Deutsche medizinische Wochenschrift
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Low back pain is the leading symptom of a family of inflammatory rheumatic diseases grouped under the umbrella term "spondyloarthritides". This paper discusses the main clinical, laboratory, and imaging features of spondyloarthritides in the diagnostic context of low back pain. It also highlights the current therapeutic principles of axial spondyloarthritis.
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Approximately 50 % of chronic gastrointestinal symptoms in primary care can be attributed to functional gastrointestinal disorders (FGID). The most frequent gastrointestinal disorders are functional dyspepsia and irritable bowel syndrome. FGID are heterogenous with regards to the amount of symptoms and associated patient's impairment as well as to the underlying pathophysiological mechanisms. ⋯ In addition, these guidelines include recommendations how to explain the disorder and the management to the patient to establish a trustful doctor-patient relationship. FGID are diagnosed by the history of a typical cluster of symptoms and by guideline - recommended exclusion of somatic gastrointestinal disorders. FGID should be managed according to the main symptoms, the associated impairment and patients' preferences in a graduated approach by education and by dietary, pharmacological and psychological treatments.
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Dtsch. Med. Wochenschr. · Apr 2022
Letter[Considerations on Excess Mortality in Germany in the year 2020 and 2021].
At the end of 2020, in Germany a discussion broke out whether the past year was characterized by excess mortality. The opposite positions arose primarily from the way data was processed. In order to correct systematic trends of the last two decades, in the present study the annual death rates for Germany were calculated as the difference to those of the year 2000 and a polynomial fit of 2nd order was carried out for the total population and for the groups of people below and from 80 years of age. ⋯ For the total population there were excess mortality rates for 2020 and 2021 with 11 500 and 10 468 deaths respectively, which in which in total is completely covered by the excess mortality of those aged 80 and over. In the age group below 80 years there was no excess mortality in the two years. For all age groups, excess mortality was most prominent in the year 2003.
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Dtsch. Med. Wochenschr. · Apr 2022
[Role of cardiovascular magnetic resonance in cardiovascular diagnostics].
Cardiovascular magnetic resonance (CMR) has become an accepted method for noninvasive imaging in cardiology. As part of a multimodality concept, this method can contribute valuable diagnostic aspects, often even as a first-choice method in a variety of diseases. Currently the availability is still limited, but the increasing time efficiency, technical stability and the growing competence will lead to more guideline-compliant use. ⋯ As with any diagnostic method a qualified application is crucial. In recent years, the technique itself has become much more stable and consensus recommendations of the Society for Cardiovascular Magnetic Resonance are available for the main indications, both for the MRI scan procedure and for the evaluation. Appropriate qualifications and certification opportunities are offered both nationally and internationally.
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Celiac disease is a T-cell-mediated autoimmune disorder. It is relevant to us for two very different reasons. Firstly, it has a prevalence of 1 % in the European population. ⋯ This again contributes to new celiac treatment modalities that will presumably alleviate the future fate of celiac disease patients. In 2022, the German guidelines for celiac disease are published by the Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS). We have summarized some of the recommendations published therein.