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[Ethische Orientierung durch interkulturelle Kompetenz in interkulturellen Behandlungssituationen]. 在跨文化治疗情况下，通过跨文化能力进行道德导向。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-09-01
Ilhan Ilkilic
{"title":"[Ethische Orientierung durch interkulturelle Kompetenz in interkulturellen Behandlungssituationen].","authors":"Ilhan Ilkilic","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>In many European countries, intercultural treatment situations are an integral part of everyday medical practice. In this context, the appearance of different interest and decision-making conflicts, which result from communication barriers, cultural practice or moral diversity, are not uncommon. In this paper, the characteristics of intercultural treatment situations with their ethical relevance are presented. Some skills and abilities of intercultural competence are also described and their function is demonstrated by a clinical ethical case. The opportunities and limitations of intercultural competence for an ethical orientation are subject of reflection.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 7","pages":"302-306"},"PeriodicalIF":0.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683399","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
[Vaskuläre Dyspnoe: Pulmonale Hypertonie]. 血管性呼吸困难：肺动脉高压。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-08-01
Dora Serény, Silvia Ulrich, Charlotte Berlier
{"title":"[Vaskuläre Dyspnoe: Pulmonale Hypertonie].","authors":"Dora Serény,&nbsp;Silvia Ulrich,&nbsp;Charlotte Berlier","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary hypertension (PH) is defined by a mean pulmonary artery pressure > 20 mmHg [1] [2]. Echocardiography is used to screen for pulmonary hypertension, but right heart catheterization is required to confirm the diagnosis. Right heart catheterization is used to measure hemodynamic parameters such as pulmonary arterial pressures and pulmonary artery wedge pressure (PAWP), which normally corresponds to the left ventricular end-diastolic pressure. In addition, cardiac output (CO) is measured using the direct Fick method or thermodilution. The pulmonary vascular resistance (PVR) can be derived from these values. Precapillary PH is defined by PAWP ≤15 mmHg and PVR >2 WU (wood units), postcapillary PH is defined by increased PAWP > 15 mmHg with PVR 2 WU due to passive backflow [3]. However, there are also combined pre- and post-capillary PH with a PAWP > 15 mmHg and elevated PVR > 2 WU. Supportive therapies for all forms of PH include diuretics, supplemental oxygen in case of hypoxemia, gentle exercise under specialized supervision, and anticoagulants for some forms. Specific drug or interventional therapies are available only for pulmonary vascular disease subgroups pulmonary arterial hypertension (group 1) and chronic thromboembolic PH (CTEPH, group 4), while for PH due to heart and lung diseases (groups 2 and 3) as well as mixed forms the therapy of the underlying disease is of major importance. Drug therapy for pulmonary vascular diseases includes endothelin receptor antagonists, phosphodiesterase-5 inhibitors and prostanoids. CTEPH requires clarification regarding surgical pulmonary endarterectomy or interventional balloon angioplasty [4]. Since the diagnosis and therapy of PH is very complex, it must be carried out in an experienced center.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 6","pages":"272-278"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683398","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
[Pulmonary Dyspnea]. [肺呼吸困难]。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-08-01
Laura C Mayer, Christian Clarenbach
{"title":"[Pulmonary Dyspnea].","authors":"Laura C Mayer,&nbsp;Christian Clarenbach","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Dyspnea is one of the most common symptoms in patients with lung diseases. The term \"dyspnea\" refers to the subjective sensation of uncomfortable breathing, which is experienced and described very differently between individuals. Because of this, diagnosis can be very challenging and similar to pain, no true objective measurement parameters of dyspnea exist. A detailed symptom history and clinical examination are critical in establishing the diagnosis, but the severity of pulmonary functional impairment does not always correlate with the clinical picture. The diagnosis of lung diseases is led by pulmonary function tests and imaging techniques, which measure the response to therapy and assess the prognostic course of the disease. The purpose of this article is to review the causes of pulmonary dyspnea, present a guide to diagnostic work-up, and introduce common differential diagnoses.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 6","pages":"251-257"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683395","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
[Fokusthema Dyspnoe - eine Einführung]. 【焦点话题呼吸困难介绍】。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-08-01
Lars Christian Huber, Mattia Arrigo
{"title":"[Fokusthema Dyspnoe - eine Einführung].","authors":"Lars Christian Huber,&nbsp;Mattia Arrigo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong></p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 6","pages":"249-250"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683392","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
[Supportive Therapie und Palliative Konzepte bei Dyspnoe]. 呼吸困难的支持性治疗和缓解概念。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-08-01
Cristian Camartin
