlängen zwischen 1 mm und 10 m) ist die Erdatmosphäre relativ gut durchlässig für elektromagnetische Signale oder hat zumindest eine Vielzahl von spektral begrenzten Transmissionsfenstern, die astronomische Beobachtungen zumindest von höheren Bergen aus möglich machen. Allerdings ist das sogenannte Ferne Infrarot (FIR, 30-300 ?m Wellenlänge) von der Erde aus fast völlig unzugänglich für astronomische Beobachtungen. Selbst für die besten Beobachtungsplätze der Erde bleibt die atmosphärische Transmission durch die immense Wasserdampf- Absorption auf ein absolutes Minimum beschränkt. Jedoch erlaubt uns das FIR Zugang zu Informationen, die sehr nützlich sind für die astrophysikalische Forschung und komplementär zu anderen Wellenlängen-Bereichen.

  10. Einfluss des Internets auf das Informations-, Einkaufs- und Verkehrsverhalten

    NASA Astrophysics Data System (ADS)

    Nerlich, Mark R.; Schiffner, Felix; Vogt, Walter

    Mit Daten aus eigenen Erhebungen können das einkaufsbezogene Informations- und Einkaufsverhalten im Zusammenhang mit den verkehrlichen Aspekten (Distanzen, Verkehrsmittel, Wegekopplungen) dargestellt werden. Die Differenzierung in die drei Produktkategorien des täglichen, mittelfristigen und des langfristigen Bedarfs berücksichtigt in erster Linie die Wertigkeit eines Gutes, die seine Erwerbshäufigkeit unmittelbar bestimmt. Der Einsatz moderner IKT wie das Internet eröffnet dem Endverbraucher neue Möglichkeiten bei Information und Einkauf. Die verkehrliche Relevanz von Online-Shopping wird deutlich, wenn man berücksichtigt, dass im Mittel rund 17% aller Online-Einkäufe, die die Probanden durchgeführt haben, Einkäufe in Ladengeschäften ersetzen. Dies gilt in verstärktem Maße für Online-Informationen: etwa die Hälfte hätte alternativ im stationären Einzelhandel stattgefunden. Da der Erwerb von Gütern des täglichen Bedarfs häufig nahräumlich und in relevantem Anteil nicht-motorisiert erfolgen kann, sind in diesem Segment - im Gegensatz zum mittel- und langfristigen Bedarf - nur geringe Substitutionseffekte zu beobachten.

  11. Projekt-und Personenfrderung * Die beantragte Projektsumme und/oder -laufzeit wurden gekrzt 1/3

    E-print Network

    Zürich, Universität

    and Endorsement under Swiss and EU laws Sitek Ania Pränataldiagnostik und Informed Consent * Thym Janina in Familial and Sporadic Alzheimer's disease * Fahrny Audrey Exploring HIV latency and latent reservoir-reactivation in humanized HIV-reporter mouse models * Generali Melanie In-vitro engineering of a human cell

  12. Universitat Stuttgart -Institut fur Wasser-und Umweltsystemmodellierung Lehrstuhl fur Hydromechanik und Hydrosystemmodellierung

    E-print Network

    Cirpka, Olaf Arie

    ) on the heat extraction and CO2 storage is analyzed. #12;II Buscheck [4] introduced a hybrid two-stage energy¨ur Hydromechanik und Hydrosystemmodellierung Prof. Dr.-Ing. Rainer Helmig Independent Study CO2 as a working fluid of geothermal energy production using Super Critical CO2 (SCCO2) as a heat extraction fluid would be about 60

  13. Correlation of fluid balance and postoperative pulmonary complications in patients after esophagectomy for cancer

    PubMed Central

    Xing, Xuezhong; Wang, Haijun; Qu, Shining; Huang, Chulin; Zhang, Hao; Wang, Hao; Sun, Kelin

    2015-01-01

    Background To investigate the association between fluid balance and postoperative pulmonary complications in patients after esophagectomy for cancer in a high volume cancer center. Methods Data of patients who admitted to intensive care unit (ICU) after esophagectomy at Cancer Hospital of Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC) between September 2008 and October 2010 were retrospectively collected and reviewed. Results There were 85 males and 15 females. Among them, 39 patients developed postoperative pulmonary complications and hospital death was observed in 3 patients (3.0%). Univariable analysis showed that patients who developed postoperative pulmonary complications had more cumulative fluid balance in day 1 to 2 (2,669±1,315 vs. 3,815±1,353 mL, P<0.001; and 4,307±1,627 vs. 5,397±2,040 mL, P=0.014, respectively) compared with patients who did not have postoperative pulmonary complications. Multivariable regression analysis demonstrated that only more cumulative fluid balance in day 1 (P=0.008; OR =1.001; 95% CI, 1.000-1.002) was independent risk factor for postoperative pulmonary complications. Conclusions Positive fluid balance in postoperative day 1 is predictive of pulmonary complications in patients after esophagectomy for cancer. PMID:26716037

  14. Effect of Music Therapy on Postoperative Pain Management in Gynecological Patients: A Literature Review.

    PubMed

    Sin, Wai Man; Chow, Ka Ming

    2015-12-01

    Unrelieved postoperative pain may have a negative impact on the physiological and psychological well-being of patients. Pharmacological methods are currently used to relieve such pain in gynecological patients; however, inadequate pain control is still reported, and the use of nonpharmacological pain-relieving methods is increasingly being advocated, one of which is music therapy. The purpose of this literature review was to identify, summarize, and critically appraise current evidence on music therapy and postoperative pain management among gynecological patients. A systematic search of MEDLINE, CINAHL, PsycINFO, British Nursing Index, and Allied and Complementary Medicine was conducted using the search terms music, gynecological, pain, surgery, operative, and post-operative to identify relevant articles in English from 1995 to the present. All identified articles were assessed independently for inclusion into review. A total of 7 articles were included after removal of duplicates and exclusion of irrelevant studies. All the included studies assessed the effects of music therapy on postoperative pain intensity, and three of them measured pain-related physiological symptoms. The findings indicated that music therapy, in general, was effective in reducing pain intensity, fatigue, anxiety, and analgesic consumption in gynecological patients during the postoperative period. It is recommended as an adjunct to pharmacological pain-relieving methods in reducing postoperative pain. Future researches on music therapy to identify the most effective application and evaluate its effect by qualitative study are recommended. PMID:26697822

  15. Sleep disturbances and quality of life in postoperative management after esophagectomy for esophageal cancer

    PubMed Central

    2014-01-01

    Background The aims of this prospective study were to analyze the predictors of postoperative sleep disturbance after esophagectomy for cancer and to identify patients at risk for postoperative hypnotic administration. Methods Sixty two consecutive patients who underwent cancer-related esophagectomy were enrolled in this study from May 2011 to February 2012. Data about perioperative management, postoperative complications, ICU stay, and vasopressor, hypnotic, and painkiller administration were retrieved. The EORTC QLQ-C30 was used and global quality of life (QL2 item) and sleep disturbance (SL item) were the primary endpoints. Univariate and multivariate analyses were performed. Results Postoperative request of hypnotics independently predicted bad quality of life outcome. Sleep disturbance after esophagectomy was independently predicted by the duration of dopamine infusion in the ICU and the daily request of benzodiazepines. Even in this case, only sleep disturbance at diagnosis revealed to be an independent predictor of hypnotic administration need. ROC curve analysis showed that sleep disturbance at diagnosis was a good predictor of benzodiazepine request (AUC?=?73%, P?=?0.02). Conclusions The use of vasopressors in the ICU affects sleep in the following postoperative period and the use of hypnotics is neither completely successful nor lacking in possible consequences. Sleep disturbance at diagnosis can successfully predict patients who can develop sleep disturbance during the postoperative period. PMID:24886219

  16. Postoperative complications following TECA-LBO in the dog and cat.

    PubMed

    Spivack, Rebecca E; Elkins, A Derrell; Moore, George E; Lantz, Gary C

    2013-01-01

    The medical records for 133 total ear canal ablations combined with lateral bulla osteotomies (TECA-LBOs) performed on 82 dogs (121 ears) and 11 cats (12 ears) between 2004 and 2010 were reviewed to determine if the duration of preoperative clinical signs was associated with the incidence of postoperative facial nerve injury and Horner's syndrome. Other perioperative complications, such as a head tilt, nystagmus, incisional drainage, draining tracts, hearing loss, as well as bacterial culture results, were noted. Postoperative facial nerve paresis occurred in 36 of 133 ears (27.1%), and paralysis occurred in 29 of 133 ears (21.8%), with no significant difference between species. Thus, postoperative facial nerve deficits occurred in 48.9% of ears. The median duration of clinically evident temporary facial nerve deficits was 2 wk for dogs and 4 wk for cats. Dogs had a significantly longer duration of preoperative clinical signs and were less likely than cats to have a mass in the ear canal. Dogs were less likely to have residual (> 1 yr) postoperative facial nerve deficits. The incidence of postoperative Horner's syndrome was significantly higher in cats than dogs. The duration of preoperative clinical signs of ear disease was not associated with postoperative facial nerve deficits. PMID:23535749

  17. Postoperative delirium. A review of 80 primary data-collection studies.

    PubMed

    Dyer, C B; Ashton, C M; Teasdale, T A

    1995-03-13

    We conducted an on-line search and manual searches for 1966 through 1992 to determine the incidence, diagnosis, risk factors, and treatment of postoperative delirium. Of the 374 citations found, 277 articles were excluded after criteria of relevance were applied. After methodologic criteria for validity were applied to the remaining 80 articles, 26 studies were retained for the final information synthesis. The incidence of postoperative delirium was 36.8% (range, 0% to 73.5%). Primary reasons for this disparity were insufficient sample size and inconsistent application of numerous diagnostic tools. One study provided statistically significant data that demonstrated that postoperative delirium is underdiagnosed by physicians and nurses. Four of the articles that met the established criteria provided risk factor data. Although age, preoperative cognitive impairment, and the use of anticholinergic drugs were significantly associated with postoperative delirium, gender, type and route of anesthesia, and sleep deprivation were not. Two studies demonstrated a decreased incidence of postoperative delirium when patients underwent preoperative psychiatric counseling or participated in a structured perioperative program. These findings indicate a need for (1) accurate incidence data with further definition of risk factors and (2) studies that address the diagnosis and treatment of this common postoperative problem. PMID:7864702

  18. Predictive Value of Postoperative Electrophysiologic Testing of the Facial Nerve After Cerebellopontine Angle Surgery

    PubMed Central

    Selesnick, Samuel H.; Digoy, G. Paul; Ptachewich, Yael; Rubin, Michael; Victor, Jonathan D.

    1998-01-01

    Our objective was to assess the ability of postoperative electroneuronography (ENoG) and electromyography (EMG) to predict clinical facial function 1 year postoperatively in patients with facial paralysis and an intact facial nerve after cerebellopontine angle surgery. The study was a prospective, nonrandomized, uncontrolled clinical trial on an outpatient basis, at a tertiary care hospital. Primary eligibility criteria include: (1) cerebellopontine angle (CPA) surgery with anatomical preservation of facial nerve, (2) complete facial nerve paralysis; and (3) 1 year follow-up. ENoG and EMG were measured at 1 and 3 months postoperatively, House-Brackmann facial nerve grade at 1 year postoperatively. The Kendall coefficient of rank correlation demonstrated that the 1 and 3 month postoperative ENoG data were significant predictors of ultimate facial nerve outcome. Tracking multiple ENoG examinations in a single patient, over time was of little predictive value. EMG was a poor predictor of facial nerve outcome. In general, patients with delayed facial nerve paralysis had better ultimate facial function than patients with immediate paralysis. Postoperative ENoG, but not EMG was a statistically significant predictor of ultimate facial nerve outcome after CPA surgery. Patients with delayed facial paralysis had better outcomes than those with immediate facial paralysis. PMID:17171049

  19. The Incidence of Early Postoperative Conductive Hearing Loss after Microvascular Decompression of Hemifacial Spasm.

    PubMed

    Ying, Tingting; Thirumala, Parthasarathy; Gardner, Paul; Habeych, Miguel; Crammond, Donald; Balzer, Jeffrey

    2015-12-01

    Objectives?To evaluate the incidence and discuss the pathogenesis of early postoperative conductive hearing loss (CHL) after microvascular decompression (MVD) for hemifacial spasm (HFS). Design?Pre- and postoperative audiogram data and brainstem auditory evoked potentials (BAEPs) from patients who had underwent MVD for HFS were analyzed. Setting?The study was conducted at the University of Pittsburgh Medical Center. Participants?MVD for HFS patients who had pre- and postoperative audiogram data, BAEP data, and normal structure of the external and middle ear were included in the study. Main Outcome Measures?CHL was diagnosed if there was an air-bone gap in pure tone audiometry of at least 10?dB at 0.5, 1, 2, or 4 kHz. Results?The incidence of early postoperative CHL in the ipsilateral ear was 18.7% postoperatively. No CHL was observed in the contralateral side. No significant relationship between CHL and intraoperative BAEP changes was found. Demographic parameters were not significantly different between groups with and without CHL. Conclusions?Early postoperative CHL is a significant complication after MVD. Fluid entering the mastoid air cells and/or bone-dust deposition during craniotomy may result in CHL. Long-term audiograms will be needed to evaluate the risk factors that lead to permanent CHL. PMID:26682118

  20. Effect of different adhesive strategies on the post-operative sensitivity of class I composite restorations

    PubMed Central

    Sancakli, Hande Sar; Yildiz, Esra; Bayrak, Isil; Ozel, Sevda

    2014-01-01

    Objective: To evaluate the post-operative sensitivity of occlusal restorations using different dentin adhesives performed by an undergraduate and a post-doctorate dentist. Materials and Methods: One hundred and eighty-eight molar occlusal restorations were placed in 39 patients (ages between 18 and 30) using 3 different kind of adhesive systems; Optibond FL (OBF), Clearfil Protect Bond (CPB), and iBond (IB) by a post-doctorate dentist or a fifth-year dental student according to the manufacturers’ instructions. Post-operative sensitivity to cold and air was evaluated using a Visual Analog Scale (VAS) after 24 hours, 30, 90, and 180 days. Data were analyzed using the Mann-Whitney U and Friedman tests (P < 0.05). Results: Post-operative sensitivity scores for OBF and CPB were higher for the dental student (P < 0.05), while IB scores did not differ statistical significantly according to the operator (P > 0.05). Conclusion: Operator skill and experience appears to play a role in determining the outcome of post-operative sensitivity of multi-step adhesive systems although the post-operative sensitivity was low. It is suggested that the less experienced clinicians (rather than experienced clinicians) should better use the self-etching dentin bonding systems with reduced application steps to minimize the potential risk of post-operative sensitivity of dental adhesives. PMID:24966741

  1. Using the Mouse Grimace Scale to Reevaluate the Efficacy of Postoperative Analgesics in Laboratory Mice

    PubMed Central

    Matsumiya, Lynn C; Sorge, Robert E; Sotocinal, Susana G; Tabaka, John M; Wieskopf, Jeffrey S; Zaloum, Austin; King, Oliver D; Mogil, Jeffrey S

    2012-01-01

    Postoperative pain management in animals is complicated greatly by the inability to recognize pain. As a result, the choice of analgesics and their doses has been based on extrapolation from greatly differing pain models or the use of measures with unclear relevance to pain. We recently developed the Mouse Grimace Scale (MGS), a facial-expression–based pain coding system adapted directly from scales used in nonverbal human populations. The MGS has shown to be a reliable, highly accurate measure of spontaneous pain of moderate duration, and therefore is particularly useful in the quantification of postoperative pain. In the present study, we quantified the relative intensity and duration of postoperative pain after a sham ventral ovariectomy (laparotomy) in outbred mice. In addition, we compiled dose–response data for 4 commonly used analgesics: buprenorphine, carprofen, ketoprofen, and acetaminophen. We found that postoperative pain in mice, as defined by facial grimacing, lasts for 36 to 48 h, and appears to show relative exacerbation during the early dark (active) photophase. We find that buprenorphine was highly effective in inhibiting postoperative pain-induced facial grimacing in mice at doses equal to or lower than current recommendations, that carprofen and ketoprofen are effective only at doses markedly higher than those currently recommended, and that acetaminophen was ineffective at any dose used. We suggest the revision of practices for postoperative pain management in mice in light of these findings. PMID:22330867

  2. Influence of preoperative emotional state on postoperative pain following orthopedic and trauma surgery

    PubMed Central

    Robleda, Gemma; Sillero-Sillero, Amalia; Puig, Teresa; Gich, Ignasi; Baños, Josep-E

    2014-01-01

    OBJECTIVES: to analyze the relationship between preoperative emotional state and the prevalence and intensity of postoperative pain and to explore predictors of postoperative pain. METHOD: observational retrospective study undertaken among 127 adult patients of orthopedic and trauma surgery. Postoperative pain was assessed with the verbal numeric scale and with five variables of emotional state: anxiety, sweating, stress, fear, and crying. The Chi-squared test, Student's t test or ANOVA and a multivariate logistic regression analysis were used for the statistical analysis. RESULTS: the prevalence of immediate postoperative pain was 28%. Anxiety was the most common emotional factor (72%) and a predictive risk factor for moderate to severe postoperative pain (OR: 4.60, 95% CI 1.38 to 15.3, p<0.05, AUC: 0.72, 95% CI: 0.62 to 0.83). Age exerted a protective effect (OR 0.96, 95% CI: 0.94-0.99, p<0.01). CONCLUSION: preoperative anxiety and age are predictors of postoperative pain in patients undergoing orthopedic and trauma surgery. PMID:25493674

  3. Effects of Interscalene Nerve Block for Postoperative Pain Management in Patients after Shoulder Surgery

    PubMed Central

    Chen, Hsiu-Pin; Shen, Shih-Jyun; Tsai, Hsin-I; Kao, Sheng-Chin; Yu, Huang-Ping

    2015-01-01

    Objectives. Shoulder surgery can produce severe postoperative pain and movement limitations. Evidence has shown that regional nerve block is an effective management for postoperative shoulder pain. The purpose of this study was to investigate the postoperative analgesic effect of intravenous patient-controlled analgesia (PCA) combined with interscalene nerve block in comparison to PCA alone after shoulder surgery. Methods. In this study, 103 patients receiving PCA combined with interscalene nerve block (PCAIB) and 48 patients receiving PCA alone after shoulder surgery were included. Patients' characteristics, preoperative shoulder score and range of motion, surgical and anesthetic condition in addition to visual analog scale (VAS) pain score, postoperative PCA consumption, and adverse outcomes were evaluated. Results. The results showed that PCA combined with interscalene nerve block (PCAIB) group required less volume of analgesics than PCA alone group in 24 hours (57.76 ± 23.29?mL versus 87.29 ± 33.73?mL, p < 0.001) and 48 hours (114.86 ± 40.97?mL versus 183.63 ± 44.83?mL, p < 0.001) postoperatively. The incidence of dizziness in PCAIB group was significantly lower than PCA group (resp., 1.9% and 14.6%, p = 0.005). VAS, nausea, and vomiting were less in group PCAIB, but in the absence of significant statistical correlation. Conclusion. Interscalene nerve block is effective postoperatively in reducing the demand for PCA analgesics and decreasing opioids-induced adverse events following shoulder surgery. PMID:26688821

  4. Imaging of the postoperative liver: review of normal appearances and common complications.

    PubMed

    Mulé, S; Colosio, A; Cazejust, J; Kianmanesh, R; Soyer, P; Hoeffel, C

    2015-10-01

    Several benign and malignant liver diseases may require surgical treatment for cure, including anatomical resections based on the segmental anatomy of the liver, non-anatomical (wedge) resections, and surgical management of biliary cysts. The type of surgery depends not only on the location and the nature of the disease, but also on the expertise of the surgeon. Whereas ultrasonography is often the first-line imaging examination in case of suspected postoperative complication, multidetector computed tomography (MDCT) is of greater value for identifying normal findings after surgery, early postoperative pathologic fluid collections and vascular thromboses, and tumor recurrence in patients who have undergone hepatic surgery. Magnetic resonance cholangiopancreatography (MRCP) is the imaging modality of choice for depicting early postoperative bile duct injuries and ischemic cholangitis that may occur in the late postoperative phase. Both MDCT and MRCP can accurately depict tumor recurrence. Radiologists should become familiar with these surgical procedures to better understand postoperative changes, and with the normal imaging appearances of various postoperative complications to better differentiate between complications and normal findings. PMID:26023007

  5. Safety of liposome extended-release bupivacaine for postoperative pain control

    PubMed Central

    Portillo, Juan; Kamar, Nawal; Melibary, Somayah; Quevedo, Eduardo; Bergese, Sergio

    2014-01-01

    Background: Ideal postoperative pain management requires a multidisciplinary approach in combination with a variety of dosage regimens. Approximately 21–30% of patients experience moderate to severe pain in the postoperative period, which may have a significant impact on recovery rate, standard of living, psychological health, and postoperative complications. Objective: Analysis of the incidence and characterization of reported adverse effects with DepoFoam bupivacaine compared to conventional bupivacaine or placebo. Methods: A systematic review of prospective studies on the use of DepoFoam versus bupivacaine or placebo was performed in order to answer the clinically relevant question: is DepoFoam a safer formulation in place of bupivacaine single injection or continuous local infusion techniques for postoperative pain management? Inclusion criteria required randomized, controlled, double-blind trials in patients 18 years old or older, single dose used for postoperative pain control, and a primary procedure performed. Results: Six studies fitted the inclusion criteria for analysis, DepoFoam bupivacaine used in therapeutic doses was well-tolerated, had a higher safety margin, and showed a favorable safety profile compared to bupivacaine and control groups. Conclusion: Extended drug delivery system DepoFoam bupivacaine is a promising drug formulation that may significantly improve postoperative care and pain control in surgical patients. PMID:24817851

  6. Die Juristische Fakultt feiert ihre Absolventinnen und Absolventen Am 1. Juli 2011 feierte die Juristische Fakultt ihre Absolventinnen und Absolventen

    E-print Network

    Kallenrode, May-Britt

    Die Juristische Fakultät feiert ihre Absolventinnen und Absolventen Am 1. Juli 2011 feierte die Bachelor Wirtschaftsrecht sowie die neu promovierten Doktorinnen und Doktoren des akademischen Jahres 2010/2011. In seiner Begrü�ung hob der Dekan Prof. Dr. Hans Schulte-Nölke die hohe Produktivität der Juristischen

  7. Fakultt fr Biologie und Vorklinische Medizin (Stand: 01.10.2014) Fakultt fr Biologie und Vorklinische Medizin

    E-print Network

    Schubart, Christoph

    Fakultät für Biologie und Vorklinische Medizin (Stand: 01.10.2014) 1 Fakultät für Biologie und. 0941 943-3117, Fax 0941 943-3325, E-Mail: bjoern.brembs@biologie.uni-regensburg.de Castrop, Wolf Hayo. 0941 943-2967, E-Mail: hayo@castrop.com Dittmer, Arne, Dr. phil. Didaktik der Biologie (Quirl), D4. 0

  8. Entwicklungsperspektiven von Social Software und dem Web 2.0

    NASA Astrophysics Data System (ADS)

    Raabe, Alexander

    Der Artikel beschäftigt sich zunächst mit dem derzeitigen und zukünftigen Einsatz von Social Software in Unternehmen. Nach dem großen Erfolg von Social Software im Web beginnen viele Unternehmen eigene Social Software-Initiativen zu entwickeln. Der Artikel zeigt die derzeit wahrgenommenen Einsatzmöglichkeiten von Social Software im Unternehmen auf, erörtert Erfolgsfaktoren für die Einführung und präsentiert mögliche Wege für die Zukunft. Nach der Diskussion des Spezialfalles Social Software in Unternehmen werden anschließend die globalen Trends und Zukunftsperspektiven des Web 2.0 in ihren technischen, wirtschaftlichen und sozialen Dimensionen dargestellt. Wie aus den besprochenen Haupttrends hervorgeht, wird die Masse an digital im Web verfügbaren Informationen stetig weiterwachsen. So stellt sich die Frage, wie es in Zukunft möglich sein wird, die Qualität der Informationssuche und der Wissensgenerierung zu verbessern. Mit dem Einsatz von semantischen Technologien im Web wird hier eine revolutionäre Möglichkeit geboten, Informationen zu filtern und intelligente, gewissermaßen verstehende" Anwendungen zu entwerfen. Auf dem Weg zu einem intelligenten Web werden sich das Semantic Web und Social Software annähern: Anwendungen wie Semantic Wikis, Semantic Weblogs, lightweight Semantic Web-Sprachen wie Microformats oder auch kommerzielle Angebote wie Freebase von Metaweb werden die ersten Vorzeichen einer dritten Generation des Webs sein.

