Dtsch Arztebl Int
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Review Meta Analysis
The diagnosis and treatment of hypertensive disorders of pregnancy: new findings for antenatal and inpatient care.
Hypertensive disorders of pregnancy (HDP) are among the leading causes of maternal and fetal morbidity and mortality. New guidelines and findings from clinical trials must be taken into account so that the diagnosis and treatment of HDP can be optimized. ⋯ Aside from hypertension and proteinuria, the definition of preeclampsia (PE) should also take organ dysfunction into account. Important aspects of antenatal care include the following: the early recognition of risk factors, measurement of the uterine arteries in the 1st and 2nd trimesters with Doppler ultrasonography (A diagnostic tool which is now well established), prophylactic oral administration of 100 mg of acetylsalicylic acid daily from the beginning of pregnancy, particularly in high-risk patients (EL I++), and appropriate measurement of blood pressure and urinary protein. Patients should be hospitalized whenever indicated. Therapeutic goals are adequate treatment of hypertension, as well as seizure prophylaxis with magnesium sulphate in severe preeclampsia to prevent maternal cerebrovascular complications (EL I++). If delivery is indicated, it should be performed, regardless of the gestational age (EL IV). Careful monitoring during the puerperium and a general medical review six weeks after delivery are essential. Women with preeclampsia have a significantly elevated long-term risk of developing cardiovascular diseases in later life (EL I++).
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Review Meta Analysis
The morbidity and mortality associated with overweight and obesity in adulthood: a systematic review.
Overweight and obesity are generally thought to elevate morbidity and mortality. New data call this supposed association into question. ⋯ The prevailing notion that overweight increases morbidity and mortality, as compared to so-called normal weight, is in need of further specification. Obesity, however, is indeed associated with an elevated risk for most of the diseases studied.
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Cataract surgery, the most frequently performed operative procedure worldwide, typically concludes with the implantation of an artificial intraocular lens (IOL) to correct aphakia (absence of the crystalline lens). ⋯ As no effective medications for cataract are available at present, its current standard treatment is the removal of the clouded lens. In industrialized countries, this is usually done with ultrasound (phacoemulsification), followed by the implantation of an IOL.