Hirslanden Klinik Linde

Perinatal mental health disorders (PMDs) are a global health concern. In industrialized countries, the prevalence of PMDs is estimated to be 20%, and they are associated with serious negative effects for women, their children and their families, along with high societal costs related to long-term impacts. In Switzerland, the PMD detection rate during obstetrical healthcare provision is very low (1-3%), and specialized healthcare services are limited. This study aimed to develop and implement an advanced practice midwife (APM) role at a Swiss obstetrics and gynecology hospital using the PEPPA framework to provide adequate screening and first-consultation services. The study uses a qualitative approach and follows the research stages using the 8-step from the participatory, evidence-based, patient-focused process for advanced practice nursing role development, implementation and evaluation (PEPPA) framework to develop and implement the APM role. Utilizing the PEPPA framework, we were able to develop, implement, and evaluate the APM role in the field of perinatal mental health. Through appropriate screening and first-consultation services, we were able to identify affected women early and facilitate treatment. In addition to stakeholder engagement and interprofessional collaboration, PEPPA serves as a beneficial framework for the process of role development, implementation, and evaluation in the midwifery profession. This study aims to assist midwives with Master's degrees in establishing corresponding roles within their practice areas, thereby enhancing care delivery. Furthermore, the current APM approach is intended to be continuously evaluated to gain new insights into its effectiveness.

Die Frage, ob ein Sturz direkt auf die Schulter eine Rotatorenmanschettenruptur verursachen kann, beschäftigt Ärzte (und Gerichte) seit vielen Jahren. Gutachter, welche sich auf die versicherungsmedizinische Literatur stützen, lehnen die Unfallkausalität in der Regel ab. Wissenschaftliche Untersuchungen dazu gibt es nicht. Der untenstehende Bericht beschreibt einen typischen Fall, bei dem ein Sturz direkt auf die Schulter eine massive Rotatorenmanschettenruptur verursacht hat.

Two adolescent, highly active athletes are presented with unspecific symptoms of anterior knee pain. Conventional radiographs and magnetic resonance imaging (MRI) showed a suspicious but pathognomonic cortical irregularity of the dorsal, medial femoral condyle. Cortical desmoid is one of the most common incidental osseous findings on conventional radiographs and MRI of the knee. It often needs no follow-up examination in asymptomatic patients. Malignancy needs however to be ruled out.

We define infection as a bacterial inflammation that prolongs the treatment period or impairs the end result. Without a proper definition of terms, statistics are not comparable. A strict differentiation of "septic" and "aseptic" is not possible. The count of contaminated air particles has a relatively low influence on the incidence of infections. Joint puncture with joint irrigation is not only an indispensable procedure in diagnosis; together with systemic antibiotics it can also combat an infection, provided that the prosthesis is still stable. Joint irrigation preceding one-stage revision improves the prognosis and should therefore always be considered. Between 1980 and 1988, out of 42 deep infections 11 were successfully treated by irrigation alone. In 26 cases healing was accomplished by one-stage revision, and there were 5 treatment failures, in only 2 of which Girdlestone resections were involved.