  9. Darwinische Kulturtheorie - Evolutionistische und "evolutionistische`` Theorien sozialen Wandels

    NASA Astrophysics Data System (ADS)

    Antweiler, Christoph

    Evolutionistische Argumentationen außerhalb der Biologie sind weit verbreitet. Wenn sie vertreten werden, heißt das mitnichten, dass sie notwendigerweise von darwinischen Argumenten geprägt sind. Wenn man Evolution und Kultur aus explizit darwinischer Perspektive zusammen bringt, bedeutet das noch lange nicht unbedingt Soziobiologie. Und es bedeutet sicherlich nicht Sozialdarwinismus. Dieser Beitrag soll einen Überblick der so genannten evolutionären Ansätze bzw. evolutionistischen Ansätze zu menschlichen Gesellschaften bzw. Kulturen geben. Es soll gezeigt werden, was in den Ansätzen analytisch zu trennen ist und was synthetisch zusammen gehört. Mein Beitrag ist nicht wissenschaftsgeschichtlich angelegt, sondern systematisch ausgerichtet und hat zwei Schwerpunkte (Antweiler 2008; Antweiler 2009b). Zum einen geht es um kausale Zusammenhänge von organischer Evolution und gesellschaftlichem Wandel. Auf der anderen Seite werden Analogien zwischen biotischer und kultureller Evolution erläutert, die als spezifische Ähnlichkeiten dieser beiden als grundsätzlich verschieden gesehenen Prozesse aufgefasst werden. Dadurch wird die Frage aufgeworfen, ob die Evolution von Organismen einerseits und die Transformation von Gesellschaften bzw. Kulturen andererseits, spezielle Fälle eines allgemeinen Modells von Evolution darstellen.

  10. Pain on the first postoperative day after head and neck cancer surgery.

    PubMed

    Inhestern, Johanna; Schuerer, Jenny; Illge, Christina; Thanos, Ira; Meissner, Winfried; Volk, Gerd Fabian; Guntinas-Lichius, Orlando

    2015-11-01

    Postoperative pain within the first 24 h after head and neck cancer (HNC) surgery was assessed. Factors influencing postoperative pain were identified. In a prospective cohort single center study 145 HNC patients rated their pain on the first postoperative day using questionnaires of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including numeric rating scales (NRS, 0-10) for the determination of patient's pain on ambulation, his maximal and minimal pain. QUIPS allowed a standardized assessment of patients' characteristics and pain-related parameters. The influence of these parameters on the patients' postoperative pain was estimated by univariate and multivariate statistical analysis. One-third had already pain prior to the surgical intervention. Overall, the mean pain on ambulation, maximal pain and minimal pain were 2.55 ± 2.36, 3.18 ± 2.86, and 1.38 ± 2.86 (NRS), respectively. 53 % of the patients had maximal pain scores >3. Multivariate analysis revealed independent predictors for more postoperative pain on ambulation: intensity of chronic preoperative pain, usage of non-opioids on ward, and existence of pain documentation on ward. Intensity of chronic preoperative pain and usage of non-opioids on ward were independent risk factors for more maximal pain. Intensity of chronic preoperative pain was independently associated to more minimal pain. Concerning pain management side effects, the risk for drowsiness increased with longer time of surgery. Postoperative pain after HNC surgery is highly variable and seems often to be unnecessarily high. Many patients seem to receive less analgesia than needed or ineffective analgesic drug regimes. PMID:25261106

  11. Comparison of bupivacaine and parecoxib for postoperative pain relief after laparoscopic cholecystectomy: a randomized controlled trial

    PubMed Central

    Lin, Shengping; Hua, Jie; Xu, Bin; Yang, Tingsong; He, Zhigang; Xu, Chenglei; Meng, Hongbo; Zhou, Bo; Song, Zhenshun

    2015-01-01

    Background: Pain is the most common complaint of patients on the first day after laparoscopic cholecystectomy (LC). The aim of this study was to compare the efficacy of local anesthesia with bupivacaine and intravenous parecoxib on postoperative abdominal pain relief up to 24 h after surgery. Methods: One hundred and eighty patients who underwent LC were randomized to one of three groups with sixty patients each: Group A received 50 mg 0.5% bupivacaine subcutaneously at trocar sites before incision closure; Group B received intravenous parecoxib (40 mg) after entering the recovery room; Group C did not receive postoperative analgesia unless needed and was served as control. The postoperative pain at 1, 2, 4, 8, 12, and 24 h after the operation was assessed using a visual analog scale (VAS). Secondary outcomes, including intraoperative and postoperative complications, the incidence of shoulder pain, pethidine requirements, postoperative nausea and vomiting, and hospital stay were also recorded. Results: At 1, 2, and 4 hours after surgery, VAS pain scores were significantly lower in group A and B compared with group C (P < 0.05 for all). There was no significant difference among the three groups at 8, 12, and 24 hours after the procedure (P > 0.05 for all). A repeated-measures ANOVA analysis revealed that VAS pain scores over the first 24 hours after LC were significantly lower in group A and B compared with group C (P = 0.014 and P = 0.029 for between-group comparison, respectively). Furthermore, the percentage of patients requiring postoperative rescue analgesics was significantly higher in group C as compared with group A and group B (P = 0.018). Conclusion: Local anesthesia with bupivacaine and intravenous parecoxib are both effective at decreasing postoperative pain and pethidine requirements after LC. PMID:26550332

  12. Ultrasound guided bilateral cervical plexus block reduces postoperative opioid consumption following thyroid surgery.

    PubMed

    Gürkan, Yavuz; Ta?, Zafer; Toker, Kamil; Solak, Mine

    2015-10-01

    Thyroid surgery may cause severe postoperative pain and discomfort for patients. Superficial cervical plexus block (SCPB) is one of the regional anesthesia techniques that can provide postoperative analgesia for thyroid surgery. The purpose of this study was to evaluate analgesic effect of ultrasound (US) guided SCPB in patients undergoing thyroid surgery. Fifty ASA I-II patients, aged 20-60, were included in this single blinded study. In a randomized and prospective manner patients were allocated to either SCPB or control group. Bilateral SCPB was performed preoperatively under US guidance using 10 ml 0.25 % bupivacaine for each side. Postoperative analgesia was provided with patient-controlled analgesia method with morphine intravenous. Primary outcome measure was postoperative opioid consumption and analyzed using Mann-Whitney U test. Secondary outcome measures were comparison of opioid side effects like nausea and vomiting and analyzed using Chi square test. VAS scores for pain at postoperative 1st, 6th, 12th, and 24th h were similar in SCPB and control groups (Median VAS values were 2.5, 3, 2, 0 and 3.5, 3, 2, 0 respectively). Postoperative morphine consumption was lower in SCPB group compared to control group at postoperative 6th, 12th, and 24th h (Median doses of morphine consumption were 4, 8, 9 and 5, 9, 11 mg respectively) (P < 0.05). Eight patients in the control group and six patients in the SCBP group had vomiting. Seven patients in the SCPB and none in the control group had hoarseness. Our study has shown that US guided SCPB has a significant analgesic effect in patients undergoing thyroid surgery. Further studies are required to search for the optimal LA dose during US guided SCPB. PMID:25344881

  13. Evaluation of postoperative analgesia in a rat model of incisional pain.

    PubMed

    St A Stewart, Laike; Martin, William J

    2003-01-01

    Effective postoperative analgesia is essential for improving patient well-being and decreasing morbidity. Historical recommendations of postoperative analgesics have been based on their effectiveness in attenuating a nociceptive response in animals that have not undergone a surgical procedure, potentially leading to over- or underestimation of postoperative analgesia requirements. This study was designed to evaluate the efficacy of four analgesics in a model of postsurgical pain, which involves surgical incision of the plantar aspect of the hindpaw in halothane-anesthetized rats. The hindpaw was selected as the injury site because it permits quantitative assessment of mechanical sensitivity, which increases as a consequence of tissue damage. As the primary endpoints for postoperative recovery, mechanical sensitivity and weight gain were determined for 5 days. Analgesic regimens included buprenorphine (0.025, 0.05, and 0.1 mg/kg subcutaneously [s.c.]; 1 ml/kg), fentanyl (0.01 and 0.1 mg/kg intraperitoneally [i.p.]; 1 ml/kg), flunixin meglumine (1.1 and 2.5 mg/kg, s.c.; 1 ml/kg) and acetaminophen (100 and 300 mg/kg orally; approximately 3 & 10 ml/kg). Drugs were administered once daily on days 0, 1, and 2 postoperatively. Buprenorphine, fentanyl, and flunixin all significantly decreased mechanical sensitivity, but buprenorphine provided the highest degree of analgesia during the postoperative treatment period. However, rats treated with buprenorphine exhibited heightened mechanical sensitivity once treatment was discontinued on day 2. Moreover, buprenorphine also compromised weight gain as compared to that of vehicle-treated animals. These findings suggest that potent nonsteroidal anti-inflammatory agents, such as flunixin, may be useful alternatives to opioid-based agents for the control of acute postoperative pain associated with a minor surgical procedure and highlight the importance of assessing the risk-benefit ratio when selecting analgesics and dosing regimens. PMID:12580571

  14. Comparison of dexmedetomidine and dexamethasone for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy

    PubMed Central

    Ismail, Eman A.; Ibrahim, Ahmed

    2015-01-01

    Background Postoperative nausea and vomiting (PONV) are common following laparoscopic cholecystectomy (LC). Dexamethasone has been reported to reduce PONV. However, there is insufficient evidence regarding the effect of dexmedetomidine in decreasing PONV. This study was designed to compare the effects of a single dose of dexmedetomidine to dexamethasone for reducing PONV after LC. Methods Eighty-six adult patients scheduled for LC were randomized to receive either single dose 1 µg/kg of dexmedetomidine (Dexmed group, N = 43) or 8 mg dexamethasone (Dexa group, N = 43) before skin incision. During the first 24 h postoperatively, the incidence and severity of PONV were assessed. Pain and sedation scores were assessed on arrival in the recovery room and early postoperatively. Analgesic and antiemetic consumption during the 24 h after surgery were calculated. Intra-operative and postoperative hemodynamics were recorded. Results Twenty-one percent of the patients in the Dexmed group developed PONV compared to 28% in the Dexa group (P = 0.6). Severity of PONV was similar between the two groups (P = 0.07). Early postoperatively, pain severity was significantly lower in the Dexmed group, but sedation scores were significantly higher. The first analgesic request was significantly delayed in the Dexmed group (P = 0.02). The total amounts of intraoperative fentanyl and postoperative tramadol administered were significantly lower in the Dexmed group. No difference in ondansetron was noted between the two groups. Mean arterial pressure and heart rate were significantly lower in the Dexmed group after administration of dexmedetomidine. No major side effects were reported. Conclusions Dexmedetomidine reduces the incidence and severity of PONV, similar to dexamethasone. It is superior to dexamethasone in reducing postoperative pain and total analgesic consumption during the first 24 h after LC. PMID:26045928

  15. Management of postoperative pain: experience of the Niamey National Hospital, Niger

    PubMed Central

    Chaibou, Maman Sani; Sanoussi, Samuila; Sani, Rachid; Toudou, Nouhou A; Daddy, Hadjara; Madougou, Moussa; Abdou, Idrissa; Abarchi, Habibou; Chobli, Martin

    2012-01-01

    Objective The aim of this study was to evaluate the management of postoperative pain at the Niamey National Hospital. Methods A prospective study was conducted in the Department of Anesthesiology and Intensive Care at the Niamey National Hospital from March to June, 2009. Data collected included age, sex, literacy, American Society of Anesthesiologists (ASA) physical status classification, type of anesthesia, type of surgery, postoperative analgesics used, and the cost of analgesics. Three types of pain assessment scale were used depending on the patient’s ability to describe his or her pain: the verbal rating scale (VRS), the numerical rating scale (NRS), or the visual analog scale (VAS). Patients were evaluated during the first 48 hours following surgery. Results The sample included 553 patients. The VRS was used for the evaluation of 72% of patients, the NRS for 14.4%, and the VAS for 13.6%. Of the VRS group, 33.9%, 8.3%, and 2.1% rated their pain as 3 or 4 out of 4 at 12, 24, and 48 hours postoperatively, respectively. For the NRS group, 33.8%, 8.8%, and 2.5% rated their pain as greater than 7 out of 10 at 12, 24, and 48 hours postoperatively, respectively. For the VAS group, 29.3%, 5.4%, and 0% rated their pain as greater than 7 out of 10 at 12, 24, and 48 hours postoperatively, respectively. Conclusion Postoperative pain assessment and management in developing countries has not been well described. Poverty, illiteracy, and inadequate training of physicians and other health personnel contribute to the underutilization of postoperative analgesia. Analysis of the results gathered at the Niamey National Hospital gives baseline data that can be the impetus to increase training in pain management and to establish standardized protocols. PMID:23271923

  16. Werktags und samstags von 10:00 bis 18:00 Uhr Eintritt: 8 / ermigt: 4 / frei fr Schlerinnen und Schler sowie fr

    E-print Network

    Brezany, Peter

    ,,Verein Ernst Mach". Rasch wurde der Wiener Kreis zum roten Tuch für die antisemitischen und reaktionären ,,Verein Ernst Mach" wurde nach den Februarkämpfen verboten, und Neurath musste ins Exil fliehen. Schlick

  17. Christian Ziethen und Peter Bress Warum Physik studieren? 3 Christian Ziethen und Peter Bress Was bietet Mainz als Studienort in der Physik? 4

    E-print Network

    EINLEITUNG Christian Ziethen und Peter Bress Warum Physik studieren? 3 Christian Ziethen und Peter Zerfälle von seltsamen Teilchen 20 Thorsten Best Ultrakalte Atome - eiskalt serviert 22 Christian Vogl

  18. Immuntherapie des Melanoms: Wirksamkeit und Wirkungsmechanismen.

    PubMed

    Wieder, Thomas; Brenner, Ellen; Braumüller, Heidi; Röcken, Martin

    2016-01-01

    Die Erkenntnisse aus 40 Jahren Forschung erlauben es, durch Antikörper-vermittelte Aktivierung des Immunsystems eine therapeutisch wirksame Antitumorantwort zu induzieren. Die "Immun-Checkpoint-Inhibitoren" sind gegen immuninhibitorische Moleküle wie cytotoxic T lymphocyte antigen 4 (CTLA4), programmed-death-1 (PD-1) oder programmed-death-ligand-1 (PD-L1) gerichtet. Die Unterbrechung der PD-1/PD-L1-Interaktion verbessert mittelfristig auch die Prognose bei Patienten mit Melanomen im Stadium IV. So sind unter Therapie mit Anti-PD-1-Antikörpern 30-60 % dieser Patienten nach eineinhalb Jahren am Leben. Antitumorale Immuntherapien verursachen nur selten eine vollständige Zerstörung der Metastasen, sondern eine Regression um 20-80 %. Fest etabliert ist, dass das Immunsystem Tumorzellen abtöten kann; dies wurde auch für Immuntherapien belegt. Präklinische Daten zeigten jedoch, dass Immunantworten Tumoren nicht nur töten können. So kann das Immunsystem über die Zytokine Interferon-? und Tumornekrosefaktor in Tumoren einen stabilen Wachstumsarrest hervorrufen, der Seneszenz genannt wird. Ein Ziel antitumoraler Immuntherapien wird also darin liegen, das Überleben der Patienten durch eine langfristige Stabilisierung der Metastasen zu sichern. Dies gilt für das Melanom und das nichtkleinzellige Lungenkarzinom. Sobald Immuntherapien auch bei häufigen Tumoren indiziert sein werden, müssen die Medikamentenpreise deutlich fallen, um sie weiterhin jenen zur Verfügung stellen zu können, die die Therapien benötigen. PMID:26713632

  19. Entwicklung und aktueller Stand der Hüftendoprothetik

    NASA Astrophysics Data System (ADS)

    Winter, Eugen

    Der künstliche Hüftgelenkersatz stellt einen der bedeutendsten medizinischen Fortschritte des vergangenen Jahrhunderts dar. Eine Hüftendoprothese (endo griech. = innen, Prothese griech. = künstlicher Ersatz eines fehlenden Körperteiles) ist dann indiziert (lat. = angezeigt), wenn bei einer hochgradigen Hüft-Arthrose konservative (= nicht-operative) Therapiemaßnahmen wie z. B. Medikamenteneinnahme, Krankengymnastik u. a. nichts mehr helfen und der betroffene Mensch sich in seiner Lebensqualität massiv beeinträchtigt fühlt. Die Implantation einer Hüftendoprothese zählt zu den 10 häufigsten Operationen in Deutschland [1]. Das Wort Arthrose leitet sich aus dem Altgriechischen ab: ?????? = arthros = Gelenk. Im deutschsprachigen Raum ist der Begriff Arthrose klar definiert. Mit der Endung ...ose ist eine degenerative (= verschleißbedingte) Erkrankung des Gelenkes gemeint. Statt dieser mechanischen Abnutzung kann aber auch eine entzündliche Erkrankung Ursache für die Gelenkzerstörung sein. Diese Entzündung eines Gelenkes nennt man im deutschsprachigen Raum Arthritis, wobei die Endung …itis auf die entzündliche Ursache hinweist (Beispiel: chronische Polyarthritis = c.P.). Im englischsprachigen Raum ist es üblich, alle Arten von Gelenkerkrankungen mit dem Wort arthritis zu beschreiben, auch die nicht entzündlichen. Arthrose und Arthritis können alle Gelenke der Körpers befallen. Zahlenmäßig steht die Arthrose im Vergleich zur Arthritis sehr weit im Vordergrund. In Deutschland leiden etwa 8 Millionen Menschen an Arthrose.

  20. Gravitation und Kosmologie. Eine Einführung in die Allgemeine Relativitätstheorie

    NASA Astrophysics Data System (ADS)

    Sexl, Roman U.; Urbantke, Helmuth K.

    Das Lehrbuch von Sexl und Urbantke gibt eine Einführung in die Allgemeine Relativitätstheorie und Kosmologie, die auch Querverbindungen zur Elementarteilchenphysik berücksichtigt. Neben den "klassischen" Resultaten der Allgemeinen Relativitätstheorie behandeln die Autoren in der vorliegenden, aktualisierten Auflage eine Vielzahl von Themen und Entwicklungen, die die Diskussion in den letzten zwei Jahrzehnten bestimmt haben. Die Auswahl des Lehrstoffes wurde dabei vor allem im Hinblick auf Leser getroffen, die einen Überblick über elementare Grundlagen der Einsteinschen Gravitationstheorie sowie Aspekte mit Querverbindungen zu anderen Branchen der theoretischen Physik (z. B. Eichtheorie der Elementarteilchen) suchen, ohne sich aber auf Relativitätstheorie spezialisieren zu wollen.

