Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jun 2020
[From a trail to an official path: new recommendations for the treatment of mild asthma].
Accumulating evidence suggests that a symptom-driven therapy with fixed combinations of inhaled corticosteroids (ICS) and formoterol is safer and more feasible in patients with mild asthma than a treatment with short-acting beta-2-agonists (SABA) alone. Therefore, the new international GINA asthma guideline (2019) recommends, for the first time, as needed low dose ICS-formoterol as the preferred controller in treatment step 1. This radical paradigm shift will have a major impact on asthma care in the future.
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Dtsch. Med. Wochenschr. · Jun 2020
[Update diagnosis and therapeutic management of pulmonary embolism].
Pulmonary embolism (PE) is a life-threatening disease and the third most frequent cardiovascular cause of death after stroke and myocardial infarction. The annual incidence is increasing. The recently published 2019 guidelines of the European Society of Cardiology integrate numerous new study findings and provide updated diagnostic and therapeutic algorithms. ⋯ Treatment decision for hemodynamically unstable patients should be made by interdisciplinary Pulmonary Embolism Response Teams. NOACs are recommended as the therapy of choice for anticoagulation of patients with PE. The duration of anticoagulation should be at least 3 months and prolonged anticoagulation should be considered for all patients without a strong triggering reversible risk factor.
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Dtsch. Med. Wochenschr. · Jun 2020
[Federal Act on Participation: Opportunities for people with severe obesity].
Children and adolescents with severe obesity suffer from significant disadvantages in many areas of life. Equal participation in life in society is hardly possible for this group of people. In order to counteract this, it was examined whether children and adolescents with severe obesity are considered disabled under the Social Code. ⋯ The authors agree that children and adolescents with severe obesity, in the most common cases, qualify to claim benefits.
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Dtsch. Med. Wochenschr. · Jun 2020
[Diagnosis and treatment of severe acute pancreatitis in critical care].
Acute pancreatitis is a potentially life-threatening disease that requires intensive care, especially in severe cases. The present article is intended to illustrate the possibilities of a rational diagnosis of acute pancreatitis as well as to provide an overview of the stage-adapted therapy, which includes both conservative measures and interventional interdisciplinary treatment strategies.
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Dtsch. Med. Wochenschr. · Jun 2020
[What is new in the diagnosis and therapy of renal cell carcinoma?]
Renal cell carcinomas (RCC) include different tumor entities, of which clear cell RCC is the most common tumor with approx. 75 % followed by the papillary RCC with 10-15 %. RCC are increasingly being diagnosed incidental in the context of abdominal diagnostics from other indications using sonography or cross-sectional imaging. ⋯ The combinations lead to a higher response rate and longer survival. In the second line and subsequent lines, there is no evidence-based data after combination therapies, but drugs can be used that were not yet part of the first-line therapy.