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Diagnostische Bronchoskopie 诊断支气管
DoctorConsult - The Journal. Wissen für Klinik und Praxis Pub Date : 2011-08-01 DOI: 10.1016/j.dcjwkp.2011.07.011
Franz Stanzel
{"title":"Diagnostische Bronchoskopie","authors":"Franz Stanzel","doi":"10.1016/j.dcjwkp.2011.07.011","DOIUrl":"https://doi.org/10.1016/j.dcjwkp.2011.07.011","url":null,"abstract":"<div><p>The flexible bronchoscope is the instrument of choice for visualization of the trachea, and even peripheral, smaller airways. The majority of examinations can be carried out under sedation and local anesthesia. Bronchoscopy under general anesthesia, mostly performed with the rigid bronchoscope, is reserved for special situations and indications. In addition to inspection, bronchoscopy allows to gather materials with different techniques. Forceps biopsy supplemented by brushes, needles and various other techniques is the most common procedure. The removal of secretions as well as washing or lavage techniques play an additional role. This allows the diagnosis of malignant diseases, especially lung cancer and other thoracic malignomas as well as infectious and interstitial lung diseases. Bronchoscopy has a high sensitivity in chest diseases and also some extrathoracic illnesses, if these involve the chest. Bronchoscopy is a safe procedure and has a low complication rate as long as indications and contraindications are strictly followed, and if carried out by a trained physician.</p></div>","PeriodicalId":100380,"journal":{"name":"DoctorConsult - The Journal. Wissen für Klinik und Praxis","volume":"2 2","pages":"Pages e113-e119"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.dcjwkp.2011.07.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psoriasis-Arthritis Psoriasis-Arthritis
DoctorConsult - The Journal. Wissen für Klinik und Praxis Pub Date : 2011-08-01 DOI: 10.1016/j.dcjwkp.2011.07.005
Prim. Priv. Doz. Dr. Peter Peichl
{"title":"Psoriasis-Arthritis","authors":"Prim. Priv. Doz. Dr. Peter Peichl","doi":"10.1016/j.dcjwkp.2011.07.005","DOIUrl":"https://doi.org/10.1016/j.dcjwkp.2011.07.005","url":null,"abstract":"<div><p>Psoriatic arthritis (also called arthritis psoriatica, arthropathic psoriasis or psoriatic arthropathy) is an independent syndrome that is not always easy to detect. Signs and symptoms are similar to those in rheumatic diseases; in addition, skin and nail changes as well as less specific discomforts in tendons and ligaments may occur. Psoriatic arthritis is a disease that may affect skin, nails, joints and sometimes spine. Skin signs are very similar to psoriasis without joint involvement. Typical are also nail changes which are more common in patients with psoriatic arthritis than in psoriasis without joint involvement. Many patients develop pinpoint size deepenings on their nails (nail pittings); occasionally yellowish discoloured „oil stains“ (yellow-brown discoloured nail lesions), cornification disorders, brittle nails or onychomadesis may occur.</p></div>","PeriodicalId":100380,"journal":{"name":"DoctorConsult - The Journal. Wissen für Klinik und Praxis","volume":"2 2","pages":"Pages e145-e147"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.dcjwkp.2011.07.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aszites 腹水
DoctorConsult - The Journal. Wissen für Klinik und Praxis Pub Date : 2011-08-01 DOI: 10.1016/j.dcjwkp.2011.07.006
Henryk Dancygier
{"title":"Aszites","authors":"Henryk Dancygier","doi":"10.1016/j.dcjwkp.2011.07.006","DOIUrl":"https://doi.org/10.1016/j.dcjwkp.2011.07.006","url":null,"abstract":"<div><p>Ascites denotes the accumulation of fluid in the peritoneal cavity. Different types of ascites can be distinguished depending on its aetiology: portal (e.g. in liver cirrhosis), cardial (e.g. in right heart failure), malignant (e.g. in peritoneal carcinosis), inflammatory or infectious (e.g. in tuberculosis), and chylous ascites (due to injury to the lymphatic vessels). Liver cirrhosis is the most common cause of ascites. During anamnesis the patient should be asked if there has been an increase of the abdominal girth. Abdominal ultrasound is the medical imaging of choice in order to discover even the smallest amount of ascites. Paracentesis is the gold standard for further analysis of ascites through biochemical, cytological and bacteriological procedures. Complications of ascites include primarily spontaneous bacterial peritonitis (SBP), hepatorenal syndrome, and hepatic hydrothorax. Treatment and prognosis of ascites depend on the underlying disease.