[Aspects of expertise which are jointly valid for German sociomedicine and statutory health care]. / Trägerübergreifende Aspekte der Begutachtung nach dem SGB IX - Teil II: Fallbeispiel -

A project group of the Medical Advisory Board of the German Federal Rehabilitation Council (BAR) developed fundamental joint principles on experts' opinions according to the social law code no. IX (SGB IX). The principles aim at medical experts working in different social organisations and statutory health care insurance. It was intended to create a "sociomedical language" which should be used as jointly as possible by experts in rehabilitation and social medicine and which is based on the ICF (International Classification of Functioning, Disability and Health, WHO 2001). Its stringent application will increase the utility of medical expertise across different institutions. The authors recommend to evaluate whether this model could provide a tool in the communication and cooperation between different sectors of the health system. Part I describes the theoretical model, Part II its application to a virtual individual case history.

[Aspects of expertising which are jointly valid for German sociomedicine and statutory health care]. / Trägerübergreifende Aspekte der Begutachtung nach dem SGB IX--Teil I: Grundlagen.

A project group of the Medical Advisory Board of the German Federal Rehabilitation Council (BAR) developed fundamental joint principles on experts' opinions according to the social law code no. IX (SGB IX). The principles aim at medical experts working in different social organisations and statutory health care insurances. It was intended to create a "sociomedical language" which should be used as jointly as possible by experts in rehabilitation and social medicine and which is based on the ICF (International Classification of Functioning, Disability and Health, WHO 2001). Its stringent application will increase the utility of medical expertise across different institutions. The authors recommend to evaluate whether this model could provide a tool in the communication and cooperation between different sectors of the health system. Part I describes the theoretical model, Part II its application to a virtual individual case history.

[Doppler sonographic detection of reduced flow velocity in the celiac trunk of the newborn infant with patent ductus arteriosus Botalli compared to a healthy control group]. / Dopplersonographischer Nachweis erniedrigter Flussgeschwindigkeiten im Truncus Coeliacus beim offenen Ductus Arteriosus Botalli des Frühgeborenen im Vergleich zu einer gesunden Kontrollgruppe.

Pulsed doppler recordings were obtained in the truncus coeliacus in 12 premature born infants (gestational age 30.3 +/- 2.5 weeks) with the clinical signs of patent ductus arteriosus Botalli (PDA) and compared to a control group of 24 healthy infants (gestational age 40.5 +/- 5.3 weeks). In all children the maximal systolic velocity, the endsystolic and the enddiastolic velocity and the pulsatility-index were measured. The 24 healthy newborns showed the following velocities: Maximal systolic velocity: 77 +/- 16 cm X s-1; endsystolic velocity: 31 +/- 10 cm X s-1; enddiastolic velocity; 18 +/- 9 cm X s-1. The pulsatility-index was 0.75 +/- 0.11. In children with PDA the maximal systolic velocity was 72 +/- 21 cm X s-1, the endsystolic velocity 15 +/- 14 cm X s-1 and the enddiastolic velocity -5 +/- 8 cm X s-1. The pulsatility-index was 1.08 +/- 0.12. All infants with large PDA showed a significant decrease of the endsystolic velocity and enddiastolic velocity, whereas the pulsatility-index was significantly increased. The decrease of the endsystolic and enddiastolic velocity in infants with large PDA in comparison to the healthy control group may lead to hypoxemic-ischemic lesions of the intestinal organs. The increased incidence of necrotizing enterocolitis in premature infants with large PDA may be the result of hypoperfusion of the small bowel.

[Doppler sonographic flow parameter of the anterior cerebral artery in patent ductus arteriosus of the newborn infant compared to a healthy control sample]. / Dopplersonographische Flussparameter in der Arteria cerebri anterior beim offenen Ductus arteriosus des Frühgeborenen im Vergleich zu einem gesunden Kontrollkollektiv.

33 premature infants (age: 32 +/- 3 weeks; birth weight 1,268 +/- 535 gs) with the clinical signs of patent ductus arteriosus Botalli (PDA) and a control group of 96 healthy infants (age: 37 +/- 4 weeks; birth weight 2 348 +/- 944 gs) were investigated. Pulsed doppler recordings were obtained in the anterior cerebral arteries (ACA) and compared with the flow pattern in the truncus coeliacus (TC). In all children the maximal systolic velocity (Vs), the endsystolic (Ves) and the enddiastolic velocity (Ved) and the pulsatility-index (PI) were measured. The 96 healthy premature born infants showed the following velocities: Vs: 41 +/- 12 cm X sec-1; Ves: 19 +/- 7 cm X sec-1; Ved: 10 +/- 4 cm X sec-1. The pulsatility-index was 0.74 +/- 0.08. In children with PDA all velocities were significantly lower than in the healthy control group: Vs: 31 +/- 10 cm X sec-1; Ves: 7 +/- 6 cm X sec-1; Ved: -1 +/- 5 cm X sec-1. Ved was more decreased than Vs resulting in a significant increase in PI (1.04 +/- 0.14). 22 infants with surgically proven large PDA (age: 31 +/- 3 weeks; birth weight: 1,160 +/- 467 gs) showed significant lower velocities (Vs: 34 +/- 8 cm X sec-1; Ves: 4 +/- 4 cm X sec-1; Ved: -4 +/- 4 cm X sec-1) in comparison with the healthy control group and the 11 children with small PDA (age: 33 +/- 4 weeks; birth weight: 1,494 +/- 621 gs).(ABSTRACT TRUNCATED AT 250 WORDS)