Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Apr 2022
[Cardiac computed tomography - Current diagnostic role in cardiology].
Computed tomography (CT) imaging of the heart requires specific equipment and protocols in order to synchronize image generation with the electrocardiogram (ECG), usually achieved via ECG-gated reconstruction or ECG-triggered acquisition. The main application of cardiac CT is coronary artery imaging. ⋯ In addition, CT has the potential to visualize coronary atherosclerotic plaque, even if non-obstructive, and data suggest that this may be a valuable guide towards more intensive risk modification strategy such as statin therapy. In recent years, the use of CT imaging to guide structural heart interventions has become another important application, and many interventions, such as transcatheter aortic valve implantation, substantially depend on CT imaging to plan the procedure, minimize risks, and optimize outcome.
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Dtsch. Med. Wochenschr. · Apr 2022
[The views of cancer out-patients on the impact of the COVID-19 pandemic].
This study investigates current needs and psychosocial burden of out-patients with cancer during the COVID-19-Pandemic. ⋯ Corona-specific distress of cancer patients relates in particular to the course of therapy, but also to a possible overload of the health care system. Oncology care teams should allow space for questions from their patients, acknowledge possible uncertainties, provide emotional support, and draw attention to reliable sources of information.
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Dtsch. Med. Wochenschr. · Apr 2022
[Low back pain from an orthopedic and pain medical point of view].
Low back pain is not a diagnosis but a symptom of various causes. The differentiation between specific and non-specific low back pain is diagnostically difficult and only of limited help with regard to the further therapeutic procedure. ⋯ Early recognition and timely adequate therapy are crucial for the prognosis of chronic low back pain. Low back pain at risk of chronicity or chronic low back pain requires early assessment and the initiation of an interdisciplinary multimodal pain therapy program (IMPT).
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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.