Wissenschaftsgläubigkeit und Wirklichkeitsverlust in der Sprach- und Literaturwissenschaft

Wissenschaftsgläubigkeit und Wirklichkeitsverlust in der Sprach- und Literaturwissenschaf

Sprachspielerische Gedichte - Analyse und Produktion (4.-6. Schuljahr)

Sprachspielerische Gedichte - Analyse und Produktion (4.-6. Schuljahr)

Arbetslönerna inom byggnadsbranschen under första kvartalet år 1976

Suomen virallinen tilasto (SVT

L’allemand : une discipline pivot

Considéré comme une discipline pivot, l’enseignement de l’allemand joue un rôle très important dans toutes les disciplines. A côté des apprentissages traditionnels se développent de nouvelles approches, en particulier dans l’entraînement aux productions écrites et à la communication orale

Security: Collective good or commodity?

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2008 Sage.The state monopoly on the legitimate use of violence in Europe and North America has been central to the development of security as a collective good. Not only has it institutionalized the state as the prime national and international security provider, it has helped to reduce the threat from other actors by either prohibiting or limiting their use of violence. The recent growth of the private security industry appears to undermine this view. Not only are private security firms proliferating at the national level; private military companies are also taking over an increasing range of military functions in both national defence and international interventions. This article seeks to provide an examination of the theoretical and practical implications of the shift from states to markets in the provision of security. Specifically, it discusses how the conceptualization of security as a commodity rather than a collective good affects the meaning and implementation of security in Western democracies.ESR

Tardy posterior interosseous nerve palsy resulting from residual dislocation of the radial head in a Monteggia fracture: a case report

<p>Abstract</p> <p>Introduction</p> <p>We report an extremely rare case of tardy posterior interosseous nerve palsy that developed 40 years after unreduced anterior dislocation of the radial head in a Monteggia fracture.</p> <p>Case presentation</p> <p>A 46-year-old Asian woman was diagnosed with tardy posterior interosseous nerve palsy resulting from residual dislocation of the radial head in a Monteggia fracture. The patient remembered that she had sustained a fracture to the right elbow when she was 6 years old but could not remember the details of either the injury or its treatment. Intra-operatively, the posterior interosseous nerve was compressed at the radial head, wrapped around the medial side of the radial neck, and ran into the distorted supinator muscle, and was stretched. We therefore excised the radial head and performed neurolysis. The function of the right hand was normal at a follow-up examination 8 months after surgery.</p> <p>Conclusion</p> <p>We theorize that excessive repeated motion with loss of elasticity of surrounding tissues because of long-term dislocation of the radial head may cause delayed posterior interosseous nerve palsy. It is necessary to make an accurate diagnosis and render proper treatment when a Monteggia fracture occurs, making sure that the radial head does not remain dislocated, to avoid possible posterior interosseous nerve palsy due to excessive pronation and supination even several decades later.</p

A ganglion cyst at the elbow causing superficial radial nerve compression: a case report

© 2008 McFarlane et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Strategies for increasing diagnostic yield of community-onset bacteraemia within the emergency department: A retrospective study

Bloodstream infections (BSI) are associated with high mortality. Therefore, reliable methods of detection are of paramount importance. Efficient strategies to improve diagnostic yield of bacteraemia within the emergency department (ED) are needed. We conducted a retrospective analysis of all ED encounters in a high-volume, city-centre university hospital within Germany during a five-year study period from October 2013 to September 2018. A time-series analysis was conducted for all ED encounters in which blood cultures (BCs) were collected. BC detection rates and diagnostic yield of community-onset bacteraemia were compared during the study period (which included 45 months prior to the start of a new diagnostic Antibiotic Stewardship (ABS) bundle and 15 months following its implementation). BCs were obtained from 5,191 out of 66,879 ED admissions (7.8%). Bacteraemia was detected in 1,013 encounters (19.5% of encounters where BCs were obtained). The overall yield of true bacteraemia (defined as yielding clinically relevant pathogens) was 14.4%. The new ABS-related diagnostic protocol resulted in an increased number of hospitalised patients with BCs collected in the ED (18% compared to 12.3%) and a significant increase in patients with two or more BC sets taken (59% compared to 25.4%), which resulted in an improved detection rate of true bacteraemia (2.5% versus 1.8% of hospital admissions) without any decrease in diagnostic yield. This simultaneous increase in BC rates without degradation of yield was a valuable finding that indicated success of this strategy. Thus, implementation of the new diagnostic ABS bundle within the ED, which included the presence of a skilled infectious disease (ID) team focused on obtaining BCs, appeared to be a valuable tool for the accurate and timely detection of community-onset bacteraemia

A diagnostic algorithm for detection of urinary tract infections in hospitalized patients with bacteriuria: The "Triple F" approach supported by Procalcitonin and paired blood and urine cultures

For acute medicine physicians, distinguishing between asymptomatic bacteriuria (ABU) and clinically relevant urinary tract infections (UTI) is challenging, resulting in overtreatment of ABU and under-recognition of urinary-source bacteraemia without genitourinary symptoms (USB). We conducted a retrospective analysis of ED encounters in a university hospital between October 2013 and September 2018 who met the following inclusion criteria: Suspected UTI with simultaneous collection of paired urinary cultures and blood cultures (PUB) and determination of Procalcitonin (PCT). We sought to develop a simple algorithm based on clinical signs and PCT for the management of suspected UTI. Individual patient presentations were retrospectively evaluated by a clinical "triple F" algorithm (F1 ="fever", F2 ="failure", F3 ="focus") supported by PCT and PUB. We identified 183 ED patients meeting the inclusion criteria. We introduced the term UTI with systemic involvement (SUTI) with three degrees of diagnostic certainty: bacteremic UTI (24.0%;44/183), probable SUTI (14.2%;26/183) and possible SUTI (27.9%;51/183). In bacteremic UTI, half of patients (54.5%;24/44) presented without genitourinary symptoms. Discordant bacteraemia was diagnosed in 16 patients (24.6% of all bacteremic patients). An alternative focus was identified in 67 patients, five patients presented withS.aureusbacteremia. 62 patients were diagnosed with possible UTI (n = 20) or ABU (n = 42). Using the proposed "triple F" algorithm, dichotomised PCT of < 0.25 pg/ml had a negative predictive value of 88.7% and 96.2% for bacteraemia und accordant bacteraemia respectively. The application of the algorithm to our cohort could have resulted in 33.3% reduction of BCs. Using the diagnostic categories "possible" or "probable" SUTI as a trigger for initiation of antimicrobial treatment would have reduced or streamlined antimicrobial use in 30.6% and 58.5% of cases, respectively. In conclusion, the "3F" algorithm supported by PCT and PUB is a promising diagnostic and antimicrobial stewardship tool