Dtsch Arztebl Int
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Six months into the COVID-19 pandemic, children appear largely spared from the direct effects of disease, suggesting age as an important predictor of infection and severity. They remain, however, impacted by far-reaching public health interventions. One crucial question often posed is whether children generally transmit SARS-CoV-2 effectively. ⋯ A generalizable pediatric evidence base is urgently needed to inform policy making now, later when facing potential subsequent waves, and extending through a future in which endemicity alongside vaccination may become the enduring reality.
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Review Meta Analysis
Ulcerative Colitis-Diagnostic and Therapeutic Algorithms.
Ulcerative colitis is a chronic inflammatory bowel disease with an estimated 150 000 patients in Germany alone. ⋯ A wide variety of drugs are now available for the treatment of ulcerative colitis, enabling the individualized choice of the best treatment for each patient. Regular surveillance colonoscopies to rule out colon carcinoma should be scheduled at intervals that depend on risk stratification.
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The reported high mortality of COVID-19 patients in intensive care has given rise to a debate over whether patients with this disease are being intubated too soon and might instead benefit from more non-invasive ventilation. ⋯ Nasal high flow, non-invasive ventilation, and invasive ventilation with intubation should be carried out in a stepwise treatment strategy, under appropriate intensive-care monitoring and with the observance of all relevant anti-infectious precautions. Germany is better prepared that other countries to provide COVID-19 patients with appropriate respiratory care, in view of the high per capita density of intensive-care beds and the availability of a nationwide, interdisciplinary intensive care registry for the guidance and coordination of intensive care in patients who need it.
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Age-related macular degeneration (AMD) is thought to cause approximately 9% of all cases of blindness worldwide. In Germany, half of all cases of blindness and high-grade visual impairment are due to AMD. In this review, the main risk factors, clinical manifestations, and treatments of this disease are presented. ⋯ More research is needed on the dry late form of AMD in particular, which is currently untreatable. The treatment of the exudative late form with VEGF inhibitors is labor-intensive and requires a close collaboration of the patient, the ophthalmologist, and the primary care physician.
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Spontaneous intracranial hypotension (SIH) is an underdiagnosed disease. Its incidence is estimated at 5 per 100 000 persons per year. ⋯ The management of patients with SIH calls for complementary imaging studies to demonstrate the causative spinal CSF leak. Often, successful treatment requires surgical closure of the leak. In view of the sparse evidence available to date, controlled studies should be performed.