Deutsche medizinische Wochenschrift
-
Dtsch. Med. Wochenschr. · Jul 2022
[Forensic expertise in emergency medicine - clinical examination step by step].
Victims of violence are not uncommon in emergency medicine. In addition to the medical necessities, the treatment of these patients also requires consideration of their psychological state, as well as the documentation of the findings in a court-approved manner and the securing of evidence, and information about psychosocial care services.
-
Dtsch. Med. Wochenschr. · Jul 2022
[Physical activity in cancer - effectiveness of exercise therapy approaches].
The positive effects of oncological exercise therapy are sufficiently proven according to scientific studies. International evidence-based guidelines confirm this importance and recommend physical exercise as part of the standard therapy for cancer. The effects of physical activity on cancer-specific deficits are versatile ranging from positive impact on fatigue syndrome, mortality, incontinence, lymphoedema, CIPN, anxiety, depression to reduction of pain. ⋯ In addition to the movement-therapeutic approach, a coordinated diet is necessary to avoid nutrition shortages. The evidence on physical activity in oncology must be considered not only in theory, but also in practice and be accepted as a general recommendation for oncology patients. The personalized OTT treatment concept represents a practical implementation and offers a targeted treatment option with low side effects.
-
Prevalence and incidence of both urinary and fecal incontinence increase with age. They reduce everyday competence and quality of life in all age groups. It is often not recognized because those affected do not express their complaints, but even if the diagnosis has been made, therapy and care often remains inadequate. ⋯ In older, especially multimorbid frail people, urinary incontinence is not primarily to be seen as a symptom of a disease, but as a "geriatric syndrome". In the interplay of multimorbidity, environmental factors and other contextual factors that can influence each other, this must be taken into account in diagnostics and therapy. Incontinence itself leads to increased immobility, thus to falls in the elderly and to mental impairments.
-
Fecal incontinence (FI) is an escalating medical problem. Due to increasing life expectancy FI becomes more evident, especially in the geriatric population. The prevalence varies from 4 % in the adult population reaching > 50 % in the octogenerians, yet most probably associated with a significant based error due to underreporting. ⋯ The mainstay in therapeutic approaches to control symptoms comprise changes in lifestyle patterns, physiotherapy and medical therapy, but depend on the patient's compliance. Invasive or even surgical treatments are circumstantial, although sacral neuromodulation has proofed to be a successful treatment modality during the past decades. Ultimately a permanent stoma may lead to symptom control and result in an increased quality of life.