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Hintergrund: Internetseiten von Krankenhausern werden zunehmend zur Informationseinholung und Beantwortung von Gesundheitsfragen herangezogen. Um den Anspruchen einer Leserschaft mit unterschiedlichem Bildungs- und Leseniveau zu genugen, mussen Internetseiten mit medizinischen Fachinformationen eine ausreichende Lesbarkeit aufweisen. Material und Methoden: Ausgewahlte Internetseiten aller Kliniken fur Allgemein- und Viszeralchirurgie an deutschen Universitatskliniken (n = 36) wurden einer systematischen Textanalyse unterzogen. Fur 9 unterschiedliche chirurgische Themengebiete wurden reprasentative Texte im Internetangebot jeder Klinik ausgewahlt. Anhand objektiver Textparameter und 5 bekannter Lesbarkeitsindizes wurden die Texte im Hinblick auf ihre Struktur und Lesbarkeit analysiert. Es wurde zudem untersucht, ob sich die Lesbarkeit der Texte in verschiedenen Regionen voneinander unterscheidet. Ergebnisse: Fur die endgultige Analyse konnten 196 Internetseiten herangezogen werden. Im Durchschnitt bestanden die Texte aus 25 Satzen und 368 Wortern. Ubereinstimmend zeigte sich bei den Lesbarkeitsindizes, dass die untersuchten Texte i. d. R. nur fur Leser mit einem hohen Bildungsniveau bzw. Akademiker verstandlich sind. Schlussfolgerung: Medizinische Experten-Laien-Texte auf Internetseiten deutscher universitarer allgemein- bzw. viszeralchirurgischer Kliniken sind fur den medizinischen Laien uberwiegend sehr schwer lesbar. Um die Allgemeinbevolkerung angemessen uber Krankheiten und Therapieoptionen sowie Schwerpunkte der Kliniken zu informieren, ist eine Uberarbeitung der meisten Texte empfehlenswert.

Einleitung: Das Internet gewinnt als Informa­tionsquelle fur Patienten in medizinischen Fragestellungen zunehmend an Bedeutung. Auf der anderen Seite haben viele Patienten Probleme, schriftliche Informationen mit medizinischen Inhalten adaquat aufzunehmen und zu verstehen. Grundbedingung fur ein Textverstandnis ist die Lesbarkeit eines Textes. Ziel der vorliegenden Untersuchung war es, die auf den Internetseiten groser deutscher plastisch-chirurgischer Klinik­en verfugbaren Texte mit Patienteninformation hinsichtlich ihrer Lesbarkeit zu untersuchen. Studiendesign: Die Internetseiten von 27 grosen Abteilungen fur Hand- und Plastische Chi­rurgie in Deutschland wurden mithilfe von 5 anerkannten Lesbarkeitsindices einer systematischen Analyse unterzogen. Anhand 20 frei gewahlter fachreprasentativer Suchbegriffe wurde auf den Internetseiten nach passenden Informationstexten gesucht. Alle Texte wurden einem von 3 thematischen Schwerpunkten zugeordnet um adaquate Vergleichsanalysen durchfuhren zu konnen. Neben der Auswertung der Lesbarkeit erfolgte die Analyse weiterer objektiver Textparameter. Ergebnisse: In die schlussendliche Analyse konnten 288 Texte einbezogen werden. Die meisten Texte fanden sich zum Themenkomplex „Handchirurgie“ (n=124), weniger zu den Komplexen „plastische Gesichtschirurgie“ (n=80) und „Lappenplastik, Brust- und Rekonstruktive Chirurgie“ (n=84). Alle angewandten Lesbarkeitsindices zeigten ubereinstimmend eine schlechte Lesbarkeit an, sodass die Texte nur fur Leser mit Hochschulbildung verstandlich erscheinen. Zwischen den Themenkomplexen bestanden keine signifikanten Unterschiede hinsichtlich der Lesbarkeit. Schlussfolgerungen: Gerade in der Kommunikation von medizinischen Informationen ist es wichtig, den Kenntnis- und Bildungsstand des Adressaten zu berucksichtigen. Die untersuchten Texte zeigten ubereinstimmend eine Lesbarkeit an, die in der Regel lediglich fur Akademiker als ausreichend verstandlich ist. Ein Grosteil der angestrebten Zielgruppe wird somit wahrscheinlich nicht ­erreicht. Soll der zunehmenden Bedeutung des Internets als ­Informationsmedium fur Patienten Rechnung getragen werden, erscheint eine Uberarbeitung der Texte sinnvoll.

