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▼ Introduction: A major barrier to eff ective secondary prevention of alcohol-related disorders in Germany is the insuffi cient integration of the addiction help system. In particular the interface between general practitioners and specifi c addiction services is often described as an obstacle in the literature. The present study examines the question of whether a structured intervention can lead to a higher number of patient referrals to alcohol counselling services and to referrals of patients in an earlier stage of the disease. Methods: Over a period of 6 months the 4 alcohol counselling services in Freiburg documented their initial contacts with their clients (sociodemographic and alcohol-related data and source of referral) with a standardised questionnaire. All general practitioners in Freiburg (N = 231) were then invited to participate in the project, which enabled them to refer patients directly to the counselling services and receive reliable feedback. In the following intervention period, in which 10 % of general practitioners in Freiburg took part (study physicians), referrals were documented in the same way as in the control period. Results: In the intervention period the rate of referral increased signifi cantly (p = 0,002). The study physicians were responsible for the improvement. Furthermore clients, who had never been in contact with the addiction help system before, were signifi cantly more likely to be referred to the counselling services by general practitioners (p < 0,001). In relation to the stage of disease no signifi cant eff ects could be found. Discussion: An easy to replicate, accessible offer improved the interface between general practitioners and alcohol counselling services. Convincing evidence that general practitioners play an important role as gate-keepers to the addiction help system was found. Physicians may require specifi c training to increase referrals of patients in an earlier stage of the disease.

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Zusammenfassung Das dermale pleomorphe Sarkom ist ein eher seltener b?sartiger Tumor chronisch belichteter Areale, der vor allem ein hohes Lokalrezidivrisiko hat. Hier zeigen wir einen Fall mit ausgedehntem Befall des behaarten Kopfes, bei dem nach tiefer Pr?paration einschlie?lich Galearesektion mittels sofortiger Anwendung eines dermalen ?quivalentes eine drohende Wundheilungsst?rung vermieden werden konnte.

The case of a man with type I allergy after the intake of camomile tea is presented. About 30 min after consumption he was hospitalised with palmar pruritus, swelling of the eyelids, upper lip and nasal mucosa as well as narrowness of the throat. Hereditary angioedema was excluded. The skin prick test confirmed the diagnosis of a type I allergy due to camomile tea.