Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jan 2020
[The specialist examination in internal medicine: a qualitative and quantitative analysis of minutes from memory].
The specialist examination entitles to independent professional conduct and is therefore of great significance for the quality of medical care. It should cover the contents of the continuing education regulations. So far, little is known about the actual content of the exam. In this study, the question was, which content and which structural characteristics do specialist examinations in internal medicine in Germany contain. ⋯ In the oral specialist examination in internal medicine in Germany as many topics as in foreign specialist examinations are examined. However, the variance between the individual exams is relatively large. A standardization of the exam is important to create equal exam conditions for all candidates.
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The prevalence of arterial hypertension with its cardiovascular diseases like myocardial infarction, stroke, chronic kidney disease and peripheral artery disease is increasing in our aging population. Despite numerous efficient and well-tolerated antihypertensive drugs more than eight million people die worldwide from the consequences of insufficiently controlled hypertension every year. One third of the german adult population suffers from high blood pressure. ⋯ It is certainly not decisive to request a broad screening for all hypertensive patients. A certain pre-selection of potential patients is mandatory. The most common types of secondary hypertension are discussed and the diagnostic and therapeutic pathways are specified.
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Hematuria is a common clinical finding and has a wide spectrum of possible causes. Erythrocytes can originate from any part of the genitourinary tract. An urine dipstick test is the first step in diagnostic approach. ⋯ If an urological pathology is suspected, sonography should be complemented by a multi-phasic computed tomography. Based on the imaging results, a retrograde ureteroscopy should be considered. Repeated urinalysis on an annual basis for two consecutive years is recommended, if no diagnosis can be established.
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Dtsch. Med. Wochenschr. · Jan 2020
Review[Anti B-cell-antibody treatment for maintenance of remission in granulomatosis with polyangiitis and microscopic polyangiitis].
Granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) are the most frequent primary necrotizing small vessel vasculitides. In these formerly fatal diseases remission can be induced by stage- and activity-adapted immunosuppressive regimens in the majority of patients. This does not lead to drug-free long-term remission or even cure. ⋯ Recent randomized controlled trials demonstrated that maintenance treatment with the anti-B-cell antibody Rituximab, administered 6-monthly as opposed to azathioprine leads to a significantly lower relapse rate but a similar profile of adverse events. These data enabled the extension of the approval of Rituximab for maintenance of remission treatment of GPA and MPA in Germany in 2018. Guidelines and expert recommendations concerning measures of infection prevention and vaccination of immunosuppressed patients as well as the management of hypogammaglobulinemia and cytopenia on Rituximab are presented in this review.
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Education of medical students requires teaching students how to navigate in the broad field of medical research. The objective of this article is to provide an overview about medical research and to show how to denote a medical study in a concise fashion. Medical research can be classified into categories according to the object of investigation. ⋯ Each research category uses a specific set of study types with names such as cross-sectional study, case-control study etc. The article describes the principles of the study types. Together, research category and study type briefly describe the design of a medical study.