Zentralblatt für Chirurgie
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The current level of knowledge about radioiodine therapy (RITh) for well-differentiated thyroid carcinoma under consideration of the recent literature is summarised. In RITh for thyroid carcinoma two major fields can be distinguished: the ablation of the thyroid remnant and the therapy of recurrences resp. local and distant metastases. ⋯ The prerequisite is an appropriate follow-up. Surveys about the application of RITh for well-differentiated thyroid carcinoma in Europe and in the USA reveal that uniform treatment recommendations designed to conform interdisciplinary demands are urgently required.
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The aim of this prospective study was to evaluate, whether early thoracic computed tomography (TCT) is superior to routine chest x-ray (CXR) in the diagnostic work up of blunt thoracic trauma and whether these additional informations influence subsequent therapeutical decisions in the early management of severely injured patients. ⋯ TCT is highly sensitive in detecting thoracic injuries after blunt chest trauma and is superior to routine CXR in visualizing lung contusions, pneumo- and hemothorax. Early TCT influences therapeutic management in a considerable subset of patients. We therefore recommend TCT in the primary diagnostic work up of multiple injured patients with suspected chest trauma, because early and exact diagnosis of all thoracic injuries along with sufficient therapeutic consequences may reduce complications and improve outcome of severely injured patients with blunt chest trauma.
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For therapeutic recommendations three different kinds of scores are essential: 1. The severity scores for trauma; 2. Severity scores for mangled extremities; 3. ⋯ The aim of these scores is to assist in the indication with regard to amputate or to save the extremity. These scoring indices can be used to evaluate the severity of a systemic inflammatory reaction syndrome with respect to multiple organ failure. All scores are dynamic values which are variable with improvement of therapy.