[Hands well - all's well : Prevention campaign of the Austrian General Accident Insurance Institution (AUVA) to reduce hand injuries]. / Hände gut ­ Alles gut : Die Präventionskampagne der österreichischen Allgemeinen Unfallversicherungsanstalt (AUVA) zur Reduzierung von Handverletzungen.

Overall, 41% of all work-related accidents lead to a hand injury. In the younger generation, the incidence rate even rises to 50%. In Austria, these accidents result in approximately half a million sick leave days per annum, an average of 12.5 days per accident. In comparison, leisure-time hand injuries show a significantly higher accident rate: 60% of hand injuries occur during leisure time. Far fewer safety measures are taken and a lack of adequate training and a disregard for safety recommendations are observed.This large number of hand injuries led to the launch of a campaign in Austria in 2014-2015 called "Hände gut - Alles Gut", (Hands well - all's well). This campaign was aimed at reducing the costs, a sum of 309 million Euros, incurred solely from work-related hand accidents, by at least 5-10%.These exorbitantly high costs are not only due to severe hand trauma, most result from a multitude of slight and superficial wounds.

Outbreak with a novel avian influenza A(H7N9) virus in China--scenarios and triggers for assessing risks and planning responses in the European Union, May 2013.

As part of the risk assessment and strategic planning related to the emergence of avian influenza A(H7N9) in China the European Centre for Disease Prevention and Control (ECDC) has considered two major scenarios. The current situation is the one of a zoonotic epidemic (Scenario A) in which the virus might be transmitted sporadically to humans in close contact with an animal reservoir. The second scenario is the movement towards efficient human to human transmission (a pandemic Scenario B). We identified epidemiological events within the different scenarios that would trigger a new risk assessment and a review of the response activities to implement in the European Union (EU). Further, we identified the surveillance activities needed to detect these events. The EU should prepare for importation of isolated human cases infected in the affected area, though this event would not change the level of public health risk. Awareness among clinicians and local public health authorities, combined with nationally available testing, will be crucial. A 'one health' surveillance strategy is needed to detect extension of the infection towards Europe. The emergence of a novel reassortant influenza A(H7N9) underlines that pandemic preparedness remains important for Europe.

[Correlation of retinal thickness with the extent of Purtscher's retinopathy]. / Korrelation der Netzhautdicke mit dem Verlauf der Purtscher-Retinopathie.

BACKGROUND: The course of Purtscher's retinopathy (PR) or Purtscher-like retinopathy (P-lR) is dependent on time, length, and expression of confluent cotton-wool spots. To correlate the course of the disease with findings of optical coherence tomography (OCT), we present two extreme courses of PR and P-lR. METHODS: Complete ophthalmological examination plus electroretinography (ERG) and OCT were performed. In the first case the follow-up was carried out until complete resorption of the edema and in the second case 8 years after the occurrence of P-lR. RESULTS: An increase of the central retinal thickness (308-430 microm was observed during the acute phase of PR. Normalization of visual acuity and central retinal thickness to 210-273 microm with an ERG within normal limits (35 ms) was achieved after 8 weeks. In the course of P-lR the marked edema was visible even after 6 months and a markedly reduced neuroretina (112-120 microm) was measured after 8 years. CONCLUSIONS: Retinal thickness analysis correlates well with organic functions in the cases of PR or P-lR. Fast reduction of the edema was associated with a good prognosis for visual acuity.

UV photoexcitation of a dissolved metalloid Ge9 cluster compound and its extensive ultrafast response.

Femtosecond pump-probe absorption spectroscopy in tetrahydrofuran solution has been used to investigate the dynamics of a metalloid cluster compound {Ge9[Si(SiMe3)3]3}(-). Upon UV photoexcitation, the transients in the near-infrared spectral region showed signatures reminiscent of excess electrons in THF (bound or quasi-free) whereas in the visible part excited state dynamics of the cluster complex dominates.

Laparoscopic extraction of a swallowed fork in a patient first diagnosed with bulimia nervosa.

