Dtsch Arztebl Int
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The N-methyl-D-aspartate (NMDA) antagonist dextromethorphan has been available in pharmacies without a prescription since 1954 as an antitussive agent. There is an alarming increase in reports of its abuse. Dextromethorphan is avidly taken, mainly by young people, as a psychoactive drug. The currently available data yield incomplete information about the extent of the problem and its significance for addiction medicine in Germany. ⋯ Dextromethorphan is a psychotropic substance that carries a potential for abuse and dependence. On the basis of the currently available data, its reclassification as a prescription drug should be considered.
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Current guidelines for assessing the risk of developing type 2 diabetes mellitus (DM) recommend using the patient's body-mass index (BMI) as a primary measure. Waist circumference measurement is recommended for overweight or obese patients only (BMI > or = 25). ⋯ These findings imply that the waist circumference is an important additional piece of information for assessing the risk of type 2 DM, particularly among persons of low or normal weight.
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Restricting the dietary intake of sodium chloride is associated with a reduction of the arterial blood pressure by approximately 4/2 mm Hg in hypertensive patients and by approximately 1/0.6 mm Hg in normotensive persons. As the cardiovascular risk is known to rise steadily with systolic blood pressure values starting from 115 mm Hg, lowering the mean blood pressure of the general population by dietary salt restriction would seem to be a practicable form of primary prevention of cardiovascular disease. ⋯ On the basis of the available studies, it seems likely that a moderate lowering of the daily intake of sodium chloride by the general population from 8 to 12 grams per day (the current value) to 5 to 6 grams per day would be a useful public health measure, with economic benefits as well. The potential risks for certain groups of individuals are foreseeable and controllable. A general reduction of dietary salt intake can only be achieved by reducing the sodium chloride content of industrially processed foods, as these account for 75% to 80% of the sodium chloride consumed daily. Aside from a general reduction of dietary salt intake, further important primary prevention measures for the general population include changes in lifestyle and in dietary habits.