Subject(s)
Ambulatory Care/legislation & jurisprudence , Delivery of Health Care/legislation & jurisprudence , Health Care Reform/legislation & jurisprudence , Hospitalists/legislation & jurisprudence , Legislation, Hospital/trends , Ambulatory Care/trends , Delivery of Health Care/trends , Forecasting , Germany , Government Regulation , Hospitalists/trendsABSTRACT
Individual health insurance companies again and again refuse the remuneration of invoices submitted by attending physicians for purely private patients or for compulsory health insurance patients with additional private insurance. As a rule the refusal is based on legal precedents or sub-statutory regulations. This article aims to help attending physicians to react argumentatively to a possible rejection of private medical billing by insurance companies for inpatient attending physician services provided.
Subject(s)
Medical Staff, Hospital/legislation & jurisprudence , Private Practice/legislation & jurisprudence , Germany , Insurance, Health, Reimbursement/legislation & jurisprudenceSubject(s)
Health Policy/trends , National Health Programs/trends , Societies, Medical/trends , Urology/trends , Forecasting , Germany , HumansABSTRACT
Today, the classical bacteria that cause venereal diseases, e.g. gonorrhea, syphilis, chancroid and inguinal granuloma, only account for a small proportion of all known sexually transmitted diseases (STDs). Other bacteria and viruses as well as yeasts, protozoa and epizoa must also be regarded as causative organisms of STD. Taken together, all sexually transmitted infections comprise more than 30 relevant STD pathogens. However, not all pathogens that can be sexually transmitted manifest diseases in the genitals and not all infections of the genitals are exclusively sexually transmitted. Concise information and tables summarising the diagnostic and therapeutic management of STDs in the field of urology allow a synoptic overview, and are in agreement with the recent international guidelines of other specialist areas. Special considerations (i.e. HIV infection, pregnancy, infants, allergy) and recommended regimens are presented.
Subject(s)
Genital Diseases, Male/diagnosis , Sexually Transmitted Diseases/diagnosis , Disease Notification/legislation & jurisprudence , Female , Genital Diseases, Male/therapy , Germany , Humans , Infant, Newborn , Male , Pregnancy , Sexually Transmitted Diseases/therapy , Societies, MedicalABSTRACT
The increasing use of interstitial brachytherapy for the treatment of prostate cancer has made it necessary to discuss and establish guidelines for the application of this treatment modality. A group of experts representing the four professional and scientific societies of urologic surgeons and radiation oncologists in Germany was formed by the German Society of Urology (Deutsche Gesellschaft für Urologie, DGU), the Association of German Urologists (Berufsverband der Deutschen Urologen e.V., BDU), the German Society for Radiation Oncology (Deutsche Gesellschaft für Radioonkologie, DEGRO) and the Association of German Radiotherapists (Berufsverband der Deutschen Strahlentherapeuten, BVDSt). This group has formulated a consensus statement consisting of recommendations and guidelines for the indications, planning, implementation and follow-up of permanent interstitial brachytherapy by seed implantation for the treatment of localized prostate cancer. These recommendations also define the responsibilities of the two medical disciplines involved in the use of this interdisciplinary treatment.
Subject(s)
Brachytherapy/methods , Health Planning Guidelines , Prostatic Neoplasms/pathology , Prostatic Neoplasms/radiotherapy , Radiation Oncology/standards , Aged , Biopsy, Needle , Brachytherapy/adverse effects , Germany , Humans , Male , Middle Aged , Neoplasm Staging , Patient Selection , Prognosis , Prostatic Neoplasms/mortality , Radiation Dosage , Risk Assessment , Survival Rate , Treatment OutcomeSubject(s)
Androgens/deficiency , Geriatrics , Age Factors , Aged , Humans , Male , Sex Factors , SyndromeABSTRACT
For the early detection of prostate cancer, a patient should undergo digital rectal examination (DRE) and PSA investigation. Follow-up of increased PSA levels detects nearly 80% of cancers. Positive predictive value of suspicious DRE and PSA is about 50%. Whereas in the first evaluation of this case-finding trial about 70% of the patients had organ-confined cancers, nearly all of the detected cancers in the follow-up investigation were organ confined. The increased number of organ-confined cancers detected in early periodical examinations can lead to a reduction of mortality and morbidity from prostate cancer.
Subject(s)
Biomarkers, Tumor/blood , Palpation , Prostate-Specific Antigen/blood , Prostate , Prostatic Neoplasms/diagnosis , Adult , Aged , Biopsy , Humans , Male , Middle Aged , Predictive Value of Tests , Prostate/pathology , Prostatic Neoplasms/bloodABSTRACT
To compare the efficacy of digital rectal examination (DRE) and serum prostate specific antigen (PSA) in early detection of prostate cancer, we initiated a prospective multicenter screening trial. In 12,542 men choosen at random with a mean age of 62 (+/- 7.5) a suspect DRE or a PSA level > 4.0 ng/ml was found in 2343 (20%). Of the presently performed 744 biopsies, 157 revealed diagnosis of prostate cancer. Although further biopsies as well as the follow up of the 12,542 men are still missing, combination of DRE and PSA value > 4.0 ng/ml appears to be superior to DRE alone with a positive predictive value of 50% versus 19% in early detection of prostate cancer.
