Zentralblatt für Chirurgie
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Traditional medical treatment approaches for incurably and terminally ill persons are often felt by the patients and their families to be lacking, since distressing physical and spiritual symptoms of the disease cannot be adequately addressed. In many cases, care in the final stage of life represents a complex medical challenge whose objective is to maintain an individually sufficient quality of life for the patient. New strategies for therapy and care evolving out of the international hospice movement have entered medical training programs under the heading of palliative medicine. ⋯ In the public itself a changed and more open treatment of the topics of death and dying is becoming apparent, resulting in a demand as well for medical treatment options. From all this, as well as the fact that Germany has been strongly hesitant to establish palliative medicine facilities, it is apparent that there is a clear need to catch up in the area of palliative medicine treatment, research and teaching. The current mood of fiscal restraint in health care may delay medical progress, but it will not be able to prevent it.
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From 1000 patients referred with diagnosis of appendicitis 483 were treated operatively, 517 conservatively. Laparotomy and histopathologic examination confirmed the correct indication for surgery in 95.2% of patients with preoperatively expected perforation, in 72.0% with the diagnosis of acute inflammation, and in 84.0% when a chronic disease was anticipated preoperatively.