Deutsche medizinische Wochenschrift
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Thrombosis and embolism are among the most common causes of death worldwide and, in addition to venous thromboembolism with the two main manifestations of deep venous thrombosis and pulmonary embolism, also include arterial thrombotic disease such as myocardial infarction, stroke and systemic arterial embolism. It is often the interaction of several predisposing factors that leads to the formation of an intravascular thrombus. ⋯ For this purpose, a risk-benefit analysis based on the individual case and regular reassessment are of particular importance. In this article, the pathophysiological concepts of venous and arterial thrombosis and the main therapeutic implications resulting from this are reviewed.
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Dtsch. Med. Wochenschr. · Jul 2023
Review[Financial Influence on Medical Decisions in Germany - A Review of the Reasons and State of Research on Economization in Inpatient Care].
Increased economization in the German health care system may have an impact on medical decisions. A selective literature search presents an overview of the current evidence on the influence of financial incentives on inpatient healthcare in Germany. Due to the current economic pressure, physicians increasingly feel subjected to financial constraints concerning indication and treatment decisions. ⋯ The literature clearly documents effects of financial pressure on job satisfaction, perceived stress, and the health of attending physicians. The current discussion on the economization of physician practice is important, especially with regard to disincentives and job satisfaction. Little is known about the risks to patient health.
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Dtsch. Med. Wochenschr. · Jul 2023
[Occupational medical aspects of COVID-19 pandemic containment: experiences from a large chemical company].
With the present paper we aim to describe the experience of a large chemical company in tackling the COVID-19 pandemic. Specifically, we describe the timing and content of implemented measures and outline the course of the pandemic from the company's perspective. ⋯ The continuous monitoring and analysis of new SARS-CoV-2 cases among employees provides valuable information for the effective management of protective measures in the company. It enables a targeted response to changes in the number of new cases on the plant site by tightening or relaxing protective measures.
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Dtsch. Med. Wochenschr. · Jul 2023
[What do health care professionals know about advance directives?].
Advance directives are important to preserve the autonomy of patients for future situations in which they are uncapable of expressing their will. They are considered helpful by many healthcare professionals in their professional practice. However, their knowledge on these documents is not well known. Misconceptions can adversely affect decisions at the end of life. This study examines healthcare professionals' knowledge of advance directives and relevant correlates. ⋯ Healthcare professionals have ethically and practically relevant knowledge deficits and a high need for further training on advance directives. Advance directives play an important role in maintaining patient autonomy and should receive more attention in training and further education equally involving non-medical professional groups.