Medizinische Klinik, Intensivmedizin und Notfallmedizin
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The review presents the concept of immunonutrition in enteral and parenteral nutrition of the critically ill. The present indications for supplementing immune enhancing and anti-inflammatory substances are summarized and discussed in accordance with the recent literature and guidelines.
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Hyponatremia is the most common electrolyte disorder in the hospital setting and is defined as a serum sodium concentration less than 135 mmol/l. Most patients have mild hyponatremia (plasma sodium concentration 130-134 mmol/l) and few if any symptoms. Serum sodium concentrations between 120 and 129 mmol/l can be associated with lack of concentration, nausea, forgetfulness, apathy and loss of balance. ⋯ Recently a new class of pharmacological agents has become available, the vaptans, orally taken vasopressin antagonists. Clinical trials showed them to provide effective, specific and safe therapy of hyponatremia. In Europe tolvaptan, the only such agent on the market is now approved for the treatment of euvolemic hyponatremia.
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Med Klin Intensivmed Notfmed · Feb 2013
Review[Chest pains in emergency admission. Diagnostics and treatment].
Thoracic pain is a common symptom in the emergency medicine setting and represents a diagnostic and therapeutic challenge. A multitude of differential diagnoses must be considered many of which are associated with a high mortality. ⋯ Also for some underlying pathologies the physical examination can have an inconspicuous or"false negative" result and atypical presentations can give rise to false interpretations. The clinical and technical diagnostic methods, the implementation and interpretation including possible sources of error and limitations will be described in detail.