Dtsch Arztebl Int
-
Physicians and pharmaceutical sales representatives (PSR) are in regular contact. The goal of the present study is systematically to assess the kind of contacts that take place and their quality with a survey of physicians in private practice. A further goal is to determine whether alternatives to current practices can be envisioned. ⋯ PSR visits and attempts to influence physicians' prescribing behavior are a part of everyday life in private medical practice, yet only a few physicians consider themselves to be susceptible to this kind of influence. A more critical attitude among physicians, and the creation of alternative educational events without drug company sponsoring, might lead to more independence and perhaps to more rational and less costly drug-prescribing practices.
-
Recurrent angioedema may affect the skin or, less commonly, the tongue, gastrointestinal tract, and larynx. Angioedema is a clinical sign that can be produced by a variety of diseases. Asphyxiation due to edematous obstruction of the upper airway is rare, but, for the affected patients, it is a permanent risk. ⋯ In patients with recurrent angioedema, the diagnostic classification of the underlying disorder as a particular type of hereditary or acquired angioedema is a prerequisite for appropriate treatment.
-
Surgery is the treatment of choice for fractured neck of femur. For middle-aged patients (aged ca. 40 to 65), there is considerable debate over the indications for arthroplasty or internal fixation. The choice of surgical technique varies widely from one region to another. In this article, we discuss the main criteria that should be used in making this decision. ⋯ Despite the increasing scarcity of resources, treatment should still be based on well-founded clinical guidelines. Minimally invasive surgery enables better function in the early postoperative phase and can thereby lower complication rates. An interdisciplinary concept for the postoperative care of elderly patients also has a major effect on the outcome.
-
Urinary incontinence can arise in a woman of any age. Its prevalence is between 10% and 40%. The main clinical problems in urogynecology are stress urinary incontinence (involuntary leakage of urine on exertion, sneezing, or coughing) and the overactive bladder syndrome (nycturia, pollakisuria, and urinary urgency with or without incontinence). ⋯ All women with urinary incontinence should undergo appropriate, specialized diagnostic evaluation and well-founded counseling in order to benefit from individualized treatment.