Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Nov 2000
Case Reports[Superior vena cava thrombosis after in vitro fertilization].
A 29-year-old female was admitted with the diagnosis of multiple deep vein thrombosis of the upper limbs and neck and pneumonia secondary to pulmonary embolism on the right side. Medical history revealed that in vitro fertilization with hormone stimulation had been carried out 5 weeks before. For ten days the patient had noticed a growing, painful swelling on the right side of her neck accompanied by difficulties in swallowing. Since this time she had experienced episodes of shortness of breath without chest pain. Clinical findings showed a soft and slightly painful swelling of the right side of the neck without dyspnoea or cyanosis at rest. Breath sounds were decreased over the right lower lung on auscultation. ⋯ In vitro fertilization with hormonal stimulation may cause serious complications in patients with unknown coagulation disorders or with an ovarian hyperstimulation syndrome. Risk factors for thromboembolism need to be ruled out carefully before starting the procedure.
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Dtsch. Med. Wochenschr. · Nov 2000
Case Reports[Eosinophilic myocarditis in Churg-Strauss syndrome. A rare cause of left heart decompensation with lung edema].
A 50-year-old woman was admitted because of marked dyspnoea at rest and signs of left heart failure with pulmonary oedema. 9 years ago, the diagnostic constellation of bronchial asthma, polyneuropathy, pericardial effusion and eosinophilia had indicated Churg-Strauss syndrome. Since then she had remained symptom-free under maintenance doses of azathioprine (for 2 years) and gradually reduced doses of steroids. ⋯ After a 10-year remission without complication of a Churg-Strauss syndrome the onset of cardiac signs is the decisive long-term prognostic factor.
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Dtsch. Med. Wochenschr. · Oct 2000
Case Reports[Unclear lactate acidosis in a patient with heart failure under long-term diuretic therapy].
A severely ill 84-year old patient, known to suffer from a chronic congestive heart failure, was admitted to the emergency room because of increasing dyspnea. His blood pressure was stable (125/80), his heart rate normal (66/min), the respiratory rate, however, was elevated at 35/min and he exhibited substantial peripheral edema. There were no signs indicating an infectious process. ⋯ Thiamine deficiency as a cause for an elevated serum lactate or lactate acidosis with or without cardiovascular failure may not be overlooked. Without adequate treatment it may end lethally, although it can be treated easily, effectively and without side effects. The potential frequency of thiamine deficiency among the normal population even in our society may be under-estimated due to the particular properties of this vitamin.
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Citation frequencies of medical journals are measured by the Journal Impact Factors (IF) published annually in the Journal Citation Report (JCR). Conclusions drawn from IF concerning the distribution of single journal articles are used worldwide for academic evaluation purposes. Because of this importance, IF are widely and controversially discussed, also regarding their derivation from a limited pool of databases (Science Citation Index, SCI). ⋯ (i) The citation analyses presented in JCRs appear limited especially regarding German-language biomedical journals. Evaluation of publications based on IF therefore should be complemented by corrective measures. (ii) Single-database searches, including SCI, at best render orientating results; database combinations are recommended when higher completeness is required.