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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  28. Wissenschaftliche Jahrestagung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie (DGPP), 2. Dreiländertagung D-A-CH; 20110909-20110911; Zürich; DOC11dgppP06 /20110818/
    Publication Date: 2011-08-18
    Description: Hintergrund: Dysphagien können nach operativer und Radiochemo-Therapie von Kopf-Hals-Tumoren auftreten. Nach einer Radiochemotherapie können ätiologisch Motorik- und Sensibilitätsstörungen, Xerostomien und Fibrosierungen für Schluckstörungen verantwortlich sein.Material und Methoden: Ein 65jähriger Mann stellte sich wegen seit 9 Monaten zunehmender Aspiration und rezidivierenden Pneumonien vor. Zehn Jahre zuvor erfolgte eine kombinierte Radiochemotherapie eines undifferenzierten Nasenrachenkarzinoms (cT4cN2cM0; Dosis 71 Gy, Chemotherapie mit 5-Fluorouracil + Mitomycin C). Vorbefunde: In einer Laryngoskopie und fiberoptischen endoskopischen Untersuchung des Schluckens (FEES) wurden mobile Stimmlippen, kein Hinweis auf Rezidivtumoren und eine schwere Aspiration beschrieben, in der Videofluoroskopie eine reduzierte Larynxelevation und ein direkter Übergang des Bolus in den Larynx. Computertomografisch ergab sich kein Hinweis auf einen Rezidivtumor.Befunde: Die maximale Mundöffnung zwischen den Inzisiven betrug 2 cm. Laryngoskopisch zeigten sich mobile Stimmlippen mit vollständigem Glottisschluss, jedoch waren die aryepiglottischen Falten nicht zu identifizieren und eine Einsicht in die Sinus piriformes nicht möglich. Die Larynxschleimhaut ging übergangslos in die Pharynxseitenwand über. In der FEES wurde die Nahrung direkt in den Larynx geleitet, in den sich auch postdeglutitive Residuen aus den Valleculae entleerten.Diskussion: Beschreibungen laryngopharyngealer Synechien nach Therapie von Nasopharynxkarzinomen finden sich im Gegensatz zur velopharyngealen Synechie in der Literatur nicht. Im vorliegenden Fall wurden sie in verschiedenen Voruntersuchungen nicht entdeckt bzw. beschrieben. Man kann vermuten, dass die regelrechte Stimmlippenbeweglichkeit und die glatte reizlose Schleimhautbeschaffenheit von einer weiteren gründliche Inspektion der laryngopharyngealen Strukuren absehen ließ. Im Rahmen der Nachsorge sollte daher besonderes Augenmerk auf derartige mögliche Spätfolgen gelegt werden.
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  54. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds); 20090907-20090910; Essen; DOC09gmds151 /20090831/
    Publication Date: 2009-08-31
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Deutscher Kongress für Orthopädie und Unfallchirurgie; 72. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 94. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 49. Tagung des Berufsverbandes der Fachärzte für Orthopädie; 20081022-20081025; Berlin; DOCPO10-1738 /20081016/
    Publication Date: 2008-10-17
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 4
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2015); 20151020-20151023; Berlin; DOCWI39-251 /20151005/
    Publication Date: 2015-10-06
    Keywords: Qualitätssicherung ; Revisionsendoprothetik ; Routinedaten ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 5
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2015); 20151020-20151023; Berlin; DOCPO13-1683 /20151005/
    Publication Date: 2015-10-06
    Keywords: Nosokomiale Infektionen ; antimikrobiell aktive Oberflächen ; Kupfer ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 6
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  82. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie; 20110601-20110605; Freiburg i. Br.; DOC11hnod180 /20110419/
    Publication Date: 2011-04-19
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    ISSN: 1432-1041
    Keywords: drug sales ; self-medication ; over-the-counter sales ; analgesics ; laxatives ; vitamins ; topical steroids
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The over-the-counter (OTC) sales of drugs were estimated by subtraction of sales on prescription and to hospitals from total drug sales in Sweden during the period 1976–1983. Increased sales of antitussives and decreased sales of expectorants characterized cough remedies. Making topical nasal decongestants available as OTC drugs immediately resulted in a large and increasing volume of OTC sales. Among analgesics, sales of acetaminophen and acetylsalisylic acid + caffeine combinations increased, while those of other groups decreased. Drugs for disorders of the alimentary tract were second to analgesics in the numbers of packs sold; amongst them antacids and laxatives dominated. Laxative sales decreased due to decreased sales of stimulant preparations. Vitamin C and multivitamin preparations dominated OTC vitamin sales. The sales of topical corticosteroids, only available as OTC drugs during the last quarter of 1983, were substantial. The OTC drug sales statistics reflect patterns of self-medication and may be used to monitor this important part of health care.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1041
