Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · May 2020
[COVID-19-Response - Strategies of the Task-Force Coronavirus and experiences upon implementation in the management of 115 cases at the University Medical Center Freiburg].
The new pandemic coronavirus SARS-CoV-2 causing coronavirus disease-2019 (COVID-19) poses immense challenges to health care systems worldwide. In the current manuscript we summarize the strategies, organisational approaches and actions of the Task-force Coronavirus at the University Medical Center Freiburg. We also report on experiences with implementation of these approaches and treatment outcomes in the first 115 COVID patients. ⋯ In the upcoming pandemic, adequate COVID management and care could be secured by a collaborative approach with inclusion of administrative departments, clinical disciplines and theoretical institutes of the University Medical Center Freiburg.
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In patients admitted with acute myocardial infarction, cardiogenic shock remains the most common cause of death. Multidisciplinary care in a specialized center and guideline-compliant treatment of cardiogenic shock are crucial for the survival and prognosis of affected patients. ⋯ Nevertheless, early revascularization of the culprit-lesion is proved to be the most important treatment modality. Although the use of active mechanical circulatory support appears to be a promising therapeutic concept to improve clinical outcome in patients with infarct-related cardiogenic shock, in the few previous randomized trials mechanical circulatory support failed to show beneficial effects on short-term and long-term survival.
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Dtsch. Med. Wochenschr. · May 2020
Case Reports[Position dependent dyspnea and cyanosis of the lips at the daily round - A case of Platypnea-Orthodeoxia Syndrome].
We elaborate a case of a 79-year-old patient who presented with position dependent shortness of breath and cyanosis of the lips at the daily round. ⋯ The combination of position dependent shortness of breath and decreased oxygen saturation should lead to the diagnosis of Platypnea-Orthodeoxia Syndrome. The underlying reasons are diverse and not only of cardiologic origin.
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Dtsch. Med. Wochenschr. · May 2020
Case Reports[Coronavirus (SARS-CoV-2) - Outbreak in North Rhine-Westphalia (District of Heinsberg) - First diagnosis of a COVID-19 manifestation in a couple].
Up to February 24th 2020 occasionally occuring SARS-CoV-2 infections in Germany without severe course. Emergency presentation of a couple in the emergency room. For seven days now, the man has fever, dry cough und physical weakness and the wife has similar symptoms of a milder form. The clinical examination shows fine crackles over both lungs and a respiratory failure of the husband. ⋯ These two cases show the starting point of an endemic spread of SARS-CoV-2 in the district of Heinsberg (North Rhine-Westphalia) and up to this point the first case of a life-threatenning course in Germany.
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In recent years, high-flow oxygen therapy (HFNC) has become established and proven as an oxygenation method for patients with severe respiratory restrictions in most intensive care units. Advantages of this method, which is used especially for patients with hypoxaemia, are the easy application and the compliance by the patient. Devices are used which enable individual oxygen therapy by means of humidification, warming up and gas flow regulation options.