Med Klin
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Chemotherapeutic options in the treatment of advanced colorectal cancer have markedly improved during the last years. This is partly due to the high-dose 5-FU regimen, but also to the development of new cytotoxic agents and drug combinations. ⋯ Prospective randomized phase III trials must confirm the best chemotherapy and the best strategy for the different subgroup of patients.
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Explicit data on the quality of health care in addition to economic data represent major instruments of internal as well as external controlling and resource allocation. ⋯ Issues of further discussion are loss of validity of indicators due to awareness and alteration of documentation habits, public disclosure, and the evaluation of indicators by means of evidence-based medicine.
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Since both migraine and vertigo are common complaints in clinical practice they may coincide in an individual patient just by chance. There are, however, numerous patients with vestibular symptoms caused by migraine, accounting for 6-8% of diagnoses in specialized dizziness clinics. CLINICAL MANIFESTATION: Migraine-associated vertigo is a vestibular disorder which manifests itself with spontaneous or positional rotational vertigo or dizziness induced by head motion. The vertigo may occur without accompanying headache and may last from seconds to several weeks. ⋯ Treatment is based on the repertoire of acute and prophylactic medications that are used for migrainous headaches. Controlled studies on the treatment of migraine-associated vertigo are still lacking.
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Case Reports
[Ruptured splenic artery aneurysm--a rare cause of recurrent gastrointestinal hemorrhages].
A 51-year-old asthenic patient attended the hospital with syncope, head injury, tarry stool and severe anemia. There was a history of alcohol and nicotine abuse, but no known preceding diseases of the liver or gastrointestinal tract. Except hypotension, examination of the patient did not show any further abnormalities. ⋯ Pseudoaneurysms of the splenic artery are an uncommon cause of gastrointestinal bleeding. The most important factor in detecting a pseudoaneurysm is considering the diagnosis. It is necessary to check for a pseudoaneurysm secondary to pancreatitis with pulsed or color Doppler imaging especially if a pseudocyst was first diagnosed with abdominal ultrasound. Because of the high mortality of a pseudoaneurysm, surgical resection or interventional radiology should be done as early as possible.