Zeitschrift für ärztliche Fortbildung und Qualitätssicherung
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Z Arztl Fortbild Qualitatssich · Oct 1999
[Continuing medical education from the view of ambulatory care physicians--representative outcomes and needs in Bremen and Saxony-Anhalt].
To study the habits of ambulatory care physicians in CME, and to investigate the motivating and negative experiences with different types of CME in Germany. ⋯ Regionally performed surveys are able to guide the planning of CME about habits, wants and needs of the target group and may increase the attendance as well as the involvement. Motivating as well as critical experiences of the participants should be regarded more rigorously in the planning. Consideration can increase the quality and the impact of CME. This applies the more, when certification of the quality of CME and of individual CME-efforts are planned. This article will be followed in one of the next issues by a second from the same survey focusing on the attitudes of ambulatory care physicians towards quality improvement and their intentions to join quality circles (peer review groups).
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Z Arztl Fortbild Qualitatssich · Jun 1999
Comparative Study[First experiences using microsurgical techniques for minimally invasive ventral interbody fusion of the lumbar spine (MINI-ALIF)].
Minimal invasive techniques recently have become more important in spine surgery. Ventral approaches for lumbar fusion techniques are known for a long time. Their disadvantages are their size and the associated trauma. ⋯ Its advantages include reduced technical and personnel effort, minimal traumatized tissue, low blood-loss, short operating times and reduced rates of complications. Additionally the surgeon does not need to be experienced in laparascopic methods. The operation technique is explained and discussed from the neurosurgical point of view.
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Z Arztl Fortbild Qualitatssich · May 1999
Review[Therapy of increased intracranial pressure in space-occupying media infarcts].
Following complete middle cerebral artery (MCA) infarction, up to 10% of all patients develop space-occupying brain edema. Despite intensive care therapy, 80% of these patients die due to transtentorial herniation. Over the past years, two alternative therapeutical options for the therapy of space-occupying MCA infarction have been developed. ⋯ Moderate hypothermia induced within the first hours after stroke has been shown to decrease ICP as well. However, the routine use of this therapy should not be recommended since further clinical studies are available. Knowledge on indications and limitations of different antiedema therapies will allow an effective therapy of increased ICP.
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Z Arztl Fortbild Qualitatssich · Mar 1999
[The DEGAM-concept--development, dissemination, implementation and evaluation of guidelines for general practice].
The German Society for General Practice/Family Medicine (DEGAM) has launched a project to develop and implement national guidelines for general practice accordingly to international models. Guidelines are seen as statements to assist practitioners and patients in deciding about appropriate, effective and efficient health care. They should be evidence-based, feasible for primary care practices, and purposefully addressing to physicians as well as practice staff and patients. ⋯ Implementation of each guideline is promoted by at least five tools (full text, quick reference guide, telephone card for practice staff; patient leaflet, and information-prescription--"infozept"). Methodological quality is checked for the first time in Germany according to the standards of the German Agency for Quality Assurance. Different targets and criteria for evaluation of guidelines in primary care are mandatory part of the DEGAM-concept.