The Internet is becoming increasing-ly important as a source of information for patients in medical issues. However, many patients have problems to adequately understand texts, especially with medical content. A basic requirement to understand a written text is the read-ability of a text. The aim of the present study was to examine texts on the websites of German -plastic-surgical hospitals with patient information regarding their readability.In this study, the read-ability of texts of 27 major departments of plastic and Hand surgery in Germany was systematically analysed using 5 recognised readability indices. First, texts were searched based on 20 representative key words and themes. Thereafter, texts were assigned to one of 3 major themes in order to enable statistical analysis. In addition to the 5 readability indices, further objective text parameters were also recorded.Overall, 288 texts were found for analyzation. Most articles were found on the topic of "handsurgery" (n=124), less were found for "facial plastic surgery" (n=80) and "flaps, breast and reconstructive surgery" (n=84). Consistently, all readability indices showed a poor readability for the vast majority of analysed texts with the text appearing readable only for readers with a higher educational level. No significant differences in readability were found between the 3 major themes.Especially in the communication of medical information, it is important to consider the knowledge and education of the addressee. The texts studied consistently showed a readability that is understandable only for academics. Thus, a large part of the intended target group is probably not reached. In order to adequately deliver online information material, a revision of the analysed internet texts appears to be recommendable.

Besides their function as one of the main contact points, websites of hospitals serve as medical information portals. All patients should be able to understand medical information texts; regardless of their literacy skills and educational level. Online texts should thus have an appropriate structure to ease their comprehension.Patient information texts on every German nonuniversity ENT hospital website (n = 125) were systematically analysed. For ten different ENT topics a representative medical information text was extracted from each website. Using objective text parameters and five established readability indices, the texts were analysed in terms of their readability and structure. Furthermore, we stratified the analysis in relation to the hospital organisation system and geographical region in Germany.Texts from 142 internet sites could be used for the definite analysis. On average, texts consisted of 15 sentences and 237 words. Readability indices congruously showed that the analysed texts could generally only be understood by a well-educated or even academic reader.The majority of patient information texts on German hospital websites are difficult to understand for most patients. In order to fulfil their goal of adequately informing the general population about disease, therapeutic options and the particular focal points of the clinic, a revision of most medical texts on the websites of German ENT hospitals is recommended.

A certain proportion of the population has limited literacy skills; therefore, it is important that any patient information published on the internet is readable to the majority of patients for whom the information is intended.Texts for 10 representative ear nose and throat (ENT) topics were extracted from each website of the 36 German ENT university hospitals. The texts were systematically analyzed by use of the German version of the Flesch ease of reading index. The texts of two topics were additionally analyzed with four more readability tools for the German language. Texts were analyzed in relation to the topic and to the geographical region.On average the texts of 185 websites consisted of 34 sentences and 401 words. Comparably, texts on cochlear implants showed the best readability scores and texts on middle ear pathology the worst. The results of the reading ease index and of the other reading analysis tools showed that all texts require a relatively high literacy level.To fulfil the ambition of informing the general population about medical issues in an adequate way, a revision of most medical texts on websites of German ENT departments at university hospitals is recommended.

This article will review the clinical and laboratory characteristics of urinary tract infection in children. The diagnostic workup, the current recommended treatment and the long-term prognosis will also be reviewed.

A case of a previously healthy, 13-year-old male with IgA nephropathy is presented in order to illustrate clinical onset and differential diagnosis of this rather common clinical entity. The laboratory and histopathological diagnosis is illustrated and discussed, as well, together with a brief discussion of possible pathogenesis. In this disorder, in which approximately 11% of affected patients experience spontaneous remission, future development of molecular probes to determine prognosis is of great importance.

