Dtsch Arztebl Int
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Acute kidney injury (AKI) often takes a complicated course if diagnosed late and undertreated. Electronic alerts that provide an early warning of AKI are intended to support treating physicians in making the diagnosis of AKI and treating it appropriately. The available evidence on the effects of such alert systems is inconsistent. ⋯ Non-randomized controlled trials of electronic alerts for AKI that were coupled with treatment recommendations have yielded evidence of improved care processes and treatment outcomes for patients with AKI. This review is limited by the low number of randomized trials and the wide variety of endpoints used in the studies that were evaluated.
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Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system. There are at least 150 000 persons with MS in Germany. Recent years have seen the approval of new drugs against. ⋯ Newer drugs for MS have enabled more effective treatment, but are also associated with a higher risk of side effects. Interdisciplinary risk management is needed.
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Electronic cigarettes (e-cigarettes) are a consumer product whose benefits and risks are currently debated. Advocates of the "tobacco harm reduction" strategy emphasize their potential as an aid to smoking cessation, while advocates of the precautionary principle emphasize their risks instead. There have been only a few studies to date on the prevalence of e-cigarette use in Germany. ⋯ The consumption of electronic cigarettes in Germany is not very widespread, but it is not negligible either. Nearly 1 in 8 Germans has tried e-cigarettes at least once. Regular consumers of e-cigarettes are almost exclusively smokers and ex-smokers.
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Dyspnea is a common symptom affecting as many as 25% of patients seen in the ambulatory setting. It can arise from many different underlying conditions and is sometimes a manifestation of a life-threatening disease. ⋯ The many causes of dyspnea make it a diagnostic challenge. Its rapid evaluation and diagnosis are crucial for reducing mortality and the burden of disease.
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Practice Guideline
The Prevention and Treatment of Retinal Complications in Diabetes.
Microvascular complications of diabetes mellitus can cause retino pathy and maculopathy, which can irreversibly damage vision and lead to blindness. The prevalence of retinopathy is 9-16% in patients with type 2 diabetes and 24-27% in patients with type 1 diabetes. 0.2-0.5% of diabetics are blind. ⋯ Regular, risk-adapted ophthalmological examinations, with standardized documentation of the findings for communication between ophthalmologists and the patients' treating primary care physicians/diabetologists, is essential for the prevention of diabetic retinal complications, and for their optimal treatment if they are already present.