Deutsche medizinische Wochenschrift
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The heart is closely connected with the endocrine system. On the one hand, the heart is an endocrine organ itself and produces several hormones like atrial and brain natriuretic peptides. On the other hand, cardiac structures are targets of many hormones like catecholamines, thyroid hormones, and corticosteroids. ⋯ In this article, we describe three instructive clinical cases of patients with hormonal disorders that mimicked cardiovascular disease. Furthermore, we shortly discuss useful diagnostic and treatment algorithms. All cases emphasize the value of interdisciplinary management of patients with cardiac symptoms.
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Dtsch. Med. Wochenschr. · Mar 2021
[Non-dialysis chronic kidney disease in primary care - a questionnaire study among general practitioners].
The majority of patients with non-dialysis chronic kidney disease are cared for by general practitioners. Especially for Germany, the evidence of this topic is still very low. The aim of the survey was to estimate the perceived frequency of non-dialysis chronic kidney disease in general practice, the use of diagnostics and therapy, used tools considering the professional background and experience of the responding general practitioners. ⋯ · General practitioners estimate the prevalence of non-dialysis chronic kidney disease in their practice at 6-15 %.. · Using the albumin/creatinine-ratio for proteinuria diagnostics is requested too rarely compared to the urine dipstick test.. · General practitioners, specialists in general medicine and internists working in general medicine have a comparable level of competence to treat patients with non-dialysis chronic kidney disease.. · Working experience is an important factor in choosing tools, especially guidelines..
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Dtsch. Med. Wochenschr. · Mar 2021
[Care of patients with chronic heart failure: an interdisciplinary challenge].
The diverse manifestations of heart failure led to complex treatment guidelines and care scenarios and therefore always require an integrated, multidisciplinary care approach. Patients with chronic heart failure suffer from a large number of cardiac and noncardiac comorbidities. For example, iron deficiency leads to decreased performance and exertional dyspnea and should be diagnosed. ⋯ ARNI and SGLT-inhibitors expand the pharmacotherapeutic possibilities and gain in importance. The constant development of diagnostic possibilities and therapeutic options must be implemented consistently into the care continuum in order to have a lasting effect. The challenge of interdisciplinary coordination can be significantly reduced through jointly agreed process logs (e. g. within the framework of integrated supply contracts or a Heart Failure Unit Network).
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Dtsch. Med. Wochenschr. · Mar 2021
[Oro- and nasopharyngeal swab for detection of SARS-CoV-2 - step-by-step approach].
Oro- and nasopharyngeal swab specimens by quantitative reverse-transcriptase polymerase chain reaction (RT-PCR) to detect SARS-CoV-2 is currently the main diagnostic tool during the ongoing COVID-19 pandemia. Accurate performance of the procedure to avoid false negative results, adequate personal protective equipment and material sparing algorithms are mandatory while obtaining swab specimens. In the current stey-by-step review a feasible approach will be presented.
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Dtsch. Med. Wochenschr. · Mar 2021
Case Reports[Unusual presentation of late reactivated tuberculosis in immunosenescence after nine decades latency].
Tuberculosis is an often underestimated infectious disease which can lead to manifest infections even after years of latency. Pulmonary manifestations are by far the most frequent, although any other organ can be equally affected. ⋯ Tuberculosis, primary or reactivated, should always be considered as a potential cause of unclear infections; especially in patients with anticipated immunosenescence.