How to avoid liability litigation in courts--suggestions from a German example.

The medical art is difficult, its results can not always be predicted. After looking at TV, patients know more or think they know more about medicine. They tend to assume faulty diagnostics or treatment by their physician, if the good result promised by the news-media or by the doctor himself has not been obtained.

Carl Liebermeister (1833-1901): a pioneer of the investigation and treatment of fever and the developer of a statistical test.

In the second half of the nineteenth century, when the typical course of various febrile clinical phenomena was found to be specific to particular infectious diseases, Carl Liebermeister successfully pioneered the investigation of the patho physiology of fever and the regulation of body temperature. He applied biophysical and pharmacological antipyresis, especially for the treatment of typhoid fever, and developed new statistical tools for the evaluation of therapeutic results.

Effects of weight-reduction on obesity-associated diseases.

Even moderate, but persistent weight-loss ameliorates most of the related diseases in obesity. Besides the consequences of the metabolic syndrome, this includes less well-known obesity-associated changes, such as impaired fertility, menstrual disorders, psychic changes, total leucocyte-count as a parameter of immunity and the impaired pulmonary function in asthma and sleep-apnoea. Life-expectancy is prolonged by diminution of visceral fat depots, whilst weight-loss by shrinking of fat-free body-mass seems to have a contrary effect.

[Prognosis in obesity, what has changed?].

Since the publication of the Build Study 1979 further analyses have refined our concepts concerning the prognosis of obesity. We have recognized that intraabdominal fat depots especially favor the development of complications and shorten life. Smoking diminishes body weight slightly, but leads to a detrimental replenishment of this intra-abdominal fat accumulation.

[Cardiac effects of a reducing diet].

40 in-patients have been treated by modified fasting during 4 weeks. Routine ECG's and radiological controls of heart size did not show signs of myocardial lesions or of an impairment of the generation, propagation or dissipation of cardiac impulse. Slightly elevated serum levels of CK, CK-MB, alpha-HBDH, SGOT, and SGPT could indicate a reduction of fat-free body-mass including some elements of myocardium.

Oral antidiabetic combination therapy with sulphonylureas and metformin.

In a multicentre trial in general practice, a total of 1823 type 2 diabetics, not adequately controlled by diet and maximal sulphonylurea therapy, were treated with additional metformin 850--2 550 mg/d for 12 weeks. The average postprandial blood sugar decreased from 15.48 mmol/l to 10.

[Problems of the elderly, insulin injecting diabetic patients in ambulatory care].

Not announced visits with interviews and practical demonstrations in the homes of 106 insulin-treated diabetics above 60 years of age produced rather sad results. Less than half of these patients were able to inject themselves. With increasing age insulin dosage was less and less correct; two thirds of the patients older than 75 years injected wrong doses.

Absence of detrimental changes of cognitive parameters during fasting.

During the first 10 d of a total fast the changes in a series of cognitive parameters: short-term memory, long-term memory, speed of information processing, vigilance, and mental control were tested in 14 obese inpatients and compared with a control group. Ten days of fasting induced no detrimental changes. An improvement in the subtest 'Repetition of digits' was interpreted as improved motivation as a consequence of successful weight reduction.

[Weight changes under thyroxine substitution for euthyroid goitre (author's transl)].

Total thyroxine levels and body weight were measured over nine months in 213 out-patients with euthyroid goitre who were taking 50--150 micrograms thyroxine daily; 40 persons receiving merely iodine-containing salt served as controls. Weight gain among the thyroxine group averaged 0.34 +/- 0.

[Lowering of cholesterol levels through adding pectins and soybean proteins to a reducing diet (author's transl)].

A mixture of soybean proteins and pectins (EMD 35327) was given to 10 obese people with and without diabetes for a period of 3 weeks in a dosage of a total of 1000 kcal/d. The control group consisted of 10 obese who were given a conventional 1000 kcal mixed diet. In comparison to the control group the test group showed a highly significant decrease of serum cholesterol, a significantly better loss of weight and somewhat lower post-prandial blood sugar and triglyceride levels.

[Differences in taste assessment of sweeteners by normal and overweight persons].

Taste assessment was tested in 20 obese and 20 normal-weight in-patients using watery solutions of saccharose and three synthetic sweeteners. Each patient was asked to assess ten different taste qualities of each solution on a point scale. There were highly significant differences between the two groups of subjects.