Skaphoidfrakturen im Kindesalter

Zusammenfassung: Dieser Übersichtsartikel behandelt die Entwicklung des Skaphoids, seine möglichen Verletzungsmuster und die Therapie frischer sowie verspätet diagnostizierter Verletzungen. Die aktuelle Literatur erlaubt für das Wachstumsalter folgende praxisrelevanten Schlussfolgerungen: Skaphoidfrakturen werden in der radiologischen Primärabklärung oft verpasst, sodass sich bei klinischem Verdacht eine initiale Ruhigstellung im Skaphoidgips für 2Wochen empfiehlt. Zeigen sich dann bei persistierenden Beschwerden im konventionellen Skaphoidstatus keine Frakturzeichen, so ist eine Abklärung mit Magnetresonanztomographie oder alternativ Computertomographie indiziert. Akute undislozierte und nur minimal dislozierte Skaphoidfrakturen können bis zum Wachstumsabschluss meist erfolgreich konservativ im Skaphoidgips behandelt werden. Verspätet diagnostizierte Frakturen und Skaphoidpseudarthrosen bis zum 16. Lebensjahr verdienen einen konservativen Therapieversuch mit prolongierter Ruhigstellung. Die chirurgische Therapie sollte massiv dislozierten Frakturen, Patienten nach erfolglosem konservativem Therapieversuch und Jugendlichen mit Pseudarthrosen, welchen eine prolongierte Ruhigstellung nicht zumutbar erscheint, vorbehalten bleibe

A Study Of The Effects Of Weekly Doses Of Niridazole On Schistosome Egg Output And Miricidial Hatching In A Patient Suffering From Bilharziasis

A CAJM article on "suppressive management" of bilharziasis.The concept of “suppressive management” in the control of bilharziasis has long been an attractive idea. If it were possible to administer a dose of a schistosomicidal drug once a week, particularly to children attending school, a significant reduction in egg output and an improvement in health would make the method worthy of careful consideration in bilharziasis control programmes

A Long-Term Study Of A Case Of Schistosoma Mansoni Subjected To Repeated Courses Of Treatment

A CAJM article on clinical testing and treatment for bilharziasis.The studies of the effects of treatment on individual patients suffering from bilharziasis has been a feature of the work of this Laboratory for some years (Blair et al. 1969b). From this work has emerged some interesting information on the disappearance and re-appearance of eggs and miracidia when treatment has failed. The earlier work was based on specimens of urine and stool passed by the patients from Monday to Friday only

Die psychosoziale/-sexuelle Entwicklung von Knaben mit einer Hypospadie

Zusammenfassung: Knaben mit einer Hypospadie sind spezifischen psychischen Belastungen im Zusammenhang mit dem chirurgischen Eingriff im Genitalbereich und einem kosmetisch und/oder funktionell beeinträchtigten Penis ausgesetzt. Während in den letzten Jahrzehnten intensive Anstrengungen zur Verbesserung der Operationstechniken unternommen worden sind, wurde die psychosoziale und psychosexuelle Entwicklung von Kindern und Jugendlichen nach Hypospadiekorrektur erst selten untersucht. Die Resultate der wenigen Studien sind insgesamt sehr widersprüchlich. Sie weisen aber auch deutlich daraufhin, dass die betroffenen Knaben unter spezifischen Problemen wie dem andersartigen Aussehen ihres Penis leiden. Das Angebot von medizinischen Verlaufskontrollen und psychosozialer Beratung muss ihnen deshalb bis ins junge Erwachsenenalter zur Verfügung gestellt werden. Für die zukünftige Forschung gilt es, in methodisch fundierten Studien Lebensqualität und Entwicklung der Knaben systematisch zu untersuchen. Dabei müssen insbesondere psychosoziale Risikofaktoren identifiziert werde

Suppressive Therapy In The Control Of Bilharziasis: A Comparative Trial In African School Children

A CAJM article on the control of bilharzia-sis in Zimbabwean (Rhodesian) African children.One of the major problems facing the health service in any country which has a high prevalence of bilharziasis is the shortage of medical personnel required for the successful treatment of the large numbers of people who show infection. However, if a totally safe regime involving the administration of relatively innocuous drug at low dosages over long periods of time to control or suppress the level of infection in the person, the administration of the drug could then be left to the teachers or to other responsible members of the community. It is in this context that the policy of suppressive therapy or management of schistosome infections shows its greatest attraction

Improving immunization practices in United States hospitals and health systems

Purpose - Payment for healthcare services in the USA has shifted from fee for service to compensation based on value and quality. The indicators used for payments are a variety of clinical measures, including administration of vaccines to patients. The purpose of this paper is to describe the implementation of programs in health systems to improve vaccination rates and patient outcomes. Design/methodology/approach - A search of the literature was conducted to find examples of vaccine programs in US health systems, and also to identify policies to improve immunization rates. Findings - Successful programs for improving vaccination rates require advocacy and support of leadership, a systematic and multidisciplinary approach, and an evaluation of local resources and capacity. Numerous examples exist of medical, nursing, and pharmacy led programs that improve vaccination rates. The department in charge has relied on the support of other groups to ensure the success. Social implications - Mandatory vaccination of healthcare personnel (HCP) in the health system has been a growing trend in the USA. Although there has been some resistance to mandatory vaccinations for HCP, the standards and requirements have resulted in improved rates in health systems, which ultimately improve efficiency and protects patients. Originality/value - This review describes considerations for implementing a successful vaccination program in a health system and provides examples of specific strategies. An overview of mandatory vaccinations for HCP is also described

Community pharmacists as vaccine providers

Purpose - The purpose of this paper is to describe the history of pharmacist involvement as vaccine providers in the USA and discuss examples of growing interests in other parts of the world. Design/methodology/approach - Literature searches were performed in PubMed as well as pharmacy-related journals. Findings - Pharmacists have been involved with the storage and management of vaccines for more than a century. Based on the unmet needs in meeting national goals for vaccination rates among adults in the USA, efforts led to training and recognizing pharmacists as vaccine providers which is now within the scope of practice for a pharmacist in all US states and territories. Pharmacists complete a comprehensive training program in vaccine sciences, regulatory considerations, as well as demonstration of skills in administering vaccines. Over 300,000 pharmacists have been trained in vaccine delivery and this represents the majority of the pharmacist workforce in the USA. There are examples of the beneficial impact of pharmacist involvement as vaccine providers in community pharmacy settings. Research limitations/implications - This review is based on a thorough review of the literature but was not conducted in a systematic fashion. Originality/value - This review provides a historical perspective and evidence of the benefit of pharmacists as vaccine providers

Influence of uncorrelated overlayers on the magnetism in thin itinerant-electron films

The influence of uncorrelated (nonmagnetic) overlayers on the magnetic properties of thin itinerant-electron films is investigated within the single-band Hubbard model. The Coulomb correlation between the electrons in the ferromagnetic layers is treated by using the spectral density approach (SDA). It is found that the presence of nonmagnetic layers has a strong effect on the magnetic properties of thin films. The Curie temperatures of very thin films are modified by the uncorrelated overlayers. The quasiparticle density of states is used to analyze the results. In addition, the coupling between the ferromagnetic layers and the nonmagnetic layers is discussed in detail. The coupling depends on the band occupation of the nonmagnetic layers, while it is almost independent of the number of the nonmagnetic layers. The induced polarization in the nonmagnetic layers shows a long-range decreasing oscillatory behavior and it depends on the coupling between ferromagnetic and nonmagnetic layers.Comment: 9 pages, RevTex, 6 figures, for related work see: http://orion.physik.hu-berlin.d