Praxis
-
Atrial fibrillation is the most common arrhythmia the general practitioner as well as the physician in the hospital has to deal with. Even if it is said to be benign, heart failure and embolism may be deleterious consequences of this arrhythmia. In this article we well discuss the management of this arrhythmia, taking into consideration the etiologic factors, the pathophysiology of atrial fibrillation and therapeutic aspects from cardioversion to prevention of embolism.
-
A 62-year-old male had tender swelling of both ears with loss of hearing due to edematous swelling of the external auditory canal. The patient complained further about dry cough, pain at the costo-sternal junctions, adynamia and weight loss. Inflammatory parameters were markedly elevated, and histologic work-up of an auricular biopsy revealed lymphocytic infiltration. These findings led to the diagnosis of chronic recurrent polychondritis actually under control after a pulse of glucocorticoids followed by maintenance therapy with 5 mg prednisone.
-
Breaking bad news is one of the most important and most difficult tasks of a physician. The training for this dialogue should be intensified during the medical curriculum. ⋯ In the northern countries of Europe the truth in medical diagnosis and prognosis is revealed in a straight way, whereas in the south and the southeast the truth is generally hidden from the patient. A few simple rules are given for the initial and the subsequent dialogues between the physician and a patient with an incurable disease.