Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Apr 2022
Case Reports[Neutralizing monoclonal antibodies in COVID-19: a case series in general practice].
Neutralizing monoclonal antibodies (mAB) against SARS-CoV-2 reduce the severity of COVID-19 in patients with risk factors. Early administration at the onset of infection is critical for their efficacy. At this early stage of the disease, family physicians are often the first help for patients and thus central to the further course of the disease. To date, however, mAB have only rarely been used in general practice. The purpose of this case series is to demonstrate that the administration of mAB is safely feasible in the primary care setting. ⋯ Neutralizing mAB can be administered safely and with manageable effort in primary care setting and can help prevent a severe course and hospitalization in patients with COVID-19 and risk factors.
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Dtsch. Med. Wochenschr. · Apr 2022
Case Reports[First clinical manifestation of chronic hepatitis C in painless progressive atrophic monoparesis of the right leg].
A 60-year-old male patient was admitted with a painless reduction in the circumference of the right calf with mild gait disturbance that had been increasing for 6 months. Neurological findings included atrophic monoparesis of the right lower leg with preserved muscle reflexes without sensory disturbances. ⋯ Chronic hepatitis C may be rarely associated with painless progressive monoparesis. With regard to pathogenesis, the significance of CSF requires further studies.
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Dtsch. Med. Wochenschr. · Apr 2022
[White Paper - Improving the care of patients with impairments following sepsis and infections].
Hundreds of thousands of individuals who experience lasting sequelae after sepsis and infections in Germany do not receive optimal care. In this White Paper we present measures for improvement, which were developed by a multidisciplinary expect panel as part of the SEPFROK project. Improved care rests on four pillars: 1. cross-sectoral assessment of sequelae and a structured discharge and transition management, 2. interdisciplinary rehabilitation and aftercare with structural support, 3. strengthening the specific health literacy of patients and families, and 4. increased research into causes, prevention and treatment of sequelae. To achieve this, appropriate cross-sectoral care structures and legal frameworks must be created.
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Dtsch. Med. Wochenschr. · Apr 2022
[Autoimmune Hepatitis - What is important for clinical practice?]
Autoimmune hepatitis is a rare but chronic autoimmune-mediated liver disease. Key features are elevated transaminases, hypergammaglobulinemia, presence of specific autoantibodies and typical histological features. Diagnostic scores are helpful in establishing the diagnosis. ⋯ First-line therapy includes steroids and azathioprine and results in biochemical and histological remission in the majority of patients. In most cases, lifelong therapy is required. Every patient should receive regular follow-up surveillance including biochemical parameters as well as sonography and elastography.
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Dtsch. Med. Wochenschr. · Apr 2022
[Safety and effectiveness of oral anticoagulation in patients with atrial fibrillation and renal insufficiency - a real-world perspective].
Non-vitamin-K dependent oral anti-coagulants (NOAC) are the current therapeutic standard for preventing strokes in patients with atrial fibrillation (AF) and should be preferred over vitamin K antagonists (VKA) in this indication. This recommendation applies also to patients with VHF and concomitant chronic kidney disease (CKD). ⋯ In addition, RWE in respect to the indication showed that the superiority of NOAC versus the VKA warfarin can also be extrapolated to phenprocoumon, the commonly used VKA in Germany. Furthermore, data include evidence that the typical progression of CKD appears to be less pronounced in individuals treated with NOAC compared to those treated with VKA.