Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Sep 2024
Comparative Study[Comparison of LDL cholesterol serum concentrations in patients after acute coronary syndrome between 2018 and 2022 in Germany and Europe].
ESC/EAS guidelines for the management of dyslipidemia after acute coronary syndrome (ACS) were updated in 2019 with lower LDL cholesterol (LDL-C) goals. Their effect on LDL-C lowering in Germany and across Europe is not known. The EuroPath IV survey was designed to compare the lipid management in patients post ACS in the year 2022 with 2018. ⋯ Achievement of LDL-C goals improved after the update of the ESC/EAS lipid guidelines in 2019 but LDL-C goal achievement remains still very low. Even less patients in Germany achieved the LDL-C goals compared to other European countries.
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Dtsch. Med. Wochenschr. · Sep 2024
Review[Small intestinal bacterial overgrowth (SIBO) - Therapy, nutrition, microbiome].
SIBO (small intestinal bacterial overgrowth) is defined by bacterial overgrowth or colonization of the small intestine in combination with gastrointestinal symptoms such as bloating, nausea, pain, diarrhoea, malabsorption and food intolerance. SIBO can be caused by various mechanisms such as reduced intestinal motility, altered gastrointestinal anatomy, reduced gastric acid or pancreatic enzyme production, altered bile acid metabolism, or immune defects. Accordingly, SIBO often develops secondary to different underlying diseases. ⋯ However, both aspects have so far been insufficiently investigated. Nevertheless, elemental diets, carbohydrate-reduced diets, as well as pre- and probiotics are potential therapy options. This article provides a summary of current knowledge on the pathophysiology, diagnosis and treatment of SIBO, with particular emphasis on the role of nutrition and the microbiome.
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Pain in the musculoskeletal system and therefore joint pain is one of the most common reasons for consulting a general practitioner (GP). Inflammatory rheumatic diseases are among the important differential diagnoses. ⋯ This article presents the first differential diagnostic steps that make it easier for the GP to make further treatment decisions. Physical examination, laboratory diagnostics and imaging are discussed, and the concept of "clinically suspect arthralgia" as well as the possible effects of treatment trials with glucocorticoids are presented.