ABSTRACT
For the participation of people with chronic eye problems in social life, the preservation of mobility is an important prerequisite. In the case of chronic illnesses they should also be given the opportunity, in accordance with the Patients Rights Act, to be able to make decisions in good time and independently on the further course of action to be taken in the event of a loss of mobility as a result of the inability to drive. In the case of a chronic progressive loss of visual acuity or loss of field of vision, the ophthalmologist should therefore initiate information and education of the patient at an early stage with respect to a possible impending inability to drive. The place, date and duration of the consultation must be documented. At the patient's request, a written evaluation report must be prepared by the examining ophthalmologist. In the daily medical routine of the clinic and practice, a distinction should be made between the medical consultation of a chronically ill eye patient on problems of driving safety and fitness to drive and the concerns regarding an assessment to determine fitness to drive in accordance with § 12, Annex 6 of the driving licence regulations.
Subject(s)
Automobile Driving , Eye Diseases , Chronic Disease , Humans , Licensure , Visual AcuityABSTRACT
Telemedical solutions are increasing with respect to diversity, frequency and scope. It should be part of medical practice to remind again and again that telemedicine does not represent a special medical field or even a subspecialty. The concept of telemedicine is more used as a superior term for different medical care concepts, provided across distance and time barriers. Telematic solutions implemented as a new field of service in ophthalmological practice or in hospitals must fulfill the following obligatory requirements in conformity with the law: patients must be informed about the range of telemedical solutions, operators must ensure medical specialist qualifications and all care responsibilities combined with the telemedical services must be guaranteed. The legal assessment standard is always the direct comparison between telemedical measures and the individual patient result of medical treatment in a face to face situation in an ophthalmologists practice as the gold standard. The court makes a targeted examination on whether the individual damage to health of a patient under telemedical care would also have normally occurred under medical treatment within the framework of regular care by a medical specialist in a practice or clinic. If the court has a well-founded doubt, the operator must be able to justify either constraints in individual cases or a better prognosis and success rate (reversal of burden of proof). Especially due to the latter aspect it is important for the operator that the standards for telemedical services of the specific medical fields are predefined by the specialist societies or that corresponding results from healthcare research projects are available.
Subject(s)
Ophthalmology , Telemedicine , Delivery of Health Care , HumansABSTRACT
A 28 years old butcher contracted a systemic trichinosis after fasting sausage. Twelve days after onset of systemic symptoms he developed a hemorrhagic maculopathy in his left eye. In addition, on both eyes there were focal atrophies of the retinal pigment epithelium in the mid-periphery. We believe a causal connection of the maculopathy with his serologically proven trichinosis as a retinal involvement is well known in trichinosis and histologically demonstrated by Herrenschwand (1928). To our knowledge this is the first case of hemorrhagic maculopathy in trichinosis.
Subject(s)
Antibodies, Helminth/analysis , Chorioretinitis/diagnosis , Meat Products/adverse effects , Occupational Diseases/diagnosis , Trichinella/immunology , Trichinellosis/diagnosis , Adult , Animals , Chorioretinitis/immunology , Cicatrix/diagnosis , Cicatrix/immunology , Fluorescein Angiography , Humans , Macula Lutea/immunology , Male , Occupational Diseases/immunology , Retinal Hemorrhage/diagnosis , Retinal Hemorrhage/immunology , Retinal Neovascularization/diagnosis , Retinal Neovascularization/immunology , Trichinellosis/immunologyABSTRACT
The authors demonstrate a rare case of an adenocarcinoma of the uterus associated with a uterus septus. The concomitance of carcinoma and congenital uterine anomalies is coincidental and has no causal connection. Congenital anomalies of the uterus which remain undetected can be responsible for serious delay in diagnosis of carcinoma and may adversely interfere with treatment efforts.
Subject(s)
Adenocarcinoma/pathology , Uterine Neoplasms/pathology , Uterus/abnormalities , Aged , Diagnosis, Differential , Endometrium/pathology , Female , Humans , Uterus/pathology , Vagina/abnormalitiesABSTRACT
Yersinioses are zoonoses inspite of the fact, that the pathogen is rarely transferred directly from the animal to man, but mostly from contaminated food or contaminated surroundings. Enteritis or enterocolitis develop in most cases after infection with Y. enterocolitica (enteritic form), whereas pseudoappendicitis accompanied by massive mesenterial lymphadenitis of the ileocecal lymph nodes with or without the participation of adjacent parts of the intestine develops after infection with Y. pseudotuberculosis (pseudoappendicitic form). Some complications like arthritis and erythema nodosum occur rather frequently and may help to establish the diagnosis; septicemia occurs very rarely and is as yet lethal in 50% of cases. Confirmation of yersiniosis is in general not possible on clinical grounds only. Also microscopic as well as macroscopic morphological findings will allow a tentative diagnosis only. Confirmation must come from bacteriologic or serologic findings.
