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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Evidenzbasierte Primärversorgung und Pflege; 9. Jahrestagung Deutsches Netzwerk Evidenzbasierte Medizin und Kongress der Deutschen Gesellschaft für Pflegewissenschaft; 20080222-20080223; Witten; DOC08ebmV52 /20080212/
    Publication Date: 2008-02-12
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  7. Deutscher Kongress für Versorgungsforschung des Deutschen Netzwerks für Versorgungsforschung; 20081016-20081018; Köln; DOCE6.6 /20081006/
    Publication Date: 2008-10-07
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science; Düsseldorf, Köln
    In:  Symposium E-Learning: Aktueller Stand und Chancen in der Allgemeinmedizin; 20050708-20050709; Frankfurt; DOC05elearn17 /20050630/
    Publication Date: 2005-07-01
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 4
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMS German Medical Science; VOL: 7; DOC08 /20090824/
    Publication Date: 2009-09-08
    Description: Introduction: Although several online continuing medical education (CME) offers exist, the utilization of these by physicians is still low. In this study, we aimed to investigate the attitude towards and use of the Internet and online CME in German general practitioners (GPs) and to identify potential starting points to increase the use of online CME. Methods: In June 2006, a standardized 6-page questionnaire with 27 questions on the topic "Internet and online continuing education" was sent to all general practitioners in 6 districts (n=1304) of South Baden and South Württemberg in Germany. Data were analyzed using descriptive statistics, and exploratory regression analyses were performed to identify predictors of online CME usage. Furthermore, selected barriers were investigated in detail. Results: A total of 351 questionnaires were sent back, of which 349 could be included in the analysis (27% response rate). The sample is representative of the population contacted with respect to gender and qualifications. Univariate analyses showed that users of online CME were two years younger than non-users on average. Users spent two hours more on the Internet per week than non-users, and had been using the Internet for one year longer. Finally, users had better Internet skills, more often had previous experiences with online CME, and assessed the effectiveness of online CME to be higher and perceived fewer problems than non-users. Discussion: Measures to implement and increase the use of online CME can be aimed at different levels. The most important starting points are likely to be offering GPs the possibility to gain experience with online CME and improving their attitudes towards online CME. But for some physician populations, e.g. elderly or physicians with less Internet exp〈TextGroup〉 er 〈/TextGroup〉ience, e-learning might be an inferior option in comparison to tradi〈TextGroup〉 tio 〈/TextGroup〉nal CME.
    Description: Einleitung: Es gibt zwar inzwischen zahlreiche medizinische Online-Fortbildungsangebote (CME), aber die Nutzung dieser Angebote durch Ärzte ist gering. Das Ziel dieser Untersuchung war es, die Einstellungen gegenüber und die Nutzung von Internet und Online-Fortbildungen durch Hausärzte zu erfassen und mögliche Ansatzpunkte zur Erhöhung der Nutzung von Online-CME-Angeboten zu identifizieren. Methodik: Im Juni 2006 wurde ein 6-seitiger standardisierter Fragebogen mit 27 Fragen zum Thema "Internet und Online-Fortbildung" an alle Ärzte aus 6 Kreisen (n=1304) der KV-Bezirke Südbaden und Süd-Württemberg versandt. Die Daten wurden deskriptiv-statistisch und regressionsanalytisch ausgewertet. Darüber hinaus wurden Hindernisse bei der Nutzung von Online-Angeboten untersucht. Ergebnisse: 351 Fragebögen wurden zurückgesandt, 349 konnten in die Analyse eingeschlossen werden (27%). Die Stichprobe ist in Bezug auf Geschlecht und Fachrichtung repräsentativ für die angeschriebene Gesamtstichprobe. Univariate Analysen zeigten, dass die Nutzer von Online-CME-Angeboten im Durchschnitt 2 Jahre jünger waren als Nicht-Nutzer. Die Nutzer verbrachten zwei Stunden pro Woche mehr im Internet als Nicht-Nutzer und nutzten das Internet bereits ein Jahr länger. Nutzer schätzten ihre Internetkenntnisse besser ein als Nicht-Nutzer, hatten häufiger bereits Erfahrung mit Online-Fortbildungsangeboten, schätzten die Effektivität von Online-CME-Angeboten höher ein und erlebten weniger Hindernisse bei der Nutzung solcher Angebote. Diskussion: Maßnahmen zur Erhöhung der Nutzung von Online-CME-Angeboten können an verschieden Stellen ansetzen. Ein wichtiger Ansatzpunkt ist, Ärzten die Möglichkeit zu geben, Erfahrungen mit solchen Angeboten zu sammeln und die Einstellung in Bezug auf die Einschätzung der Effektivität von Online-Angeboten zu verbessern. Für einige Ärzte-Populationen, beispielsweise ältere oder Ärzte mit wenig Internet-Erfahrung, mögen allerdings traditionelle CME-Fortbildungen besser geeignet sein als Online-CME-Angebote.
