Deutsche medizinische Wochenschrift
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In Germany the postmortem examination has to be performed by a physician. It has to include the determination of at least one sign of death, a statement about the time and cause of death and the distinction between a "death by natural causes" in the sense of the law and its opposite.
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Dtsch. Med. Wochenschr. · Jun 2015
Review[Current strategies against multi-drug resistant organisms].
The global spread of multi-drug resistant organisms (MDRO) is a major threat to public health. Fighting MDRO spread requires a multi-faceted approach as summarized in the German Antibiotic Resistance Strategy (DART). In the hospital, this includes antibiotic stewardship concepts and strict infection control measures. ⋯ In contrast, novel antibiotics against carbapenemase producing Gram-negatives are still lacking. Current studies have shown, that a colistin-based combination treatment can improve the prognosis in these patients. The following article reviews MDRO definitions, burden of disease, treatment options and general strategies against MDRO.
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Dtsch. Med. Wochenschr. · Jun 2015
[Rheumatoid arthritis and lung - more than a minor aspect of the disease].
Although rheumatoid arthritis (RA) mainly manifests as polyarthritis, there is growing evidence that the initiation of the pathological immune reaction against citrullinated peptides takes place in the lung. However, in spite of this important role of the lung in pathophysiology, clinically manifest lung involvement has been demonstrated only in about 2-5 % of the patients with RA, and therefore is relatively rare. ⋯ Methotrexate (MTX), as the most important disease modifying drug for treatment of RA is not associated with the appearance or progression of interstitial lung disease in RA. MTX-induced pneumonitis is a rare, although potentially severe complication of this treatment.
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Dtsch. Med. Wochenschr. · Jun 2015
Multicenter Study Clinical Trial[Atrial Fibrillation in Germany].
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Dtsch. Med. Wochenschr. · Jun 2015
[Three shades of fluids: Bergström 2.0 / Furosemide stress test / replacement fluid for therapeutic plasma exchange].
Fluids play an important role in clinical nephrology.1) Temperature of dialysate fluid has recently re-attracted a lot of attention. Individualized cooling of the dialysate (0.5 °C below predialysis ear temperature) has been shown to not only prevent intradialytic hypotension but also to improve myocardial contractility and to prevent white matter changes in CKD5D.2) Access fluid in AKI is associated with an increased mortality. ⋯ Alternative solutions such as immunoadsorption should be studied and employed for those indications where replenishment of plasma components is not necessary. Further, a seperate reimbursement of repalcement fluid seems necessary to avoid a decline in treatment quality.