Der Internist
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Patient safety is a key element of high-quality healthcare. Digitalization, new eHealth applications and data-based algorithms have high potential to make a significant contribution. ⋯ Although there should be no doubt that technology is an important instrument for increasing patient safety, new technologies also involve new risks. Furthermore, technical measures must always be embedded in an overall concept of organizational measures, adequate education, training and accompanying research in order to generate the highest possible benefits and lowest possible risks.
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Laboratory diagnostics are essential for diagnosis, initiation of therapy, and monitoring of patients. Laboratory results that are overlooked or incorrectly interpreted lead to adverse events and endanger patient safety. Clinical decision support systems (CDSSs) may facilitate appropriate interpretation of results and subsequent medical response. ⋯ Through interdisciplinary development and constant optimization, a specific CDSS with high acceptance among clinicians was developed. Initial results in the case of severe hypokalemia show a positive effect on patient care. Thereby, more complex frameworks such as sepsis diagnostics or acute coronary syndrome are implemented. The limited availability of standardized and digital clinical data is challenging. In addition to the application of classic decision trees in CDSS, the use of machine learning offers a promising perspective for future developments.
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Case Reports
[Hematochezia and right-sided upper abdominal pain after puncture of a liver abscess in a 75-year-old male].
This article presents the case of a 75-year-old male patient, who underwent a percutaneous abscess puncture of a liver abscess. A few days after the puncture and drainage there was a sudden onset of right upper quadrant abdominal pain accompanied by hematochezia. ⋯ A false aneurysm of the cystic artery was identified only after a CT angiography of the abdomen. Due to spontaneous cessation of the bleeding a cholecystectomy was subsequently performed for definitive treatment of the false aneurysm.