Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Nov 2020
[New developments in outpatient parenteral antibiotic therapy (OPAT)].
Long term intravenous antibiotic therapy is required for the treatment of selected infections. Outpatient parenteral antibiotic therapy (OPAT) allows patients who require intravenous treatment to be treated outside of the hospital with equal efficacy and safety as in-hospital; prolonged intravenous antibiotic therapy is required for the treatment of selected infections. OPAT is particularly beneficial for patients. ⋯ Furthermore, the risk of nosocomial infections can be reduced, especially through multi-resistant pathogens. Outpatient prescriptions shorten the inpatient length of stay and costs can be saved. Additionally the reception capacities of hospitals will be increased.
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Diabetes mellitus is a chronic metabolic disease associated with multiple long-term complications. Besides macro- and microvascular complications, patient's well-being can be severely impaired by complications affecting the nervous system. ⋯ Insufficient glycemic control, young age at diagnosis of diabetes are discussed as risk factors for developing diabetes complications. The early identification and prevention of factors predicting diabetes complications that affect the nervous system are still challenging and in need for further research.
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Dtsch. Med. Wochenschr. · Nov 2020
Case Reports[Sudden exercise dyspnea in a young woman - an interdisciplinary case in the emergency room].
A 39-year-old woman with suddenly occurring exercise dyspnea is admitted under the suspicion of pulmonary embolism. In medical history, she mentions a recently completed fertility treatment. ⋯ OHSS is primarily a gynaecological condition, but physicians may encounter it with exercise dyspnea or abdominal pain as presenting symptoms. Symptoms can be treated well at an early stage, and severe courses can usually be prevented. In this case, clinical history and sonography could disprove the initially suspected diagnosis of pulmonary embolism.
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Dtsch. Med. Wochenschr. · Nov 2020
[Practice of euthanasia among physicians and nurses in German hospitals].
Active euthanasia and physician-assisted suicide are controversially discussed in Germany. Empirical studies are missing to estimate their respective incidence, including passive and indirect euthanasia in German hospitals. Physicians and nurses in German hospitals were surveyed regarding their practice of euthanasia and possible influence factors. ⋯ Euthanasia is practiced by physicians and nurses in German hospitals. The Incidence of different types of euthanasia and relevant influence factors are discussed considering methodical limitations.
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Peripheral artery occlusive disease is a prevalent but underdiagnosed manifestation in patients with diabetes and also in patients with diabetic foot ulceration. There is insufficient awareness of its clinical manifestations, including intermittent claudication and critical limb ischemia and of its risk of adverse limb outcomes. This review aims to highlight essential elements of the prevalence of peripheral artery disease in patients with diabetes and the the pathway of clinical diagnosis. We report the actual standards and evidence based, interdisciplinary management including conservative, interventional and surgical treatment options and also the needs of follow-up care.