Praxis
-
The lumbar spinal stenosis (LSS) is defined as a narrowing of the spinal canal together with neuronal and vascular structures via circumjacent bone and soft tissue. In patients aged over 65 years, the LSS is among the most frequent causes of lumbago, either with or without sciatica. The prevalence will continue to augment because of the increased life expectancy. ⋯ The indication for surgery is given, if the pain and limitation of walking distance are not tolerable any more. Additional fusion should be taken into account, when degenerative spondylolisthesis or other pathomorphological alterations result in an instability. Conservative and surgical therapeutic goals imply pain relief, amelioration of the physical functionality, mobility and general quality of life.
-
We report on a 46-year-old man with vasospastic angina. The differential diagnosis, the eventful course of the patient and in particular the clinical image with diagnostic approach, therapy and prognosis of vasospastic angina are discussed.
-
We report the case of a 38-year-old patient with a rupture of the right Achilles tendon after physical exercise. A few days before he had been treated with ciprofloxacine 500mg bid for chlamydial urethritis. We discuss know risk factors for Achilles tendon ruptures and the possible contribution of ciprofloxacin and fluorquinolones in this case.
-
Historical Article
[An era of pioneers?--the weekly "Der Spiegel" and its reports on service medicine in Western Germany 1947-1955].
After 1945, Western medicine was influenced mostly by investigations from Britain and the USA. This paper deals with the presentation of German medicine in the German weekly "Der Spiegel" between 1947 and 1955, when German society changed from a post-war community focussed on survival to a modern western society. The paper will particularly focus on medicine as a service, dealing not with diagnostic and therapeutic innovations, but with troublesome every-day problems of body and soul at the border of health and disease. The paper argues that "service medicine" was an important tool for German medicine to achieve social acceptance and to integrate itself into the new German democratic society with its private market economy.