Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Aug 2024
Review[Differential diagnosis and therapy of immune thrombocytopenia].
Immune thrombocytopenia is caused by autoantibodies against surface antigens on platelets. Since only about 50 % of cases will allow the identification of glycoprotein-specific antibodies, ITP remains a diagnosis of exclusion. ⋯ The second line consists of thrombopoietin receptor agonists, rituximab, or splenectomy. For further lines of therapy, Fostamatinib and non-steroidal immunosuppressives are available.
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Acute inflammation of the liver (hepatitis) can be triggered by at least five different hepatotropic viruses - hepatitis viruses A, B, C, D and E. Hepatitis viruses A and E are transmitted via contaminated food and smear infections, whereas hepatitis viruses B, C and D are transmitted through direct contact with blood and other body fluids when these penetrate the skin or mucous membranes. This article is intended to provide a brief overview of the different forms of acute viral hepatitis, diagnosis, course and treatment.
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Port systems provide safe venous access for patients with poor venous status and are essential for the long-term administration of drugs such as chemotherapeutics. However, they are not without complications. Port infection is a life-threatening situation; the infection rate in current studies varies from 0.8% to 7.5% and is significantly higher in cancer patients at 16-31%. The purpose of this SOP is to provide an overview of the management of port infections.
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The current S3 guideline, "Positioning Therapy and Mobilization of Critically Ill Patients in Intensive Care Units", introduces methodological changes and substantive updates compared to the previous version. Additionally, new evidence-based insights with specified PICO questions have been integrated, aiming for a more precise application of recommendations in clinical practice and thus enhancing the care of critically ill patients. A notable aspect is the more nuanced approach to early mobilization, which is recommended to commence within the first 72 hours of ICU admission. ⋯ It is recommended as a therapeutic option for invasively ventilated patients with ARDS and impaired arterial oxygenation (PaO2/FiO2 <150mmHg), with a recommended minimum duration of 12 hours, ideally 16 hours. Special recommendations apply, for example, to COVID-19 patients with acute hypoxemic respiratory failure, where awake proning should be considered. Additionally, new chapters have been introduced focusing on assistive devices and neuromuscular electrical stimulation.
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Dtsch. Med. Wochenschr. · Aug 2024
Case Reports[Fiber endoscopic evaluation of swallowing (FEES) - an important tool for diagnosing myasthenia gravis].
A 76-year old man was admitted with a globus sensation and weight loss for further investigations to our geriatric ward. A gastroscopic evaluation executed before had been unremarkable. ⋯ FEES can be a valid diagnosis tool for a pharyngeal type of a myasthenia gravis.