Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jul 2020
[Closing the gap in conservative obesity therapy: a fully health insurance-financed obesity program - Prospective analysis of clinical real world data].
The obesity treatment program "Leipziger Adipositasmanagement" is a long-term (i. e., four years long) conservative treatment program which is completely covered by a public health insurance company for patients with obesity grades 2 and 3 (i. e., body mass index > 35 kg/m2). Here we evaluate the effectiveness of the first part of the program which was on average 72 weeks long. ⋯ The available real world data show, that an obesity treatment program, which is completely covered by a public health insurance company, can reach a clinically significant weight loss with metabolic improvements. The treatment program "Leipziger Adipositasmanagement" contributes to improving long-term treatment of obesity in Germany.
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The control and management of infection with the novel SARS-CoV-2 virus requires multidisciplinary work between specialists on all levels. This article aims to provide an overview of the current knowledge of COVID-19 from the view of infectious diseases physicians including all the uncertainties of our understanding of the pathogenesis and immunity.
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Dtsch. Med. Wochenschr. · Jul 2020
Review Case Reports[Inflammatory Muscle Pain: Polymyalgia Rheumatica with or without Large Vessel Vasculitis].
Polymyalgia rheumatica (PMR) is characterized by rapidly evolving shoulder and pelvic girdle pain with fatigue, weight loss, night sweats and elevated CRP and ESR. Giant cell arteritis (GCA) can occur in PMR and vice versa. Headache and scalp tenderness are typical for GCA. ⋯ The prednisolone dose can be discontinued within 1 year in about 50 % of GCA patients. Additional treatment with tocilizumab allows to reduce flares and decrease glucocorticoid doses. Tocilizumab is particularly useful in patients with relapses and with increased risk of glucocorticoid side effects.
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A 66-year-old female patient was admitted to the emergency department following bitter zucchini ingestion. Clinical symptoms were tachycardia, hypotension, somnolence, diarrhea, hematochezia as well as exsiccosis, nausea and emesis. ⋯ Acute food poisoning due to cucurbitacin - containing pumpkin is rare but can occur in small gardening units in association with higher outside temperatures. Cucurbitacin poisoning has to be taken into account for differential diagnosis in food poisoning. Bitter taste is essential to diagnose cucurbitacin intoxications.
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Dtsch. Med. Wochenschr. · Jul 2020
Comparative Study[Anticoagulation for Stroke Prevention in Atrial Fibrillation].
Anticoagulation with oral antagonists without vitamin K (NOACs) is the preferred therapy for stroke prevention in atrial fibrillation. Vitamin K antagonists (VKA) should only be prescribed if there are contraindications to NOAC (e. g. mechanical heart valves, rheumatic mitral stenosis). The guideline recommendations are based on dedicated NOAC development programs with large randomized clinical phase III studies. ⋯ Due to their pharmacokinetic and dynamic properties, NOACs are much easier to handle than VKA. Amongst other advantages, this implies that in case of short interruptions in anticoagulation therapy (e. g. for surgical procedures), bridging therapy with heparin is no longer required. This will reduce bleeding complications dramatically.