Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Mar 2024
[A desperate family member. Suggestions for a successful interaction].
In everyday clinical practice relatives are often perceived as an additional burden, as a problem. Relatives appear, for example, to be overwhelmed, desperate, (co-)affected, demanding, or in some cases even (verbally) abusive. ⋯ Such judgements are often made intuitively and without reflection and are therefore a permanent obstacle to further communication on the ward. This article is therefore intended to provide a deeper understanding of the situation of distressed relatives and to show ways of achieving a successful relationship with these relatives.
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Dtsch. Med. Wochenschr. · Mar 2024
[Current therapeutic standards in advanced soft tissue sarcomas].
Soft tissue sarcomas account for less than 1% of tumors in adults. With more than 80 different subtypes and often dismal prognosis, treatment of patients with soft tissue sarcomas is diagnostically and therapeutically complex. In patients with localized disease, surgery remains the mainstay of therapy. ⋯ In patients with disseminated metastatic disease, chemotherapy with anthracyclines remains the backbone of therapy. Immune checkpoint inhibitors have proven to be effective for patients with alveolar soft part sarcoma and targeted therapies with NTRK-inhibitors should be evaluated in patients with NTRK-fusions. This article focuses on current standards and developments in the treatment of soft tissue sarcomas.
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Dtsch. Med. Wochenschr. · Mar 2024
[Diagnostic stewardship in outpatient and hospital medicine with focus on microbiological urinary and bloodstream diagnostics].
Targeted infection diagnosis supports decision-making in the rational use of antibiotics usually encompassed as Antibiotic Stewardship (ABS). Similar to ABS, the term "Diagnostic Stewardship" (DGS) is suggested, whereas DGS includes, beneath general, predominantly microbiological infection diagnostics - with specific pathogen detection, conventional via culture or immunology, increasingly also using molecular biological methods. Especially in microbiology, pre-analytics, analytics and post-analytics play an essential role. Pathogen characterization is accompanied by an antimicrobial susceptibility test (with S-I-R classification), which deserves special attention, especially in the context of ABS. All of these aspects are dealt with in this work and represented using two practical examples of urinary and bloodstream diagnostics that are relevant for outpatients and inpatients.
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Dtsch. Med. Wochenschr. · Mar 2024
[Clinical courses and costs for hospitalizations of potentially immunocompromised COVID-19 patients in Germany].
Patients at increased risk of inadequate immune response to COVID-19 vaccinations due to their underlying disease or therapy are potentially vulnerable to severe COVID-19 courses. The aim is to assess the population size, clinical courses and hospitalization costs of these patients in Germany. ⋯ The risk group is vulnerable to COVID-19 and requires additional resources in the German hospital sector. This results in a need for further protective measures. Further studies are needed to evaluate the impact of different viral variants, active and passive immunizations, and therapies on clinical COVID-19 courses and their costs.