Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Sep 2012
Review[Immunosuppression in inflammatory bowel disease: When, how and how long?].
Immunosuppressive treatment is an important tool in the therapy of patients with inflammatory bowel disease. Treatment goal is a long lasting remission. ⋯ Conventional immunosuppressives (azathioprine/6-mercaptopurine, methotrexate, the calcineurin inhibitors cyclosporine A and tacrolimus), and anti-TNF antibodies (infliximab, adalimumab) are available. Current guidelines set the frame for the rational use of these drugs.
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Dtsch. Med. Wochenschr. · Sep 2012
Case Reports[Pulsatile tumor on the left side of the thorax after heart surgery].
In a 67-year-old woman a large haematoma developed on the left side of the chest after two sternotomies because of an aortic valve and aorta ascendens replacement for aortic type A dissection. After a few weeks, a pulsating mass remained over the 6th left parasternal intercostal space. A consultant general surgeon punctured the lesion and aspirated bright red blood. The patient was transferred for further diagnostic procedures to the cardiology department. ⋯ After sternotomy a pseudoaneurysm of the left internal mammary artery had developed. As a noninvasive imaging modalitiy the magnetic resonance angiography showed well the exact flow into the aneurysm and allowed the planning of the intervention. The closure was achieved with a microcoil with preservation of the native internal mammary artery.
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Dtsch. Med. Wochenschr. · Sep 2012
Review Comparative Study[Colonoscopy: propofol well suited for sedation].
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Dtsch. Med. Wochenschr. · Sep 2012
Case Reports[21-year-old woman with Reye's syndrome after influenza].
A 21-year old woman was referred to the hospital because of progressively deteriorating consciousness. Initially agitation and irritability, later confusion and delirium predominated. Previously influenza with high temperature, headache and vomiting had occurred and been treated with acetylsalicylic acid for some days. Non preliminary diseases were reported. CLINICAL INVESTIGATION: Besides of the deterioration in consciousness no clinical or neurological abnormalities were found. Electroencephalography demonstrated general abnormalities of medium range. Cranial magnetic resonance imaging and liquor investigations showed no pathological findings. In laboratory tests a marked increase of transaminases and ammonia were found. The toxicological screening was normal. ⋯ Reye's syndrome is an acute illness characterized by hepatic encephalopathy and fatty degeneration of the liver. It often occurs after viral infections. After a viral infection that was eventually treated with acetylsalicylic acid Reye's syndrome has to be discussed after exclusion of common causes of hepatic failure.
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Dtsch. Med. Wochenschr. · Sep 2012
[PPI-sensitive diarrhea - unusual case of an adolescent with sporadic gastrinoma].
A 14-year-old boy was admitted to hospital because of chronic episodic diarrhea lasting for 4 years. Previous investigations in the past had not revealed the cause of the symptoms. ⋯ In patients with chronic diarrhea, especially if the symptoms are PPI-sensitive, a gastrinoma should be considered.