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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As staff shortage in intensive care medicine increases, sustainable recruitment and retention of qualified professionals becomes increasingly crucial. Current surveys indicate that sufficient onboarding is a key element to success in this context. ⋯ This paper was developed under the leadership of the Junge DIVI, a multidisciplinary and multiprofessional initiative of young professionals, within the German Interdisciplinary Association of Critical Care and Emergency Medicine (DIVI). It was based on a systematic literature research and consensus-building among various professional groups and disciplines, offering - for the first time - uniform, standardized, practical guidance for implementing structured onboarding for different professionals in intensive care units in Germany.
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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.
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Amyloidosis are rare protein misfolding and deposition diseases which, with very few exceptions, are treatable easily nowadays. The prognosis depends on the form of amyloidosis, which is particularly unfavorable for heart involvement that is diagnosed too late. ⋯ Once the diagnosis has been made, treatment should be started without delay. Amyloidosis centers offer support in the diagnosis and development as well as clinical trials of an optimal therapy concept.