Research Group Heussler (Malaria I) - Bernhard-Nocht-Institut für ...
Research Group Heussler (Malaria I) - Bernhard-Nocht-Institut für ...
Research Group Heussler (Malaria I) - Bernhard-Nocht-Institut für ...
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Clinical Department<br />
Department Head’s Summary<br />
Introduction<br />
The Clinical Department of the <strong>Bernhard</strong> <strong>Nocht</strong> <strong>Institut</strong>e<br />
for Tropical Medicine consists of the patient-admitting<br />
wards, an Outpatient Department for tropical diseases,<br />
a Department for Travel Advice and Vaccinations, and a<br />
Department for Clinical <strong>Research</strong>. Main emphasis is on<br />
patient care, counselling of hospital doctors and general<br />
practitioners all over Germany in cases of complicated<br />
differential diagnoses and therapeutic problems, pretravel<br />
advice and immunizations, training and continued<br />
medical education of students, specialised medical<br />
staff and doctors as well as in clinical research. The<br />
Clinic is<br />
financed by income from medical services.<br />
Patient Care on the Wards<br />
The Clinical Department is a national reference centre<br />
for infectious diseases with main emphasis on tropical<br />
medicine. The Department is included in the hospital<br />
requirement plan of the Free and Hanseatic City<br />
of Hamburg. There are presently 62 in-patient beds.<br />
Besides the treatment of internal diseases in general,<br />
expert competence is available in diagnostics and treatment<br />
of imported tropical and other infectious diseases<br />
(including HIV and AIDS).<br />
The Clinical Department is specialised in differential<br />
diagnosis of infectious diseases (e.g. malaria, meningitis,<br />
viral haemorrhagic fevers), furthermore HIV-associated<br />
diseases, mycobacterial infections, and immunologic<br />
diseases like immunodeficiency syndromes and autoimmune<br />
diseases and specific genetic diseases such<br />
as sickle cell anemia and familial mediterrean fever<br />
(FMF). The Department is equipped with modern endoscopic<br />
technology (gastroscopy, coloscopy), X-ray unit,<br />
and sonography (echocardiography, Doppler ultrasonograpy,<br />
abdominal ultrasonography). The staff of the<br />
Clinic also includes two psychologists and two physiotherapists.<br />
Furthermore, the Clinical Department is specialised<br />
in the treatment of patients with highly contagious diseases<br />
– about 50 patients suspected of SARS were admitted<br />
in 2003. For this type of patient, two isolation<br />
units are kept at disposal: in the future, low pressure<br />
units are planned to guarantee intensive care for highly<br />
contagious patients, e. g. with Lassa or Ebola fever. In<br />
spring 2003, on the occasion of an Ebola outbreak in<br />
the Democratic Republic of Congo, the Clinical Department<br />
provided a doctor for field assistance during a<br />
WHO operation.<br />
Furthermore, the Clinical Department has regular<br />
contact with those general practitioners in Hamburg<br />
Clinical Department<br />
96<br />
and surroundings, who are specialised in tropical<br />
medicine.<br />
Since 2003, the Clinical Department has started taking<br />
up the installation of the case-related flat rate system<br />
(DRG System), a medical controller has been employed<br />
and a new hospital information system is being<br />
installed.<br />
Outpatient Department for<br />
Tropical Medicine<br />
The Outpatient Department of the Clinical Department<br />
is authorized to examine patients in view of specific<br />
diseases – mainly infectious diseases imported from<br />
tropical and subtropical countries – these patients being<br />
referred to us by general practitioners authorized by the<br />
Health Insurances. Thus, checks are carried out before<br />
and after stays in tropical areas, furthermore we examine<br />
cases of unclear fever and of unclear diarrhea as well<br />
as cases of suspected parasitic diseases. Skin irritations<br />
are frequent indications for differential diagnoses.<br />
Further services of the Outpatient Department are<br />
expatriate precaution checks for missions in tropical<br />
countries (acc. G35), consultations after HIV exposition,<br />
consultations and vaccinations with regards to rabies<br />
as well as consultations following injuries caused by<br />
poisonous animals. There is long term patient care in<br />
cases of familial mediterrean fever (FMF), and<br />
echinococcosis as well as borrelioses and chronic<br />
hepatitis B or C.<br />
As been the case for many years already, there<br />
continues to be thousands of phone consultations per<br />
year to give advice to general practitioners and hospitals<br />
in difficult cases of diagnosis and treatment, especially<br />
when patients with complicated malaria are treated in<br />
intensive care units. In the scope of epidemic disease<br />
control our Clinical Department is a reference centre<br />
for cases of suspected highly contagious diseases.<br />
Vaccinations and Travel Advice<br />
The Vaccination Centre and the Centre for Travel<br />
Advice are main components of the Clinical Department.<br />
In 2002 and 2003, about 8000 vaccinations of travellers<br />
were given per year. The service was improved by extending<br />
the office hours, to date two additional opening<br />
nights per week are offered to working persons. When<br />
evaluating a questionnaire which had been distributed<br />
among visitors to our vaccination centre, it was found<br />
out that 96% of the travellers were satisfied with the<br />
services of our vaccination centre.<br />
The Centre for Travel Advice (RMZ – “Reisemedizinisches<br />
Zentrum”) has been continuing its work successfully.<br />
Clients can request information in clearly-writ-
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