Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Oct 2021
Review[Post-COVID sequela of the lung - follow up and treatment].
Most people recover completely after an acute infection with the novel corona virus SARS-CoV2. But some people continue to experience symptoms after their recovery. This phenomenon is called post-acute or long-COVID (from week 4 after the infection up to week 12) and persistent post-COVID (symptoms for effects that persist 12 or more weeks after onset). ⋯ Today, 18 months after the first infections in Europe we have access to the first practical guidelines for the long-/post-COVID syndrome. Further on first prospective studies analysing the incidence of post-COVID are now available. In this review we will discuss some questions about treatment and follow up of patients suffering from pulmonary sequelae after their COVID-19 infection, based on the actual literature.
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Dtsch. Med. Wochenschr. · Oct 2021
Review[Aspirin in primary prevention of cardiovascular and cerebrovascular diseases].
Acetylsalicylic acid (aspirin) is one of the most used medications worldwide. The antithrombotic agent acts mainly through inhibition of cyclooxygenase-1 and consequently thromboxane A2 synthesis, causing an irreversible suppression of platelet function. Despite of its proven benefit in the treatment and secondary prevention of atherosclerotic diseases, its use for the primary prevention remains controversial due to an unclear balance between the benefits and risks of aspirin. Moreover, the recent evidence indicates that the risk of major bleeding outweighs the potential to reduce ischemic events in patients without atherosclerotic diseases, thus, precluding the general use of aspirin for the primary prevention.
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Dtsch. Med. Wochenschr. · Oct 2021
Review[Excited Delirium Syndrome (ExDS): emergence and emergency management].
The Excited Delirium Syndrome (ExDS) is a state of maximum psychophysiological excitation far beyond mental agitation. Patients themselves are at an acute risk and put others at a high risk. We present data from eleven patients and a short literature review. ⋯ Seven had significant injuries at the time of admission to the hospital. The aggressive "psychiatric" presentation of ExDS can lead to vital risks being overlooked (hyperexcitation, acidosis, rhabdomyolysis, hypoxemia, and cardiovascular decompensation), which may even be increased by severe methods of restraint (hogtie; positional asphyxia). Early recognition of ExDS and its risks, comprehensive management and the prevention of inappropriate treatment will help to reduce fatal outcomes.
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Dtsch. Med. Wochenschr. · Oct 2021
Review[Step by step - A diagnostic approach to bleeding disorders].
The main symptom of hemorrhagic diathesis is an increased bleeding tendency. Due to the subjectivity of various features of the bleeding history, unclarity of the family history, and an individualization of the extent of diagnostic the evaluation of a suspected bleeding disorder represents a challenging endeavour in hematology. Hemorrhagic diathesis can be divided into the following sub-categories: disorders in primary hemostasis (e. g. von Willebrand disease, different causes of thrombocytopenia), secondary hemostasis (e. g. hemophilia A and B, Vitamin K deficiency) and fibrinolysis, and in connective tissue or vascular formation. This article reviews available diagnostic methods for bleeding disorders, from structured patient history to highly specialized laboratory diagnosis.
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Dtsch. Med. Wochenschr. · Oct 2021
Review[Asthma-COPD-Overlap - diagnostic and therapeutic management].
Asthma-COPD Overlap (ACO) is a fuzzy and controversial term intended to characterize patients who have characteristics of asthma and COPD. Since there is no uniform definition, the information on prevalence varies considerably. There is no special diagnostic algorithm and no clear therapy recommendations, as ACO is underrepresented in therapeutic studies. The current clinical consequence of this dilemma should be to differentiate the leading obstructive airway disease asthma or COPD and to treat the predominant phenotype.