Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Oct 2020
Case Reports[Quadruple negative SARS-CoV-2-PCR: still COVID-19 pneumonia!]
A 78-year-old man fell ill with weakness, coughing and fever 19 days after a cruise in early April 2020 and was admitted 4 days later with increasing shortness of breath. ⋯ In case of a high degree of clinical suspicion in combination with typical findings of thoracic imaging, the suspected diagnosis COVID-19 disease should be maintained even in case of multiple negative SARS-CoV-2-PCR. Seroconversion occurs a few days to 2 weeks after the onset of symptoms and can be used to confirm the diagnosis.
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Artificial intelligence (AI) is currently transforming all aspects of our daily life, including the practice of medicine. Artificial neural networks are a key method of AI. They can very effectively detect subtle patterns in imaging data and speech or text data. ⋯ Our focus is on AI-based analysis of endoscopy images, non-invasive imaging and histology images. In these applications, AI can support human pattern recognition. Beyond detection and classification of pathological findings, AI can predict clinical outcome from subtle image features.
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The 2019 guidelines of the European Society of Cardiology (ESC) rename stable coronary heart disease to chronic coronary syndrome (CCS). Under CCS, six different scenarios have been defined, which take its heterogeneity into account. An important part of the current guideline plays the diagnostic assessment of the pre-test probability in the event of the possible presence of stenosing coronary heart disease. ⋯ Imaging techniques such as CT angiography have been significantly upgraded as diagnostic procedures for the detection of CHD, while exercise ECG is no longer routinely recommended in this regard. Invasive coronary angiography with revascularization option remains a central diagnostic and therapeutic procedure. In addition to antianginal, lipid-lowering and antithrombotic therapy, the current CCS guideline places special emphasis on prevention by means of lifestyle modification.
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Recommendations for vaccination of patients with rheumatic Diseases. Patients with rheumatic diseases are particularly at risk from infections. ⋯ Important new developments, such as sequential vaccination against pneumococcus or the approval of a vaccine against Herpes Zoster, improve the possibilities of an effective infection protection. Special attention must be paid to the current recommendations for the use of live vaccines like MMR vaccination in patients under immunosuppressive therapy.
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Dtsch. Med. Wochenschr. · Oct 2020
Case Reports[Infection of the orbita due to Delftia acidovorans after a cat scratch].
A 60 years old woman experienced a cat scratch 34 months ago on the left eyelid. Chronic, progredient skin lesions and headache developed. Treatments with cortisone, pimecrolimus, pregabalin and metamizole were not successful. After 24 months the patient complained of severe bulbus pain in the left eye, increased eye movement pain, and high photosensitivity. There were granulomatous papules in the area of the eye. ⋯ D. acidovorans has not yet appeared as a zoonotic pathogen but should be included in the case of injury by animals in the differential diagnostic considerations.