Deutsche medizinische Wochenschrift
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Sarcopenia is characterized by a generalized loss of muscle function, strength and mass and is codable in Germany since 2018 in the ICD-10-GM (M62.50). For screening in primary care, it is possible to determine muscle function and strength by means of a sarcopenia questionnaire (SARC-F) as a self-filler with 5 questions of restrictions. With an increased score of 4 and higher, an examination of the musculature and a determination of the skeletal muscle mass index should be performed via dual energy X-ray absorption measurement (DXA) or bioelectric impedance analysis (BIA). ⋯ The severity of the disease is defined by additional examinations such as gait speed, timed up and go test (TUG) and/or short physical performance battery (SPPB). Patients with sarcopenia suffer from increasing immobility and disability and have an increased risk of falls, fractures and mortality. Frequently, co-morbidities should be clarified in all affected patients.
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Dtsch. Med. Wochenschr. · Sep 2020
[Contract of the German Health Insurance AOK Hessen Concerning Prolonged Weaning-Methods and First Experiences].
In recent years, the number of patients requiring mechanical ventilation has increased steadily. In some cases, weaning is not successful. These patients depend on home mechanical ventilation and intensive outpatient care. Surprisingly, most of these patients were never treated in a weaning center. Thus, weaning might still be possible in at least some of them. Health insurance companies have recognized this problem. ⋯ In this paper, we introduce the concept of the home care ventilation centers. Initial data suggests that home care ventilation centers can contribute to successful weaning.
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Dtsch. Med. Wochenschr. · Sep 2020
[Current ESPEN Guideline Clinical Nutrition and Hydration in Geriatrics].
Malnutrition, dehydration and obesity are relevant health problems with far-reaching consequences for older people. Routine screening for malnutrition and dehydration should be carried out in order to identify vulnerable and affected persons at an early stage and to be able to take timely countermeasures. ⋯ An ingestion deficiency dehydration should be diagnosed on the basis of serum osmolality and requires a rapid compensation of the deficit by hypotonic fluids - depending on the severity, in the form of drinks, subcutaneously or intravenously. Weight loss in old age should only be considered in cases of obesity with associated health problems and should be achieved by moderate energy reduction in combination with physical exercise.