[Effect of perioperative antibiotic prophylaxis on hemodynamic stability during surgery: detection of complex interaction in a simulated clinical randomized animal study].

In a clinic modelling randomised trial (CMRT) in three groups of 10 land-race pietren pigs each it could be shown that the influence of prophylactic antibiotic administration on intraoperative hemodynamic stability and histamine release is only evident, if by stepwise addition of complicating factors the overall complexity of the experimental setting is increased. Different antibiotic regimen for prophylaxis significantly affected the incidence of cardiovascular instabilities only after relevant blood loss, restoration of circulation and subsequent submaximal induction of anaphylactoid reactions by the histamine liberator Polymyxin B. In conclusion, preclinical testing of therapeutic agents in complex clinic modelling randomised trials should be mandatory to avoid the possible hazards of misconducted clinical trials.

[Expenditure and reliability of ICD/ICPM-coding in routine surgery].

Because of the changing legal basis for hospital reimbursement German hospitals have to classify their cases by ICD-9- and an adapted ICPM code (OPS-301) and have to give an advance calculation of the Diagnosis Related Groups (DRG) starting from January 1996. From January 1st 1996 to the 31st of December 1996 all diagnoses and therapies in a general surgery hospital were classified according to ICD-9- and ICPM (OPS-301). This coding was not computer-assisted but was controlled in a multiple step process.