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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Deutscher Kongress für Orthopädie und Unfallchirurgie; 71. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 93. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 48. Tagung des Berufsverbandes der Fachärzte für Orthopädie; 20071024-20071027; Berlin; DOCW41-1363 /20071009/
    Publication Date: 2007-10-10
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    ISSN: 1433-7339
    Keywords: Key words Osteolytic bone disease ; Pamidronate ; Terminal care ; Costs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The goals of this study were the assessment (1) of all costs of terminal care of patients with osteolytic bone disease and pain and (2) of the economic consequences of the pamidronate treatment as observed in a prospective clinical trial on the effectiveness of pamidronate. A total of 70 patients were recruited, who were all suffering from advanced tumour diseases (60% breast cancer, 21% multiple myeloma, and 19% other tumours). In a single-institution study the patients were randomly assigned to receive, in a double-blinded setting, pamidronate 60 mg i.v. or 90 mg i.v. every 3 weeks for a maximum of six cycles. Perception of pain intensity was recorded by self-assessment, using a linear analogue scale. Follow-up lasted 6 months after treatment. All elements of direct costs of in-patient and out-patient care were recorded in cooperation with the hospital administration and the health insurance companies [Krankenkassen]. Average monthly direct costs amounted to ECU 1,290 (±410) and 1,050 (±430) during the treatment phase and follow-up, respectively. Average in-patient costs were about three times the out-patient costs. Significantly higher costs (by a factor of 2) were observed for terminal care in hospital (last 3 months before death) than for continued care (of patients surviving the study period). The treatment with pamidronate reduced pain significantly but did not add noticeably to the costs. The study showed that it is practicable and quite efficient to combine a pharmaco-economic evaluation with a clinical trial, although it may be difficult (depending on the setting and availability of information) to assess true costs, i.e. total resource usage.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1420-911X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1437-1596
    Keywords: Key words Clinical forensic medicine ; Diagnostic imaging ; Diaphanoscopy ; Invisible subcutaneous hematomas ; Soft tissue injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Law
    Notes: Abstract A significant proportion of subcutaneous hematomas remain undetected after external visual examination of the body. In the case of a cadaver such hematomas can be easily identified through a cutaneous incision but in living persons the diagnosis becomes more complicated. The usual methods, based on diagnostic imaging, do not combine sufficient reliability and feasibility. The results of our investigations demonstrated that forensic diaphanoscopy is a highly sensitive (95%) and specific (97%) means to determine the presence or absence of subcutaneous invisible hematomas. In addition, it is possible to locate such hematomas with great precision, to draw their shape and evaluate their magnitude. The lower limit of detection is of the order of 1 mm. The advantages of this method lie in the fact that it is reliable, non-invasive, has no side effects, is simple to carry out and allows real time scanning.
    Type of Medium: Electronic Resource
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