[Principles of intervertebral disc assessment in private accident insurance]. / Grundlagen der Bandscheibenbegutachtung in der privaten Unfallversicherung (I).

Due to the spread of intervertebral disc degeneration, insurance companies and experts are regularly confronted with related assessments of insured persons under their private accident insurance. These claims pose a particular challenge for experts, since, in addition to the clinical assessment of the facts, extensive knowledge of general accident insurance conditions, case law and current study findings is required. Each case can only be properly assessed through simultaneous consideration of both the medical and legal facts. These guidelines serve as the basis for experts and claims.managers with respect to the appropriate individual factual assessment of intervertebral disc degeneration in private accident insurance.

Cardiovascular magnetic resonance feature-tracking assessment of myocardial mechanics: Intervendor agreement and considerations regarding reproducibility.

AIM: To assess intervendor agreement of cardiovascular magnetic resonance feature tracking (CMR-FT) and to study the impact of repeated measures on reproducibility. MATERIALS AND METHODS: Ten healthy volunteers underwent cine imaging in short-axis orientation at rest and with dobutamine stimulation (10 and 20 µg/kg/min). All images were analysed three times using two types of software (TomTec, Unterschleissheim, Germany and Circle, cvi(42), Calgary, Canada) to assess global left ventricular circumferential (Ecc) and radial (Err) strains and torsion. Differences in intra- and interobserver variability within and between software types were assessed based on single and averaged measurements (two and three repetitions with subsequent averaging of results, respectively) as determined by Bland-Altman analysis, intraclass correlation coefficients (ICC), and coefficient of variation (CoV). RESULTS: Myocardial strains and torsion significantly increased on dobutamine stimulation with both types of software (p<0.05). Resting Ecc and torsion as well as Ecc values during dobutamine stimulation were lower measured with Circle (p<0.05). Intra- and interobserver variability between software types was lowest for Ecc (ICC 0.81 [0.63-0.91], 0.87 [0.72-0.94] and CoV 12.47% and 14.3%, respectively) irrespective of the number of analysis repetitions. Err and torsion showed higher variability that markedly improved for torsion with repeated analyses and to a lesser extent for Err. On an intravendor level TomTec showed better reproducibility for Ecc and torsion and Circle for Err. CONCLUSIONS: CMR-FT strain and torsion measurements are subject to considerable intervendor variability, which can be reduced using three analysis repetitions. For both vendors, Ecc qualifies as the most robust parameter with the best agreement, albeit lower Ecc values obtained using Circle, and warrants further investigation of incremental clinical merit.

[understanding and radiation hygiene assessment of solar UV exposure in Germany]. / Erfassung und strahlenhygienische Bewertung der solaren UV-Exposition in Deutschland.

In order to monitor the natural ultraviolet (UV) radiation and to assess it from the point of view of radiation hygiene, the Federal Office for Radiation Protection (BfS) and the Federal Environmental Agency (UBA) have built up a common network for UV monitoring. Since 1993, the ground-level solar UV radiation has been measured at four sites in Germany every 6 minutes, with spectroradiometers in the wavelength range between 290 and 400 nm. Because erythema (sunborn) is of special interest in terms of radiation hygiene, the erythemal weighted irradiance was used as a measure for the biological effect of UV exposure. For this purpose, the measured spectral irradiance was multiplied by the relative erythemal weighting function, and the resulting function integrated from 290 to 400 nm. In the summer months of June and July 1999, the erythemal irradiance exceeded regularly the value of 175 mW/m2 in the south of Germany. In the north, values of not less than 160 mW/m2 were measured during this period. These values correspond to an UV index of more than 7 or 6, respectively--a high exposure regarding to the classification of the German Radiation Protection Commission (SSK), for which (absolute) sun protection is recommend. Between 1995 and 1999, the four sites were characterized by a small increase of the ground-level UV exposure of approx. 10%. Nevertheless, in consideration of the manifold factors affecting the acquired data, the measuring period of 5 years is still insufficient to demonstrate an ozone-dependent effect.