Med Klin
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Diabetic nephropathy is an important complication of diabetes types 1 and 2 and contributes to overall morbidity and mortality. Incidence and prevalence data often come from controlled clinical studies and there is only few information obtained on the primary care level. TUV is an abbreviation for "Technischer Uberwachungsverein" (Technical Safety Standards Authority) which regularly checks cars and technical equipment in Germany. In analogy to this, the name "diabetes TUV" was chosen to demonstrate the continuous surveillance of diabetic patients. The diabetes TUV is an initiative of the "Deutsche Betriebskrankenkasse" ("Deutsche BKK"), with 1.1 million members the largest works sickness fund in Germany, that have entered into a contract with the German associations of family physicians and ophthalmologists to improve integrated care for patients with diabetes. The aim of this retrospective study was to screen the diabetes TUV registry data regarding nephropathy. ⋯ The analysis of the diabetes TUV data has revealed a higher prevalence of renal disease as previously described. Data clustering could be an indicator of documentation failure. From the obtained information, it cannot be determined whether the decrease in renal function in the diabetes TUV patients is due to diabetic nephropathy and/or other renal diseases. The diabetes TUV of the Deutsche BKK is a valuable approach to detect early renal abnormalities in diabetic patients on the primary care level. The quality of documentation, however, must be improved.
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Little is known about the epidemiology of hepatitis C in Germany and in particular about the route of infection. The current study prospectively analyzed epidemiologic and clinical data of patients with chronic hepatitis C virus (HCV) infection. ⋯ Hepatitis C should be excluded in all patients with elevated liver enzymes. In risk groups with a high prevalence of hepatitis C, the infection should be looked for even when liver enzymes are normal.
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Review
[Mesenchymal stem cells from bone marrow. Phenotype, aspects of biology, and clinical perspectives].
Since their initial description by Friedenstein et al. 30 years ago, mesenchymal stem cells have been characterized as a cell population of the bone marrow, which is easily accessible and readily manageable for in vitro manipulation. ⋯ Further preclinical studies as well as clinical cell therapy studies are essential to fully exploit the potential of mesenchymal stem cells in regenerative medicine, cellular immunotherapy, and gene therapy.
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Intermediate care units (IMC) have been introduced to provide optimal patient management according to disease severity and to bridge the gap between intensive care (ICU) and general wards. Most patients that are referred to an IMC need monitoring and intensive analgetic treatment. Over the past years noninvasive ventilation (NIV) and weaning have emerged as important new forms of active treatment in the IMC. ⋯ NIV reduces mortality, the need for intubation as well as ICU and hospital length of stay in patients with chronic obstructive pulmonary disease (COPD) and other disorders that cause respiratory failure. In many cases NIV can be performed in the IMC, a fact that reduces the number of ICU admissions, lowers costs and improves patient care. The high prevalence of pulmonary diseases and NIV emphasizes the importance of pneumologists as directors of both ICU and IMC.