RESUMO
This paper gives a comparative overview of the current clinical care of patients experiencing pain in the musculoskeletal system in Austria and in Germany. The questionnaire used in this study was modified from one used in a survey carried out in Germany in 2002. In our version we asked specifically about pain in the musculoskeletal system. In all 228 health care facilities were reviewed, 56.6% of which offer at least one option for pain therapy. In Austria, the majority of patients with pain in the musculoskeletal system are treated by specialists in the departments of anaesthesiology, internal medicine, and orthopaedics. In 17.4% of the clinics in Austria there are plans to extend the pain therapy they offer, but in over half of the hospitals that responded facilities for pain therapy are considered to be vulnerable. The study highlights a significant higher percentage of in-patient pain therapy services in Austria, while in Germany, in contrast, there are more outpatient options for pain therapy. The quality of pain therapy could by further improved by more intense cooperation between the inpatient and outpatient sectors and by the establishment of interdisciplinary and multimodal solutions.
Assuntos
Comparação Transcultural , Doenças Musculoesqueléticas/terapia , Clínicas de Dor/estatística & dados numéricos , Manejo da Dor , Assistência Ambulatorial/economia , Assistência Ambulatorial/estatística & dados numéricos , Áustria , Análise Custo-Benefício , Atenção à Saúde/economia , Atenção à Saúde/estatística & dados numéricos , Economia Médica , Alemanha , Inquéritos Epidemiológicos , Humanos , Medicina/estatística & dados numéricos , Doenças Musculoesqueléticas/economia , Doenças Musculoesqueléticas/epidemiologia , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/estatística & dados numéricos , Dor/economia , Dor/epidemiologia , Clínicas de Dor/economia , Clínicas de Dor/organização & administração , Admissão do Paciente/economia , Admissão do Paciente/estatística & dados numéricos , Equipe de Assistência ao Paciente/economia , Equipe de Assistência ao Paciente/estatística & dados numéricos , Especialização , Inquéritos e QuestionáriosRESUMO
In advanced periodontal diseases, where the root surface a longer time is exposed to the oral environment, retaining of teeth is only possible through de novo-attachment of the periodontal ligament on the diseased root surface. Even when surgical reconstruction of the alveolar bone is successful, connective tissue fibers fail to attach to the affected dental cementum. Patients with two- and three wall pockets can be successfully treated by Nymans method of guided tissue regeneration. However the restoration of the dental attachment apparatus in cases with advanced horizontal destruction of the alveolar bone is still an unsolved problem of periodontal therapy. Investigations of an artificial attachment support will be presented. A synthetic felt glued onto the root surface with special dental adhesives shall obtain the necessary support reattachment of the connective tissue fibers at the periodontitis affect root.
Assuntos
Regeneração Tecidual Guiada Periodontal , Ligamento Periodontal/fisiopatologia , Bolsa Periodontal/cirurgia , Humanos , Raiz DentáriaAssuntos
Traumatismos Faciais/terapia , Fraturas Maxilomandibulares/terapia , Traumatismos Dentários , Adolescente , Fatores Etários , Criança , Pré-Escolar , Traumatismos Faciais/etiologia , Feminino , Humanos , Fraturas Maxilomandibulares/etiologia , Masculino , Avulsão Dentária/terapia , Fraturas dos Dentes/etiologia , Fraturas dos Dentes/terapiaAssuntos
Assistência Odontológica para a Pessoa com Deficiência , Transtornos Hemorrágicos , Anticoagulantes/uso terapêutico , Combinação de Medicamentos/uso terapêutico , Fator XIII/uso terapêutico , Adesivo Tecidual de Fibrina , Fibrinogênio/uso terapêutico , Transtornos Hemorrágicos/fisiopatologia , Humanos , Trombina/uso terapêutico , Adesivos Teciduais/uso terapêutico , Extração DentáriaAssuntos
Fator XIII/uso terapêutico , Fibrinogênio/uso terapêutico , Transtornos Hemorrágicos/fisiopatologia , Trombina/uso terapêutico , Adesivos Teciduais/uso terapêutico , Extração Dentária , Anticoagulantes/uso terapêutico , Combinação de Medicamentos/uso terapêutico , Adesivo Tecidual de Fibrina , HumanosAssuntos
Dequalínio/uso terapêutico , Dor Pós-Operatória/prevenção & controle , Pancreatina/uso terapêutico , Polietilenoglicóis/uso terapêutico , Prednisolona/análogos & derivados , Compostos de Quinolínio/uso terapêutico , Extração Dentária/efeitos adversos , Tirotricina/uso terapêutico , Combinação de Medicamentos/uso terapêutico , Humanos , Dor Pós-Operatória/etiologia , Prednisolona/uso terapêuticoRESUMO
In 144 patients with bleeding disorders and in 11 patients with normal coagulation, 517 wound sealings were performed using the fibrin adhesion system (FAS) with the primary object of local hemostasis. Excellent results were obtained in patients with bleeding disorders caused by impaired thrombocyte function or anticoagulant therapy. Replacement therapy or the withdrawal of anticoagulant medication was thereby avoided. Ultimate hemostasis in patients with hemophilia was achieved by fibrin sealing in combination with low-dose replacement therapy with clotting factor concentrates. Though the risk of hepatitis transmission cannot be completely ruled out, the advantages, such as excellent tissue tolerance, complete resorption, and a wide spectrum of practical uses, speak in favor of the use of this physiologic tissue adhesive.
