[Daptomycin-induced eosinophilic pneumonia associated with an early endoprosthesis infection]. / Daptomycin-induzierte eosinophile Pneumonitis im Rahmen eines Endoprothesenfrühinfektes.

Acute eosinophilic pneumonia (AEP) is a rare disease characteristically involving eosinophilic infiltration of lung parenchyma as well as fever, dyspnea, and coughing. A differentiation is made between primary and secondary AEP depending on the underlying etiology. Substances that most frequently cause secondary AEP are antibiotics, such as the lipopeptide daptomycin. This is a case report about a 69-year-old female patient who underwent antibiotic treatment with daptomycin for an infection of a knee prosthesis. During the treatment, signs of pneumonia developed and included the increased dependence on mechanical ventilation of the previously intubated patient, infiltrates on a chest X­ray, fever, and an increase in serum inflammation markers. Proof of bacteria as an underlying pathogen was not possible. A thoracic computed tomography (CT) scan showed opacities that are commonly seen in interstitial lung disease. Termination of daptomycin treatment due to renal failure led to an improvement of pulmonary symptoms. Re-exposure to daptomycin resulted in a recurrence of the symptoms. The diagnostic criteria for AEP according to Uppal et al. include 1) current exposure to daptomycin, 2) dyspnea with increased oxygen requirements or necessity for mechanical ventilation, 3) new infiltrates on chest X­ray or CT scan, 4) bronchoalveolar lavage with eosinophilia >25%, 5) improvement of clinical symptoms following daptomycin withdrawal, and 6) fever. With 5 out of the 6 criteria by Uppal et al. positive-an eosinophilia >25% being the only unmet criteria-an AEP induced by daptomycin was diagnosed. Withdrawal of daptomycin as well as high-dose cortisol bolus treatment led to a rapid recovery.

[Births and children after assisted reproductive technologies. A retrospective analysis with special regard to multiple pregnancies at the Department of Obstetrics and Gynecology, Paracelsus Medical University Salzburg (2000-2009) with an extrapolation for Austria]. / Geburten und Kinder nach assistierter Fortpflanzungshilfe. Eine retrospektive Analyse unter besonderer Berücksichtigung von Mehrlingsschwangerschaften an der Universitätsklinik für Frauenheilkunde und Geburtshilfe Salzburg (2000-2009) mit einer Hochrechnung für Österreich.

BACKGROUND: Austria still lacks a baby-take-home rate after assisted reproductive technologies (ART) and therefore an adequate quality management of ART. PATIENTS AND METHODS: This paper extrapolates data about births/infants after ART at the University Clinic of Obstetrics and Gynaecology (PMU/SALK) in Salzburg for Austria, especially in regard to multiple births/infants collected between 2000 and 2009. RESULTS: On average 2 271 infants were born per year during the last 10 years. Among them, 76 infants (3.34% of all children) were born after ART. Of all children conceived by ART and born (759) at the University Clinic of Obstetrics and Gynaecology 368 are multiples. This is 48.5% of all children born after ART. 31.6% of all multiples born were conceived through ART. DISCUSSION: The extrapolation of data concerning multiples results in 1 255 multiples/year after ART for Austria. CONCLUSION: Without a baby-take-home rate, serious quality management of reproductive medicine is impossible. Online registration of deliveries and infants is the only adequate approach. The data of this statistical extrapolation from a single perinatal center not only provide a survey about the situation in Austria, but also support the claim of a quantitative (numbers) as well as qualitative (condition of infants) baby-take-home rate after ART.

[Fritz König (1866-1952): pioneer of osteosynthesis and his influence on traumatology]. / Fritz König (1866-1952). Wegbereiter der Osteosynthese und seine Einflüsse auf die Unfallheilkunde.

Fritz König (1866-1952) was 1918-1935 ordinary professor of surgery at the University of Wuerzburg. A main interest of his work was the technique and indication of osteosynthesis. Since 1900 he investigated methods (wire suture, intra- and extramedullary splint, external fixator, plate) and materials (ivory, steel; wire, screws). All his life he aimed to standardize the technique of osteosynthesis, to work out and spread clear indications for the surgical treatment of fractures, and to carry his point against the resistance of the social accident insurance caused by bad results of a lot of surgeons. His importance is not based on the invention of a great deal of instruments but on his endeavour for the fundamentals of osteosynthesis.

[Pseudarthrosis of the scaphoid bone and carpal instability. Correlations--development--consequences]. / Kahnbeinpseudarthrose und karpale Instabilität. Zusammenhänge--Entstehung--Auswirkungen.

In combination with its ligamentous connections, the scaphoid bone represents an essential stabilizing factor within the wrist. This stabilizing function disappears after trauma causing a displaced fracture of the scaphoid bone or extensive rupture of ligamentous structures fixing the scaphoid in its position. Hence carpal instability results, detectible radiographically by alteration of defined wrist angles. Since this is so, one might suppose that, together with other wellknown reasons, carpal instability would be of great importance in the development of a scaphoid nonunion. However, after evaluation of 76 cases, a scaphoid nonunion with carpal instability was found in only 27.6%. Moreover, surgical treatment of the scaphoid nonunion alone does not correct the abnormal wrist angles. Despite this observation, we do not consider simultaneous ligamentous repair to be necessary, because few problems remained after bony healing in such cases.

[Inguinal hernia in old age]. / Die Leistenhernie im Alter.

By retrospective analysis of the medical records from 1978-1985, the rates of incarceration, postoperative complications and lethality were determined with particular consideration of elective and emergency operations. The proportion of over 60 year old patients with inguinal hernia was 37.3%. The rate of incarceration in these patients (9.8%) was more than five times as high as in patients under 60 years old (1.8%); with increasing age, it rose from 3% to 36%. The Bassini technique predominated in the surgical treatment of the hernia. The rate of postoperative complications was 7.5%, wound infections (3.35%) and hematomas (3.07%) being the most frequent. Four patients died postoperatively, mostly of pulmonary complications; this corresponds to a lethality of 1.1% as compared to this corresponds to a lethality of 1.1% as compared to 0% in patients under 60 years old. Emergency operations in incarcerated hernia display a lethality (5.71%) which is more than nine times as high as in elective operations (0.62%). The indication for surgery is hence to be established rather extensively in the elderly, since the danger of incarceration rises.

Behavioral cohabitation: increasing satisfaction among nonmarried dyads?

The present study reports upon a standard behavior therapy treatment package applied to three clinically referred cohabitating couples. Multidimensional assessment measures included reports by self, partner, and external observers of couples' interactions. Moreover, a multiple-baseline design across couples was employed as a means of evaluating treatment efficacy. Therapy involved the weekly administration of bibliotherapy and exercise material, with therapist contact purposely minimized. An analysis of results indicates modest treatment success with considerable between-subject variability. These findings are discussed with regard to gender differences, ceiling effects, and utilization of standardized therapy packages. Recommendations are made for future behavioral cohabitation research.

[The Braun apparatus for mixed ether-chloroform anesthesia. A contribution to the early history of combination anesthesia]. / Der Braunsche Apparat zur Ather-Chloroform-Mischnarkose. Ein Beitrag zur Frühgeschichte der Kombinationsnarkose.

The Braun ether-chloroform vaporiser was very frequently used during the first fifty years of the 20th century, mainly in the German speaking region. This primacy was principally involved by the simple management, the universal possibilities of application and the "expedient" combination of ether and chloroform: this term means the differential employment of these two substances for conducting individual anaesthesia. Heinrich Braun had published his method after extensive experimental studies, here briefly referred to; further reasons for the considerable success of the apparatus are discussed.