To examine the relationship between the objective premedical credentials and performances on Step 2 on the United States Medical Licensing Examination (USMLE) of 480 students in three classes at the Virginia Commonwealth University Medical College of Virginia School of Medicine. The purpose of the study was to seek those selection criteria that might best predict performance on an examination designed to assess problem-solving skills, the essence of clinical medicine.Premedical data from two classes (1193, 1994) were analyzed, and a regression equation was used to calculate theoretical USMLE Step 2 scores for the students in the class of 1995, who had not yet taken this examination. The premedical variables were scores on the verbal and math section on the Scholastic Aptitude Test (SAT), scores on the six sections of the pre-1991 Medical College Admission Test (MCAT), grade-point average (GPA) in science courses required of premedical students, and undergraduate major. Once the class of 1995 had taken the USMLE Step 2, the equation was cross validated, and the theoretical and actual scores of the class of 1995 were correlated.The correlation between theoretical and actual scores was r = .443. In the analysis for the classes of 1993 and 1994, the single variables most highly predictive of USMLE Step 2 performance were scores on the verbal section of the SAT (r = .317) and the Skills Analysis: Reading section of the MCAT (r = .331). However, the MCAT scores were excluded from the final regression analysis because of the pre-1991 MCAT cannot be useful in predicting the performances of present medical school applicants. The resulting regression equation (using the SAT verbal section and premedical GPA) was able to account for 21.2% of the variance for the class of 1995.The use of the verbal section of the SAT as a predictive factor is unique. It is significant that this variable was strongly related to premedical GPA, suggesting that high verbal aptitude serves one well, even when coping with complex scientific concepts.

The transport of L-proline was studied in brush-border membrane vesicles isolated from the kidneys of newborn rats. In contrast with the rapid initial uptake with an ‘overshoot’ observed in adult vesicles, uptake by the newborn vesicle was slow, showed no ‘overshoot’, and proline continued to accumulate at a time when the adult vesicle had already equilibrated. L-Proline transport in the newborn rat occurs by Na+-dependent and independent mechanisms. There appeared to be essentially no uptake by anti-luminal vesicles isolated from newborn rat kidney. These observations may help to explain the prolinuria that occurs in the newborn animal.

The recent developments in cofactor therapy of inherited biochemical disease has awakened interest in biotin as a therapeutic agent. This review briefly details the physiological and biochemical aspects of human biotin metabolism. The role of biotin in therapy of human disease is critically examined and the relevant literature extensively reviewed. It is our hope that this review will stimulate further clinical interest in the treatment of biotin-responsive human disorders.

Isolated renal tubule preparations were made from newborn Sprague-Dawley rats and used to study initial entry rate kinetics of glycine. The results were compared to those obtained in the isolated tubule preparation from the adult rat kidney. While initial rates of glycine uptake were identical for newborn and adult tubules, significant differences in influx kinetics were demonstrated. Of the two apparent transport Km systems shown to be present in the newborn tubule, the high-affinity, low-capacity system accounts for about 40% of total glycine uptake at physiologic concentrations. The high-affinity, low-capacity system of the adult tissue accounts for about 10% of total uptake at the same concentration range. The data lend strength to the argument against the concept that the physiologic hyperglycinuria of the newborn rat is due to either impaired ability to concentrate glycine intracellularly or to absence of one or more transport mechanisms for glycine.

3-Methylglutaconic aciduria has been found in two distinct syndromes. In one there is deficient activity of 3-methylglutaconyl coenzyme A hydratase, and the only clinical manifestation observed has been retardation of speech development. In the other, which includes a majority of the patients studied, we document that the activity of this enzyme in fibroblast extracts is normal. The phenotype of this disorder is one of profound neurological impairment with retarded psychomotor development, hypotonicity and/or spasticity, convulsions or EEG abnormalities, and sensorineural changes in the eye and ear.

Glycine uptake by newborn rat renal cortical slices in the presence of 2 mM diamide remained unchanged from control value during incubation times up to 30 minutes. Longer exposure to diamide resulted in decreased net uptake. Kinetic analysis of this phenomenon indicated a noncompetitive inhibitory effect of diamide upon the low-affinity glycine uptake system, whereas glycine uptake on the high-affinity system was obliterated. A similar analysis of the diamide effects on adult tissue indicated a noncompetitive inhibition of both the low- and high-affinity glycine transport systems. Diamide did not cause any demonstrable change in glycine efflux from newborn cortical slices. Thus the decreased net uptake we observed in newborn slices in the presence of diamide could be explained solely on the basis of an effect on glycine entry. Simultaneous measurements of intracellular glutathione (GSH) levels in the newborn tissue showed a lack of any direct relationship between the transport effects of diamide and its oxidative effect on reduced glutathione.

A hemodensitometer (photoelectric plethysmograph) has been utilized to sense the perfusion pulse at the plantar surface of the arch of the foot of premature babies. The sensed pulse-wave signal is then passed through a low-pass filter and then recorded. The resultant signal correlated well with the nasal mask respiration signal.