Deutsche medizinische Wochenschrift
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Obesity is a highly prevalent, chronically progressing disease. Obesity represents a challenge for people living with obesity, health care professionals and the society, because it is also associated with several comorbid diseases. ⋯ The treatment access gap is mainly caused by a lack of legal frameworks for the guideline-driven obesity management. A currently developed disease management program for obesity has the potential to fill the gap in obesity management in the future.
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Diabetes is one of the most common chronical diseases in old age. More than 50 % of the patients are older than 65 years. Elderly with diabetes often suffer from functional or cognitive deficits that should be registered in therapy. ⋯ Simple therapy regimens should be preferred to avoid polypharmacia and to preserve patient's independence. Specific risks of old age under new antidiabetic drugs should be noted. Check-ups and treatment of diabetic complications, especially the diabetic foot should be consequently induced considerating age-specific features.
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Therapeutic fasting has found its way into modern medicine in the last decade through a multitude of experimental work and animal studies as well as increasing clinical research. It is a procedure with a tradition dating back thousands of years and thus comes with a variety of different practices. What they all have in common, is the reduction of daily food intake for a limited period of time. This has a variety of effects on metabolism, cells and organ systems, which can make it a potent tool in medical practice.
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Dtsch. Med. Wochenschr. · Aug 2023
Review[Patient safety 4.0: "Failure of the Week" It's all about role modelling!].
The rate of mistakes and near misses in clinical medicine remains staggering. The tendency to cover up mistakes is rampant in "name-blame-shame" cultures. The need for safe forums where mistakes can be openly discussed in the interest of patient safety is evident. Following a comprehensive review of the literature, a semi-structured weekly conference, named "mistake of the week" (MOTW), was introduced, enabling physicians to voluntarily discuss their mistakes and near-misses. The MOTW is intended to encourage cultural change in how physicians approach, process, accept and learn from their own and their peers' mistakes. This study seeks to assess if physicians appreciate, benefit from and are motivated to participate in MOTW. ⋯ The MOTW conference models an ideal forum to mitigate hierarchy and promote a sustainable organizational dynamic in which mistakes and near misses can be discussed in an environment free from "name-blame-shame", with the ultimate goal of potentially improving patient care and safety.
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Diabetes mellitus is the most common metabolic disease with >500 million people affected worldwide and currently 8,7 million in Germany. About 90% of diabetes cases are due to type 2 diabetes mellitus (T2D). This form of diabetes is characterized by an increased release of proinflammatory adipokines, endothelial dysfunction and hyperglycemia, among others. ⋯ People with diabetes are therefore generally considered a high-risk cardiovascular group and require special attention in the diagnosis and treatment of cardiovascular disease. Contributing factors to reduce high cardiovascular risk include a healthy lifestyle, normalization of blood pressure, optimization of blood lipid levels, and specific diabetes therapy tailored to cardiovascular risk. This review addresses the specific treatment options for reducing cardiovascular risk in patients with diabetes mellitus.