Diagnostic accuracy of the care dependency scale.

Aim: This paper reports an investigation of the diagnostic accuracy of the Care Dependency Scale (CDS).

Background: Assessment tools can be described in terms of diagnostic accuracy, or the ability to correctly classify subjects into clinically relevant subgroups. Diagnostic accuracy can be determined by several techniques as sensitivity, specificity, receiver operating curve analysis and likelihood ratios.

The role of splenectomy in the treatment of relapsing thrombotic thrombocytopenic purpura.

Thrombotic thrombocytopenic purpura (TTP) is a serious disorder of unknown etiology. Clinical findings are the result of vascular occlusions by platelet aggregates. Treatment with plasma exchange, often used in combination with corticosteroids, vincristine, aspirin, and dipyridamole, has reduced mortality to 20%.

Urine cytology as a screening method for transitional-cell carcinoma in dialysis patients with analgesic nephropathy.

The abuse of analgesic-containing drugs leads to chronic nephropathy with an increased risk of developing a transitional-cell carcinoma of the urinary tract. In our experience follow-up is often stopped or has never been started when patients present for dialysis. We use urine cytology as the screening method.

[Determination of alkali resistance by skin patch testing].

298 patients suffering from eczema were tested for alkali-resistance by means of the method according to Burckhardt-Locher (ARBL) as well as patch-testing. If ARBL revealed decreased alkali-resistance, there was a high correlation with the outcome of the patch-test of alkalis. If ARBL showed normal values, however, additional patch-testing detected reduced alkali-resistance in 42.

Vinyl chloride-induced hepatic coproporphyrinuria with transition to chronic hepatic porphyria.

A chronic hepatic disorder of porphyrin metabolism was found in 36 workers with vinyl chloride (VC)-induced hepatic injury following long-time industrial exposure. Pathologic porphyrinuria, especially secondary coproporphyrinuria with transition to subclinical chronic hepatic porphyria, is a consistent pathobiochemical parameter for the recognition of VC hepatic lesions. The porphyrinuria is of diagnostic value for the incipient toxic phase.

[Benign symmetrical lipomatosis in women. Association with alcoholic hepatopathy].

Benign symmetric lipomatosis or Launois-Bensaude syndrome is a condition characterized by diffuse, unencapsulated, painless growth of lipomatous tissue with a peculiar symmetric topology occurring predominantly in middle-aged men. In the present study a short survey of the clinical manifestations, differential diagnosis, current pathophysiologic theories, and therapy of this disease is given. From the literature published since 1950 112 observations are reviewed with respect to alcohol abuse in the premorbid period and other coexisting illnesses.

[Course of rapid hyposensitization with insect venom with special reference to local reaction, as a contribution to risk reduction].

After critical evaluation of literature as well as the results obtained in this department up to now concerning skin tests and therapy with whole body extracts, we changed our mode of treatment of sting allergy to desensitization with pure insect venom. Clinical observations concerning the course of the rapid desensitization led to an accentuation of the local reaction as an important sign of the compatibility of the therapy. On account of local reaction patterns concerning the dosage of the venom, a significant reduction of the rate of side effects could be achieved in this high risk therapy.

[Significance and results of rhinomanometry in allergologic diagnosis].

109 provocations with rhinomanogram were performed, 107 of them showed the following results: When there was a skin reaction of 2/5 according to Hansen, provocation and strength of intracutaneous test revealed a significant correlation. The most eminent win of information was achieved in 61% by challenge with housedust, whereas it was about 30% by challenge with mite or pollen. The most important indication for nasal challenge is the control of the clinical relevance of an allergen in view of a planned hyposensitization therapy.

[The vinyl-chloride disease].

Workers engaged in the PVC-production, who were long-term exposed to the gaseous base vinyl chloride exhibit a complex pattern of damages. Changes of the skin, vascular and bone system, as well as thrombocytopenia, liver fibrosis with portal hypertension, disturbances of the porphyrin metabolism and alterations of the central nervous system were observed. Moreover vinyl chloride is oncogenic and may cause angiosarcoma of the liver.

[Industrial medicine aspects of lesions due to vinyl chloride].

The VC-disease is another example of the constant threat working people are exposed to. A resonable collaboation of all competent bodies will allow to minimize the hazards or to remove them, and thus to "humanize" the working conditions. The VC-disease should be recognized as an occupational disease, the maximal concentration of VC at the working place should be standardized.

[Occupationally induced sensitization of respiratory airways by animal-hair and animal-dust].

An occupational sensitization of the respiratory tract caused by hair and dust of laboratory animals (Mastomys natalensis) was reported in 3 persons. Intracutaneous tests confirmed the relationship between the professional activity and the clinical symptoms of an inhalation allergy. The very pronounced reaction to different dust extracts and the special conditions of exposure suggest an occupational sensitization to the dust of laboratory animals.

[Sequential scintigraphy of liver and spleen in patients with polyvinyl chloride disease (author's transl)].

Occurence of severe liver damage including angiosarcoma in polyvinyl chloride production workers necessitates regular control investigations of liver and spleen. Radioisotope techniques with small irradiation doses which give valid results should be used. Investigations of 15 patients with PVC-induced liver disease showed that hepatic perfusion as demonstrated by 99mTc pertechnate does not correlate with the uptake of sulphide colloid in the hepatic reticuloendothelial system.