Two years' experience with Web-based teleconsulting in dermatology.

A non-commercial teledermatology network based on store-and-forward operation was established in April 2002. The aim was to create an easy-to-use platform for teleconsultation services, where physicians could seek diagnostic advice in dermatology from a pool of expert consultants and where they could present and discuss challenging dermatology cases with special emphasis on diagnosis and therapy. An online moderated discussion forum was added in October 2003. During the first two years, 348 health-care professionals from 45 countries registered to use the Website. A total of 783 requests for consultations were answered; 285 requests concerned pigmented skin lesions, 440 requests were from the whole range of clinical dermatology and 58 requests were about non-melanoma skin cancer. Of a total of 133 requests analysed, 80 (60%) were answered within one day, 47 (35%) within one week, five (4%) within two weeks and one (1%) consultation was answered in more than two weeks. Our experience with a discretionary, non-commercial, multilingual Website for open-access teleconsulting in dermatology appears to be successful. The Website represents an example of user-generated content, together with active interaction between users, who can present and discuss cases with remote colleagues.

[Cross cultural psychometric comparison of major depression in Chile and Germany]. / Comparación psicométrica transcultural de la depresión mayor entre Chile y Alemania.

BACKGROUND: Depressive symptoms and personality features of patients with mood disorders are supposed to have a strong variability in cross cultural studies. The clinical profile, the outcome and the treatment response seem to be different across the world. AIM: To investigate the differences and similarities of major depressive disorders in Chile and Germany. MATERIAL AND METHODS: Sixty seven Chilean and German depressive inpatients, without comorbidity on axis I or II were studied. Diagnosis of depression was based on DSM IV and ICD 10 criteria for major depression. Symptomatology was assessed using the self reporting questionnaire (SRQ-20), the Symptom checklist-90-revisited (SCL 90-R), the Beck inventory for Depression (BDI), and the Hamilton scale for depression (HAM-D). Personality was assessed with the Munich Personality Scale. RESULTS: Only the SRQ-20 shows significantly higher tendency towards depression among Chilean patients. At the personality level, Chileans exhibited higher scores in extroversion, neuroticism, esoteric and isolating tendencies. CONCLUSIONS: These results help to understand differences and similarities between depressive syndromes across cultures. They suggest that the relation between symptomatology, some personality traits and severe major depression has little variability across cultures.

[Decrease in premature birth rate through consequent application of diagnostic and therapeutic standards in pregnancy monitoring]. / Senkung der Frühgeburtenrate durch konsequente Anwendung von Diagnostik- und Therapiestandards in der Schwangerenbetreuung.

All pregnant women living in the district of Suhl have been observed in our prenatal outpatient department. All gave birth in our department for obstetrics and gynaecology. This observation is made on the base of a standard. From 1981-1987 there were 5,657 pregnant women with singleton pregnancies. In this time the rate of premature birth was on an average of 4.7%. But, over the time there was a slope from 7.3 to 2.8%. Consecutively there was a decrease of 50% in perinatal mortality. The successful standards for observation of pregnant women used in our department have been discussed.