Dtsch Arztebl Int
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Point-of-care testing (POCT) for the demonstration of pathogens was introduced several years ago. The present study describes the current technical status of POCT, giving some examples, and summarizes the specific advantages and disadvantages of the POCT approach in microbiology. ⋯ The test systems available today are technically mature and offer good to very good performance. For HIV, malaria, group A streptococci, and legionellae, POCT testing, when indicated, is on a par with conventional procedures. The information yielded by rapid tests for pneumococci and for influenza tends to be supplementary in nature. The rapid test for group B streptococci is unsuitable for routine use because its sensitivity is still too low compared with bacterial culture. POCT can be successful only if the tests are performed correctly by trained personnel, quality management procedures are followed, and the severity of illness and the epidemiological circumstances are taken into account when interpreting the results.
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The incidence of melanoma has increased fivefold during the past three decades. Melanoma can no longer be classified as rare; rather, it is now one of the more frequent tumors. ⋯ The recommendations presented here are based predominantly on the results of prospective randomized trials.
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Tonsillectomy is one of the most frequently performed surgical interventions in children. In the following, indications, preoperative evaluation, surgical techniques and postoperative complications will be discussed. ⋯ Tonsillectomy is one of the most frequently performed interventions in children but should be considered with care, as life-threatening complications can occur.
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Acute postoperative pain management is still far from satisfactory despite the availability of high-quality guidelines and advanced pain management techniques. ⋯ QUIPS shows that outcomes in postoperative pain management can be measured and compared in routine clinical practice. This may lead to improved care. QUIPS reveals which operations are the most painful. Quality improvement initiatives should use as few resources as possible, measure the quality of the outcomes, and provide rapid feedback. Structural and process parameters should be continuously reevaluated to determine their suitability as indicators of quality.