Deutsche medizinische Wochenschrift
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The global prevalence of osteoporotic fractures and the socioeconomic burden is increasing with aging of the population. Frailty, sarcopenia, malnutrition and a propensity to falls are contributing to osteoporotic fractures in old age with an estimated 750 000 fragility fractures per year in Germany. Despite this increasing number of fractures, osteoporosis remains underdiagnosed and undertreated in the geriatric population. ⋯ Because of the high prevalence of calcium and/or vitamin D deficiency in old age, close monitoring and appropriate substitution are essential in the management of osteoporosis in the elderly. Anti-osteoporotic drugs are effective and well tolerated in the geriatric population and should be initiated to prevent fractures in high risk cohorts and for secondary prevention. Recently, coordinator-based fracture liaison services have been shown to effectively reduce fracture risk in the high risk geriatric population.
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Dtsch. Med. Wochenschr. · Jun 2020
[Acquired immune thrombocytopenia: An update on aspects of diagnosis and management relevant for intensive care medicine].
Acquired thrombocytopenias represent a group of bleeding diseases, which can be mediated by immune or non-immune factors. Acquired immune thrombocytopenia (AITP) leads to an accelerated decrease in platelet count by platelet reactive antibodies arising from several mechanisms. ⋯ The aforementioned disorders are characterized by a severe reduction in platelet count (< 20 × 109/l), which is, with the exception of HIT, associated with high bleeding risk. In this review we provide current insight into recent achievements regarding diagnosis and management of AITP.
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Dtsch. Med. Wochenschr. · Jun 2020
[Update diagnosis and therapeutic management of pulmonary embolism].
Pulmonary embolism (PE) is a life-threatening disease and the third most frequent cardiovascular cause of death after stroke and myocardial infarction. The annual incidence is increasing. The recently published 2019 guidelines of the European Society of Cardiology integrate numerous new study findings and provide updated diagnostic and therapeutic algorithms. ⋯ Treatment decision for hemodynamically unstable patients should be made by interdisciplinary Pulmonary Embolism Response Teams. NOACs are recommended as the therapy of choice for anticoagulation of patients with PE. The duration of anticoagulation should be at least 3 months and prolonged anticoagulation should be considered for all patients without a strong triggering reversible risk factor.
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Dtsch. Med. Wochenschr. · Jun 2020
[Federal Act on Participation: Opportunities for people with severe obesity].
Children and adolescents with severe obesity suffer from significant disadvantages in many areas of life. Equal participation in life in society is hardly possible for this group of people. In order to counteract this, it was examined whether children and adolescents with severe obesity are considered disabled under the Social Code. ⋯ The authors agree that children and adolescents with severe obesity, in the most common cases, qualify to claim benefits.