Ultrasound therapy: new method could strengthen the brain in Alzheimer’s disease
He is allowed to be "Specialist in plastic and aesthetic surgery" (earlier "Plastic surgery specialist") describe.
Such a specialist must have completed six years of advanced training after completing his medical degree. During this time, the doctors learn certain surgical techniques and activities. If in doubt, you should ask the state medical associations whether it is really a specialist.
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Also in the DGPRÄC professional association, medical professionals are only allowed to become members if they have successfully completed the relevant specialist training. Anyone who wants to have an operation abroad should be aware that different rules apply there.
Sources used: dpa news agency
Help research via app – this is still happening in clinical studies. That should change in the future. Numerous diseases could be treated more efficiently. But what about data protection?
The raffle for the most expensive drug in the world, a custom-made gene therapy for terminally ill babies, attracted a lot of attention: Pharmaceutical companies rely on personalized medicine and need huge amounts of data for this. Also from the smartphone.
App collects all data
Draw a round eight on the smartphone screen or arrange characters and numbers together as quickly as possible – that sounds like a nice gimmick, but the Floodlight app from the Swiss pharmaceutical company Roche is primarily intended to feed the researchers with data. Data from multiple sclerosis patients.
The app counts steps and pace, and patients upload information about their condition. It is still only open to clinical trial participants, but that is about to change. Data is the new gold in the pharmaceutical industry. "They are the central driver for changes and innovations in the pharmaceutical industry in the coming years"says Roche President Christoph Franz.
Personalized medicine for patients
The pharmaceutical industry relies heavily on personalized medicine or precision medicine. On the one hand, this is something like the multi-million dollar gene therapy for terminally ill babies, which the pharmaceutical company Novartis is raffling off 100 times. Or the Kymriah gene therapy for aggressive leukemia. The drugs are manufactured individually for each patient.
But what is also meant is a development that is intended to revolutionize the treatment of all patients. For high blood pressure, mean A, for heart failure, mean B: That patients with the same illness usually receive the same pills should soon be a thing of the past. To do this, the pharmaceutical industry needs a lot of patient data.
Data can reveal unknown relationships
They should come from studies, apps and doctor’s offices. More and more often, doctors are recording information in an electronic patient file on the computer instead of on the index card. "We can expect an explosion of data in the next few years"says Anne-Marie Martin, Head of Precision Medicine at Novartis.
This includes findings, X-ray and MRI images, laboratory analyzes, studies and also the good old doctor’s consultation – simply everything that is available about the health of every person. The analysis of massive amounts of data can reveal relationships that were previously unknown. Certain gene or cell characteristics, but also age, weight, a previous illness, other medication, place of residence, ethnicity or the time of use can influence whether a drug works or not.
Concern about data protection
But what about data protection? Patients worry that one day health insurances will be able to charge a risk surcharge for genetic diabetes, for example.video game violence argumentative essay Even the planned introduction of the electronic patient file on January 1, 2021 would be problematic, warned the Bavarian Association of Statutory Health Insurance Dentists. Practices are not adequately protected from hacker attacks, and 2,000 euros are available for patient files.
The drug companies say they want anonymized data so that patients cannot be identified. Experts in IT security, data protection, artificial intelligence and medicine are currently working on a standard for the secure processing of medical data on behalf of the Federal Ministry of Research.
Treatment tailored to the needs of the patient
"If you analyze such data, treatments can be offered that are precisely tailored to the patient"says Roche spokesman Daniel Grotzky. Martin from Novartis says: "On the one hand, we can filter out the patients for whom a certain treatment is particularly effective; on the other hand, the data also feed the discovery engine." New drugs could be developed for patients who do not respond to conventional therapy.
In oncology, it is often common practice to determine cell receptors and, depending on the results, treat two women with breast cancer differently. In diseases of the central nervous system such as multiple sclerosis (MS), great advances can also be expected, says Martin.
Use in Alzheimer’s research
In Alzheimer’s research, Roche has developed a test that can measure a protein that could be responsible for the death of nerve cells. If the substance can be reliably measured and there is at some point an Alzheimer’s drug, patients could be treated before the first signs. The company is also testing implants the size of a grain of rice in the eyes of patients with retinal diseases that can lead to blindness. It is checked whether the individual, optimal dosage of the active ingredient brings better results for patients.
Data, data, data: Novartis is already combining patient information from studies in a database so that information from more than two million patients can be digitally analyzed. Roche has acquired Flatiron Health, a US company specializing in cancer patient data, and Foundation Medicine, which creates genetic profiles.
Profitable for all sides
Personalized medicine is seen as a win-win-win situation. Patients benefit because they are treated effectively more quickly. Health insurance companies save money because patients do not need to try expensive drugs that do not help. And pharmaceutical companies can negotiate better prices with higher accuracy. "If one can demonstrate the success of the treatment with the patient, the value of compensation from the healthcare system also becomes clearer"says Roche spokesman Grotzky.
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Finland is considered the gold standard in the use of health data. Patient data has been electronically recorded there for years. In the project "FinnGen" the genome of half a million Finns will be deciphered.
