Innere Medizin

Since the first edition, Get Through Medical School has been a bestselling revision guide for undergraduate medical students. Retaining the classic questions types, this second edition benefits from a host of new questions and more explanatory information, allowing medical students to test themselves on all they need to know to pass their exams.

Hyponatremia is a common electrolyte disorder found in a variety of settings. Manifestations range from subtle abnormalities to convulsions and death. New treatment options, such as Antidiuretic Hormone (ADH) antagonists, have created the need for a resource presenting the latest evidence and clinical approaches.Hyponatremia: Evaluation and Treatment is a comprehensive review of hyponatremia, with an emphasis on managing this disorder from diagnosis to treatment. The incidence and occurrence of acute and chronic hyponatremia in general terms are covered, as well as disorders of the central nervous system, heart and liver with their relation to hyponatremia. Common clinical scenarios are presented along with both traditional and new methods of treatment.Authored by experts on this disorder from around the world, experienced members of the medical community and trainees alike will find Hyponatremia as an indispensible guide to diagnosis, managing and treating patients with hyponatremia.

This monograph series is intended to provide medical information scien­ tists, health care administrators, physicians, nurses, other health care pro­ viders, and computer science professionals with successful examples and experiences of computer applications in health care settings. Through these computer applications, we attempt to show what is effective and efficient, and hope to provide guidance on the acquisition or design of medical information systems so that costly mistakes can be avoided. Health care provider organizations such as hospitals and clinics are experiencing large demands for clinical information because of a transition from a "fee-for-service" to a "capitation-based" health care economy. This transition changes the way health care services are being paid for. Previ­ ously, nearly all health care services were paid for by insurance companies after the services were performed. Today, many procedures need to be pre approved and many charges for clinical services must be justified to the insurance plans. Ultimately, in a totally capitated system, the more patient care services are provided per patient, the less profitable the health care provider organization will be. Clearly, the financial risks have shifted from the insurance carriers to the health care provider organizations. For hospitals and clinics to assess these financial risks, management needs to know what services are to be provided and how to reduce them without impacting the quality of care. The balancing act of reducing costs but maintaining health care quality and patient satisfaction requires accurate information about the clinical services.

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The Second Meeting of the International Society for Trace Element Research in Humans (ISTERH) was held in Tokyo from August 28 through September 1,1989. On August 27, the day preceding the opening of the meeting, a typhoon made a direct attack on Tokyo, welcoming guests from all over the world in a rather violent way. To our great relief, the weather during the week of the meeting turned out to be exceptionally agreeable for that time of year in Tokyo. We were also pleased to see the entire scheduled course of the meeting, including the social activities, carried out smoothly and the contents of the program favorably appraised. The meeting was attended by 518 scientists from 30 countries. Recent unrest following steps toward democratization in the Communist bloc gave rise to some apprehension; therefore, we were particularly pleased to see attendants from China, Eastern Europe, and the Soviet Union. No one could possibly have predicted the drastic change in Eastern Europe that followed, but again, we were relieved to learn (by a subsequent letter) of the safety of an attendant from Rumania, who had been our greatest concern. A total of 384 papers were contributed to the meeting. The abstracts for all have been published in the Journal of Trace Elements in Experimental Medicine, vol 2, No. 2/3 (1989). This proceedings carries 64 subjects introduced in the Special Session.

The Nutrition and Health series of books have had great success because each volume has the consistent overriding mission of providing health professionals with texts that are essential because each includes (1) a synthesis of the state of the science, (2) timely, in-depth reviews by the leading researchers in their respective ?elds, (3) extensive, up-to-date fully annotated ref- ence lists, (4) a detailed index, (5) relevant tables and ?gures, (6) identi?cation of paradigm shifts and the consequences, (7) virtually no overlap of information between chapters, but targeted, inter-chapter referrals, (8) suggestions of areas for future research, and (9) balanced, data-driven answers to patient as well as health professionals questions which are based upon the totality of evidence rather than the ?ndings of any single study. The series volumes are not the outcome of a symposium. Rather, each editor has the potential to examine a chosen area with a broad perspective, both in subject matter and in the choice of chapter authors. The editor(s), whose training(s) is (are) both research and practice oriented, has(ve) the opportunity to develop a primary objective for their book, de?ne the scope and focus, and then invite the leading authorities to be part of their initiative. The authors are encouraged to provide an overview of the ?eld, discuss their own research, and relate the research ?ndings to potential human health consequences.

