Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jun 2023
[COPD - what has changed in GOLD 2023 and is relevant for clinical practice?].
The annual report of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) is one of the most relevant documents covering prevention, diagnosis and treatment of chronic obstructive pulmonary disease (COPD). The 2023 edition contains a number of changes with impact on clinical practice. For assessment and categorization, a new patient group termed E based on individual exacerbation history has been introduced. ⋯ When there is an indication for ICS therapy, a combination of LABA, LAMA and ICS should be used. For these triple combinations, a significant reduction of mortality could be demonstrated in selected patient populations. GOLD proposes a new definition and assessment of COPD exacerbations focussing on objectively assessible parameters and relevant differential diagnoses.
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Headaches are one of the most frequent causes of consultations in general practice. Of more than 350 known headache tendencies, tension-type headache and migraine are particularly common in general practice. Medication overuse headache (MOH) is also common but rarely diagnosed. ⋯ A detailed neurological examination completes the basic diagnosis. Additional laboratory and instrumental diagnostics follow in cases of atypical headache or clinical suspicion of secondary headache. This article focuses on the diagnosis and treatment of Tension-type Headache, migraine and Medication Overuse Headache.