112 Works

3.4.4. Qualitätssicherung medizinischen Handelns

Olaf von dem Knesebeck
Kapitel des Online Lehrbuch der Medizinischen Psychologie und Medizinischen Soziologie

Operating on nerves: Surgical approaches, primary and secondary repair, nerve grafting and nerve transfer

Timothy Hems
Exploration and repair of nerves requires specialized equipment, detailed anatomical knowledge, and expertise in microsurgery. This chapter includes details of a primary and secondary repair of nerves. Nerve repairs are most often carried out using sutures, but alternative methods of coaptation are reviewed. The management of nerve defects is discussed and techniques for nerve grafting are described.

Treatment of chronic bacterial prostatitis

Gianpaolo Perletti, Florian M. E. Wagenlehner, Visnja Skerk & Vittorio Magri
Bacterial infection of the prostate can be demonstrated by the Meares and Stamey 4-glass or the pre and post prostate massage (PPM) 2-glass test in only about 10% of men with symptoms of chronic prostatitis. NIH-category II chronic bacterial prostatitis (CBP) is mainly caused by Gram-negative uropathogens, whereas the role of certain Gram-positive and sexually-transmitted pathogens is still discussed. For treatment, fluoroquinolones are considered the drugs of choice because of their favorable pharmacokinetic properties and...

Genital infections during pregnancy

José Tirán Saucedo
Genital infections during pregnancy are a major health problem in many parts of the world, with the particularity of being responsible for complications to the mother and infant, on top of being a burden to the health system. This chapter will be a discussion of the main genital infections during pregnancy: candidiasis, trichomoniasis, herpes, chlamydia, gonorrhea, bacterial vaginosis, aerobic vaginitis and human papillomavirus. Many of their complications are pregnancy-related for which a prompt diagnosis, effective...

Phimosis and urinary tract infection: An Asian perspective

Akihiro Kanematsu & Shingo Yamamoto
Circumcision, the surgical removal of the prepuce, has originally been performed as a ritual procedure among people of certain religions and ethnicities. There are many studies on whether this procedure has advantageous effects on the prevention of urinary tract infection (UTI), mainly from North America and Australia, where circumcision prevalence is between 20 and 80%. Bacterial colonization in the prepuce is documented in literature and could be a legitimate reason why catheterization, but not the...

The role of Oxalobacter formigenes in calcium oxalate stone disease

Roswitha Siener
Calcium oxalate is the major component of about 75% of all urinary stones. Hyperoxaluria is a primary risk factor for calcium oxalate stone formation. The bioavailability of ingested oxalate and the extent of intestinal absorption of dietary oxalate are considered to be important factors in hyperoxaluria. Oxalobacter formigenes is a Gram-negative anaerobic bacterium that colonizes the intestinal tract. It is unique in that it requires oxalate both as an energy and carbon source. The only...

Infection induced urinary stones

Walter Ludwig Strohmaier
Stones composed of struvite, carbonate apatite and ammonium urate are regarded as induced by urinary tract infection (UTI) with bacteria producing the enzyme urease (mainly Proteus species) which splits urea into ammonium and carbonate ions resulting in supersaturation and alkalization of the urine. Struvite and apatite crystals form and grow to stones. Compared to other mineral types infection induced stones (IIS) represent only a small percentage of urinary stones. Nevertheless they deserve special attention. Due...

Antibiotic consumption and resistance of gram-negative pathogens (collateral damage)

Milan Cizman & Tina Plankar Srovin
Antibiotics are commonly prescribed in community and hospital care. Overuse and misuse favors emergence and spread of resistant bacteria. The ATC/DDD methodology is commonly used for presenting the drug utilization data. In primary care, the consumption is usually expressed in DDD per 1,000 inhabitants per day, in hospital, preferably in DDD per 100 bed days and DDD per 100 admissions. The alternative metric is days of therapy (DOT), which needs IT support. Antibiotics have ecological...

Commentary on chapter “Male circumcision protects against urinary tract infections”

Yazan F. Rawashdeh & Gitte M. Hvistendahl
Chapter of Living Handbook Urogenital Infections and Inflammations

Asymptomatic bacteriuria in pregnancy – Is it still necessary to screen and treat?

Caroline Schneeberger & Brenda Kazemier
Asymptomatic bacteriuria (ASB) in pregnancy occurs in 2–10% of pregnant women although higher frequencies have also been reported, up to 40%. Pregnant women are more prone to develop urinary tract infections (UTI) because of dilatation of the renal system and decreased peristalsis of the ureters and bladder facilitating bacterial colonisation and ascending infection in pregnancy. Enterobacteriaceae comprise approximately the majority of urine isolates, of which Escherichia coli is the most common pathogen. A urine culture...

Prevention of prematurity by early diagnosis and treatment of bacterial urogenital infections – The role of bacterial vaginosis

Udo B Hoyme
Bacterial vaginosis has a significant relative risk for miscarriage or prematurity of 1.4–6.9%. In the initial Erfurt trial 0.3% of the neonates with gestational age less than 32+0 weeks were seen in an intervention group vs. 3.3% (p less than .01) in the control group; in the Thuringia campaign the figures were 0.94% vs. 1.36% (p less than .01) for the entire state. The rate of newborns less than 1,000 g was reduced to 0.38%,...

Diagnosis of uncomplicated cystitis (UC)

Guido Schmiemann & Klaus Gebhardt
Urinary tract infections are among the most common bacterial infections and are responsible for 25% of antibiotic prescriptions in primary care. This chapter presents current evidence from a systematic literature search with a focus on systematic reviews and recent guidelines on diagnosing uncomplicated cystitis (UC). Starting with a general approach on the diagnostic process in suspected UC the pros and cons of different diagnostic strategies are discussed. Due to the high prevalence of UC the...

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