Zeitschrift für ärztliche Fortbildung
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In only 30% of back pain patients an underlying pathology can be found. Rheumatologic causes in a narrow sense are fibromyalgia, osteoporosis and the group of spondylathropathies and reactive arthritis. Infectious disorders of the spine are emergency cases and need immediate and interdisciplinary action. ⋯ In acute, nonspecific back pain, the aim is to prevent a chronification of disease by instruction and education of the patient and an early start of physical therapy. The rehabilitation process in chronic cases in complex and may need psychobehavioral methods for pain control. Pharmacologic modalities of treatment-simple analgesics, nonsteroidal antirheumatic drugs, muscle relaxants and antidepressants-should only be used for a limited period and monitored constantly.
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Z Arztl Fortbild (Jena) · Jan 1997
[Backache--orthopedic diagnosis and special therapeutic possibilities].
Back pain is a wide-spread complaint in modern society and in part an adverse effect resulting from present-day lifestyles. To date, too little attention has been drawn to efficient prevention. The treatment of patients affected with back pain today calls for an in-depth pathophysiological knowledge about the mechanism occurring on the spine. ⋯ Today, the overwhelming majority of back pain patients undergo a non-operative treatment. In case the conservative applications prove inefficient, it is possible to successfully operate on patients a with disc prolaps, degenerative instabilities as well as osseous spinal foraminal stenoses. A precondition is a precise causal diagnosis and a clear indication for operative intervention.
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Z Arztl Fortbild (Jena) · Nov 1996
[Medical expert assessment in civil and criminal law--medical expert assessment from the viewpoint of the attorney].
Dealing with a medical expert assessment requires experience and perseverance of the lawyer. Exact knowledge about the expert opinion itself and the procedural options is of greatest importance due to the decisive impact of the medical expert assessment on the outcome of the lawsuit. The lawyer has to consider at any time of the process whether he can initiate an expert assessment, whether he has to evaluate, criticize or question obtained expert assessments, whether he has to challenge the expert or possibly has to introduce another expert into the lawsuit. The expert witness has to have professional knowledge and the lawyer as well as the court have to absorb this knowledge and use it accordingly.
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Z Arztl Fortbild (Jena) · Nov 1996
Review[Medical expert assessment in civil and criminal law from the medical viewpoint].
The demands on a medical witness are discussed. Physicians have to learn to deal with the legal conditions of their profession but lawyers have to be ready to understand the circumstances of the medical activity. ⋯ However, a definition of the term "expert" is missing. There are rules for the continuing medical training by the German societies of physicians which should guide the courts.
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Regarding the liability of the expert witness, is has to be differentiated between the responsibility according to the civil law and the criminal law. Responsibility in the criminal law means the punishableness for the guilty and illegal fulfillment of a criminal offense in the legal sense, while responsibility in the civil law means compensation towards another citizen. Criminal prosecution occurs ex officio. Prerequisite for prosecution in the civil law is an action of the victim.