Hepatology - A Clinical Textbook, Fifth Edition

Hepatology is an ever - changing field. The editors and authors of Hepatology − A Clinical Textbook have made every effort to provide information that is accurate and complete as of thedate of publication. However, in view of the rapid changes occurring in medical science, as well as the possibility of human error, this book may contain technical inaccuracies, typographical or other errors. Readers are advised to check the product information currently provided by the manufacturer of each drug to be administered to verify the recommen ded dose, the method and duration of administration, and contraindications. It is the responsibility of the treating physician who relies on experience and knowledge about the patient to determine dosages and the best treatment for the patient. The informa tion contained herein is provided "as is" and without warranty of any kind. The editors and Flying Publisher & Kamps disclaim responsibility for any errors or omissions or for results obtained from the use of information contained herein.

Short Guide to Hepatitis C

Hepatitis C is a rapidly developing area of medicine – diagnostic tools are ever more refined, and entirely new treatments and treatment strategies are arriving, with more on the horizon. And because the virus affects such a large and varying population – up to 170 million at last count – we think it is important to have a pocket reference especially devoted to hepatitis C. We look forward to your comments on the usefulness of our 2014 Short Guide to Hepatitis C, which is an expansion and update of the HCV chapters in Hepatology – A Clinical Textbook (2014), also published by Flying Publisher. As always, we invite qualified people everywhere to translate this book into other languages, and make them available widely. This web-based free-of- harge concept is made possible by unrestricted educational grants from the pharmaceutical industry and has allowed the material to reach countries usually not covered by print media. We are convinced that this new pocket guide concept, focusing here on hepatitis C, will become a valuable source of information for our readers.

Critical Care in in Neurology

Neurocritical care is an ever-changing field. The publishers and author of The Flying Publisher Guide to Critical Care in Neurology have made every effort to provide information that is accurate and complete as of the date of publication. However, in view of the rapid changes occurring in medical science, as well as the possibility of human error, this site may contain technical inaccuracies, typographical or other errors. It is the responsibility of the reading physician who must rely on experience and knowledge about the patient to determine the best treatment and care pathway. The information contained herein is provided “as is”, without warranty of any kind. The contributors to this book, including Flying Publisher & Kamps, disclaim responsibility for any errors or omissions or for results obtained from the use of information contained herein.

Ultrasound Blocks for the Anterior Abdominal Wall - Adult and Pediatric Surgery

Somatic post-surgical pain is invalidating and distressing to patients and carries the risk of important complications. The anterior abdominal wall is involved in most surgical procedures in general, gynecologic, obstetric, urological, vascular and pediatric surgery. Combined multimodal strategies involving nerve blocks, opiates, and non-steroidal anti-inflammatory drugs for systemic analgesia are necessary for optimal pain modulation. Anterior abdominal wall blocks, transverse abdominal plexus block, iliohypogastric and ilioinguinal nerveblock, genitofemoral nerve block and rectus sheath block have an important role as components of multimodal analgesia for somatic intraoperative and postoperative pain control. Ultrasound visualization has improved the efficacy and safety of abdominal blocks and implemented the application in the clinical setting. For this reason, they are a very important tool for all anesthesiologists who aim to treat effectively patients’ pain. This guide provides an evidence based comprehensive and necessary overview of anatomical, anesthesiological and technical information needed to safely perform these blocks.

Erarbeitung der Grundlagen zur Einführung eines Energiemanagementsystems in der GKN Stromag Dessau GmbH sowie Auswahl einer geeigneten Softwarelösung auf Grundlage einer Nutzwertanalyse

Thema dieser Ausarbeitung ist die Erarbeitung von Grundlagen zur Einführung eines Energiemanagementsystems, in der GKN Stromag Dessau GmbH, sowie die Auswahl einer geeigneten Softwarelösung, auf Grundlage einer Nutzwertanalyse. Um eine geeignete Software Lösung zu finden, wurde eine IST-Analyse des Betriebes durchgeführt und die nutzerspezifischen Anforderungen an die Software definiert. Dies ist in zwei Stufen erfolgt. In der ersten Phase wurden im Rahmen eines K.O. Systems grobe Kriterien definiert, welche die Software aufweisen muss.In der zweiten Phase wurden die verbliebenen Systeme einer Nutzwertanalyse unterzogen, um die bestmögliche Alternative zu ermitteln. Die drei besten, durch die Analyse ermittelten, Anbieter sind namentlich:- IngSoft InterWatt- My JEVis 2.1- ABB cpmPlus Energie Manager.Weiterführend wurde ein Phasenplan, für die geschätzte Einführungsdauer des Energiemanagementsystems, erstellt. Die geschätzte Einführungsdauer liegt bei 18,39 Monaten. Zusätzlich spricht diese Arbeit Empfehlungen, für die möglichen Vernetzungsmöglichkeiten von Zählern und Software, aus. Zur Umsetzung des Energiemanagementsystems wurde ein Pflichtenheft erstellt, welches die Verfahrensweisen innerhalb des Energiemanagementsystems regelt.

