Deutsche medizinische Wochenschrift
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Right heart catheterisation is a frequently used procedure in cardiology and intensive care medicine, especially for the differential diagnosis of pulmonary hypertension, shunt diagnostics and accurate calculation of the important haemodynamic parameters. Various catheters are available for the examination; the most common and safest is the use of a Swan-Ganz catheter. The complete examination includes probing of the right atrium, right ventricle, pulmonary artery and pulmonary capillary bed. In this "step-by-step" article, the authors discuss the practical aspects of this method.
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Urinary incontinence and gait disorders are common health related problems that occur especially in old age. Therefore they are called geriatric syndromes. ⋯ And further, both syndroms seem to interact closely and can be influenced by improvements of each other. Knowing and recognizing the interaction of micturition and physical performance is essential to working towards prevention of UI and to improving quality of treatment and quality of life.
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Dtsch. Med. Wochenschr. · Aug 2021
[Intravenous fluid therapy and acute kidney injury - What's new?]
Optimization of intravascular volume is crucial for patients who are at risk or undergo Acute Kidney Injury. In sepsis or after acute fluid loss extensive fluid expansion is mostly needed. However, in cardiorenal syndroms fluid overload can even lead to AKI itself and reduction of intravascular volume is needed. Thus, an individualized fluid guidance in terms of a "fluid management stewartship" for the right patient, the right drug, the right route and the right dose 1 has to be applied.
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Dtsch. Med. Wochenschr. · Aug 2021
[Coronary revascularization: Interventional therapy or coronary bypass surgery].
Coronary artery disease remains the leading cause of death and is responsible for myocardial infarction, heart failure and angina. Therapy combines optimal control of cardiovascular risk factors with coronary revascularization performed by interventional therapy or bypass surgery. ⋯ Both revascularization strategies perform similar for low level complexity three vessel or left main disease while coronary bypass surgery proved superior for more complex coronary artery disease. Heart team decision should be based on vascular anatomy and expected revascularization success under consideration of operative risk and patient preference.
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Dtsch. Med. Wochenschr. · Aug 2021
[Non-invasive cardiac imaging in the work-up of coronary artery disease].
Cardiovascular imaging has experienced and is still experiencing tremendous advancements as far as hardware as well as software technology is concerned. In every day clinical routine, crucial decisions are daily being taken based on imaging findings. ⋯ Furthermore, a growing body of scientific evidence is currently available that show the clinical relevance of different imaging methods in the clarification of different disease constellations. This article describes various imaging modalities that are used in the work-up of CAD in everyday cardiac routine.