  1. Endoskopie, minimal invasive chirurgische und navigierte Verfahren in der Urologie

    NASA Astrophysics Data System (ADS)

    Grosse, Joachim; von Walter, Matthias; Jakse, Gerhard

    Betrachtet man die letzten 100 Jahre der Urologie in Deutschland seit Gründung ihrer Fachgesellschaft 1906 in Stuttgart, so sind sicherlich die letzten 25 Jahre von umfassenden Entwicklungen mit z. T. vollständigen Umwälzungen bisheriger Therapien und Methoden auf urologischen Fachgebiet gekennzeichnet. In erster Linie handelte es sich dabei um minimal invasive endoskopische Techniken wie perkutane Nierenchirurgie, Ureterorenoskopie, videoendoskopisch unterstütze transurethrale Elektroresektionen der Prostata und von Blasentumore sowie die Laparoskopie. Sie führten zu besseren operativen Ergebnissen und einer deutlichen Senkung der Morbidität der entsprechenden Behandlung urologischer Krankheitsbilder, mit der Konsequenz, dass einige bisher als Standard gültige offene Operationsverfahren abgelöst wurden.

  2. Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after laparoscopic gynecological surgery

    PubMed Central

    Park, Joong-Ho; Lee, Chiu; Shin, Youngmin; Ban, Jong-Seouk; Lee, Ji-Hyang

    2015-01-01

    Background Opioids are widely used in boluses and patient-controlled analgesia (PCA) for postoperative pain control. In this study, we compared the effects of oxycodone and fentanyl on postoperative pain in patients with intravenous patient-controlled analgesia (IV-PCA) after laparoscopic gynecological surgery. Methods Seventy-four patients undergoing elective total laparoscopic hysterectomy or laparoscopic myomectomy were randomly assigned to the administration of either fentanyl or oxycodone using IV-PCA (potency ratio 1 : 60). The cumulative dose administered in the patient-controlled mode during the initial 48 hours after the operation was measured. Patients were also assessed for postoperative pain severity, adverse effects, and patient satisfaction. Results No significant differences were observed in patient satisfaction with the analgesia during the postoperative period. Patients in the oxycodone group experienced significantly more dizziness compared to the fentanyl group. Patients in the oxycodone group showed significantly lower consumption of opioid in the patient-controlled mode (10.1 ± 8.5 ml vs. 16.6 ± 12.0 ml, P = 0.013). Conclusions Our data suggest that oxycodone and fentanyl demonstrated similar effects, and therefore oxycodone may be a good alternative to fentanyl in postoperative pain management. Further studies in various clinical settings will be needed to determine the adequate potency ratio. PMID:25844134

  3. Outcomes of WHO Grade I Meningiomas Receiving Definitive or Postoperative Radiotherapy

    SciTech Connect

    Tanzler, Emily; Morris, Christopher G.; Kirwan, Jessica M.; Amdur, Robert J.; Mendenhall, William M.

    2011-02-01

    Purpose: We analyzed long-term local control and complications in patients with either pathologically confirmed or clinical World Health Organization Grade I meningiomas treated with definitive or postoperative radiotherapy (RT) at the University of Florida. Methods: Between 1984 and 2006, 146 patients were treated with definitive (n = 88) or postoperative RT after subtotal resection (n = 57) or gross total resection (n = 1). Patients were treated with conventional (n = 41), stereotactic (n = 103), or intensity-modulated RT (n = 2) to a median dose of 52.7 Gy and followed for a median of 7.3 years (range, 0.6-22.0 years) Results: The local control rates at 5 and 10 years were as follows: definitive RT, 99% and 99%; postoperative RT, 96% and 93%; and overall, 97% and 96%, respectively. The 5- and 10-year cause-specific survival rates were as follows: definitive RT 94% and 94%, postoperative RT, 100% and 96%; and overall, 96% and 95%, respectively. The 5- and 10-year overall survival rates were as follows: definitive RT, 81% and 75%; postoperative RT, 96% and 85%; and overall, 87% and 79%, respectively. Severe RT complications occurred in 6.8% of patients; severe surgery-related complications occurred in 10 (17%) of 58 patients treated surgically. Conclusions: The likelihood of cure after definitive RT or following subtotal resection is excellent. However, a small population of patients experience severe complications, even at the moderate dose used for this disease.

  4. A comparative study of intravenous paracetamol and intravenous tramadol for postoperative analgesia in laparotomies

    PubMed Central

    Shahid, Mohammed; Manjula, B. P.; Sunil, B. V.

    2015-01-01

    Background: Pain in the perioperative setting or thereafter plays a significant role in delaying an otherwise successful recovery. Hence, mitigation of such postoperative pain assumes importance. Among the various agents employed for such mitigation, opioids and non-steroidal anti-inflammatory drugs have for some time taken center stage. However, alas they are not without their share of adverse effects. This study was undertaken with the purpose of elucidating the efficacy of intravenous (IV) paracetamol as compared to IV tramadol in mitigating postoperative pain while observing its effect on hemodynamic stability and the presence of adverse drug reactions, if any. Materials and Methods: A total of 60 randomized cases aged ranges from 20 to 60 years of both sexes divided into two groups (each for paracetamol and tramadol) scheduled for laparotomies were administered IV paracetamol and tramadol for postoperative pain relief and assessed with visual analog scale (VAS) score and variations in vital parameters to ascertain extent of pain relief and post-operative nausea vomiting (PONV). Results: Data so collected was statistically interpreted, and observations extrapolated. Save for a perceptible decline in PONV with paracetamol group compared with tramadol group with a statistically significant P < 0.001, nothing statistically significant was observed in any other parameter, including VAS scores between either group. Conclusion: IV paracetamol is a safer alternative to tramadol with lesser PONV in the postoperative period translates into the lesser duration of hospitalization and hence earlier discharge. PMID:26712966

  5. Lymphatic Territories (Lymphosomes) in a Canine: An Animal Model for Investigation of Postoperative Lymphatic Alterations

    PubMed Central

    Suami, Hiroo; Yamashita, Shuji; Soto-Miranda, Miguel A.; Chang, David W.

    2013-01-01

    Background Lymph node dissection is often performed as a part of surgical treatment for breast cancer and malignant melanoma to prevent malignant cells from traveling via the lymphatic system. Currently little is known about postoperative lymphatic drainage pattern alterations. This knowledge may be useful for management of recurrent cancer and prevention of breast cancer related lymphedema. We mapped the complete superficial lymphatic system of a dog and used this canine model to perform preliminary studies of lymphatic architectural changes in postoperative condition. Methods Lymphatic territories (lymphosomes) were mapped with 4 female mongrel carcasses using an indocyanine green (ICG) fluorescent lymphography and a radiographic microinjection technique. Two live dogs were then subjected to unilateral lymph node dissection of lymph basins of the forelimb, and ICG lymphography and lymphangiogram were performed 6 months after the surgery to investigate lymphatic changes. Lymphatic patterns in the carcass were then compared with postoperative lymphatic patterns in the live dogs. Results Ten lymphosomes were identified, corresponding with ten lymphatic basins. Postoperative fluorescent lymphographic images and lymphangiograms in the live dogs revealed small caliber lymphatic network fulfilling gaps in the surgical area and collateral lymphatic vessels arising from the network connecting to lymph nodes in the contralateral and ipsilateral neck in one dog and the ipsilateral subclavicular vein in another dog. Conclusion Our canine lymphosome map allowed us to observe lymphatic collateral formations after lymph node dissection in live dogs. This canine model may help clarify our understanding of postoperative lymphatic changes in humans in future studies. PMID:23894435

  6. Effect of submucosal application of tramadol on postoperative pain after third molar surgery.

    PubMed

    Gönül, Onur; Sat?lm??, Tülin; Bayram, Ferit; Göçmen, Gökhan; Sipahi, Aysegül; Göker, Kamil

    2015-01-01

    The aim of this study was to evaluate the effectiveness of submucosal application of tramadol, for acute postoperative facial pain, following the extraction of impacted third molar teeth. This prospective, double-blind, randomised placebo-controlled study included 60 ASA I-II patients undergoing impacted third molar surgery under local anaesthesia. Following the surgical procedure, patients were randomly divided into two groups; group T (1 mg/kg tramadol) and group S (2-mL saline). Treatments were applied submucosally after surgery. Pain after extraction was evaluated using a visual analogue scale (VAS) 0.5, 1, 2, 4, 6, 12, 24, and 48 h postoperatively. The time at which the first analgesic drug was taken, the total analgesic dose used, and adverse tissue reactions were also evaluated. In group T, postoperative VAS scores were significantly lower compared to that in group S (p?post-operative submucosal application of tramadol is an effective method for reducing acute post-operative facial pain after impacted third molar surgery. PMID:26467984

  7. Perioperative local infiltration anesthesia with ropivacaine has no effect on postoperative pain after total hip arthroplasty.

    PubMed

    Hofstad, Janne Kristin; Winther, Siri B; Rian, Torbjørn; Foss, Olav A; Husby, Otto S; Wik, Tina S

    2015-12-01

    Background and purpose - The local infiltration analgesia (LIA) technique has been widely used to reduce opioid requirements and to improve postoperative mobilization following total hip arthroplasty (THA). However, the evidence for the efficacy of LIA in THA is not yet clear. We determined whether single-shot LIA in addition to a multimodal analgesic regimen would reduce acute postoperative pain and opioid requirements after THA. Patients and methods - 116 patients undergoing primary THA under spinal anesthesia were included in this randomized, double-blind, placebo-controlled trial. All patients received oral opioid-sparing multimodal analgesia: etoricoxib, acetaminophen, and glucocorticoid. The patients were randomized to receive either 150 mL ropivacaine (2 mg/mL) and 0.5 mL epinephrine (1 mg/mL) or 150 mL 0.9% saline. Rescue analgesic consisted of morphine and oxycodone as needed. The primary endpoint was pain during mobilization in the recovery unit. Secondary endpoints were pain during mobilization on the day after surgery and total postoperative opioid requirements on the first postoperative day. Results - The levels of pain during mobilization-both in the recovery unit and on the day after surgery-and consumption of opioids on the first postoperative day were similar in the 2 groups. Interpretation - LIA did not provide any extra analgesic effect after THA over and above that from the multimodal analgesic regimen used in this study. PMID:25997827

  8. Comparing the Impact of Intraperitoneal Hydrocortisone With Bupivacaine on Postoperative Pain After Laparoscopic Cholecystectomy

    PubMed Central

    Amini, Shahram; Sabzi Sarvestani, Amene

    2014-01-01

    Background: Postoperative pain is a major complaint following laparoscopic cholecystectomy. Objectives: The aim of this study was to compare the impact of intraperitoneal hydrocortisone with intraperitoneal bupivacaine on pain relief after laparoscopic cholecystectomy Patients and Methods: In a double blind clinical trial, 63 candidates for laparoscopic cholecystectomy were randomly allocated to receive intraperitoneal instillation of either 100 mg bupivacaine in 250 mL normal saline (n = 32) or 100 mg hydrocortisone in 250 mL normal saline (n = 31) before insufflation of CO2 into the peritoneum for postoperative pain relief. Patients were investigated regarding abdominal and shoulder pain using (visual analog scale) VAS in recovery room and at 6, 12 and 24 hours postoperatively. Patients were also followed regarding postoperative analgesic requirements, nausea and vomiting, and return of bowel function. Results: Sixty patients completed the study. Patients in the hydrocortisone group had no statistically significant abdominal and shoulder pain scores compared to the bupivacaine group. The patients were similar regarding postoperative analgesic requirements, return of bowel function, nausea and vomiting. No adverse effect was detected in either group. Conclusions: Intraperitoneal administration of hydrocortisone is as effective as bupivacaine to reduce pain and analgesic requirements after laparoscopic cholecystectomy. PMID:25337471

  9. OSAS Surgery and Postoperative Discomfort: Phase I Surgery versus Phase II Surgery

    PubMed Central

    Gasparini, Giulio; Pelo, Sandro; Foresta, Enrico; Boniello, Roberto; Romandini, Mario; Cervelli, Daniele; Azzuni, Camillo; Marianetti, Tito Matteo

    2015-01-01

    Introduction. This study aims to investigate the reasons that discourage the patients affected by OSAS to undergo orthognathic surgery and compares the postoperative discomfort of phase I (soft tissue surgery) and phase II (orthognathic surgery) procedures for treatment of OSAS. Material and Methods. A pool of 46 patients affected by OSAS was divided into two groups: “surgery patients” who accepted surgical treatments of their condition and “no surgery patients” who refused surgical procedures. The “surgery patients” group was further subdivided into two arms: patients who accepted phase I procedures (IP) and those who accepted phase II (IIP). To better understand the motivations behind the refusal of II phase procedures, we asked the patients belonging to both the IP group and “no surgery” group to indicate the main reason that influenced their decision to avoid II phase procedures. We also monitored and compared five parameters of postoperative discomfort: pain, painkiller assumption, length of hospitalization, foreign body sensation, and diet assumption following IP and IIP procedures. Results. The main reason to avoid IIP procedures was the concern of a more severe postoperative discomfort. Comparison of the postoperative discomfort following IP versus IIP procedures showed that the former scored worse in 4 out of 5 parameters analyzed. Conclusion. IIP procedures produce less postoperative discomfort. IIP procedures, namely, orthognathic surgery, should be the first choice intervention in patients affected by OSAS and dentoskeletal malformation. PMID:25695081

  10. Imaging memory and predicting postoperative memory decline in temporal lobe epilepsy: Insights from functional imaging.

    PubMed

    Dupont, S

    2015-03-01

    After medial temporal lobe epilepsy (MTLE) surgery, there is considerable individual variation in the extent, nature and direction of postoperative memory change. Before surgery, epileptic patients who are surgery candidates need precise information about the potential cognitive after effects, and particularly in temporal lobe epilepsy, postoperative memory changes. Clinical and neuropsychological data may bring useful information to predict the postoperative memory outcome, but, these data are not always sufficient to replace the Wada test, considered for a long time, as the gold standard to predict postoperative decline following surgery. In any case, numerous studies demonstrate that the Wada procedure can be nowadays reliably replaced by functional MRI (fMRI) activation studies. A vast majority of fMRI studies suggest that it is the functional adequacy of the resected hippocampus rather than the functional reserve of the contralateral hippocampus that determines the extent of postoperative memory decline. In addition, new functional neuroimaging procedures that explore more widespread network disruptions commonly found in MTLE such as diffusion-tensor imaging (DTI) or connectivity studies could in the future constitute a reliable approach combined with fMRI activation studies to significantly improve the prediction of postsurgical memory decline. PMID:25726354

  11. Effectiveness of Submucosal Dexamethasone to Control Postoperative Pain & Swelling in Apicectomy of Maxillary Anterior Teeth

    PubMed Central

    Shah, Shahzad Ali; Khan, Irfanullah; Shah, Humera Shahzad

    2011-01-01

    Purpose The purpose of this study was to evaluate the effect of submucosal dexamethasone injection to control postoperative pain and swelling in apicectomy of maxillary anterior teeth. Methods A randomized, controlled trial comprising 60 adult patients (68.3% male, 31.7% female) with no local or systemic problems was conducted. Patients were randomly divided into two groups: Group A was given 4mg dexamethasone injection perioperatively. Group B (control group) was treated conventionally without any steroid injection. Postoperative pain and swelling was evaluated using a visual analog scale (VAS). Objective measurements of facial pain and swelling were performed daily up to six days postoperatively. Results Dexamethasone group showed significant reduction in pain and swelling postoperatively compared with the control. Conclusion Submucosal dexamethasone 4mg injection is an effective therapeutic strategy for swift and comfortable improvement after surgical procedure and has a significant effect on reducing postoperative pain and swelling. The treatment offers a simple, safe, painless, noninvasive and cost effective therapeutic option for moderate and severe cases. PMID:23267293

  12. Efficacy of intrathecal esmolol on heat-evoked responses in a postoperative pain model.

    PubMed

    Ono, Hitomi; Ohtani, Norimasa; Matoba, Atsuko; Kido, Kanta; Yasui, Yutaka; Masaki, Eiji

    2015-01-01

    Perioperative tachycardia and hypertension are often treated with esmolol, a short-acting ?1-adrenoceptor antagonist. Besides its cardiac effect, esmolol is reported to exert antinociceptive effects. This study examined the efficacy of intrathecal (IT) esmolol on pain responses in a postoperative pain model. Male Sprague-Dawley rats (250-300 g) were anesthetized with sevoflurane and an IT catheter was implanted. Six days after catheter implantation, a postoperative pain model was established by plantar incision under sevoflurane anesthesia. Withdrawal latencies were assessed by applying a focused radiant heat source before plantar incision; 1 day after the incision (before esmolol administration); and 5, 10, and 15 minutes after bolus administration of IT esmolol. Plantar incision produced hypersensitivity in the postoperative pain model expressed as decreased withdrawal latency to heat stimulation (before incision: 13.9 ± 0.29 seconds and 1 day after incision: 6.3 ± 0.26 seconds). These decreased latencies caused by incision were significantly increased by esmolol administration (40 ?g, 80 ?g) at 5 minutes (10.7 ± 1.16 seconds, 10.5 ± 1.16 seconds). No postoperative antinociceptive effects of esmolol were observed at 10 or 15 minutes. IT administration of esmolol produced antinociceptive effects of short duration in a rat postoperative pain model. These results suggest that IT esmolol could offer a new strategy for managing perioperative pain, although an alternative approach is necessary to lengthen the duration of the analgesia. PMID:23411610

  13. [A case of malignant hyperthermia with evident symptoms in the postoperative period].

    PubMed

    Hari, Junko; Takenami, Tamie; Hayashi, Tsunehito; Ueno, Tetsuo; Yamada, Yukari; Okamoto, Hirotsugu

    2013-03-01

    A 36-year-old man (185 cm tall, weighing 85 kg) was scheduled for fixation of a right carpal bone fracture. He had no operative history, and his preoperative laboratory data were normal. A laryngeal mask was inserted after intravenous propofol and fentanyl administration without a muscle relaxant. Anesthesia was maintained by sevoflurane in a mixture of air and oxygen. A tourniquet was placed on the right upper arm. One hour after the operation, his heart rate increased to 90-100 beats x min(-1) from 70-80 beats x min(-1) at the start of the operation, and tachycardic continued, even after release of the tourniquet. Although end-tidal CO2 was 50-60 mmHg, his body temperature remained 37.6 degrees C, and neither muscle stiffness nor brown urine was observed. The duration of the operation and the duration of anesthesia were 2 hours 40 min and 4 hours, respectively. The patient went back to the ward without myalgia after removal of the laryngeal mask. On the postoperative day one, the patient had brown urine. On the postoperative day 2, he experienced myalgia of the upper and lower extremities and masseter muscle. On the postoperative day 3, myoglobinuria was detected. As in this case, although evident symptoms of malignant hyperthermia are not always observed during operations, some cases show obvious symptoms during the postoperative period. Thus, it is important to be aware of the symptoms of malignant hyperthermia postoperatively for early diagnosis and treatment. PMID:23544344

  14. Intraoperative Hemorrhage and Postoperative Sequelae after Intraoral Vertical Ramus Osteotomy to Treat Mandibular Prognathism

    PubMed Central

    Chen, Chun-Ming; Lai, Steven; Chen, Ker-Kong; Lee, Huey-Er

    2015-01-01

    Objective. To investigate the factors affecting intraoperative hemorrhage and postoperative sequelae after orthognathic surgery. Materials and Methods. Eighty patients with mandibular prognathism underwent surgical mandibular setback with intraoral vertical ramus osteotomy (IVRO). The correlation between the blood loss volume and postoperative VAS with the gender, age, and operating time was assessed using the t-test and Spearman rank correlation coefficient. The correlation between the magnitude of mandibular setback with the presence of TMJ clicking symptoms and lip sensation was also assessed. Results. The mean operating time and blood loss volume for men and women were 249.52?min and 229.39?min, and 104.03?mL and 86.12?mL, respectively. The mean VAS in men and women was 3.21 and 2.93, and 1.79 and 1.32 on the first and second postoperative days. There is no gender difference in the operating time, blood loss, VAS, TMJ symptoms, and lip numbness. The magnitude of mandibular setback was not correlated with immediate and long-term postoperative lip numbness. Conclusion. There are no gender differences in the intraoperative hemorrhage and postoperative sequelae (pain, lip numbness, and TMJ symptoms). In addition, neither symptom was significantly correlated with the amount of mandibular setback. PMID:26543855

  15. Second-Look Endoscopy after Gastric Endoscopic Submucosal Dissection for Reducing Delayed Postoperative Bleeding

    PubMed Central

    Park, Chan Hyuk; Park, Jun Chul; Lee, Hyuk; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan

    2015-01-01

    Background/Aims This stuy evaluated the role of a second-look endoscopy after gastric endoscopic submucosal dissection in patients without signs of bleeding. Methods Between March 2011 and March 2012, 407 patients with gastric neoplasms who underwent endoscopic submucosal dissection for 445 lesions were retrospectively reviewed. After the patients had undergone endoscopic submucosal dissection, they were allocated to two groups (with or without second-look endoscopy) according to the following endoscopy. The postoperative bleeding risk of the lesions was not considered when allocating the patients. Results The delayed postoperative bleeding rates did not differ between the two groups (with vs without second-look endoscopy, 3.0% vs 2.1%; p=0.546). However, a tumor in the upper-third of the stomach (odds ratio [OR], 5.353; 95% confidence interval [CI], 1.075 to 26.650) and specimen size greater than 40 mm (OR, 4.794; 95% CI, 1.307 to 17.588) were both independent risk factors for delayed postoperative bleeding. Additionally, second-look endoscopy was not related to reduced delayed postoperative bleeding. However, delayed postoperative bleeding in the patients who did not undergo a second-look endoscopy occurred significantly earlier than that in patients who underwent a second-look endoscopy (4.5 and 14.0 days, respectively, p=0.022). Conclusions A routine second-look endoscopy after gastric endoscopic submucosal dissection is not necessary for all patients. PMID:25170062

  16. Preemptive versus postoperative lumiracoxib for analgesia in ambulatory arthroscopic knee surgery

    PubMed Central

    Grifka, Joachim; Enz, Rudolf; Zink, Joachim; Hugot, Jean Louis; Kreiss, Andreas; Arulmani, Udayasankar; Yu, Vincent; Rebuli, Rosemary; Krammer, Gerhard

