Schweizerische Rundschau für Medizin Praxis = Revue suisse de médecine Praxis
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In cardiovascular emergency medicine echocardiography allows in many patients a quick and gentle bedside examination. In particular in patients with acute arterial hypotension, suspected or known acute coronary heart disease and its complications and in patients with acute heart failure due to valvular heart disease a valuable narrowing down of the differential diagnosis can be achieved by the use of echocardiography. However, the use of echocardiography in acutely ill patients demands highly skilled investigators to avoid potentially dangerous errors. The echocardiographic examination in intensive or emergency care patients represents an invaluable diagnostic tool today and becomes a toy only in inexperienced hands.
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Schweiz. Rundsch. Med. Prax. · Oct 1990
[The eye as a reference organ for diseases of the nervous system. Simple examination methods for office practice and at the bedside].
The eye is not only for vision. In diseases of the nervous system it can fulfill the task of a diagnostic tool. As a highly developed sensory organ, the eye is affected by disorders of the visual pathways, the pupillo-motor structures or the ocular motor system. Several simple clinical tests are presented which can be performed in practice or at the bedside without any technical equipment.
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In Colles' fractures of the radius the distal fragment is slanted dorsally and radially, dislocated dorsally and radially and supinated. The radius is shortened. Furthermore a comminution-zone of the dorsal cortex is found. ⋯ The cast should push the carpus slightly palmwards and hold the hand in light ulnar-duction. Immobilization is retained for four to six weeks. Radiologic review is performed 4, 8, 12 and 16 days post reduction so that timely change to a different form of fixation is possible in case of secondary dislocation.
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From 1987 to 1989, 14 adults with acute epiglottitis were seen and treated at the ENT clinic of Geneva. All patients presented with a severe sore throat as primary symptom. An indirect laryngoscopy, which bears no risk in adults, was performed and revealed a swollen, cherry-red epiglottis. ⋯ In most cases, these patients can be treated medically with antibiotics and corticoids, and there is no need for systematic orotracheal intubation. However, patients presenting with respiratory distress syndrome or stridor require intubation, which may be impossible because of edema of the epiglottis. Therefore, a surgeon must be ready to perform a tracheotomy.
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Schweiz. Rundsch. Med. Prax. · Jun 1990
Historical Article[A historical approach to herniated disk].
It is not more than sixty years ago that a relationship between rupture of an intervertebral disk and possible involvement of the spinal canal with its nervous structures had first been established. However, our knowledge of the intervertebral disk on the one hand, and of myelo- and radiculopathies on the other, is much older. Some of the steps leading to the 'discovery' of disk herniation are pointed out and illustrated.