Dtsch Arztebl Int
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Review Comparative Study
Bilateral endoprosthetic total hip or knee arthroplasty.
More than 300 000 joint replacement operations are performed in Germany every year, and the number is rising. In this article, we consider the question of simultaneous bilateral joint replacement at the hips or knees. Such procedures are indicated in patients suffering from bilateral, symptomatic arthrosis. ⋯ Simultaneous bilateral hip arthroplasty is safer for the patient and facilitates rehabilitation, regardless of the patient's age and ASA status (ASA, American Society of Anesthesiologists). With regard to the knees, there are two additional issues, namely the more frequent need for transfusion and somewhat higher mortality of a simultaneous bilateral procedure. Therefore, we recommend simultaneous bilateral knee arthroplasty only for patients in ASA classes 1 and 2. Simultaneous bilateral arthroplasty of either the hip or knee incurs lower costs than two separate operations.
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Epidemic keratoconjunctivitis (EKC) is a highly contagious infection of the ocular surface. 316 cases were diagnosed in Germany in the first 8 months of 2010, corresponding to a 300% increase above the typical figures for recent years. This outbreak motivates us to present the current recommendations concerning EKC. ⋯ The first priority in the treatment of patients with definite or suspected EKC is the rigorous application of hygienic measures in medical facilities, particularly because there is still no effective drug treatment for this disease. No virostatic agent has yet been demonstrated to influence its course, either subjectively or objectively.
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The mass panic at the Love Parade 2010 attracted a great deal of public attention in Germany and abroad. The goals of this paper are to summarize the available data on the injured persons and their treatment, and to assess the preparations that should be made for such an eventuality and the acute measures that should be taken if it occurs. ⋯ These data permit a detailed view of the medical care that was provided. In situations of this kind, the main problems can be dealt with through targeted and structured preparation and optimized emergency plans which consider both foreseeable and unforeseeable events. Priority must be given to rapid diagnostic assessment and clinical decision-making; the prerequisites for these are transparent institutional structures and clear assignments of responsibility.