Der Internist
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In an international comparison, Germany is in the top group for health care. Not only since the economic burdens of the corona pandemic, however, has there been agreement of the necessity of exploiting the considerable efficiency and effectiveness reserves that also exist in this area. Particularly in the interface area between outpatient and inpatient care, increasingly divergent development paths are beeing discusssed. Despite scientific findings to the contrary, integrative cooperative structures threaten to fall behind.
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Case Reports
[Intermittent disturbances of perception during fasting in a 46-year-old female patient].
We report the case of a 46-year-old female patient who presented in the emergency department with intermittent disturbances of perception when fasting. ⋯ If multiple symptoms of hypoglycemia are present, an insulinoma as the cause must be considered in the differential diagnostics.
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Approximately 40% of patients with heart failure show cognitive deficits, such as concentration difficulties, attention deficits, and memory impairment. Affected patients have a higher rate of rehospitalization and an increased mortality. This could be due to low adherence mediated by a lack of disease-specific knowledge and strategies to deal with symptom exacerbation. ⋯ In this respect the heart failure itself as well as cardiovascular risk factors and comorbidities play a role. Orientating neuropsychological screening tests can show a first indication of the presence of cognitive impairment. When identified, the causes can be specifically treated and care can be optimized through certain measures, such as the involvement of caregivers and healthcare providers.