Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Sep 2004
[Prehospital treatment of the acute coronary syndrome in the emergency medical services in Bavaria].
Regarding patients suffering from cardiovascular diseases, the most common reason for call-outs of German emergency physicians is in 37.2 % of cases, the acute coronary syndrome (ACS). Despite substantial improvements in diagnosis and therapy a reduction of mortality rate has not been documented. ⋯ Structural and logistic conditions for an early care in Bavaria are provided for prehospital treatment of patients with ACS. However, life support provided by paramedic personnel and medical therapy by the emergency physician still can be improved. The actual protocol of emergency physicians does not provide a complete view of the prehospital medical care.
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Dtsch. Med. Wochenschr. · Sep 2004
Comparative Study[Characterization of medical and neurological care of stroke patients. An analysis of the data from the project, "Safeguarding Quality in Stroke Care," of the Regional Medical Council of Baden-Württemberg].
Patients with stroke are treated in either medical or neurological units. This study investigated whether the two cohorts differ regarding their demographic composition, previous diseases, severity of the stroke and comorbidity. ⋯ Patients after an acute stroke treated in medical wards differ significantly from those in stroke units by being older. Previous diseases and acute neurological deficits are more common, independent of age, and they are more disabled at discharge.
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Dtsch. Med. Wochenschr. · Sep 2004
Case Reports[Rare pulmonary manifestation of an intracranial meningothelial meningioma].
A 53-year-old sailor was admitted to our department with the history of severe headache, dysphasia and mild psychotic behavior. Routine chest X-rays several weeks before had shown a focal lung lesion in the lower lobe of the right lung. The patient was without pulmonary symptoms. ⋯ Pulmonary metastases of benign intracranial meningiomas are rare but should be considered in the differential diagnosis, especially in cases with an undiscovered primary tumor.
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Dtsch. Med. Wochenschr. · Sep 2004
[Iron replacement in hemodialysis patients with a normal serum ferritin level].
Iron deficiency limits the efficacy of recombinant human erythropoietin (rhEPO) therapy in end-stage renal disease patients. Therefore it is essential that serum ferritin levels should be maintened > 200 micro g/l. Functional iron deficiency occurs with serum ferritin levels > 200 micro g/l and transferrin saturation (TFS) lower than 20 %. The purpose of this study was to determine the efficacy of iron therapy in dialysis patients with serum ferritin levels higher than 200 micro g/l. ⋯ Consistent intravenous iron therapy in combination with subcutaneous rhEPO had a rapid effect on the correction of anemia in patients with even optimal serum ferritin levels receiving chronic hemodialysis. There was no difference between patients with low, barely adequate and optimal TFS. It is concluded that there is a need for consistent intravenous iron therapy also in hemodialysis patients with optimal serum ferritin levels to correct anemia.