Deutsche medizinische Wochenschrift
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Diabetes mellitus is a chronic metabolic disease associated with multiple long-term complications. Besides macro- and microvascular complications, patient's well-being can be severely impaired by complications affecting the nervous system. ⋯ Insufficient glycemic control, young age at diagnosis of diabetes are discussed as risk factors for developing diabetes complications. The early identification and prevention of factors predicting diabetes complications that affect the nervous system are still challenging and in need for further research.
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Acid-base disorders due to different etiologies are frequently encountered in daily clinical practice and may result in life-threatening situations. Basic knowledge of the diagnostic and therapeutic approach of acid-base disorders is therefore essential for every clinician. ⋯ Undirected buffering with HCO3- should be avoided, since the application of HCO3- might lead to severe side effects. A strict diagnostic pathway for the diagnosis of acid-base disorders is required, which should be vigorously applied:- analysis of the pH to classify acidemia or alkalemia- analysis of pCO2 and HCO3- to classify the primary acid base disorder- analysis of the adequate regulation in order to detect additional acid-base disorders- analysis of the anion gap and the relationship of the anion gap vs. the change in HCO3- to detect further metabolic disordersMetabolic acidosis can be divided into two main etiologies:- acidosis with addition of acid with increased anion gap,- acidosis with loss of HCO3- with normal anion gap.
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Dtsch. Med. Wochenschr. · Nov 2020
Review[The Gastrointestinal Tract in Intensive Care Medicine - Overview 2020].
Gastrointestinal dysfunctions and failure are common clinical incidents in critically ill patients, which are recognized as both, primary and even more often as secondary diagnoses as consequence of an already existing disease or as a corollary of intensive care treatment. These functional complications may aggravate into life-threatening emergencies and are highly associated with prognosis and increased mortality. This article gives an overview about the pathophysiology, diagnostics and therapy of three very relevant current topics in intensive care medicine: prophylaxis and management of gastrointestinal bleeding, gastrointestinal motility and absorption disorders as well as different forms of liver dysfunctions.
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Dtsch. Med. Wochenschr. · Nov 2020
[Magnesium: Relevance for general practitioners - a position paper of the Society for Magnesium Research e. V.]
Magnesium deficiency is to be expected in the population and particularly among risk groups. Magnesium deficiency can cause numerous symptoms, is per se pathological and thus requires treatment. Diagnostics is based on clinical symptoms in conjunction with anamnestic criteria and laboratory parameters. ⋯ Physicians should pay more attention to magnesium in order to avoid deficits as a cause for multiple symptoms and risk factor for diseases. Optimisation of magnesium status may make an important contribution to the prevention of diseases. Oral magnesium therapy is safe and cost effective.