Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Distal tibial fracture--an indication for osteosynthesis with the unreamed intramedullary nail?].
In a prospective study, 50 fractures of the distal fifth of the tibia with additional involvement of the ankle joint in 18 patients were stabilized by unreamed nailing. In all, 90% of all fractures healed uneventfully without further surgical intervention after unreamed nailing, the highest ratio of complications (22%) being seen in all patients with distal fractures of the fibula without additional plating (of the fibula). Tibial fractures close to the ankle joint can be managed by unreamed nailing; distal fractures of the fibula should be additionally stabilized by fibular plating.
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In a cooperative effort involving each medical society the joint study group of the medical research societies in Germany (AWMF) has established guidelines for the diagnosis and treatment of various diseases. Special guidelines which pertain specifically to operative intensive care medicine do not exist. However, official recommendations have been made for intensive care management in general. ⋯ Also yet the value of those guidelines cannot be assessed. It is beyond doubt that besides being of benefit, they do present some dangers. One must point out that these guide lines are recommendations and not rules upon which medical liability may be based.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
Comparative Study[Surgical research and publications in Germany--an analysis of 1984-1994].
The present study analyses a selection of German and American surgical and cancer research journals from the years 1984 and 1994. The aim of the study was to evaluate the amount of publications by German surgeons in these journals. ⋯ In parallel, German surgeons are still the major contributors to German language journals, but increasingly publish in the American ones as well. The impact factor is one of the major selection criteria on to which journal a paper shall be submitted.
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Ever-increasing knowledge of the pathomechanisms and the phasic pathogenesis of ARDS has increased the demand for adequate monitoring and has modified therapeutic strategies. The influence of monitoring by double indicator dilution technique (COLD system) with the close measurement of extravascular lung water on the diagnosis and therapy of ARDS is presented. Pressure-controlled ventilation (< 35 cm H2O) in combination with moderate PEEP, kinetic therapy (prone position) and elective CVVH already in the early stages of ARDS can be regarded as the standard therapy. The effectiveness of NO inhalation, prostaglandins and radical scavengers still has to be improved in controlled clinical trials.