Deutsche medizinische Wochenschrift
-
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has stated that pulmonary rehabilitation (PR) is the most effective therapeutic intervention to reduce dyspnoea and to improve physical performance and quality of life for patients with obstructive lung disease. New innovative studies raised in the area of PR:1) Pulmonary fibrosis & asthma bronchiale - While PR is recommended for chronic respiratory diseases other than COPD (chronic obstructive pulmonary disease) in the respective disease-specific treatment guidelines, PR in some pathologies is underrated. For example, there is a growing body of evidence showing the effectiveness of structured and multidisciplinary PR programs in pulmonary fibrosis and asthma bronchial patients;2) Coronavirus SARS-CoV-2 - There is preliminary evidence that COVID-19 patients can benefit from a PR program. The current COVID-19 position paper of the German Respiratory Society e. V. (DGP) regarding PR recommendations suggests that early rehabilitative therapies are already indicated during hospitalisation on the normal or intensive care unit and that rehabilitative interventions should be continued after discharge as a follow-up treatment in PR centres in order to reduce long-term consequences of COVID-19 disease;3) Telehealth meets PR - To further improve the effectiveness of PR in COPD patients using recent technologies, a supplementary "digital exercise program" can contribute to greater benefits compared to PR alone.
-
Conspiracy theories are a most elaborate form of gossip. They have a long tradition and arise preferably during times of drawn out crises, as for example the Corona-pandemic. Hard-wired anxiety, personal powerlessness, palpable socioeconomic consequences, complex causes and insufficient solutions, disconcerting leadership and modern means of communication form fertile ground for conspiracy theories. They are much more than a peculiar marginal phenomenon as they undermine concerted action and distort open discussions, spreading germs and doubts, increasing risks and costs. This paper describes individual, social and communicative mechanisms underlying conspiracy theories and their inclusive ("we, who know"), conclusive (cognitive closure versus inconclusive facts) and exclusive effects ("we versus the establishment and the ignorants").
-
Dtsch. Med. Wochenschr. · Dec 2020
[Pain management for older care receivers in the ambulatory care setting].
Chronic pain experienced by care receivers who live in their own homes is an issue of great importance, due to its frequency and intensity. The impacts of pain in this vulnerable group are manifested particularly in the form of marked adverse effects on mobility and activity. ⋯ Too little attention has been paid up to now to the challenges of interdisciplinary care for older care receivers in the ambulatory care setting, although interdisciplinarity in pain management has long been a stated requirement. Multidisciplinary action based on agreed guidelines and standards is the key to appropriate pain management. The interface communication between professional groups needs to be optimized in order to provide adequate care for the care receiver.
-
Reactive arthritis (ReA) is an aseptic, immune mediated arthritis with typical manifestations following urogenital, gastrointestinal or respiratory tract infections. The interval between the antecedent infection and arthritis is ranging from several days to 4-6 weeks. ReA is classified as member of the group of spondyloarthritides. ⋯ Post-streptococcal arthritis, Lyme arthritis (Borreliosis) and viral arthritis are not classified as ReA within the spondyloarthritis group. In the treatment of ReA, antibiotics are not used. Acute ReA is treated by nonsteroidal anti-inflammatory drugs, and refractory (chronic) arthritis by steroids, sulfasalazine and TNF inhibitors. Notably, only a few original papers on ReA have been published within the last years.
-
Both in hospitals and outpatient settings, fewer fluoroquinolones have been prescribed in Germany in recent years. The consumption of cephalosporins also decreased somewhat in favor of penicillin derivatives. The aminoglycosides, which have only rarely been prescribed, can now be used again as a suitable alternative - but only parenterally - due to their relatively favorable activity and low resistance rates among typical urinary tract infection pathogens. ⋯ These betalactams should be given with extended infusion times, e. g. over 4 hours. Linezolid should be considered as a reserve drug and not be used empirically, but only in targeted therapy. With regard to an alleged penicillin allergy, the risk of true allergic reactions can be differentiated by careful taking of the history; on that ground patient subgroups can be defined that may be re-exposed without further allergological examinations.