Geburtsh Frauenheilk
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Geburtsh Frauenheilk · Apr 1994
Review Case Reports[Unilateral, sensorimotor femoral nerve paralysis following abdominal gynecological operation].
Unilateral or bilateral femoral nerve functional deficiency deficit occurs as a rare iatrogenic complication of gynaecological abdominal or vaginal surgery. Self-retaining abdominal retractors, that exert a constant pressure on the femoral nerve during the operation, are the most frequent cause. ⋯ The favourable prognosis of the femoral nerve sensory and motor deficiencies can be complicated by damage to the knee joint resulting from leg muscle paresis. A personal observation and a literary review on sensomotor paresis after gynaecological abdominal surgery are discussed.
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Geburtsh Frauenheilk · Jun 1991
Review[What benefit and harm can be expected from screening and routine examinations and from their omission?].
Benefit and harm of screening and routine tests or their omission are dealt with in four parts. In the first part methods are described to evaluate the diagnostic value of medical testing. The concepts of diagnostic sensitivity, diagnostic specificity, and pre- and posttest probability of a diagnosis are defined. ⋯ This is due to the large share of "healthy" women among the gynaecological patients, as well as the fact that treatment of early detected recurrences shows no demonstrable advantage over treatment of later detected recurrences. In the fourth part, we show that no adverse forensic consequences are to be expected if diagnostic tests are omitted because of demonstrably low diagnostic value. In case of legal procedures against the physician, a medical expert will have to evaluate the diagnostic value of the omitted test objectively from an "ex-ante" point of view, using the methods defined in the first part.(ABSTRACT TRUNCATED AT 250 WORDS)
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A great number of patients with gynaecological malignant diseases suffer from severe pain, caused, for example, by bone metastases of breast cancer or tumour infiltration of the pelvis and the lumbar plexus in uterine cancer. Several methods of treatment are available depending upon the origin of pain. It is possible to achieve pain relief by radiotherapy or by cytostatic therapy. ⋯ If possible, the oral route should be selected. If vomiting occurs, or if patients are unable to take oral medication, morphine can be given peridurally, intrathecally or by infusion. Often, an additional treatment is necessary with different medicaments like tricyclic antidepressants and corticosteroids.