Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jun 1985
[Letters of discharge from a University Department of Medicine. Attempt at an analysis of their contents].
498 discharge letters, written by physicians at the Second Department of Medicine, University of Vienna were subjected to the following content analysis: procedures employed to reach a diagnostic result, length and preferred content of letters, delay between discharge of patient and posting of letter and relationship between pragmatic versus knowledge-oriented concepts. Routine hospital diagnostic procedures achieved a marked increase in accuracy in terms of medical diagnosis over initial admittance diagnosis. ⋯ Letters addressed to general practitioners were longer and contained more assessment of the patient's condition than letters to specialists. Letters on average left the hospital 30 days after the patient's discharge.
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Patients who are Jehovah's Witnesses present a special problem when undergoing open heart surgery since they refuse blood transfusion. We performed 15 open heart operations for both acquired and congenital heart disease using a modified version of isovolaemic haemodilution and bloodless prime technique of extracorporeal circulation. ⋯ One death might have been at least indirectly related to the regimen which excludes blood substitution. We believe that our experience demonstrates the feasibility of open heart procedures in Jehovah's Witnesses, although the mortality risk is increased in these patients.