Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jul 2021
Review[Update 2021: COVID-19 from the perspective of neurology].
Neurological complications, direct affection of neuronal structures in the course of infections with SARS-CoV-2 and long-term effects ("long COVID") are evident. This article aims to summarize and evaluate the current literature on this topic.
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Dtsch. Med. Wochenschr. · Jul 2021
Review[Update 2021: Coronavirus pandemic - challenges for geriatrics].
Nobody supposed that after one year of the pandemia, the SARS-CoV-2 Virus and its emerging mutants dominates the press, our lives and the health system as a whole. As for Geriatric Medicine, many things have also changed: The majority of COVID-19 patients are no more the (oldest) old and mortality is less observed in multimorbid persons, as most of them have been vaccinated. (Oldest) old persons are still especially vulnerable to die due to a COVD-19 infection. In longterm care, a significant higher mortality was seen in the former waves, but now, some longterm care facilities have more places that they can fill. ⋯ Ressource allocationin stormy times is now more openly discussed, especially who should be admitted to intensive care units. This has led to more detailed and new guidelines which may help even when the pandemia is over. Here, some thoughts regarding the care of older adults in times of the pandemia are discussed.
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Pain in the musculoskeletal system and in the joints is what comes to mind first when people talk about rheumatic diseases. However, rheumatic diseases are multisystem disorders that can affect every organ system. Therefore, ocular manifestations are common and can occur in almost every rheumatic disease. ⋯ Furthermore, we cover uveitis and associated diseases such as spondyloarthritis or sarcoidosis. Also, we discuss giant cell arteritis as a rheumatological emergency. All in all, we aim to give a synopsis of clinical presentations, important diagnostic measures, and current therapeutic options of the above-mentioned disorders.
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Retinal microvascular function is highly depending on macrovascular circulation and especially on blood pressure variability and nocturnal blood pressure. The eyes are more subject to central hemodynamics compared to peripheral pressures. Pulse wave analysis is essential here and can reveal masked aortic hypertension. ⋯ Early hypertensive changes can be visualized best by laser scanning multi-color devices, and the vessel diameters (AV-Ratio) are measured precisely by static vessel analysis. Functional disorders of vascular motility are delineated reproducibly by devices for dynamic vessel analysis. Also functional effects of cardiovascular therapy measures can be judged by these means: micro- meets macrocirculation.
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Dtsch. Med. Wochenschr. · Jul 2021
[COVID-19: Compulsory vaccination for workers in the medical field?]
Now that the majority of medical personnel have been vaccinated against COVID-19 or are at least willing to be vaccinated, it is necessary to discuss whether employees can be required to be vaccinated. Can employers demand proof of vaccination, and are there consequences under labor law for refusing to vaccinate? Currently, there is no general legal COVID-19 vaccination requirement. Any mandatory vaccination is an encroachment on the fundamental right to physical integrity and to informational self-determination. This encroachment on fundamental rights must be weighed up in each individual case.