    2008-01-01

    We compared the efficacy and safety of preemptive vs postoperative dosing of lumiracoxib 400 mg in patients undergoing minor ambulatory arthroscopic knee surgery. Eligible patients were randomized to preemptive lumiracoxib, postoperative lumiracoxib, and placebo. The main efficacy parameter was pain intensity (PI) (0–100 mm visual analog scale) in the target knee upon movement, 2 hours after surgery. Other efficacy variables included PI in the target knee at rest and upon movement at 1, 3, 4, and 24 hours, time to first rescue medication intake. In the lumiracoxib preemptive and postoperative groups, the estimated treatment difference compared to placebo for primary endpoint was ?4.0 (95% CI: ?9, ?1; p = 0.007) and ?3.5 (95% CI: ?8.5, 0; p = 0.052), respectively. There was no statistical significant difference between two active treatment groups (p = 0.602). Both preemptive and postoperative lumiracoxib resulted in significantly lower PI scores at rest and after movement at all time-points and no statistically significant difference was observed between the active treatments. Time to rescue medication intake was comparable for both active treatments. The proportion of adverse events was similar among all groups. We conclude that the efficacy of lumiracoxib 400 mg is not affected by the timing of administration (preemptive or postoperative). PMID:21197285

  17. Preemptive versus postoperative lumiracoxib for analgesia in ambulatory arthroscopic knee surgery.

    PubMed

    Grifka, Joachim; Enz, Rudolf; Zink, Joachim; Hugot, Jean Louis; Kreiss, Andreas; Arulmani, Udayasankar; Yu, Vincent; Rebuli, Rosemary; Krammer, Gerhard

    2008-01-01

    We compared the efficacy and safety of preemptive vs postoperative dosing of lumiracoxib 400 mg in patients undergoing minor ambulatory arthroscopic knee surgery. Eligible patients were randomized to preemptive lumiracoxib, postoperative lumiracoxib, and placebo. The main efficacy parameter was pain intensity (PI) (0-100 mm visual analog scale) in the target knee upon movement, 2 hours after surgery. Other efficacy variables included PI in the target knee at rest and upon movement at 1, 3, 4, and 24 hours, time to first rescue medication intake. In the lumiracoxib preemptive and postoperative groups, the estimated treatment difference compared to placebo for primary endpoint was -4.0 (95% CI: -9, -1; p = 0.007) and -3.5 (95% CI: -8.5, 0; p = 0.052), respectively. There was no statistical significant difference between two active treatment groups (p = 0.602). Both preemptive and postoperative lumiracoxib resulted in significantly lower PI scores at rest and after movement at all time-points and no statistically significant difference was observed between the active treatments. Time to rescue medication intake was comparable for both active treatments. The proportion of adverse events was similar among all groups. We conclude that the efficacy of lumiracoxib 400 mg is not affected by the timing of administration (preemptive or postoperative). PMID:21197285

  18. Etoricoxib - preemptive and postoperative analgesia (EPPA) in patients with laparotomy or thoracotomy - design and protocols

    PubMed Central

    2010-01-01

    Background and Objective Our objective was to report on the design and essentials of the Etoricoxib protocol- Preemptive and Postoperative Analgesia (EPPA) Trial, investigating whether preemptive analgesia with cox-2 inhibitors is more efficacious than placebo in patients who receive either laparotomy or thoracotomy. Design and Methods The study is a 2 × 2 factorial armed, double blinded, bicentric, randomised placebo-controlled trial comparing (a) etoricoxib and (b) placebo in a pre- and postoperative setting. The total observation period is 6 months. According to a power analysis, 120 patients scheduled for abdominal or thoracic surgery will randomly be allocated to either the preemptive or the postoperative treatment group. These two groups are each divided into two arms. Preemptive group patients receive etoricoxib prior to surgery and either etoricoxib again or placebo postoperatively. Postoperative group patients receive placebo prior to surgery and either placebo again or etoricoxib after surgery (2 × 2 factorial study design). The Main Outcome Measure is the cumulative use of morphine within the first 48 hours after surgery (measured by patient controlled analgesia PCA). Secondary outcome parameters include a broad range of tests including sensoric perception and genetic polymorphisms. Discussion The results of this study will provide information on the analgesic effectiveness of etoricoxib in preemptive analgesia and will give hints on possible preventive effects of persistent pain. Trial registration NCT00716833 PMID:20504378

  19. Aufgabe S1 F10 Die Bauteile 1,2,3 sind gelenkig miteinander verbunden, in A und B gelagert und

    E-print Network

    Peters, Norbert

    Aufgabe S1 F10 Die Bauteile 1,2,3 sind gelenkig miteinander verbunden, in A und B gelagert und durch das Gewicht G1 der Scheibe 1 belastet. Annahmen: Die Gelenke seien reibungsfrei. Das Material der Scheibe 1 ist homogen verteilt. Die Bauteile 2 und 3 sollen als gewichtslos betrachtet werden. Geg.: a , G

  20. Entwurf und Verifikation von Hardware/Software -SystemenEntwurf und Verifikation von Hardware/Software -Systemen Lehrstuhl fr Technische Informatik

    E-print Network

    Ould Ahmedou, Mohameden

    Entwurf und Verifikation von Hardware/Software - SystemenEntwurf und Verifikation von Hardware Exploration Applikation Plattform SimulativeSimulative und analytischeund analytische Bewertung von virtuellenBewertung von virtuellen PrototypenPrototypen FrFrüühzeitige Aufdeckung derhzeitige Aufdeckung der Verletzung

  1. Effect of chewing gum on the postoperative recovery of gastrointestinal function

    PubMed Central

    Ge, Wei; Chen, Gang; Ding, Yi-Tao

    2015-01-01

    Postoperative gastrointestinal dysfunction remains a source of morbidity and the major determinant of length of stay after abdominal operation. There are many different reasons for postoperative gastrointestinal dysfunction such as stress response, perioperative interventions, bowel manipulation and so on. The mechanism of enhanced recovery from postoperative gastrointestinal dysfunction with the help of chewing gum is believed to be the cephalic-vagal stimulation of digestion which increases the promotability of neural and humoral factors that act on different parts of the gastrointestinal tract. Recently, there were a series of randomized controlled trials to confirm the role of chewing gum in the recovery of gastrointestinal function. The results suggested that chewing gum enhanced early recovery of bowel function following abdominal surgery expect the gastrointestinal surgery. However, the effect of chewing gum in gastrointestinal surgery was controversial. PMID:26550107

  2. Gabapentin as an adjuvant for postoperative pain management in dogs undergoing mastectomy

    PubMed Central

    CROCIOLLI, Giulianne Carla; CASSU, Renata Navarro; BARBERO, Rafael Cabral; ROCHA, Thalita Leone A; GOMES, Denis Robson; NICÁCIO, Gabriel Montoro

    2015-01-01

    This study aimed to evaluate the analgesic efficacy of gabapentin as an adjuvant for postoperative pain management in dogs. Twenty dogs undergoing mastectomy were randomized to receive perioperative oral placebo or gabapentin (10 mg/kg). All dogs were premedicated with intramuscular acepromazine (0.03 mg/kg) and morphine (0.3 mg/ kg). Anesthesia was induced with propofol (4 mg/kg) intravenously and maintained with isoflurane. Intravenous meloxicam (0.2 mg/kg) was administered preoperatively. Postoperative analgesia was evaluated for 72 hr. Rescue analgesia was provided with intramuscular morphine (0.5 mg/kg). Dogs in the Placebo group received significantly more morphine doses than the Gabapentin group (P=0.021), despite no significant differences in pain scores. Perioperative gabapentin reduced the postoperative morphine requirements in dogs after mastectomy. PMID:25816802

  3. Effect of hyaluronic acid on postoperative intraperitoneal adhesion formation in the rat model

    SciTech Connect

    Urman, B.; Gomel, V.; Jetha, N. )

    1991-09-01

    The aim of this study was to determine the effectiveness of hyaluronic acid solution in preventing intraperitoneal (IP) adhesions. The study design was prospective, randomized and blinded and involved 83 rats. Measured serosal injury was inflicted using a CO2 laser on the right uterine horn of the rat. Animals randomized to groups 1 and 2 received either 0.4% hyaluronic acid or its diluent phosphate-buffered saline (PBS) intraperitoneally before and after the injury. In groups 3 and 4, the same solutions were used only after the injury. Postoperative adhesions were assessed at second-look laparotomy. Histologic assessment of the fresh laser injury was carried out on uteri pretreated with hyaluronic acid, PBS, or nothing. Pretreatment with hyaluronic acid was associated with a significant reduction in postoperative adhesions and a significantly decreased crater depth. Hyaluronic acid appears to reduce postoperative IP adhesion formation by coating the serosal surfaces and decreasing the extent of initial tissue injury.

  4. Postoperative Acute Exacerbation of IPF after Lung Resection for Primary Lung Cancer

    PubMed Central

    Watanabe, Atsushi; Kawaharada, Nobuyoshi; Higami, Tetsuya

    2011-01-01

    Idiopathic pulmonary fibrosis (IPF) is characterized by slowly progressive respiratory dysfunction. Nevertheless, some IPF patients experience acute exacerbations generally characterized by suddenly worsening and fatal respiratory failure with new lung opacities and pathological lesions of diffuse alveolar damage. Acute exacerbation of idiopathic pulmonary fibrosis (AEIPF) is a fatal disorder defined by rapid deterioration of IPF. The condition sometimes occurs in patients who underwent lung resection for primary lung cancer in the acute and subacute postoperative phases. The exact etiology and pathogenesis remain unknown, but the condition is characterized by diffuse alveolar damage superimposed on a background of IPF that probably occurs as a result of a massive lung injury due to some unknown factors. This systematic review shows that the outcome, however, is poor, with postoperative mortality ranging from 33.3% to 100%. In this paper, the etiology, risk factors, pathogenesis, therapy, prognosis, and predictors of postoperative AEIPF are described. PMID:21637373

  5. Liver injury and complications in the postoperative trauma patient: CT evaluation

    SciTech Connect

    Haney, P.J.; Whitley, N.O.; Brotman, S.; Cunat, J.S.; Whitley, J.

    1982-08-01

    Twenty-eight patients with surgically documented and classified hepatic injury were studied by computed tomography (CT) in the postoperative period.CT demonstrated no abnormalities in 12 of these patients, most of whom has sustained simple lacerations of the liver. Of the 16 patients with abnormal scans, perihepatic fluid collections were present in six, five of whom had simple lacerations at surgery. The other 10 patients had CT evidence of parenchymal abnormalities, and all of these had sustained major hepatic injuries. CT is usful in depicting the postoperative anatomy, and in many cases demonstrates the nature and extent of damage; the likelihood of finding an abnormality varies with the severity of the injury, even though repair has been attempted. The frequent problem of postoperative sepsis is also amenable to CT evaluation, but the changes demonstrated are often nonspecific and the possibility of residual hepatic injury has to be considered. Finally, CT can document healing of parenchymal injury.

  6. The efficacy of preemptive analgesia for postoperative pain control: a systematic review of the literature.

    PubMed

    Penprase, Barbara; Brunetto, Elisa; Dahmani, Eman; Forthoffer, Jola Janaqi; Kapoor, Samantha

    2015-01-01

    The purpose of preemptive analgesia is to reduce postoperative pain, contributing to a more comfortable recovery period and reducing the need for narcotic pain control. The efficacy of preemptive analgesia remains controversial. This systematic review of the literature evaluated the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 (COX-2) inhibitors, and gabapentin as preemptive oral analgesics for surgical patients. Included articles were limited to studies of adult patients that compared the difference in postoperative pain between control and treatment groups. Of 40 studies reviewed, 14 met the inclusion criteria, including two on NSAIDs, four on COX-2 inhibitors, and eight on gabapentin. Research was predominantly conducted outside the United States. Gabapentin and COX-2 inhibitors were found to be the most effective preemptive analgesics for postoperative pain control. As part of a collaborative team, perioperative nurses and certified RN anesthetists are responsible for ongoing pain assessment and management for preemptive analgesic interventions. PMID:25537330

  7. Variationen über Walther von Dyck und Dyck-Sprachen

    NASA Astrophysics Data System (ADS)

    Diekert, Volker; Lange, Klaus-Jörn

    Die Dyck-Sprachen sind ein Grundbegriff aus dem Bereich der formalen Sprachen. Ausgehend von der Person des Namensgebers werden ihre Geschichte und ihre Bedeutung in der theoretischen Informatik in diesem Überblick dargestellt.

  8. Diplomanden-und Doktorandenseminar des Instituts fr Informatik

    E-print Network

    Zachmann, Gabriel

    Diplomanden- und Doktorandenseminar des Instituts für Informatik Architecture and Methods The operation of dedicated content repositories is a change in perspective of content lifecycle management-server architectures are the prevailing design approach for content repositories. However, systems built according

  9. Stefan Kowarik und Hans-Jrgen Wnsche 40365 Quantenmechanik

    E-print Network

    Wünsche, Hans-Jürgen "Ede"

    der QM David Mermin ,,Shut up and calculate!" Halt`s Maul und rechne! · Varianten der Kopenhagener Interpretation · Ensemble-Interpretationen · De-Broglie-Bohm-Theorie · Viele-Welten-Interpretation · Konsistente

  10. Deutsche Auenpolitik in einer Welt der Kriege und Krisen Expertenkonferenz

    E-print Network

    Schubart, Christoph

    Bundeswehr vor neuen Herausforderungen Oberst a.D. Ralph D. Thiele Vorsitzender der Politisch-Militärischen Gesellschaft und ehem. Kommandeur des Zentrums für Transformation der Bundeswehr Moderation: Dr. Gerlinde

  11. Transplantate und Implantate im Mittelohrbereich - Teil 1 (Stand 2002)

    NASA Astrophysics Data System (ADS)

    Kempf, Hans-Georg; Lenarz, Thomas; Eckert, Karl-Ludwig

    In Deutschland leben ungefähr 12 Millionen Menschen, die an einer ein- oder beidseitigen Schwerhörigkeit leiden. Diese kann angeboren oder im Laufe des Lebens erworben sein. Klinisch und therapeutisch wichtig ist die Unterscheidung, ob die Ursache der Schwerhörigkeit im Bereich des Mittelohres, d. h. der Schallübertragung, oder im Bereich des Innenohres, der Hörnerven und der zentralen Hörbahnabschnitte, d. h. der Schallempfindung, liegt. 2,5 Millionen Schwerhörige haben dabei das Problem der Schallübertragung, d.h. die Störung liegt im Mittelohrbereich, und hier kann man in der Regel mit operativen, mikrochirurgisch durchgeführten Massnahmen helfen [1, 2]. Im Vordergrund steht als Ursache hier die chronische Mittelohrentzündung, die sich als Perforation des Trommelfells, als Defekt oder Unterbrechung der Gehörknöchelchen oder auch als Cholesteatom, einer sogenannte Knocheneiterung äussern kann [3]. Therapeutisch und damit als Prinzip der operativen Hörverbesserung steht primär der Verschluss des Trommelfells oder eine Rekonstruktion der Gehörknöchelchen an.

  12. Methodik der Erfassung und Bewertung von Biodiversitätsschäden aus ökologischer Sicht

    NASA Astrophysics Data System (ADS)

    Wiegleb, Gerhard; Krawczynski, René; Wagner, Hans-Georg

    Mit der Verabschiedung des Umweltschadensgesetzes (USchadG) hat der Schutz der Biodiversität in Deutschland ein neues Stadium erreicht. Zum ersten Male wird selbst die Vermeidung und Restitution der nichtintendierten Schädigung der Biodiversität in Gestalt bestimmter Arten und Lebensräume in ein umfassendes Naturschutzkonzept einbezogen. Das USchadG geht damit über die bisherigen Ansätze zum Schutz der belebten Natur hinaus, da es gleichzeitig neben der Erhaltung eines als günstig erkannten Ist-Zustandes der Biodiversität der Vermeidung vorhersehbarer Schäden sowie auch der Restitution nach einem eingetretenen Schaden verpflichtet ist. Naturschutzsystematisch gehört es wegen der Betonung der Vermeidung und Sanierung zum Bereich des reaktiven Naturschutzes (Gefahrenabwehr und Gefahrenbeseitigung), dem auch die Eingriffsregelung des Bundesnaturschutzgesetzes (BNatSchG), die Umweltverträglichkeitsprüfung nach Umweltverträglichkeitsprüfungsgesetz (UVPG) sowie die FFH-Verträglichkeitsprüfung nach Fauna-Flora-Habitat-Richtlinie (FFH-RL) zuzurechnen sind. Stärker noch als in den genannten Regelungen tritt im USchadG das Verursacherprinzip gegenüber der allgemeinen Umweltvorsorge in den Vordergrund.

  13. Hundert Jahre Zukunft Visionen zum Computer-und Informationszeitalter

    E-print Network

    Institut für Pervasive Computing, ETH Zürich Le futur n'est plus ce qu'il était Paul Valéry Kurzfassung Abwasch und servieren Kaffee. Nur das Web, E-Commerce, Such- maschinen, SMS, Spielkonsolen, Blogs, Ebay

  14. Eidgenssische Technische Hochschule Zrich Institut fr Geodsie und Photogrammetrie

    E-print Network

    Giger, Christine

    , Militärgeografisches Institut Freitag 6.12.2002 16.00 Uhr GIS and Virtual Reality in History and Archeology Leiter Satellitennavigations- system, Status und Entwicklungen Leiter: Prof. Dr. H.-G. Kahle Referent: Markus Bruns, European

  15. Zentrum fur Technomathematik Fachbereich 3 Mathematik und Informatik

    E-print Network

    Dashkovskiy, Sergey

    , e.g. satellite control, shape- optimization, aerodynamics, trajectory planning, reentry problems is the optimization of trajectories for aerospace applications. Nonlinear optimization problems arising fromZentrum f¨ur Technomathematik Fachbereich 3 ­ Mathematik und Informatik Nonlinear Optimization

  16. Prfungsordnung fr den Diplomstudiengang Umwelt-und Bioingenieurwissenschaft

    E-print Network

    Ott, Albrecht

    Verfahrenstechnik) an der Universität Bayreuth vom 10. März 2000 i. d. F. der Zweiten Änderungssatzung vom 25 Bioingenieurwissenschaft (Werkstoff- und Verfahrenstechnik). Durch die Diplomprüfung soll festgestellt werden, ob der

  17. Radical Arylation of Phenols, Phenyl ethers, Furans und Phenylamines

    E-print Network

    Radical Arylation of Phenols, Phenyl ethers, Furans und Phenylamines Technology offer TUM 2008-09E- and hydroxybiphenyls. The radical arylation can be used for the functionaliza- tion of phenols, anilines, phenyl ethers

  18. Mathematisch-Naturwissenschaftliche Fakultt Fachspezifische Studien-und

    E-print Network

    Röder, Beate

    lehramtsbezogene Master- studium im Fach Mathematik (Schwerpunkt Gymnasium) Erstes und Zweites Fach Überfachlicher Masterstudium im Fach ,,Mathematik" (Schwerpunkt Gymnasium) Gemäß § 17 Abs. 1 Ziffer 3 der Verfassung der Prüfungsordnung für das lehramtsbezogene Masterstudium im Fach Mathematik (Schwerpunkt Gymnasium), der Studien

  19. Anterior Chamber Depth and Refractive Change in Late Postoperative Capsular Bag Distension Syndrome: A Retrospective Analysis

    PubMed Central

    Yang, Min Kyu; Wee, Won Ryang; Kwon, Ji-Won; Han, Young Keun

    2015-01-01

    Purpose To assess the characteristic findings and effects of laser capsulotomy in patients with late postoperative capsular bag distension syndrome (CBDS). Methods Twenty patients diagnosed with late postoperative CBDS between July 2010 and August 2013 were retrospectively reviewed. Before and 1 week after capsulotomy, changes in the anterior chamber depth (ACD) were assessed using ultrasound biomicroscopy. Changes in the refractive status and uncorrected visual acuity (UCVA) were also measured 1 week and 1 month after capsulotomy. For patients who received bilateral cataract surgery, preoperative ACD and axial length measured by IOLMaster were compared between the two eyes. Results Twenty-two eyes from 20 patients who had undergone laser capsulotomy showed a mean UCVA improvement of 0.27 ± 0.24 logMAR (range, 0.00–0.90). ACD was increased by an average of +0.04 mm (95% confidence interval, +0.01 to +0.06 mm, p = 0.034), equivalent to predicted refractive change of +0.10 D. The discrepancy between actual (+1.33 D) and predicted refractive change after capsulotomy suggests that refractive change may not be generated from IOL displacement in late postoperative CBDS. Preoperative ACD was deeper in the eye with late postoperative CBDS in all bilaterally pseudophakic patients (mean, 3.68 mm vs. 3.44 mm in the fellow eye, p = 0.068). Conclusions Late postoperative CBDS showed refractive changes that were resolved successfully after laser capsulotomy. The convex lens effects of opalescent material in the distended capsular bag may play a major role in myopic shift. A larger preoperative ACD is possibly associated with the development of late postoperative CBDS. PMID:25910003

  20. Morphometric MRI alterations and postoperative seizure control in refractory temporal lobe epilepsy

    PubMed Central

    Keller, Simon S; Richardson, Mark P; O'Muircheartaigh, Jonathan; Schoene-Bake, Jan-Christoph; Elger, Christian; Weber, Bernd

    2015-01-01

    Refractory mesial temporal lobe epilepsy (mTLE) is a debilitating condition potentially amenable to resective surgery. However, between 40 and 50% patients continue to experience postoperative seizures. The development of imaging prognostic markers of postoperative seizure outcome is a crucial objective for epilepsy research. In the present study, we performed analyses of preoperative cortical thickness and subcortical surface shape on MRI in 115 of patients with mTLE and radiologically defined hippocampal sclerosis being considered for surgery, and 80 healthy controls. Patients with excellent (International League Against Epilepsy outcome (ILAE) I) and suboptimal (ILAE II–VI) postoperative outcomes had a comparable distribution of preoperative atrophy across the cortex, basal ganglia, and amygdala. Conventional volumetry of whole hippocampal and extrahippocampal subcortical structures, and of global gray and white matter, could not differentiate between patient outcome groups. However, surface shape analysis revealed localized atrophy of the thalamus bilaterally and of the posterior/lateral hippocampus contralateral to intended resection in patients with persistent postoperative seizures relative to those rendered seizure free. Data uncorrected for multiple comparisons also revealed focal atrophy of the ipsilateral hippocampus posterior to the margins of resection in patients with persistent seizures. This data indicates that persistent postoperative seizures after temporal lobe surgery are related to localized preoperative shape alterations of the thalamus bilaterally and the hippocampus contralateral to intended resection. Imaging techniques that have the potential to unlock prognostic markers of postoperative outcome in individual patients should focus assessment on a bihemispheric thalamohippocampal network in prospective patients with refractory mTLE being considered for temporal lobe surgery. PMID:25704244

  1. Influence of ethnicity on the perception and treatment of early post-operative pain

    PubMed Central

    Scott, Simon; Griffin-Teall, Nicola; Thompson, Jonathan

    2015-01-01

    Background: Previous studies indicated that patients from Black, Asian and minority ethnic (BAME) groups tend to receive less analgesics compared to Caucasian (White) patients after similar surgical procedures. Most such data originated from North America and suggested that health-care professionals may perceive the expression of excessive pain by BAME patient groups as an exaggerated response to pain, rather than sub-optimal treatment. There are limited data comparing acute pain management between South Asian and White British patients. Objective: We aimed to investigate correlation between patients’ ethnicity and disparities of early post-operative pain perception/management, in an ethnically diverse population. Methods: We conducted a retrospective case note review of acute post-operative pain after total abdominal hysterectomy (TAH) in 60 South Asian and 60 age-matched White British females. Data for 140 variables (pre-, intra- and post-operative) for each patient were recorded. We used propensity score matching to produce 30 closely matched patients in each group minimizing effects of recorded co-variates. Data were analysed with and without propensity score matching. Results: There were no significant differences in acute post-operative pain scores, morphine requirements, pain management, adverse effects or duration of post-operative care unit stay between South Asian and White British patients. The median duration of hospital stay of South Asian patients was longer (4.5?days versus 3.0?days, p?post-operative pain nor pain management are influenced significantly by South Asian ethnicity. PMID:26516573

  2. Does postoperative mechanical ventilation predispose to bronchopleural fistula formation in patients undergoing pneumonectomy?

