Deutsche medizinische Wochenschrift
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Autoimmune diseases may affect all parts of the gastrointestinal system and the liver. Autoantibodies can be very helpful in the diagnosis of these diseases. For detection, two main diagnostic techniques are available: indirect immunofluorescence technique (IFT) as well as solid phase assays as e. g. ⋯ Antibody diagnosis for celiac disease has been implemented in all common guidelines. For liver and pancreatic autoimmune diseases, there is a solid history for the significance of the detection of circulating autoantibodies. Knowledge of available tests and accurate implementation accelerates correct diagnosis in many cases.
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The incidence of pancreatic cancer is rising in Germany. At present pancreatic cancer is the third commonest cause of cancer death but is expected to become the second in 2030 and finally the leading cause of cancer death in 2050. ⋯ Smoking cessation and -in case of obesity- intentional weight loss can reduce PC risk by as much as 50 %. Early detection of asymptomatic sporadic PC at stage IA - stage IA-PC now has a 5-year-survival rate of about 80 %- has become a realistic chance for people older than 50 years with new-onset diabetes.
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Autoimmune diagnostics plays a central role in the detection of various acute and/or chronic diseases in both nephrology and rheumatology, which are associated with high morbidity and mortality if left untreated or not detected in time. Patients are threatened with significant limitations in everyday skills and quality of life due to loss of kidney function and dialysis, immobilizing and destructive joint processes or also significant damage of organ systems. In all of these autoimmune diseases, early diagnosis and treatment is of central importance for the further course and prognosis of disease. ⋯ Detection of antibodies in the absence of disease symptoms often leads to uncertainty and unnecessary further diagnostics. Therefore, an unfounded "antibody screening" is not recommended. A rational antibody diagnostics is an integral part of the diagnostics and during treatment of nephrological and rheumatological diseases like glomerulonephrititis, pulmorenal syndrome, SLE and other collagenosis, thrombotic microangiopathy (HUS/TTP) and rheumatoid arthritis.
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Dtsch. Med. Wochenschr. · Mar 2023
[Anxiety, agitation, suicidality - Psychiatric emergencies in the general hospital].
Psychiatric emergencies are encountered by every physician - regardless of specialty. Nevertheless, psychiatric emergencies in general hospitals are often a very significant challenge. In this article, the most important psychiatric emergency situations, diagnostic aspects as well as corresponding therapy options are presented.
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Pituitary insufficiency is a partial or complete failure of secretion of one or more hormones from the pituitary gland. The pituitary gland is located in the hypophysial fossa of the sella turcica of the os sphenoidale and produces ACTH, LH, FSH, GH, TSH, and prolactin. Pituitary insufficiency can be caused by acute damage, such as secondary to traumatic brain injury. ⋯ Alteration of pituitary hormone secretion can also occur physiologically as in pregnancy, depression or obesity. Substitution therapy of the failed corticotropic, thyrotropic and gonadotropic axis is corresponding to the therapy of a primary endorgan insufficiency. Adequate diagnosis and treatment of pituitary insufficiency is important, as this may prevent life-threatening crises such as an adrenal crisis.