[Working under pressure]. / Arbeiten unter erschwerten Bedingungen. Betreuung von Patienten im Regionalgefängnis Bern und der Bewachungs- station des Inselspitals Bern--Dokumentation und Literaturübersicht.

From medical view the main problems of investigation and convicts are in particular in the range of the drugs and alcohol illnesses to see transferable diseases (HIV, hepatitis B - C and tuberculosis) and psychological illnesses. These complex diseases require a close meshed and intensive support of each individual patient and represent actually the main problem during an arrest. The development of the health service could address the new requirements making possible cost-conscious acting in handling with resources in the health service. In the canton Berne 957197 inhabitants live on a total area of 5959 km2. The police and military management operates the regional and district prisons as well as the transportation service for prisoners in the canton Berne for prisoners. The canton Berne has altogether 327 places. Since May 1971 persons from the regional and district prison and the penal institutions needing hospitalisation can be accepted. In the University hospital Berne on a specially equipped guard station and be cared for their medical problems. The prisoners profit in such a way from the entire range of the university facilities.

[Pneumatosis cystoides intestinalis: a rare illness in adults]. / Diffuse epigastrische Beschwerden und Meläna.

Pneumatosis cystoides intestinalis (PCI) is a rare illness in adults with gas filled blebs found in the submucosa or subserosa of the bowel wall. The main localization is the terminal ileum although all parts of the intestine can be affected. Clinical symptoms can vary from aqueous-slimy, bloody diarrhea to constipation and/or vague abdominal pain. Patients can also be completely asymptomatic. In symptomatic patients the therapy of PI is based on the assumed pathogenesis, so that a combined treatment of metronidazole 1500 mg daily during a period of 6-8 weeks additionally and oxygen application (PaO2 of 200-350 mmHg) for 7 days is suggested. In addition, elemental diets are recommended. Complications are indicated in the literature with 3%. In particular mechanical ileus, invagination and perforation as well as substantial intestinal bleeding up to the volvolus lead to further diagnostic and therapeutic steps. A surgical intervention is reserved for rare cases.

[MRI-based diagnosis of an acute bilateral compartment syndrome]. / Akutes bilaterales Kompartmentsyndrom der Tibialis-anterior-Loge.

The acute compartment syndrome describes a posttraumatic or inflammatory edema, which leads to a painful constraint of muscular movement and paresthesia. An increase in pressure in the anatomical compartment is postulated. The main symptoms include local swelling, sensory loss, local muscle weakness as well as late livid discoloration. Therapy of choice is an early fasciotomy with decompression to avoid serious complications like muscle necrosis. Here we report a 22 year old patient who postoperatively suffered from a bilateral paresis of the foot jack. Further examinations by electromyography and magnetic resonance imaging (MRI) led to the diagnosis of an acute bilateral compartment syndrome.

[Anticoagulation: the present and the future]. / Antikoagulation: heute und in Zukunft.

Because of its central role in the coagulation cascade thrombin is an attractive target for its inhibition. Many limitations of conventional anticoagulants have been eliminated by the development of the direct oral thrombin inhibitor ximelagatran. Thus, this compound may fulfil the criteria of an ideal anticoagulant. The antithrombotic efficacy and safety of this inhibitor is presently studied in a large clinical development program.