Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Nov 2020
Case Reports[Sudden exercise dyspnea in a young woman - an interdisciplinary case in the emergency room].
A 39-year-old woman with suddenly occurring exercise dyspnea is admitted under the suspicion of pulmonary embolism. In medical history, she mentions a recently completed fertility treatment. ⋯ OHSS is primarily a gynaecological condition, but physicians may encounter it with exercise dyspnea or abdominal pain as presenting symptoms. Symptoms can be treated well at an early stage, and severe courses can usually be prevented. In this case, clinical history and sonography could disprove the initially suspected diagnosis of pulmonary embolism.
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Inadequate antibiotic prescribing has been observed in many settings both in hospitals as well as in primary care. Most often there is uncertainty about the indication for antibiotic treatment itself, prescribers are reluctant to deescalate, and therapy duration is too long which results most often in overprescribing. ⋯ Over- but also underprescribing of antimicrobial agents is a serious patient safety issue that needs to be addressed in specific programmes at different levels of the healthcare system. Interventional studies have shown that programmes implementing or intensifying audit and feedback with clinical reevaluation by experts can be very efficient to reduce inadequate prescribing.