Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jan 2021
Case Reports[Celebrations with consequences: fever, dyspnea and chest pain].
We report on a 35-year-old male patient who presented to the emergency department a day after celebrations. The night before, the alcoholized patient tried to spit fire with an oily fuel paste. A fever, dyspnea and chest pain were present. ⋯ Aspiration of oily fuel paste led to lipoid pneumonia. Few such cases have been described so far, but the medical history, symptoms and radiological imaging are very characteristic. Antibiotic therapy is not primarily necessary, however, depending on the clinical condition may help to prevent bacterial superinfection. The administration of systemic steroids is controversial in this situation.
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Pharmacogenomics (PGx) is a key component of personalized medicine to improve clinical outcome of drug therapy and/or to avoid adverse drug reactions. Major efforts are currently spent internationally to implement PGx diagnostics into clinical practice. Evidence-based recommendations for dose-adjusted treatment which are established by international expert groups covering clinical and pharmacological expertise are publicly available. Clinical relevant examples for PGx diagnostics such as genetic testing for dihydropyrimidin-dehydrogenase and thiopurin-S-methyltransferase, as well as for various cytochrome P450 enzymes are summarized to promote the clinical implementation process of PGx in Germany.
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Dtsch. Med. Wochenschr. · Jan 2021
Historical Article[The early phase of the COVID-19 pandemic in Bavaria, Germany].
The effect of non pharmacological interventions (NPIs) during an epidemic disease outbreak is well accepted dating back to historical events. NPIs involve numerous measurements like hygiene rules or contact restriction that are applied during given situations, while so far only limited quantitative data exist to rate the overall effectiveness. ⋯ To be effective, NPIs need to applied early, if possible even before the beginning of the exponential phase.
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Dtsch. Med. Wochenschr. · Jan 2021
Case Reports[Retrorectal teratoma (dermoid cyst) of an adult - Diagnosis and treatment based on an example of a case report].
A 29 year old woman was introduced to the surgical department with a history of pain in the lower lumbar spine. ⋯ Retrorectal Tumors not associated with the rectum in the small pelvic are rare. These tumors should be surgically removed.
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The updated guidelines for the management of dyslipidaemias 2019 sticks to the concept of individual risk-based intervention strategies, but intensifies LDL-C goals. Next to the established SCORE system non-invasive imaging techniques such as coronary CT or ultrasound of carotid or femoral arteries are now recommended for improved risk stratification. Screening for lipoprotein(a) identifies persons at higher cardiovascular risk. ⋯ Cardiovascular risk reduction depends on the absolute lowering of LDL-C, duration of therapy and the individual cardiovascular risk. For patients at very high risk the new LDL-C goal is < 1.4 mmol/l (55 mg/dl) and reduction of ≥ 50 % from baseline. The overall aim is to reduce "cholesterol life years".