[Results of a Survey of Insurance Holders on Cure Regimes Performed in Foreign European Countries]. / Ergebnisse einer Versichertenbefragung zur Inanspruchnahme ambulanter Vorsorgeleistungen (Kurmaßnahmen) im europäischen Ausland.

OBJECTIVE: The aim of this study was to investigate the reasons of the insured in Germany for taking cure regimes in foreign European countries. METHODS: Health insurances conducted a survey including insurance holders in Germany who had taken a cure regime in a foreign European country in 2012 or 2011. In a paper-pencil interview, the sample was asked why they performed the cure regime abroad, how satisfied they were regarding the quality of the health professionals and the treatment, respectively, how long a positive effect lasted, where they spent their cure regime and about their plans regarding a future treatment in a health resort. RESULTS: In total, 443 insurance holders (60.7% female, mean age 68 years) were included. Price-performance ratio of board, lodging and treatment (75.6%), the health resorts' reputation (64.5%) and recommendations of the personal environment (56.1%) were the main reasons for taking a cure regime abroad. Most of the participants were satisfied with the quality of the health professionals and the health resort; two thirds rated the effect as lasting longer than 3 months. The study population predominantly took services of health resorts located in the Czech Republic, in Hungary and in Poland. For taking a cure in the future, most of the study participants (77%) preferred health resorts abroad, however, a gender-specific analysis revealed this trend to be more pronounced in the male study population. CONCLUSION: Based on the results of the survey one might suggest that cost factors along with high level of satisfaction regarding the quality of treatments provided at the health resorts abroad, positively influence the decision for taking a cure regime in a foreign country. In the sample of this study, the decision is rarely based on the health insurances' or the health resorts' promotion activity, respectively. However, to conclude on the total population, requires data of a representative sample.

Factors affecting time off work in patients with traumatic hand injuries-A bio-psycho-social perspective.

Hand injuries are common and can result in a long time off work. To analyse and identify factors affecting time of work, a holistic view on patients is needed. World Health Organization's International Classification of Functioning, Disability and Health (ICF) with its bio-psycho-social perspective provides such a holistic view. The purpose of this study is to analyse time off work in patients with traumatic hand injuries and to identify factors affecting time off work from a bio-psycho-social perspective. We used factors derived from the ICF Core Set for Hand Conditions to predict time off work by applying Cox regression analyses and Kaplan-Meier method using data of a multicentre prospective study in nine German Level 1 hand trauma centres. In total, 231 study participants with a broad range of hand injuries were included. From these, 178 patients (77%) returned to work within 200 days. Impairments in mobility of joint functions and sensory functions related to temperature and other stimuli as well as higher hand strain at work led to extended time off work. Gender, fine hand use and employment status additionally influenced time off work in sub-models. Our results demonstrate that a bio-psycho-social perspective is recommended when investigating time off work.

International Classification of Functioning, Disability and Health: development of an assessment set to evaluate functioning based on the Brief ICF Core Set for Hand Conditions - ICF HandA.

Timely identification of patients' problems after disorder or injury of the hand requires a thorough functional assessment. However, the variety of outcome measures available makes it difficult to choose the appropriate instrument. The brief International Classification of Functioning, Disability and Health (Brief ICF Core Set for Hand Conditions) provides a standard for what aspects need to be measured in hand injuries and disorders without specifying how to make the assessment. We developed the ICF-based Assessment Hand (ICF HandA), an assessment set for functioning based on the Brief ICF Core Set for Hand Conditions. First, we performed a literature review and an expert survey to pool outcome measures appropriate to assess functioning in clinical practice. At an interdisciplinary consensus conference experts decided on the outcome measures to be included in the ICF HandA. The ICF HandA provides a consensus on outcome measures and instruments to systematically assess function in patients with hand injuries and disorders.

Effect of caffeic acid phenethyl ester on oxidant and anti-oxidant status of liver and serum in a rat model with acute methanol intoxication.