Swallowed foreign bodies are relatively common problem. The first reports date back about 3000 years. The first medical report was done by Mestivier in 1759. Several studies show that up to 90% of the foreign bodies (FBs) pass spontaneously and 10% to 20% require an endoscopic removal. Surgical intervention is only indicated in approximately 1% of the cases. Surgical intervention is only necessary, for example, when large or sharp FBs are involved because of the potential risk of perforation and obstruction. The surgical therapy can be carried out by means of laparotomy or laparoscopy; laparoscopy has to be given the first priority whenever possible. The advantages of a laparoscopic procedure are well-known: reduced postoperative pain, better lung function, less postoperative bowel obstruction, shorter hospital stay, and faster reconvalescence. We report an unusual case of an unintentional ingested fork, which required a laparoscopic extraction using three trocars. The 20-year-old female patient was then subsequently diagnosed with bulimia nervosa for the first time during her hospital stay. The patient was discharged home on the fourth postoperative day after an unremarkable course.

CGP 9000: a new orally active, broad-spectrum cephalosporin.

CGP 9000, (7-[D-2-amino-2-(1,4-cyclohexadienyl)-acetamido]-3-methoxy-3-cephem-4-carboxylic acid), is a new broad-spectrum cephalosporin antibiotic. Its antibacterial activity in vitro (MIC) is similar, but its bactericidal efficacy superior to that of cephalexin and cephradine. Upon oral administration to mice infected with various bacteria, CGP 9000 is, in general, 2 to 7 times more effective than either cephalexin or cephradine.

Detection of DNA adducts in declining hop plants grown on fields formerly treated with heptachlor, a persistent insecticide.

Hop decline was observed in Alsace, eastern France, in reparcelled sugar beet fields formerly abundantly treated with an insecticide, heptachlor. Leaves were collected from 'declining hops' grown in an heptachlor-contaminated area and from 'healthy hops' grown in a soil not contaminated by heptachlor. These two samples came from hop vines treated with other usual pesticides. 'Control' hop leaves came from soil neither treated with pesticide nor contaminated with heptachlor. Hypermodified nucleotides (DNA adducts) were detected using the (32)P-postlabelling method. No detectable DNA adducts were found in the 'control' specimen, whereas eight adducts were detected in the 'healthy hops' specimen, probably due to the usual pesticide treatment. However, 16 adducts, nine of which were new adducts, could be detected in the 'declining hops' specimen. It may therefore be supposed that the presence of these hypermodified nucleotides perturbs gene expression and so contributes to the hop decline. In addition, to confirm the genotoxicity of heptachlor, it is shown that it induces DNA adducts in bean-cell suspension culture as well. Finally, it is proposed, in the case of alternate cultures scheduled in fields which were formerly treated with pesticides, adapted to other cultures, that particular attention should be given to the history of the soils.

[Laparoscopic adhesiolysis - results following prospective surveillance]. / Die laparoskopische Therapie des Adhäsionsbauchs. Ergebnisse einer prospektiven Beobachtungsstudie.

INTRODUCTION: About 90 % of the patients have abdominal surgery develop adhesions afterward. Studies analyzing complications and follow-up even in emergency cases are rare. METHODS: Intra- and postoperative findings and complications and follow-up were analyzed in a prospective trial between January 1994 and June 1998. RESULTS: We performed laparoscopic procedures in 56 patients with complaints of obstructing adhesive bands or adhesions. Ninety-six percent of the patients have had abdominal surgery; 51.8 % were treated as emergency cases with acute pain, 48.2 % with chronic abdominal pain. Intraoperatively, 37.5 % of the patients showed single adhesive bands; 62.5 % showed adhesions. Mean operation time was 60 min, conversion rate: 5.4 %. Complications were recorded according to the "Cologne classification": class I: 78.6 %, class II: 8.9 %, class III: 1.8 %, class IV: 10.8 %, class V: 0 %. The postoperative hospital stay was 6 days on average. CONCLUSION: Our study suggests that laparoscopic adhesiolysis can be done safely in emergency cases and in patients with extensive adhesions as well.

[Internet presence of surgical clinics in Germany. Current data and future prospects]. / Internetpräsenz Chirurgischer Kliniken in Deutschland. Aktuelle Daten und Zukunftsausblick.

