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Biomedical subjects

R Bosch

Publications and source records attributed to R Bosch.

81 records · Page 5Linked to original sources
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[Value of ultrasound in differential diagnosis of pediatric hip joint effusion (Perthes disease, C. fugax, epiphysiolysis coapitis femoris].

UNLABELLED: Hip pain during infancy is frequently harmless by nature and hardly demands any therapeutic intervention. A careful differential diagnosis is of great importance. AIM: In our study we attempted to evaluate the significance of sonography as a non-radiant and economical aid in the differential diagnosis of hip diseases during infancy. METHODS: The study population consisted of children aged from 2 to 14 years, who visited our clinic with hip complaints and evident capsular distension (more than 2 mm compared to the contralateral hip joint) and without preceeding diagnosis. The study period was from 1988 to 1995. From the 82 children enrolled in this study we diagnosed Coxitis fugax (n = 54), Morbus Perthes (n = 19), Epiphysiolysis capitis femoris (n = 5), rheumatic Arthritis (n = 2), septic Arthritis (n = 1) and femoral Osteoid-Osteoma (n = 1). All patients with Coxitis fugax were scheduled for clinical and sonographic re-examination. RESULTS: Coxitis fugax is the most frequent disease of the hip during infancy. Perthes disease is the most important differential diagnosis up to the age of 10 years. Epiphysiolysis capitis femoris and rheumatic diseases proved to be most common differential diagnosis among elderly children. As a result of our study we were able to establish a diagnostic algorithm of hip diseases during infancy. Sonographic examination proves to be of great value especially in the differential diagnosis of Coxitis fugax and M. Perthes. In many cases the X-ray examinations which were previously mandatory could even be dispensed with. RELEVANCE: Although this concept requires careful supervision of the patients, it spares 60% of the children from undergoing X-ray examinations or MRI.

Adolescent↗
PubMedDate not supplied

Intranet-based multi-purpose medical records in orthopaedics.

Quality assurance in orthopaedics--as in any medical speciality--relies on precise medical records. Data quality is crucial for statistical evaluation; missing values cannot be avoided but must be minimized. The quality assurance system must be accessible from many locations within the clinic; given the complex and heterogeneous computing infrastructure this is a technological challenge. Intranet technology--the application of internet-tools in local networks--can help to solve the technical problems. A generic Intranet-based quality assurance system in orthopaedics was designed, implemented and evaluated. The basic concept is an intranet data entry form which is generated semi-automatically from the data definition. This form is adapted according to the individual needs of the doctors (intelligent data entry). By flexible data transformation the same data set is used for clinical reports as well as scientific evaluations. The first use was for ultrasound examinations of neonatal hips. A report form consisting of 56 items was designed. Within the first 9-month period 1303 cases have been documented.

Attitude of Health Personnel↗
PubMedDate not supplied

[Bacillary angiomatosis: report of 2 cases].

BACKGROUND: Epithelioid bacillary angiomatosis (EBA) was studied as an infectious disease associated to immunosuppressive states, establishing the bases for performing differential diagnosis with other pathologic processes. METHODS: Two new cases of EBA in patients with human immunodeficiency virus infection (HIV) are presented. Diagnosis was performed by anatomopathologic study of the cutaneous lesions which had undergone biopsy. RESULTS: In one of the cases bacillary structures were observed under electron microscopy. This patient also presented Kaposi sarcoma (KS) with histologic study being therefore necessary to perform differential diagnosis between these pathologic processes. Both patients presented good response to treatment with erythromycin. CONCLUSIONS: 1) EBA is an infectious disease of good prognosis with antibiotic treatment which fundamentally affects severely immunosuppressed patients with human immunodeficiency virus infection. 2) Biopsy is the only differential diagnostic method for this disease with other processes with similar clinical appearance and different prognosis as in Kaposi sarcoma which may even coexist in these patients.

AIDS-Related Opportunistic Infections↗