Laser treatment in diabetic retinopathy

Diabetic retinopathy is a leading cause of visual impairment and blindness in developed countries due to macular edema and proliferative diabetic retinopathy (PDR). For both complications laser treatment may offer proven therapy: the Diabetic Retinopathy Study demonstrated that panretinal scatter photocoagulation reduces the risk of severe visual loss by >= 50% in eyes with high-risk characteristics. Pan-retinal scatter coagulation may also be beneficial in other PDR and severe nonproliferative diabetic retinopathy (NPDR) under certain conditions. For clinically significant macular edema the Early Treatment of Diabetic Retinopathy Study could show that immediate focal laser photocoagulation reduces the risk of moderate visual loss by at least 50%. When and how to perform laser treatment is described in detail, offering a proven treatment for many problems associated with diabetic retinopathy based on a high evidence level. Copyright (c) 2007 S. Karger AG, Basel

"Selbstscreen-Prodrom" - ein Selbstbeurteilungsinstrument zur Früherkennung von psychischen Erkrankungen und Psychosen

OBJECTIVE: In the past years, the significance of early detection of psychoses has been increasingly recognized. Screening for the onset of disorders should focus on individuals seeking treatment in an outpatient setting and should preferably operate stepwise. Within a prospective study for the early detection of psychoses (FePsy = Früh Erkennung von PSYchosen) the self-rating instrument "Self-screen Prodrome" was developed to differentiate between healthy individuals, individuals with psychosis or an at-risk mental state for psychosis and patients with other ICD-10 diagnoses. METHOD: The "Self-screen Prodrome" was developed by taking established risk factors and early signs of disease into account. In particular, prodromes and pre-psychotic symptoms were captured. A total score and a subscale were analyzed with regard to validity and reliability. RESULTS: The total score "Self-screen Prodrome" distinguished between outpatients with a mental disorder and healthy individuals (Cut-off < or = 6; sensitivity: 85 % specificity: 91 %). Additionally the subscale distinguished between psychosis-(risk)-individuals and outpatients with other ICD-10 psychiatric diagnoses (Cut-off < or = 2; sensitivity: 85 % specificity: 39 %). CONCLUSION: The "Self-screen Prodrome" is a useful instrument that a) separates mentally ill patients from healthy individuals and b) filters individuals with a risk of developing psychoses from patients with other ICD-10 diagnoses for further screening. The next step in the early detection of psychoses for identified individuals should be a detailed psychiatric exploration by experts

Kaudalanästhesie bei Kindern: Stellenwert und Aspekte zur Sicherheit

Zusammenfassung: Der Kaudalblock ist die am häufigsten durchgeführte Regionalanästhesietechnik zur perioperativen Analgesie bei Kindern. Komplikationen treten äußerst selten auf. Dennoch sind bei der Indikationsstellung lokale und systemische Ausschlusskriterien zu prüfen. Zur Gewährleistung einer optimalen Qualität und Sicherheit sind technische Details strikt zu beachten. Intravaskuläre Injektionen sind unbedingt zu vermeiden. Zu deren Früherkennung ist der Adrenalinzusatz hilfreich. Die Wahl des Lokalanästhetikums (LA) hingegen dürfte hinsichtlich der Sicherheit von zweitrangiger Bedeutung sein. Als Adjuvans bietet Clonidin bei geringen Nebeneffekten die meisten Vorteile. Die systemische LA-Intoxikation ist eine sehr seltene, aber potenziell letale Komplikation. Entsprechend müssen alle Anstrengungen zu Prävention und Früherkennung unternommen werden. Kommt es trotzdem zum Herz-Kreislauf-Kollaps, werden unverzüglich Reanimationsmaßnahmen gemäß den aktuellen Leitlinien eingeleitet. Adrenalin ist dabei Erstlinienmedikation; die Lipidtherapie ist kein Ersatz, sondern eine mögliche sekundäre Ergänzun

Früherkennung von Personen mit hohem Arbeitslosigkeitsrisiko : Ergebnisse einer EU-Studie (Early recognition of people with a high risk of unemployment : results of an EU study)

"From 2000 to 2001, PLS RAMBØLL Management, on the instructions of the European Commission, conducted a study on methods of recognising in advance unemployed people who are at risk of becoming long-term unemployed. The study showed that the implementation of systematic early recognition procedures is still in its infancy in the European context. This paper discusses in detail the assumptions that form the basis of early recognition and presents the key results of the study. What emerges clearly is the urgent need for a systematic evaluation and continuous monitoring of the labour administration in general and of the early recognition procedure in particular." (Author's abstract, IAB-Doku) ((en))Arbeitslosigkeit - Risiko, Früherkennung - Methode, Langzeitarbeitslosigkeit, Europäische Union