BACKGROUND: Methanol toxicity is one of the major public health problems because it can cause severe morbidity and mortality. Methanol intoxication causes changes in the balance between the production of free radicals and antioxidant capacity. AIMS: We aimed to investigate the effects of caffeic acid phenethyl ester (CAPE) on the total oxidant status, total antioxidant status (TAS), and oxidative stress index (OSI) parameters of the liver and the serum in a rat model of acute methanol intoxication. MATERIALS AND METHODS: Rats were treated with intraperitoneal (i.p.) Methotrexate (MTX) for 7 days. On the 8th day, i.p. Methanol was administered in the methanol, ethanol and CAPE groups. Four hours after methanol treatment, ethanol was injected i.p. in the ethanol group; CAPE (i.p.) in the CAPE group; serum physiologic i.p. in other groups. After 8 hours, rats were killed and the serum and the liver samples were obtained for biochemical analyses. RESULTS: The OSI value was significantly higher in the methanol group compared to the ethanol and CAPE groups. Serum TAS levels of the methanol group were significantly different compared to the control group, but not compared to the MTX group. The amelioration of oxidative stress was greater in the CAPE group compared to the ethanol group but was not statistically significant. CONCLUSION: This study demonstrates that CAPE treatment ameliorates oxidative stress in the serum and liver in a rat model of acute methanol intoxication.

Determination of trace amounts of manganese in nickel by fourth-derivative spectrophotometry.

Fourth-derivative absorption spectra were used to determine trace amounts of manganese in nickel salts. Optimum conditions for the oxidation of microgram amounts of Mn(II) to MnO(-)(4) in the presence of large amounts of nickel were established. Fourth-derivative spectra provided good sensitivity and selectivity for this determination. Attention has been paid to the effect of instrumental parameters on the results obtained. Limitations of the peak-to-trough and zero-crossing measurement techniques have been examined. Manganese (1 x 10(-3)-2 x 10(-5)%) in nickel salts (nitrate, sulphate and chloride) and in nickel powder was determined with good precision and accuracy.

Extractive separation and spectrophotometric determination of palladium and platinum with dithizone in the presence of stannous chloride.

The conditions [acid used, presence of chloride and tin(II)] for the extractive separation and spectrophotometric determination of palladium and platinum as the dithizonates Pd(HDz)(2) and Pt(HDz)(2) have been examined. In the absence of stannous chloride platinum does not undergo extraction. Conditions for the separation and determination of these metals in the presence of mercury, gold and copper, which are also extracted with dithizone into carbon tetrachloride or chloroform under the conditions suitable for palladium (1M sulphuric acid/0.1M hydrochloric acid), have been defined. The mercury and gold dithizonates are formed quickly and can be removed before the palladium and platinum compounds have had time to form. They can be decomposed with iodide. Copper dithizonate is decomposed by reduction with tin(II). The proposed procedure has been applied to the determination of palladium in technical platinum metal.

Spectrophotometric determination of ruthenium and osmium.

The optimum conditions for preparation of stable solutions of ruthenate and osmate, after alkaline fusion of ruthenium(IV) compounds, ruthenium metal and osmium metal in a silver crucible, have been determined. The molar absorptivities of ruthenate and osmate are 1.74 x 10(3) 1. mole(-1).cm(-1) at 465 nm (Ru) and 2.75 x 10(3) 1.mole(-1).cm(-1) at 340 nm (Os) in 2M sodium hydroxide. A differential spectrophotometric method has been developed for determination of ruthenium in ruthenium dioxide, lead ruthenite and bismuth pyroruthenate. Simultaneous spectrophotometric determination is proposed for ruthenium and osmium. The other platinum metals interfere seriously only when present in > 1:1 w/w ratio to Ru.

Trace elements in children with chronic and recurrent tonsillitis.

Trace elements are indispensable for life and play a very important role in the essential functions. According to some reports in the literature lower trace element levels increase the susceptibility to recurrent infections. Since there are no reports available in the English literature about the effects of trace elements on recurrent and chronic tonsillitis, 37 children with recurrent and chronic tonsillitis were evaluated for Zn, Cu and Mg levels. Serum levels of Zn in 6 patients were slightly lower than the normal limit. All the other serum levels of Zn, Cu and Mg were within the normal range. On the other hand, the mean serum level of Zn in the 37 patients was significantly lower than in a control group of 28 age and sex matched children. In contrast, the mean serum levels of Cu and Mg in the patients were significantly higher than in the control group. Whether this alteration in the trace element status causes or fosters recurrent and chronic tonsillitis is not clear.