It's what you say not what you pay

We study manager-employee interactions in experiments set in a corporate environment where payoffs depend on employees coordinating at high effort levels; the underlying game being played repeatedly by employees is a weak-link game. In the absence of managerial intervention subjects invariably slip into coordination failure. To overcome a history of coordination failure, managers have two instruments at their disposal, increasing employees' financial incentives to coordinate and communication with employees. We find that communication is a more effective tool than incentive changes for leading organizations out of performance traps. Examining the content of managers' communication, the most effective messages specifically request a high effort, point out the mutual benefits of high effort, and imply that employees are being paid well.

Personal relations and their effect on behavior in an organizational setting: an experimental study

We study how personal relations affect performance in organizations. In the experimental game we use a manager has to assign different degrees of decision power to two employees. These two employees then have to make distributive decisions which affect themselves and the manager. Our focus is on the effects on managers' assignment of decision power and on employees' distributive decisions of one of the employees and the manager knowing each other personally. Our evidence shows that managers tend to favor employees that they personally know and that these employees tend, more than other employees, to favor the manager in their distributive decisions. However, this behavior does not affect the performance of the employees that do not know the manager. All these effects are independent of whether the employees that know the manager are more or less productive than those who do not know the manager. The results shed light on discrimination and nepotism and its consequences for the performance of family firms and other organizations.

Codes of best practice in competitive markets for managers

We study firms' corporate governance in environments where possibly heterogeneous shareholders compete for possibly heterogeneous managers. A firm, formed by a shareholder and a manager, can sign either an incentive contract or a contract including a Code of Best Practice. A Code allows for a better manager's control but makes manager's decisions hard to react when market conditions change. It tends to be adopted in markets with low volatility and in low-competitive environments. The firms with the best projects tend to adopt the Code when managers are not too heterogeneous while the best managers tend to be hired through incentive contracts when the projects are similar. Although the matching between shareholders and managers is often positively assortative, the shareholders with the best projects might be willing to renounce to hire the best managers, signing contracts including Codes with lower-ability managers.

Violence: les femmes font confiance au milieu médical [Partner violence: women trust health professionals]

In 2008, the department of gynaecology and obstetrics of a university hospital centre implemented a program addressing interpersonal partner violence (screening, prevention and care of the patient victims). A qualitative survey was conducted to identify the needs and feelings of patients. The results show that patients are in favour of being actively and directly questioned about violence during the consultation and that they trust medical doctors and nurses to help and support them.

Characteristics of HIV patients referred to a medication adherence program in Switzerland.

Background Since August 2004, HIV patients who encounter -or are at risk of -problems with their antiretroviral treatment (ART) are referred by their physician to a medication adherence program at the community pharmacy of the Department of Ambulatory Care and Community Medicine in Lausanne (Switzerland). The program combines motivational interviewing and electronic drug monitoring. Objective To compare the demographic and clinical characteristics as well as ART of HIV patients referred to the adherence program versus those of the entire HIV population followed in the same infection disease department in the same time frame. Method Retrospective descriptive cross-sectional study. Study time frame was defined according to the period with the highest number of HIV patients visiting the adherence program. Results Subjects included in the adherence program had more often a protease inhibitor-based regimen (64 %; 95 % CI [52-75 %] vs. 37 %) and lower CD4 cell counts (419 (252.0, 521.0); 95 % CI [305-472] vs. 500 (351.0, 720.0)) than the entire HIV population. A majority of women were included in the adherence program (66 %; 95 % CI [54-76 %] vs. 39% in the entire HIV population). Conclusion Subjects referred to the adherence program were different from the entire HIV population and showed worse clinical outcomes and were more often under salvage therapy. More women than men were included. Reasons for such a difference need to be further explored.

