Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Aug 2002
[Treatment regulations and treatment limits: factors influencing clinical decision-making].
Providing or withholding of treatment is based on a variety of factors. We sought for criteria in clinical decision making and reviewed attitudes towards clinical intuition and the patient's will. ⋯ A patient's will plays a prominent role in clinical decision making, especially in decisions to withdraw or to withhold treatment. Cost containment and research interest have been called less important, a remarkable response from research-based university hospitals. Also remarkable is the recognition and importance of clinical intuition in situations of complex or missing information. This important aspect is rarely discussed in the literature or in medical education. The widely voiced concern that priorities in clinical care are guided by scientific interest, financial or technical possibilities could not be confirmed.
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Dtsch. Med. Wochenschr. · Jul 2002
[Stroke management on general medical departments. A multicenter study in Austria].
Despite the claimed superiority of Stroke Units a majority of patients with acute stroke is still treated on general medical departments in many countries. In Austria 90 % of 121 medical departments state that they take care of stroke patients routinely or at least sometimes. Therefore, our aim was to evaluate whether stroke management on medical wards meets up-to-date standards. ⋯ Outcome of stroke patients treated on general medical departments seems to be fairly comparable to that commonly reported by neurological Stroke Units. Further improvements may be obtained by implementation of integrated "mixed assessment" units into medical departments.
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Type 2 diabetes represents the most common form of carbohydrate disorders affecting at least 5% of the population in the industrialized world. In addition to genetic predisposition obesity and a sedentary lifestyle are the main promoters. Recent data clearly suggest that lifestyle intervention in people at increased risk can potently reduce the incidence of the disease. In overt type 2 diabetes, good glycaemic control and aggressive management of associated cardiovascular risk factors may prevent its multiple and costly complications.
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Dtsch. Med. Wochenschr. · Apr 2002
Case Reports[Pulmonary and pleural metastasis of a malignant granular cell tumor].
A 72-year-old woman, who suffered from increasing dyspnea and productive cough was admitted to hospital. Clinical examination revealed a reduced respiratory sounds over the left lung and a painless and unmovable tumor in the area of the left hip. ⋯ A rare malignant granular cell tumor was discovered by detecting tumor tissue of granular cell tumor in the pleura and within a tumor in the left gluteus area. Another indication of a metastatic disease were multifocal lesions in the lung detected by CT-scan. Curative treatment was not possible.