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8. Tox-Box: securing drops of life - an enhanced health-related approach for risk assessment of drinking water in Germany. Tox-Box: die Tropfen des Lebens bewahren - gesundheitsbasierte Risikobewertung für Trinkwasser in Deutschland

Author

Grummt, T., Kuckelkorn, J., Bahlmann, Arnold Aloys, Baumstark-Khan, C., Brack, Werner, Braunbeck, T., Feles, S., Gartiser, S., Glatt, H., Heinze, R., Hellweg, C.E., Hollert, H., Junek, R., Knauer, M., Kneib-Kissinger, B., Kramer, M., Krauss, Martin, Küster, Eberhard, Maletz, S., Meinl, W., Noman, A., Prantl, E.-M., Rabbow, E., Redelstein, R., Rettberg, P., Schadenboeck, W., Schmidt, C., Schulze, Tobias, Seiler, T.-B., Spitta, L., Stengel, D., Waldmann, P., Eckhardt, A., Grummt, T., Kuckelkorn, J., Bahlmann, Arnold Aloys, Baumstark-Khan, C., Brack, Werner, Braunbeck, T., Feles, S., Gartiser, S., Glatt, H., Heinze, R., Hellweg, C.E., Hollert, H., Junek, R., Knauer, M., Kneib-Kissinger, B., Kramer, M., Krauss, Martin, Küster, Eberhard, Maletz, S., Meinl, W., Noman, A., Prantl, E.-M., Rabbow, E., Redelstein, R., Rettberg, P., Schadenboeck, W., Schmidt, C., Schulze, Tobias, Seiler, T.-B., Spitta, L., Stengel, D., Waldmann, P., and Eckhardt, A.

Abstract

This article introduces ‘Tox-Box’, a joint research project designed to develop a holistic approach towards a harmonized testing strategy for exposure- and hazard-based risk management of anthropogenic trace substances in drinking water to secure a long-term drinking water supply. The main task of the Tox-Box consortium is to enhance the existing health-related indicator value concept (German: GOW-Konzept - Gesundheitlicher Orientierungswert) through development and prioritization of additional end point-related testing strategies for genotoxicity, neurotoxicity, germ cell damage, and endocrine effects. In this context, substance-specific modes of action will be identified and characterized. Toxicological data collected by the 12 Tox-Box subprojects will be evaluated and weighted to structure a hierarchical testing strategy for an improved risk assessment. A technical guidance document for exposure and hazard-based risk management of anthropogenic trace substances in drinking water will eventually be prepared.Dieser Artikel stellt das Verbundprojekt “Tox-Box” vor, das einen ganzheitlichen Ansatz für eine harmonisierte Teststrategie eines Expositions-bezogenen und Gefahren-basierten Risikomanagements von anthropogenen Spurenstoffen in Trinkwasser entwickeln und somit einen Beitrag zur langfristigen Sicherung der Trinkwasserversorgung leisten soll. Die Hauptaufgabe des Tox-Box-Konsortiums ist die Weiterentwicklung des bestehenden GOW-Konzeptes (Gesundheitlicher Orientierungswert) durch Erforschung und Priorisierung zusätzlicher Endpunkt-bezogener Teststrategien für Gentoxizität, Neurotoxizität, Keimzellschädigung und endokrine Effekte. In diesem Kontext werden zudem Substanz-spezifische Wirkmechanismen identifiziert und charakterisiert. Im Anschluss werden die toxikologischen Daten aus den 12 Teilprojekten evaluiert und gewichtet um eine hierarchische Teststrategie für eine verbesserte Risikobewertung zu erstellen. Zum Abschluss des Projektes wird eine technische Rich

Published
2013

9. Less complications in shunt surgery: gravitational valves are proven to be effective in the therapy of the idiophatic normal pressure hydrocephalus (SVASONA)

Author

Meier, U, Lemcke, J, Müller, C, Fritsch, M, Kehler, U, Langer, N, Kiefer, M, Eymann, R, Schuhmann, MU, Speil, A, Weber, F, Remenez, V, Rohde, V, Ludwig, HC, Stengel, D, Meier, U, Lemcke, J, Müller, C, Fritsch, M, Kehler, U, Langer, N, Kiefer, M, Eymann, R, Schuhmann, MU, Speil, A, Weber, F, Remenez, V, Rohde, V, Ludwig, HC, and Stengel, D

Published
2012

12. Less complications in shunt surgery: gravitational valves are proven to be effective in the therapy of the idiophatic normal pressure hydrocephalus (SVASONA)

