Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Apr 2022
Case Reports[BCG-therapy as a rare reason for postrenal failure].
In the following case report, we describe a patient with acute renal failure due to an urinary congestion level II-III under BCG-(Bacillus Calmette-Guérin)-therapy because of bladder cancer. Cystoscopy revealed the diagnosis of BCG-induced intramural narrowing of distal ureters bilaterally. ⋯ Although postrenal failure is relatively rare (5 %), also seldom causes such as medication-induced (e. g. BCG) ureter stenosis has to be included into the differential diagnosis.
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Dtsch. Med. Wochenschr. · Apr 2022
[Lower back pain in the primary care setting - Non-specific and specific pain].
A systematic survey of the symptoms of back pain in terms of triggering event and onset, nature and the extent of influenceability of the pain (lying or standing, under stress, nocturnal pain, localized percussion tenderness, B- symptoms, etc.), as well as structured clinical examination (segment height, radiance, projection, reflex status, sensitivity and motor function) allows an initial and therefore orienting classification of back pain as non-specific or specific. In the primary care setting many patients can be treated extremely effectively and economically from a cost perspective. In addition to the fastest possible pain relief, it is important to prevent the disease becoming chronic. ⋯ Causes of specific back pain include: fractures, infections, radiculopathy, tumors, axial spondylarthritis as well as extravertebral causes. In the further cause of treatment, it may be necessary to consult medical specialists in the fields of radiology, orthopedics, neurology, neurosurgery, rheumatology, psychotherapy, psychiatry, among others. Treatment is managed by the primary care provider, who should also receive and re-evaluate all findings during the course of the disease.
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Dtsch. Med. Wochenschr. · Apr 2022
[The views of cancer out-patients on the impact of the COVID-19 pandemic].
This study investigates current needs and psychosocial burden of out-patients with cancer during the COVID-19-Pandemic. ⋯ Corona-specific distress of cancer patients relates in particular to the course of therapy, but also to a possible overload of the health care system. Oncology care teams should allow space for questions from their patients, acknowledge possible uncertainties, provide emotional support, and draw attention to reliable sources of information.
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Dtsch. Med. Wochenschr. · Apr 2022
Case Reports[Neutralizing monoclonal antibodies in COVID-19: a case series in general practice].
Neutralizing monoclonal antibodies (mAB) against SARS-CoV-2 reduce the severity of COVID-19 in patients with risk factors. Early administration at the onset of infection is critical for their efficacy. At this early stage of the disease, family physicians are often the first help for patients and thus central to the further course of the disease. To date, however, mAB have only rarely been used in general practice. The purpose of this case series is to demonstrate that the administration of mAB is safely feasible in the primary care setting. ⋯ Neutralizing mAB can be administered safely and with manageable effort in primary care setting and can help prevent a severe course and hospitalization in patients with COVID-19 and risk factors.
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Dtsch. Med. Wochenschr. · Apr 2022
Case Reports[First clinical manifestation of chronic hepatitis C in painless progressive atrophic monoparesis of the right leg].
A 60-year-old male patient was admitted with a painless reduction in the circumference of the right calf with mild gait disturbance that had been increasing for 6 months. Neurological findings included atrophic monoparesis of the right lower leg with preserved muscle reflexes without sensory disturbances. ⋯ Chronic hepatitis C may be rarely associated with painless progressive monoparesis. With regard to pathogenesis, the significance of CSF requires further studies.