Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Case Reports
[Neuralgia of the genitofemoral nerve after hernioplasty. Therapy by peripheral nerve stimulation].
The peripheral nerve stimulation (PNS) is an established therapy in the management of neuropathic pain. Here, we describe a case of successful epifascial stimulation in the proximity of the genitofemoral nerve, which was injured during an endoscopic hernioplasty. ⋯ There were no adverse events until now. In conclusion, PNS is a promising procedure in the treatment of neuralgia after hernioplasty.
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Interactive Tutorial
[Local and regional anaesthesia. Principles and techniques].
Local and regional anaesthesia procedures are common in most surgical practices. Continuous regional anaesthesia techniques may improve the outcome and significantly reduce postoperative pain. Epidural anaesthesia is recommended for abdominal and thoracic surgery, whereas continuous peripheral regional anaesthesia via a catheter is advantageous for limb surgery. Although these techniques are very safe, emergency treatment of life-threatening complications must be available.
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Multiresistant, extended spectrum beta lactamase (ESBL)-producing pathogens are an increasing problem in daily clinical life. This paper summarizes the development of resistance as well as epidemiology, diagnostics, and treatment of ESBL-producing micro-organisms. We analyzed microbiological data collected at the Grosshadern Clinic in Germany between 1996 and 2007, in order to assess the importance of these micro-organisms to medical practice and surgical care units. ⋯ The results show an increasing prevalence of ESBL-producing pathogens in hospitalized patients and in surgical departments. The resulting rise in treatment costs and patient risk require thorough knowledge of risk factors, therapy, and preventive measures.
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CHIR-Net is a German national surgical network for clinical trials. It is supported by the Federal Ministry for Education and Research (BMBF 01GH0605) to establish infrastructure and expertise in the conduct of clinical trials within the surgical disciplines. An important aspect of this network is a qualified advanced training for physicians deployed at the CHIR-Net as part of a job rotation. ⋯ After the rotation time at the CHIR-Net the skilled physicians act as multipliers of specialized knowledge on clinical research. In this way the acquired expertise will be transferred into clinical practice and treatment of patients within research projects will benefit directly.