Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Changes in postgraduate education (health policy prerequisites, work schedule regulation)].
Postgraduate training is an integral part of becoming a doctor. Postgraduate training in Germany is learning by doing, while working as a doctor. ⋯ There is a clear disproportion between the demand for postgraduate-training posts and the corresponding supply. By flexibilisation of the regulations for postgraduate training and by complementing methods for training and learning, the downward movement of the capacities for postgraduate training will be taken care of.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Blunt thoracic trauma--therapeutic relevance of results of roentgen image, ultrasound and computerized tomography].
In 60 patients with severe thoracic trauma the diagnostic procedures--X-ray of the chest, sonography and thoracic computed tomography (CT)--were reviewed for their incidence of finding all injuries. X-ray of the chest often failed to detect lung contusion and injuries in the mediastinal space. Four of five ruptures of the diaphragm were incidental findings on the occasion of laparotomy because of intraabdominal bleeding.
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Guidelines for the treatment of fractures in children include social and therapeutic parameters, such as adequate hospitalization for children, a definitive therapy with a low degree of invasiveness, and a high degree of freedom of mobility. The selection of a method is linked to the patient's requests. ⋯ Therapeutic strategies should be compared not only with regard to results, but also with regard to effectivity and efficiency. There are no strict guidelines in therapeutic procedures whatsoever.
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In a cooperative effort involving each medical society the joint study group of the medical research societies in Germany (AWMF) has established guidelines for the diagnosis and treatment of various diseases. Special guidelines which pertain specifically to operative intensive care medicine do not exist. However, official recommendations have been made for intensive care management in general. ⋯ Also yet the value of those guidelines cannot be assessed. It is beyond doubt that besides being of benefit, they do present some dangers. One must point out that these guide lines are recommendations and not rules upon which medical liability may be based.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Unnecessary admission from the surgical social medicine viewpoint].
Wrongfully inpatient admission means unnecessary treatment of patients with the means of a hospital. In a study of the Medical Service (MDK) in the German state of Hessen 58% of 954 inpatients were considered wrongfully admitted. 199 patients were treated surgically, the wrongful admission rate of 63% is caused by an unnecessary duration of pre- and postoperative treatment time as well as by organizational deficits.