Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Apr 2023
[Ultrasound diagnostics: Differentiated vision - upgrading - better reimbursement].
Ultrasonography is an imaging modality of great importance in everyday clinical practice. Technical innovations continuously expand the diagnostic and therapeutic possibilities of ultrasonography requiring continuous upskilling of sonographers. Only a small number of practitioners, in hospital and practice settings in Germany, currently have the required level of skills. ⋯ A modern high-end ultrasound scanner in the hands of a qualified sonographer is a diagnostic high-tech precision instrument, which can compete with any other imaging modality. In conclusion, basic sonography, as it is currently practised should be separated from high-end sonography, requiring extensive training and better remuneration. In this context the introduction of a new medical board speciality for ultrasonography, "Advanced Ultrasonography", with corresponding upgrading should be recommended for high-end sonography.
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Dtsch. Med. Wochenschr. · Apr 2023
Observational Study[Treatment and LDL cholesterol adjustment in patients with high and very high cardiovascular risk in Germany compared with Europe - data from the SANTORINI registry].
Current 2019 ESC/EAS guidelines for the management of dyslipidemia recommend LDL cholesterol (LDL-C) goals according to the patients' cardiovascular (CV) risk. SANTORINI is the first large European observational study since the 2019 guidelines to assess whether lipid management in patients at high and very high CV risk has improved. ⋯ The 2019 ESC/EAS guideline recommendations are only implemented in a minority of patients. The study identifies opportunities for improvements in the prevention of CV diseases in Germany.
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Dtsch. Med. Wochenschr. · Apr 2023
[Diagnostic delaying factors in hepatic alveolar echinococcosis].
The purpose of this study was to analyze the diagnostic workflow of patients with alveolar echinococcosis (AE) and to identify possible diagnosis-delaying factors. ⋯ The diagnostic clarification process of AE patients is lengthy and stressful. The psychological burden of a questionable malignant diagnosis is considerable. Early use of contrast-enhanced sonography and, if necessary, puncture of unclear hepatic masses helps to shorten the difficult diagnostic process.
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Dtsch. Med. Wochenschr. · Apr 2023
[Clinical use of psychotropic drugs: A look at antipsychotic drugs].
Antipsychotic drugs were originally developed to treat the positive symptoms of schizophrenia (e.g., delusions, hallucinations). Nowadays, antipsychotic drugs are also commonly used in the treatment of geriatric patients, especially those suffering from dementia. When treating behavioural symptoms of dementia, the use of antipsychotic drugs should not be first choice and when they do present the best treatment option, they should not be used long-term. ⋯ In the following, the use of antipsychotic drugs in the treatment of schizophrenia and behavioural symptoms in dementia according to the respective treatment guidelines will be explained. In addition, the pharmacological receptor profiles of frequently used antipsychotic drugs (e.g., risperidone, haloperidol, quetiapine, aripiprazole) are presented and the expected adverse drug reactions, such as extrapyramidal symptoms and hyperprolactinemia, are explained. Treatment options of the most common adverse drug reactions associated with antipsychotic drugs are also presented.