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Ingolstadt, Germany

Ruth M.,Klinikum Ingolstadt GmbH | Weber M.,Lauenforde | Zenz M.,Universitatsklinik For Anaesthesiologie

Background: The goal of this study was to evaluate the efficacy of laser acupuncture for the clinical picture of chronic back pain under everyday conditions using a randomized, double-blind, placebo-controlled study design. A further aim was to analyze to what extent placebo effects also influence the outcome of acupuncture under these conditions. Patients and methods: The study included male and female patients with chronic back pain (lasting longer than 6 months) aged between 30 and 77 years with a pain score of at least 5 on a visual analog scale. The main criterion was achieving alleviation of pain by at least 50% 3 months after the start of treatment. The assessment tools used were the Von Korff questionnaire supplemented by the FFbH, FABQ, and SF-12. In addition, the participants were questioned about whether they perceived anything during the treatment and how certain they were that they had received treatment with active or inactive lasers. Results: A total of 111 patients were included in the study and were treated according to the randomization list in two groups each consisting of 51 subjects. The study was completed as scheduled by 102 participants. Analysis of the primary outcome measure, improvement of the pain score by more than 50% over baseline, revealed improvements in both treatment groups between the time points used for measurement. The placebo group exhibited better levels than the group that received laser treatment. No efficacy advantage of laser acupuncture over placebo treatment could be determined. Conclusion: It was possible to completely blind the acupuncture forms with the study design employed. Perhaps the consistent exclusion of nonspecific treatment effects contributed to this result. It cannot be ruled out that the effects of acupuncture are based on a strong placebo effect. © Deutsche Gesellschaft zum Studium. Source

Systemic autoimmune diseases often present with diffuse symptoms. Laboratory diagnosis therefore plays a fundamental role and may facilitate confirmation or negation of a clinical diagnosis, differential diagnosis, evaluation of activity and prognosis, involvement of organs and drug side effects. However, results must be interpreted in clinical context. The most important laboratory parameters are autoantibodies and inflammation markers. The basic laboratory evaluation should be performed in the first line to support an early presentation of the patient to the specialist or in the hospital, allowing initiation of a specific therapy to prevent irreversible organ damage. Verification of certain autoantibodies is included in the classification criteria or in the definition of a disease entity. © Georg Thieme Verlag KG Stuttgart New York. Source

Orth M.,Institute For Laboratoriumsmedizin | Aufenanger J.,Klinikum Ingolstadt GmbH | Hoffmann G.,Trillium GmbH | Hofmann W.,Stadtisches Klinikum Munich GmbH | And 6 more authors.

Eine labormedizinische Diagnostik ist bei vielen Patienten für eine erfolgreiche medizinische Behandlung notwendig. Sowohl aus ökonomischen als auch aus ethischen Gründen sollten labormedizinische Leistungen weder zu häufig (als .,Wiederholungsuntersuchungen") noch zu selten angefordert werden. Mit diesen Empfehlungen werden für eine Reihe von labormedizinischen Untersuchungen anhand von Studien, pathophysiologischen Zusammenhängen und Konsensus Empfehlungen für eine sinnvolle Wiederholungsfrequenz gegeben. Diese Empfehlungen betreffen das minimale Zeitintervall zwischen 2 Messungen sowie die Kriterien zur Durchführung einer Wiederholungsbestimmung. Ergänzt werden diese Empfehlungen mit grundsätzlichen Überlegungen zur Indikation und Untersuchungsfrequenz von labormedizinischen Untersuchungen. © 2014 by De Gruyter 2014. Source

Gross-Fengels W.,Abteilung Radiologie | Heuser L.,Ruhr University Bochum | Vorwerk D.,Klinikum Ingolstadt GmbH | Helmberger T.,Institute For Diagnostische Und Interventionelle Radiologie Und Nuklearmedizin

Diagnosis and therapy of vascular diseases are increasingly being performed following a multimodal, interdisciplinary and less invasive approach. The introduction of specialized, organ-related centers is a logical consequence in view of a better treatment quality and a more effective use of resources. The German societies of radiology, vascular surgery and angiology jointly developed a process of certification, which has been successfully applied to more than 100 units in Germany. In this article the terms and results of the process are described and possible effects on the quality and structures of the healthcare system are discussed. © 2011 Springer-Verlag. Source

Orth M.,Institute For Laboratoriumsmedizin | Aufenanger J.,Klinikum Ingolstadt GmbH | Klosson R.J.,Institute For Laboratoriumsmedizin

Benchmarking is a systematic and continuous process to compare products, services, and processes - in quantitative and qualitative aspects. Benchmarking in labo ratory medicine departments of hospitals is a frequently used but only poorly standardized method. Sophisticated procedures for data collection are necessary due to large heterogeneity and complexity of activities performed in laboratory medicine with regard to type of testing, response times, availability and amount of different resources needed for single analysis and reporting. These prerequisites are difficult to fulfill. In internal benchmarking projects - i.e., monitoring of productivity, costs, and revenues within one laboratory over an extended period of time - the current tools for data collection are generally suited for use. In external benchmarking, however, several pitfalls may obscure the results. Broadly, external benchmarking projects compare only partial processes with sufficient validity. Differences in benchmarking have to be controlled for improvements of data collection and for changes of surrounding conditions outside the laboratory. This review lists different approaches for benchmarking projects in laboratory medicine departments and describes their strengths and weaknesses. Source

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