Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jan 2009
[Health insurance discount contracts: problems and risks for the general practitioner in the medical care of patients with chronic illness].
The German federal Health Insurance law to strengthen competition between the pharmaceutical companies commits pharmacies to hand out drugs from discount contract drug suppliers of a patient's health insurance company. Thus patients are confronted with constantly changing drug packets. This study aimed at exploring whether patients have been properly informed about the new discount contracts and if they have experienced changes and problems in their long- term medications. ⋯ This study demonstrates that the information which patients have on the new health insurance law is not adequate enough. Many of them felt insecure because of the changes of long-term medications. One fifth of the patients reported errors in their drug intake or their confusion about their drugs. There is a high risk that these circumstances may trigger further diseases or complications. The cost savings as intended by the health insurance companies may therefore not be achieved by discount contracts.
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Dtsch. Med. Wochenschr. · Jan 2009
Review[Analogies between heart and respiratory muscle failure. Importance to clinical practice].
Heart failure is an established diagnosis. Respiratory muscle or ventilatory pump failure, however, is less well known. The latter becomes obvious through hypercapnia, caused by hypoventilation. ⋯ The latter treatment in particular will increase patient endurance and quality of life and decrease mortality. Heart and respiratory pump failure share many common features. Since both take care of oxygen supply to the body, their function and compensatory mechanisms are closely related and linked.
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Dtsch. Med. Wochenschr. · Jan 2009
Review[MCI-plus: mild cognitive impairment with rapid progression. Part I: prevention and therapy].
Mild Cognitive Impairment (MCI) is a prevalent problem in the elderly and many patients show predictors of rapid cognitive decline ("MCI-plus"). MCI-plus represents a syndrome with growing importance in an ageing society, which will increasingly affect primary medicine and most other clinical specialties. ⋯ Psychological and medical co-morbidity in MCI-plus will therefore offer important opportunities to delay and to avoid the manifestation of dementia. We will review and discuss current training and treatment options including symptomatic and causal interventions.
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Dtsch. Med. Wochenschr. · Jan 2009
Randomized Controlled Trial["Laryngeal Tube-D" (LT-D) and "Laryngeal Mask" (LMA)].
In 2005 the European Resuscitation Council (ERC) published a revised version of the guidelines for Advanced Life Support (ALS). One of the aims was to reduce the time without chest compression in the first period of cardiac arrest. We evaluated in a manikin study whether using the single use laryngeal tube (LT-D) instead of single use laryngeal mask (LMA) for emergency airway management could reduce the "No Flow Time" (NFT). The NFT is defined as the time during which no chest compressions take place. ⋯ In this manikin study data showed that the LT-D may be a good alternative airway device compared to LMA for providing and maintaining a patent airway during resuscitation.
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Dtsch. Med. Wochenschr. · Jan 2009
Randomized Controlled Trial[Selective primary obesity prevention in children].
Obesity in children is characterized by a rapid gain of weight starting at an age of 4 to 5 years. We investigated whether low threshold prevention prevented a further increase of the Standard-Deviation-Score of the BMI (BMI SDS) in children with impending obesity. ⋯ A low threshold intervention in early childhood could successfully prevent an increase of obesity.