Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · May 2021
[Interdisciplinary aspects of oral anticoagulation with NOACs in atrial fibrillation].
Stroke prophylaxis with non-vitamin K-dependent oral anticoagulants (NOAKs) in patients with non-valvular atrial fibrillation (nvVHF) is now firmly established in routine clinical practice. The definition of nvVHF includes the absence of a mechanical heart valve and AF not associated with moderate- or high-grade mitral valve stenosis. ⋯ Not least for this reason, uncertainties are repeatedly observed in practice, which can have far-reaching consequences for the individual patient. For this reason, a committee consisting of representatives from general medicine, geriatrics, cardiology, nephrology and neurology has gathered to identify aspects of practical relevance from the various disciplines and to jointly develop practical guidelines to improve therapy safety for patients in everyday life.
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Dtsch. Med. Wochenschr. · May 2021
[The conservative emergency room - care of acutely critically ill non-trauma patients].
Treatment of critically ill non-trauma patients is challenging, due to the broad spectrum of underlying diseases in this clinical setting. It has been shown that outcome in these patients is poor due to high age, comorbidities and severeness of acute disease. In most cases it is crucial to establish diagnosis and start specific treatment immediately to improve patients' outcome. ⋯ Subsequent patient management can be organized using the primary and secondary survey. These aim to detect and treat life threatening pathologies first and, within a second step, to expand the diagnosis and therapy according to the individual case. Special focus should be put on communication, using crew resource management training, and on the provision on an open and constructive approach to making mistakes.
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Dtsch. Med. Wochenschr. · May 2021
[Cystic cervical lymph node swelling - Thyroglobin-FNA allows to diagnose metastasizing papillary thyroid carcinoma].
A patient presented with a cystic mass in the lateral triangle of the neck. ⋯ Swelling of the cervical lymph nodes may have many causes, and rarely may be the metastasis of a thyroid carcinoma. We present a simple way to detect lymphatic metastatic thyroid carcinoma with the help of a case report.
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Dtsch. Med. Wochenschr. · May 2021
[Died from or with dementia? The relationship between dementia and cause of death].
Specifying a singular specific cause of death or an appropriate causal chain in the death certificate can be challenging, especially in cases of elderly, multimorbid deceased persons. The German cause of death statistics suggest that mental illnesses, including dementia, are beneath the most frequent causes of death. ⋯ These recommendations are not only to be seen against an academic background. The correct registration of dementia in the causes of death statistics may be a basis for decision making in health politics and is hence in the interest of optimal patient care.
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The review summarizes the management and therapy of cirrhosis. Special focus is made on the complications of cirrhosis, like variceal bleeding, ascites, renal failure and hepatic encephalopathy.