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Mortensen posted an update 1 year, 6 months ago
Clinical signs of an infection of the hand can be subtle initially or in a chronic state. But even in a progressive stadium it might be difficult to define an involvement of soft tissue, joint or bone. This review article addresses the diagnostic options of radiologic imaging. Radiographs of the affected region are the basic diagnostics. Sonographics provides information about an abscess or effusion versus diffuse edema and phlegmon. Both are in most situations promptly available. In chronic cases and unclear findings, MRI is of value. With bone involvement and an implant related osteomyelitis suspected, CT is the most valid method.Acute infections of the hand can be a pathology with severe consequences. Alongside the surgical therapy, it is necessary to establish a systemic antiinfective therapy as well. The most frequent bacteria in acute hand infections are Staphylococcus aureus and, less frequently, different Streptococci. If the infection is the result of a bite wound, the most frequently found bacterium is Pasteurella multocida. Fortunately, the susceptibility to frequently used antibiotics in the (middle-)European area is quite good – according to the literature, resistances are rare. First line antibiotics are 1st and 2nd generation cephalosporins as well as aminopenicillins in combination with beta-lactamase inhibitors. Especially in multi-morbid patients or infections with unusual aetiology, a broader bacterial spectrum is to be expected. It is very effective to collect a tissue sample or swab for microbiological analysis before the establishment of the antiinfective therapy to gain valuable information about the prospective therapy. Ultimately, hand infections are a pathology to be treated with increased attention to avoid severe complications. A close cooperation with the involved specialties and physiotherapists should be sought to guarantee the best possible outcome.This review article addresses the incidence, types, and causes of hand infections, as well as risk factors and differential diagnosis.
In sight of increasing bacterial resistances, appropriate and cautious antibiotic therapy (antibiotic stewardship) is becoming more and more important, in private practices as well. A current S3 guideline is available for the treatment of uncomplicated urinary tract infections, which recommends that regular epidemiological examinations of pathogen sensitivity are to be carried out promptly and locally. With this said, the antibiotic prescriptions of the resident doctors in Hesse were examined and compared with the sensitivity of the most important pathogens causing urinary tract infections.
The prescription data for antibiotics (ATC J01) for the area of the Association of Statutory Health Insurance Physicians in Hessen for the years 2013 to 2020 were received from Insight Health GmbH & Co. KG, Waldems-Esch, which manages the data. A large laboratory that supplies numerous resident doctors in the Rhine-Main region provided sensitivity data tested according to CLSI until the year 2016 and from 2017 obiological diagnostics, in our opinion, in transferring this observation in the Rhine-Main area and in Hesse, trimethoprim can also continue to be used empirically for uncomplicated urinary tract infections.
Registries are an essential research tool to investigate the long-term course of diseases and their impact on the affected. The project digiDEM Bayern will set up a prospective dementia registry to collect long-term data of people with dementia and their caregivers in Bavaria (Germany) supported by more than 300 research partners.
The objective of this article is to outline an information technology (IT) architecture for the integration of a registry and comprehensive participant management in a dementia study. Measures to ensure high data quality, study governance, along with data privacy, and security are to be included in the architecture.
The architecture was developed based on an iterative, stakeholder-oriented process. The development was inspired by the Twin Peaks Model that focuses on the codevelopment of requirements and architecture. We gradually moved from a general to a detailed understanding of both the requirements and design through a series of iterations. The experience learned from the sible.
This article outlines an IT architecture to integrate a registry and participant management in a dementia research project. The framework was discussed and developed with the involvement of numerous stakeholders. Due to its adaptability of used software systems, a transfer to other projects should be easily possible.
As has been proven by numerous studies, people with gender identity disorders have a reduced quality of life. Considerable psychological strain leads to depressive and anxiety disorders and increased suicidal tendencies compared with the normal population. Colivelin In addition, social limitations reduce the quality of life. More and more transsexual people use the possibility of undergoing gender reassignment surgery. However, this surgery means a radical change in a patient’s life. This work aims to analyse whether surgical interventions help to improve the quality of and satisfaction with life of transmen and transwomen in a long-lasting way.
A systematic literature search was conducted using the PubMed, Embase and Cochrane Library databases. Our analysis only included original retrospective or prospective studies concerning the quality of life after gender reassignment surgery.
Twenty-seven studies were included. Quality of life was analysed retrospectively in 20 studies and prospectively in 7 studies. Fou life of transsexual people lags behind.
Numerous studies have proven that gender reassignment surgery helps to reduce the level of suffering in transmen and transwomen. Satisfaction with life, mental and physical health as well as social life improve after surgical treatment combined with endocrinologic and psychological treatment. However, compared with the normal population, the quality of life of transsexual people lags behind.
DNA methylation-based epigenetic age measures have been used as biological aging markers and are associated with a healthy lifespan. Few population-based studies have examined the relation between diet and epigenetic age acceleration.
We aimed to investigate the relation between diet quality and epigenetic age acceleration.
We analyzed data from 1995 participants (mean age, 67 years; 55% women) of the Framingham Heart Study Offspring Cohort. Cross-sectional associations between the Dietary Approaches to Stop Hypertension (DASH) score and 3 whole-blood DNA methylation-derived epigenetic age acceleration measures-Dunedin Pace of Aging Methylation (DunedinPoAm), GrimAge acceleration (GrimAA), and PhenoAge acceleration (PhenoAA)-were examined. A mediation analysis was conducted to assess the mediating role of epigenetic age acceleration in relation to DASH and all-cause mortality.
A higher DASH score was associated with lower levels of DunedinPoAm (β = -0.05; SE=0.02; P=0.007), GrimAA (β = -0.09; SE=0.02; P<0.