Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Nov 2006
[Prognosis after complete surgical resection for non-small cell lung cancer based on the staging classification].
The importance of accurate staging according to the international TNM staging system of non-small cell lung cancer (NSCLC) for patient management and ascertaining individual prognosis cannot be overemphasized. The TNM classification is scheduled to be revised in 2007. In a large single-center collective we investigated the prognosis for patients who had complete resection of a NSCLC. ⋯ The TNM and stage grouping classification is valid for defining prognosis and prognosis-related criteria in patients with NSCLC. The difference in prognosis between clinical stages IIIB and IV was significant, but not that between all the other related subgroups. Concordance with histological staging demonstrated the quality of existing clinical staging methods and related strategies. Complete surgical resection, age, gender, histology and stage of the disease significantly influenced long-term survival.
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Dtsch. Med. Wochenschr. · Nov 2006
[Significance of multiple organ failure for the prognosis of surgical intensive care patients].
The association of multiple organ failure and acute prognosis is an established fact in intensive care medicine. However, it is unclear whether the number of failing organs is an independent determinant of acute mortality, and whether there are additional effects on long-term outcome. ⋯ The effect of multiple organ failure on long-term prognosis emphasizes the importance of this variable for patient outcome. Therefore, multiple organ failure must be part of all therapeutic concepts in critical care. Within those, preventive measures are definitively preferable to keep the number of failing organs as small as possible.
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The various acute and chronic demands and burdens put ICU staff at greater risk for developing psychological and stress disorders. It was the aim of this study to assess the prevalence rates of burnout-syndrome in anesthetists, and to evaluate the contribution of working conditions to the development of burnout. ⋯ Burnout-syndrome and psychosomatic symptoms are frequent in intensive care doctors. But preventive measures such as adequate resources at the work place and supervision can influence personal behavior and working conditions, and thus reduce the risk of burnout.