40 research outputs found
Untersuchung der medizinischen Infrastruktur Griechenlands im Hinblick auf die Versorgung von im Ausland erkrankten deutschen Geschäftsreisenden und Touristen
No full textUntersuchung der medizinischen Infrastruktur Griechenlands im Hinblick auf die Versorgung von im Ausland erkrankten deutschen Geschäftsreisenden und Touristen
No full textThe Power of Protocol: Professional Identity Development and Governmentality in Post-socialist Health Care
No full textAbstract: The Czech Republic is experiencing a growing trend of health-care worker emigration. Although some emigrate for long periods of time, many return after a few months or years abroad and re-enter the Czech health system. The nurses' narratives in this study draw on experiences in Czech, British, and Saudi hospitals to explore the role standardised medical policies, procedures, and protocols play in the development and maintenance of a nurse's professional identity in the post-socialist context. The author suggests that performance of protocols versus informality of practice in health-care settings provides a lens through which to view professional identity in post-socialism. In fi elds such as health care, standards operate as measures of security that create normative rules of governmentality, regulate behaviour, and prevent harm. The nurses in this study describe the majority of Czech hospitals as lacking standard protocols for patient care. Encountering strict rules of practice in foreign hospitals leads them to evaluate the professionalism and quality of Czech health care and their own selves as nurses. Their assessment is often based on their own ability to effectively perform within the standardised system. The author's primary analysis for this presentation will concentrate on the ways that standardisation relates to ideas about professionalism and nursing autonomy and status
Author Correction: Proteomic and interactomic insights into the molecular basis of cell functional diversity
No full textSilicon Luminescence Spectra Modelling and the Impact of Dopants
No full textAbstractThis paper presents findings on applying physical models in the literature to describe silicon luminescence spectra at 80 – 300K. Incorporation of exciton recombination models are shown to disagree with the measured luminescence spectra, whereas a free electron-hole recombination model is shown to match well with the luminescence spectra. However, the lack of consideration for excitons is not justified, as Bludau et al. [J. Appl. Phys., vol. 45, p. 1846, 1974] reported that excitons are present even at room temperature. The second part of the paper demonstrates the impact of shallow dopants on the silicon luminescence spectra at 79K. The ratio of the dopant-related peak to the band-to-band peak intensities correlates with the dopant concentration, indicating that luminescence spectroscopy has the potential for quantifying dopant concentrations in silicon in this temperature range
Influence of a Lordotic Cage Profile on Global and Segmental Lordosis in the Context of Lumbar TLIF Surgeries: A Retrospective Radiological Analysis
No full textBackground/Objectives: Cage implantation decompresses neural elements, stabilizes segments, and promotes fusion, with sagittal balance influenced by cage size, geometry, and position. This retrospective study compared the effects of lumbar interbody cages with 10° and 15° lordotic angles on global and segmental lordosis in patients undergoing transforaminal lumbar interbody fusion (TLIF). Methods: Data from 215 patients who underwent 259 TLIF procedures between 2018 and 2022 were analyzed. All the surgeries were performed by a single senior orthopedic spine surgeon, and cages were selected by the surgeon based on patients’ clinical and anatomical factors. Radiographic assessments included measurements of global and segmental lordosis. Results: Patients who received 15° cages demonstrated significantly greater segmental lordosis compared to those who received 10° cages in both bisegmental and monosegmental procedures (p < 0.001). While the global lordosis in the 10°-cage group remained unchanged postoperatively (p = 0.687), bisegmental procedures showed a small but statistically significant increase (p = 0.035). Moreover, global lordosis did not significantly differ between the 10°- and 15°-cage groups. Conclusions: Cage geometry significantly influenced segmental lordosis, with 15° cages achieving overall more superior radiographic results compared to 10° cages. However, global lordosis was unaffected by cage angle, thereby highlighting the multifaceted nature of factors that influence overall spinal alignment. These findings provide valuable insights into lumbar spine surgery, thus emphasizing the need for comprehensive preoperative planning and consideration of individual patient characteristics
The burden of periprosthetic joint infections: patient-reported outcomes and qualitative insights into periprosthetic joint infections
No full textIntroduction : Periprosthetic joint infections (PJIs) have a severe physical impact and impose a significant psychological burden. This study aimed to compare patient-reported outcome measures (PROMs) and qualitative interview data within the same study cohort. Methods : A total of 28 PJI patients were identified after completing treatment for hip or knee PJIs. Qualitative interviews were conducted, and PROMs – such as the hip disability and osteoarthritis outcome score (HOOS), knee injury and osteoarthritis outcome score (KOOS), hospital anxiety and depression scale – total (HADS-T) score, and brief pain inventory (BPI) score – were assessed. The data were then evaluated for correlations between the PROMs and the qualitative interview findings. Results : A total of 20 out of 28 (71.4 %) patients scored above the accepted threshold of ≥10on the HADS-T. A total of 8 out of 28 (28.6 %) patients scored low on the HADS-T. Through semi-structured interviews, we further evaluated the two groups: a high-HADS-T-scoring group and a low-HADS-T-scoring group. PJI patients scoring high on the HADS-T experienced a heavier psychological burden than those scoring low on the HADS-T. Our qualitative data show that the high-HADS-T-scoring group perceived their PJI experience as troubling and psychologically distressing; moreover patients in the high-HADS-T-scoring group did not deal with the PJI as well as those in the low-HADS-T-scoring group. Conclusions : This study provides valuable information regarding the screening of PJI patients who are at risk of psychological disorders using the HADS-T. Following screening, it also provides insight into which patients should be closely monitored and which patients should be offered professional psychological support, as the latter resource is limited and needs to be distributed sensibly. PJI patients scoring above ≥10on the HADS-T are high-risk patients and should be offered professional psychological support
Intraoperative Radiotherapy during Kyphoplasty for Vertebral Metastases (Kypho-IORT): First Clinical Results
No full textAims and backgroundKyphoplasty is an effective procedure providing structural stability and pain alleviation in vertebral metastases. To prevent early regrowth, patients typically receive postoperative fractionated radiotherapy, which is associated with long treatment duration. Therefore, we established a new approach to deliver intraoperative radiotherapy during kyphoplasty to shorten the treatment time and reach structural stability and sterilization of the metastases (Kypho-IORT).Methods and study designFor Kypho-IORT, a 50 kV X-ray source with a specially designed applicator was used. A radiation dose of 8 Gy in 5 mm distance was delivered. After radiation the device was removed and the kyphoplasty was completed according to the standard procedure. Since August 2009, 18 patients with instable or painful spinal metastases received Kypho-IORT. The median age was 63 years (range, 43–73).ResultsKypho-IORT was successfully performed in 18 of 21 vertebral lesions (86%). No severe complications occurred during or early after IORT. The median pain score using a visual analogue scale decreased from 5/10 before the procedure to 2.5/10 at day 1 (P <0.001) and to 0/10 six weeks after the procedure (P = 0.001). Imaging studies were available for 15 of 18 patients. Stable disease within the irradiated vertebral body was seen in 14 patients (93%) and local progressive disease in one patient (7%). No re-irradiation due to local progressive disease or pain recurrence was necessary within the median follow-up of 4.5 months.ConclusionsKypho-IORT is well tolerated without severe side effects and provides fast improvement of pain. Although stable disease was seen in 93% of the patients, a longer follow-up is necessary to assess the effectiveness. A dose escalation study to establish the maximally tolerated dose has been initiated.</jats:sec
Precision IORT – Image guided intraoperative radiation therapy (igIORT) using online treatment planning including tissue heterogeneity correction
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