Deutsche medizinische Wochenschrift
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The physician has to make numerous and legally far-reaching determinations in the course of the post-mortem examination. These can have considerable consequences for relatives and, moreover, for society. Therefore, the correct performance of post-mortem examinations and the correct evaluation of the findings is an extremely responsible task that every physician should master.
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There is robust evidence for the clinical efficacy of telemedicine in heart failure (HF) patients to reduce mortality and morbidity. For the first time, the Federal Joint Committee (G-BA) has approved telemedicine for HF patients as a digital method of care for a well-defined heart failure population. ⋯ The implementation of telemedicine in the German health care system is a complex process including the introduction of telemedical technologies, educational programs for the patients as well as the implementation of standard operating procedures (SOPs) for the staff of telemedical centers. The ongoing research in telemedicine in HF patients is focusing on three issues: a) research to extend the suitable HF-population for telemonitoring; b) research on new telemedical sensor technologies, e.g. a new pulmonary pressure measurement system (Cordella) and a system for wireless measurement of left atrial pressure (V-LAP); c) the introduction of methods of artifical intelligence (AI), e.g. the AI-based speech analysis using a smart phone to characterize the pulmonary fluid status.
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Complement is a central part of the immune system. In the human body, complement is responsible for recognition of infectious microbes, for coordinating the adaptive immune response, controlling homeotic reactions and for the non-inflammatory removal of modified self-cells and infectious microbes. Complement is also closely linked to another proteolytic cascade, the coagulation system. ⋯ In addition, clinical guidelines are developed for Diagnosis and Therapy of complement mediated diseases, new biomarkers are evaluated in clinical studies, and diagnostic guidelines are in development. The recent Covid infections showed a clear link of complement in thrombo inflammation, which ultimately results in kidney damage. These aspects have increased further the focus of complement inhibitors in COVID infections.
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The symptom "headache" is an interdisciplinary clinical picture with multiple differential diagnoses. On the one hand, headache can be a symptom of harmless diseases, on the other hand, it can be an expression of a serious condition with a high-risk potential for the patient. Radiological cross-sectional imaging, laboratory investigations or a diagnostic lumbar puncture are absent in the prehospital setting. ⋯ Recognition of potentially dangerous causes is also essential for mission tactical reasons (target hospital). A reliable distinction is not always possible prehospital, so that in case of doubt, a presentation to the hospital should be made. Therapeutically, the focus is on treatment according to the ABCDE scheme and symptomatic therapy.
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Dtsch. Med. Wochenschr. · Jun 2023
[Drug therapy of the acute migraine attack and prophylaxis of migraine].
Migraine has a prevalence of 10 % in Germany, making it the most common neurological disorder. Migraine is a prevalent disorder not only for neurologist, it's an everyday topic for general physicians and internal medicine as well. ⋯ Medications include beta-blockers, flunarizine, anticonvulsants, amitriptyline or, in the case of chronic migraine, onabotulinumtoxinA. If these drugs are not effective, are not tolerated or contraindicated, monoclonal antibodies against calcitonin gene-related peptide (CGRP) or the CGRP receptor can be used.