Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Oct 1999
Comparative Study[Time delays in admission to a Stroke Unit and emergency treatment of patients with ischemic stroke].
This observational study describes the time delays involved in the emergency treatment of acute strokes admitted for treatment in the acute stroke unit of the Landesnervenklinik Gugging, Austria. The aim was to define avoidable delays in the prehospital and intrahospital phase. ⋯ This study shows the necessity for continuing efforts to increase public awareness for immediate hospitalisation after stroke in order to achieve a higher rate of urgent and direct admission to a stroke unit.
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Dtsch. Med. Wochenschr. · Oct 1999
Comparative Study[Supply of emergency physicians for patients with stroke in the Münster area. A cross-sectional study of the quality of regional health care].
Advances in understanding the pathophysiology and treatment of stroke have led to changed requirements, including the prehospital phase, for the care of patients with acute stroke. Rapid transport to a regional stroke centre is nowadays considered to be the standard for optimal quality of care. A retrospective cross-sectional analysis was undertaken in 1996 in the region of the town of Münster to test the quality of medical care provided by physicians on emergency call. ⋯ This analysis indicates that modern prehospital treatment of stroke patients does not reach adequate standards. In particular, it is not comprehensive. While the "action time" is usually adequate, there are deficiencies regarding the quality of medical care and the choice of the admission hospital. Further education for emergency physicians with respect to the management of stroke syndrome should be an integral part of any regional quality programme. The number of hospitals with adequate competence in the acute management of stroke cases is still insufficient.
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Dtsch. Med. Wochenschr. · Oct 1999
Comparative Study[Extracorporeal shockwave lithotripsy in cholecystolithiasis using a new type of minilithotripter].
Extracorporeal shock wave lithotripsy (ESWL) of gallstones has until now required fixed, nearly room-sized and expensive equipment. It has become even less cost-effective with an increase in the number of laparoscopic cholecystectomies. The authors have technically modified a mini-lithotripter, used for dissolving salivary stones, for application against gallstones (by changing the energy spectrum and depth of focus). ⋯ The cheaper mini-lithotripter, costing only a third of the conventional ESWL, is equally effective in the dissolution of gallstones.