Early renal transplant dysfunction due to arterial kinking stenosis

The main differential diagnoses of early renal trans-plant dysfunction include ischaemic damage, cyclospo-rin toxicity, and rejection [1]. Rarer causes include bleeding, ureteral obstruction, urinary leak, venou

Reliability of movement control tests in the lumbar spine

<p>Abstract</p> <p>Background</p> <p>Movement control dysfunction [MCD] reduces active control of movements. Patients with MCD might form an important subgroup among patients with non specific low back pain. The diagnosis is based on the observation of active movements. Although widely used clinically, only a few studies have been performed to determine the test reliability. The aim of this study was to determine the inter- and intra-observer reliability of movement control dysfunction tests of the lumbar spine.</p> <p>Methods</p> <p>We videoed patients performing a standardized test battery consisting of 10 active movement tests for motor control in 27 patients with non specific low back pain and 13 patients with other diagnoses but without back pain. Four physiotherapists independently rated test performances as correct or incorrect per observation, blinded to all other patient information and to each other. The study was conducted in a private physiotherapy outpatient practice in Reinach, Switzerland. Kappa coefficients, percentage agreements and confidence intervals for inter- and intra-rater results were calculated.</p> <p>Results</p> <p>The kappa values for inter-tester reliability ranged between 0.24 – 0.71. Six tests out of ten showed a substantial reliability [k > 0.6]. Intra-tester reliability was between 0.51 – 0.96, all tests but one showed substantial reliability [k > 0.6].</p> <p>Conclusion</p> <p>Physiotherapists were able to reliably rate most of the tests in this series of motor control tasks as being performed correctly or not, by viewing films of patients with and without back pain performing the task.</p

Die Inguinal-Hernienplastik nach Lichtenstein: Eine einfache und komplikationsarme Technik, besonders geeignet für die Tageschirurgie [The Lichtenstein inguinal hernia-plasty: a simple and complication-free technique, especially suited for ambulatory surgery].

A consecutive series of 353 patients who underwent Lichtenstein mesh repair for inguinal hernia from the 1st of July 1994 to the 30th of July 1995 were studied. We analysed our indication, technique, complications, follow-up and outcome. Special consideration was given to the advantages and acceptance of day-case surgery. Our results suggest that the Lichtenstein repair should be considered as a new standard procedure, especially outside of hernia centres

Télématique et chirurgie: méthodologie, terminologie et mode d'emploi [Telematic and surgery: methods, terminology and instructions]

BACKGROUND: Telematic is the application of computer technology in modern telecommunication. Telemedicine will be of growing importance in the international collaboration in surgery. OBJECTIVE: Review of the different telematic applications for surgery and presentation of technology and tools. Practical user's guide. METHOD: Analysis of our international network of telesurgical staff meetings between 6 University Hospitals. Review of the situation of telemedicine in Switzerland and around the world. RESULTS: After performing some comparative tests we chose to work with 6 ISDN channels at the world wide standard H.320 (rate of 384 Kb/s) which is widely available in Switzerland and around the world. Technical options, market opportunities and relationship between needs and goals of telemedicine are presented on a user point of view. DISCUSSION: More than 70 telesurgical staff meetings allowed us to get an overview of this technology, in order to benefit of telemedicine applications for teaching and clinical use. Important factors are the analysis of needs and goals prior to the teleconference. CONCLUSION: Consultation, second opinion, teaching and training should be new clinical applications of telemedicine, leading to an increase of surgical quality control in Europe and in the world

[Course system of the Working Group for Gastro-intestinal Surgery Davos]

Training in technical skills is essential for advanced surgical education. Training is moving more and more from the operating room to surgical training laboratories. A crucial impulse for this development came from Davos, where the first skills course was organized in 1984 after the formation of the Working Group for Gastro-intestinal (GI) Surgery (AGC Davos). Since this first course more than 5,000 residents have successfully completed the GI skills training course in Davos and many of the alumni are themselves teaching surgery today. The level and quality of this course has remained stable for 27 years on a high quality level although teaching has continuously been adjusted to modern techniques. The language of this international workshop is English. The number of applications exceeds the course capacity every year, which is an indication for the need of such training courses and should be principally included into the skills curriculum for surgeons