Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Oct 2024
Review[Post-thrombotic syndrome - Prophylaxis, diagnostics and complication management].
The post-thrombotic syndrome PTS occurs when a relevant residual thrombus load remains after a deep vein thrombosis and/or the function of the venous valves is disturbed. The knowledge of the different types of PTS generates individualized therapeutic and secondary prophylactic approaches. Immediate compression, movement in compression garments and an effective anticoagulation are crucial for both the prevention and the outcome of post thrombotic syndromes.
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Dtsch. Med. Wochenschr. · Oct 2024
Review[Environmental diagnostics for venous thromboembolism - thrombophilia and tumor screening].
Inadequate treatment of venous thromboembolism can have fatal consequences that are often irreversible. If the indication is given, long-term therapeutic anticoagulation may be necessary to reduce the risk of recurrence for those affected. ⋯ A careful assessment of possible contributing factors is therefore essential. If uncertainty persists, comprehensive environmental diagnostics with regard to thrombophilia or cancer can be helpful.
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Women have a higher lifetime risk of venous thromboembolism (VTE) than men. Hormone-associated risk factors such as pregnancy, contraception and hormone replacement therapy contribute significantly to this. ⋯ Affected women should be informed that the risk of VTE recurrence is increased in a subsequent pregnancy and usually requires VTE prophylaxis with low molecular weight heparin during pregnancy. If the suspicion of recurrent VTE arises during pregnancy, diagnostics must be carried out promptly so that deep vein thrombosis and/or pulmonary embolism can be reliably confirmed or ruled out.
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Dtsch. Med. Wochenschr. · Oct 2024
Case Reports[Emergence of a multidrug-resistant tuberculosis through inadequate treatment of isoniazid monoresistance].
We admitted a 65-year-old patient with suspected reactivation of a pulmonary tuberculosis for further diagnosis. ⋯ Treating tuberculosis, considering drug resistances is crucial. To avoid ineffective therapy, molecular diagnostic methods are recommended, however, cultural testing remains essential. Diagnostic latency, rising rates of drug resistances and lengthy treatment courses contribute to the complexity of treatment. In Germany, specialized outpatient clinics are available since 2014 for diagnosis and treatment of patients with tuberculosis or non-tuberculous mycobacterial diseases, even in the event of mere suspicion.