Effects of protein energy malnutrition on circulating thyroid hormones.

The effect of protein energy malnutrition (PEM) in the children on serum levels of total thyroxine (TT4), total triodothyronine (TT3) and thyrotropin (TSH) were evaluated. There were 107 children aged 2 to 60 months in the malnutrition group and 54 healthy age and sex matched controls. Serum TT4 and TT3 were all reduced in the malnutrition group. This decrease in TT3 was more significant (p < 0.01) in severe malnutrition than in mild PEM. Serum TSH levels in the malnutrition and control groups were similar. These results suggest that the children remained euthyroid and represent an adaptive response to protein energy malnutrition.

Histological and immunohistochemical studies of the structure of lymph nodes in Kilis goats.

Ten healthy adult Kilis goat mesenteric lymph nodes were used to examine the general structure of lymph nodes, lymphocytes, plasma cells, reticular cells and reticular fibers using histological methods. We also detected T lymphocytes using anti-CD3 [SP7], anti-CD4 [74-12-4], mouse anti-bovine CD4 [CC30] and mouse anti-bovine CD8 [CC63] monoclonal antibodies (mAb); and B lymphocytes using anti-CD79a [HM57] mAb, macrophages using anti-macrophage [MAC387] mAb and follicular dendritic cells using anti-S100 polyclonal antibody (pAb). The distribution of these cells also was studied. Although the primer antibodies we used for CD3, CD8, CD79a, MAC387 and S100 worked well, the primer antibodies for CD4 were ineffective for paraffin embedded goat lymph nodes.

Comparison of efficacy of azithromycin vs. doxycycline in the treatment of acne vulgaris.

Acne vulgaris is a common inflammatory disorder of the skin. Oral antibiotics are known to be effective in its treatment. A randomized, investigator-blinded study was performed to compare the efficacy of azithromycin with doxycycline. Fifty-one patients were randomized to receive either azithromycin 500 mg/day on 3 consecutive days per week in the first, on 2 consecutive days per week in the second, and on 1 day per week in the third month. The other group was given doxycycline twice a day for the first month and once a day for the second and third months. Clinical assessment was made at baseline, at the end of first, second, third, and post-treatment first and second months. Side effects were recorded. Statistically significant improvement for the facial lesions were obtained with both drugs. Neither drug was shown to be more effective than the other. The beneficial effect continued until 2 months after treatment. In the azithromycin group three patients had diarrohea, while photosensitivity was seen in two patients using doxycycline. This study indicates that azithromycin is at least as effective as doxycycline in the treatment of acne.

Trace elements in chronic sinusitis.

Trace elements are indispensable for life and play an important role in the immunological system. Since it is believed that serum trace element values decrease in chronic infections, 43 patients with chronic sinusitis were evaluated for Zn, Mg and Cu levels. While all trace elements were found to be within normal ranges, Cu values were found to be significantly lower than in a control group of 20 age- and sex-matched volunteers. The reasons for this are unclear in the present study.

Lactate dehydrogenase and its isoenzymes in serum from patients with multiple myeloma.

Concentrations of total lactate dehydrogenase (LDH; EC 1.1.1.27) and LDH isoenzyme patterns were studied in serum of 19 patients with multiple myeloma and in 19 healthy controls. Patients were divided into three groups (pretreatment, nonresponders, and responders to treatment), based on their clinical status at the time of blood sampling for LDH. The LDH values were found to be significantly higher (P less than 0.05) in the pretreatment group and in the nonresponders than in the responders and the control group, the mean +/- SE values being 445 +/- 35 and 532 +/- 75 units/mL vs 349 +/- 75 and 190 +/- 7.1 units/mL, respectively. Compared with responders and healthy controls, newly diagnosed patients and nonresponders had slight diminutions in LDH-1 and LDH-2, but increased LDH-3. We conclude that determination of LDH and its isoenzymes in serum can be of value as prognostic factors in patients with multiple myeloma.