Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Dec 2020
Review Historical Article[Rahel Hirsch (1870-1953): A Tribute For The 150th Birthday Of The First Female Professor Of Medicine In Germany].
Rahel Hirsch, whose 150th birthday was celebrated on 15 September 2020, is one of the female pioneers of medicine in Germany. Since it was not yet possible for women to study medicine in Germany at the end of the 19th century, she initially worked as a teacher. In 1898 she went to Switzerland to study medicine, graduating in Strasbourg in 1903. ⋯ As a Jew during the dictatorship of the National Socialists, she was marginalised and increasingly endangered, and emigrated to England in 1938. There she lived in modest circumstances and died in London in 1953. Rahel Hirsch, who asserted herself in a male-dominated environment both as a doctor and as a scientist, is a suitable role model for those who work for more gender equality in medicine and society today.
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Dtsch. Med. Wochenschr. · Dec 2020
Review[Therapeutic drug monitoring of antiinfectives in intensive care unit patients - what's new?]
Pharmacokinetic and pharmacodynamic changes in intensive care unit patients can increase the risk for therapeutic failure or adverse effects of anti-infective therapy. Therapeutic drug monitoring (TDM) can inform required dose adaptions. The present article reviews the current practice and outlines modern approaches for decision making such as model-informed precision dosing software using the area-under-the-concentration-time-curve as target in favor of simplistic decision making based on trough concentrations. Moreover, the current recommendations for performing TDM of beta-lactams, aminoglycosides, linezolid, glycopeptides and voriconazole are concisely summarized.
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Dtsch. Med. Wochenschr. · Dec 2020
Review Historical Article[Franciscus Sylvius: A Life for Clinic, Research, Teaching And a Little Gin].
Franciscus Sylvius, latinized from Franz de le Boë (*15 March 1614 in Hanau; † 14 November 1672 in Leiden), was a Hessian-Dutch physician, anatomist, and natural scientist of Flemish descent. He was an important clinician and iatrochemist, and is considered the founder of scientifically oriented medicine and clinical chemistry. Sylvius introduced the concept of affinity and dealt with digestive processes and body fluids. ⋯ For heartburn and digestive disorders, Sylvius mixed juniper berries, herbs and alcohol to create a medicine. According to legend, Sylvius marketed this medicine as Genever, for which the name Gin was later adopted in the British Isles, but not only used for medical purposes. Accordingly, the city of birth of Sylvius today calls itself a "birthplace of gin".
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Dtsch. Med. Wochenschr. · Dec 2020
Review[Supraventricular tachycardia - ECG interpretation and clinical management].
Supraventricular tachycardia (SVT) is a very common cause of hospital admission and its diagnostic and treatment may be difficult sometimes. While vagal maneuvers or intravenous adenosis administration during 12-lead ECG recording should be performed in hemodynamically stable patients for diagnosis and treatment, hemodynamically unstable patients should be carioverted immediately. The new ESC guideline (2019) on diagnosis and clinical management of SVT significantly upgrades catheter ablation and gives it a new preferential status. ⋯ The therapy of supraventricular tachycardia during pregnancy should be free of antiarrhythmic medication, especially in the first trimester. If ablation is necessary during pregnancy, only fluoroscopy-free mapping systems should be used. This review covers aspects of ECG diagnosis and guideline-based treatment of SVT.
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Dtsch. Med. Wochenschr. · Dec 2020
Review[Behavioural Changes Caused by Parasites: The Parasite Manipulation Hypothesis].
Bacteria, archaeae, fungi and viruses of the intestinal microbiome play an important role as symbionts in the complex human ecosystem. Parasites, which account for about 40 % of the earth's biodiversity, depend on hosts to complete their life cycle. This article explains how they use them and which signalling pathways play a role in this, using toxoplasmosis and malaria as examples. ⋯ The assumption of an adaptive manipulation of humans by T. gondii in the sense of a cause-effect relationship is not proven. Alternative explanations include the inflammatory and immunological processes on the host side, which change the neuronal signal transduction as concomitant symptoms of an infection. Even without confirmation of parasitic manipulation in humans, it could be worthwhile to further investigate the observed associations in order to develop new possibilities for diagnosis and therapy, e. g. for schizophrenia.