The online Cough Clinic: developing guideline-based diagnosis and advice.

The aim of the present study was make chronic cough guidelines more practical and user friendly by developing an internet-based interactive diagnostic questionnaire for chronic cough. A prospective cohort study of chronic cough sufferers was conducted in the UK, following European Respiratory Society guidelines for the diagnosis and management of chronic cough. Depending on the response to 16 specific questions, the medical condition responsible for the patient's chronic cough was ascertained according to a predetermined diagnostic algorithm designed to differentiate the three common causes of chronic cough. Appropriate advice and treatment recommendations were then provided. 8,546 adults with chronic cough completed the Cough Clinic diagnostic questionnaire. 46.1% were suggested to have reflux, 38.7% asthma and 15.2% rhinitis. Participants found the website easy to use (94%), the advice helpful (73%) and that it helped them to communicate with their general practitioner better (60%), and 62% reported taking the recommended treatment. The Cough Clinic, an internet-based diagnostic site for chronic cough, had a large uptake by chronic cough sufferers in the UK. Almost half were diagnosed as having reflux as the probable cause of their chronic cough. Internet diagnosis by expert algorithm provides a novel mechanism for patients to access guideline-recommended therapies and enhances dialogue between patients and physicians.

Orange juice classification with a biologically based neural network.

Dystal, an artificial neural network, was used to classify orange juice products. Nine varieties of oranges collected from six geographical regions were processed into single-strength, reconstituted or frozen concentrated orange juice. The data set represented 240 authentic and 173 adulterated samples of juices; 16 variables [8 flavone and flavanone glycoside concentrations measured by high-performance liquid chromatography (HPLC) and 8 trace element concentrations measured by inductively coupled plasma spectroscopy] were selected to characterize each juice and were used as input to Dystal. Dystal correctly classified 89.8% of the juices as authentic or adulterated. Classification performance increased monotonically as the percentage of pulpwash in the sample increased. Dystal correctly identified 92.5% of the juices by variety (Valencia vs non-Valencia).

[Importance of computerized tomography in staging bladder tumors]. / Die Bedeutung der Computertomographie bei der Stadieneinteilung der Harnblasentumoren.

As an additional diagnostic part CT has been applied to 53 patients suffering from urinary bladder tumors and treated in the Urological Department of Detmold Hospital. In cases of small papillary, apparently clinically not invasive urinary bladder tumor, the application of CT is not indicated for staging. Additional information with respect to invasively growing bladder tumors, however, can be provided.

[Inverted urothelial papilloma]. / Das invertierte Papillom des Urothels.

A case of an inverted urothelial papilloma is presented and the cases published so far are summarized. As it easily can be mixed up with a transitional cell carcinoma, the cystoscopic appearance and the histology are of special importance. To know the microscopic pattern and the clinical parameter is mandatory for urologist and pathologist, since the prognosis of the inverted urothelial papilloma following endoscopic resection seems to be very good. In case of obstructive symptoms, as seen in prostatic hypertrophy, an inverted papilloma should be considered.

[Proposal for surgical treatment of retroperitoneal fibrosis (author's transl)]. / Ein Vorschlag zur operativen Behandlung der retroperitonealen Fibrose.

A new method of surgical treatment for retroperitoneal fibrosis is demonstrated on 3 patients. 31 months postoperatively the results are excellent. The operation is easy to perform, without complications and recurrences.

Indwelling and transrenal splint techniques for pyeloplasty.

A report is presented on experience with 118 pyeloplasties using indwelling and transrenal splints. Detailed analysis of infections with both splint modifications has confirmed that better long-term results are achieved with internal drainage, due to the absence of potential contamination between splint and renal parenchyma which exists with external drainage.