Ch Hürny | PubMed Health

PubMed2006

[Breaking bad news].

Breaking bad news is a difficult task of the physician. With three short records of cancer patients frequent difficulties and errors in the disclosure of diagnosis and prognosis are highlighted. In addition to its medical definition "cancer" has also a metaphoric meaning, which may substantially compromise the communication between patient and physician. Therefore the term cancer has to be explicitly used in talking to the patient and its current meaning for the patient has to be clarified. In estimating the prognosis with the patient precaution is essential since wrong predictions may geopardize the confidence of the patient in this physician substantially and even compromise further treatment. Breaking bad news is not a one way communication. Patient reactions have to be acknowledged, understood and catched up in a supportive way.

Adult↗

PubMed2004

[Dementia assessment in the Memory Clinic St. Gallen: do further diagnostic work up or therapy lead to a change of diagnosis?].

We evaluated 143 patients referred to the Memory Clinic St. Gallen for ambulatory dementia assessment between 1995 and 1999. We assessed demographic data, medical results and follow-up data over a mean period of 16 months. 63% of the patients suffered from dementia, 14% had a mild cognitive impairment, 1% had a preexisting debility and 22% had no cognitive deficit. The cause of dementia was Alzheimer's disease in 40% of the patients. Vascular dementia (2.8%) and reversible forms of dementia (2.1%) were underrepresented. In 63 out of 143 patients we examined, if further diagnostic work up (CT or MRI, laboratory testing etc.) or empirical medication by the family physicians led to a change of the initial diagnosis. Follow-up findings confirmed the initial diagnosis in 87.3% of cases. Based on these results we conclude that expensive diagnostic procedures are not necessary in most patients referred for the ambulatory assessment of dementia.

Aged↗