INTRODUCTION: The aim of this study was to obtain an overview of the use of the Internet by surgical departments in Germany as a presentation platform and information resource for their patients. METHODS: After a randomizing a total of 1,760 surgical departments in Germany, 200 were chosen and asked about their Internet use. RESULTS: Most of the questionnaires (81.5%) were received and analyzed; 32.5% of the German surgical departments are represented on the Internet; 81.4% of the clinics without a homepage are planning to have one in the future. The hospitals represent themselves on average on two HTML documents. CONCLUSION: Approximately a third of the German surgical departments currently give information over the Internet with a wide and heterogeneous spectrum. In the near future approx. 80% of the German surgical departments will have online presence. Therefore, the increasing demand for medical information by the patients will be fulfilled. The professionalism and effectiveness of the home-pages can be increased through registration with many search engines and the use of e-mail.

[Internet presence in surgical departments in Germany. II. Legal bases of medical Internet presence]. / Chirurgische Internetpräsenz in Deutschland, Teil II. Rechtliche Grundlagen ärztlicher Internetpräsenz.

In recent years, the Internet has generally been growing throughout the world, and physicians have taken to the Web as well. Besides its use for medical data research, physicians and hospitals are increasingly discovering the Internet as a vehicle for the presentation of their scope of practice. In this regard, the legal frameworks in Germany are strictly regulated. This article presents current legal standards and consequences to be faced when the law on prohibited advertising is broken. Included are references to specific laws concerning Internet pages.

[Experimental acute necrotico-hemorrhagic pancreatitis in dogs. Treatment by intraductal block]. / Pancréatite aiguë nécrotico-hémorragique expérimentale chez le chien. Traitement par blocage intra-canalaire.

The aim of this experimental study was to demonstrate that the mortality of calcium chlorine induced acute pancreatitis in the dog was decreased by the intraductal injection of solid substances. Seventy-two dogs were used. In the control group (n = 5) the mortality was 100%. Three different drugs were used for the intraductal injection: Ethibloc (n = 37), Tissucol (n = 10) and silicones (n = 10). The mortality rate has been respectively of 13.5, 10 and 10%. In order to define at which level of the pancreatic duct the obstruction had a maximum efficiency, 10 dogs underwent a distal ligation of the pancreatic duct after induction of the pancreatitis. The mortality rate in this group was 100%. It can be therefore concluded that only the complete obstruction of the pancreatic duct decreases the mortality rate in this experimental model.

[The new "Marburg rehabilitation concept". "On the status of exercise equipment within the scope of rehabilitation of patients after surgery of the anterior cruciate ligament"]. / Das neue "Marburger Rehabilitationskonzept". "Uber den Stellenwert von Ubungsgeräten im Rahmen der Rehabilitation von Patienten nach Operationen am vorderen Kreuzband".

The surgical treatment of acute and chronic injuries of the anterior cruciate ligament (ACL) is still incontinous. Different techniques and materials are used to reconstruct and repair this important structure. This causes that the kind of postoperative treatment is even inhomogeneous. Concepts of "early mobilization" correspond to the results of basic research on pathobiomechanical effects of joint immobilization. There is a large variety on the information concerning method, success and length of rehabilitation. The final aim of our research was the development of a new rehabilitation strategy for patients in addition to out-patient physiotherapy. The reconstruction and repair of ACL is in our hospital done by an autograft of patellar tendon, "bone-tendon-bone", in augmentation with a "3-mm-Trevira cruciate ligament prosthesis". In our prospective, controlled and randomized clinical study "group A" (n = 20) practiced in addition to their out-patient physiotherapy twice a week under the direction of a medical doctor and the control of a physiotherapist with the equipment of a fitness-center. "Group B" (n = 20) passed only the out-patient physiotherapy. Both groups were examined regularly with special regard to the active motion of the knee joint, the power and the circumference of the leg. Also the "Marschall-Tegner" and the "Lysholm-Gilquist-Score" were determined. In our study we found that the "New-Marburg-rehabilitation-concept" is an useful supplement to the out-patient physiotherapy. All examined data showed a clear increase in "group A" in comparison to "group B".

[Prevention of hand injuries - current situation in Europe]. / Prävention von Handverletzungen - Aktueller Stand in Europa.

