Deutsche medizinische Wochenschrift
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Cancer treatments, although life prolonging, are associated with side effects. The occurrence, duration, and severity of side effects vary, depending on treatment received. Long-term effects refer to effects that manifest during treatment and persist long after treatment has ended. ⋯ This overview aims to provide a non-exhaustive overview of the long-term and late effects associated with the traditional mainstay of cancer treatments (surgery, radiotherapy, chemotherapy) and newer treatments such as immunotherapy. In conclusion, long-term and late effects of cancer treatment can be associated with a high burden for those affected, including a reduction in their ability to function and health-related quality of life. Given the large and further growing number of cancer survivors and the abundance of long-term and late effects, it is essential to develop and implement risk-adapted, multidisciplinary survivorship care programmes.
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Dtsch. Med. Wochenschr. · Jan 2025
Review[Acutely Altered Mental Status: When the Patient is Acting Odd].
An acutely altered mental status is a common presenting complaint. A wide variety of neurological, systemic or psychiatric conditions can be the cause. Sometimes there is even overlap of various diseases that contribute to the patient's confusion. ⋯ Nevertheless, even with just limited preclinical resources perceptive teams are able to gather and analyse enough information to diagnose and treat the patient. The result of this detective work can be quite rewarding, especially if the initial diagnosis is confirmed. Therapeutic measures preclinically focus on maintaining the cerebral equilibrium.
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Dtsch. Med. Wochenschr. · Jan 2025
Review[Renal replacement therapy in Germany: An overview with a clinical focus].
In Germany, around 80000 people are currently dependent on permanent renal replacement therapy (RRT). Due to demographic developments and improvements in life expectancy, the prevalence will continue to increase even if the effects of newer pharmacological substances such as SGLT2 inhibitors and GLP1 agonists are promising in inhibiting progression. There are basically three different methods of renal replacement therapy and their variants: Kidney transplantation (KTX), peritoneal dialysis (PD), hemodialysis (HD)/hemodiafiltration (HDF). ⋯ PD and HD are considered to be equivalent in terms of mortality. Currently, HDF is increasingly coming back into focus after the last randomized controlled trial (CONVINCE trial) proved its superiority over conventional HD. Kidney transplantation is clearly superior to dialysis therapy in terms of life expectancy; according to a meta-analysis, the risk of death is reduced by around 55% in comparison.
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Dtsch. Med. Wochenschr. · Jan 2025
Case Reports[Atypical spontaneous bacterial peritonitis linked to streptococcal toxic shock syndrome].
A 59-year-old female patient with an unremarkable medical history presented with watery diarrhea, severe lower abdominal pain, and fever for approximately 7 days. Physical examination revealed a distended abdomen, bowel sounds were absent, and there was an acute abdomen with generalized guarding and significantly elevated inflammatory markers. ⋯ Primary spontaneous bacterial peritonitis caused by Streptococcus pyogenes is a rare cause of acute abdomen. An early diagnosis and immediate antibiotic therapy are crucial for prognosis.
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The examination of urine and its evaluation are central components in the diagnostic pathway for kidney diseases. Essential to this process is the correct analysis and interpretation of the urine sediment. A nephritic sediment indicates glomerular kidney disease with high specificity. This article explains the diagnosis, evaluation, and implications of a nephritic sediment.