Clinical Study Routine Follow-Up Cranial Computed Tomography for Deeply Sedated, Intubated, and Ventilated Multiple Trauma Patients with Suspected Severe Head Injury

Background. Missed or delayed detection of progressive neuronal damage after traumatic brain injury (TBI) may have negative impact on the outcome. We investigated whether routine follow-up CT is beneficial in sedated and mechanically ventilated trauma patients. Methods. The study design is a retrospective chart review. A routine follow-up cCT was performed 6 hours after the admission scan. We defined 2 groups of patients, group I: patients with equal or recurrent pathologies and group II: patients with new findings or progression of known pathologies. Results. A progression of intracranial injury was found in 63 patients (42%) and 18 patients (12%) had new findings in cCT 2 (group II). In group II a change in therapy was found in 44 out of 81 patients (54%). 55 patients with progression or new findings on the second cCT had no clinical signs of neurological deterioration. Of those 24 patients (44%) had therapeutic consequences due to the results of the follow-up cCT. Conclusion. We found new diagnosis or progression of intracranial pathology in 54% of the patients. In 54% of patients with new findings and progression of pathology, therapy was changed due to the results of follow-up cCT. In trauma patients who are sedated and ventilated for different reasons a routine follow-up CT is beneficial

Der Erbnachweis gegenüber Kreditinstituten in der Dogmatik des deutschen Privatrechts | Zugleich eine Analyse ausgewählter Nachweismöglichkeiten

Aus den Grundprinzipien des deutschen Erbrechts – Gesamtrechtsnachfolge und Vonselbsterwerb – resultiert ein Spannungsverhältnis zwischen dem Interesse der Kreditinstitute an einer rechtssicheren Legitimation einerseits und dem Interesse des oder der Erben an einer kostengünstigen und zügigen Nachlassregulierung andererseits. Hiervon ausgehend entwickelt die Arbeit in methodenreflektierter Anwendung der Grundsätze juristischer Hermeneutik die Antwort des Gesetzes auf die Frage nach den Anforderungen, die an den Nachweis des Erbrechts zu stellen sind. Zu diesem Zweck wird hinter das vom Gesetzgeber Gedachte zurückgegangen und sodann auf Basis der legislativen Wertungen herausgearbeitet, dass das Gesetz in Bezug auf den Schutz des Rechtsverkehrs lückenhaft ist. Aus dieser Erkenntnis wird ein Grundsatz für den Erbnachweis gegenüber Kreditinstituten abgeleitet. Abschließend werden die Grenzen des gewonnenen Grundsatzes aufgezeigt.»Proof of Inheritance to Credit Institutions in the Doctrine of German Private Law«: The question of the requirements for proof of inheritance has occupied the courts since the BGB came into force. The background to this is the underlying tension between the interest of banks in legally secure legitimation on the one hand and the interest of the heir or heirs in a cost-effective and speedy settlement of the estate on the other. The present study examines how the question raised can be answered in accordance with the values of the law

Routine Follow-Up Cranial Computed Tomography for Deeply Sedated, Intubated, and Ventilated Multiple Trauma Patients with Suspected Severe Head Injury

Background. Missed or delayed detection of progressive neuronal damage after traumatic brain injury (TBI) may have negative impact on the outcome. We investigated whether routine follow-up CT is beneficial in sedated and mechanically ventilated trauma patients. Methods. The study design is a retrospective chart review. A routine follow-up cCT was performed 6 hours after the admission scan. We defined 2 groups of patients, group I: patients with equal or recurrent pathologies and group II: patients with new findings or progression of known pathologies. Results. A progression of intracranial injury was found in 63 patients (42%) and 18 patients (12%) had new findings in cCT 2 (group II). In group II a change in therapy was found in 44 out of 81 patients (54%). 55 patients with progression or new findings on the second cCT had no clinical signs of neurological deterioration. Of those 24 patients (44%) had therapeutic consequences due to the results of the follow-up cCT. Conclusion. We found new diagnosis or progression of intracranial pathology in 54% of the patients. In 54% of patients with new findings and progression of pathology, therapy was changed due to the results of follow-up cCT. In trauma patients who are sedated and ventilated for different reasons a routine follow-up CT is beneficial