[Legal aspects of the professional discretion of physicians and other health and social welfare personnel].
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Biomedical subjects
Publications and source records attributed to H Lange.
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Ten=hour sleep monitoring was carried out in 34 patients suffering from a vital depressive illness as well as in a group of 16 healthy volunteers; 18 of the depressed patients were deprived of treatment. The EEG was evaluated visually for data concerning the REM cycle and the REM latency. Spectral analysis of the all-night recordings yielded interval histograms for a group comparison of background activity. Fourier spectrograms and digital filtering were used to analyze ultradian patterns within the long-term frequency distribution. The result showed a trend in depression toward prolongation of the REM cycle and shortening of REM latencies. More significant, however, was the activation of 16- to 8-Hz waves together with a decreased occurrence of delta activity in depressed subjects without treatment. Depressed patients had significantly slower ultradian periodicities with 102-min cycles compared to 86-min cycles in healthy subjects. This disturbance could be temporally located in the early morning hours.
The indication for renal transplantation has to be made individually in every single case, considering the few absolute contraindications (tumors, acute infections and the presence of cyto-toxical antibodies) and the general risks. Chances of success, resulting from the EDTA-statistics from 1979 concerning the survival rate of patients and the functional rate of the transplant of donors deceased or alive, are discussed as well as possible complications. The good rehabilitation of successfully transplanted patients must be especially emphasized. Risk factors are: advanced age, adipositas, cardio-vascular and pulmonary lesions as well as gastro-intestinal disease in the past and diabetes mellitus with certain reservation. The possible effects the the transplant caused by the underlying disease leading on renal insufficiency and systemic diseases which limit the indication are outlined and discusssed. Good interdisciplinary cooperation in the pre- and postoperative phase is necessary.
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40 patients, who underwent maxillo-facial surgery, were fed with the native physiological diet Nutro-Drip via nasogastric tubes for 10 days. Due to intolerance in 5% of the patients, the nutrition had to be interrupted. The other patients received 1500-2500 ml Nutro-Drip per 24 h (= 1605--2675 kcal = 6780-11300 J). Transient side effects were: diarrhoe 3,8%; nausea 0,8%; eructation and/or heartburn 1,1%; squeezing of the stomach 1,1%. In these patients nutrition with Nutro-Drip was not interrupted. The mean frequency of defecation was 0,81/day. There were no significant changes in body weight, serum electrolytes, water balance, blood sugar, liver enzymes, serum cholesterol, and acid-base balance during the feeding with Nutro-Drip. Immediately after surgery there was a statistically significant decrease in potassium, protein, and albumin levels in the serum with the tendency to normal values during Nutro-Drip feeding. During the postoperative period the urea content of the serum increased continuously without altering creatinin levels in the serum. Nutro-Drip seems to be very suitable for tube-feeding in patients with normal gastro-intestinal tract.
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