Deutsche medizinische Wochenschrift
-
Abdominal pain is one of the most common complaints that lead to an emergency department visit. Depending on the interpretation of the definition, 20-40 % of these patients present with an acute abdomen. This term summarizes a variety of diseases that often occur in the abdominal cavity, mostly acute, and can be accompanied by symptoms such as nausea and vomiting. ⋯ The goal must be to move from symptom-based to causal therapy as quickly as possible and to clarify whether a patient needs to be referred to an emergency operation or whether there is time for further differential diagnostic measures. The prognosis of the acute abdomen often depends on the time latency until the definitive therapy is initiated. Rapid and determined action by the experienced initial examiner are important prerequisites for a favorable course of the disease process.
-
Hyponatremia is a common condition affecting hospitalized and ambulatory patients as well. The clinical spectrum of hyponatremia can range from asymptomatic laboratory findings to severely symptomatic conditions such as acute epileptic seizures. ⋯ As hyponatremia can be a potentially life-threatening condition, it requires an efficient management with the goal of identifying the etiology and to subsequently provide adequate treatment, while avoiding treatment-related adverse effects such as overcorrection and pontine myelinolysis. This article summarizes the pathophysiology and differential diagnosis, as well as useful diagnostic tests and therapy of hyponatremia in a practice-oriented manner.
-
Dtsch. Med. Wochenschr. · Oct 2020
[Abdominal Emergencies in The View of an Intensivist - Intra-abdominal Hypertension and Abdominal Compartment Syndrome].
In critically ill patients an intra-abdominal hypertension is a common phenomenon. An IAH is defined as an IAP persistent ≥ 12 mmHg, an abdominal compartment syndrome is defined as an IAP persistent ≥ 20 mmHg in combination with new organ failure. ⋯ The bladder pressure should be measured in a standardized manner. The therapy of IAH should be individualized.
-
Recommendations for vaccination of patients with rheumatic Diseases. Patients with rheumatic diseases are particularly at risk from infections. ⋯ Important new developments, such as sequential vaccination against pneumococcus or the approval of a vaccine against Herpes Zoster, improve the possibilities of an effective infection protection. Special attention must be paid to the current recommendations for the use of live vaccines like MMR vaccination in patients under immunosuppressive therapy.