Praxis
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Homeopathy can be characterized by three axioms "treating like with like" (law of similars), "increasing effects with increasing potency" (potentization) and "effects on the basis of ultra-high dilutions" (beyond-molecular effects), where it is unlikely that the dilutions contain a single molecule of the original substance. On the basis of these tenets and the clinical evidence further research priorities are developed. Current reviews indicate small homeopathic verum effects, even after adjustment for internal validity and publication-bias. ⋯ There is neither convincing evidence for specific drug pictures by placebo-controlled drug provings, nor is the reliability of homeopathic diagnosis proven. By reason of extensive, individual interviews, preceeding every classical homeopathic remedy finding, placebo-effects could play an important therapeutical role. The relevance of homeopathic placebo-effects should be explored against other sham treatments and an untreated group.
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In most cases pain in the right upper abdominal quadrant is of biliary origin. Diseases of the biliary system are often visualized by ultrasonography; however, a negative test does not rule out a biliary cause. ⋯ CT/scintigraphy) and/or endoscopic (upper GI endoscopy, ERCP) examinations. In difficult diagnostic situations specialized diagnostic tools may be indicated (e.g. manometry in suspected dysfunction sphincter of the Oddi.
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Food allergy (hypersensitivity) is a form of adverse food reaction in which the reaction is caused by an immunological response to a food. Most immediate allergic reactions to food are IgE-mediated. The prevalence of food allergy in the general population without the oral allergy syndrome is about 1-2%. ⋯ The only proven form of management in food allergy is strict elimination of the offending food. Food-allergic patients must be provided with emergency medications. Identification of allergens and their characterization finally will improve our understanding for pathophysiologic mechanisms of food allergy.
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Overall, pain is one of the most common symptoms associated with cancer and often produces greater anticipatory distress than other features of the disease. Drug selection depends on the intensity of pain rather than on the specific pathophysiology. Mild to moderate pain can often be treated effectively by so-called "weak" opioids. ⋯ Antidepressants, anticonvulsants and some antiarrhytmics are used as co-analgesics. Oral medication alone can guarantee pain relief in about 95% of the patients. The WHO analgesic ladder has proven effective in all settings of patients care.
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Bullet wounds are a rare occurrence during times of peace. Recently, however, there has been a general increase in the number and severity of this type of trauma in our case load. First, the possible firearms and the individual types of ammunition will be discussed. ⋯ From the therapeutic side, tetanus serum and antibiotics as a prophylactic are recommended initially. The operative treatment should take place depending on the injury with the removal of a possible projectile. Bullet wounds always require an interdisciplinary approach to treatment.