Hand injuries are a frequent occurrence and account for 41% of all occupational injuries. In general such accidents are the result of stress, inattention, tiredness, use of defective or poorly maintained machinery. However, artention must equally be directed at the large number of accidents occurring in leisure time activities since the inability to work due to a leisure time accident is similarly cost-intensive. Throughout Europe attempts have been made in the past 10 years to improve prevention. At the initiative of the Hand Trauma Committee (HTC) of FESSH prevention conferences were stated in 2009. These have in part reduced the number of hand injuries in -Europe. In Austria a special controlling committee was founded by the Austrian Workers' Compensation Board (AUVA) with the specific objective of reducing the number of hand injuries. Similarly the "Circle for Leisure Time Hand Injury Prevention" was created to specifically deal with hand injuries occurring during leisure time activities. Through the cooperation of these 2 committees and implementation of the thus decided measures, a reduction in the number of accidents involving the hand is to be expected with a concomitant reduction in the associated costs.

[Purtscher's syndrome. An example of a rare occurrence of ocular complication after thoracic compression trauma]. / Das Purtscher-Syndrom. Fallbeispiel einer seltenen okulären Komplikation nach Thoraxkompressionstrauma.

Purtscher's retinopathy is a traumatic angiopathy, most commonly caused by head and chest trauma. Retinal signs include white ischemic infarcts (cotton-wool spots or Purtscher flecken) and hemorrhages (dot and blot, preretinal, or flame). The prognosis for patients with decreased vision is unpredictable. We report one case of this disease developing 3 days after a motorcycle accident.

The value of screening tests in applicants for professional pilot medical certification.

Good medicine does not consist in the indiscriminate application of laboratory examinations to a patient, but rather in having so clear a comprehension of the probabilities and possibilities of a case as to know what tests may be expected to give information of value.' (Francis Peabody, 1922)

Effects of beta blockade on systolic and diastolic left ventricular function at rest and during exercise in patients with chronic stable angina pectoris.

This study examined the effects of beta blockade with betaxolol, a cardioselective, lipid-soluble, beta-adrenergic-blocking agent, on rest and exercise systolic and diastolic left ventricular function in 15 patients, aged 40 to 70 years (mean = 52), with chronic stable angina pectoris. Each patient underwent three upright exercise studies at identical workloads; the first was a baseline study, the second was done 3 hours after a single oral dose, and the third was obtained after chronic therapy for 2 weeks. Beta blockade was evident by significant decreases in heart rate, systolic blood pressure, and diastolic blood pressure at rest and during exercise (p less than 0.04). Although there were no significant changes (at rest or during exercise) in mean left ventricular ejection fraction and peak filling rate, individual variations were seen after 3 hours and 2 weeks of therapy. During chronic therapy, the peak filling rate increased in three patients, decreased in five, and remained unchanged in seven. Also, discordant changes in systolic and diastolic functions were seen at rest and during exercise during both acute and chronic therapy. Thus, although acute and chronic beta blockade produces no significant changes in mean measurements of diastolic and systolic left ventricular performance, individual variations and discordant results are seen in many patients. The acute effects are generally consistent with the chronic effects, but exceptions are present.

The use of rest and exercise radionuclide ventriculography in risk stratification in patients with suspected coronary artery disease.

The study examined the value of rest and exercise radionuclide ventriculography in risk stratification in patients with suspected coronary artery disease. There were 604 patients, 474 men and 130 women, aged 55 +/- 11 years (mean +/- standard deviation). At a follow-up of 18 +/- 10 months, there were 43 hard cardiac events: 27 patients died of cardiac causes and 16 had nonfatal acute myocardial infarctions. Univariate and multivariate survival analysis of the 10 most important clinical and exercise variables identified the exercise left ventricular ejection fraction as the most important predictor of death and total cardiac events (chi 2 = 18.1 and 29.6, respectively). The exercise heart rate was a significant, independent, but much weaker predictor of cardiac death and total events (chi 2 = 8.4 and 3.9, respectively), while exercise tolerance was a significant independent predictor of cardiac death only (chi 2 = 6.4). Actuarial life table analysis showed that the risk for future cardiac events increased in stepwise fashion as the exercise ejection fraction decreased. Thus, the exercise left ventricular ejection fraction is a useful prognosticator in patients with suspected coronary artery disease. This finding has important implications in patient management.