</p></div>","PeriodicalId":100380,"journal":{"name":"DoctorConsult - The Journal. Wissen für Klinik und Praxis","volume":"2 2","pages":"Pages e87-e96"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.dcjwkp.2011.07.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sjögren-Syndrom Sjögren's 综合症
DoctorConsult - The Journal. Wissen für Klinik und Praxis Pub Date : 2011-08-01 DOI: 10.1016/j.dcjwkp.2011.07.008
Prim. Priv. Doz. Dr. Peter Peichl
{"title":"Sjögren-Syndrom","authors":"Prim. Priv. Doz. Dr. Peter Peichl","doi":"10.1016/j.dcjwkp.2011.07.008","DOIUrl":"https://doi.org/10.1016/j.dcjwkp.2011.07.008","url":null,"abstract":"<div><p>Sjögren's syndrome (also known as Mikulicz disease<span><span> and Sicca syndrome) is a disease that is based on a malfunction of the body's immune system. These defence mechanisms then turn on one's own body by mistake. The immune system does not recognise the own body anymore and its control and regulatory mechanisms which are meant to limit autoimmune reactions are disturbed. Autoantibodies which occur in Sjögren's disease attack the body's own substances, so called autoantigens, and contribute essentially to the disease-causing process of autoimmune diseases. In Sjögren's syndrome, the body's own defence mechanism turns on </span>exocrine glands<span>, including salivary glands and the eye's tear glands, causing dry eyes and mouth.</span></span></p></div>","PeriodicalId":100380,"journal":{"name":"DoctorConsult - The Journal. Wissen für Klinik und Praxis","volume":"2 2","pages":"Pages e149-e151"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.dcjwkp.2011.07.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bildgebende Diagnostik des Kolons
DoctorConsult - The Journal. Wissen für Klinik und Praxis Pub Date : 2011-08-01 DOI: 10.1016/j.dcjwkp.2011.03.005
Markus Holtmann , Markus Düx , Günter Kauffmann
{"title":"Bildgebende Diagnostik des Kolons","authors":"Markus Holtmann ,&nbsp;Markus Düx ,&nbsp;Günter Kauffmann","doi":"10.1016/j.dcjwkp.2011.03.005","DOIUrl":"10.1016/j.dcjwkp.2011.03.005","url":null,"abstract":"<div><p>Radiologic evaluation and pathologic finding of colon diseases are main aspects of this article. The radiological examinations of the colon are described including basic technical considerations as well as the significance and restrictions of the diagnostic tests. Following tests are listed: Endoscopy, plain film of the abdomen, sonography, barium study of the colo, Gastrografin<sup>®</sup> radiography, computertomography, virtual coloscopy, MRI, angiography, endosonography, szintigraphy and FDG-PET. Radiologic tests for polyposis, colorectal cancer, mesenteric ischemia, Crohn's disease, ulcerative colitis, diverticulosis and diverticulitis are described in detail, followed by specific findings with exemplary images.</p></div>","PeriodicalId":100380,"journal":{"name":"DoctorConsult - The Journal. Wissen für Klinik und Praxis","volume":"2 2","pages":"Pages e121-e129"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.dcjwkp.2011.03.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89618613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Hypertrophe Kardiomyopathie 高眼压症
DoctorConsult - The Journal. Wissen für Klinik und Praxis Pub Date : 2011-08-01 DOI: 10.1016/j.dcjwkp.2011.07.004
Heiko Kilter, Michael Böhm
