Dtsch Arztebl Int
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Infection of the spinal column is rare, and often recognized and treated too late. Spondylodiscitis is osteomyelitis of the spine and can cause severe symptoms. Hospital mortality is in the region of 2% to 17%. ⋯ Spondylodiscitis should be borne in mind in cases of diffuse back pain and non-specific symptoms. MRI is the diagnostic modality of choice for detecting spondylodiscitis. Thanks to precise monitoring of conservative treatments and primarily stable surgical techniques, prolonged immobilization of the patient is no longer necessary nowadays.
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Optimal wound management remains the subject of active research. Improved knowledge of physiological wound healing, systemic research into wound dressing and the evaluation of chemical disinfection have given rise to new approaches to wound care. ⋯ New findings in molecular and cell biology have improved our understanding of physiological wound healing, and approach to wound care and dressing.
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The choice of type of heart valve prosthesis is determined by the patient's age since bioprostheses have a limited lifespan. This article reviews current recommendations and the literature on cardiac valve replacement. ⋯ The choice of heart valve prosthesis should be tailored to each patient taking into account the patient's age, life expectancy, comorbidities, and life style. Different decisions may be made now than those based on earlier recommendations resulting in an individualized treatment, in patients over the age of 65 or 70.