Geburtsh Frauenheilk
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Geburtsh Frauenheilk · May 1992
Case Reports[Continuous ambulatory intravenous morphine infusion for pain therapy in advanced ovarian cancer].
We report on a female outpatient with cancer of the ovary, who received continuous intravenous morphine infusion for terminal pain control. The patient was treated over a period of 48 days with a morphine dosage ranging from 10 to 60 mg/h, which kept her free of pain. ⋯ At a later stage, we complemented the treatment with Diazepam and Haloperidol. No side-effects were observed over the whole period of morphine infusion.
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Geburtsh Frauenheilk · May 1992
Case Reports["Hospital tourism". Case report of Munchausen syndrome].
We report on a 29-year old patient, who was treated as an inpatient in 95 different hospitals (altogether 173 times) within 7 years. The gynaecologist can suspect Münchausen's syndrome, if the following aspects are recorded: dramatic clinical admissions patterns, (frequently out of the normal consultation time); a history of several operations and many short stays in different hospitals. Special care in diagnostics should be taken to avoid further unnecessary surgical interventions.
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Geburtsh Frauenheilk · Aug 1991
Case Reports[Marfan syndrome and pregnancy, complicated by dissecting aneurysm].
Pregnant women with a Marfan syndrome carry a risk of developing an aortic arc dissection. As the developing aneurism may be diagnosed by echocardiography, this method should be applied repeatedly during pregnancy. We report the case of a Marfan patient, who developed an acute aortic dissection during the third trimester of her pregnancy and discuss the guidance and surveillance of Marfan patients who are or wish to become pregnant.
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Geburtsh Frauenheilk · Jun 1991
Review[What benefit and harm can be expected from screening and routine examinations and from their omission?].
Benefit and harm of screening and routine tests or their omission are dealt with in four parts. In the first part methods are described to evaluate the diagnostic value of medical testing. The concepts of diagnostic sensitivity, diagnostic specificity, and pre- and posttest probability of a diagnosis are defined. ⋯ This is due to the large share of "healthy" women among the gynaecological patients, as well as the fact that treatment of early detected recurrences shows no demonstrable advantage over treatment of later detected recurrences. In the fourth part, we show that no adverse forensic consequences are to be expected if diagnostic tests are omitted because of demonstrably low diagnostic value. In case of legal procedures against the physician, a medical expert will have to evaluate the diagnostic value of the omitted test objectively from an "ex-ante" point of view, using the methods defined in the first part.(ABSTRACT TRUNCATED AT 250 WORDS)