Der Anaesthesist
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The mortality of patients with sepsis and septic shock is still unacceptably high. An effective antibiotic treatment within 1 h of recognition of sepsis is an important target of sepsis treatment. Delays lead to an increase in mortality; therefore, structured treatment concepts form a rational foundation, taking relevant diagnostic and treatment steps into consideration. ⋯ In complicated septic courses with multiple anti-infective treatment or recurrent sepsis, PCR-based procedures can be used in addition to therapy monitoring and diagnostics. Novel antibiotics represent potent alternatives in the treatment of MDR infections. Due to the often defined spectrum of pathogens and the practically absent resistance, they are suitable for targeted treatment of severe MDR infections (therapy escalation).
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In naturally occurring numbers the frequencies of digits 1-9 in the leading position are counterintuitively distributed because the frequencies of occurrence are unequal. Benford-Newcomb's law describes the expected distribution of these frequencies. It was previously shown that known fraudulent articles consistently violated this law. ⋯ All 12 of the known falsified articles violated Benford-Newcomb's law, which indicated that this analysis had a high sensitivity. The low specificity of the assessment may be explained by the assumptions made about the articles identified for comparison. Violations of Benford-Newcomb's law about the frequencies of the leading digits cannot serve as proof of falsification but they may provide a basis for deeper discussions between the editor and author about a submitted work.
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The brachial plexus is commonly blocked at the interscalene level for shoulder and proximal humeral surgery. There are only a few publications about the interscalene technique in pediatric patients for a peripheral nerve block. Ultrasound-guided peripheral nerve block has become increasingly more popular for pediatric patients because of high success rates and safety concerns. We used ultrasound-guided interscalene brachial plexus block in an 18-month-old child with an acute upper respiratory infection who had a supracondylar fracture of the humerus.
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Regarding survival and quality of life, recent mass casualty incidents have once more emphasized the importance of early identification of the correct degree of injury or illness, to enable prioritizing treatment of patients and transportation to an appropriate hospital. The present study investigated international triage algorithms in terms of sensitivity (SE) and specificity (SP) as well as the process duration in a relevant emergency patient cohort. ⋯ Triage procedures with acceptable diagnostic quality exist to identify the most severely injured. Due to its high rate of false positive results (overtriage) in this study, the recently developed PRIOR algorithm could result in exhaustion of available resources for the severely injured and therefore to undertreatment of correctly assigned triage category I cases within mass casualty incidents. Non-surgical patients are still poorly allocated by the available algorithms. Contribution available free of charge by "Free Access".
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The number of patients treated with cardiac implantable electronic devices (CIED) is continously increasing. Knowledge of the medical indications and technical mode of functioning of these devices is a basic prerequisite for the safe perioperative care of this patient cohort. ⋯ The safe performance of interventions is possible as long as some basic rules are followed. An interdisciplinary approach involving all participating disciplines is necessary in order to adequately deal with the high demands placed on the logistics.