Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Mar 2022
[Novel European Heart Failure Guidelines - Change in Treatment Paradigms].
NEW DRUG THERAPY ALGORITHM FOR HEART FAILURE WITH LVEF ≤ 40 %: The new Heart Failure Guidelines 2021 recommend a fundamentally new treatment algorithm for heart failure (HF) with reduced ejection fraction ≤ 40 % (HFrEF). This involves, that all four mortality reducing substances (ARNI or ACE-Inhibitor, Betablocker, MRA und SGLT-2-Inhibitor) are given as fast as possible. The conventional sequence with stepwise uptitration is no longer recommended.
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Amelanotic melanoma (AM) is a subtype of melanoma characterized by a diminished or lacking melanin synthesis. AM, especially ulcerated variants of the plantar region (AMP), are often clinically misdiagnosed, leading to a delay in treatment initiation. ⋯ AMP shows a variety of clinical presentations and particularly elderly patients with many accompanying medical conditions are in danger of incorrect clinical diagnoses. Therefore, we recommend to biopsy any amelanotic plantar ulcer or tumor that does not respond to treatment within 6 weeks to rule out AM.
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Dtsch. Med. Wochenschr. · Mar 2022
[Loss of information in cross-sectoral treatment: causes and solutions].
Missing information on patients and their medication is a leading cause of medication errors and preventable harm. The TOP Projects uses pharmacy claim data and electronic decision support to improve quality and safety of care on hospital admission. In a survey 100 % of responding hospitals in Germany consider this approach helpful and important to improve availability of necessary information and medication safety and to reduce workload.
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The prevalence of Parkinson's disease (PD) will double by 2030. PD is no longer regarded as a single disease entity. Monogenetic forms may appear clinically identical to sporadic PD. ⋯ Patients who need levodopa more than 5 times a day and who have severe, disturbing OFF phases (> 2 hours a day) despite optimal non-levodopa-based treatment can consider these options. PD stage and symptom-focused, guideline-based physiotherapy has a positive effect on the course of the disease, everyday performance and quality of life and reduces the risk of falling. Multidisciplinary networks are proving effective in reducing falls and hospital admissions.