Assuntos
Fator XIII/uso terapêutico , Fibrinogênio/uso terapêutico , Hemostasia Cirúrgica/métodos , Boca/cirurgia , Trombina/uso terapêutico , Adesivos Teciduais/uso terapêutico , Anticoagulantes/administração & dosagem , Transtornos da Coagulação Sanguínea/fisiopatologia , Combinação de Medicamentos/uso terapêutico , Adesivo Tecidual de Fibrina , Humanos , CicatrizaçãoRESUMO
The prognostic significance of so-called organ sites was investigated in 585 cases with carcinoma of the oral cavity and lips. For the subsamples studied the numerical distribution of TNM categories, life tables and life table comparisons were computed. This produced the following results: 1. There is no demonstrable difference in prognosis between identical T catagories in the organs of the oral cavity. 2. In some cases there is a significant difference between identical N categories in organs of the oral cavity. In the No category this is, however, attributable to the substantial differences in the numerical distribution of T categories. By contrast, a logical explanation for the computationally demonstrable significant differences in the Nx category is not available. The problem is currently being investigated. 3. An assessment of identical TN combinations in the "organs" of the oral cavity proved to be impossible on account of the inadequate number of cases available. The so-called "organ localization" of primary tumours in the oral cavity need not - at least for the time being - be accorded any prognostic relevance. The findings should, however, be re-examined on the basis of greater numbers.
Assuntos
Neoplasias Bucais/patologia , Análise Atuarial , Idoso , Carcinoma/patologia , Feminino , Humanos , Neoplasias Labiais/patologia , Masculino , Neoplasias Mandibulares/patologia , Neoplasias Maxilares/patologia , Pessoa de Meia-Idade , Soalho Bucal/patologia , Metástase Neoplásica , Estadiamento de Neoplasias , Neoplasias Palatinas/patologia , Palato Mole/patologia , Prognóstico , Estudos Retrospectivos , Fatores Sexuais , Fatores de Tempo , Neoplasias da Língua/patologiaRESUMO
UNLABELLED: The German-Austrian-Swiss Research Team on Maxillofacial Tumours is investigating a series of 585 carcinomas of the oral cavity, lips and oropharynx by biostatistical methods. The aim of the study is the determination of relevant prognostic symptoms of oral cavity carcinomas, classification of the series on the basis of these symptoms, the determination of therapeutic efficacy and the assessment of collective and individual prognosis. PRELIMINARY RESULTS: 1. Factors of prognostic relevance are probably only tumour size and intensity of regional metastases. 2. The classification of the series becomes problematic due to the lack of relevant prognostic factors.
Assuntos
Neoplasias Bucais/classificação , Feminino , Humanos , Metástase Linfática , Masculino , Neoplasias Bucais/cirurgia , Metástase Neoplásica , Recidiva Local de Neoplasia , Prognóstico , Estudos RetrospectivosRESUMO
The prognostic significance of primary tumour site in carcinomas of the oral cavity was investigated in a series of 585 cases. For the subsamples (levels and areas of oral cavity) studied, the numerical distribution of TNM categories, life tables and life table comparisons were computed. This produced the following results: Given an identical extension and analogous metastazising rate, there is no computationally demonstrable difference in prognosis between primary tumours sited at different levels and areas of the oral cavity. The exception are the T1Nx categories, for which a difference exists between precanine and retromolar sites. These results should be re-examined on the basis of a larger series.