Wiener medizinische Wochenschrift
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In Physical Medicine and Rehabilitation structural and functional disorders in the genesis of back pain are of great importance. From an epidemiological point of view this has great consequences. Active and passive forms of physical therapy are available. ⋯ Sometimes a combination of active and passive forms are of benefit. Every treatment concept has to pay regard to the actuality of pain, the load of every day life and the physical and social situation of the patient. Last but not least one has to learn to cope with the pain.
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Wien Med Wochenschr · Jan 1994
[The Balint group: analysis of the physician-patient relationship. A medical discussion in the group].
It is given a short introduction about the method of the work of Balint-groups. The importance of this method for the graduate medical education and further medical development is described. The differentiation between psychotherapeutical supervision groups and the discussion of cases in general are illustrated. Michael Balint is introduced.
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Intravenous regional anesthesia is a well established technique since the start of this century. It is easy to perform, with rapid onset of analgesia and safe to practice, when proper patient monitoring (ECG, intermittent blood pressure monitoring, oxygen delivery by nasal insufflation) is established and a local anesthetic solution with low systemic toxicity (e.g. prilocaine) is used. When choosing this technique of regional anesthesia it is an important condition, that the operative procedure has to be finished before the tourniquet of the upper arm is released. ⋯ When using prilocaine or mepivacaine as local anesthetic drug a complete surgical analgesia of 30 up to 45 min can be achieved. Long-acting local anesthetics should not be used because of their increased systemic toxicity under the aspect of drug wash-out at the end of the procedure or in terms of inadvertent cuff release. The site of action of intravenous regional anesthesia has been controversial, since adequate clinical investigations with contrast media and radio isotopes proved, that the principal site of action is at the peripheral nerve endings.
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In a retrospective study the frequency of hypokalemia was investigated in a large group of hospitalized patients. In a period of 1 year 33,426 patients were hospitalized, of these 1,177 (3.52%) revealed serum potassium level of less than or equal to 3.0 mmol/l. On admission to the hospital 592 (50.3%) showed serum potassium levels within normal range and developed their hypokalemia in the hospital. ⋯ The main causes of hypokalemia were diuretics and gastrointestinal potassium loss. Severe hypokalemia (less than or equal to 2.5 mmol/l) is a predisposing factor for the occurrence of ectopic ventricular activity in patients with preexisting myocardial lesions like left ventricular hypertrophy or after myocardial infarction. Therefore in patients with preexisting myocardial lesions and severe hypokalemia potassium replacement therapy may be needed.
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Wien Med Wochenschr · Jan 1992
Review[Placebo forte: contribution to the demystification of a therapy principle].
Placebo effects are an important component in the success of any therapy. Several forms of placebos exist. ⋯ Thus they exceed the frequently cited "suggestion". The discriminative use of placebos in therapy can be helpful.