RESUMO
Inguinal hernia operations represent the most frequent operations overall with 300,000 interventions annually in Germany, Austria and Switzerland (DACH region). Despite the announced political willingness and the increasing pressure from the legislator to avoid costly inpatient treatment by carrying out as many outpatient operations as possible, outpatient treatment has so far played a subordinate role in the DACH region. The Boards of the specialist societies the German Hernia Society (DHG), the Surgical Working Group Hernia (CAH of the DHG), the Austrian Hernia Society (ÖHG) and the Swiss Working Group Hernia Surgery (SAHC) make inroads into this problem, describe the initial position and assess the current situation.
Assuntos
Hérnia Inguinal , Humanos , Hérnia Inguinal/cirurgia , Pacientes Ambulatoriais , Alemanha , HerniorrafiaRESUMO
Particular problems of abdominal surgery in geriatric patients were analyzed in a retrospective study of 1569 surgical procedures of the abdomen carried out in 1420 patients aged 70 years or more. Emergency procedures were necessary in 357 (22.8%) cases with a lethality of 25.5% compared to 8.8% in the elective group. Morbidity was also visibly different in both groups (59.3% vs. 40.2%). While the average time of hospitalisation was 22.4 days, almost 80% of our patients could be released and 12.6% died in hospital.
Assuntos
Abdome/cirurgia , Complicações Pós-Operatórias/mortalidade , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Emergências , Feminino , Avaliação Geriátrica , Alemanha/epidemiologia , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
The intrathecal synthesis of antibodies to human immunodeficiency virus (HIV) was determined by 3 different immunoassays in 15 African patients with pre-acquired immunodeficiency syndrome (AIDS) and AIDS. Isoelectric focusing together with affinity-mediated immunoblot were found to be superior to enzyme-linked immunosorbent assay and Western blot in providing information not only about the antigen specificity of locally produced antibodies but also about their clonal distribution. In 9 of the subjects, HIV-specific oligoclonal bands were demonstrable with higher frequency or intensity in the cerebrospinal fluid than in the autologous serum, indicating autochthonous synthesis of HIV-related antibodies.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Doenças do Sistema Nervoso Central/microbiologia , Anticorpos Anti-HIV/análise , Síndrome da Imunodeficiência Adquirida/imunologia , Adulto , Western Blotting , Doenças do Sistema Nervoso Central/imunologia , Ensaio de Imunoadsorção Enzimática , Feminino , Anticorpos Anti-HIV/biossíntese , Humanos , Immunoblotting , Focalização Isoelétrica , Masculino , Pessoa de Meia-Idade , TanzâniaRESUMO
To assess the possible role of sexually transmitted diseases as cofactors for the spread of AIDS, 248 adult patients were tested for the presence of antibodies against human immunodeficiency virus (HIV), hepatitis B virus (HBV) and syphilis. The survey was conducted in a hospital at Kagondo, Kagera Region, Northwest Tanzania, Africa. Subjects were randomly chosen from the outpatient clinic to include those with and without sexually transmitted diseases, as well as AIDS/pre-AIDS patients. The data were univariately and multivariately analysed by linear logit models, including interactions of demographic parameters. The results obtained reveal a strong association between the presence of antibodies against HIV, syphilis and HBV, respectively. The HBV/HIV-correlation remained stable in the multivariate analysis including interactions of social parameters, in contrast to the syphilis/HIV-correlation. We assume that this reflects the lower virulence of HBV as compared to that of syphilis. The prevalence of anti-HBV antibodies seems to be a more reliable marker for high sexual activity than those against syphilis. The possibility that HBV and HIV act as cofactors for each other's transmission could not be ruled out.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Soropositividade para HIV/complicações , Hepatite B/complicações , Infecções Sexualmente Transmissíveis/complicações , Síndrome da Imunodeficiência Adquirida/diagnóstico , Anticorpos Antivirais/análise , Feminino , Anticorpos Anti-HIV/análise , Hepatite B/diagnóstico , Antígenos de Superfície da Hepatite B/análise , Humanos , Masculino , Testes Sorológicos , Infecções Sexualmente Transmissíveis/diagnóstico , Sífilis/complicações , Sífilis/diagnóstico , TanzâniaRESUMO
A 31-year-old woman returned to her native Germany, after a two-year stay in Tanzania, suffering from cutaneous diphtheria which had spread to nose and throat. One of her three children, a four-year-old boy, also had Corynebacterium diphtheria in his throat, without any symptoms. Both mother and child had been immunized against diphtheria.