    Keywords: drug prescription ; cost of drugs ; age dependency ; population study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Drug prescribing in Sweden under the National Insurance Act has been continuously recorded since 1974. A random sample of 1 in 288 is drawn from the about 24 million prescriptions issued yearly and the following data are recorded: dispensing pharmacy, type of prescription, year and month of dispensing, year of birth and sex of the patient, trade name, quantity, dosage, and price of the drug. The numbers of prescriptions of drugs free of charge increased by 32% between 1974 and 1983, while that of price deducted drugs decreased by 7%. The national cost of drugs rose sharply during the period. The per capita cost of drugs to persons aged ≥75 years was more than eight-fold higher than for persons aged ≤14 years. A two-fold difference in the number of prescription items was found between women and men, and there were nine- to tenfold differences between age-groups. Total prescribing varied modestly over time, as did the prescribing to most patient groups and for most groups of drugs. Exceptions to this were prescribing to children, particularly of antiallergic drugs for which a 50% increase was observed between 1974 and 1975, mainly due to increased prescribing of phenylpropanolamine. The recording of prescriptions as described is useful for early identification of new patterns of drug use and for mapping drug utilization and drug dosages in different age groups. The system is particularly powerful as a complement to other methods for recording drug use in Sweden, e.g. wholesale sales statistics and individual prescription monitoring in the county of Jämtland. Together these systems offer a unique data base for drug utilization studies.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1041
    Keywords: Psychotropic drugs ; drug utilisation ; geographical differences ; prescribing habits
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Marked differences in the utilisation of psychotropic drugs between the three major urban areas in Sweden were recorded from four sources of information: drug supplies from wholesalers to pharmacies, drug supplies to hospitals for in-patient use, drugs sold on prescription for out-patient use, and out-patient consultation and drug prescribing as recorded by physicians. The total sales of psychotropics in the counties of Gothenburg (110,8 defined daily doses per 1000 inhabitants per day) and Malmö (102,1) were much higher than in the county of Stockholm (73,4), with about 25% of the difference being accounted for by diazepam. Differences in the total sales of psychotropics were not explained by any differences in hospital sales, which amounted to about 10% in all counties. Prescription sales differed due to the higher average number of DDD (defined daily doses) per prescription in Gothenburg and Malmö than in Stockholm (total psychotropics 8 and 15%, respectively), and especially because of the higher number of prescriptions per inhabitant (about 40 and 30–35%, respectively). There was no substantial difference in the pattern of diagnoses between areas, but there was a noticeable difference with regard to prescriber category, as psychiatrists accounted for more of the prescriptions in Stockholm than in Gothenburg and Malmö. The results raise questions about over- and under-treatment of mental disorders and about abuse of drugs. In order to explain the geographical differences in psychotropic drug sales morbidity patterns and prescribing practices should be further explored.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1041
    Keywords: prescription monitoring ; drug dosage ; Sweden ; Jämtland
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Prescribed doses of drugs for which individualisation of dosage is deemed necessary were recorded from one national and one local Swedish prescription monitoring study for the years 1976, 1982 and 1985. Dose patterns were analysed in order to determine whether the practice of individualising drug doses had become more widely adopted by physicians. Amongst drugs eliminated primarily by metabolism, (propranolol and amitriptyline were prescribed in highly variable doses (30-fold or more). The three commonest doses of these agents accounted for about 60% of the prescriptions. In general, doses decreased with increasing patient age. Prescribing practices for piroxicam differed markedly from those of propranolol and amitriptyline, with one fixed dose of piroxicam accounting for about 90% of all prescriptions. For drugs eliminated mainly by renal excretion (digoxin, cimetidine and atenolol) there was an 8–10-fold variation in the prescribed doses. The most frequent dose of these drugs accounted for 40–60% of the prescriptions. Doses of cimetidine and atenolol were lowered only in the oldest patients. The doses of digoxin decreased more evenly with increasing age, and were reduced in elderly patients on long-term maintenance therapy. The difference in digoxin dose between young and old patients increased during the study period. Prescription monitoring as a method for following-up drug usage may be instrumental in evaluating the effect of drug educational efforts.
    Type of Medium: Electronic Resource
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