Web-Based Development of Standard Operating Procedures and Midwifery Trainings at Ugandan Birth Clinic in the Framework of Implementing a Quality Improvement System for the MEWU-Midwife Exchange with Uganda.

Introduction: High maternal and newborn mortality rates in Sub-Saharan Africa indicate the need for global action interventions. Thus, the clinic cooperation midwife exchange with Uganda (MEWU) between Hannover Medical School and Mutolere Hospital, Uganda, was founded. This study, as the first intervention within the MEWU framework, explored whether a web-based approach is suitable for developing, training, and establishing standard operating procedures (SOPs) at Mutolere Hospital.

Microsurgical anterior decompression and internal fixation with iliac bone graft and titanium plates for treatment of cervical intervertebral disc herniation.

42 cervical interbody fusions with iliac bone graft and titanium plate fixation were performed between October 1991 and March 1994. The mean follow up period in this study was 10.7 months.

[Experiences with ventral stabilization in vertebral metastases in the area of the thoracic and lumbar spine].

43 cases of tumor resection followed by ventral stabilisation are reported in 42 patients with metastases in the spine. Indications for surgery were beginning or incomplete transversal lesion of the spinal cord, bedrest for at least 3 weeks, unsusceible pain caused by instability, or unsuccessful conservative and radiotherapeutic treatment. 46.

[Results of cervical chordotomy with and without rhizotomy in therapy-resistant pain in the shoulder and arm].

Herein we report on 39 patients, who were treated with the upper cervical cordotomy (C1/C2), because of intractable pain of the shoulder and arm region. 30 patients suffered from malignant tumors, 9 had a benign lesion. A simultaneous cordotomy and rhizotomy was performed in 9 tumor patients and in 2 patients with a benign lesion.

[Dorsal inter- and extracorporal osteosynthesis for tumours of the thoracic vertebral bodies (author's transl)].

Various surgical alternatives for benign and malignant tumours of the thoracic vertebral bodies are compared. The objective of surgery, i.e.

[Ventral osteosynthesis for the treatment of metastatic tumours of the superior thoracic spine (author's transl)].

In patients with carcinoma, resection of one or more adjacent destroyed vertebral bodies is indicated in selected cases to preserve or restore walking. Stabilization of the spine with bone cement and metal plating ensures early mobilization, which is desirable in patients with limited survival. In the upper thoracic spine the location and number of the destroyed vertebral bodies will dictate the operative approach.

Intradural variant of cervical nerve root fibres. Potential cause of misinterpreting the segmental location of cervical disc prolpases from clinical evidence.

In 40 postmortem specimens the cervical posterior roots were examined under the surgical microscope, and intradural communicating fibres between neighbouring segments were demonstrated. The implications of these frequent variants for the diagnosis of prolapsed cervical discs are discussed.

[Psychic disturbances in patients with cervical intervertebral disk changes and cervical osteochondrosis].

The paper is concerned with the investigation of 51 patients with alterations of cervical intervertebral disks and cervical osteochondrosis who have undergone surgical intervention. The examination included a psychiatric interview as well as the application of paper pencil tests. Seventeen patients indicated symptoms of an endogenous depression.

[Anterior cervical intervertebral disk operation without secondary fusion. Clinical and experimental studies].

The problems of the spontaneous fusion after cervical discectomy were studied in 12 patients. An examination after the operation showed an improvement of the neurological-radicular symptoms, but 75% of the patients complained about severe pains in the area of neck and shoulders. The cause of these complaints was found by radiological examination to be an angular kyphosis of the cervical spine combined with the subluxation of the intervertebral joints in the operated segment.

[The effect of propanidid in patients with an increased tendency to cerebral convulsions (author's transl)].

In view of the observation of tonic-clonic convulsions after the use of Propanidid in certan patients, a study was undertaken of the effects of this drug (7 mg/kg) on the EEG of 2 volunteers with a known history of epilepsy. Both subjects developed tonic-clonic convulsions and showed typical alterations of the EEG pattern even before the onset of hyperventilation. These EEG alterations were producible also during complete relaxation.