Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Dec 1998
[Attitude towards physician-assisted suicide among German doctors. A representative survey of the medical district association of Würzburg].
The widespread legalization of "physician assisted suicide" (PAS) in The Netherlands and comparable tendencies in other European countries have given rise to discussions of this topic in Germany. This questionnaire was undertaken because of the dearth of previous informative studies in Germany. ⋯ The results of this study differ from similar enquiries in other countries in demonstrating a relatively strong rejection of active assistance in patient-suicide. Those German specialists who would most likely be confronted with this problem (e.g. neurologists, intensivists, anaesthetists, oncologists) tended towards a greater readiness to agree to physician-assisted suicide. A dialogue between doctors in different specialties is an urgent requirement and should be intensively pursued.
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Dtsch. Med. Wochenschr. · Oct 1998
[Aortic valve insufficiency in aneurysms of the ascending aorta: functional results following valve-sparing reconstruction].
Changes in geometry of the aortic root, especially a dilatation of the sinotubular junction, are the major causes of aortic valve regurgitation in ascending aortic aneurysm. In valves without structural defect, a valve sparing aortic root reconstruction may be a therapeutic option. Aim of this study was the assessment of functional results, in the early postoperative, and during follow-up, in a large patient cohort from one centre. ⋯ Valve sparing aortic root reconstruction is a promising alternative to the composite replacement of the ascending aorta. Low perioperative morbidity and mortality rates as well as favourable functional results were demonstrated. Long-term anticoagulation can be avoided. Long-term follow-up will be necessary to assess the definitive role of this new surgical approach.
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Dtsch. Med. Wochenschr. · Oct 1998
[Treatment of the aortic valve and ascending aorta. The significance of reconstructive methods on the aortic root].
The standard surgical repair of disease of the aortic valve and the ascending aorta has been combined replacement, which includes the disadvantage of inserting a mechanical valve. We have investigated an individualized approach which preserves the native valve. ⋯ The described individualized approach makes it possible to preserve the native aortic valve in most patients with aortic regurgitation, at a low risk. Follow-up observations so far indicate good results of the reconstruction.
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Dtsch. Med. Wochenschr. · Sep 1998
Case Reports[Endoscopic projectile extraction in treatment of a gunshot injury to the head].
A 14-year-old boy had in war-torn Bosnia sustained a transcranial gunshot wound from a 7.65 mm bullet. After primary medical care with craniotomy and the removal of bony fragments and cerebral debris followed by a duraplasty, he was transported to the French-German Field Hospital. On arrival he was breathing spontaneously and in stable cardiovascular state but with impaired responsiveness and somnolent. His pupils were moderately dilated with slight anisocoria (right > left). His gaze was deviated to the left and he had vertical gaze paralysis as well as right central facial nerve paresis. In addition he had a mild diencephalic syndrome, right hemiplegia and a right hemihypaesthesia with increased muscle tone, especially of the leg, paratonia and right positive Babinski reflex. There also was a marked ciliospinal reflex and he had a bulbar speech as well as cognitive and memory abnormalities. ⋯ Endoscopic transcranial removal of a bullet wedged in the brain is a relatively sparing neurological procedure which, under unusual circumstances and conditions, can achieve a satisfactory result even with limited facilities.