    PubMed

    Toufektzian, Levon; Patris, Vasileios; Sepsas, Evangelos; Konstantinou, Marios

    2015-09-01

    A best evidence topic was written according to a structured protocol. The question addressed was whether postoperative mechanical ventilation has any effect on the incidence of development of bronchopleural fistulas (BPFs) in patients undergoing pneumonectomy. A total of 40 papers were identified using the reported search, of which 8, all retrospective, represented the best evidence to answer the clinical question. The authors, date, journal, country, study type, population, outcomes and key results are tabulated. Of the eight identified papers, six of them reported a statistically significant relationship between postoperative mechanical ventilation and the occurrence of bronchopleural fistula in patients undergoing pneumonectomy (P = 0.027-0.0001). In two of these studies, postoperative mechanical ventilation was identified during multivariate analysis as an independent predictor for the development of BPF after pneumonectomy (odds ratio 15.57 and 33.1), indicating a causal relationship whereas, in the other four reports, statistical significance was the result of univariate analysis. In another study, the difference between these two groups approached but did not reach statistical significance (P = 0.057). Finally, one study reported no association between postoperative mechanical ventilation and the development of post-pneumonectomy BPF (0.16). Apart from mechanical ventilation, pre-existing pleuropulmonary infection was reported by one study as an independent predictor for the development of post-pneumonectomy BPF whereas, in two other studies, its impact approached but did not reach statistical significance. Another study did not find any association between preoperative infection and postoperative BPF occurrence. In conclusion, the majority of the reported studies report a significant relationship between mechanical ventilation after pneumonectomy and the occurrence of BPF. Every effort should be made to achieve extubation at the earliest possible time to withdraw the effects of the continuous barotrauma on the bronchial stump, although its impact cannot be quantified. Performing pneumonectomy in the presence of infectious conditions may contribute to the development of postoperative BPF, but its role is less well defined. PMID:26069338

  3. Caudal ropivacaine and bupivacaine for postoperative analgesia in infants undergoing lower abdominal surgery

    PubMed Central

    Cinar, Surhan Ozer; Isil, Canan Tulay; Sahin, Sevtap Hekimoglu; Paksoy, Inci

    2015-01-01

    Objective: To compare the postoperative analgesic efficacy of ropivacaine 0.175% and bupivacaine 0.175% injected caudally into infants for lower abdominal surgery. Methods: Eighty infants, aged 3-12 months, ASA I-II scheduled to undergo lower abdominal surgery were randomly allocated to one of the two groups: Group R received 1ml.kg-1 0.175% ropivacaine and Group B received 1ml.kg-1 0.175% bupivacaine via caudal route. Postoperative analgesia, sedation and motor block were evaluated with modified objective pain scale, three-point scale and modified Bromage scale respectively. Postoperative measurements including mean arterial pressure (MAP), heart rate (HR), pain (OPS), sedation and motor block score were recorded for four hours in the postoperative recovery room. Parents were contacted by telephone after 24 hours to question duration of analgesia and side effects. Results: No significant differences were found among the groups in demographic data, MAP, HR, OPS and sedation scores during four hours postoperatively. The duration of analgesia was 527.5±150.62 minutes in Group R, 692.77±139.01 minutes in Group B (p=0.004). Twelve (30%) patients in Group R, 16 (40%) patients in groupB needed rescue analgesics (p=0.348). Rescue analgesics were administered (1 time/2 times) (9/3) (22.5/7.5%) in Group R and 16/0 (40/0%) in Group B, where no statistically significant difference was determined between the groups (p=0.071). Motor blockade was observed in 7 (17.5%) patients in Group R, and 8 (20%) patients in Group B (p=0.774). Conclusion: This study indicated, that a concentration of 0.175% ropivacaine and 0.175% bupivacaine administered to the infants via caudal route both provided effective and similar postoperative pain relief in infants, who underwent lower abdominal surgery. PMID:26430427

  4. Effect of cavity disinfection on postoperative sensitivity associated with amalgam restorations.

    PubMed

    Al-Omari, Wael M; Al-Omari, Qasem D; Omar, Ridwaan

    2006-01-01

    This clinical study assessed the postoperative cold sensitivity reported by patients following the Class I and Class II amalgam restoration of primary carious lesions after different cavity treatments. One hundred and twenty patients, each with a previously untreated tooth requiring an amalgam restoration due to the presence of a carious lesion, were included. Sixty teeth had lesions that were radiographically judged to be located in the middle third of dentin, and another 60 were located in the inner third of dentin. Six different cavity treatment regimens were used: Group 1--no treatment; Group 2--calcium hydroxide liner (Life); Group 3--cavity varnish (Copalite); Group 4--resin modified glass ionomer liner (Vitrebond); Group 5--dentin adhesive resin liner (Single Bond); Group 6--chlorhexidine disinfectant (Consepsis). Patients were telephoned on days 2 and 7 postoperatively and asked whether they experienced sensitivity to cold, and if so, its duration and intensity. If sensitivity remained up to day 7, patients were also contacted on days 30 and 90. The Kruskal-Wallis test showed postoperative sensitivity to be significantly different among cavity treatments at days 2, 7 and 30 (p = 0.026, 0.044, 0.015, respectively). Lesion depth also affected postoperative sensitivity at day 2, with 27% of teeth with middle-third lesions producing pain, and 58% of those with lesions extending to the inner third producing pain (p = 0.000). This difference showed up at 7 and 30 days (p = 0.001, 0.015, respectively). Of the 51 teeth with sensitivity at day 2, 17 had mild pain, 26 were moderately painful and 8 had severe pain; each category reduced in degree of sensitivity and number with time. It would seem that medium-term (beyond 30 days) postoperative sensitivity is affected neither by the method of cavity treatment nor the depth of lesion, although, in the shorter-term, these factors do influence the postoperative sensitivity reported. PMID:16827017

  5. Bedside Tool for Predicting the Risk of Postoperative Atrial Fibrillation After Cardiac Surgery: The POAF Score

    PubMed Central

    Mariscalco, Giovanni; Biancari, Fausto; Zanobini, Marco; Cottini, Marzia; Piffaretti, Gabriele; Saccocci, Matteo; Banach, Maciej; Beghi, Cesare; Angelini, Gianni D.

    2014-01-01

    Background Atrial fibrillation (AF) remains the most common complication after cardiac surgery. The present study aim was to derive an effective bedside tool to predict postoperative AF and its related complications. Methods and Results Data of 17 262 patients undergoing adult cardiac surgery were retrieved at 3 European university hospitals. A risk score for postoperative AF (POAF score) was derived and validated. In the overall series, 4561 patients (26.4%) developed postoperative AF. In the derivation cohort age, chronic obstructive pulmonary disease, emergency operation, preoperative intra?aortic balloon pump, left ventricular ejection fraction <30%, estimated glomerular filtration rate <15 mL/min per m2 or dialysis, and any heart valve surgery were independent AF predictors. POAF score was calculated by summing weighting points for each independent AF predictor. According to the prediction model, the incidences of postoperative AF in the derivation cohort were 0, 11.1%; 1, 20.1%; 2, 28.7%; and ?3, 40.9% (P<0.001), and in the validation cohort they were 0, 13.2%; 1, 19.5%; 2, 29.9%; and ?3, 42.5% (P<0.001). Patients with a POAF score ?3, compared with those without arrhythmia, revealed an increased risk of hospital mortality (5.5% versus 3.2%, P=0.001), death after the first postoperative day (5.1% versus 2.6%, P<0.001), cerebrovascular accident (7.8% versus 4.2%, P<0.001), acute kidney injury (15.1% versus 7.1%, P<0.001), renal replacement therapy (3.8% versus 1.4%, P<0.001), and length of hospital stay (mean 13.2 versus 10.2 days, P<0.001). Conclusions The POAF score is a simple, accurate bedside tool to predict postoperative AF and its related or accompanying complications. PMID:24663335

  6. Effect of Intraoperative Dexmedetomidine Infusion on Postoperative Bowel Movements in Patients Undergoing Laparoscopic Gastrectomy

    PubMed Central

    Cho, Jin Sun; Kim, Hyoung-Il; Lee, Ki-Young; An, Ji Yeong; Bai, Sun Joon; Cho, Ju Yeon; Yoo, Young Chul

    2015-01-01

    Abstract Sympathetic hyperactivation is one of the causes of postoperative ileus, which occurs frequently after abdominal surgery and adversely influences the patient's prognosis. We aimed to investigate whether dexmedetomidine (DEX) could attenuate postoperative ileus in patients undergoing laparoscopic gastrectomy. Ninety-two patients were randomized to the control (n?=?46) or DEX group (n?=?46). DEX was administered at a loading dose of 0.5??g/kg for 10 minutes, followed by an infusion rate of 0.4??g/kg/h from insufflation of the pneumoperitoneum to the end of surgery. The primary goal was to compare postoperative bowel movements by evaluating the time to first flatus. The balance of the autonomic nervous system, duration of postoperative hospital stay, and pain scores were assessed. The time to first flatus was shorter in the DEX group compared with the control group (67.2?±?16.8 hours vs 79.9?±?15.9 hours, P?postoperative hospital stay was shorter in the DEX group compared with the control group (5.4?±?0.7 days vs 5.8?±?1.1 days, P?=?0.04). Patients in the DEX group had lower pain scores and required fewer analgesics at 1 hour postoperatively. DEX facilitated bowel movements and reduced the length of hospital stay in patients undergoing laparoscopic gastrectomy. This may be attributed to the sympatholytic and opioid-sparing effects of DEX. PMID:26091461

  7. Positive Surgical Margins in Soft Tissue Sarcoma Treated With Preoperative Radiation: Is a Postoperative Boost Necessary?

    SciTech Connect

    Al Yami, Ali; Griffin, Anthony M.; Ferguson, Peter C.; Catton, Charles N.; Chung, Peter W.M.

    2010-07-15

    Purpose: For patients with an extremity soft tissue sarcoma (STS) treated with preoperative radiotherapy and surgically excised with positive margins, we retrospectively reviewed whether a postoperative radiation boost reduced the risk of local recurrence (LR). Methods and Materials: A total of 216 patients with positive margins after resection of an extremity STS treated between 1986 and 2003 were identified from our institution's prospectively collected database. Patient demographics, radiation therapy parameters including timing and dose, classification of positive margin status, reasons for not administering a postoperative boost, and oncologic outcome were collected and evaluated. Results: Of the 216 patients with a positive surgical margin, 52 patients were treated with preoperative radiation therapy alone (50 Gy), whereas 41 received preoperative radiation therapy plus a postoperative boost (80% received 16 Gy postoperatively for a total of 66 Gy). There was no difference in baseline tumor characteristics between the two groups. Six of 52 patients in the group receiving preoperative radiation alone developed a LR compared with 9 of 41 in the boost group. Five-year estimated LR-free survivals were 90.4% and 73.8%, respectively (p = 0.13). Conclusions: We found that including the postoperative radiation boost after preoperative radiation and a margin-positive excision did not provide an advantage in preventing LR for patients treated with external beam radiotherapy. Given that higher radiation doses placed patients at greater risk for late complications such as fracture, fibrosis, edema, and joint stiffness, judicious avoidance of the postoperative boost while maintaining an equivalent rate of local control can reduce the risk of these difficult-to-treat morbidities.

  8. To Operate or Not: Prediction of 3-Month Postoperative Mortality in Geriatric Cancer Patients

    PubMed Central

    Chou, Wen-Chi; Liu, Keng-Hao; Lu, Chang-Hsien; Hung, Yu-Shin; Chen, Miao-Fen; Cheng, Yu-Fan; Wang, Cheng-Hsu; Lin, Yung-Chang; Yeh, Ta-Sen

    2016-01-01

    Context: Appropriate selection of aging patient who fit for cancer surgery is an art-of-state. Objectives: This study aimed to identify predictive factors pertinent to 3-month postoperative mortality in geriatric cancer patients. Methods: A total of 8,425 patients over 70 years old with solid cancer received radical surgery between 2007 and 2012 at four affiliated hospitals of the Chang Gung Memorial Hospital were included. The clinical variables of patients who died within 3 months post-surgery were analyzed retrospectively. Recursive partitioning analysis (RPA) was performed by randomly selecting 50% of the patients (testing set) to identify specific groups of patients with the lowest and highest probability of 3-month postoperative mortality. The remaining 50% were used as validation set of the model. Results: Patients' gender, Eastern Cooperative Oncology Group performance (ECOG scale), Charlson comorbidity index (CCI), American Society of Anesthesiologist physical status, age, tumor staging, and mode of admission were independent variables that predicted 3-month postoperative mortality. The RPA model identified patients with an ECOG scale of 0-2, localized tumor stage, and a CCI of 0-2 as having the lowest probability of 3-month postoperative mortality (1.1% and 1.3% in the testing set and validation set, respectively). Conversely, an ECOG scale of 3-4 and a CCI >2 were associated with the highest probability of 3-month postoperative mortality (55.2% and 47.8% in the testing set and validation set, respectively). Conclusion: We identified ECOG scale and CCI score were the two most influencing factors that determined 3-month postoperative mortality in geriatric cancer patients. PMID:26722355

  9. Colorectal resection in deep pelvic endometriosis: Surgical technique and post-operative complications

    PubMed Central

    Milone, Marco; Vignali, Andrea; Milone, Francesco; Pignata, Giusto; Elmore, Ugo; Musella, Mario; De Placido, Giuseppe; Mollo, Antonio; Fernandez, Loredana Maria Sosa; Coretti, Guido; Bracale, Umberto; Rosati, Riccardo

    2015-01-01

    AIM: To investigate the impact of different surgical techniques on post-operative complications after colorectal resection for endometriosis. METHODS: A multicenter case-controlled study using the prospectively collected data of 90 women (22 with and 68 without post-operative complications) who underwent laparoscopic colorectal resection for endometriosis was designed to evaluate any risk factors of post-operative complications. The prospectively collected data included: gender, age, body mass index, American Society of Anesthesiologists risk class, endometriosis localization (from anal verge), operative time, conversion, intraoperative complications, and post-operative surgical complications such as anastomotic dehiscence, bleeding, infection, and bowel dysfunction. RESULTS: A similar number of complicated cases have been registered for the different surgical techniques evaluated (laparoscopy, single access, flexure mobilization, mesenteric artery ligation, and transvaginal specimen extraction). A multivariate regression analysis showed that, after adjusting for major clinical, demographic, and surgical characteristics, complicated cases were only associated with endometriosis localization from the anal verge (OR = 0.8, 95%CI: 0.74-0.98, P = 0.03). After analyzing the association of post-operative complications and each different surgical technique, we found that only bowel dysfunction after surgery was associated with mesenteric artery ligation (11 out of 44 dysfunctions in the mesenteric artery ligation group vs 2 out of 36 cases in the no mesenteric artery ligation group; P = 0.03). CONCLUSION: Although further randomized clinical trials are needed to give a definitive conclusion, laparoscopic colorectal resection for deep infiltrating endometriosis appears to be both feasible and safe. Surgical technique cannot be considered a risk factor of post-operative complications. PMID:26715819

  10. Die Grundlagen der Fernsehtechnik: Systemtheorie und Technik der Bildübertragung

    NASA Astrophysics Data System (ADS)

    Mahler, Gerhard

    Umfassende Einführung in die Grundlagen der Bewegtbild-Übertragung von den Anfängen bis zum heutigen Stand des digitalen Fernsehens mit einer aus der Praxis entstandenen systemtheoretischen Analyse. Die kompakte und anschaulich bebilderte Darstellung mit elementaren mathematischen Beschreibungen macht es dem Leser leicht, sich in die Bildübertragungstechnik einzuarbeiten. Thematische Einheiten erweitern den Wissensstoff - u.a. zu den Themen visuelle Wahrnehmung, mehrdimensionale Signaldarstellung, Farbmetrik, Digitalisierung, Elektronenoptik - und zeigen deren Anwendung auf die elektronische Bildübertragung.

  11. Traditionelles Bauen und Wohnen der Salar in Nordwest-China

    E-print Network

    Wagner, Mayke; Flitsch, Mareile; Winterstein, Claudia; Lehmann, Heike; Heuß ner, Karl-Uwe; Ren, Xiaoyan; Xiao, Yongming; Cai, Linhai; Wulf-Rheidt, Ulrike; Tarasov, Pavel; Dwyer, Arienne M.

    2007-01-01

    frühagrarischer Fundorte im Nordbaktrien der Spätbronzezeit 61 Gropp, G. und Kurbanov, Sh., Erster Vorbericht über die Ausgrabungen in Sandzar Sah (Magian), Tadzikistan 2003 9 Wagner, M., Flitsch, M., Winterstein, C, Lehmann, H., Heußner, K.-U., Xiaoyan, R...., Yongming, X., Linhai, C, Wulf-Rheidt, U., Tarasov, P., Dwyer, A., Traditionelles Bauen und Wohnen der Salar in Nordwest-China 127 Winckelmann Lecture 2006 Korn, L., Saljuq dorne Chambers in Iran. A multi-faceted phenomenon of Islamic art 235 Table...

  12. Biologie statt Philosophie? Evolutionäre Kulturerklärungen und ihre Grenzen

    NASA Astrophysics Data System (ADS)

    Illies, Christian

    Vor über siebzig Jahren fand man in einer Höhle nahe Hohlenstein-Stadel, im heutigen Baden-Württemberg, eine Frau, die keiner bekannten Spezies und nicht einmal eindeutig den Hominiden zugeordnet werden konnte. Wegen ihres Aussehens wurde sie schon bald als "Löwenfrau“ bekannt (unterdessen wird sie als "Löwenmensch“ bezeichnet, da die in solchen Fragen Klarheit schaffenden Geschlechtsteile bei der Figur fehlen und in Zeiten von gender mainstreaming derartige Festlegungen gerne vermieden werden), denn sie hatte eine menschlich-aufrechte, unbehaarte Gestalt mit weiblichen Rundungen, aber zugleich eine Mähne, sowie Augen, Ohren und Schnauze eines Löwen. Eine sehr weitläufige Verwandte des Minotaurus, so schien es, und doch wesentlich älter als alle Bewohner des Olymps, denn vermutlich wurde die knapp 30 cm große Skulptur bereits in der Altsteinzeit vor etwa 32.000 Jahren aus Mammut-Elfenbein geschnitzt. Wir wissen nicht, ob sie kultischen Zwecken diente oder ein Kind mit ihr spielte, ob sie als Glücksbringer für die Jagd oder als Schamanin mit Löwenmaske verehrt und gefürchtet wurde. Aber die Löwenfrau legt nahe, dass der Mensch schon im Morgendämmern seiner Kultur über die eigene Nähe, aber auch Distanz zum Tier nachgedacht haben muss. Die Frage nach der menschlichen Selbstverortung begegnet uns in dieser Figur, und sie bestimmt viele Zeugnisse menschlichen Nachdenkens, welche uns die Altertumswissenschaften vorlegen. Mit dem Begriff "animal rationale“, wie er unter Bezug auf Aristoteles geprägt wurde, findet sie schließlich ihre klassische, für das Abendland lange Zeit maßgebliche Antwort: Der Mensch als Tier, dessen spezifisches Merkmal die Vernunftbegabtheit ist, die ihn zugleich von allen anderen Tieren abgrenzt und über sie stellt. Aber wo genau verläuft die Grenze? Und wie kann der Mensch beides zugleich sein? Die aristotelische Definition beantwortet diese Fragen nach der Doppelnatur nicht, sondern erhebt das offene Rätsel gleichsam zur Wesensbestimmung des Menschen.

  13. Terror mit Atomwaffen: reale Gefahr? Nukleare und Radiologische Waffen

    NASA Astrophysics Data System (ADS)

    Harigel, Gert G.

