Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Sep 2006
Case Reports[Recurrent autoreactive pericardial effusion. Impact of an aetiological classification of pericarditis].
A 36 year-old man suffered from fever, fatigue, pleurodynia and precordial discomfort. His family physician suspected febrile tracheobronchitis and treated it with ampicillin for 5 days. Because symptoms persisted an ECG was done which suggested acute myocardial infarction. The patient underwent an emergency coronary angiography which excluded coronary artery disease and aortic dissection. Pericarditis was suspected and the patient put on aspirin, 500 mg/d. Because of persisting cardiac symptoms an echocardiography was performed which revealed systolic separation between epi- and pericardium, characteristic of a small pericardial effusion after acute pericarditis. The symptoms improved after one week of treatment with diclofenac and the ECG had become normal. Two months later the patient was seen at our cardiac outpatient clinic. He had night sweats, sporadic precordial pain and severe dyspnoe. ⋯ After exclusion of bacterial and viral pericardial infection, a high single dose of intrapericardial triamcinolone combined with long-term oral colchicine has proven to be a highly efficacious treatment of autoreactive pericarditis which will avoid relapses in most cases.
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Dtsch. Med. Wochenschr. · Sep 2006
[In-hospital resuscitation. Concept of first-responder resuscitation using semi-automated external defibrillators (AED)].
The prognosis after in-hospital resuscitation has not significantly improved in the last 40 years. This account presents the results over a three-year period of a hospital-wide emergency plan which implements the use of an automated external defibrillator (AED) by the first responder to the emergency call. ⋯ An immediate resuscitation plan consisting of an integrated programme of early defibrillation is feasible and seems to achieve an improved prognosis for patients who have sustained an in-hospital cardiac arrest.
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Dtsch. Med. Wochenschr. · Aug 2006
Review[Chemotherapy induced-vomiting--a practical guide for prevention and therapy].
Nausea and vomiting are considered as two of the most distressing side effects of chemotherapy. The frequency of nausea and vomiting depends primarily on the emetogenic potential of the chemotherapeutic agents used. With the introduction of the neurokinin-1-receptor-antagonists in combination with 5-HT(3) receptor-antagonists and steroid approximately 70-90 % of patients receiving highly emetogenic chemotherapy can be protected from emesis. Here, the most recent developments in the antiemetic therapy including the latest guidelines for antiemetic prophylaxis are described.