Ràdio participativa amb difusió per Internet

Aquesta memòria reuneix una explicació del treball que s'ha dut a terme per a desenvolupar el projecte final de carrera. Aquest tracta d'implementar una ràdio musical que s'emet per Internet però amb la característica d'ésser una ràdio que decideixi la programació musical en funció de la seva audiència. Per a realitzar això es distingiran dos tipus d'usuaris: els oients i els gestors de la ràdio musical. El gestors de la ràdio tindran la responsabilitat d'alimentar de música la ràdio, etiquetar i classificar aquesta música perquè la ràdio estableixi criteris de similitud entre cançons. Els oients seran responsables d'opinar sobre les cançons que emet la ràdio, si els agrada o desagrada, per guiar la ràdio cap al gust musical del propi oient. La complexitat està en què no es tracta d'una ràdio musical amb un sol oient sinó que hi ha diferents oients i s'haurà de saber gestionar correctament els gustos dispersos dels oients. En el present document recullim tots els treballs realitzats, l'anàlisis formal del problema, l'explicació de la solució proposada i com hem realitzat aquesta solució.

Gestor intel·ligent d'assignació de recursos

Aquest projecte és una eina per a la gestió avançada del Comitè Tècnic d’Àrbitres de Futbol Sala de Catalunya. Creant una base de dades forta i robusta com la que ens proporciona la tecnologia ORACLE, i agafant APEX com a gestor de continguts de la base de dades, hem creat una aplicació per realitzar l'assignació d'arbitratges i altres recursos d'una manera intel·ligent i equitativa.

Prévention des alcoolisations aiguës a l'adolescence: quel rôle pour le médecin de famille [Prevention of binge drinking in adolescents: do family doctors have a role to play?].

Binge drinking has nearly become the norm for young people and is thus worrying. Although alcohol use in males attracts more media attention, females are also frequently affected. A variety of preventive measures can be proposed: at the individual level by parents, peers and family doctors; at the school and community level, particularly to postpone age of first use and first episode of drunkenness; at the structural level through a policy restricting access to alcohol for young people and increasing its price. Family doctors can play an important role in identifying at risk users and individualising preventive messages to which these young people are exposed in other contexts.

Perioperative antiplatelet therapy.

Aspirin is recommended as a lifelong therapy that should never be interrupted for patients with cardiovascular dis- ease. Clopidogrel therapy is mandatory for six weeks after placement of bare-metal stents, three to six months after myocardial infarction, and at least 12 months after placement of drug-eluting stents. Because of the hypercoagulable state induced by surgery, early withdrawal of antiplatelet therapy for secondary prevention of cardiovascular disease increases the risk of postoperative myocardial infarction and death five- to 10-fold in stented patients who are on continuous dual antiplatelet therapy. The shorter the time between revascularization and surgery, the higher the risk of adverse cardiac events. Elective surgery should be postponed beyond these periods, whereas vital, semiurgent, or urgent operations should be performed under continued dual antiplatelet therapy. The risk of surgical hemorrhage is increased approximately 20 percent by aspirin or clopidogrel alone, and 50 percent by dual antiplatelet therapy. The present clinical data suggest that the risk of a cardiovascular event when stopping antiplatelet agents preoperatively is higher than the risk of surgical bleeding when continuing these drugs, except during surgery in a closed space (e.g., intracranial, posterior eye chamber) or surgeries associated with massive bleeding and difficult hemostasis.

Readiness to participate in psychiatric research.

BACKGROUND: The feasibility of clinical trials depends, among other factors, on the number of eligible patients, the recruitment process, and the readiness of patients to participate in research. Seeking patients' views about their experience in research projects may allow investigators to develop more effective recruitment and retention strategies. METHODS: A total of 100 patients consecutively admitted to a psychiatric university hospital were interviewed with respect to their willingness to participate in a study. For a different study scenario, patients were asked whether they would be ready to participate if such a study were organized in the service and to indicate their reasons for refusing or for participating. RESULTS: The general readiness to participate in a study ranged between 70% and 96%. The prospect of remuneration did not notably augment the potential consent rate. The most common and spontaneous motivation for agreeing to take part in a study was to help science progress and to allow future patients to benefit from improved diagnosis and treatment (87%). The presence or lack of a financial incentive was rarely chosen as an argument to agree (23%) or to refuse (7%) to participate. Patients relied mainly on their treating physicians when contemplating possible participation in a study (family physician [65%] and hospital physician [54%]). CONCLUSIONS: Clinicians and, in particular, treating doctors can play an important role in facilitating the recruitment process.