Non-invasive assessment of parasitic nematode species diversity in wild Soay sheep using molecular markers.

Considerable effort has been put into detecting and identifying parasitic nematodes in live ruminants, but to date most studies are limited to a small group of nematodes and/or to experimentally infected sheep. In this study, a PCR-based assay using species-specific primer pairs, located in the second internal transcribed spacer ribosomal DNA, was developed to identify nine different species from six different families of parasitic nematodes in a wild, unmanaged and naturally infected population of sheep. Each primer pair was tested for its specificity and sensitivity and it exclusively amplified the species it was designed for and exhibited a high degree of sensitivity. The method was applied to eggs and cultured larvae to identify the parasitic nematodes present in a pooled faecal sample from several host individuals with unknown parasite burden. To test detection reliability, a faecal sample from an individual with known parasite burden (through post-mortem analysis) was also examined. All species present could be correctly identified by PCR, but detecting very low levels and/or early stages of infection proved to be difficult. The method was also tested for its applicability to high through-put screening of faecal samples.

[Communication barriers in the management of immigrants and their children. An analysis and possible solutions based on case reports]. / Kommunikationsbarrieren in der Betreuung von MigrantInnen und deren Kindern. Analyse and Lösungsvorschläge anhand von Fallbeispielen.

Up to 41% of patients treated in health care institutions and hospitals in Vienna are non-German-speaking. As one half of the foreign population of Vienna speaks little or no German, their treatment in health care institutions is a difficult issue. Based on exemplary case reports, linguistic and socio-cultural communication barriers in health care are presented and the problematic area of foreign-language communication is analysed. Misunderstandings due to communication barriers not only have a negative financial impact on health care economy, they also complicate the individual care of these patients. Based on the experience gained thus far and in concurrence with the developments in other European countries, the use of professional interpreters who combine their role as linguistic intermediaries with the cultural features of foreign-language patients (community interpreters) should be encouraged. The use of specifically trained internal hospital staff is recommended as well. A concept to coordinate central organisations that provide interpreters in the public field may substantially enhance the quality and efficiency of health care in this special situation.

[Clinical and radiologic legal assessment of spinal injuries using the segmental principle]. / Die klinische und radiologische Begutachtung von Wirbelsäulenverletzungen nach dem Segmentprinzip.

Cat scanning of the traumatized spine led to an approved classification of different types of lesions. Its application is important--not only for therapeutic reasons but also for the judgement of the end results. The classification enables the definition of a remaining instability (radiological and clinical) and is useful for the evaluation of the prognosis according to the structural changes within the motion segments. The conventional way of appreciating working capacity is no longer satisfying considering the improved diagnostic tools and the increasing frequency of various deformities, instability and even ankylosis and their combinations. As in the evaluation of peripheral joint function a concept is proposed, which is based on the structural changes in the motion segments and their motility. According to the kind and amount of deformity and instability the segment value is multiplicated with factors 1 to 6. The number of involved segments is added to obtain the definite range of working capacity. The concept is practicable in all parts of the vertebral column and allows a differentiated judgement within the usual percentages.

[Demonstration of subchondral density pattern using CT-osteoabsorptiometry (CT-OAM) for the assessment of individual joint stress in live patients]. / Die Darstellung der subchondralen Dichtemuster mittels der CT-Osteoabsorptiometrie (CT-OAM) zur Beurteilung der individuellen Gelenkbeanspruchung am Lebenden.

The researches of Pauwels and those following him have demonstrated that the subchondral bone density distribution below the surface of a joint is a metrical parameter which mirrors the predominant stress acting on that joint. Their technique of x-ray densitometry cannot, however, be used during life. By employing computer tomography, a new method has been developed--CT-osteoabsorptiometry (CT-OAM)--which can be used to obtain the density distribution pattern in the living subject. By means of a comparative investigation on specimens which were examined both with traditional x-ray densitometry and with CT absorptiometry, it has been shown that the new method can produce the same results, but providing the great advantage to be used on the living. In addition, the density distribution pattern of the glenoid cavity has been examined in patients with various shoulder conditions, and also in gymnasts who exercise on the rings. The distribution of subchondral bone density showed different patterns in the different groups examined. Both the comparison of the methods and the subsequent study confirmed that CT osteoabsorptiometry enables assessment to be made of the individual long-term stresses acting on a living joint.

[Sonography in acute pancreatitis--diagnosis, assessment of etiology and evaluating prognosis]. / Die Sonographie bei der akuten Pankreatitis--Diagnose, Atiologieklärung und Prognoseabschätzung.

Fifty consecutive patients suffering from acute pancreatitis were studied prospectively with regard to the role of ultrasound (US) in diagnosis, in detection of a biliary origin, and in initial assessment of prognosis. In six patients the pancreas could not be visualised, whereas in 19 only partial examination was possible. In 34% no diagnostic abnormalities were found. US was superior to computed tomography (CT) in respect to the detection of small amounts of ascites, but less suitable than CT for the detection of necrosis. Compared to endoscopic retrograde cholangiography US was of little help in detecting bile duct stones. Neither a lethal outcome nor a severe course could be predicted with sufficient accuracy. The positive predictive value for the presence of necrosis was 33% and the negative predictive value 67%. The data demonstrate a limited role of US in diagnosis and staging in acute pancreatitis.

[Sonographic imaging and assessment of stomach wall changes]. / Sonographische Darstellung und Beurteilung von Magenwandveränderungen.

By the use of a special method of investigation, the true value of percutaneous echography was investigated using 28 patients with primary gastric neoplasms and 3 patients with secondary infiltration of the gastric wall, for the proof and the judgement of the tumors, their extension and their metastases. Tumorous gastric wall thickening could be demonstrated in 87% (27/31), tumor invasion in neighbouring structures in 85% (12/14) and lymph nodes metastases in 66% (10/15). In all patients, who had liver metastases (4) or ascites (5) they were demonstrable. The sonographic appearance of the different gastric wall changes are described and discussed.