Author

Meier, U, Lemcke, J, Müller, C, Fritsch, M, Kehler, U, Langer, N, Kiefer, M, Eymann, R, Schuhmann, MU, Speil, A, Weber, F, Remenez, V, Rohde, V, Ludwig, HC, Stengel, D, Meier, U, Lemcke, J, Müller, C, Fritsch, M, Kehler, U, Langer, N, Kiefer, M, Eymann, R, Schuhmann, MU, Speil, A, Weber, F, Remenez, V, Rohde, V, Ludwig, HC, and Stengel, D

Published
2012

13. Results of the SVASONA study in idiopathic normal pressure hydrocephalus

Author

Meier, U, Lemcke, J, Müller, C, Fritsch, MJ, Kiefer, M, Eymann, R, Kehler, U, Langer, N, Schuhmann, M, Speil, A, Weber, F, Remenez, V, Rohde, V, Ludwig, C, Stengel, D, Meier, U, Lemcke, J, Müller, C, Fritsch, MJ, Kiefer, M, Eymann, R, Kehler, U, Langer, N, Schuhmann, M, Speil, A, Weber, F, Remenez, V, Rohde, V, Ludwig, C, and Stengel, D

Published
2011

14. Results of the SVASONA study in idiopathic normal pressure hydrocephalus

Author

Meier, U, Lemcke, J, Müller, C, Fritsch, MJ, Kiefer, M, Eymann, R, Kehler, U, Langer, N, Schuhmann, M, Speil, A, Weber, F, Remenez, V, Rohde, V, Ludwig, C, Stengel, D, Meier, U, Lemcke, J, Müller, C, Fritsch, MJ, Kiefer, M, Eymann, R, Kehler, U, Langer, N, Schuhmann, M, Speil, A, Weber, F, Remenez, V, Rohde, V, Ludwig, C, and Stengel, D

Published
2011

15. Functional separation of septic and aseptic surgical procedures

Author

Kramer, A, Assadian, O, Wendt, M, Stengel, D, Seifert, J, Kramer, A, Assadian, O, Wendt, M, Stengel, D, and Seifert, J

Abstract

Current evidence does not favour constructional over functional separation of septic and aseptic surgical procedures in terms of overall hygiene maintenance and incidence of skin and soft tissue infections. In both laminar and turbulent flow air operating theatres, air is not a relevant source of pathogens if surface disinfection is carried out properly.Final cleaning after a septic procedure includes a thorough wipe-disinfection of all potentially contaminated near and distant surfaces, including maintaining the necessary and effective exposure time of the chosen surface disinfectant. Cleaning utensils and clothes of all team members must be disposed of before leaving the theatre, and a complete change of gowns is mandatory before re-entering the operating room area. Strict adherence to this code of behaviour will allow for efficient functional separation of clean and contaminated surgical procedures without compromising patient safety., Es gibt keine epidemiologische Evidenz für den Einfluss der baulichen Trennung aseptischer/septischer OP auf die SSI-Rate. Im Ergebnis eines diesbezüglichen Risk Assessments geht sowohl bei Turbulenzarmer Verdrängungströmung (TAV) als auch bei turbulenter Belüftung nach Schlussdesinfektion des OPs von der Raumluft keine Infektionsgefährdung für die nächste OP aus. Die Schlussdesinfektion nach septischer OP beinhaltet die gründliche Wischdesinfektion aller potentiell kontaminierten Flächen auch im patientenfernen Umfeld mit Abwarten der deklarierten Einwirkungszeit, den Wechsel der Reinigungsutensilien und Bereichskleidung des Reinigungspersonals, die Ausschleusung des OP-Teams mit Wechsel der Bereichskleidung und erneute Einschleusung sowie den Wechsel der Bereichskleidung vons Anästhesieteam und Springer.

Published
2011

16. Methods of Health Economic Evaluation for Health Services Research

Author

Icks, A., Chernyak, N., Bestehorn, K., Brueggenjuergen, B., Bruns, J., Dame, O., Dintsios, C. -M., Dreinhoefer, K., Gandjour, A., Gerber, A., Greiner, W., Hermanek, P., Hessel, F., Heymann, R., Huppertz, E., Jacke, C., Kaechele, H., Kilian, R., Klingenberger, D., Kolominsky-Rabas, P., Kraemer, H., Krauth, C., Luengen, M., Neumann, T., Porzsolt, F., Prenzler, A., Pueschner, F., Riedel, R., Ruether, A., Salize, H. J., Scharnetzky, E., Schwerd, W., Selbmann, H. -K., Siebert, H., Stengel, D., Stock, S., Voeller, H., Wasem, J., Schrappe, M., Icks, A., Chernyak, N., Bestehorn, K., Brueggenjuergen, B., Bruns, J., Dame, O., Dintsios, C. -M., Dreinhoefer, K., Gandjour, A., Gerber, A., Greiner, W., Hermanek, P., Hessel, F., Heymann, R., Huppertz, E., Jacke, C., Kaechele, H., Kilian, R., Klingenberger, D., Kolominsky-Rabas, P., Kraemer, H., Krauth, C., Luengen, M., Neumann, T., Porzsolt, F., Prenzler, A., Pueschner, F., Riedel, R., Ruether, A., Salize, H. J., Scharnetzky, E., Schwerd, W., Selbmann, H. -K., Siebert, H., Stengel, D., Stock, S., Voeller, H., Wasem, J., and Schrappe, M.

