Therapeutische Umschau. Revue thérapeutique
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Extraintestinal manifestations in chronic inflammatory bowel diseases Abstract. Chronic inflammatory bowel diseases (IBD) are inflammatory gastrointestinal disorders that are not limited to the gastrointestinal tract. Various organ systems may be involved, making IBD a systemic disease. ⋯ Early detection of EIM allows targeted therapy and reduces the overall morbidity of the affected patients. Of importance is the fact that EIM can occur in up to 25 % of all IBD patients before the onset of the first Crohn's episode or ulcerative colitis. Therefore, dermatologists, ophthalmologists and rheumatologists should beware of this possible association in EIM and the simultaneous occurrence of intestinal symptoms.
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Easy come, easy go? Current strategies for maintaining the effects of pulmonary rehabilitation in COPD patients Abstract. Pulmonary rehabilitation (PR) is a comprehensive treatment method in the non-drug management of chronic respiratory diseases. Most evident data exists for COPD patients. ⋯ They are still subject of current research. Therefore concrete recommendations are still missing and further studies are necessary. This review aims to give an overview of the existing results in this field.
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Review Comparative Study
[Palliative Sedation: Comments on a controversial topic].
Palliative Sedation: Comments on a controversial topic Abstract. Palliative sedation (PS) is an accepted medical practice for terminally ill patients. It intends the alleviation of unbearable suffering by intentionally lowering the level of consciousness. ⋯ Most ethical controversies are related to the latter form of PS: 1: Is existential or psychosocial suffering a possible indication for PS? 2: What is the earliest possible time point to start PS? 3: The withdrawal or withholding of artificial nutrition and hydration during PS. A critical reflection of these ethical controversial aspects within the treatment team is highly desirable. However, the patient's well-being and the respect for the patient's decisions that are based on experiences which are made only by him or her, must remain the guiding principle for medical actions.
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Acute ischaemic stroke - Update Abstract. Intravenous thrombolysis and / or endovascular therapy are effective and safe in acute ischaemic stroke if patients are selected accordingly. Despite bleeding complications, disability rates may be lowered by treatment. Latest studies investigated intravenous thrombolysis with rt-PA in a treatment window of > 4.5 hours after symptom onset or in case of unknown symptom onset, the application of tenecteplase as thrombolytic agent applied intravenously with and without endovascular therapy, endovascular therapy in a treatment window of > 6 - 24 hours or in case of unknown symptom onset as well as outcome in dependence of general anaesthesia or conscious sedation for endovascular therapy.
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The number of individuals with autoimmune diseases treated with immunosuppressive drugs is increasing steadily. The variety of immunosuppressive drugs and in particular biological therapies is also rising. The autoimmune disease itself as well as the immunosuppressive therapy increases the risk of infection in this population. ⋯ Live vaccines are generally contraindicated under immunosuppressive therapy due to safety concerns. However, specific exceptions apply. Furthermore, certain time intervals for the administration of live vaccines after pausing or ceasing an immunosuppressive therapy should be respected.