Das Siemens Schwel-Brenn-Verfahren

Das Schwel-Brenn-Verfahren wurde von der Fa. Siemens fuer die thermische Behandlung von Abfaellen entwickelt. In dieser Arbeit werden die in der Literatur publizierten Informationen zusammengefasst. Neben einer ausfuehrlichen Verfahrensbeschreibung wird auch auf die Entwicklungsgeschichte und die erste grosstechnische eingegangen. Weitere Schwerpunkte bilden die Eigenschaften der Reststoffe sowie Stoff- und Energiebilanzen. Aussserdem werden die in der Literatur durchgefuehrten Vergleiche des Schwel-Brenn-Verfahrens mit anderen Systemen zur thermischen Abfallbehandlung vorgestellt. Eine Auswertung der vorliegenden Informationen zeigt fuer die Stoff- und Energiebilanzen groessere Schwankungen. Ausserdem sind nicht alle Stoffe sicher zu bilanzieren. Anhand der gesammelten Informationen kann das Schwel-Brenn-Verfahren nicht sicher beurteilt werden. Es muessen die Erfahrungen aus der ersten grosstechnischen Anlage bei Ulm abgewartet werden. (orig.)The Thermal Waste Recycling Technology has been developed by the Siemens company for the thermal waste treatment. In this paper the informations published in the literature are summarized. An exact description of the process and in addition the history of development is reviewed. Further main points are the properties of the ashes, the energy balance and mass balance. Moreover comparisons of the Thermal Waste Recycling Technology with other systems for the thermal waste treatment mentioned in the literature are summarized. An evaluation of the published data shows deviations in the mass and energy balances. In addition not all substances could be surely balanced. As a result surve valuation of the Thermal Waste Recycling Technology is not possible. Experiences of the technical scale plant have to be remained to be seen. (orig.)SIGLEAvailable from FIZ Karlsruhe / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Idiopathic ventricular fibrillation – Long term prognosis in relation to clinical findings and ECG patterns in a Swedish cohort

Background: Idiopathic ventricular fibrillation (IVF) is a rare cause of sudden cardiac arrest which may pose therapeutic and prognostic challenges. To date, the only effective treatment for survivors of cardiac arrest is the insertion of an implantable cardioverter-defibrillator (ICD). We sought to review the long-term outcome of a Swedish cohort with IVF. Methods and results: Fifty patients with IVF diagnosis between 1988 and 2016 (mean age at index 34.3, 56% male), were followed for a median 13.8 years in this retrospective multicenter observational study. No cardiac mortality was reported. 32% (n = 16) of patients had recurrence of ventricular fibrillation or sustained ventricular tachycardia, requiring ICD therapy, at a median time of 1.9 years (range 0.1–20.3) from the index event. Annual incidence rate of ventricular tachyarrhythmia was 3.1%. Abnormal ECG at baseline did not predict appropriate ICD therapy (p = 0.56). During the follow-up period, 14% (n = 7) patients received a cardiac diagnosis. Follow-up genetic testing was low (26%), however did confirm pathogenic mutations in three cases. Conclusion: Idiopathic VF is a rare diagnosis with a relatively good prognosis provided ICD therapy is initiated. Routine clinical follow-up is recommended due to potential late emerging cardiac pathology. ECG changes are common, but have no prognostic value in determining the risk of ventricular arrhythmias recurrence. Screening for genetic diseases has previously been low, and this calls for improvement, especially since cheaper and more comprehensive genetic panels are now readily available

Does botulinum toxin improve the function of the patient with spasticity after stroke? Toxina botulínica proporciona melhora funcional em pacientes com espasticidade secundária a acidente vascular cerebral?

Post-stroke spasticity is an important cause of disability in adults, due to muscle hyperactivity, which results in limb stiffness and muscle spasm. The prognosis for these patients depends on several features such as early management and adequate physical therapy to avoid muscle shortening, pain, and their consequences. Although several papers have shown that intramuscular injections of botulinum toxin type A (BT-A) decreases spasticity in post-stroke patients, few authors have demonstrated functional improvement after this therapy. In order to assess if individualized BT-A injections improves upper limb function in post-stroke spastic patients, we prospectively followed 20 consecutive patients of 18 years of age or more with spastic hemiparesis secondary to stroke. Fulg-Meyer scale modified for upper limbs, measure of functional independence (MFI), Ashworth modified scale, and goniometry were applied in the beginning of the investigation and in the 16th and 32nd weeks. BT-A was applied at baseline and in the 16th week. All subjects were submitted to rehabilitation therapy. All patients showed improvement according to Ashworth modified scale and increase in the range of motion, which were sustained until the 32nd week (p<0.05). The assessment of the first three parameters of the Fulg-Meyer scale and the evaluations of the motor part of the Functional Independence Measure showed statistically improvement until the end of the study. We conclude that proper choice of muscles and individualized doses of BT-A can improve function in selected post-stroke patients.<br>Espasticidade secundária a acidente vascular cerebral (AVC) é importante causa de incapacidade em adultos. O prognóstico para estes pacientes depende de vários fatores como tratamento precoce e terapia física adequada, evitando encurtamento muscular, dor e outras conseqüências. Vários estudos têm demonstrado que aplicacões intramusculares de toxina botulínica do tipo A (TxB-A) reduzem a espasticidade após AVC, entretanto poucos autores observaram melhora funcional de membros superiores com esta terapêutica. Para determinar se aplicações individualizadas de TxB-A melhoram a função no membro superior espástico de pacientes com hemiparesia secundária a AVC, acompanhamos 20 pacientes com história de AVC entre 6 meses e 5 anos. A escala de Fulg-Meyer para membros superiores, a medida de independência funcional, a escala modificada de Ashworth e goniometria foram aplicadas no início da investigação, na 16ª e 32ª semanas. TxB-A foi aplicada no início do estudo e na 16ª semana e todos os participantes foram tratados adicionalmente com fisioterapia. Observamos melhora na escala de Ashworth e aumento na amplitude de movimento em todos os pacientes até a 32ª semana (p<0.05). A análise dos 3 primeiros parâmetros da escala de Fulg-Meyer e a parte motora da MIF mostraram melhora estatisticamente significante até o final do estudo. Concluímos que a escolha adequada dos músculos e doses individualizadas de TxB-A melhoram a função em pacientes com espasticidade pós-AV