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  • 1
    ISSN: 0340-1855
    Keywords: Schlüsselwörter Sakroiliitis ; Spondylarthropathie ; Magnetresonanztomographie ; Strahlenexposition ; Kosteneffektivität ; Key words Sacroiliitis ; Spondyloarthropathy ; magnetic resonance imaging ; radiation ; exposure ; cost effectiveness
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Involvement of the sacroiliac joints is a hallmark of the spondyloarthropathies, especially in ankylosing spondylitis. The conventional diagnostic imaging of sacroiliitis in early stages might cause problems, because sensitivity of conventional radiographic methods is known to be too low in early stages of the disease. Magnetic resonance imaging of the sacroiliac joints certainly enables one to detect acute as well as chronic inflammatory changes in all stages of the disease. The potential disadvantages of this method are the dependency on the examiner, the lack of standardization, and the relatively high costs. Therefore, the „Workgroup of Diagnostic Imaging in Rheumatology of the Regional Center of Rheumatology of Berlin“ including experienced rheumatologists, skeletal radiologists, and orthopedists acquired an imaging graduation for detection of sacroiliitis in consideration of the clinical background, the technical details of the methods, questions of ionizing radiation exposure, and cost effectiveness.
    Notes: Zusammenfassung Die entzündliche Beteiligung der Sakroiliakalgelenke ist das Schlüsselsymptom der Spondylarthropathien, vor allem bei der ankylosierenden Spondylitis. Die konventionelle bildgebende Diagnostik der Sakroiliitis gilt in den Frühstadien als problematisch, da die Sensitivität konventioneller Röntgenaufnahmen hier sehr gering ist. Die Magnetresonanztomographie der Sakroiliakalgelenke ist in der Lage, sowohl akut entzündliche als auch chronische Veränderungen in allen Stadien zu erfassen. Mögliche Nachteile dieser Methode sind Untersucherabhängigkeit, bislang fehlende Standardisierung sowie die noch relativ hohen Kosten. Deshalb hat der „Arbeitskreis bildgebende Diagnostik in der Rheumatologie des Regionalen Rheumazentrums Berlin“, welcher sich aus erfahrenen Rheumatologen, Skelettradiologen und Orthopäden zusammensetzt, eine Übersicht der bildgebenden Diagnostik der Sakroiliitis erarbeitet, in welcher neben dem klinischen Hintergrund auch technische Details ausgeführt und Strahlenexposition und Kosteneffektivität berücksichtigt werden.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1076
    Keywords: Key words Longitudinal studies ; Growth ; Infant ; Short-term measurement ; Clinical practice
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A longitudinal growth study with monthly measurements during the 1st year of life was conducted by nine paediatricians working in private practice in Zurich. Of 92 children, none was lost to the study and only 32 of 1104 planned visits were missed; the quality of the measurements was comparable to that of a specialised university clinic. Compared to the Zurich Longitudinal Growth Studies, children of this study were considerably heavier and taller. In 92% of the subjects, growth velocity was at least once outside the reference range (3rd–97th percentile). For weight increments, the corresponding proportion was 87%. Conclusions The data indicate that current standards for the 1st year of life for the Zurich area might no longer be appropriate and need to be updated. The currently used velocity percentiles based on 3-monthly measurements are not suitable to assess individual height and weight increments calculated from monthly measurements.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 1303-1310 
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopic cholecystectomy — Bile duct injuries
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We set out to analyze the technical aspects, intraoperative complications, morbidity, and mortality of laparoscopic cholecystectomy in a multi-institutional study representative of Switzerland. Methods: Data were collected from 10,174 patients from 82 surgical services. A total of 353 different parameters per patient were included. Results: We found intraoperative complications in 34.4% of patients and had a conversion rate of 8.2%. This rate was significantly increased in patients with complicated cholelithiasis and in those with previous upper—but not lower—abdominal surgery. In most cases, conversions to open procedures were required because of technical difficulties due to inflammatory changes and/or unclear anatomical findings at the time of operation. Bleeding was a common intraoperative complication, that significantly increased the risk of conversion. Patients with loss of gallstones in the peritoneal cavity had increased rates of abscesses. The rate of common bile duct injuries was 0.31%, but it decreased significantly as the laparoscopic experience of the surgeon increased. The rate of common bile duct injuries was not increased in patients with acute cholecystitis or in the 1.32% of patients undergoing laparoscopic common bile duct exploration. Intraoperative cholangiography did not reduce the risk of common bile duct injuries, but it allowed them to be diagnosed intraoperatively in 75% of patients. Local complications were recorded in 4.79% of patients, and systemic complications were seen in 5.59%. The mortality rate was 0.2%. Conclusions: Although laparoscopic cholecystectomy is a safe procedure, the rate of conversion to open cholecystectomy is still substantial. The conversion rate depends both on the indication and intraoperative complications. There is still a 10.38% morbidity associated with the procedure; however, the incidence of common bile duct injuries, which decreases with growing laparoscopic experience, was relatively low.
    Type of Medium: Electronic Resource
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