Der Internist
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The diagnostic pathway for the evaluation of patients with dyspnea requires a thorough history taking and physical examination. Based on the results of these basic steps a broad variety of additional diagnostic tests are available. ⋯ Among these are electrocardiography (ECG), laboratory parameters, X-ray examination, echocardiography, spirometry and whole body plethysmography and finally spiroergometry. This article presents a focused review of what each of these diagnostic modalities can contribute to the diagnostic process for dyspnea.
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Dyspnea represents one of the most frequent and heterogeneous symptoms. The term dyspnea describes the subjective perception of an inadequate effort to breathe. In general, acute and chronic forms have to be differentiated. ⋯ The differential diagnosis needs a structured approach including anamnestic and medical technical methods, aiming an efficient differentiation of cardiac and pulmonary causes. As a high number of patients suffer from more than one significant disease, the differential diagnostic assessment needs to be focused on the assessment of the predominant cause of the dyspnea. For this purpose, exercise tests provide helpful algorithms to answer this question.
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Randomized Controlled Trial
[Effects of glycemic index on cardiovascular risk factors: The OmniCarb randomized clinical trial].
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Hyperkalemia is a common clinical problem. While several options are available to treat acute hyperkalemia, there are few options for long-term treatment. ⋯ Sodium zirconium cyclosilicate and patiromer are two new oral potassium binders awaiting approval. The efficacy of these novel potassium-lowering agents were tested in several phase 3 short-term studies published in late 2014.
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Randomized Controlled Trial Multicenter Study
[Endovascular treatment for acute ischemic stroke : Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN)].