Medizinische Klinik最新文献_第9页

[Interdisciplinary emergency admissions. Assurance of treatment quality and efficiency with an integrated treatment approach]. [跨学科紧急录取。通过综合治疗方法保证治疗质量和效率]。

Medizinische Klinik Pub Date : 2010-06-01 Epub Date: 2010-06-26 DOI: 10.1007/s00063-010-1072-0

Tassilo Bonzel

引用次数: 1

[Gallstone ileus in underlying stenosis of the sigmoid due to recurrent diverticulitis--a rare complication of cholelithiasis]. [复发性憩室炎引起乙状结肠基础狭窄的胆石性肠梗阻-胆石症的罕见并发症]。

Medizinische Klinik Pub Date : 2010-06-01 Epub Date: 2010-06-26 DOI: 10.1007/s00063-010-1074-y

Rui Sun, Lorenz Theilmann, Ulrich Vöhringer, Ahmed Abdel Samie

{"title":"[Gallstone ileus in underlying stenosis of the sigmoid due to recurrent diverticulitis--a rare complication of cholelithiasis].","authors":"Rui Sun, Lorenz Theilmann, Ulrich Vöhringer, Ahmed Abdel Samie","doi":"10.1007/s00063-010-1074-y","DOIUrl":"https://doi.org/10.1007/s00063-010-1074-y","url":null,"abstract":"Background: Gallstone ileus is a rare complication of cholelithiasis and an uncommon cause of intestinal obstruction. It accounts for about 1-4% of all mechanical bowel obstructions. The clinical symptoms and signs of gallstone ileus are mostly nonspecific.Case report: An 82-year-old woman with recurrent diverticulitis of the sigmoid was admitted because of cramping right upper abdominal pain and signs of large bowel obstruction. Abdominal ultrasound revealed pneumobilia and severe diverticulitis of the sigmoid with signs of ileus. Endoscopic retrograde cholangiography visualized the cholecystoenteric fistula. In addition, computed tomography (CT) scan revealed two stones 3 cm in diameter leading to nearly complete obstruction of the sigmoid. The patient underwent an open cholecystectomy, closure of the cholecystoenteric fistula, and sigmoidectomy.Conclusion: This case report demonstrates that relative stenoses of the sigmoid due to recurrent diverticulitis may predispose to the impaction of foreign bodies. Gallstone ileus is a rare but important differential diagnosis of intestinal obstruction. Ultrasound and CT scans are very helpful in diagnosing gallstone ileus. The treatment is surgical. Unfortunately, surgical therapy of this rare complication is associated with a high morbidity and mortality rate due to multiple comorbidities and age-related problems of these patients. The management of patients with gallstone ileus should be individualized.","PeriodicalId":18420,"journal":{"name":"Medizinische Klinik","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00063-010-1074-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29085092","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: 4

[Scabbard trachea]. 剑鞘气管。

Medizinische Klinik Pub Date : 2010-05-01 DOI: 10.1007/s00063-010-1065-z

Martin Brueck, Albert Druehe

引用次数: 0

[Cost of illness in Alzheimer's disease]. [阿尔茨海默病的疾病成本]。

Medizinische Klinik Pub Date : 2010-05-01 Epub Date: 2010-05-26 DOI: 10.1007/s00063-010-1060-4

Peter Kiencke, Reinhard Rychlik, Christine Grimm, Dietmar Daniel

{"title":"[Cost of illness in Alzheimer's disease].","authors":"Peter Kiencke, Reinhard Rychlik, Christine Grimm, Dietmar Daniel","doi":"10.1007/s00063-010-1060-4","DOIUrl":"https://doi.org/10.1007/s00063-010-1060-4","url":null,"abstract":"Purpose: The aim of this analysis was to generate cost data of provider services, drug acquisition, hospitalization, nursing care services, and adjuvants for patients with Alzheimer's disease, as well as to describe the distribution and development of care levels.Material and methods: The analysis is based on anonymized data of patients with Alzheimer's disease who were insured by a large German statutory health insurance (Barmer Krankenkasse [BARMER]) in 2005 (n = 48,322). The study population was classified into three treatment groups: patients, who received memantine and no other antidementives, psychotropic drugs or hypnotics/sedatives (memantine group); patients who neither received memantine nor other antidementives, but psychotropic drugs and hypnotics/ sedatives (PHS group); and patients who received no antidementives or symptomatic therapy at all (\"no dementia-specific AM\"). Costs were fully assessed for patients in each treatment group and correlated with the care level.Results: In the memantine group, fewer patients needed care than in the other two groups. Total costs per patient averaged 7,028 Euros in the memantine group, 13,549 Euros in the PHS group, and 8,817 Euros in the group with no specific medication. Higher costs in the PHS group and in the group without drug treatment were mainly caused by a considerably higher rate of patients in need of care, of which nursing care made up the highest proportion. Fewer costs for medical treatment could not compensate the additional expenditures for nursing care. Patients in the PHS group had the highest average costs in all cost categories except for specific drug cost.Conclusion: The results demonstrate that non-antidementive therapy for Alzheimer's disease causes higher costs especially in nursing care. The memantine group proved superior even though it had the highest costs in the specific drug category.","PeriodicalId":18420,"journal":{"name":"Medizinische Klinik","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00063-010-1060-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29017091","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: 7

