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  • 1
    Electronic Resource
    Electronic Resource
    Policy Making on Reserves of Dutch University Hospitals: A Case Study (2003)
    Oxford, UK and Boston, USA : Blackwell Publishing Ltd
    Financial accountability and management 19 (2003), S. 0 
    Details
    ISSN: 1468-0408
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Economics
    Notes: Organizations in the health care sector are increasingly managed and judged on the basis of economic criteria. Because they are faced with growing risks, reserves need to be sufficiently high. This paper entails a case study on policy making regarding reserves in a particular segment of the Dutch health care sector, i.e. university hospitals. After describing the various major risks of health care organizations, the three stages of the case study will be presented. First, we developed, in collaboration with experts from the university hospitals, a model for establishing sufficient reserves. Second, an advisory committee of the Dutch government formulated guidelines for policy making on this issue. Finally, after the recommendations of this committee became the basis for policy making on reserves, we examined the changes in the actual reserve policy of the university hospitals. The way in which health care organizations can cope with their perceived risks by establishing sufficient reserves or by taking other actions is hardly covered in the literature on public sector or not–for–profit organizations. This paper endeavours to raise relevant questions and to suggest preliminary answers by describing and critically appraising a case study on this subject.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/1468-0408.00161
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  • 2
    Electronic Resource
    Electronic Resource
    Die Bedeutung der Spurenelemente im Rahmen einer parenteralen Ernährung am Beispiel der Elemente Kupfer, Zink und Chrom (1975)
    Springer
    European journal of nutrition 14 (1975), S. 302-308 
    Details
    ISSN: 1436-6215
    Source: Springer Online Journal Archives 1860-2000
    Topics: Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition , Medicine
    Description / Table of Contents: Summary Biochemical function and biological significance of Cu, Zn and Cr are revieved briefly. During a longterm parenteral nutrition a depletion of the organism of copper and zinc is to be expected. Therefore, in parenteral nutrition, an early substitution of zinc seems to be usefull. Up to now a similar recommendation for copper cannot be given. As many infusion solutions are contaminated with chromium, there is no need to substitute this element in parenteral nutrition.
    Notes: Zusammenfassung Biochemische Funktion und biologische Bedeutung von Cu, Zn und Cr werden kurz dargestellt. Im Rahmen einer langfristigen parenteralen Ernährung sind Kupfer- und Zinkmangelerscheinungen zu erwarten. Ihre Auswirkungen auf den Stoffwechsel werden diskutiert, und eine frühzeitige Zinksubstition wird empfohlen. Bei Kupfer können die Autoren keine entsprechende Empfehlung geben. Eine Chromsubstitution bei parenteraler Ernährung scheint nicht notwendig zu sein, da verschiedene untersuchte Infusionslösungen mit Chrom verunreinigt sind.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02025868
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Total hip arthroplasty after arthrodesis of the hip joint (2000)
    Springer
    Archives of orthopaedic and trauma surgery 120 (2000), S. 176-178 
    Details
    ISSN: 1434-3916
    Keywords: Key words Hip arthrodesis ; Total hip arthoplasty
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The results of 15 conversions of a hip arthrodesis into a total hip arthroplasty performed in the years 1980–¶1995 are reported. Fifteen patients (8 men, 7 women) underwent total hip arthroplasty 30.9 (range 2–61) years after spontaneous or operative fusion of a hip joint. The primary indications of the conversion were low-back pain ¶(n = 10), knee pain (n = 2) and hip problems (n = 3). At follow-up examination 5.4 (range 2–13.3) years postoperatively, the Harris Hip Score averaged 86.0 (range 70.1–¶99.0). Six patients were pain-free, 7 had less pain, 2 felt no improvement of pain. All patients confirmed that they would undergo the operation again. The Trendelenburg sign was negative or mild in 8 patients and moderate to severe in 7. Aseptic loosening of 2 stems (1 cemented, 1 cementless) and 2 deep infections required revision surgery. We conclude that this operation can lead to satisfactory results even after a long duration of the arthrodesis. However, full function with no pain and a negative Trendelenburg sign could be obtained in only 20% (3/15) of the cases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050038
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  • 4
    Electronic Resource
    Electronic Resource
    Traumapatienten – Vergleichbare Datenlage herstellen (2000)
    Springer
    Der Anaesthesist 49 (2000), S. 253-254 
    Details
    ISSN: 1432-055X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050825
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  • 5
    Electronic Resource
    Electronic Resource
    Forschung – Publikationen – Impact-Faktoren –“-Mittel”-Korruption Gedanken zu einem deutschen Phänomen (2000)
    Springer
    Der Anaesthesist 49 (2000), S. 371-372 
    Details
    ISSN: 1432-055X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010070104
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    Paper (German National Licenses)
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  • 6
    Electronic Resource
    Electronic Resource
    Raised plasma kininogen levels in rheumatoid patients—Response to therapy with nonsteroidal anti-inflammatory drugs (1976)
