Effects of state-wide implementation of the Los Angeles Motor Scale for triage of stroke patients in clinical practice.

Background: The prehospital identification of stroke patients with large-vessel occlusion (LVO), that should be immediately transported to a thrombectomy capable centre is an unsolved problem. Our aim was to determine whether implementation of a state-wide standard operating procedure (SOP) using the Los Angeles Motor Scale (LAMS) is feasible and enables correct triage of stroke patients to hospitals offering (comprehensive stroke centres, CSCs) or not offering (primary stroke centres, PSCs) thrombectomy.

Methods: Prospective study involving all patients with suspected acute stroke treated in a 4-month period in a state-wide network of all stroke-treating hospitals (eight PSCs and two CSCs).

[Difficult Decisions in Therapy of Severe Stroke and Progressed Neurodegenerative Disease - Decision process in fields of limited communication and willing capability].

Severe stroke and neurodegenerative diseases often cause limitations in communication and willing capability. Decision processes in these conditions assume primarily a positive medical indication for any intervention. If not obtainable from an individual by itself, by a disposal or by a legal custodian, the presumed will of a patient has to be detected carefully.

Prehospital Stroke Management Optimized by Use of Clinical Scoring vs Mobile Stroke Unit for Triage of Patients With Stroke: A Randomized Clinical Trial.

Importance: Transferring patients with large-vessel occlusion (LVO) or intracranial hemorrhage (ICH) to hospitals not providing interventional treatment options is an unresolved medical problem.

Objective: To determine how optimized prehospital management (OPM) based on use of the Los Angeles Motor Scale (LAMS) compares with management in a Mobile Stroke Unit (MSU) in accurately triaging patients to the appropriate hospital with (comprehensive stroke center [CSC]) or without (primary stroke center [PSC]) interventional treatment.

Design, Setting, And Participants: In this randomized multicenter trial with 3-month follow-up, patients were assigned week-wise to one of the pathways between June 15, 2015, and November 15, 2017, in 2 regions of Saarland, Germany; 708 of 824 suspected stroke patients did not meet inclusion criteria, resulting in a study population of 116 adult patients.

[Radiculomyelopathy in schistosomiasis].

The increasing migration of people from their homeland in far distant regions to Europe in the last few years has strongly influenced the rise of previously rarely seen diseases. They not only originate from the respective homeland but also from the transit countries during the migration process. We report the case of a 27-year-old male migrant from Eritrea, who after months of flight as a refugee travelling through various African countries, presented at our hospital with a progressive, painful radiculopathy.

Estimation of the amount of tropospheric ozone in a cloudy sky by ground-based Fourier-transform infrared emission spectroscopy.

The problem of retrieving minor concentrations of constituents by ground-based Fourier-transform infrared emission spectroscopy is addressed by means of the concept of differential optical emission spectroscopy in analogy to the concept of differential optical absorption spectroscopy. Using the prominent nu3 ozone feature at 1043 cm(-1), we show that the strength of the spectral signature depends not only on the amount of ozone but also on the atmospheric thermal structure. This dependence can be described by a rather accurate approximation, which was used to construct a simple diagram to estimate the amount of column ozone between the instrument site and a cloud deck as well as to determine the detection limit.