[Optimizing health care using the example of rehabilitation. Intended goals have to be defined and achieved goals have to be confirmed]. [以康复为例优化卫生保健。预定的目标必须被定义，实现的目标必须被确认。

Medizinische Klinik Pub Date : 2010-05-01 Epub Date: 2010-05-26 DOI: 10.1007/s00063-010-1063-1

Franz Porzsolt, Theo Zimmermann

引用次数: 3

[The role of platelets in atherosclerosis, diabetes mellitus, and chronic kidney disease. An attempt at explaining the TREAT study results]. 血小板在动脉粥样硬化、糖尿病和慢性肾脏疾病中的作用。试图解释TREAT研究结果]。

Medizinische Klinik Pub Date : 2010-05-01 Epub Date: 2010-05-26 DOI: 10.1007/s00063-010-1062-2

Norbert Maurin

{"title":"[The role of platelets in atherosclerosis, diabetes mellitus, and chronic kidney disease. An attempt at explaining the TREAT study results].","authors":"Norbert Maurin","doi":"10.1007/s00063-010-1062-2","DOIUrl":"https://doi.org/10.1007/s00063-010-1062-2","url":null,"abstract":"Erythropoiesis-stimulating agents (ESA) are used to treat renal anemia. The TREAT study (Trial to Reduce Cardiovascular Events with Aranesp Ther- apy) of diabetic patients with chronic kidney disease (CKD) found that the risk of stroke was significantly higher than in the control arm. This raises the question as to what causes this phenomenon. Platelets may play a crucial role in this context. Atherogenesis involves complex interactions between platelets and monocytes (platelet-monocyte crosstalk) and with endothelial cells. Platelets are activated in cases of diabetes mellitus, especially. During atherogenesis, partial functions of platelets other than those inhibited by aspirin, as a cyclooxygenase inhibitor, or by adenosine diphosphate receptor P2Y(12)antagonists, such as thienopyridines, are of relevance. During platelet-monocyte crosstalk, specifically, an important role is played by adhesion receptors such as selectins and integrins. In addition, ESA cause platelet activation by direct and indirect mechanisms. Antagonistic thereto is a renal bleeding tendency in cases of severe CKD, due to platelet dysfunction, which can be remedied with appropriate renal replacement therapy and administration of ESA in order to reach a hemoglobin (Hb) level of 10 g/dl. However, if the Hb level exceeds 10 g/dl, the even stronger platelet activation caused by ESA, combined with the activation caused by diabetes, leads to a prothrombotic state, which in patients with severe atherosclerosis can result in acute atherothrombotic complications, in the genesis of which platelets play a key role. This would be one hypothesis for explaining the increased incidence of strokes in the TREAT study.","PeriodicalId":18420,"journal":{"name":"Medizinische Klinik","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00063-010-1062-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29017093","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: 6

[Varicella and herpes zoster. Part 1: virology, epidemiology, clinical picture, laboratory diagnostics]. 水痘和带状疱疹。第1部分:病毒学，流行病学，临床图像，实验室诊断]。

Medizinische Klinik Pub Date : 2010-05-01 Epub Date: 2010-05-26 DOI: 10.1007/s00063-010-1061-3

Miriam Wittek, Hans Wilhelm Doerr, Regina Allwinn

引用次数: 12

[Urinalysis in routine clinical care]. 【临床常规护理中的尿液分析】。

Medizinische Klinik Pub Date : 2010-05-01 DOI: 10.1007/s00063-010-1064-0

Mariam Abu-Tair

引用次数: 2

[Allopurinol-induced hypersensitivity syndrome resulting in death]. [别嘌呤醇引起的过敏综合征导致死亡]。

Medizinische Klinik Pub Date : 2010-04-01 DOI: 10.1007/s00063-010-1037-3

Sören Laurisch, Maren Jaedtke, Reyhan Demir, Sajoscha A Sorrentino, Jan T Kielstein, Hans-Oliver Rennekampff, Peter M Vogt, Gerd P Meyer, Martin Fuchs, Gunnar Klein, Hartmut Drexler, Bernhard Schieffer, L Christian Napp

引用次数: 4

[Internal medicine in a postmodern society. Address at the festive evening event to mark the 116th Congress of the German Society of Internal Medicine on 11 April 2010]. 后现代社会的内科医学。2010年4月11日，在庆祝德国内科学会第116届大会的节日晚会上的讲话。

Medizinische Klinik Pub Date : 2010-04-01 DOI: 10.1007/s00063-010-1050-6

Jürgen Schölmerich

引用次数: 1