Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Nov 2007
Review[New developments in diagnostic and therapy of asymptomatic carotid stenosis].
Stroke is the leading cause of long-term major disability in developed countries, although several improvements could be achieved in acute stroke therapy (e. g. thrombolysis, stroke-unit treatment, optimized early rehabilitation strategies). Therefore, primary prevention is essential to reduce the burden of stroke. 10 -20 % of all cerebral ischemias are caused due to stenosis or occlusion of the extracranial carotid arteries. This review summarizes the indications, diagnostics as well as the actual data for a medical, endovascular or operative treatment of asymptomatic carotid stenosis.
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Dtsch. Med. Wochenschr. · Nov 2007
Review[Global warming: trailblazer for tropical infections in Germany?].
Since 1850, the CO (2) content of the atmosphere has increased from 280 to 360 ppm, and the average surface temperature has risen from 14.6 to 15.3 C. A further increase between 1.8 and 4.0 C is expected for the 21st century. Temperate and cold climate zones are affected predominantly, but tropical regions are not spared. ⋯ Global warming may lead to the emergence of diseases which at present are not endemic in Germany, like West Nile fever, Dengue fever, or Leishmaniases, and to enhanced transmission of borreliosis and tick-borne encephalitis. Malaria and cholera, in contrast, are influenced more strongly by socioeconomic factors. Improved surveillance and intensified research on the relationship between climate change and infectious diseases is needed.
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Dtsch. Med. Wochenschr. · Nov 2007
[Evaluation of clinical trials following an approval from a research ethics committee].
According to the Medical Association's professional code of conduct a consultation of the responsible ethics committee has to be undertaken prior to biomedical research. Up to date there has been no systematic analysis of published results after an approval from the research ethics committee of the Medical Association Westfalen-Lippe. A measure for the importance are publications of concluded trials. This work presents a comprehensive collection and evaluation of clinical trials that were approved in 1996. ⋯ This work represents an unprecedented and detailed analysis of the clinical studies approved by a German ethics committee. In the course of this work a comprehensive catalogue with criteria to facilitate a collection and tracking mechanism was established. This should enable the ethics committee to comply with their new duties. A great amount of the clinical trials were presented in publications to the scientific community.
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Dtsch. Med. Wochenschr. · Nov 2007
Case Reports[Fever and nonspecific pulmonary lesions--a rare differential diagnosis].
A 70-year-old woman presented with rapidly increasing weakness, night sweats, progressive dyspnea and daily fever up to 39 C. 30 years before early stage breast cancer had successfully been treated by resection. ⋯ Nonspecific constitutional symptoms, a large variety of potential clinical presentations and the infrequency of the disease render the ante mortem diagnosis of an intravascular lymphoma difficult. Treatment follows the same principles as in nodal aggressive non-Hodgkin's lymphomas.
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Dtsch. Med. Wochenschr. · Oct 2007
Review[Mirror feed-back - a new method for the treatment of neuropathic pain].
The mirror feedback therapy is a method for treatment of neuropathic pain syndromes that are associated with a missing or disordered afferent sensory input. That concerns especially the phantom limb pain, the pain after plexus or spinal nerve root injury and the complex regional pain syndrome. This therapeutic method has been increasingly implemented in the past few years. ⋯ During the therapy the patients are instructed to use the mirror in a way that the image of the mirrored healthy limb seems to appear in the place of the missing or affected extremity. The mirror image produces an illusion of two "healthy" limbs. An ergotherapeutic training program with sensory and motor training elements based on the visual impressions is performed additionally.