    Springer
    Inflammation research 6 (1976), S. 449-450 
    Details
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01973257
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    Paper (German National Licenses)
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  • 7
    Electronic Resource
    Electronic Resource
    A novel relationship between plasma kininogen and rheumatoid disease (1976)
    Springer
    Inflammation research 6 (1976), S. 147-153 
    Details
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Plasma kininogen levels in the peripheral venous blood of untreated patients with active rheumatoid disease was found to be more than twice the levels measured in healthy normal individuals or in convalescing uncomplicated fracture patients. Treatment with oral indomethacin or aspirin lowered the kininogen levels nearly to normal. Sequential studies showed that the fall in kiniogen was very rapid, occurring within 1–2 hours of ingestion of drug, and was parallelled by reduction in the clinical indices of inflammation. Control studies showed that the kininogen changes were not due to changes in plasma volume or non-specific changes in plasma protein concentration. Indomethacin treatment had no effect on plasma kininogen levels in healthy volunteers. The significance of this finding will be discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01972199
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    Paper (German National Licenses)
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  • 8
    Electronic Resource
    Electronic Resource
    Suitability of non-glucose-carbohydrates for parenteral nutrition (1975)
    Springer
    Intensive care medicine 1 (1975), S. 105-113 
    Details
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Postoperative parenteral nutrition can only be optimally effective if the characteristics of post-traumatic metabolism are taken into account. Two main possibilities are discussed for the carbohydrate component of parenteral nutrition during this phase: glucose with high doses of insulin or non-glucose carbohydrates (sugar substitutes) possibly in a suitable combination with glucose. The risks as well as the technical and organisational problems involved in the use of them are discussed and the authors prefer the second of the two alternatives. Possible side effects of nonglucose carbohydrates are pointed out and it is shown how these can be avoided by observing dose guidelines. So far a combination of fructose : glucose : xylitol in a ratio of 2 : 1 : 1 with a total dose of 0.50 g/kg/hour has been studied most thoroughly. This combination normalises the fat metabolism and improves glucose tolerance without requiring exogenous insulin. Experiences with this combination as well as individual non-glucose carbohydrates in the postoperative phase are mentioned. Controlled infusions of non glucose carbohydrates on operated patients have been given continuously for up to 7 days and in some cases even for several weeks. No side effects, no deviations from a steady state and no abnormal changes of the laboratory values occurred. The authors are of the opinion that non glucose carbohydrates are necessary if the facilities for frequent blood sugar controls are not available.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00571657
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  • 9
    Electronic Resource
    Electronic Resource
    Ischemia/reperfusion-induced changes in intracellular free Ca2+ levels in rat skeletal muscle fibers – an in vivo study (2000)
    Springer
    Pflügers Archiv 440 (2000), S. 302-308 
    Details
    ISSN: 1432-2013
    Keywords: Flow motion Indo-1/AM Intracellular calcium Intravital microscopy Ischemia/reperfusion Local flow pattern
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Accumulation of intracellular free calcium (Ca2+ i) may play an essential role in the ischemia/reperfusion injury of skeletal muscle. Although it has been shown that Ca2+ i levels significantly increase during ischemia/reperfusion, it is still a matter of debate whether Ca2+ i increases during ischemia alone. It was the aim of this study to monitor the in vivo Ca2+ i levels in the rat spinotrapezius muscle during ischemia of varying duration and reperfusion, using a ratiometric fluorescence technique, and to investigate the relationship between the postischemic flow patterns and Ca2+ i, if any. The muscle was loaded with Indo-1/AM and imaged by a cooled digital camera. Pre- and postischemic tissue perfusion was assessed by means of an analogue camera. Our results show that short-term ischemia (5, 15 and 30 min) and subsequent reperfusion (60 min) does not alter Ca2+ i homeostasis and that tissue perfusion promptly recovers after the insult. One or two hours of ischemia resulted in changes in Ca2+ i levels, varying from preparation to preparation; increases in some and no changes in others. In these preparations three distinct flow patterns – normal, compromised and no-reflow – could be distinguished during the 60-min reperfusion. Our main conclusion is that in skeletal muscle Ca2+ i levels may increase, the increase probably depending on the muscle fiber type exposed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004240000287
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  • 10
    Electronic Resource
    Electronic Resource
    Parenterale Ernährung (1976)
    Springer
    Langenbeck's archives of surgery 343 (1976), S. 251-265 
    Details
    ISSN: 1435-2451
    Keywords: Parenteral nutrition ; Amino acids ; Carbohydrates ; Fats ; Water and electrolyte requirements
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01300572
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