    2006-01-01

    Können Terroristen sich nukleare Massenvernichtungswaffen beschaffen? Dazu müssten sie ausreichende Mengen an waffenfähigem, spaltbarem Material stehlen. Selbst der Bau einer primitiven Atombombe erfordert einen hohen technischen Aufwand und Spezialisten. Wahrscheinlicher ist deshalb der Diebstahl einer kleinen taktischen Kernwaffe. Alternativ könnten Terroristen sich radioaktives Material aus zivilen Quellen beschaffen und daraus eine Schmutzige Bombe bauen. Eine solche radiologische Waffe wäre keine echte Massenvernichtungswaffe, doch ihre psychologische Wirkung könnte stark sein. Das macht sie für Terroristen attraktiv, weswegen diese Gefahr ernst genommen werden muss.

  14. Postoperative complications and survival of elderly breast cancer patients: a FOCUS study analysis.

    PubMed

    de Glas, N A; Kiderlen, M; Bastiaannet, E; de Craen, A J M; van de Water, W; van de Velde, C J H; Liefers, G J

    2013-04-01

    Old age is associated with comorbidity and decreased functioning which influences treatment decisions in elderly breast cancer patients. The purpose of this study was to identify risk factors for complications after breast cancer surgery in elderly patients, and to assess mortality in patients with postoperative complications. The FOCUS cohort is a detailed retrospective cohort of all breast cancer patients aged 65 years and older who were diagnosed between 1997 and 2004 in the South-West of the Netherlands. Risk factors for postoperative complications were assessed using univariable and multivariable logistic regression models. One-year survival and overall survival were calculated using univariable and multivariable Cox Regression models, and relative survival was calculated according to the Ederer II method. 3179 patients received surgery, of whom 19 % (n = 618) developed 1 or more postoperative complication(s). The odds ratio of having postoperative complications increased with age [OR 1.85 (95 % confidence interval (CI) 1.37-2.50, p = 0.001) in patients >85 years] and number of concomitant diseases [OR 1.71 (95 % CI 1.30-2.24, p ? 0.001) for 4 or more concomitant diseases]. One-year overall survival, overall survival, and relative survival were worse in patients with postoperative complications [multivariable HR 1.49 (95 % CI 1.05-2.11), p = 0.025. HR 1.21, (95 % CI 1.07-1.36), p = 0.002 and RER 1.19 (95 % CI 1.05-1.34), p = 0.006 respectively]. Stratified for comorbidity, relative survival was lower in patients without comorbidity only. Increasing number of concomitant disease increased the risk of postoperative complications. Although elderly patients with comorbidity did have a higher risk of postoperative complications, relative mortality was not higher in this group. This suggests that postoperative complications in itself did not lead to higher relative mortality, but that the high relative mortality was most likely due to geriatric parameters such as comorbidity or poor physical function. PMID:23446810

  15. Use of postoperative irradiation for the prevention of heterotopic bone formation after total hip replacement

    SciTech Connect

    Sylvester, J.E.; Greenberg, P.; Selch, M.T.; Thomas, B.J.; Amstutz, H.

    1988-03-01

    Formation of heterotopic bone (HTB) following total hip replacement may partially or completely ankylose the joint space, causing pain and/or limiting the range of motion. Patients at high risk for formation of HTB postoperatively include those with previous HTB formation, heterotopic osteoarthritis, and active rheumatoid spondylitis. Patients in these high risk groups have a 63-69% incidence of post-operative HTB formation, usually seen radiographically by 2 months post-operation. From 1980-1986 twenty-nine hips in 28 consecutively treated patients were irradiated post-operatively at the UCLA Center for the Health Sciences. The indication for irradiation was documented HTB formation previously in 26 of the 27 hips presented below. From 1980-1982 patients received 20 Gray (Gy) in 2 Gy fractions; from 1982-1986 the dose was reduced to 10 Gy in 2 Gy fractions. Twenty-seven hips in 26 patients completed therapy and were available for evaluation, with a minimum of 2 month follow-up, and a median follow-up of 12 months. Three of 27 hips developed significant HTB (Brooker grade III or IV) post-operatively, whereas 5 of 27 hips developed minor, nonsymptomatic HTB (Brooker grade I). When irradiation was begun by postoperative day 4, 0 of 17 hips formed significant HTB. If irradiation began after post-operative day 4, 3 of 10 hips formed significant HTB (Brooker grade III or IV). These 3 hips received doses of 10 Gy in one hip and 20 Gy in the other 2 hips. There were no differences in the incidence or severity of side effects in the 10 Gy vs. the 20 Gy treatment groups. Eighteen hips received 10 Gy, 8 hips 20 Gy and, 1 hip 12 Gy. In conclusion, 10 Gy in 5 fractions appears as effective as 20 Gy in 10 fractions at preventing post-operative formation of HTB. For optimal results, treatment should begin as early as possible prior to post-operative day 4.

  16. Prevalence of and risk factors for persistent postoperative nonanginal pain after cardiac surgery: a 2-year prospective multicentre study

    PubMed Central

    Choinière, Manon; Watt-Watson, Judy; Victor, J. Charles; Baskett, Roger J.F.; Bussières, Jean S.; Carrier, Michel; Cogan, Jennifer; Costello, Judy; Feindel, Christopher; Guertin, Marie-Claude; Racine, Mélanie; Taillefer, Marie-Christine

    2014-01-01

    Background: Persistent postoperative pain continues to be an underrecognized complication. We examined the prevalence of and risk factors for this type of pain after cardiac surgery. Methods: We enrolled patients scheduled for coronary artery bypass grafting or valve replacement, or both, from Feb. 8, 2005, to Sept. 1, 2009. Validated measures were used to assess (a) preoperative anxiety and depression, tendency to catastrophize in the face of pain, health-related quality of life and presence of persistent pain; (b) pain intensity and interference in the first postoperative week; and (c) presence and intensity of persistent postoperative pain at 3, 6, 12 and 24 months after surgery. The primary outcome was the presence of persistent postoperative pain during 24 months of follow-up. Results: A total of 1247 patients completed the preoperative assessment. Follow-up retention rates at 3 and 24 months were 84% and 78%, respectively. The prevalence of persistent postoperative pain decreased significantly over time, from 40.1% at 3 months to 22.1% at 6 months, 16.5% at 12 months and 9.5% at 24 months; the pain was rated as moderate to severe in 3.6% at 24 months. Acute postoperative pain predicted both the presence and severity of persistent postoperative pain. The more intense the pain during the first week after surgery and the more it interfered with functioning, the more likely the patients were to report persistent postoperative pain. Pre-existing persistent pain and increased preoperative anxiety also predicted the presence of persistent postoperative pain. Interpretation: Persistent postoperative pain of nonanginal origin after cardiac surgery affected a substantial proportion of the study population. Future research is needed to determine whether interventions to modify certain risk factors, such as preoperative anxiety and the severity of pain before and immediately after surgery, may help to minimize or prevent persistent postoperative pain. PMID:24566643

  17. Professionelles Learning Service Management an Hochschulen

    NASA Astrophysics Data System (ADS)

    Baume, Matthias; Rathmayer, Sabine; Gergintchev, Ivan; Schulze, Elvira

    Aufbauend auf den Großteils bereits geschaffenen eLearning Infrastrukturen für eine moderne Organisation stehen nahezu alle Hochschulen vor der Aufgabe, geeignete Lern- und Wissensmanagementkonzepte in Hinblick auf die Dienstgüte und den Anwenderbezug zu realisieren. Ein möglicher Lösungsansatz ist dabei die Entwicklung und Umsetzung eines Rahmenkonzeptes zur Verbesserung und Weiterentwicklung der Lehr-/Lernprozesse für Dozenten und Studenten am Beispiel bereits vorhandener und etablierter Service-Management-Konzepte. Übertragen auf die universitäre Organisation und Lehre, wäre ein derartiges Rahmenwerk zur Planung, Erbringung und Unterstützung von Lehr-/Lerndienstleistungen mit Einbezug der wichtigsten Lehr-/Lernprozesse ein dringend benötigter und fundamentaler Schritt hin zu einer schrittweisen Professionalisierung und Verbesserung der Hochschullehre. Der Beitrag erschließt eine Konzeptskizze für professionelles Learning Service Management an Hochschulen und gibt einen Ausblick auf die mögliche Vorgehensweise bei dessen Implementierung und Evaluierung.

  18. Reglement ber die Videoberwachung und die Videountersttzung an der Universitt Zrich

    E-print Network

    Zürich, Universität

    Reglement über die Videoüberwachung und die Videounterstützung an der Universität Zürich (vom 15. Januar 2015) Die Universitätsleitung, gestützt auf § 31 Abs. 2 des Gesetzes über die Universität Zürich vom 15. März 19981 und § 56

  19. VDI-Richtlinien - mit Technischen Regeln Wirtschaftlichkeit erhöhen und Standards setzen

    NASA Astrophysics Data System (ADS)

    Mandelartz, Johannes

    Der Verein Deutscher Ingenieure e.V. (VDI) ist ein gemeinnütziger, wirtschaftlich und politisch unabhängiger, technisch-wissenschaftlicher Verein von Ingenieuren und Naturwissenschaftlern. Mit über 137 000 persönlich zugeordneten Mitgliedern ist er eine der größten Ingenieur-Vereinigungen Europas und gilt in Deutschland als führender Sprecher der Technik und der Ingenieure. 1856 gegründet, hat er viele für die Technik wesentliche Entwicklungen in Gang gesetzt, so im Bereich der technischen Überwachung, der technischen Regelsetzung und Normung, der Arbeitsstudien, im gewerblichen Rechtsschutz und im Patentwesen. Seit seiner Gründung sieht es der VDI als seine Aufgabe, "das Zusammenwirken aller geistiger Kräfte der Technik im Bewusstsein ethischer Verantwortung zu fördern“ und die Lebensmöglichkeiten aller Menschen durch Entwicklung und sinnvoller Anwendung technischer Mittel zu verbessern.

  20. Studien-und Prfungsordnung der Universitt Stuttgart fr den Bachelorstudiengang Verfahrenstechnik

    E-print Network

    Reyle, Uwe

    Verfahrenstechnik Vom 23. August 2011 Aufgrund von § 34 Abs. 1 Satz 3 des Landeshochschulgesetzes vom 01- und Prüfungsordnung für den Bachelorstudiengang Verfahrenstechnik beschlossen. Der Rektor der Prüfungsordnung für den Bachelorstudiengang Verfahrenstechnik beschreibt den Aufbau des Studiums und die

  1. Prfungs-und Studienordnung fr den Teilstudiengang Dnisch im Lehramtsstudiengang Gymnasium

    E-print Network

    Greifswald, Ernst-Moritz-Arndt-Universität

    1 Prüfungs- und Studienordnung für den Teilstudiengang Dänisch im Lehramtsstudiengang Gymnasium Dänisch im Lehramtsstudiengang Gymnasium die folgende Prüfungs- und Studienordnung als Satzung Teilstudiengang Dänisch im Lehramtsstudiengang Gymnasium. Dieser Studiengang stellt einen Studiengang im Sinne von

  2. Prfungs-und Studienordnung fr den Teilstudiengang Norwegisch im Lehramtsstudiengang Gymnasium

    E-print Network

    Greifswald, Ernst-Moritz-Arndt-Universität

    1 Prüfungs- und Studienordnung für den Teilstudiengang Norwegisch im Lehramtsstudiengang Gymnasium Norwegisch im Lehramtsstudiengang Gymnasium die folgende Prüfungs- und Studienordnung als Satzung Teilstudiengang Norwegisch im Lehramtsstudiengang Gymnasium. Dieser Studiengang stellt einen Studiengang im Sinne

  3. Nichtamtliche Lesefassung der Prfungs-und Studienordnung Lehramt Gymnasium Evangelische Religion

    E-print Network

    Greifswald, Ernst-Moritz-Arndt-Universität

    Nichtamtliche Lesefassung der Prüfungs- und Studienordnung Lehramt Gymnasium Evangelische Religion Prüfungs- und Studienordnung für den Teilstudiengang Evangelische Religion im Lehramtsstudiengang Gymnasium-Moritz-Arndt- Universität Greifswald für den Teilstudiengang Evangelische Religion im Lehramtsstudiengang Gymnasium die

  4. Impact of Intraoperative Acetaminophen Administration on Postoperative Opioid Consumption in Patients Undergoing Hip or Knee Replacement

    PubMed Central

    Vaughan, Cathy; McGee, Ann

    2014-01-01

    Abstract Background: Opioid utilization for acute pain has been associated with numerous adverse events, potentially resulting in longer inpatient stays and increased costs. Objective: To examine the effect of intravenous (IV) acetaminophen administered intraoperatively on postoperative opioid consumption in adult subjects who underwent hip or knee replacement. Methods: This retrospective cohort study evaluated postoperative opioid consumption in 176 randomly selected adult subjects who underwent hip or knee replacement at Duke University Hospital (DUH). Eighty-eight subjects received a single, intraoperative, 1 g dose of IV acetaminophen. The other subjects did not receive any IV acetaminophen. This study evaluated mean opioid consumption (in oral morphine equivalents) during the 24-hour postoperative period in the 2 groups. Other endpoints included length of stay in the postanesthesia care unit (PACU), incidence of oversedation, need for acute opioid reversal, and adjunctive analgesic utilization. Results: Subjects who were given a single dose of intraoperative acetaminophen received an average of 149.3 mg of oral morphine equivalents during the 24 hours following surgery compared to 147.2 mg in participants who were not exposed to IV acetaminophen (P = .904). The difference in average length of PACU stay between the IV acetaminophen group (163 minutes) and those subjects not exposed to IV acetaminophen (169 minutes) was not statistically significant (P = .588). No subjects in the study experienced oversedation or required acute opioid reversal. Conclusion: There was not a statistically significant difference in postoperative opioid consumption between patients receiving and not receiving IV acetaminophen intraoperatively. PMID:25673891

  5. Postoperative rhabdomyolysis following robotic renal and adrenal surgery: a cautionary tale of compounding risk factors.

    PubMed

    Terry, Russell S; Gerke, Travis; Mason, James B; Sorensen, Matthew D; Joseph, Jason P; Dahm, Philipp; Su, Li-Ming

    2015-09-01

    This study aimed at reviewing a contemporary series of patients who underwent robotic renal and adrenal surgery by a single surgeon at a tertiary referral academic medical center over a 6-year period, specifically focusing on the unique and serious complication of post-operative rhabdomyolysis of the dependent lower extremity. The cases of 315 consecutive patients who underwent robotic upper tract surgery over a 6-year period from August 2008 to June 2014 using a standardized patient positioning were reviewed and analyzed for patient characteristics and surgical variables that may be associated with the development of post-operative rhabdomyolysis. The incidence of post-operative rhabdomyolysis in our series was 3/315 (0.95 %). All three affected patients had undergone robotic nephroureterectomy. Those patients who developed rhabdomyolysis had significantly higher mean Body Mass Index, Charlson Comorbidity Index, and median length of stay than those who did not. The mean OR time in the rhabdomyolysis group was noted to be 52 min longer than the non-rhabdomyolysis group, though this value did not reach statistical significance. Given the trends of increasing obesity in the United States and abroad as well as the continued rise in robotic upper tract urologic surgeries, urologists need to be increasingly vigilant for recognizing the risk factors and early treatment of the unique complication of post-operative rhabdomyolysis. PMID:26531199

  6. [The Development of a Care Protocol for Postoperative Pressure Sore Prevention].

    PubMed

    Huang, Yu-Ling; Lin, Hui-Ling; Wang, Fang; Wu, Shu-Fang Vivienne

    2015-12-01

    Pressure sores are a common complication caused by long periods of bed rest following major surgery. These sores may increase patient postoperative pain, increase the risk of infections, lengthen the pe-riod of hospitalization, and increase the duration and costs of nursing care. Therefore, maintaining the skin integrity of surgical patients is an important responsibility for operating room nurses and an indicator of nursing care quality. While pressure-sore risk assessment tools and interoperative strategies are available and used in foreign countries, there has been little related research conducted in Taiwan. After examining the relevant literature and considering the current postoperative pressure sore situation in Taiwan, the author developed a postoperative pressure sore care protocol as a reference for clinical staff. Protocol procedures include major breakthrough developments in areas such as post-survey risk assessment for pressure ulcers, pressure ulcer prevention strategies that take surgery-related risk factors into consideration, extra care and protection measures for surgical supine patients, and post-pressure sores. The developed postoperative pressure sore protocol may be incorporated into surgical care procedures during the post-surgical care period in order to effectively prevent the occurrence of post-surgery pressure ulcers. Furthermore, the developed protocol offers the potential to improve and strengthen the quality of surgical care in terms of both healthcare and post-surgical care. PMID:26645449

  7. The Impact of Educational Status on the Postoperative Perception of Pain

    PubMed Central

    Mimigianni, Christina; Raptis, Demetris; Sourtse, Gionous; Sgourakis, George; Karaliotas, Constantine

    2015-01-01

    Background Postoperative (PO) pain interferes with the recovery and mobilization of the surgical patients. The impact of the educational status has not been studied adequately up to now. Methods This prospective study involved 400 consecutive general surgery patients. Various factors known to be associated with the perception of pain including the educational status were recorded as was the preoperative and postoperative pain and the analgesia requirements for the 1st PO week. Based on the educational status, we classified the patients in 3 groups and we compared these groups for the main outcomes: i.e. PO pain and PO analgesia. Results There were 145 patients of lower education (junior school), 150 patients of high education (high school) and 101 of higher education (university). Patients of lower education were found to experience more pain than patients of higher education in all postoperative days (from the 2nd to the 6th). No difference was identified in the type and quantity of the analgesia used. The subgroup analysis showed that patients with depression and young patients (< 40 years) had the maximum effect. Conclusions The educational status may be a significant predictor of postoperative pain due to various reasons, including the poor understanding of the preoperative information, the level of anxiety and depression caused by that and the suboptimal request and use of analgesia. Younger patients (< 40), and patients with subclinical depression are mostly affected while there is no impact on patients over 60 years old. PMID:26495081

  8. Post-operative effects on silver coated tumor endoprosthesis and biofilm prophylaxis systems

    NASA Astrophysics Data System (ADS)

    Heinrich, L.; Ahrens, H.; Wahrenburg, M.; Pajaziti, B.; Kurzina, I. A.

    2015-11-01

    Despite the high state of the art in limp replacement and the reconstructive tumor surgery, failures cannot be excluded. Investigations on post-operative effects on explanted silver coated modules of MUTARS® prostheses have disclosed changes in the silver surface. Both, the silver coatings and the perioperative lavage with antiseptics reduce efficiently the risks of infections.

  9. Texture Feature Analysis for Prediction of Postoperative Liver Failure Prior to Surgery

    E-print Network

    Miga, Michael I.

    Texture Feature Analysis for Prediction of Postoperative Liver Failure Prior to Surgery Amber L of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA b Department of Surgery, Memorial Sloan demonstrate that texture analysis is a valuable tool for quantifying liver function prior to surgery, which

  10. Surgeons' aims and pain assessment strategies when managing paediatric post-operative pain: A qualitative study.

    PubMed

    Twycross, Alison M; Williams, Anna M; Finley, G Allen

    2014-04-11

    Children experience moderate to severe pain post-operatively. Nurses have been found to have a variety of aims in this context. Surgeons' aims when managing post-operative pain have not been explored. This qualitative study set out to explore paediatric surgeons' aims when managing post-operative pain in one paediatric hospital in Canada. Consultant surgeons (n = 8) across various specialities took part in semi-structured interviews. Surgeons' overarching aim was to keep the child comfortable. Various definitions of comfortable were given, relating to the child's experience of pain itself and their ability to undertake activities of daily living. Children's behavioural pain cues seem to be a primary consideration when making treatment decisions. Parents' views regarding their child's pain were also seen as important, suggesting children may not be seen as competent to make decisions on their own behalf. The need to maintain a realistic approach was emphasised and pain management described as a balancing act. Surgeons may draw on both tacit and explicit knowledge when assessing children's pain. There appears to be an expectation among surgeons that some pain is to be expected post-operatively and that the diagnostic value of pain may, in some cases, supersede concerns for the child's pain experience. PMID:24728398

  11. Postoperative analgesia for Enhanced recovery in Joint replacement: Audit of a new electronic prescribing order set

    PubMed Central

    Wright, Jonathan; Cullinger, Benjamin; Bacarese-Hamilton, Ian

    2015-01-01

    Enhanced recovery in joint replacement has been shown to reduce length of inpatient stay, reduce re-admission rates, and can improve early functional recovery. Postoperative analgesia is an important component of the group of interventions required to form a holistic enhanced recovery protocol. The introduction of electronic prescribing provides the opportunity to introduce some standardisation, where clinically appropriate, in the prescription of an evidence based postoperative analgesia protocol. Enhanced recovery following joint replacement has been used at this institution since 2011. An order set for the postoperative analgesia protocol was introduced to the in house electronic prescribing system in August 2014 (JAC Medicines Management; JAC Computer Services Ltd., Basildon, UK). An audit was performed to follow the effect of the new system on compliance with the postoperative analgesia guidelines. Improvements were seen following introduction of the electronic prescribing protocol in all criteria of the guideline with a demonstrated improvement in overall compliance from 0% to 35% in the first loop, with subsequent audit showing further improvement to 59% compliance. Use of an embedded order set within an electronic prescribing system has demonstrated improved compliance with an enhanced recovery protocol. This ensures that the correct evidence based protocol is available to guide the junior clinician at the point of care, when the medication is being prescribed.

