Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Sep 2020
Review[Malnutrition In older people - Screening And Assessment].
Malnutrition is widespread in older people and if not treated leads to numerous negative clinical consequences, such as functional decline and in-hospital complications as well as increased health care costs. Prerequisites for a successful prevention and therapy of malnutrition are the early identification of persons at risk or those affected and a detailed assessment of their nutritional situation. Based on the current literature, this article provides an overview of important aspects considered in the screening and assessment of malnutrition in older people, such as the use of malnutrition screening tools, the application of diagnostic criteria, the quantification of energy and protein deficiencies, the identification of potential causes of malnutrition and the determination of individual preferences and resources.
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Dtsch. Med. Wochenschr. · Sep 2020
Review[Meningitis, Meningoencephalitis - A Chameleon in (Emergency) Medicine].
A wide range of pathogens can cause meningitis or meningoencephalitis. Guiding symptoms of meningitis are headache, fever, nausea, vomiting and meningism. ⋯ An early start of therapy is crucial. In addition to rapid pathogen-specific treatment, specialized neurological intensive care medicine is life-saving.
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Dtsch. Med. Wochenschr. · Sep 2020
Review[Out-of-hospital cardiac arrest: current diagnostic and therapeutical concepts].
Out-of-hospital circulatory arrest represents a challenging situation in emergency medicine even until today. Despite optimal emergency care and clinical treatment pathways, we are faced with a mortality rate above 90 %. It is possible to improve the survival rate to more than 40 % under ideal clinical and preclinical conditions. ⋯ Mechanical circulatory support devices may be considered adjunct to pharmacological measures for hemodynamic stabilization. Due to lack of evidence, these devices are currently under evaluation and prospectively randomized trials. We expect new treatment algorithms for optimal care of these high-risk patients in the near future.
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A "smoke-free" society is assumed if less than 5 % of a population smoke. We predict when this goal could be reached in Germany. To reduce the proportion of smokers in the population, the World Health Organization recommends a bundle of measures (MPOWER) that should minimize both the supply of and the demand for tobacco. The current level of implementation of these recommendations in Germany is presented. ⋯ After various tobacco prevention measures were implemented, a trend towards non-smoking began in Germany. The continual price increase recommended by the World Health Organization, the further restriction of availability, the ban on all tobacco advertising and promotion, the support of smoking cessation as well as the education of the population appear to be necessary to reinforce this trend and to achieve the health policy goal of a smoke-free society in 2040.
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Dtsch. Med. Wochenschr. · Sep 2020
[Current ESPEN Guideline Clinical Nutrition and Hydration in Geriatrics].
Malnutrition, dehydration and obesity are relevant health problems with far-reaching consequences for older people. Routine screening for malnutrition and dehydration should be carried out in order to identify vulnerable and affected persons at an early stage and to be able to take timely countermeasures. ⋯ An ingestion deficiency dehydration should be diagnosed on the basis of serum osmolality and requires a rapid compensation of the deficit by hypotonic fluids - depending on the severity, in the form of drinks, subcutaneously or intravenously. Weight loss in old age should only be considered in cases of obesity with associated health problems and should be achieved by moderate energy reduction in combination with physical exercise.