Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Mar 2020
Review[Diagnostics and Treatment of indeterminate Biliary Stenoses].
Biliary stenoses represent a differential diagnostic challenge. Diagnostic methods to clarify the underlying dignity are often invasive, and provide high specificity beside insufficient sensitivity. In many cases, an accurate diagnosis is only possible over time, and therefore limits curative treatment options. This article provides an overview of the diagnostic challenges and treatment options for unclear biliary stenosis.
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Community-acquired pneumonia (CAP) is one of the most common infectious diseases worldwide. To reduce the high morbidity and mortality of CAP, appropriate diagnosis, risk stratification and therapy are necessary. This review summarizes the current recommendations for the management of CAP in Germany. ⋯ A reevaluation in the first 48-72 hours is mandatory. A therapy duration of 5-7 days is usually sufficient. Preventive influenza and pneumococcal vaccination and nicotine withdrawal are important.
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Dtsch. Med. Wochenschr. · Mar 2020
Case Reports[Dermatomyositis associated with rapid progression of pulmonary involvement].
In this case series we present three patients with autoimmune dermatomyositis or polymyositis with rapid-progressive interstitial pulmonary involvement. Despite intensive escalation of the immunosuppressive therapy the patients developed acute respiratory distress syndrome with lethal outcome only a few months after diagnosis. ⋯ Dermatomyositis and polymyositis are rare autoimmune diseases with variable clinical manifestations and several different antibody constellations. In particular the presence of anti-MDA5 antibodies is associated with progressive pulmonary involvement, complicated progression and poor prognosis.