Diabetes mellitus places a significant burden on the U.S. healthcare system. Because of the potential to reduce diabetic complications and costs through intensive management, diabetes has become a primary target for disease management programs. We performed a retrospective analysis of short-term baseline and follow-up clinical, economic, and member and provider satisfaction data from approximately 7,000 people with diabetes being treated through seven managed care plans using Diabetes Treatment Centers of America's Diabetes NetCare, (Nashville, TN), a comprehensive diabetes management program. Our analysis indicates that Diabetes NetCare achieved gross economic adjusted savings of $50 per diabetic member per month (12.3%), with gross unadjusted savings of $44 (10.9%) per diabetic member per month. Hospital admissions per 1,000 diabetic member years decreased by 18%, and bed days fell by 21%. Patients with diabetes were more likely to get HbAlc tests, foot exams, eye exams, and cholesterol screenings while enrolled in the program. These data suggest that implementation of a comprehensive healthcare management program for people with diabetes can lead to substantial improvements in costs and clinical outcomes in the short-term. It is expected that improvements will increase over time, with continuing improvements in health status and a reduction in the number of future diabetic complications.

In the early clinical phase the comprehensive imaging of patients with multiple trauma using helical CT is already established. Aim of this study was to assess whether MSCT may improve the patient management and the diagnostic results. The procedure is designed as follows: after life-thretening treatment x-ray of chest and ultrasound are carried out in the emergency room. Then the patient is moved to CT. From 1998 to december 2000 241 patients were examined using a single slice helical CT (Somatom plus 4), in 2001 79 patients using a 4-slice helical CT (Somatom VZ, Siemens Med.Sol.). After CT selected radiograms of the extremities were taken. 359 of 360 procedures were carried out successfully. Excluding 1 case (death during 1-sl.h CT) all relevant lesions of head, neck, and body were diagnosed. Although the patients had an injury severity score of approximately 30. The change from 1 slice-helical CT to 4 slice-helical CT allowed us to reduce the stay in the CT room from 28 to 16 min. The total lethality decreased by approximately 4%. Advantages for the patient arose from the standardized examination protocol using multislice CT. If integrated in an interdisciplinary management concept, it is a good compromise between examination time, comprehensive diagnostic imaging, life-saving therapeutic procedures, and therapy planning.

Offspring behavior results from the combined expression of maternal and paternal genes. Genomic imprinting, however, silences some genes in a parent-of-origin specific manner, a process that, among all animals, occurs only in mammals. How genomic imprinting affects the behavior of mammalian offspring remains poorly understood. Here we studied the effects of the loss of the paternally inherited gene Magel2 on the emission of separation-induced ultrasonic vocalization (USV) by mouse pups. Using quantitative analysis of more than one hundred thousand USVs, we characterized the rate of vocalizations as well as their spectral features from postnatal days 6 to 12 (P6-P12), a critical phase during mouse development when pups fully depend on the mother for survival. Our analyses show that Magel2 deficient offspring emit separation-induced vocalizations at lower rates and with altered spectral features. Using methods for a holistic analysis of the entire vocal repertoire of pups, we found that Magel2 deficient mice at postnatal day 8 (P8) emit USVs that resemble the vocal repertoire of wildtype mice at older ages (P10-12). These results suggest that the deficiency of this paternally inherited gene impairs the expression of separation-induced vocalization in pups, a behavior that supports pup growth and development.

Recently the «EFSUMB guidelines and recommendations on the clinical practice of contrast enhanced ultrasound (CEUS): update 2012 on non-hepatic applications» have been published. In the following paper a short summary and comments on the guidelines are given.

Ultrasound in addition to endoscopy and radiological methods has become widely accepted for diagnosis and evaluation of therapeutic success of gastrointestinal diseases. In addition to the lumen and more importantly the wall (layering) and the surroundings of the gastrointestinal tract functional processes (peristalsis, bloodflow) can be analysed as well. The current role of gastrointestinal ultrasound was discussed during the Davos meeting 2011 of the «Schweizerische Gesellschaft für Ultraschall» (SGUM) and the literature is summarised in this article.