Search

Spontaneous pneumothorax is a potentially life-threatening situation. Therefore, it is mandatory to treat it safely. The incidence is approximately 10 out of 100 000 residents per year. It occurs through an immediate disruption of the visceral pleura that results in an accumulation of air in the pleural space. According to its etiology, spontaneous pneumothorax is divided into 2 groups. Whereas primary spontaneous pneumothorax occurs in healthy individuals without any detectable lung disease, secondary spontaneous pneumothorax occurs in patients with preexisting. Diagnosis of pneumothorax is typically made by chest x-ray. After diagnosis pneumothorax is traditionally treated by an insertion of a thoracic tube.Recently, thoracic ultrasound gained influence in diagnosis of pneumothorax and primarily conservative treatment strategies have been shown to be safe and equally effective in particular groups of patients. This article aims to present and discuss these upcoming strategies., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Flexible ureteroscopy (fURS) has become a success story in urology. Since its implementation into the treatment of urolithiasis, fURS has demonstrated excellent clinical performance and safety. In recent years, the spread of disposable ureteroscopes has shaped the field of endoscopic stone treatment. However, the primary advantage of these devices is that they improve the workflow in urology theatres (no sterilisation, no repair costs) and possibly minimise bacteria transfer in working channels rather than being a real technological "game changer". Novel disruptive improvements such as automatic laser lithotripsy or intrarenal pressure and temperature control in real time are still waiting to enter the clinical routine. These innovations might take fURS to the next level and disruptively change endoscopic stone treatment., Competing Interests: Die Autoren geben an, dass kein Interessenskonflikt bez. der Veröffentlichung vorliegt.Arkadiusz Miernik ist Berater von RichardWolf GmbH (Knittlingen, Deutschland), Lisa laser OHG (Katlenburg-Lindau, Deutschland) sowie Patentinhaber des zitierten bioinspirierten Klebstoffes zur kompletten Entfernung von Steinfragmenten. Darüber hinaus besitzt Arkadiusz Miernik eine Erfindungsmeldung zum Schleusensystem mit integrierter Temperatur- und Druckmessung während endoskopischer Therapie am Harntrakt., (© Georg Thieme Verlag KG Stuttgart · New York.)

Effective lighting is a key factor in achieving a good image, not just in dental photography. A variety of light sources can be used for this. It is important to know the colour quality of the light sources and adjust the camera accordingly. This helps to avoid unwanted alterations in colour. Lighting is crucial to a successful image. It controls not only the lightness or darkness of the image, but also the tone, feel and atmosphere of the picture. Manipulating the light, for example by using special filters, can also be a useful diagnostic tool for treatment., (Copyright 2023 . License: This work is licensed under a Creative Commons Attribution 4.0 International License.)

Analysis of the composition of a urinary stone is one of the most important steps in the clinical management of patients with urolithiasis. Fourier transform infrared spectroscopy, X-ray diffractometry and petrographic microscopy are the techniques currently used. Novel technical developments in recent years - such as Raman spectroscopy and hyperspectral imaging - have resulted in new approaches to improve urinary stone analysis. In future, table-top portable systems may be used that allow stones to be rapidly examined directly after the operation. These systems may even be integrated into lithotripsy laser systems., (© Georg Thieme Verlag KG Stuttgart · New York.)

Surveys among employees are getting more and more relevant in hospital settings since an increase in both (1) efficiency and (2) quality in connection with (3) enhanced patient orientation will only be achieved, if at the same time the employees' health status and satisfaction are taken into account. Thus, the objective of this study was to compare the satisfaction of employees in a single hospital enquired in 2002 with that of 2005. Particular consideration was given to their view of quality management. Is there a correlation between employees' satisfaction, their degree of information on quality management, and their assessment of quality management? In the survey of 2005 employees were more satisfied with their work and their working conditions than in the previous inquiry conducted in 2002. They felt less mental stress, despite the declining length of hospitalisation combined with a higher turnover of in-hospital cases and with lower numbers of full-time staff. The employees' satisfaction, however, differed widely among the three departments with regard to the items "involvement with decisions" and "support by the superiors". The overall assessment of quality management is positive. Specific items such as the assessment of the management's commitment to quality management were strongly influenced by the employees' degree of information on quality management, which varies between departments. In the department with the lowest work satisfaction quality management was attributed a high potential for change and improvement. After quality management will have been implemented throughout the hospital, a new survey should be undertaken to evaluate whether quality management affects the employees' satisfaction with their work.

This study describes the experience with hypofractionated radiation therapy of squamous cell carcinoma and melanoma in dogs and cats. A total dose of 32-48 Gray (Gy) was delivered once a week in 8 Gy fractions. 34 animals in which a complete surgical excision was impossible were treated. There was no tumor detectable macroscopically in 14 patients at the beginning of radiation therapy. In 20 animals the median volume of the tumor was 9.9 cm3. The median survival times and the local tumor control of squamous cell carcinoma of the oral and nasal cavities and of the body are comparable to results which were reached with a Monday-Wednesday-Friday scheme. For the treatment of Melanoma the hypofractionated radiation therapy is first choice. There are no significant side effects. Late side effects did not occur. 88% of the owners are satisfied with this kind of treatment and would choose it again.

Denervation of the canine hip joint capsule is described as a surgical therapy method in the treatment of canine hip joint dysplasia and arthrosis. The goal of this operation is a removal of the pain immediately and a reactivation of the dynamic active component of the hip joint in moving the body forward. Simple removal of the periosteum of the craniolateral acetabulum edge destroys the rami articulares of the cranial glutaeal nerve and the rami articulares dorsalis of the sciatic nerve. Within 10 years now we performed the denervation of the canine hip joint capsule. Evaluation of the post operative clinical course in 269 cases revealed an impressive improvement of lameness due to pain relief in almost 92% of the cases.

Numerous morphological changes can be observed in human myocardium failing because of dilated cardiomyopathy. These can be observed by electron microscopy and by immunofluorescence microscopy using monoclonal antibodies. These changes include: 1) the occurrence of hypertrophied and atrophied myocytes as well as cells of normal size, 2) degenerative changes in myocytes; these consist of nuclei of varying size and shape, lack of contractile material, disorganization of the cytoskeleton, and sequestration of cellular particles into the extracellular space and 3) an enlarged extracellular space, that is, fibrosis, which contains increased amounts of the different matrix proteins such as fibronectin and laminin, the various collagens, and chondroitin sulfate, in addition to cellular debris and numerous macrophages and fibroblasts. On the basis of these findings it is hypothetized that there exists an interaction between myocytes and the extracellular matrix. The cells of the latter may be stimulated to higher rates of proteins synthesis by the presence of cellular debris. This process, in turn, may be harmful for the structural integrity of myocytes which consequently sequester more cellular particles. In this manner, a vicious circle may be started that leads to further structural and functional deterioration of the myocardium, finally resulting in failure.