Das Problem der verantworteten Therapieentscheidung in der Neonatologie

Definition of the problem: Physicians and nurses who work in neonatology—as in intensive care at all—are often forced to decide whether to stop or to continue with the treatment of a severely ill patient. The literature provides several decision making instruments, which are meant to help and to rationalize such decisions. Method and conclusion: Two of these instruments (“Schema zur ethischen Urteilsbildung nach dem Muster der aristotelischen Ethik”, Honnefelder 1994; “Nimwegener Methode für ethische Fallbesprechung”, Gordijn 1998) were tested by retrospectively examining two cases of our NICU. Results of our study show that the use of a decision making instrument is basically helpful. But the above mentioned instruments showed also shortcomings when used in the framework of neonatology. Therefore we developed the “Kölner Arbeitsbogen zur ethischen Entscheidungsfindung in der Neonatologie”, which is adapted to the specific needs of neonatology.     

Delayed renal dysfunction and flash pulmonary edema post endovascular abdominal aneurysm repair

After endovascular aortic repair (EVAR), the deterioration in long‐term renal function is probably multifactorial. Preoperative renal failure is an independent risk factor. Postoperative renal dysfunction can be associated with inadvertent renal artery occlusion, renal artery complications as stenosis, plaque dislodgement, or dissection. Ischemic nephropathy can accelerate hypertension and circulatory congestion. We report a case of coverage of the renal arteries symptomatic with flash pulmonary edema and renal failure 15 months after EVAR, suggesting a delayed endograft migration. The patient had complete resolution of symptoms and renal function after renal artery stenting with placement between endograft and aneurysm to the left renal artery.     

Noiseless Subsystems and the Structure of the Commutant in Quantum Error Correction

The effect of noise on a quantum system can be described by a set of operators obtained from the interaction Hamiltonian. Recently it has been shown that generalized quantum error correcting codes can be derived by studying the algebra of this set of operators. This led to the discovery of noiseless subsystems. They are described by a set of operators obtained from the commutant of the noise generators. In this paper we derive a general method to compute the structure of this commutant in the case of unital noise. PACS: 03.67.–a, 03.67.Pp