  12. Prevalence, outcome and risk factors for postoperative pyothorax in 232 dogs undergoing thoracic surgery

    PubMed Central

    Meakin, L B; Salonen, L K; Baines, S J; Brockman, D J; Gregory, S P; Halfacree, Z J; Lipscomb, V J; Lee, K C

    2013-01-01

    Objective To determine the prevalence, outcome and risk factors for postoperative pyothorax in dogs undergoing thoracic surgery. Methods Case records were reviewed retrospectively to identify dogs with post thoracic surgery pyothorax, defined as septic neutrophilic inflammation within the pleural space based on cytology and/or a positive bacterial culture of pleural fluid. Those identified were reviewed for potential risk factors for postoperative pyothorax based on biological plausibility and previously published data. These potential risk factors were explored by multivariable logistic regression. Results Of 232 dogs undergoing thoracic surgery, 15 (6·5%) dogs developed pyothorax. Bacteria cultured included methicillin-resistant Staphylococcus aureus and multi-resistant Escherichia coli. Of these dogs, six died, four were euthanased and five were treated successfully. A diagnosis of idiopathic chylothorax [Odds Ratio (OR)=12·5, 95% Confidence Interval (CI)=2·7-58·5, P=0·001], preoperative intrathoracic biopsy (OR=14·3, 95% CI=1·7-118·7, P=0·014) and preoperative thoracocentesis (OR=11·2, 95% CI=1·6-78·2, P=0·015) were identified as independent risk factors for development of postoperative pyothorax. Clinical Significance Idiopathic chylothorax, intrathoracic biopsy and prior thoracocentesis are independent risk factors for postoperative pyothorax, which was associated with a 67% mortality rate. PMID:23581608

  13. Nerve Blockage Attenuates Postoperative Inflammation in Hippocampus of Young Rat Model with Surgical Trauma

    PubMed Central

    He, Yi; Li, Zhi; Zuo, Yun-Xia

    2015-01-01

    It is hypothesized that central nervous system inflammation induced by systematic inflammation due to surgical trauma plays a critical role in postoperative cognitive dysfunction. The potential inhibitory effect of nerve blockage with local anesthetics on peripheral inflammatory response has been reported. We hypothesize that nerve blockage may be effective in reducing postoperative inflammation and cognitive decline. The rats at the age of 4 weeks were subjected to general anesthesia and humeral fracture fixation, in combination with brachial plexus block, saline versus ropivacaine, respectively. The rats from control group underwent general anesthesia only. The expression of proinflammatory cytokines in plasma and in hippocampus was measured. Open field test and new object recognition task were performed before surgery and on postoperative days (POD) 1, 3, and 7. Compared with control group, the level of cytokines in plasma and hippocampus revealed an obvious increase in surgery groups. The effect of brachial plexus block on decreasing cytokines was observed. The rats exposed to surgery without brachial plexus block showed behavior impairment. Our results indicated that nerve blockage could downregulate proinflammatory cytokines in hippocampus after humeral fixation surgery, which may ameliorate the postoperative cognitive dysfunction in young rats. PMID:26664150

  14. Postoperative Respiratory Complications of Laryngeal Mask Airway and Tracheal Tube in Ear, Nose and Throat Operations

    PubMed Central

    Safaeian, Reza; Hassani, Valiollah; Movasaghi, Gholamreza; Alimian, Mahzad; Faiz, Hamid Reza

    2015-01-01

    Background: Supraglottic devices could be used to reduce postoperative respiratory complications, but there are few studies focused on their use in more prolonged surgeries. Objectives: In this study, we compared postoperative respiratory complications in patients with prolonged ear, nose and throat (ENT) surgeries, whose airways were controlled with tracheal tube or laryngeal mask airway (LMA). Materials and Methods: In a randomized control trial (RCT), 171 candidates of prolonged ENT surgeries were randomly assigned into two groups. In group one (n = 85) LMA and in group two (n = 86) endotracheal tube were used for airway control. The incidences of four postoperative respiratory complications including sore throat, hoarseness, cough and shortness of breath in immediate postoperative period were measured and compared among patients of each group. Results: Sore throat was recorded in 32.9% of patients with LMA and 44.2% of intubated patients, but it was not statistically significant (Fisher’s Exact test = 0.158). Hoarseness was recorded in 3.5% of patients with LMA and 24.4% of intubated patients (Fisher’s Exact test = 0.000). In 1.2% of patients with LMA cough was recorded; it was also seen in 7% of the intubated patients (Fisher’s Exact test = 0.005). Shortness of breath was mentioned by two intubated patients (2.3%) and in patient with LMA we did not record this complication. Conclusions: LMA in prolonged ENT surgeries was associated with reduced respiratory complications. PMID:26473104

  15. Comparison between two thoracotomy closure techniques: postoperative pain and pulmonary function*

    PubMed Central

    Leandro, Juliana Duarte; Rodrigues, Olavo Ribeiro; Slaets, Annie France Frere; Schmidt, Aurelino F.; Yaekashi, Milton L.

    2014-01-01

    OBJECTIVE: To compare two thoracotomy closure techniques (pericostal and transcostal suture) in terms of postoperative pain and pulmonary function. METHODS: This was a prospective, randomized, double-blind study carried out in the Department of Thoracic Surgery of the Luzia de Pinho Melo Hospital das Clínicas and at the University of Mogi das Cruzes, both located in the city of Mogi das Cruzes, Brazil. We included 30 patients (18-75 years of age) undergoing posterolateral or anterolateral thoracotomy. The patients were randomized into two groups by the type of thoracotomy closure: pericostal suture (PS; n = 16) and transcostal suture (TS; n = 14). Pain intensity during the immediate and late postoperative periods was assessed by a visual analogic scale and the McGill Pain Questionnaire. Spirometry variables (FEV1, FVC, FEV1/FVC ratio, and PEF) were determined in the preoperative period and on postoperative days 21 and 60. RESULTS: Pain intensity was significantly greater in the PS group than in the TS group. Between the preoperative and postoperative periods, there were decreases in the spirometry variables studied. Those decreases were significant in the PS group but not in the TS group. CONCLUSIONS: The patients in the TS group experienced less immediate and late post-thoracotomy pain than did those in the PS group, as well as showing smaller reductions in the spirometry parameters. Therefore, transcostal suture is recommended over pericostal suture as the thoracotomy closure technique of choice. PMID:25210961

  16. EARLY POSTOPERATIVE MAGNETIC RESONANCE IMAGING FINDINGS IN FIVE DOGS WITH CONFIRMED AND SUSPECTED BRAIN TUMORS.

    PubMed

    Chow, Kathleen Ella; Tyrrell, Dayle; Long, Sam Nicholas

    2015-01-01

    Early postoperative neuroimaging has been performed in people for over 20 years to detect residual brain tumor tissue and surgical complications. The purpose of this retrospective study was to describe characteristics observed using early postoperative magnetic resonance imaging in a group of dogs undergoing craniotomy for brain tumor removal. Two independent observers came to a consensus opinion for presence/absence of the following MRI characteristics: residual tumor tissue; hemorrhage and ischemic lesions; abnormal enhancement (including the margins of the resection cavity, choroid plexus, meninges) and signal intensity changes on diffusion-weighted imaging. Five dogs were included in the study, having had preoperative and early postoperative MRI acquired within four days after surgery. The most commonly observed characteristics were abnormal meningeal enhancement, linear enhancement at margins of the resection cavity, hemorrhage, and a thin rim of hyperintensity surrounding the resection cavity on diffusion-weighted imaging. Residual tumor tissue was detected in one case of an enhancing tumor and in one case of a tumor containing areas of hemorrhage preoperatively. Residual tumor tissue was suspected but could not be confirmed when tumors were nonenhancing. Findings supported the use of early postoperative MRI as a method for detecting residual brain tumor tissue in dogs. PMID:26372362

  17. Role of transcutaneous electrical nerve stimulation in post-operative analgesia

    PubMed Central

    Kerai, Sukhyanti; Saxena, Kirti Nath; Taneja, Bharti; Sehrawat, Lalit

    2014-01-01

    The use of transcutaneous electrical nerve stimulation (TENS) as non-pharmacological therapeutic modality is increasing. The types of TENS used clinically are conventional TENS, acupuncture TENS and intense TENS. Their working is believed to be based on gate control theory of pain and activation of endogenous opioids. TENS has been used in anaesthesia for treatment of post-operative analgesia, post-operative nausea vomiting and labour analgesia. Evidence to support analgesic efficacy of TENS is ambiguous. A systematic search of literature on PubMed and Cochrane Library from July 2012 to January 2014 identified a total of eight clinical trials investigating post-operative analgesic effects of TENS including a total of 442 patients. Most of the studies have demonstrated clinically significant reduction in pain intensity and supplemental analgesic requirement. However, these trials vary in TENS parameters used that is, duration, intensity, frequency of stimulation and location of electrodes. Further studies with adequate sample size and good methodological design are warranted to establish general recommendation for use of TENS for post-operative pain. PMID:25197104

  18. Effect of Pre-Designed Instructions for Mothers of Children with Hypospadias on Reducing Postoperative Complications

    ERIC Educational Resources Information Center

    Mohamed, Sanaa A.

    2015-01-01

    Hypospadias is a common congenital anomaly with a prevalence estimated to be as high as 1 in 125 live male births. Complications after surgical procedures are possible. The incidence of complications can be reduced by meticulous preoperative planning, and judicious postoperative care. So the aim of the study was to investigate the effect of…

  19. Postoperative Arrhythmias after Cardiac Surgery: Incidence, Risk Factors, and Therapeutic Management

    PubMed Central

    Cianflone, Domenico

    2014-01-01

    Arrhythmias are a known complication after cardiac surgery and represent a major cause of morbidity, increased length of hospital stay, and economic costs. However, little is known about incidence, risk factors, and treatment of early postoperative arrhythmias. Both tachyarrhythmias and bradyarrhythmias can present in the postoperative period. In this setting, atrial fibrillation is the most common heart rhythm disorder. Postoperative atrial fibrillation is often self-limiting, but it may require anticoagulation therapy and either a rate or rhythm control strategy. However, ventricular arrhythmias and conduction disturbances can also occur. Sustained ventricular arrhythmias in the recovery period after cardiac surgery may warrant acute treatment and long-term preventive strategy in the absence of reversible causes. Transient bradyarrhythmias may be managed with temporary pacing wires placed at surgery, but significant and persistent atrioventricular block or sinus node dysfunction can occur with the need for permanent pacing. We provide a complete and updated review about mechanisms, risk factors, and treatment strategies for the main postoperative arrhythmias. PMID:24511410

  20. Marginal Misses After Postoperative Intensity-Modulated Radiotherapy for Head and Neck Cancer

    SciTech Connect

    Chen, Allen M.; Farwell, D. Gregory; Luu, Quang; Chen, Leon M.; Vijayakumar, Srinivasan; Purdy, James A.

    2011-08-01

    Purpose: To describe the spatial distribution of local-regional recurrence (LRR) among patients treated postoperatively with intensity-modulated radiotherapy (IMRT) for head and neck cancer. Methods and Materials: The medical records of 90 consecutive patients treated by gross total resection and postoperative IMRT for squamous cell carcinoma of the head and neck from January 2003 to July 2009 were reviewed. Sites of disease were the oral cavity (43 patients), oropharynx (20 patients), larynx (15 patients), and hypopharynx (12 patients). Fifty patients (56%) received concurrent chemotherapy. Results: Seventeen of 90 patients treated with postoperative IMRT experienced LRR, yielding a 2-year estimate of local regional control of 80%. Among the LRR patients, 11 patients were classified as in-field recurrences, occurring within the physician-designated clinical target volume, and 6 patients were categorized as marginal recurrences. There were no out-of-field geographical misses. Sites of marginal LRRs included the contralateral neck adjacent to the spared parotid gland (3 patients), the dermal/subcutaneous surface (2 patients), and the retropharyngeal/retrostyloid lymph node region (1 patient). Conclusions: Although the incidence of geographical misses was relatively low, the possibility of this phenomenon should be considered in the design of target volumes among patients treated by postoperative IMRT for head and neck cancer.

  1. Postoperative Bleeding Risk for Oral Surgery under Continued Clopidogrel Antiplatelet Therapy

    PubMed Central

    Zeuch, Jürgen; Haase, Martina; Semmusch, Jan; Eichhorn, Wolfgang

    2015-01-01

    Object. To determine the incidence of postoperative bleeding for oral osteotomy carried out under continued monoantiplatelet therapy with clopidogrel and dual therapy with clopidogrel/aspirin. Design. Retrospective single center observatory study of two study groups and a control group. Methods. A total of 64 and 60 oral osteotomy procedures carried out under continued monoclopidogrel therapy and dual clopidogrel/aspirin therapy, respectively, were followed for two weeks for postoperative bleeding. Another 281 similar procedures were also followed as a control group. All oral osteotomy procedures were carried out on an outpatient basis. Results. We observed postoperative bleeding in 2/281 (0.7%) cases in the control group, in 1/64 (1.6%) cases in the clopidogrel group, and in 2/60 (3.3%) cases in the dual clopidogrel/aspirin group. The corresponding 95% confidence intervals are 0–1.7%, 0–4.7%, and 0–7.8%, respectively, and the incidences did not differ significantly among the three groups (P > 0.09). Postoperative hemorrhage was treated successfully in all cases with local measures. No changes of antiplatelet medication, transfusion, nor hospitalisation were necessary. No major cardiovascular events were recorded. Conclusions. Our results indicate that minor oral surgery can be performed safely under continued monoantiplatelet medication with clopidogrel or dual antiplatelet medication with clopidogrel/aspirin. PMID:25632402

  2. Low Dose Aminophylline Effectively Decreases the Risk of Post-Operative Apnea in Premature Infants

    PubMed Central

    Roodneshin, Fatemeh

    2014-01-01

    Background Retinopathy of prematurity (ROP) is the most common reason behind surgical procedures in premature newborns. Anesthesia in these patients is life-threatening due to post-operative apnea of prematurity (POA). This study aimed to determine the predisposing factors to POA in premature infants and to explore the role of prophylactic aminophylline in decreasing the incidence of POA. Materials and Methods Fifty patients with prematurity who were candidates for elective eye surgery (less than one hour) were selected and received aminophylline (3 mg/kg) 5 minutes after the induction of anesthesia with sevoflurane. Patients were kept in the recovery room for 2 hours post-operation in an incubator and were monitored for SPO2, apnea, bradycardia and other signs of desaturation and apnea. Results There were no statistically significant differences in the gestational age and weight, sex, postconceptual age and weight and other demographic characteristics between the experimental and control groups. Gestational age<28 weeks, postconceptual age<60 weeks, birth weight, operation weight and anemia (OR=1.91; 95% CI: 1.24-3.73; P=0.012) were the predisposing factors associated with postoperative apnea. Treatment with aminophylline as compared with the placebo was associated with a significantly decreased risk of post-operative apnea (OR=0.53; 95% CI 0.28–0.98; P=0.034). Conclusion Aminophylline can be used prophylactically to decrease the risk of postoperative apnea with no major adverse effects. PMID:25713589

  3. Comparison of Pre- and Postoperative Hemoglobin and Hematocrit Levels in Hip Arthroscopy

    PubMed Central

    Seijas, Roberto; Espinosa, Wenceslao; Sallent, Andrea; Cuscó, Xavier; Cugat, Ramón; Ares, Oscar

    2015-01-01

    Purpose : to assess the loss in hematocrit and hemoglobin, if any, 24 hours after hip arthroscopy. Methods : thirty-five patients were included. Laboratory tests including complete blood count and white blood cells were performed one week prior to surgery and 24 hours after. Surgical time, volume of saline perfusion and pump perfusion was also recorded. Results : mean preoperative hematocrit was 42.01% (4.63 SD), whereas mean postoperative hematocrit at 24 h decreased to 36.78% (SD 5.11) (p <0.021.). Mean preoperative hemoglobin was 14.23 g/dL (1.73 SD), and mean postoperative hemoglobin at 24 h decreased to 12.40 g/dL (SD 1.92) (p =0.03.). Platelets and white blood cells, as well as the remaining biochemical parameters showed no significant difference between preoperative and postoperative samples. Lost blood volume worked out with the logarithmic method for estimated blood loss was which 0.78 liters (SD 0.45). Lost blood volume taking into account, the red blood cell mass was also 0.78 liters (SD 0.45). Conclusion : a significant decrease in hemoglobin and hematocrit after hip arthroscopy was observed. Although patients did not show clinical signs of anemia or bleeding, blood loss should be considered when planning a hip arthroscopy, especially in patients at risk of anemia. According to our results, we recommend a postoperative control analysis at 24 h. Level of Evidence : level II, Diagnostic Study. PMID:26401169

  4. Impact of Nursing Educational Program on Reducing or Preventing Postoperative Complications for Patients after Intracranial Surgery

    ERIC Educational Resources Information Center

    Elmowla, Rasha Ali Ahmed Abd; El-Lateef, Zienab Abd; El-khayat, Roshdy

    2015-01-01

    Intracranial surgery means any surgery performed inside the skull to treat problems in the brain and surrounding structures. Aim: Evaluate the impact of nursing educational program on reducing or preventing postoperative complications for patients after intracranial surgery. Subjects and methods: Sixty adult patients had intracranial surgery (burr…

  5. Association of pre and intraoperative variables with postoperative complications in coronary artery bypass graft surgery

    PubMed Central

    Gimenes, Camila; Barrile, Silvia Regina; Martinelli, Bruno; Ronchi, Carlos Fernando; Arca, Eduardo Aguilar; Gimenes, Rodrigo; Okoshi, Marina Politi; Okoshi, Katashi

    2013-01-01

    Objective To associate the pre- and intraoperative variables with postoperative complications of patients undergoing coronary artery bypass graft surgery. Methods The pre- and intraoperative risk factors of individuals of both genders with diagnosis of coronary insufficiency undergoing coronary artery bypass graft have been studied. Results Fifty-eight individuals with median age 62 ± 10 year-old were included in the study, 67% of whom were male. Fourteen (24.1%) patients were smokers, 39 (67.2%) had previous myocardial infarction history, 11 (19%) had undergone coronary angioplasty, 74% had hypertension, 27% had diabetes mellitus, 64% had dyslipidemia and 15.5% had chronic obstructive pulmonary disease. Eighteen (31%) patients presented postoperative complications, most frequent being: infection in surgical incision, difficulties in deambulation, dyspnea, urinary infection and generalized weakness. Male patients had fewer complications than females (P=0.005). Patients with chronic obstructive pulmonary disease remained hospitalized for longer time periods (P=0.019). Postoperative complications occurred in 50% of the patients with creatinine increased, while only 27.1% of the patients with normal value of creatinine had complications (P=0.049). In addition, complications occurred in 50% of the patients with diabetes mellitus, while only 23.8% of patients without diabetes mellitus had complications (P=0.032). The intraoperative factors showed no statistically significant differences. Conclusion The preoperative factors are associated with postoperative complications in patients undergoing coronary artery bypass graft surgery. PMID:24598958

  6. Meta-analysis of the efficacy of extradural clonidine to relieve postoperative pain: an impossible task.

    PubMed

    Armand, S; Langlade, A; Boutros, A; Lobjoit, K; Monrigal, C; Ramboatiana, R; Rauss, A; Bonnet, F

    1998-08-01

    Clonidine, an alpha2 adrenoceptor agonist, has anti-hypertensive and anti-nociceptive effects. It is commonly used in association with local anaesthetics and opioids to enhance the quality and duration of extradural analgesia in the postoperative period, and to decrease the incidence of side effects. As a sole analgesic, it has seldom been used to relieve postoperative pain. The dose of extradural clonidine to achieve good pain relief without deleterious side effects remains undetermined. In order to address this problem, we performed a computer search via two well-known databases, Medline and Excerpta Medica, covering the period from 1985 to September 1997. One hundred and fifty-nine articles were retrieved of which 38 dealt with extradural clonidine and postoperative pain. All but 16 studies suffered from serious design flaws, such as lack of controls and/or randomization, or inadequate statistical analysis. The data from these studies were difficult to interpret because of the tremendous variation in variables, especially dose of clonidine, level of extradural injection, time of administration, type of anaesthesia, type of surgery, and reference and rescue drugs. The simultaneous extradural use of local anaesthetics and opioids further hindered data interpretation, and precluded any meta-analysis. Proposals for a standard study design are made to help comparison between studies involving extradural clonidine and postoperative pain. PMID:9813509

  7. Pedobarography in the Assessment of Postoperative Calcaneal Fracture Pressure With Gait.

    PubMed

    Genc, Yasin; Gultekin, Alper; Duymus, Tahir Mutlu; Mutlu, Serhat; Mutlu, Harun; Komur, Baran

    2016-01-01

    The purpose of the present study was to evaluate the benefits and importance of pedobarography in the diagnosis and treatment of plantar pressure changes in the postoperative follow-up of calcaneus fractures treated with open reduction and internal fixation. The 28 patients included 23 males (82%) and 5 females (18%). The clinical evaluation was performed using the American Orthopaedic Foot and Ankle Society hindfoot scoring system. The Böhler and Gissane angles were measured on the preoperative and postoperative radiographs. In the postoperative follow-up period (mean ± standard deviation 22.25 ± 10.8 months), all the patients underwent analysis with a dynamic pedobarogram. Because the arch index of the operated feet was 29.73% and that of the nonoperated feet was 28.94%, a similar slightly low arch was seen in both feet (p = .078). When the plantar surface maximum pressures were evaluated, a significant reduction was seen in the operated feet in the second, third, fourth, and fifth metatarsals and the medial hindfoot (p < .05). Displaced intra-articular calcaneus fractures resulted in a significant reduction in maximum pressure of the second, third, fourth, and fifth metatarsals and the medial hindfoot. Also, the hindfoot pressure was lateralized. Pedobarography is a simple and useful method for the diagnosis of plantar pressure changes occurring postoperatively. PMID:26364236

  8. Auditing Analgesic Use in Post-operative Setting in a Teaching Hospital

    PubMed Central

    Bathini, Prapthi

    2015-01-01

    Introduction: Managing postoperative pain efficiently is one important therapeutic challenge in the hospitals. Combination use of analgesics is in vogue, where in drugs from the opioid and non-opioid group are given synergistically. The aim of this study is to audit the use of different analgesics on the first postoperative day. Effort has been made to look into the drug or drug combinations used and other factors associated with their use. Materials and Methods: Retrospective, cross sectional observational study was conducted over a period of 11 months in a tertiary care teaching hospital at Hyderabad with approval from institutional ethics committee. Medical records of 649 patients on the first postoperative day were analysed for analgesics by various indicators. Results: Average number of drugs per encounter was 4.23. Percentage of patients prescribed drugs from national essential drug list/WHO was 81.94%. Most common analgesic (monotherapy) prescribed was tramadol followed by diclofenac and the most common combination drugs prescribed were tramadol+Paracetamol. The most common route of administration was intravenous. All the drugs except piroxicam, were in the lower limit of the recommended daily dose. Conclusion: The present study gives an idea of the overall pattern of analgesic drug use in postoperative patients. The drug combinations used, the most common single use drug can be made out. The health professionals can be encouraged to prescribe by generic name and from the National List of Essential Medicines NLEMs. PMID:26023565

  9. Patient stress in intensive care: comparison between a coronary care unit and a general postoperative unit

    PubMed Central

    Dias, Douglas de Sá; Resende, Mariane Vanessa; Diniz, Gisele do Carmo Leite Machado

    2015-01-01

    Objective To evaluate and compare stressors identified by patients of a coronary intensive care unit with those perceived by patients of a general postoperative intensive care unit. Methods This cross-sectional and descriptive study was conducted in the coronary intensive care and general postoperative intensive care units of a private hospital. In total, 60 patients participated in the study, 30 in each intensive care unit. The stressor scale was used in the intensive care units to identify the stressors. The mean score of each item of the scale was calculated followed by the total stress score. The differences between groups were considered significant when p < 0.05. Results The mean ages of patients were 55.63 ± 13.58 years in the coronary intensive care unit and 53.60 ± 17.47 years in the general postoperative intensive care unit. For patients in the coronary intensive care unit, the main stressors were “being in pain”, “being unable to fulfill family roles” and “being bored”. For patients in the general postoperative intensive care unit, the main stressors were “being in pain”, “being unable to fulfill family roles” and “not being able to communicate”. The mean total stress scores were 104.20 ± 30.95 in the coronary intensive care unit and 116.66 ± 23.72 (p = 0.085) in the general postoperative intensive care unit. When each stressor was compared separately, significant differences were noted only between three items. “Having nurses constantly doing things around your bed” was more stressful to the patients in the general postoperative intensive care unit than to those in the coronary intensive care unit (p = 0.013). Conversely, “hearing unfamiliar sounds and noises” and “hearing people talk about you” were the most stressful items for the patients in the coronary intensive care unit (p = 0.046 and 0.005, respectively). Conclusion The perception of major stressors and the total stress score were similar between patients in the coronary intensive care and general postoperative intensive care units. PMID:25909309

  10. Preoperative narcotic utilization: accuracy of patient self-reporting and its association with postoperative narcotic consumption.

