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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Anaesthesist 49 (2000), S. 371-372 
    ISSN: 1432-055X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Der Anaesthesist 49 (2000), S. 253-254 
    ISSN: 1432-055X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK and Boston, USA : Blackwell Publishing Ltd
    Financial accountability and management 19 (2003), S. 0 
    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
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Notfall + Rettungsmedizin 3 (2000), S. 63-63 
    ISSN: 1436-0578
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Notfall + Rettungsmedizin 3 (2000), S. 64-71 
    ISSN: 1436-0578
    Keywords: Schlüsselwörter Notfallmedizin ; Ausstattung ; Diagnostik ; Überwachung ; Transport ; Therapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die Zielsetzung dieses mit Unterstützung der Stiftung BINZ durchgeführten Workshops bestand darin, Vorgaben für eine sinnvolle und den Aufgaben entsprechende Ausstattung der Rettungsmittel (Abb. 1) zur Diagnose, Überwachung und Therapie bei Notfallpatienten durch Normen und Gesetze zu definieren. Dazu war es notwendig, die behandlungsbedürftigen Krankheitsbilder zu analysieren, daraus die Anforderungen für die Ausstattung abzuleiten und zu begründen, die Sinnhaftigkeit von Parametern für die Diagnostik und Überwachung zu prüfen, Empfehlungen für die Ergonomie der Arbeitsplätze zu erstellen und schließlich Fragen der Dokumentation und des Datentransfers zu erörtern. Dabei wurden auch Fragen und Probleme präzisiert und einer Bearbeitung durch die zuständigen Gremien in der DIVI oder der BAND zugeordnet. Tabelle 1 bietet eine Übersicht über die Referenten des Workshops und die von ihnen vorgestellten Themenbereiche. Die hier vorliegende Zusammenstellung kann bei der umfassenden Thematik selbstverständlich nicht alle Details der Empfehlungen und Begründungen enthalten. Sie soll aber einen Überblick über die Grundsätze der Empfehlungen vermitteln.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Notfall + Rettungsmedizin 3 (2000), S. 104-106 
    ISSN: 1436-0578
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Patienten mit Kammerflimmern und pulsloser ventrikulärer Tachykardie sowie mit Tachykardien und klinischen Zeichen der Instabilität werden bisher unter Anwendung monophasischer Stromkurven defibrilliert bzw. kardiovertiert. Bereits Ende der 60er Jahre wurden in Rußland alternativ biphasische Stromkurven angewandt [4]. Seit Beginn der 80er Jahre wird diese Technik auch im anglo-amerikanischen Raum untersucht. Nach der Anwendung in implantierten Cardiovertern-Defibrillatoren (AICD) [9] steht seit Ende 1996 ein halbautomatisches Gerät für die transthorakale Anwendung zur Verfügung. Der folgende Fallbericht schildert die erfolgreiche Kardioversion mit biphasischer Technik als Ultima Ratio-Maßnahme bei supraventrikulärer Tachykardie.
    Type of Medium: Electronic Resource
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  • 7
    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
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 120 (2000), S. 176-178 
    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
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