    Keywords: Internet ; online continuing medical education ; physicians ; Internet ; medizinische Online-Fortbildungsangebote ; Ärzte ; ddc: 610
    Language: English
    Type: article
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  • 5
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    German Medical Science; Düsseldorf, Köln
    In:  GMS Zeitschrift für Medizinische Ausbildung; VOL: 22; DOC39 /20050815/
    Publication Date: 2005-08-16
    Keywords: ddc: 610
    Language: German
    Type: article
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  • 6
    ISSN: 1432-1076
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A newborn with fatal neonatal listeriosis developed septic shock, neutropenia, thrombocytopenia and profound hypoxaemia due to severe pulmonary hypertension. Tumour necrosis factor α, interleukin-1-β and interferon-γ serum concentrations were markedly elevated, suggesting the participation of these cytokines in the aetiopathogenesis of shock induced by Listeria monocytogenes in the neonate.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1076
    Keywords: Tumour necrosis factor-α ; Preterm neonates ; Newborns ; Infection ; Septic shock
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Tumour necrosis factor-α (TNF-α) is an important mediator in the pathogenesis of Gram-negative shock. In order to assess the role of TNF-α as a marker of the severity of infections in the neonates, serum TNF-α concentrations were determined at the time of septic work-up in 69 newborns (gestational age: 28–40 weeks). Nine patients had systemic infection (group A), four of them with signs of circulatory failure. Eleven patients had positive cultures of gastric aspiration or placental smears (group B) and 49 patients had completly negative septic work-up. Patients of group A had significantly more elevated serum TNF-α levels than patients of group B and C. Within group A, patients with circulatory failure had mean serum TNF-α concentration of 2165±817 pg/ml versus 27±8 pg/ml in newborns without shock. Serum TNF-α concentrations of more than 15 pg/ml detected systemic infections in eight out of nine patients. The specificity was 98% (1 elevated TNF-α concentration out of 60 non infected patients). These data indicate that premature neonates and term newborns are able to produce TNF-α when they are infected. Highly elevated TNF-α concentrations are found in severe systemic infections causing cardiovascular impairment.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1434-808X
    Keywords: Schlüsselwörter Erektile Dysfunktion ; psychogene Erektionsstörungen ; Sexualtherapie ; Psychotherapie ; Psychosomatik ; Kombination psychotherapeutischer und medikamentöser Verfahren ; Key words Erectile dysfunction ; Psychogenic causes ; Sex therapy ; Psychotherapy ; Psychosomatics ; Combination therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In the light of highly successful somatic therapies psychotherapeutic interventions in erectile dysfunction are nowadays less considered. But they are nevertheless highly effective and needed according to the psycho-somatic nature of the condition. In this article we present an etiologic framework of psychogenic erectile dysfunction as well as the diagnostic approach and therapeutic interventions. Finally we discuss the need for an increased research in the combination of psychotherapeutic and medical therapy.
    Notes: Zusammenfassung Angesichts großer Erfolge in der medikamentösen Behandlung der erektilen Dysfunktion haben psychotherapeutische Interventionen in letzter Zeit wenig Aufmerksamkeit erhalten. Doch ist bei Erektionsstörungen als psycho-physisches Gesamtgeschehen auch die Kenntnis psychologischer Faktoren für eine erfolgreiche Behandlung nötig. Die vorliegende Arbeit stellt grundlegende ätiologische Konzepte psychogener Erektionsstörungen vor, erläutert die psychologische Diagnostik und die gängigen Modelle für Sexualberatung und Sexualtherapie. Schließlich wird die Möglichkeit einer Kombination von medikamentöser und psychotherapeutischer Behandlung diskutiert.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1238
    Keywords: Amrinone ; Vasodilator ; Inotrope ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The hemodynamic effects of amrinone were assessed in seven children following cardiac surgery. Amrinone was administered as a bolus of 1 mg kg−1 body wt., followed by continuous infusion at 10 μg kg−1 min−1 for 1 h and two stepwise increases to 20 and 40 μg kg−1 min−1 for 30 min each. Hemodynamic data were obtained and plasma concentrations of amrinone measured 1 h after the bolus dose and immediately before each increment of the infusion rate. Amrinone levels ranged from 0.7 to 2.3 mgl−1. Administration of amrinone lowered systemic vascular resistance from 20.0±4.3 to 16.5±4.6 mmHgl−1 min−1m−2 (p〈0.05) and reduced mean arterial pressure from 71.7±9.5 to 62.6±13.5 mmHg (p〈0.05) at the highest infusion rate, confirming the known vasodilative effect of the drug. However, these effects did not result in a statistically significant increase in stroke volume (35.0±7.5 to 35.5±7.0 ml m−2, NS) or cardiac index (3.10±0.50 to 3.20±0.40 l min−1 m−2). One additional patient, in whom a higher loading dose was tried in order to achieve a higher plasma concentration, developed systemic hypotension. A correlation was established between the plasma concentrations of amrinone and the percentage decrease in systemic resistance (r=0.70,p〈0.05). These results suggest that in children after open heart surgery, amrinone acts primarily as a systemic vasodilator, with questionable inotropic effect. Accordingly, its use should be restricted to children with severe cardiac failure and documented highly elevated afterload.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1238
    Keywords: Heart defects ; Congenital ; Child ; Nitric oxide ; Pulmonary hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 16-month-old girl developed severe pulmonary hyptertension after closure of a large ventricular septal defect. All conventional therapeutic measures failed; an attempt to add nitric oxide at a continous low dose to the inspired gas allowed resolution of pulmonary hypertension and low cardiac output. This report documents that continuous inhalation of low dose nitric oxide is capable of selective resolution of pulmonary hypertension following cardiac surgery for a large septal defect in a child. This suggests that a transient dysfunction in the release of nitric oxide by the pulmonary endothelial cell is responsible for the vasoconstriction.
    Type of Medium: Electronic Resource
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