Sources used: dpa news agency
People in need of care receive care allowance if, for example, relatives look after them at home. But what if relatives support hospital staff with care?
If people are cared for at home by relatives, for example, there is care allowance. This entitlement does not apply to the time that people in need of care are inpatient in the hospital. This is shown by a decision of the Nuremberg Social Court (Az: S 18 P 37/19), to which the German Lawyers Association (DAV) refers.
In the negotiated case, a mother looked after her seriously ill child, even during a hospital stay lasting several months – until it died. The woman was convinced that without her commitment, the quality of care would not have been adequate – because of the staffing situation in hospitals. The nursing care fund did not pay any nursing allowance during the hospital stay. The mother complained against this.
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She got no right in court. Because from a legal point of view, there is no entitlement to care allowance during this time. Although the mother had relieved the hospital staff, the conditions for the care allowance were not met. Because the long-term care insurance pays it so that people in need of care can stay in their home for as long as possible.
Sources used: dpa news agency
The assumption of treatment costs repeatedly causes disputes between patients and health insurance companies. A special case arises when doctors make an incorrect diagnosis. Who then has to pay?
Only if drugs are approved for a disease do health insurances usually have to cover the costs. But what if the doctors’ initial diagnosis is incorrect and it later turns out that the drug is approved for the actual disease?
In that case, the health insurance fund also has to pay retrospectively, as a ruling by the State Social Court of Hesse shows (Az .: L 8 KR 687/18), to which the Medical Law Working Group in the German Lawyers’ Association refers.
Plaintiff received incorrect diagnosis
The specific case concerned a man who was initially diagnosed with ganglionitis. The doctors wanted to treat him with immunoglobulins. But the fund declined to pay for it.
The reason: The drug is not approved for this. The man with statutory health insurance was treated at his own expense. Then it turned out that his symptoms were caused by an autoimmune inflammation of the posterior spinal root. Immunoglobulins are approved for treatment for this condition.
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The man sued to pay the costs – and was successful. The cash register had to pay him around 35,000 euros. The Regional Social Court did not accept their argument that the man was only entitled to reimbursement from the time the diagnosis was changed. The rejection of a service remains unlawful even if this unlawfulness only becomes apparent in the course of the procedure.
Sources used: dpa-tmn news agency
Abdominal pain, diarrhea or raging headaches – emergencies also occur on weekends and public holidays. But emergency rooms are overcrowded and doctors’ offices are closed.
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When an acute emergency arises, the question arises as to where those affected can best get help. Drive to the emergency room at the nearest hospital, go to an on-call practice or wait until the family doctor’s practice is open again?
When you can contact the on-call service
This question can be answered quickly by calling a nationwide telephone number that is not familiar to everyone: 116 117. This number can be used to contact the medical on-call service outside of practice opening hours – including on Sundays and public holidays. The experts help estimate which path is the right one. "They also arrange a doctor’s home visit if necessary", says Christoph Kranich from the Hamburg consumer center.
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For all illnesses that are not life-threatening, the medical on-call service is the right place to go. This is the case, for example, with acute abdominal pain or diarrhea. Even if a fever rises above 39 degrees or someone has cut themselves, the on-call service is the right choice. The call is free for patients. The medical help behind the number is organized by the statutory health insurance associations.
In some regions there is also a pediatrician or an ophthalmologist on call. In case of doubt, you can also find out about this via 116 117. If you have severe toothache at night or on the weekend, the medical on-call service is not the right contact. In that case, patients should better contact the dental on-call service.
In the event of life-threatening symptoms, go to the emergency room
Instead of contacting the on-call service, some people drive straight to the emergency room of a hospital. "This can mean that the emergency rooms of the clinics are overcrowded, especially in large cities, and minor cases limit the capacities for real emergencies", warns Roland Stahl from the National Association of Statutory Health Insurance Physicians (KBV) in Berlin.
"For laypeople themselves, however, it is not always easy to assess whether there is a medical emergency or not", admits Prof. Gerrit Matthes. He is the Medical Director of the Clinic for Trauma and Reconstructive Surgery at the Ernst von Bergmann Clinic in Potsdam. A medical emergency is when the symptoms are or could become life-threatening. Then those affected or bystanders should call the emergency services on 112.
Life-threatening, for example, is when someone is unconscious or has a significant loss of consciousness. A case for the 112 is also shortness of breath or severe chest or heart pain. Heavy, unstoppable bleeding and accidents with suspected severe injuries are also a medical emergency, as are severe burns. The ambulance should also be called immediately in the event of an electrical accident.
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Pick up the phone in case of poisoning
Children can also accidentally drink cleaning agents, pesticides or swallow medication. Then poison emergency calls offer telephone help around the clock. Parents should have the local poison control number to hand. The best thing to do is to save it in the address book of the cell phone – just like that of the medical on-call service.
Sources used: dpa
A few years ago the doctor’s letter came in the mail – now patients are often the people who deliver the document themselves.