Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
-
Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
[Recommendations and guidelines for perioperative pain therapy in Germany].
The management of perioperative and post-traumatic pain in clinical practice is still significantly deficient in Germany as shown in a recently published representative and anonymous survey of 1,000 surgical clinics. Several steps were undertaken to improve the situation: in 1992, an agreement on responsibilities and organization was achieved between the "Berufsverbände" of German Surgeons and of Anaesthesiologists. In 1997, recommendations on the treatment of perioperative and post-traumatic pain were published by the two "Berufsverbände" together with the Scientific Societies of Surgeons and Anaesthesiologists. In 1998, national guidelines based on consensus methods in collaboration with the Association of the Scientific Medical Societies in Germany (AWMF) will be published at the Internet address http://www.uni-duesseldorf.de/WWW/AWMF/.
-
Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
[Detection of disseminated carcinoma cells in bone marrow and peripheral blood in primary breast cancer with RT/PCR of parathyroid hormone-related protein (PTHrP)].
The analysis of tissue specific gene expression by reverse transcription based RT/PCR methods is currently evaluated as a method for the detection of tumor cell dissemination in patients with cancer. Breast cancer tissues express PTHrP and the level of PTHrP expression in the primary tumor correlates with the incidence of metastases in the bone. We applied a RT/PCR assay of PTHrP to detect tumor cells in the mononuclear cell fraction of peripheral blood (pb) and bone marrow (bm) of patients with newly diagnosed breast cancer. ⋯ During the period of observation there was no local and metastatic relapse detectable in the group of patients with primary lymph node negative breast cancer. In summary the increased risk for local or systemic relapse would have been predictable by RT/PCR of PTHrP alone in pb in 4 of the 9 local and in 2 of the 7 early metastatic relapses. Further follow-up of the patient cohort analysed is needed to assess the value of the RT/PCR of PTHrP as a prognostic and predictive marker in patients with breast cancer.
-
Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Comparative Study[Effect of pneumoperitoneum on hemodynamics and intestinal integrity in endotoxinemia: CO2 versus helium].
In a study in pigs pathophysiological effects of a pneumoperitoneum (PP) established during endotoxemia (2 micrograms/kg b.w./hr) were investigated. In this situation a PP with carbon dioxide (CO2) or helium induces a deterioration of systemic hemodynamics or acid-base-stability. ⋯ A CO2-PP adversely affects the intestinal energy metabolism and leads to significantly increased endotoxin levels in contrast to helium after desufflation of the abdominal cavity. Data of this study at least demand for a careful monitoring, if laparoscopy is performed in septic and critically ill patients.
-
Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Changes in postgraduate education (health policy prerequisites, work schedule regulation)].
Postgraduate training is an integral part of becoming a doctor. Postgraduate training in Germany is learning by doing, while working as a doctor. ⋯ There is a clear disproportion between the demand for postgraduate-training posts and the corresponding supply. By flexibilisation of the regulations for postgraduate training and by complementing methods for training and learning, the downward movement of the capacities for postgraduate training will be taken care of.