Zeitschrift für ärztliche Fortbildung
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In only 30% of back pain patients an underlying pathology can be found. Rheumatologic causes in a narrow sense are fibromyalgia, osteoporosis and the group of spondylathropathies and reactive arthritis. Infectious disorders of the spine are emergency cases and need immediate and interdisciplinary action. ⋯ In acute, nonspecific back pain, the aim is to prevent a chronification of disease by instruction and education of the patient and an early start of physical therapy. The rehabilitation process in chronic cases in complex and may need psychobehavioral methods for pain control. Pharmacologic modalities of treatment-simple analgesics, nonsteroidal antirheumatic drugs, muscle relaxants and antidepressants-should only be used for a limited period and monitored constantly.
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Z Arztl Fortbild (Jena) · Jan 1997
[Backache--orthopedic diagnosis and special therapeutic possibilities].
Back pain is a wide-spread complaint in modern society and in part an adverse effect resulting from present-day lifestyles. To date, too little attention has been drawn to efficient prevention. The treatment of patients affected with back pain today calls for an in-depth pathophysiological knowledge about the mechanism occurring on the spine. ⋯ Today, the overwhelming majority of back pain patients undergo a non-operative treatment. In case the conservative applications prove inefficient, it is possible to successfully operate on patients a with disc prolaps, degenerative instabilities as well as osseous spinal foraminal stenoses. A precondition is a precise causal diagnosis and a clear indication for operative intervention.
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Z Arztl Fortbild (Jena) · Nov 1996
[Medical expert assessment in psychiatry from the legal viewpoint].
The subjects of psychiatric assessments do vary greatly. The main subject of criminal proceedings seems to be that of criminal responsibility. ⋯ Criminal responsibility cannot be the deterministically interpreted freedom of will. The prevailing law does only answer insufficiently the question of selection or consultation of further experts.
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Z Arztl Fortbild (Jena) · Nov 1996
[Medical expert assessment in civil and criminal law--medical expert assessment from the viewpoint of the attorney].
Dealing with a medical expert assessment requires experience and perseverance of the lawyer. Exact knowledge about the expert opinion itself and the procedural options is of greatest importance due to the decisive impact of the medical expert assessment on the outcome of the lawsuit. The lawyer has to consider at any time of the process whether he can initiate an expert assessment, whether he has to evaluate, criticize or question obtained expert assessments, whether he has to challenge the expert or possibly has to introduce another expert into the lawsuit. The expert witness has to have professional knowledge and the lawyer as well as the court have to absorb this knowledge and use it accordingly.
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Z Arztl Fortbild (Jena) · Nov 1996
[Medical expert assessment in civil and criminal law--stand for evaluating medical expert assessment].
The standard for the assessment of the medical expert opinion is defined by the high demands expected from the judgement of a high court: Objectiveness, solid knowledge, self-criticism, in contestability in diction and firmness in the argumentation. From the legal point of view, the knowledge of the medical expert witness has to clearly go beyond the knowledge of his profession. ⋯ It is necessary for a physician as an expert witness to have basic knowledge about the evidence law and the medical liability process. On the other hand, judges and lawyers should basically know the medical way of thinking.