Activity

The constipation severity increased gradually until around 5 years and declined thereafter. More severe constipation was better associated with the DP than with the SP. CONCLUSION The result of the analysis of stool frequency and soiling in patients with HD indicated that shorter ASs resulted in fewer bowel movements and less severe soiling. However, with the increase in patient age, the differences became similar. Compared to the DP, the SP was associated with an increased frequency of bowel movements and soiling severity; however, the constipation severity was lower.The German Society of Paediatric Oncology and Haematology (GPOH) and the German Cancer Society (DKG) have defined criteria for DKG certification of paediatric oncology departments. Since 2017, several paediatric oncology departments have already been certified according to these criteria. DKG certification aims for the harmonized and transparent presentation of the quality of care of paediatric oncology patients, as described by Mensah et al. The definition of certification criteria led to controversies within the GPOH about how far the criteria themselves would withstand scientific verifiability.We critically reviewed the paper by Mensah et al. asking whether valid conclusions for the German health system could be drawn from it. We found that currently defined criteria for DKG certification of paediatric oncology departments lack scientific evidence for German paediatric cancer centres in critical aspects.This article challenges case numbers as a parameter for the measurement of quality of care in German paediatric oncology. We try to contribute to an open discussion about alternative criteria for ensuring quality of care in German paediatric oncology departments.The perineal approach for prostate biopsy (PB) is a sterile alternative to conventional transrectal PB. Targeted local anesthesia allows perineal prostate biopsy (pPB) to be performed without general anesthesia. This paper presents the first results after establishing perineal MRI/ultrasound fusion biopsy (pFB) under local anesthesia without standard perioperative antibiotic prophylaxis. For this purpose, 144 patients were included in the study after pFB at the Vivantes Klinikum am Urban. No peri-interventional antibiotic prophylaxis was applied. Peri- and postoperatively, the pain sensation, measured using an analogue pain scale from 0-10, and complications were recorded. The median patient age was 68 and the median prostate-specific antigen (PSA) value 7.07 ng/ml. In all, 49% of the patients received primary PB. The overall detection rate for prostate cancer (PCa) was 71% and for PI-RADS 3, 4 and 5 was 44, 71 and 92%, respectively. The median pain sensation during biopsy was 2. Furthermore, 63% of patients with a transrectal prebiopsy considered this to be more painful and another 20% expressed similar pain levels. Only 1 patient developed a febrile urinary tract infection. The pFB of the prostate under local anesthesia without antibiotic, perioperative prophylaxis is a suitable alternative to the transrectal PB with regard to the detection rate of PCa, the side effect profile and the subjective pain perception of the patients during the intervention.BACKGROUND A cancer diagnosis is always associated with a threat to life and therefore demands a great deal of the decision maker. For patients, this means making decisions under high emotional stress. On the other hand, medical facts can limit freedom of choice. For interactions with the patient in medical practice, this often means a balancing act between honesty and hope. OBJECTIVE This article aims to present factors that influence medical decisions in the area of conflict between ethical and moral obligations towards the patient and the daily routine of oncological care. MATERIALS AND METHODS The current study is a narrative review. RESULTS There are different decision models and decision principles, all of which are influenced by the physician-patient relationship. In oncology, informing patents with regard to lifetime and quality of life is particularly demanding. Sometimes a balancing act between honesty and hope must be made. CONCLUSION In every treatment situation but particularly in the palliative situation, open and honest communication is absolutely necessary. It must be ensured that the patient receives all the necessary information, understands it, and includes it in the decision-making process. An emphatic but clear naming of the medical facts allows the patient to maintain his autonomy and dignity.OBJECTIVE The treatment of thoracic spine (TS) fractures with additional sternal fractures compared to TS fractures without sternal fractures is discussed controversionally, because in some studies it was stated that sternal fractures decrease the thoracic stability. We hypothesized that both types of fractures can be treated the same way by posterior stabilization alone. METHODS A total number of 69 patients with thoracic fractures, with or without additional sternal fractures, were examined, regarding the angle of kyphosis after fracture, postoperatively and after 6 and 12 months. We also recorded the outcome using the Odom’s score and the time until patients returned to work and the activity level. RESULTS It was found that the angle of kyphosis was nearly physiological after stabilization in both groups and a loss of reduction after 1 year was also comparable, either in the patients suffering from the additional sternal fracture or not. In addition, the Odom’s score and the time until return to work and the activity level were comparable in both groups. CONCLUSION We did not find any arguments to preserve additional anterior stabilization or reasons for different treatment strategies either additional sternal fractures occur in thoracic spine fractures or not.Larvae of container-breeding mosquitoes develop in a wide range of container habitats found in residential neighborhoods. find more Different mosquito species may exhibit preference for different container types and sizes. Due to phenological differences, species composition in container habitats may change over time. We first conducted weekly neighborhood container surveys to determine the types of container habitats found in residential neighborhoods, and to determine mosquito species composition over time within these habitats. We then conducted an oviposition choice field assay to determine whether female mosquitoes of different species preferentially oviposit in different container types commonly found in neighborhoods. Halfway through the experiment, the largest container was removed at half the sites to test the hypothesis that incomplete source reduction alters oviposition preference among the remaining containers. In the neighborhood surveys, large containers had the greatest mosquito densities and the highest species richness.