Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Nov 2020
Case Reports[Polycythemia vera as a cause for progressive cognitive impairment].
A 82-years old woman was admitted with a progressive cognitive decline for further investigations and treatment. ⋯ In this case report we were able to relate the progressive cognitive impairment in the context of newly diagnosed Pv in conjunction with pre-existing SAE. After Pv-directed therapy cognition improved. This case report underlines the importance of a good diagnostic work-up of patients with cognitive impairment to rule out secondary and possible treatable causes.
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Dtsch. Med. Wochenschr. · Nov 2020
[New developments in outpatient parenteral antibiotic therapy (OPAT)].
Long term intravenous antibiotic therapy is required for the treatment of selected infections. Outpatient parenteral antibiotic therapy (OPAT) allows patients who require intravenous treatment to be treated outside of the hospital with equal efficacy and safety as in-hospital; prolonged intravenous antibiotic therapy is required for the treatment of selected infections. OPAT is particularly beneficial for patients. ⋯ Furthermore, the risk of nosocomial infections can be reduced, especially through multi-resistant pathogens. Outpatient prescriptions shorten the inpatient length of stay and costs can be saved. Additionally the reception capacities of hospitals will be increased.
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Dtsch. Med. Wochenschr. · Nov 2020
Case Reports[Sudden exercise dyspnea in a young woman - an interdisciplinary case in the emergency room].
A 39-year-old woman with suddenly occurring exercise dyspnea is admitted under the suspicion of pulmonary embolism. In medical history, she mentions a recently completed fertility treatment. ⋯ OHSS is primarily a gynaecological condition, but physicians may encounter it with exercise dyspnea or abdominal pain as presenting symptoms. Symptoms can be treated well at an early stage, and severe courses can usually be prevented. In this case, clinical history and sonography could disprove the initially suspected diagnosis of pulmonary embolism.
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Dtsch. Med. Wochenschr. · Nov 2020
[Practice of euthanasia among physicians and nurses in German hospitals].
Active euthanasia and physician-assisted suicide are controversially discussed in Germany. Empirical studies are missing to estimate their respective incidence, including passive and indirect euthanasia in German hospitals. Physicians and nurses in German hospitals were surveyed regarding their practice of euthanasia and possible influence factors. ⋯ Euthanasia is practiced by physicians and nurses in German hospitals. The Incidence of different types of euthanasia and relevant influence factors are discussed considering methodical limitations.
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Inadequate antibiotic prescribing has been observed in many settings both in hospitals as well as in primary care. Most often there is uncertainty about the indication for antibiotic treatment itself, prescribers are reluctant to deescalate, and therapy duration is too long which results most often in overprescribing. ⋯ Over- but also underprescribing of antimicrobial agents is a serious patient safety issue that needs to be addressed in specific programmes at different levels of the healthcare system. Interventional studies have shown that programmes implementing or intensifying audit and feedback with clinical reevaluation by experts can be very efficient to reduce inadequate prescribing.