PubMed Health⌕ Search

Biomedical subjects

H Butke

Publications and source records attributed to H Butke.

4 recordsLinked to original sources

[Legal and epidemiological aspects of strong opioids].

In spite of the fact that the treatment of pain is highly developed, outpatient care of patients suffering from chronic pain is frequently insufficient. In particular general practitioners often refrain from prescribing the necessary pain therapy with opioids. Because of the contract regarding medical treatment, however, the patient has a legal claim to adequate pain treatment, if necessary by administration of opioids. The failure to meet this claim may not only give rise to a claim for damages towards the doctor, but even to a charge of bodily injury. In comparison, charging the physician with criminal behavior on the basis of the Narcotics Act is rather unlikely. Negligent or incorrect prescription of narcotic drugs does not constitute criminal behavior, but an administrative offence. Even this is hardly something which the physician has to fear. Any medically necessary administration of opioids is covered by the Narcotics Prescription Ordinance. The narcotics prescription form, however, remains indispensable for the safety in the use of narcotics. The doctor's prescription alone is obviously not sufficient to curb the considerable abuse of pharmaceutical products among the population. In the course of the introduction of EDP-readable narcotics prescription form as of 1 July 1995, however, the issuing of this kind of prescription was further simplified. Handwritten particulars will soon be entirely a thing of the past. Now that the legal and administrative conditions for prescribing opioids have been consolidated, the main objective is to exhaust the possibilities of prescription for the benefit of patients suffering from pain in a better way. This is first and foremost, an organizational and technical task of the medical professional group. In particular, training and continuing education in the field of pain therapy must be further developed without delay.

English Abstract↗

Diagnosis of early gastric cancer.

Early gastric cancer is being encountered with increasing frequency in Germany as well as Japan and elsewhere through greater awareness, selection of high risk patients and improved diagnostic methods. We consider endoscopy superior to radiology in the detection of early gastric cancer. Polypoid lesions of the stomach need endoscopic biopsy or removal for proper diagnosis. Gastric ulcers should be followed by endoscopy and guided biopsies until healing is complete. Adequate sampling of a suspected gastric lesion may require multiple biopsy specimens for accurate histological interpretation.

Biopsy↗

A new technuque of ERC(P) using a straight-view fiberscope.

A new technuque of ERC(P) using a forward-veiwing fiberscope is described in details. By this procedure the position of the maximal bended tip of the instrument provides a more selective cannulation of the common bile duct, preventing the risk of pancreatic duct filling. The method was performed in 15 cases and succeeded in 12. ERCP, using this technique, can be performed after normal esophago-gastro-duodenoscopy. However, at present time it is not a routine procedure. Technical improvements on the instrument are necessary to facilitate the method.

Ampulla of Vater↗

Peroral direct cholangioscopy (PDCS) using routine straight-view endoscope: first report.

A new endoscopic method, the peroral direct cholangioscopy (PDCS) is described. A prograde fiberscope of 8.8 mm diameter can be directly inserted, without using a second scope as a guide, into the biliary system after EPT (endoscopic papillotomy). The lumen of the common bile duct is observed entirely and exactly. The image is excellent. Also acessories may be inserted into the duct via the biopsy channel under direct control.

Aged↗