Deutsche medizinische Wochenschrift
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The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has stated that pulmonary rehabilitation (PR) is the most effective therapeutic intervention to reduce dyspnoea and to improve physical performance and quality of life for patients with obstructive lung disease. New innovative studies raised in the area of PR:1) Pulmonary fibrosis & asthma bronchiale - While PR is recommended for chronic respiratory diseases other than COPD (chronic obstructive pulmonary disease) in the respective disease-specific treatment guidelines, PR in some pathologies is underrated. For example, there is a growing body of evidence showing the effectiveness of structured and multidisciplinary PR programs in pulmonary fibrosis and asthma bronchial patients;2) Coronavirus SARS-CoV-2 - There is preliminary evidence that COVID-19 patients can benefit from a PR program. The current COVID-19 position paper of the German Respiratory Society e. V. (DGP) regarding PR recommendations suggests that early rehabilitative therapies are already indicated during hospitalisation on the normal or intensive care unit and that rehabilitative interventions should be continued after discharge as a follow-up treatment in PR centres in order to reduce long-term consequences of COVID-19 disease;3) Telehealth meets PR - To further improve the effectiveness of PR in COPD patients using recent technologies, a supplementary "digital exercise program" can contribute to greater benefits compared to PR alone.
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Dtsch. Med. Wochenschr. · Dec 2020
Case Reports[Aspiration pneumonia after ingestion of kerosene - lamp oil is not a remedy].
We present the case of a 78-year old man, who developed aspiration pneumonia and consecutive sepsis after ingestion of a small amount of kerosene. ⋯ Psychiatric consultation may be helpful to diagnostically contextualize behaviour suggesting a mental illness.
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Dtsch. Med. Wochenschr. · Dec 2020
Review Historical Article[Franciscus Sylvius: A Life for Clinic, Research, Teaching And a Little Gin].
Franciscus Sylvius, latinized from Franz de le Boë (*15 March 1614 in Hanau; † 14 November 1672 in Leiden), was a Hessian-Dutch physician, anatomist, and natural scientist of Flemish descent. He was an important clinician and iatrochemist, and is considered the founder of scientifically oriented medicine and clinical chemistry. Sylvius introduced the concept of affinity and dealt with digestive processes and body fluids. ⋯ For heartburn and digestive disorders, Sylvius mixed juniper berries, herbs and alcohol to create a medicine. According to legend, Sylvius marketed this medicine as Genever, for which the name Gin was later adopted in the British Isles, but not only used for medical purposes. Accordingly, the city of birth of Sylvius today calls itself a "birthplace of gin".
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Dtsch. Med. Wochenschr. · Dec 2020
Review[Therapeutic drug monitoring of antiinfectives in intensive care unit patients - what's new?]
Pharmacokinetic and pharmacodynamic changes in intensive care unit patients can increase the risk for therapeutic failure or adverse effects of anti-infective therapy. Therapeutic drug monitoring (TDM) can inform required dose adaptions. The present article reviews the current practice and outlines modern approaches for decision making such as model-informed precision dosing software using the area-under-the-concentration-time-curve as target in favor of simplistic decision making based on trough concentrations. Moreover, the current recommendations for performing TDM of beta-lactams, aminoglycosides, linezolid, glycopeptides and voriconazole are concisely summarized.
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Dtsch. Med. Wochenschr. · Dec 2020
Review[Placebo Effect - The Benefit of "Nothingness" in Pain Therapy].
For a long time considered ineffective, placebos nowadays have an accepted role in studies as well as clinical practice. The identification of psychological as well as neurophysiological mechanisms helped to conceptualize and legitimize the placebo effect. ⋯ Consequently, the benefits of a thoughtfully applied placebo effect are increasingly being exploited. This article reviews the concept and current understanding of the placebo effect and depicts its use in the field of pain management.