Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · May 2008
Review[The Göttingen palliative emergency card: improvement of emergency medical care for ambulatory palliative care patients. The "yellow card for rescue services"].
Currently more and more patients with cancer will be treated at home, especially at the final stage of their disease. Relatives and nursing services will therefore be confronted with acute emergency situations concerning these patients. The handling of these acute situations may be beyond the relatives' coping capacity. ⋯ Because of the complexity of an advance directive it is essential to indicated the patient's wishes in a short and quickly read form in case an emergency arises. This is one of the reasons for producing a short version like the "Göttingen palliative emergency card". In acute situations it is then possible quickly to make known the patient's wishes The patient may be given the possibility of remaining at home after an emergency situation has been dealt with successfully.
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Dtsch. Med. Wochenschr. · May 2008
Review[The status of imaging methods for the treatment of patients with Parkinson's syndrome].
The accuracy of the diagnosis of Parkinson's disease early in the course of the disease remains a clinical challenge. Imaging of dopamine transporters with DatSCAN and SPEC tomography contributes to identifying patients without nigral degeneration and thus helps preventing unnecessary and potentially harmful treatments. The cost of these imaging procedures needs to be set against the cost of unnecessary medication.
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Dtsch. Med. Wochenschr. · May 2008
[Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in patients in long-term care in hospitals, rehabilitation centers and nursing homes of a rural district in Germany].
In recent years multi-resistant pathogens, particularly methicillin-resistant Staphylococcus aureus (MRSA) have been causing increasing problems in hospitals and nursing homes. In Germany area-wide and interdisciplinary studies of prevalence of MRSA have not previously been conducted. For this reason we investigated the its prevalence in a cross-sectional study, which included patients in hospitals, rehabilitation centers and nursing homes in a rural district in Germany. ⋯ This first regional cross-sectional study provides supportive data for MRSA surveillance in Germany and the data provide a basis for additional preventative measures.
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Dtsch. Med. Wochenschr. · Apr 2008
Multicenter Study[Weaning from mechanical ventilation. A survey of the situation in pneumologic respiratory facilities in Germany].
The prevalence of difficult or prolonged weaning from mechanical ventilation is increasing because of a growing number of elderly patients with multiple diseases and pulmonary problems requiring mechanical ventilation. Intensive care units (ICU) are inclined to refer to specialized unit those patients who are difficult to wean. A nationwide survey of German facilities was conducted and this article reports the current state of weaning centers staffed by chest physicians. ⋯ Weaning was successful in two thirds of patients who had been on prolonged mechanical ventilation and had then been transferred to weaning facilities staffed by chest physicians. These centres effectively improved the quality of care of patients on prolonged mechanical ventilation by avoiding long-term invasive ventilation and sparing cost-intensive ICU resources. The problems that still exist may be overcome by a network of weaning facilities.
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Dtsch. Med. Wochenschr. · Apr 2008
Case Reports[Bilateral fractures of the humerus after hypoglycemic seizure].
An 87 year-old woman with insulin dependent diabetes was referred to our hospital because she had sustained a generalized tonic-clonic seizure. Initial blood sugar concentration before hospital admission was 1.1 mmol/l. ⋯ The presentation of simultaneous bilateral fractures of the humerus is a rare but severe and almost pathognomonic complications of generalized tonic-clonic seizures, for example in the context of marked hypoglycemia. Appropriate monitoring and treatment of blood sugar levels in diabetics must be emphasized.