Praxis
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Lactic acidosis is a serious clinical situation associated with a high case fatality rate. Lactic acidosis is particularly found in conditions with an insufficient supply of oxigen in the tissue. Other causes for lactic acidosis can be hepatic or renal insufficiency. ⋯ We present a 64-year-old female patient with metformin-associated lactic acidosis. She had several pre-existing risk factors to develop a lactic acidosis. On her referral to the hospital she suffered from acute renal failure which is considered to be a contraindication for the use of metformin.
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Compression-induced damage to the peripheral nerves can cause persistent, mostly exercise-related intensified pain syndromes. In the presence of brachialgia, compression neuropathies must always be considered when rendering the differential diagnosis, whether in the scapular region (e.g. suprascapular syndrome) in the elbow (e.g. supinator syndrome) or the hand (carpal tunnel syndrome, distal ulnar tunnel syndrome). ⋯ Focal neural damage, its exact localization and degree of severity can all be confirmed by the targeted use of electroneurography and needle myography. These procedures will also allow a prognostic estimation and provide information about whether surgical therapeutic procedures are indicated.
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The "Komplikationenliste" (list of complications) of the association of the heads of departments of the Swiss society of internal medicine is a clinical tool for the registration and reduction of complications/errors of medical treatment. It is the aim to improve patient safety in hospital medicine. ⋯ All the complications and errors are communicated to all the departments of internal medicine in Switzerland in order to reduce them. The principle for the reduction of such events is the elimination of unsafe actions and conditions and apparently harmless errors in daily diagnostic and therapeutic interventions in order to avoid potentially serious consequences.