MMW Fortschritte der Medizin
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Sleep disorders could be the symptoms of organic or non-organic conditions. The diagnostics comprises a detailed medical history of the patient complemented by a sleep diary, as well as organic medical and psychological/psychiatric examinations. ⋯ Nondrug strategies include sleep hygiene, stimulus control, sleep restriction and cognitive techniques. For sleep disturbances due to a psychological or organic disease, the primary condition must be treated.
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The diagnosis of restless legs syndrome is made on the basis of the clinical symptoms and, if applicable, complemented with a polysomnography. This is followed by neurophysiological examinations and laboratory diagnostics and permits a differentiation between idiopathic and secondary RLS. ⋯ An idiopathic RLS is treated with drugs. Primarily, L-dopa/benserazide and dopaminergic agonists are used, but opioids and anticonvulsants are also successful.
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Inspection of a corpse by the physician is a responsible last service he can offer his patient. Apart from reliably establishing death and the time of its occurrence, the physician must thoroughly inspect the corpse to clarify the cause of death. ⋯ Only then do statistics on causes of death in the population make sense and can provide useful data. If an unnatural cause of death is suspected, or if it is not possible to ascertain the cause, the police or public prosecutor (coroner) must be notified.
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Comparative Study
[Pain therapy. Extensive possibilities not adequately utilized].
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Review Comparative Study
[How to recognize POAD? The diagnosis of peripheral occlusive arterial disease in the physician's office].
Peripheral occlusive arterial disease (POAD) encompasses all stenotic and occlusive changes affecting the aorta and arteries supplying the extremities, and in 90% of the cases is due to atherosclerosis. In the majority of patients the lower extremities are involved, andonly every third patient has symptoms. ⋯ Doppler sonography and determination of the Doppler pressure index (ankle-brachial index) make possible a noninvasive accurate staging. Color-coded duplex sonography and imaging procedures provide further information, and are indispensable for establishing the indication for interventional measures.