{"title":"Hypertrophe Kardiomyopathie","authors":"Heiko Kilter,&nbsp;Michael Böhm","doi":"10.1016/j.dcjwkp.2011.07.004","DOIUrl":"https://doi.org/10.1016/j.dcjwkp.2011.07.004","url":null,"abstract":"<div><p>Hypertrophic cardiomyopathy (HCM) is associated with hypertrophy of the left and/or right ventricle. Development of the disease may be based on genetic predispositions. An increased frequency in families can be seen in 50% of cases. Up to 0.2% of the general population are affected. But there is probably a high number of unknown cases because sudden cardiac death is often the first manifestation of HCM. HCM is also the most frequent cause of sudden deaths among adolescents and athletes. Symptoms can be very different. Most patients have no or mild clinical signs, but symptoms of diastolic heart failure are possible. Diagnosis is based on ECG, 24 hour ECG, echocardiography, cardiac catheter, and other methods. For treatment drugs like beta blockers or calcium antagonists can be helpful. Other therapeutic options are a percutaneous septal myocardial ablation. In case of left ventricular dilatation prognosis is relatively poor. Overall mortality per year is estimated up to 2% for adults and up to 4 to 6% for children.</p></div>","PeriodicalId":100380,"journal":{"name":"DoctorConsult - The Journal. Wissen für Klinik und Praxis","volume":"2 2","pages":"Pages e139-e144"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.dcjwkp.2011.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dilatative Kardiomyopathie 扩张性心肌病
DoctorConsult - The Journal. Wissen für Klinik und Praxis Pub Date : 2011-08-01 DOI: 10.1016/j.dcjwkp.2011.07.003
Heiko Kilter, Michael Böhm
{"title":"Dilatative Kardiomyopathie","authors":"Heiko Kilter,&nbsp;Michael Böhm","doi":"10.1016/j.dcjwkp.2011.07.003","DOIUrl":"https://doi.org/10.1016/j.dcjwkp.2011.07.003","url":null,"abstract":"<div><p>Dilated cardiomyopathy is characterized by a dilatation and reduced systolic function of one or both ventricles. The atria are often also dilated. Causes of the disease are mostly unknown but genetic and/or exogen factors may play a role. Aspects like poor controlled blood pressure or alcohol abuse can promote disease progression. The incidence is 5 to 10 cases in 100,000 people. There is an increased familial frequency in 20 to 35% of cases. Symptoms coincide mostly with those of congestive systolic heart failure. Diagnosis is based on the exclusion of other diseases. Possible methods of diagnosis are echocardiography and cardiac catheter including coronary angiography. Therapy corresponds to the treatment of chronic heart failure.</p></div>","PeriodicalId":100380,"journal":{"name":"DoctorConsult - The Journal. Wissen für Klinik und Praxis","volume":"2 2","pages":"Pages e135-e137"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.dcjwkp.2011.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rheumatische Therapien in der Schwangerschaft 怀孕时的急救疗法
DoctorConsult - The Journal. Wissen für Klinik und Praxis Pub Date : 2011-08-01 DOI: 10.1016/j.dcjwkp.2011.07.010
Prim. Priv. Doz. Dr. Peter Peichl
{"title":"Rheumatische Therapien in der Schwangerschaft","authors":"Prim. Priv. Doz. Dr. Peter Peichl","doi":"10.1016/j.dcjwkp.2011.07.010","DOIUrl":"10.1016/j.dcjwkp.2011.07.010","url":null,"abstract":"<div><p>Pregnancy and rheumatic diseases share many contact points. Some rheumatic diseases are obviously hormone-dependent and may occur after pregnancy for the first time. It is regularly observed that the intensity of rheumatic diseases increases or decreases during pregnancy. In general, rheumatic disease is no contraindication for pregnancy. With most medications, however, pregnancy should be avoided during treatment, and therefore safe contraception should be ensured. Only few medications are unproblematic during pregnancy. Apart from cortisone there are good safety data available for chloroquine, sulfasalazine as well as some biologicals. Nevertheless the use of those medicines should be weighed up interdisciplinarily (rheumatology, gynaecology and patient).</p></div>","PeriodicalId":100380,"journal":{"name":"DoctorConsult - The Journal. Wissen für Klinik und Praxis","volume":"2 2","pages":"Pages e153-e156"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.dcjwkp.2011.07.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79501488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Präexzitationssyndrome, mit einer akzessorischen Leitungsbahn assoziierte atrio-ventrikuläre (AV)-Reentry-Tachykardien 排定前症候群、与亚洲类总指挥机构(AV)承诺心室
DoctorConsult - The Journal. Wissen für Klinik und Praxis Pub Date : 2011-08-01 DOI: 10.1016/j.dcjwkp.2011.07.007
J. Christoph Geller
