Deutsche medizinische Wochenschrift
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The incidence rate of epilepsy has importantly increased during the last decades due to the rising expectation of life. Special clinical aspects have to be considered for the correct diagnosis and differential diagnosis of epileptic seizures in the elderly: On one hand, the etiology of epilepsy in the elderly is different from epilepsies of younger people with a higher rate of symptomatic epilepsies compared to younger people. ⋯ If LTVEM cannot be performed also home-video-registration could be useful. Medical treatment of epilepsies in the elderly has to be done with special consideration of comorbidity and metabolic changes in this age group.
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Dtsch. Med. Wochenschr. · Jun 2022
[Polycystic kidneys: Genetic testing and correct classification clinically and therapeutically of increasing significance].
Cystic kidney disease is a clinically and genetically diverse group of diseases, with more than 100 genes known to date. One in 500 is affected worldwide, mostly due to a malfunction of cilia. New genes have been identified recently for the most common form autosomal dominant polycystic kidney disease (ADPKD). ⋯ Due to the number and complexity of genes that need to be considered, a tailored NGS (Next Generation Sequencing) approach using a customized, well-balanced multi-gene panel is cost-effective and currently the method of choice. Differences in the quality of laboratories must be taken into account. With this, the genetic etiology and underlying mutation(s) can be found in most cases.
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Dtsch. Med. Wochenschr. · Jun 2022
[Endovascular Therapy of Chronic Iliofemoral Venous Outflow Obstructions].
Deep vein thrombosis (DVT) is associated with a high cost burden for health care systems because of secondary cost intensive complications like pulmonary embolism and especially the post thrombotic syndrome (PTS). Current standard therapy of anticoagulation for DVT therapy has not changed through the years leaving patients especially with iliofemoral vein thrombus on a high-risk situation for developing PTS. For patients with chronic venous outflow obstruction of the iliac vein system dedicated venous stents and recanalization techniques are today available.