Therapeutische Umschau. Revue thérapeutique
-
Anaphylaxis is a life-threatening allergological emergency: it has to be recognized and treated immediately by the physician. Most often anaphylaxis is caused by drugs, foods and insect stings. Emergency treatment consists in intramuscular application of adrenaline and volume substitution. ⋯ All patients have to be hospitalized immediately and treated on an intensive care unit. After anaphylaxis the following preventive measures are most important: consultation with an allergist, including instruction for allergen avoidance and emergency medications. In anaphylaxis induced by insect stings specific immunotherapy should be started.
-
The incidence of paediatric supraventricular tachycardias is approximately 0.1-0.4%. AV node and AV reentrant tachycardias represent the most common supraventricular tachycardias in children. Atrial ectopic tachycardias are the second most common group of pediatric arrhythmias with a predominance in younger children. ⋯ During the last decade the widespread use of newer antiarrhythmic agents and the invention of radiofrequency catheter ablation have revolutionized the treatment of supraventricular tachycardias in children. A thorough knowledge of these various treatments options is essential to achieve a safe and effective management of supraventricular tachycardias in children. This article focuses on diagnostic and therapeutic aspects of the most frequent supraventricular tachycardias.
-
A growing, heterogeneous group of children with congenital heart disease is surviving into adulthood due to advances in medicine. These patients including those with simple and complex congenital heart disease and operated on during childhood are facing long-term complications. Superspecialist care and expertise are required during their life to deal with their unique problems the most common being ventricular failure, arrhythmias, valve and conduit longevity. ⋯ An interdisciplinary team offers all non-invasive and invasive facilities for diagnostic and therapeutic procedures in a supraregional referral center. A close collaboration among all physicians is crucial for optimal care and management. Integration of adolescents with congenital heart disease into an adult medical system improves both compliance and quality of care and supports the patient's esteem because many medical aspects and lifestyle issues are completely different from those during childhood.
-
Before the development of the snowboard sport, the fracture of the lateral process of the talus was a very rare injury. Since the increasing popularity of snowboarding, starting in Europe at about 1980, these fractures occurred more frequently. The largest epidemiological serie from Kirkpatrick in 1998 reports an incidence of 2.3% of all snowboarding injuries representing 15% of all snowboarding ankle injuries [1]. ⋯ Physicians caring for snowboarders should look specifically for fracture of the lateral process of the talus in a snowboarder with a lateral ankle or foot injury [3]. This fracture can mimic a lateral ankle sprain, yet the fracture is easily missed on plain radiographs of the ankle. Because displaced or comminuted fractures can cause long-term disability, primary care physicians and specialists alike need to be aware of the association of this fracture with snowboarding [3].
-
An important part of patients with spinal cord disorder suffers chronic pain. Especially the neuropathic pain syndrome is a problem. The pain lost his function of a protective warning sign, it can reduce the quality of life dramatically. We show the diagnosis and pharmacotherapy in neuropathic pain syndromes in patients with spinal cord disorder.