[Effective skill training by means of E-learning in orthopaedic surgery]. / Effektives Training der chirurgischen Röntgenbefundung durch E-Learning.

BACKGROUND: The effectiveness of e-learning for reporting of x-ray-findings in a prospective, randomized trial was tested. MATERIAL AND METHODS: Twenty advanced medical students were randomized into two groups. The test group practiced 4-6 hours with the newly developed software, the control group used conventional learning material. Afterwards, a test was carried out including 30 pathologic x-ray films that were randomly spread through 200 non-pathologic images. The required time, the number of correctly appraised images and the frequency of falsely suspected pathologies were recorded. In addition, we asked for an assessment of the own capabilities in evaluating x-ray films and of passing the radiology training. RESULTS: The test group showed a markedly improved efficiency in comparison to the control group in all parameters. The required time was 57.4% shorter than in the control group (p < 0.05), 18.3% more cases were evaluated correctly (p < 0.05). The frequency of falsely suspected pathologies decreased by 61% (p < 0.05). There was no significant correlation of the objective abilities of a student with his/her self-assessment or of passing the radiology course. CONCLUSION: This study shows that an effective standardized training of practical skills by means of e-learning is feasible and reasonable.

[Salvia divinorum--representation of a new drug in the Internet]. / Salvia divinorum--Präsenz einer neuen Droge im Internet.

AIM OF THE STUDY: The German pages of the Internet were searched for the presence of the hallucinogenic herbal drug Salvia divinorum, which is not dealt with in current addiction medicine or psychiatric text books. The investigation is part of the EU sponsored project "Psychonaut" as preparatory work for the development of an Internet-based early warning system. METHODS: The first 100 websites of the search using "Salvia divinorum" were compared with the search results for "cannabis" and "LSD". The following aspects of the sites were especially analyzed: the originator, marketing of drugs, and the attitude towards drug use. RESULTS: Salvia was offered for sale on approximately a third of the sites (29%); cannabis and LSD were not marketed on any sites. Official websites such as those from governmental organizations or universities were seldom found when searching for "Salvia divinorum", and then only under the last hits. The percentage of institutional sites (e. g. public organizations) were 12% with Salvia, 21% with cannabis, and 38% with LSD. A drug-friendly attitude was found at 64 % of the sites with regard to Salvia, 58% for cannabis, and 24% for LSD. CONCLUSION: The drug help system must be aware of that the Internet is a source of drug-related information, and of drug trade. As this investigation shows, sites often have a drug-friendly attitude. The low availability of official information on Salvia divinorum (also outside the Internet) relative to the presence of drug-friendly or drug trading sites is an indication that new trends of drug consumption can be tracked in the Internet before they will be found in official literature.

A novel synthesis of 14 alpha, 15 alpha-methylene estradiol (J 824).

A novel approach to the synthesis of the orally active estrogen 14 alpha,15 alpha-methylene estradiol (8, J 824) is described, starting with 3-methoxy-estra-1,3,5(10),8,14-pentaen-17 alpha-ol (5). The 14 alpha, 15 alpha-methylene bridge was sonochemically introduced by regioselective and stereoselective Simmons-Smith methylenation of the 14-double bond. Birch reduction of the 8-double bond provided the desired 8 beta-H, 9 alpha-H steroid, whereas ionic hydrogenation afforded the 8 beta-H, 9 beta-H isomer, together with an epimerization of the 17 alpha-hydroxy group. Oxidation of the Birch product yielded the corresponding 17-oxo steroid, which gave the title compound by diborane reduction. For radioimmunoassay development the 6-(O-carboxymethyl)-oximino derivative of 8 was prepared as hapten and the 2-hydroxy derivative of 8 was synthesized as a potential metabolite of 8, and 8 was tritium labeled as well.