Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Feb 2022
Observational Study[How do internal medicine patients choose their hospital? A cross-sectional study].
The free choice of hospital by patients is promoted by health policy and is to be supported by the quality reports of hospitals. But how do patients choose a hospital? How many can decide for themselves, where do they inform themselves and what are their decision criteria in the specific situation? This will be answered for inpatients of internal medicine in comparison to those of other specialties. ⋯ In internal medicine, fewer patients can decide on the hospital themselves. These then decide quite predominantly on the basis of their previous experience with the hospital and continue the renewed treatment in the hospital with which they are also familiar. A small proportion of younger, more educated and less hospital-experienced patients inform themselves more actively before elective procedures. Patients' treatment experiences are central to their own and their relatives' choice of hospital via social exchange.
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Dtsch. Med. Wochenschr. · Feb 2022
[Primary hyperparathyreoidism - diagnostic procedures and management].
Hypercalcemia as a laboratory result is often diagnosed during evaluation for osteoporosis. Any form of hypercalcemia should be evaluated further. Owing to fluctuating calcium levels, the measurement should be repeated and corrected for elevated albumin levels by calculation or by measuring ionized calcium. ⋯ Postsurgical calcium and vitamin-D administration will prevent postsurgical hypocalcemia and hungry-bone disease, and may optimize the outcome of BMD. Treatment of osteoporosis without fractures might not be necessary, owing to normalization of BMD several years after parathyroid surgery. The continuation of specific anti-osteoporotic treatment with bisphosphonates post-surgery did not have any advantage and hence cannot be recommended.
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Dtsch. Med. Wochenschr. · Feb 2022
[Modern drug therapy for systemic sclerosis associated interstitial lung disease].
Systemic Sclerosis with Interstitial Lung Disease (SSc-ILD) is associated with an increased risk of morbidity and mortality. Because of a lack of approved medications that can effectively influence SSc-ILD disease course, there is a need for new therapeutic options. ⋯ Recently, a phase III study demonstrated the positive effect of the antifibrotic agent nintedanib on the loss of lung volume and thus disease progression in patients with SSc-ILD. Due to its synergistic mechanism of action, combination therapy with nintedanib and mycophenolate could be a complementary treatment approach for SSc-ILD in the future.
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Dtsch. Med. Wochenschr. · Feb 2022
[Non-pharmacological interventions in dementia: an overview with special consideration of digital offerings].
Non-pharmacological interventions such as cognitive therapy, physical activity, and creative art approaches are important components of appropriate care for persons with dementia and their relatives. Although relationships and interpersonal interactions undoubtedly play an important role in all these activities, digital technologies have increasingly established themselves in this area in recent years. ⋯ When using them, it should therefore be borne in mind that although they may represent a valuable supplement, they can never replace human attention. Furthermore, limitations in their practical application, such as unfamiliarity when using digital technologies or excessive demands of cognitively limited users, as well as important ethical aspects (e. g., data protections, personality rights, dignity and self-determination in old age) should not be ignored.