Dtsch Arztebl Int
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The aging of the population will make fecal incontinence an increasingly important socioeconomic problem in the coming decades. Already today, the cost to society of treating incontinence with inserts, diapers, and closed systems exceeds the total cost of all cardiac and anti-inflammatory medications. ⋯ The challenge today, therefore, is not just to encourage patients to seek medical help early, but also to raise physicians' awareness of fecal incontinence and their readiness to treat it, so that they can provide competent individual counseling and treatment to all patients who suffer from it.
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Stress incontinence in men is a rare, usually iatrogenic condition. Its prevalence can be expected to rise in the future because of the increasingly common performance of radical prostatectomy. Most men who have undergone prostatectomy experience a transient disturbance of urinary continence. Such disturbances are only rarely due to structural damage to the sphincter apparatus and therefore have a good prognosis for spontaneous recovery. ⋯ Post-prostatectomy incontinence has a good prognosis and should thus be treated conservatively at first. If it nonetheless persists, surgical treatment is indicated for patients who choose it after being fully informed about their options.
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In 2004, the German federal state of Baden-Württemberg implemented a quality management system for pre-hospital emergency care. Since then, there has been a semi-annual assessment of the frequency of different types of emergency medical interventions and the quality of care. ⋯ Even in the face of increasing utilization, the quality of emergency medical care in Baden-Württemberg has remained high. Since a quality management system was introduced in 2004, the physicians in charge of emergency medical teams have had access to the data that they need in order to evaluate and further develop the services that they provide.
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Comprehensive, systematic reviews on the benefit of vision screening in preschool children were published in 2008 by major national organizations in both Germany and the United Kingdom. These reviews raised public interest in the topic. ⋯ The available data do not allow any firm conclusion about the efficacy and cost-effectiveness of preschool vision screening. Further clinical studies are needed to answer these questions.