PubMed Health⌕ Search

Biomedical subjects

A Schmelzer

Publications and source records attributed to A Schmelzer.

14 recordsLinked to original sources
PubMed2000

[Evaluating the cost effectiveness of an ENT clinic by the physician. Development of a special cost and proceeds overview].

The realization of expense and proceeds-correctional measures in the area of medicine is a current problem caused by the lack of transparency of medical costs. The responsibility and the influence on management success is increasingly assigned on the head physicians. The concerning people should be informed about the economic status of their clinic. Only on this precondition selective and efficient measures are possible. Within the scope of a project in three different ENT-clinics, a special system of expense and proceeds-survey was developed using the existing cost accounting of the hospital. This survey enables the physician to estimate the economic efficiency and weakness of his clinic. After providing four auxiliary tables, it is possible to get a global view on the expenses and proceeds which are relevant for the physician. This method will allow to find the reasons for low rentability using different options of calculation. Systematic control of medical-economic processes will be considerably simplified for the physicians.

Cost-Benefit Analysis↗
PubMed1999

[Postoperative treatment after ear surgery].

The paper gives an overview on postoperative treatment after ear surgery, especially tympanoplastic, mastoid-surgery and stapes-surgery. Suggestions for treatment are given according to the different post-operative stages and situations. Careful cleaning of the ear canal, using the operative microscope, removal of debris, granulations and polyp and drying of the canal are most important.

Ear↗
PubMed1997

The JEVIN trial: a population-based survey on the quality of diabetes care in Germany: 1994/1995 compared to 1989/1990.

Since 1990 in most Eastern European countries health care systems have been decentralized or are undergoing the processes of decentralization. Increasingly, diabetic patients are no longer treated by diabetologists but by non-specialized physicians. During the same period structured treatment and teaching programmes have been introduced and health care is increasingly influenced by the St. Vincent declaration. To show the effect of these changes on the quality of diabetes care 90% (n = 244) of all insulin-treated diabetic patients aged 16 to 60 years and living in the city of Jena (100247 inhabitants) were studied in 1994/1995. The results were compared with the baseline examination of 1989/1990 (n = 190). HbA1c (HbA1c/mean normal) in IDDM patients under specialized care was similar in 1994/1995 (1.54 +/- 0.27, n = 47) to 1989/1990 (1.52 +/- 0.31, n = 131, p = 0.0018), but higher under non-specialized care (1.71 +/- 0.38, n = 80, p = 0.0087). In the total group of NIDDM patients there was no significant change in HbA1c (1994/1995: 1.75 +/- 0.4, n = 117, vs 1989/1990: 1.78 +/- 0.4, n = 59, p = 0.67), but with a tendency to higher HbA1c under non-specialized (1.81 +/- 0.4, n = 79) compared to specialized care (1.66 +/- 0.39, n = 38, p = 0.06). Incidence of severe hypoglycaemia (IDDM 0.13; NIDDM 0.04), ketoacidosis (0.02; 0.01) and the prevalence of nephropathy (21%; 35%) and neuropathy (24%; 38%) remained unchanged in comparison to 1989/1990, whereas there was an increase in the prevalence of diabetic retinopathy. Specialized care is mandatory for patients with IDDM.

Adult↗
PubMed1994

[Uncertainties in preliminary calculations of overall treatment costs with special reference to costs of medical risk].

This paper explains the problems in calculating global compensation for medical treatment from the physician's point of view. This new system of financing hospitals will be introduced in Germany in 1996. In routine procedures such as tonsillectomy, the costs for complications are not sufficiently included in the price calculation. Basing on "postoperative bleeding after tonsillectomy" as an example, we calculated the costs of this complication per year. A scheme for calculating these costs as well as the costs for concomitant diseases for each case is presented. Evidently the overall price does not include substantial costs, and hence foreseeable losses are inevitable.

Cost Control↗
PubMed1992

[Therapy of Frey's syndrome with an anhidrotic gel].

In recent years we treated 53 patients suffering from Frey's syndrome with an antihidrotic gel. The active ingredient we used was aluminiumtrichloridhexahydrate. In addition to presenting a historic review we will also demonstrate and discuss our results. The study concludes, that this gel is effective in treating Frey's syndrome.

Adolescent↗
PubMed1992

Blindness following paranasal sinus surgery: a report of two cases.

Two cases of blindness following paranasal sinus surgery are presented. The first patient, a 38-year old man, developed a delayed massive haemorrhage, after bilateral sphenoethmoidectomy. This hemorrhage could be stopped by electric cauterisation under endoscopical control. During this reintervention the patient developed total blindness of his right eye, and a restriction of the inferotemporal left visual field. The second patient, a 10-year old girl, developed, after bilateral spheno-ethmoidectomy for isolated sphenoiditis, total blindness of the left eye and paralysis of the ipsilateral extraocular muscles. According to the literature, blindness secondary to paranasal surgery is mainly due to retrobulbar hemorrhage. In the first case blindness was due to a direct cauterisation of the optic nerve, after perforation of the lamina papyracea. In the second case, blindness was probably due to a hemorrhage in the orbital apex.

Adult↗
PubMed1992

Local anesthesia of the head and neck.

In theory, most ear, nose, and throat surgery involving the soft tissues of the head and neck may be performed under local anesthesia. This includes surgery on the middle ear, even mastoidectomy; partial or total laryngectomies; surgery on the nose and paranasal sinuses; and surgery on the major salivary glands. For this purpose, local anesthetics, with or without epinephrine, are administered either by infiltration injection or by topical application. The selection of either local or general anesthesia for a surgical procedure will depend on many important factors, not the least of which is the preference of the patient. This paper presents factors to be considered in making this choice, as well as surgical indications and contraindications to the use of local anesthesia.

Anesthesia, General↗
PubMed1992

[Abnormal postoperative findings in the external ear canal and tympanic membrane and their treatment].

We describe uncommon complications after tympanoplasty affecting the outer auditory canal and the tympanic membrane such as stenosis of the auditory canal, fistulas, lateralization of the tympanic membrane, anulus cholesteatoma and cholesteatoma of the auditory canal. Typical findings are discussed and explained with the aid of illustrations. Treatment and indications for revision are discussed.

Cholesteatoma↗
PubMedDate not supplied

The lipofuscin content of Scarpas ganglion of normal and Menière's disease patients related to age: a histologic and morphometric study.

Vestibular ganglia were removed post mortem from 25 patients with normal inner ear function and 9 patients with known Menière's disease. The lipofuscin content of the ganglion cells of all specimens were analysed and the two groups compared. The age range of the non-Menière's patients was from 14 to 82 years, and of the Menière's patients from 42 to 72 years. All ganglion cells contained lipofuscin, mostly in the form of large granules. Lipofuscin was concentrated in the lateral areas of the ganglion cells and in each polar extension. In both groups the content of lipofuscin in ganglia increased with age. The increase in the Menière cases was greater. In age-matched data no non-Menière's ganglion reached the content of lipofuscin of a Menière's ganglion. The average percentage of lipofuscin in Scarpa's ganglion was determined by counting lipofuscin granule area in different levels of one ganglion. The portion of lipofuscin in the cytoplasm of ganglion cells of the Menière ganglions was increased about 44% compared with the non-Menière ganglions, if the average percentage of lipofuscin was set at 100%. The increase of 44% is nearly constant between 40 and 70 years. This is a relative increase, because the ganglion cells of the Menière's patients are 12% smaller than those of the healthy persons. Taking into account the different sizes of the ganglion cells these is an absolute increase of lipofuscin in the Menière cases of 28%.

Adult↗