Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Nov 2008
Review[Modern artificial respiration concepts in the treatment of acute respiratory distress syndrome].
In current intensive care medicine mechanical ventilation is of particular importance. In recent years new ventilation concepts have been established. ⋯ Alternative treatment options are high-frequency-oscillatory ventilation, extracorporeal assist devices or a combination of both in order to apply an extrem small tidal volume. These alternative treatment options have never been evaluated in randomised controlled trials, so a definite statement for practical application cannot be made.
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Dtsch. Med. Wochenschr. · Nov 2008
Case Reports[Cytomegalovirus colitis in an elderly polytraumatised patient].
During a long-term stay on a intensive-care unit a polytraumatised elderly patient developed hematochezia, which was refractory to blood transfusion. ⋯ CMV colitis should be considered in immunoincompetent patients after more common etiologies for severe diarrhea have been excluded. Timely diagnosis is essential to improve the outcome for elderly patients or patients with severe co-morbidities.
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Dtsch. Med. Wochenschr. · Nov 2008
Case Reports[Massive pleural effusion complicating chronic pancreatitis. Treatment by endoscopic closure of a pancreatic-mediastinal fistula].
A 53-year-old man was admitted because of anuria, dyspnea and a septic temperature. The patients' history included chronic alcoholism, chronic pancreatitis, COPD and a right nephrectomy because of nephrolithiasis. Urosepsis was initially suspected. ⋯ Pancreatic-pleural or pancreatic-mediastinal fistula is a rare complication of pancreatitis associated with unilateral pleural effusion. Combined internal endoscopic drainage and external chest drainage is the treatment of choice. After failure of routine endoscopic therapy, endoscopic closure of fistulas using fibrin glue might offer an alternative treatment strategy.
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Abnormal liver function tests occur in 3 - 5% of pregnancies for different reasons. Apart from pre-existing liver diseases liver diseases occurring during pregnancy, such as gall stones or viral hepatitis, most liver dysfunctions in pregnancy are caused by one of the five pregnancy-related liver diseases. The five known pregnancy-related liver diseases can be classified in two main categories depending on their association with or without preeclampsia. ⋯ However, many life-threatening maternal complications like liver hematoma or rupture and abruptio placentae can occur. Acute fatty liver of pregnancy is also a severe illness occuring mostly in the third trimester; microvesicular fat deposition in the liver can cause liver failure with coagulopathy and encephalopathy. Only the immediate delivery of the fetus can save mother and child.