Der jüdische Scheidungsakt : Agende zum Gebrauch bei Ehescheidungen

auf Grund des Sh[ulḥan] ʻA[rukh] O[raḥ] Ḥ[ayim] ins Dt. übertr. u. unter Quellenangabe zsgest. u. bearb. von L. Dünner

Probleme der Teleologie bei Maimonides, Thomas von Aquin und Spinoza

Giessen, Univ., Habil.-Schr.

Jevreji u Beogradu

napisao Ignjat Šlang

Festskrift i anledning af Professor David Simonsens 70-aarige Fødselsdag

Nir Daṿid likhvod ha-rav he-ḥakham R. Daṿid Simonsen

Patient-rated Outcomes of Lumbar Fusion in Patients with Degenerative Disease of the Lumbar Spine: Does Age Matter?

Introduction: Current demographic changes are characterized by population aging, such that the surgical treatment of degenerative spine conditions in the elderly is gaining increasing relevance. However, there is a general reluctance to consider spinal fusion procedures in this patient age group due to the increased likelihood of complications. The aim of this study was to assess the patient-rated outcome and complication rates associated with lumbar fusion procedures in three different age groups. Methods: This was a retrospective analysis of prospectively collected data from consecutive patients who underwent first-time, one to three level posterior instrumented fusion between 2004 and 2011, due to degenerative disease of the lumbar spine. Data were obtained from our Spine Surgery Outcomes Database (linked to the International Spine Tango Register). Before surgery, patients completed the multidimensional Core Outcome Measures Index (COMI), and at 3 and 12 months after surgery they completed the COMI and rated the Global Treatment Outcome (GTO) and their satisfaction with care. Patients were divided into three groups according to their age: younger (≥50y <65y; n = 317), older (≥65y <80y; n = 350), and geriatric (≥ 80y; n = 40). Results: 707 consecutive patients were included. The preoperative comorbidity status differed significantly (p < 0.0001) between the age groups, with the highest scores in the geriatric group. General medical complications during surgery were lower in the younger age group (7%) than in the older (13.4%; p = 0.006) and geriatric groups (17.5%; p = 0.007). Duration of hospital stay was longer (p = 0.006) in the older group (10.8 ± 3.7 days) than the younger (10.0 ± 3.6 days) group. There were no significant group differences (p>0.05) for any of the COMI domains covering pain, function, symptom specific well-being, general quality of life, and social and work disability at either 3 months’ or 12 months’ follow-up. Similarly, there were no differences (p>0.05) between the age groups for GTO and patient-rated satisfaction at either follow-up. Conclusions: Preoperative comorbidity and general medical complications during lumbar fusion for degenerative disorders of the lumbar spine are both greater in geriatric patients than in younger patients. However, patient-rated outcome is as good in the elderly as it is in younger age groups. These data suggest that geriatric age per se is not a contraindication to instrumented fusion for lumbar degenerative disease.

Is fast track management after elective cranial surgery safe and can it replace routine early postoperative computed tomography?

Aims: Patient management following elective cranial surgery varies between different neurosurgical institutions. Early routine postoperative cranial computed tomography (CT) is often performed while keeping patients sedated and ventilated for several hours. We hypothesize that fast track management without routine CT scanning, i.e., early extubation within one hour allowing neurological monitoring, is safe and does not increase the rate of return to OR compared with published data. Methods: We prospectively screened 1118 patients with cranial procedures performed at our department over a period of two years. 420 patients with elective brain surgery older than 18 years with no history of prior cranial surgery were included. Routine neurosurgical practice as it is performed at our department was not altered for this observational study. Fast track management was aimed for all cases, extubated and awake patients were further monitored. CT scanning within 48 hours after surgery was not performed except for unexpected neurological deterioration. This study was registered at ClinicalTrials.gov (NCT01987648). Results: 420 elective craniotomies were performed for 310 supra- and 110 infratentorial lesions. 398 patients (94.8%) were able to be extubated within 1 hour, 21 (5%) within 6 hours, and 1 patient (0.2%) was extubated 9 hours after surgery. Emergency CT within 48 hours was performed for 36 patients (8.6%, 26 supra- and 10 infratentorial cases) due to unexpected neurological worsening. Of these 36 patients 5 had to return to the OR (hemorrhage in 3, swelling in 2 cases). Return to OR rate of all included cases was 1.2%. This rate compares favorably with 1-4% as quoted in the current literature. No patient returned to the OR without prior CT imaging. Of 398 patients extubated within one hour 2 (0.5%) returned to the OR. Patients who couldn’t be extubated within the first hour had a higher risk of returning to the OR (3 of 22, i.e., 14%). Overall 30-day mortality was 0.2% (1 patient). Conclusions: Early extubation and CT imaging performed only for patients with unexpected neurological worsening after elective craniotomy procedures is safe and does not increase patient mortality or the return to OR rate. With this fast track approach early postoperative cranial CT for detection of postoperative complications in the absence of an unexpected neurological finding is not justified. Acknowledgments The authors thank Nicole Söll, study nurse, Department of Neurosurgery, Bern University Hospital, Switzerland for crucial support in data collection and managing the database.

Ḥanokh la-naʿar! : follshṭändige hebraeʾishe und yuedish-dayṭshe lezefibel

fon aynem praḳṭishen shulmanne

Ragionamento sulla lingua del testo Misnico ossia : progetto d'aumentare la lingua ebrea colle voci del testo Misnico onde arricchire una tale lingua

dal Anania Coen

Lazaru Belelē Hoi mnēsteres tēs en tō Ethnikō Panepistēmio edras tes Ebrai͏̈kēs : elenchos tōn hypoblētheisōn diatribōn

In griech. Schr.

(Ozrot Chajim) : Katalog der Michael'schen Bibliothek

hrsg. von den Michael'schen Erben. Nebst einem, vielfache Berichtigungen und Excerpte enthaltenden Register zum Verzeichnis der Handschriften von M. Steinschneider und einem Vorworte von L. Zunz

Prospectus of the Library of Ephraim Deinard at New Orleans, Louisiana : also a list of Jewish antiquities, depicting the "history of religion", on exhibition at the Smithsonian Institution at Washington, D. C., and at New Orleans, Louisiana

Devir Efrayim

Hebräisch-deutsches Wörterbuch nebst kurzer Grammmatik : mit Paradigmen der Substantiva und Verba

von David Cassel

Institutiones Hebraicæ

Eliæ Schnegassii Gothani

Libro d'istruzione religiosa : ad uso delle classi inferiori nelle scuole israelitiche

Teilw. in hebr. Schr. und Sprache