Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jul 2004
[Ethical decision-making at the end of life--knowledge and attitudes of medical students].
Physicians are often confronted with ethical and legal questions at the end of life. In this study we asked medical students at the universities of Mainz and Berlin (Charité) about the "Guidelines on Physicians' Aid to the Dying" issued by the German Medical Association: their moral attitude and legal knowledge regarding the limitation of medical procedures at the end of life and their judgement about the quality of medical education on these topics. ⋯ Only a minority of medical students was informed about ethical principles and legal regulations regarding end-of-life decisions. Teaching of ethical and legal knowledge and integration of these issues into clinical problem solving should be mandatory.
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Dtsch. Med. Wochenschr. · Jul 2004
Case Reports[Chronic upper abdominal pain without improvement after using proton pump inhibitors].
A 57-year-old woman was admitted to our hospital because of relapsing, therapy-resistant pain, predominantly in the upper abdomen. The symptoms began 6 years previously, after a resection of parts of the small intestine for an ileus of unclear cause. Subsequently 11 (!) gastroscopies showed repeatedly gastritis and Helicobacter pylori- negative gastric and/or small intestinal ulcers which were treated with proton pump inhibitors. This led to no significant improvement of the complaints and produced no healing. ⋯ Our case report shows that in patients with uncharacteristic abdominal pain and gastric ulcers, which improve inadequately under the usual medication such as proton pump inhibitors, less common illnesses must be considered. Despite the rarity of eosinophilic gastroenteropathy the exact (histological) diagnosis plays an important role, because a specific therapy with corticosteroids and/or azathioprine can induce improvement of the symptoms.