Zeitschrift für die gesamte innere Medizin und ihre Grenzgebiete
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Fever is a cardinal symptom of most infectious diseases; the febrile conditions not caused by infection are, however, not sufficiently taken into consideration in diagnosis and therapy. In 297 infections with a febrile course only in 26.26% of the cases a therapy with antibiotics was indicated. ⋯ Virus infections stand in the first place of an unnecessary and, therefore, uncritical chemotherapy. With a casuistic report on the sequels of an uncritical chemotherapy is referred to the dangers for the patient and to the not insignificant economic burden for the society.
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The importance of internal medicine for the care of patients with carcinoma increases. This is particularly connected with the rapid development of the antineoplastic drug therapy. However, these are not the only tasks of the internal specialists. ⋯ For this a profound specialisation within the field of internal medicine is necessary. A subspecialisation acknowledged by the state would be a stimulus, but it is not compulsorily necessary. This introduction into the topic shall the internal specialist make clear his role and responsibility in the oncologic care and facilitate the communication with other specialities.
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Shock and disturbance of haemostasis are described as the cause of a common severe basic disease evoking them. Haemodynamically rheological changes with disturbances of the perfusion of high degree which in the extreme case via formations of microcoagulations may lead to organ necroses with irreversible deleterius loss of organs are common to both. Bodily dysregulations may also lead to an increase of the potential of fibrinolysis with dramatic haemorrhagic complications. A coarsely orienting stage division of the consumption coagulopathy allows aimed therapeutic measures after differentiated indication, such as the application of antifibrinolytics and aimed haemosubstitution under heparin protection.