Langzeitmedikation und perioperatives Management

Zusammenfassung: Anästhesisten und Operateure sehen sich zunehmend mit Patienten konfrontiert, die unter einer medikamentösen Dauertherapie stehen. Ein Teil dieser Medikamente können mit Anästhetika oder anästhesiologischen und/oder chirurgischen Interventionen interagieren. Als Folge können Komplikationen wie Blutungen, Ischämien, Infektionen oder schwere Kreislaufreaktionen auftreten. Andererseits birgt oft gerade das perioperative Absetzen von Medikamenten die größere Gefahr. Der Anteil ambulant durchgeführter Operationen hat in den letzten Jahren stark zugenommen und wird voraussichtlich auch in Zukunft zunehmen. Seit Einführung der Fallpauschalen (in der Schweiz bevorstehend) wird der Patient in der Regel erst am Vortag der Operation stationär aufgenommen. Somit sind sowohl zuweisende Ärzte als auch Anästhesisten und Operateure gezwungen, sich frühzeitig mit Fragen der perioperativen Pharmakotherapie auseinanderzusetzen. Dieser Übersichtsartikel behandelt das Management der wichtigsten Medikamentenklassen während der perioperativen Phase. Neben kardial und zentral wirksamen Medikamenten und Wirkstoffen, welche auf die Hämostase und das endokrine System wirken, werden Spezialfälle wie Immunsuppressiva und Phytopharmaka behandel

COMPARISON OF FOREST STRUCTURE METRICS DERIVED FROM UAV LIDAR AND ALS DATA

Point clouds derived from airborne laser scanning (ALS) and from LiDAR sensors mounted on unmanned aerial vehicles (ULS) reveal differences caused by the different sensor systems and acquisition geometries. These differences in the system characteristics are reflected in forest structure metrics that are derived from the respective point clouds. In our study, we investigate the completeness of scene coverage between the two systems and address differences between structure metrics derived from ULS and ALS, namely in point height quantiles, fractional cover (fc), the vertical complexity index (VCI) and the number of canopy layers (nLayers). The metrics are evaluated for raster cell sizes of 1–10 m in order to investigate the spatial scale on which the sensor systems provide comparable metrics. We found highest correspondences between ALS and ULS in the VCI- and the nLayers-metrics, while fc revealed large differences. For the height quantiles, the absolute differences were larger for the 10%- (h10) and the 50%- (h50) than for the 90%- (h90) height quantile. Furthermore, we found differences between ALS- and ULS-metrics to decrease for larger cell sizes, except for fc, for which the differences increased, and h50 and h90, respectively, for which the differences were relatively stable for all cell sizes

Snow Control - An RCT protocol for a web-based self-help therapy to reduce cocaine consumption in problematic cocaine users

Background: Cocaine use has increased in most European countries, including Switzerland, and many states worldwide. The international literature has described treatment models that target the general population. In addition to supplying informative measures at the level of primary and secondary prevention, the literature also offers web-based self-help tools for problematic substance users, which is in line with tertiary prevention. Such programs, however, have been primarily tested on individuals with problematic alcohol and cannabis consumption, but not on cocaine-dependent individuals. Methods/Design: This paper presents the protocol of a randomised clinical trial to test the effectiveness of a web-based self-help therapy to reduce cocaine use in problematic cocaine users. The primary outcome is severity of cocaine dependence. Secondary outcome measures include cocaine craving, consumption of cocaine and other substances of abuse in the past month, and changes in depression characteristics. The therapy group will receive a 6-week self-help therapy to reduce cocaine consumption based on methods of Cognitive Behavioural Therapy, principles of Motivational Interviewing and self-control practices. The control group will be presented weekly psycho-educative information with a quiz. The predictive validity of participant characteristics on treatment retention and outcome will be explored. Discussion: To the best of our knowledge, this will be the first randomised clinical trial to test the effectiveness of online self-help therapy to reduce or abstain from cocaine use. It will also investigate predictors of outcome and retention. This trial is registered at Current Controlled Trials and is traceable as NTR-ISRCTN93702927

LHC phenomenology of dark matter with a color-octet partner

Colored dark sectors where the dark matter particle is accompanied by colored partners have recently attracted theoretical and phenomenological interest. We explore the possibility that the dark sector consists of the dark matter particle and a color-octet partner, where the interaction with the Standard Model is governed by an effective operator involving gluons. The resulting interactions resemble the color analogues of electric and magnetic dipole moments. Although many phenomenological features of this kind of model only depend on the group representation of the partner under SU(3)c, we point out that interesting collider signatures such as R-hadrons are indeed controlled by the interaction operator between the dark and visible sector. We perform a study of the current constraints and future reach of LHC searches, where the complementarity between different possible signals is highlighted and exploited