    PubMed

    Ahn, Junyoung; Bohl, Daniel D; Tabaraee, Ehsan; Aboushaala, Khaled; Elboghdady, Islam M; Singh, Kern

    2016-01-01

    OBJECT Little is known about the accuracy of reporting of preoperative narcotic utilization in spinal surgery. As such, the purpose of this study is to compare postoperative narcotic consumption between preoperative narcotic utilizers who do and do not accurately self-report preoperative utilization. METHODS Patients who underwent anterior cervical discectomy and fusion, minimally invasive lumbar discectomy, or minimally invasive transforaminal lumbar interbody fusion procedures between 2013 and 2014 were prospectively identified. The accuracy of self-reporting preoperative narcotic consumption was determined utilizing the Illinois Prescription Monitoring Program. Total inpatient narcotic consumption during postoperative Days 0 and 1 was compared according to the demographics and preoperative narcotic reporting accuracy. Similarly, the proportion of patients who continued to be dependent on narcotic medications at each postoperative visit was compared according to the demographics and preoperative narcotic reporting accuracy. RESULTS A total of 195 patients met the inclusion criteria. Of these, 25% did not use narcotics preoperatively, while 47% and 28% did do so with accurate and inaccurate reporting, respectively. Patients who used narcotics preoperatively were more likely to demonstrate elevated inpatient narcotic consumption (adjusted RR 5.3; 95% CI 1.4-20.1; p = 0.013). However, such patients were no more or less likely to be dependent on narcotic medications at the first (p = 0.618) or second (p = 0.798) postoperative visit. Among patients who used narcotics preoperatively, no differences were demonstrated in terms of inpatient narcotic consumption (p = 0.182) or narcotic dependence following the first (p = 0.982) or second (p = 0.866) postoperative visit according to the self-reported accuracy of preoperative narcotic utilization. The only preoperative factors that were independently associated with elevated inpatient narcotic consumption were workers' compensation status and procedure type. The only preoperative factors that were independently associated with narcotic dependence at the first postoperative visit were female sex, workers' compensation status, and procedure type. The only preoperative factor that was independently associated with narcotic dependence at the second postoperative visit was procedure type. CONCLUSIONS The findings suggest that determining the actual preoperative narcotic utilization in patients who undergo spine surgery may help optimize postoperative pain management. Approximately 75% of patients used narcotics preoperatively. Patients who used narcotics preoperatively demonstrated significantly higher inpatient narcotic consumption, but this difference did not persist following discharge. Finally, postoperative narcotic consumption (inpatient and following discharge) was independent of the self-reported accuracy of preoperative narcotic utilization. Taken together, these findings suggest that corroboration between the patient's self-reported preoperative narcotic utilization and other sources of information (e.g., family members and narcotic registries) may be clinically valuable with respect to minimizing narcotic requirements, thereby potentially improving the management of postoperative pain. PMID:26360141

  11. [Comparative evaluation of efficacy of the upper part of the face endoscopic lifting in dynamics of postoperative period].

    PubMed

    Kozynets', H P; Pinchuk, V D; Tkach, O S

    2014-05-01

    Comparative estimation of results for endoscopic lifting of the face upper part in dynamics of early and late postoperative period was adduced. In accordance to results of analysis, concerning the eyebrows height in a control terms, there was established, that through one year postoperatively the eyebrows have a tendency towards ptosis due to activity of the eyes circular muscles. Deterioration of the result achieved post-operatively is less prominent in patients after preliminary chemical denervation of mimic muscles. Chemical denervation of the eyes circular muscles, using injections of botulinic toxine type A before 2 weeks preoperatively secures a stable fixation of tissues in early postoperative period, what permits to escape loss of the result achieved, secures the results improvement in late postoperative period in 3.7 times. PMID:25675766

  12. Postoperative pain, nausea and vomiting among pre- and postmenopausal women undergoing cystocele and rectocele repair surgery

    PubMed Central

    Abaszadeh, Abolfazl; Yari, Fatemeh; Yousefi, Nazanin

    2015-01-01

    Background Postoperative nausea and vomiting (PONV) and postoperative pain are among the most common side-effects of surgery. Many factors, such as a change in the level of sex hormones, are reported to affect these complications. This study aimed to evaluate the probable effects of the menopause on PONV and postoperative pain. Methods Prospective study, in which a total number of 144 female patients undergoing cystocele or rectocele repair surgery under standardized spinal anesthesia were included. Patients were divided into two equally sized sample groups of pre- and postmenopausal women (n = 72). The occurrence of PONV, the severity of pain as assessed by visual analog scale (VAS) pain score, and the quantity of morphine and metoclopramide required were recorded at 2, 4, 6, 12, 18 and 24 h after surgery. Results The mean VAS pain score and the mean quantity of morphine required was higher among premenopausal women (P = 0.006). Moreover, these patients required more morphine for their pain management during the first 24 h after surgery compared to postmenopausal women (P < 0.0001). No difference was observed between the two groups regarding the incidence of PONV (P = 0.09 and P = 1.00 for nausea and vomiting, respectively) and the mean amount of metoclopramide required (P = 0.38). Conclusions Premenopausal women are more likely to suffer from postoperative pain after cystocele and rectocele repair surgery. Further studies regarding the measurement of hormonal changes among surgical patients in both pre- and postmenopausal women are recommended to evaluate the effects on PONV and postoperative pain. PMID:26634082

  13. Thirty days post-operative mortality after surgery for colorectal cancer: a descriptive study

    PubMed Central

    van Eeghen, Elmer E.; den Boer, Frank C.

    2015-01-01

    Background The goal of surgery for colorectal cancer is cure. Unfortunately post-operative mortality occurs. This study aims to identify co-morbidity and causes of mortality in the post-operative period in relation to direct technical complications of surgery. Methods All consecutive patients who underwent surgery for colorectal cancer were included. Co-morbidity was determined via the Charlson co-morbidity score. The post-operative course was studied and cause of death within 30 days was determined. Patients were divided in two groups: group 1 died within 30 days after surgery and group 2 survived for longer than 30 days. Results Twenty three out of 333 patients (6.9%) with colon cancer and 6 out of 112 (5.3%) with rectal cancer died in the post-operative period. Patients in group 1 were significantly older than patients in group 2 (P<0.001). Patients in group 1 with colon cancer also significantly had more often a higher stage of cancer (P=0.03). The Charlson co-morbidity score for patients with colon cancer in group 1 was mean 5.17 (SD 1.57, range, 1-8), and for rectal cancer mean 4.83 (SD 2.32, range, 2-7). There was no difference in Charlson co-morbidity score when patients from groups 1 and 2 were compared. In group 1, 13 (44%) died as a direct consequence of technical surgical complications. Sixteen patients died due to complications because of pre-existing co-morbidity. Conclusions Post-operative mortality very often is the direct result of pre-existing co-morbidity and not always the direct result of the surgical procedure. PMID:26697192

  14. A Comparison of Postoperative Outcomes in Immediate Versus Delayed Reconstruction After Mastectomy

    PubMed Central

    Massenburg, Benjamin B.; Rozehnal, John M.; Gupta, Nachi; Rosa, Jonatan Hernandez; Ingargiola, Michael J.; Taub, Peter J.

    2015-01-01

    Objective: The objective of this study was to evaluate the frequency of various postoperative complications in patients undergoing either immediate or delayed breast reconstruction after mastectomy for malignancy. Methods: The ACS-NSQIP 2005–2012 database was queried for patients who underwent mastectomy for the treatment of breast malignancy. These mastectomy cases were then stratified, generating “mastectomy alone” and “mastectomy with immediate reconstruction” cohorts. Database analysis also identified “delayed-reconstruction” oncologic patients. All patients undergoing reconstruction were then stratified into the tissue expander/implant or flap-based reconstruction group. The frequency of postoperative complications was assessed. A multiplicative risk model was used to calculate the probability of postoperative complications after undergoing a mastectomy alone, followed by reconstruction on a different date. These values were compared with the frequency of postoperative complications in the “mastectomy with immediate reconstruction” cohort, and 1-sample binomial tests were performed to determine statistical significance. Results: A total of 49,450 cases that underwent either mastectomy alone (n = 30,226), mastectomy with immediately tissue expander/implant reconstruction (n = 13,513), mastectomy with immediate flap reconstruction (n = 2854), delayed tissue expander/implant reconstruction (n = 2047), or delayed flap reconstruction (n = 810) were identified. When compared with a delayed reconstructive model, immediate reconstruction after mastectomy was associated with increased flap or tissue expander/implant failure. However, delayed reconstructive modalities were associated with increased postoperative medical and surgical complications. Finally, in flap-based reconstruction, the incidence of return to the operating room was higher in delayed reconstruction than in immediate reconstruction. Conclusions: Awareness of complications associated with each reconstructive modality will allow both surgeons and patients to effectively decide upon reconstructive options. PMID:26483861

  15. Nebulized ketamine decreases incidence and severity of post-operative sore throat

    PubMed Central

    Ahuja, Vanita; Mitra, Sukanya; Sarna, Rashi

    2015-01-01

    Background and Aims: Post-operative sore throat (POST) occurs in 21-65% of patients. Ketamine used earlier as gargle for reducing POST has limitations. The aim of this study was to see if nebulised ketamine reduces POST. Methods: We conducted a prospective, randomised, placebo-control, and double-blind controlled trial. After written informed consent, 100 patients belonging to American Society of Anaesthesiologists physical status I-II in the age group 20-60 years, of either sex undergoing surgery under general anaesthesia (GA) were enrolled. Patients were randomised into two groups; group saline (S) received saline nebulisation 5.0 ml and group ketamine (K) received ketamine 50 mg (1.0 ml) with 4.0 ml of saline nebulisation for 15 min. GA was induced 10 min after completion of nebulisation in the patients. The POST and haemodynamic monitoring were done pre-nebulization, pre-induction, on reaching post-anaesthesia care unit, and at 2, 4, 6, 8, 12 and 24 h post-operatively. POST was graded on a four-point scale (0-3). Results: The overall incidence of POST was 33%; 23 patients (46%) in saline and 10 patients (20%) in ketamine group experienced POST (Fisher's exact P = 0.01). The use of ketamine nebulization attenuated POST at 2 h and 4 h post-operatively (P < 0.05). The primary outcome was incidence of POST at 4 h; 13 patients in group S versus 4 patients in group K (P = 0.03) experienced POST at 4 h. The moderate sore throat occurred in 6 patients in group S and none in group K at 2 h, post-operatively (P = 0.02). Conclusion: Ketamine nebulization significantly attenuated the incidence and severity of POST, especially in the early post-operative period, with no adverse effects. PMID:25684812

  16. Perioperative synbiotics decrease postoperative complications in periampullary neoplasms: a randomized, double-blind clinical trial.

    PubMed

    Sommacal, Heloisa Martins; Bersch, Vivian Pierri; Vitola, Santo Pascoal; Osvaldt, Alessandro Bersch

    2015-01-01

    Periampullary neoplasms are rapidly progressive tumors with a poor prognosis and high morbidity and mortality rates, which have a negative influence on patient outcomes. Some probiotics and prebiotics have the ability to protect the intestinal barrier and prevent bacterial translocation, infection, and postoperative complications. We evaluated the use of synbiotics in a prospective, double-blind study of patients undergoing surgery for periampullary neoplasms (PNs) and assessed the effect of these agents on nutritional status, postoperative complications, antibiotic use, length of hospital stay, and mortality. Patients were randomized to receive probiotics and prebiotics-synbiotics--group S [Lactobacillus acidophilus 10, 1 × 10(9)CFU, Lactobacillus rhamnosus HS 111, 1 × 10(9) CFU, Lactobacillus casei 10, 1 × 10(9) CFU, Bifidobacterium bifidum, 1 × 10(9)CFU, and fructooligosaccharides (FOS) 100 mg]--or placebo-controls--group C, twice daily, for a total of 14 days. Risk, clinical status, and postoperative complication rates were assessed. Twenty-three patients were allocated to each group. The incidence of postoperative infection was significantly lower in group S (6 of 23 patients, 26.1%) than in group C (16 of 23 patients, 69.6%) (P = 0.00). Duration of antibiotic therapy was also shorter in group S (mean = 9 days vs. 15 days in group C; P = 0.01). Noninfectious complications were less common in group S (6 of 23 vs. 14 of 23 patients in group C; P = 0.03). Mean length of hospital stay was 12 ± 5 days in group S vs. 23 ± 14 days in group C (P = 0.00). No deaths occurred in group S, whereas 6 deaths occurred in group C (P = 0.02). Perioperative administration of synbiotics reduces postoperative mortality and complication rates in patients undergoing surgery for PNs. PMID:25803626

  17. Risk factors of postoperative recurrences in patients with clinical stage I NSCLC

    PubMed Central

    2014-01-01

    Background Despite advances in radiation therapy, chemotherapy, and newly developed molecular targeting therapies, long-term survival after resection for patients with NSCLC remains less than 50%. We investigated factors predicting postoperative locoregional recurrences and distant metastases in patients with clinical stage I non-small-cell lung cancer (NSCLC) after surgical resection. Methods All patients with clinical stage I NSCLC, who underwent surgical resection between January 2002 and June 2006, were reviewed retrospectively. Multiple logistic regression analyses were used to identify independent risk factors for patients with locoregional recurrences and distant metastases. Results A total of 261 patients were eligible. Overall survival was significant related to locoregional recurrences (P?=?0.03) and distant metastases (P <0.001). There were significant differences of locoregional recurrence in tumor differentiation (P?=?0.032) and advanced pathological stage (P?=?0.002). In the group of distant metastases, there were significant differences in tumor differentiation (P?=?0.035), lymphovascular space invasion (P?=?0.031). Among the relationship between pattern of distant metastasis and clinicopathologic variables in patients with clinical stage I NSCLC, SUVmax (P?=?0.02) and tumor size (P?=?0.001) had significant differences. According to multiple logistic regression analysis, tumor differentiation is the only risk factor of postoperative outcome for locoregional recurrence and serum CEA (>3.5 ng/mL) is the predictor of distant metastasis. Conclusions Tumor differentiation and serum CEA were predictors of postoperative relapse for clinical stage I NSCLC after surgical resection. Risk factors of postoperative recurrence in patients with clinical stage I NSCLC may enable us to optimize the patient selection for postoperative adjuvant therapies or neoadjuvant treatment before surgery. PMID:24410748

  18. Postoperative pain management with transdermal fentanyl after forefoot surgery: a randomized, placebo-controlled study

    PubMed Central

    Merivirta, Riika; Pitkänen, Mikko; Alanen, Jouko; Haapoja, Elina; Koivisto, Mari; Kuusniemi, Kristiina

    2015-01-01

    Background Quality of life is decreased in patients with hallux valgus deformity, mainly because of pain. Significant improvement is usually achieved by surgery. However, postoperative pain can be moderate to severe for 2–3 days. The aim of the present study was to evaluate the use of transdermal fentanyl for postoperative pain management after forefoot surgery. Methods Sixty patients undergoing hallux valgus or hallux rigidus surgery were allocated to receive a patch delivering either fentanyl 12 ?g/hour or placebo for postoperative pain. The consumption of rescue opioid oxycodone, the primary outcome measure, was evaluated daily until the fourth postoperative day. Total consumption of oxycodone during the study period was also assessed. Pain scores and possible adverse effects were evaluated every 6 hours during the first 24 hours and on the fourth postoperative day. Results The use of rescue opioid was low in both groups, the median (range) consumption of oxycodone being 10 (0–50) mg on the day of surgery (no difference between the groups, P=0.31) and 0 (0–35) mg thereafter. The total combined consumption was 10 (0–105) mg in the fentanyl group and 20 (0–70) mg in the placebo group (P=0.23). There were no statistically significant differences in pain scores or adverse effects between the groups. Conclusion As a part of multimodal analgesia with ibuprofen and acetaminophen, a patch delivering fentanyl 12 ?g/hour did not significantly decrease the consumption of rescue opioid or pain scores after forefoot surgery. PMID:25653553

  19. Preoperative Versus Postoperative Radiotherapy in Soft-Tissue Sarcoma: Multi-Institutional Analysis of 821 Patients

    SciTech Connect

    Sampath, Sagus; Schultheiss, Timothy E.; Hitchcock, Ying J.; Randall, R. Lor; Shrieve, Dennis C.; Wong, Jeffrey Y.C.

    2011-10-01

    Purpose: To assess the impact of radiotherapy (RT) sequencing with surgery on overall survival (OS), cause-specific survival (CSS), local failure, and distant failure in soft-tissue sarcoma (STS). Methods and Materials: A retrospective analysis was conducted using the National Oncology Database, a proprietary database of aggregated tumor registries owned by IMPAC Medical Systems (Sunnyvale, CA). Patients with STS of all major anatomic sites who received definitive surgery and either preoperative (preop) or postoperative (postop) RT were included. Patients were also required to have known stage and grade. Prognostic factors for survival were identified using multivariate techniques. Survival was calculated using the Kaplan-Meier method, and compared for statistical significance (p < 0.05) using the log-rank test. Results: A total of 821 patients met inclusion criteria. The median follow-up time was 63 months. Age, stage, histology, gender, tumor size, and RT sequence were independent predictors for OS (p < 0.05). Preop RT was associated with significantly improved OS and CSS compared with postop RT (hazard ratio [HR] = 0.72, 95% confidence interval [CI] 0.56-0.91, p < 0.01, and HR = 0.64, 95% CI 0.46-0.88, p < 0.01, respectively). The 5-year CSS was 79% and 74%, in favor of preop RT (log-rank, p < 0.05). Preop RT was also significantly associated with a reduced risk for local and distant relapse compared with postop RT. Conclusion: Preoperative RT is associated with a reduced cancer-specific mortality compared with postoperative RT in STS. The results of this study may serve as motivation to conduct future prospective studies with larger patient numbers.

  20. Is low serum albumin associated with postoperative complications in patients undergoing cardiac surgery?

    PubMed

    Karas, Pamela L; Goh, Sean L; Dhital, Kumud

    2015-12-01

    A best evidence topic was written according to a structured protocol. The clinical question investigated was: is low serum albumin associated with postoperative complications in patients undergoing cardiac surgery? There were 62 papers retrieved using the reported search strategy. Of these, 12 publications embodied the best evidence to answer this clinical question. The authors, journal, date and country of the publication, patient group investigated, study design, relevant outcomes and results of these papers were tabulated. This paper includes a total of 12 589 patients, and of the papers reviewed, 4 were level 3 and 8 level 4. Each of the publications reviewed and compared either all or some of the following postoperative complications: mortality, postoperative bleeding requiring reoperation, prolonged hospital stay and ventilatory support, infection, liver dysfunction, delirium and acute kidney injury (AKI). Of the studies that examined postoperative mortality, all except for three established a significant multivariate association with low preoperative albumin level. Some scepticism is required in accepting other results that were only present in univariate analysis. While three studies examined multiple levels of serum albumin, most dichotomized the serum albumin levels into normal and abnormal groups. This led to differing classifications of hypoalbuminaemia, ranging from less than 2.5 to 4.0 g/dl. The available evidence, however, suggests that low preoperative serum albumin level in patients undergoing cardiac surgery is associated with the following: (i) increased risk of mortality after surgery and (ii) greater incidence of postoperative morbidity. While the evidence supports the use of preoperative albumin in assessing post-cardiac surgery complications, a specific level of albumin considered to be abnormal cannot be concluded from this review. PMID:26362629