Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jun 2020
[Acquired immune thrombocytopenia: An update on aspects of diagnosis and management relevant for intensive care medicine].
Acquired thrombocytopenias represent a group of bleeding diseases, which can be mediated by immune or non-immune factors. Acquired immune thrombocytopenia (AITP) leads to an accelerated decrease in platelet count by platelet reactive antibodies arising from several mechanisms. ⋯ The aforementioned disorders are characterized by a severe reduction in platelet count (< 20 × 109/l), which is, with the exception of HIT, associated with high bleeding risk. In this review we provide current insight into recent achievements regarding diagnosis and management of AITP.
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Dtsch. Med. Wochenschr. · Jun 2020
[From a trail to an official path: new recommendations for the treatment of mild asthma].
Accumulating evidence suggests that a symptom-driven therapy with fixed combinations of inhaled corticosteroids (ICS) and formoterol is safer and more feasible in patients with mild asthma than a treatment with short-acting beta-2-agonists (SABA) alone. Therefore, the new international GINA asthma guideline (2019) recommends, for the first time, as needed low dose ICS-formoterol as the preferred controller in treatment step 1. This radical paradigm shift will have a major impact on asthma care in the future.
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Dtsch. Med. Wochenschr. · Jun 2020
[Update diagnosis and therapeutic management of pulmonary embolism].
Pulmonary embolism (PE) is a life-threatening disease and the third most frequent cardiovascular cause of death after stroke and myocardial infarction. The annual incidence is increasing. The recently published 2019 guidelines of the European Society of Cardiology integrate numerous new study findings and provide updated diagnostic and therapeutic algorithms. ⋯ Treatment decision for hemodynamically unstable patients should be made by interdisciplinary Pulmonary Embolism Response Teams. NOACs are recommended as the therapy of choice for anticoagulation of patients with PE. The duration of anticoagulation should be at least 3 months and prolonged anticoagulation should be considered for all patients without a strong triggering reversible risk factor.
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Dtsch. Med. Wochenschr. · Jun 2020
[Federal Act on Participation: Opportunities for people with severe obesity].
Children and adolescents with severe obesity suffer from significant disadvantages in many areas of life. Equal participation in life in society is hardly possible for this group of people. In order to counteract this, it was examined whether children and adolescents with severe obesity are considered disabled under the Social Code. ⋯ The authors agree that children and adolescents with severe obesity, in the most common cases, qualify to claim benefits.
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Dtsch. Med. Wochenschr. · Jun 2020
[Diagnosis and treatment of severe acute pancreatitis in critical care].
Acute pancreatitis is a potentially life-threatening disease that requires intensive care, especially in severe cases. The present article is intended to illustrate the possibilities of a rational diagnosis of acute pancreatitis as well as to provide an overview of the stage-adapted therapy, which includes both conservative measures and interventional interdisciplinary treatment strategies.