Der vorliegende Band umfasst Beiträge der Schüler von Kurt Kochsiek, die zu dessen 70. Geburtstag ein wissenschaftliches Symposium mit dem Thema "Kardiovaskuläre Forschung 2000" veranstaltet haben. Entsprechend den Forschungsschwerpunkten der Kochsiek'schen Schule wird die Messung der Koronardurchblutung und des Herzstoffwechsels bis hin zu modernsten Methoden der Magnetresonanztechnologie diskutiert. Weitere Beiträge behandeln aktuelle Aspekte der entzündlichen Kardiomyopathie, die Beziehung zwischen epidemiologischen Untersuchungen und der Krankheitsentstehung im kardiovaskulären System sowie die Zusammenhänge zwischen Herz und Niere, insbesondere bei chronischem Herzversagen. Schließlich wird die mögliche Bedeutung des NO-Signalweges für die Krankheitsentstehung erörtert. Der Band gibt daher einen breiten Überblick über wichtige aktuelle kardiovaskuläre Forschungsthemen.

Die Ausbildung des Arztes muß problemorientiert sein. Die bisherige Praxis des Medizinstudiums bereitet die jungen Ärzte nur unzureichend auf die Anforderungen in Klinik und Praxis vor. Daher wurde als bundesweites Signal das Münchener Ausbildungsmodell entwickelt, welches von der Harvard Medical School übernommen wurde. Dieses etabliert sich als Modell an mehreren Universitäten: München, Dresden, Lübeck, Heidelberg und Berlin. Die vorliegende Broschüre dient als Kursbegleitung. Sie ist ein Leitfaden zum praktischen Unterricht am Krankenbett.

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Kreislauferkrankungen zeigen in der Bundesrepublik Deutschland eine außerordentlich hohe Morbidität, dies bereits in den mittleren Altersgruppen, und die höchste Mortalität. Die thromboemboli­ schen Erkrankungen des arteriellen und venösen Systems machen etwa 50% aller Todesursachen aus, bei den 35-bis 44jährigen be­ reits über 20% und bei den 45-bis 55jährigen bereits 30%. Allein an Herzinfarkten versterben Z.Z. bei uns über 170000 Menschen/Jahr (mit weiterhin steigender Tendenz), an Lungenembolien etwa 20000. Rund 2% der 35- bis 44jährigen und 6% der 45- bis 54jährigen Männer haben eine periphere arterielle Verschlußkrankheit (AVK). Über 50% der über 15jährigen zeigen periphere Venenver­ änderungen; etwa 1 Mio. Menschen leiden bei uns an einem post­ thrombotischen Syndrom. Die Häufigkeit der tiefen Venenthrom­ bose liegt in einem allgemein-intemistischen Sektionsgut zwischen 40 und 60%, die Prävalenz an Lungenembolien zwischen 15 und 20%. Über 50% aller Schlaganfallpatienten haben das 65. Lebensjahr noch nicht erreicht und waren noch berufstätig. Rund 70% aller Patienten, die uns zu einer angiologischen Beurteilung mit Ultra­ schall-Doppler-Untersuchung überwiesen wurden, waren noch nicht berentet. Herz-Kreislauf-Erkrankungen sind mit über 40% die weitaus häufigste Ursache einer Frühinvalidität.

1. Die vektorielle Betrachtungsweise.- 2. Die üblichen EKG-Ableitungen und ihre Beziehung zueinander.- 3. Die Deutung der "elektrischen" Lage des Herzens.- 4. Das normale Elektrokardiogramm, Beschreibung und Grenzbefunde.- 5. Gedächtnishilfe zur systematischen EKG-Beschreibung und Beurteilung.- 6. Ventrikuläre Leitungsstörungen - Schenkelblockbilder.- 7. Das WPW-Syndrom.- 8. Das EKG bei Hypertrophie einzelner Herzteile.- 9. Das Herzinfarkt-EKG.- 10. Die Endteilveränderungen.- 11. Das Belastungs-EKG.- 12. Diagnostik der Herzrhythmusstörungen im EKG.- 13. Das Schrittmacher-EKG.- 14. Das EKG des Kindes.- 15. Zur Technik des EKG-Schreibens.- 16. Abschließende Warnungen zur EKG-Diagnostik.