Abstract

On August 30, 2010, the German Network for Health Services Research [Deutsches Netzwerk Versorgungsforschung e.V. (DNVF e.V.)] approved the Memorandum III Methods for Health Services Research, supported by the member societies mentioned as authors and published in this Journal [Gesundheitswesen 2010; 72: 739-748]. The present paper focuses on methodological issues of economic evaluation of health care technologies. It complements the Memorandum III Methods for Health Services Research, part 2. First, general methodological principles of the economic evaluations of health care technologies are outlined. In order to adequately reflect costs and outcomes of health care interventions in the routine health care, data from different sources are required (e.g., comparative efficacy or effectiveness studies, registers, administrative data, etc.). Therefore, various data sources, which might be used for economic evaluations, are presented, and their strengths and limitations are stated. Finally, the need for methodological advancement with regard to data collection and analysis and issues pertaining to communication and dissemination of results of health economic evaluations are discussed.

Published
2010

27. Methods of Health Economic Evaluation for Health Services Research

Author

Icks, A., Chernyak, N., Bestehorn, K., Brueggenjuergen, B., Bruns, J., Dame, O., Dintsios, C. -M., Dreinhoefer, K., Gandjour, A., Gerber, A., Greiner, W., Hermanek, P., Hessel, F., Heymann, R., Huppertz, E., Jacke, C., Kaechele, H., Kilian, R., Klingenberger, D., Kolominsky-Rabas, P., Kraemer, H., Krauth, C., Luengen, M., Neumann, T., Porzsolt, F., Prenzler, A., Pueschner, F., Riedel, R., Ruether, A., Salize, H. J., Scharnetzky, E., Schwerd, W., Selbmann, H. -K., Siebert, H., Stengel, D., Stock, S., Voeller, H., Wasem, J., Schrappe, M., Icks, A., Chernyak, N., Bestehorn, K., Brueggenjuergen, B., Bruns, J., Dame, O., Dintsios, C. -M., Dreinhoefer, K., Gandjour, A., Gerber, A., Greiner, W., Hermanek, P., Hessel, F., Heymann, R., Huppertz, E., Jacke, C., Kaechele, H., Kilian, R., Klingenberger, D., Kolominsky-Rabas, P., Kraemer, H., Krauth, C., Luengen, M., Neumann, T., Porzsolt, F., Prenzler, A., Pueschner, F., Riedel, R., Ruether, A., Salize, H. J., Scharnetzky, E., Schwerd, W., Selbmann, H. -K., Siebert, H., Stengel, D., Stock, S., Voeller, H., Wasem, J., and Schrappe, M.

Abstract

On August 30, 2010, the German Network for Health Services Research [Deutsches Netzwerk Versorgungsforschung e.V. (DNVF e.V.)] approved the Memorandum III Methods for Health Services Research, supported by the member societies mentioned as authors and published in this Journal [Gesundheitswesen 2010; 72: 739-748]. The present paper focuses on methodological issues of economic evaluation of health care technologies. It complements the Memorandum III Methods for Health Services Research, part 2. First, general methodological principles of the economic evaluations of health care technologies are outlined. In order to adequately reflect costs and outcomes of health care interventions in the routine health care, data from different sources are required (e.g., comparative efficacy or effectiveness studies, registers, administrative data, etc.). Therefore, various data sources, which might be used for economic evaluations, are presented, and their strengths and limitations are stated. Finally, the need for methodological advancement with regard to data collection and analysis and issues pertaining to communication and dissemination of results of health economic evaluations are discussed.

Published
2010

39. Liposarkome: Problematik der Biopsie

Author

Glehr, M, Stengel, D, Scheipl, S, Gruber, G, Ertl, W, Leithner, A, Windhager, R, Glehr, M, Stengel, D, Scheipl, S, Gruber, G, Ertl, W, Leithner, A, and Windhager, R

Published
2007

43. Liposarkome: Problematik der Biopsie

Author

Glehr, M, Stengel, D, Scheipl, S, Gruber, G, Ertl, W, Leithner, A, Windhager, R, Glehr, M, Stengel, D, Scheipl, S, Gruber, G, Ertl, W, Leithner, A, and Windhager, R

Published
2007

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