Deutsche medizinische Wochenschrift
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We report the case of a 27-year-old Syrian patient who came to the emergency department with a syncopal episode. No medical history could be raised due to a language barrier and so the clinical presentation was leading. ⋯ Obscure clinical symptoms alongside signs of shock, should always considered to be an allergic reaction in absence of sepsis or hemorrhage. In anaphylaxis, echinococcosis should always be included in the differential diagnosis.
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Dtsch. Med. Wochenschr. · Sep 2020
[Pharmaceutical Treatment Options in Heart Failure with Preserved Ejection Fraction].
Heart Failure causes an enormous individual and societal burden of disease with severe symptoms, a reduction in activities of daily life, frequent hospitalizations and poor prognosis. The field of heart failure with reduced ejection fraction has seen substantial innovation in the past years. ⋯ Today we have only symptoms and risk factors-based therapeutic options, and include basically diuretics, RAAsi, and antidiabetics, respectively. A causal therapy is still missing.
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Dtsch. Med. Wochenschr. · Sep 2020
[Contract of the German Health Insurance AOK Hessen Concerning Prolonged Weaning-Methods and First Experiences].
In recent years, the number of patients requiring mechanical ventilation has increased steadily. In some cases, weaning is not successful. These patients depend on home mechanical ventilation and intensive outpatient care. Surprisingly, most of these patients were never treated in a weaning center. Thus, weaning might still be possible in at least some of them. Health insurance companies have recognized this problem. ⋯ In this paper, we introduce the concept of the home care ventilation centers. Initial data suggests that home care ventilation centers can contribute to successful weaning.
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Dtsch. Med. Wochenschr. · Sep 2020
[Current ESPEN Guideline Clinical Nutrition and Hydration in Geriatrics].
Malnutrition, dehydration and obesity are relevant health problems with far-reaching consequences for older people. Routine screening for malnutrition and dehydration should be carried out in order to identify vulnerable and affected persons at an early stage and to be able to take timely countermeasures. ⋯ An ingestion deficiency dehydration should be diagnosed on the basis of serum osmolality and requires a rapid compensation of the deficit by hypotonic fluids - depending on the severity, in the form of drinks, subcutaneously or intravenously. Weight loss in old age should only be considered in cases of obesity with associated health problems and should be achieved by moderate energy reduction in combination with physical exercise.