{"title":"Präexzitationssyndrome, mit einer akzessorischen Leitungsbahn assoziierte atrio-ventrikuläre (AV)-Reentry-Tachykardien","authors":"J. Christoph Geller","doi":"10.1016/j.dcjwkp.2011.07.007","DOIUrl":"10.1016/j.dcjwkp.2011.07.007","url":null,"abstract":"<div><p>Paroxysmal tachycardia is often caused by accessory pathways. In general, paroxysmal tachycardia is not a life-threatening condition. However, fast antegrade conduction of atrial fibrillation via an accessory pathway with short antegrade refractory period constitutes an exception. In antegrade conduction a characteristic delta wave is visible in the sinus rhythm, caused by fused activation of the ventricle both via accessory pathways and AV node. However, there are also accessory pathways that conduct only retrogradely. These may also be responsible for tachycardia. Due to the potential hazard by fast antegrade conduction via an accessory pathway during atrial fibrillation it may make sense to measure the antegrade refractory period of the accessory pathway even in asymptomatic patients with ventricular pre-excitation on a case-to-case basis. For this purpose, either invasive electrophysiological examination or oesophageal electrode aided stimulation is necessary <span>[1]</span>, <span>[2]</span>. It is uncertain whether only intermittent pre-excitation also comes with good prognosis <span>[3]</span>. Nowadays catheter ablation of the accessory pathway is the treatment of choice in symptomatic patients, while continuous medication only plays a minor part. In asymptomatic patients with pre-excitation visible in the ECG, indication for ablation must be considered very carefully. Normally, ablation treatment in the absence of any symptoms is only performed in special risk groups.</p></div>","PeriodicalId":100380,"journal":{"name":"DoctorConsult - The Journal. Wissen für Klinik und Praxis","volume":"2 2","pages":"Pages e97-e103"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.dcjwkp.2011.07.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91528393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sarkoidose 肉样瘤病
DoctorConsult - The Journal. Wissen für Klinik und Praxis Pub Date : 2011-08-01 DOI: 10.1016/j.dcjwkp.2011.05.001
Axel F.G. von Bierbrauer
{"title":"Sarkoidose","authors":"Axel F.G. von Bierbrauer","doi":"10.1016/j.dcjwkp.2011.05.001","DOIUrl":"https://doi.org/10.1016/j.dcjwkp.2011.05.001","url":null,"abstract":"<div><p>Sarcoidosis is a multisystem disorder of unknown aetiology. The pathogenetic principle is a granulomatous inflammatory reaction, probably caused by an overwhelming cell-mediated immune response to an antigen. The disorder is characterised by an inflammatory infiltration by non-caseating granulomas developing in the affected organs.</p><p>In most cases the lung is involved (&gt; 90%) and a “classical” bilateral hilar lymphadenopathy develops and/or an increase of mostly reticulo-nodular opacities can be observed in chest X-ray.</p><p>Basically sarcoidosis can affect each and every organ system, and up to 30% of patients show extrapulmonary involvement. Essential diagnostic procedures include chest X-ray, chest CT, bronchoscopy, pulmonary function testing and complementary determination of laboratory parameters.</p><p>The clinical course is highly variable; however, in general the prognosis of sarcoidosis is good, and in most cases spontaneous recovery can be expected. This specifically applies to highly acute courses such as bilateral hilar lymphadenopathy syndrome (Lofgren's syndrome). However, at least 10% of untreated cases develop chronic progressive courses with relevant impairment of organ systems eventually resulting in premature death (e.g. pulmonary fibrosis).</p><p>If any therapy is required at all, long-term administration of glucocorticoids is the basic element of treatment in sarcoidosis. In rare cases the administration of more potent immunosuppressive drugs such as methotrexate, azathioprine, or cyclophosphamide is required.</p></div>","PeriodicalId":100380,"journal":{"name":"DoctorConsult - The Journal. Wissen für Klinik und Praxis","volume":"2 2","pages":"Pages e75-e79"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.dcjwkp.2011.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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