{"title":"[Supportive Therapie und Palliative Konzepte bei Dyspnoe].","authors":"Cristian Camartin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Palliative care aims to treat patients who symptomatically are affected by an advanced, incurable disease. Dyspnoea is one of the most common symptoms in various diseases, not only the oncological ones. The treatment of these symptoms requires consideration from different points of view. In palliative care, the bio-psycho-socio-spiritual and cultural model is often applied. Here, different dimensions of the disease are considered, which are especially involved in the case of dyspnoea. The physiology of dyspnoea is very complex and is influenced by various neuronal as well as pulmonary anatomical structures. Various non-pharmacological as well as pharmacological treatment approaches can lead to a decrease in dyspnoea. In particular, active physiotherapy and assistive devices optimise the symptoms. From the pharmacological side, mainly opioids but also benzodiazepines, oxygen and Butylscopolamin are used. In the case of very advanced disease, the use of deep continuous sedation to relieve symptoms may be justified if the symptoms are refractory to therapy. Successful treatment of dyspnoea leads to a substantial improvement in the quality of life of palliative care patients.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 6","pages":"291-296"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683396","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
[Dyspnoea and Anxiety]. [呼吸困难和焦虑]。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-08-01
Sophia Lea Hoff, Paul Hoff
{"title":"[Dyspnoea and Anxiety].","authors":"Sophia Lea Hoff,&nbsp;Paul Hoff","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Any acute state of dyspnoea will lead to feelings of insecurity and anxiety. In this context the paper elucidates the conceptual horizon of anxiety, stretching from its status as «normal», essential element of conditio humana, to representing a symptom of another (somatic or mental) illness and to constituting a psychiatric disorder of its own. In any case of acute dyspnoea it is important to «normalize» the patient's anxiety, i.e. to contextualize it as a comprehensible reaction to the stressing experience and not as proof of personal weakness. If dyspnoea and anxiety occur in a patient with a preexisting psychiatric disorder, defining the appropriate therapeutic steps will be more complex and demanding, especially with regard to a targeted interdisciplinary cooperation (consultation liaison psychiatry). The paper highlights the principles of psychopharmacological and psychotherapeutical interventions, a stable therapeutical relationship always defining the center of any treatment procedure.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 6","pages":"284-288"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683391","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
[Vaskuläre Dyspnoe: Lungenembolie]. [血管性呼吸困难：肺栓塞]。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-08-01
Mattia Arrigo, Lars Christian Huber
{"title":"[Vaskuläre Dyspnoe: Lungenembolie].","authors":"Mattia Arrigo, Lars Christian Huber","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>In clinical practice, the differentiation of pulmonary embolism from other entities often remains difficult. Of utmost importance is the estimation of the pretest probability of the disease: predictive scoring systems and the use of clinical gestalt are equally useful tools. Exclusion or confirmation of the disease requires the rationale use of additional investigations (laboratory, imaging). In this article, we provide clinical engrams and outline our diagnostic algorithm. Based on the latest recommendations, we summarize the therapeutic approach for patients with pulmonary embolism. The importance of follow-up visits after the initial event is discussed in the last part. The assessment of risk factors promoting the development of venous thromboembolism is crucial for estimating the risk of recurrence. Excessive screening (thrombophilia testing or tumor investigations) are of minor relevance.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 6","pages":"265-270"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683397","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
[Dyspnoe bei Dekonditionierung und die Rolle der Rehabilitation]. 呼吸困难在解除适应和康复中的作用。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-08-01
Alexander J Turk
{"title":"[Dyspnoe bei Dekonditionierung und die Rolle der Rehabilitation].","authors":"Alexander J Turk","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong></p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 6","pages":"289-290"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683390","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
[Kardiale Dyspnoe]. [心脏呼吸困难]
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-08-01
Tobias Höfflinghaus
{"title":"[Kardiale Dyspnoe].","authors":"Tobias Höfflinghaus","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Often dyspnea is caused by cardiac disease which has a dismal prognosis if left untreated. This article is focused on primary care and provides an overview of the most important etiologies, evaluation algorithms and therapies.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 6","pages":"258-263"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683393","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
[Metabolische Ursachen von Dyspnoe]. [呼吸困难的代谢原因]。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-08-01
Roger Schneiter, Philipp A Gerber
{"title":"[Metabolische Ursachen von Dyspnoe].","authors":"Roger Schneiter,&nbsp;Philipp A Gerber","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Endocrinological or metabolic disorders often affect a wide variety of functions of the organism. This can also include an impairment of respiratory function. Diabetic ketoacidosis as a result of insulin deficiency is a typical metabolic acidosis, which the body tries to compensate by an increased exhalation of carbon dioxide. This leads to the classic picture of \"Kussmaul\" breathing. Due to the increased use of SGLT2 inhibitors, which can reduce the otherwise typical hyperglycemia and thus complicate diagnosis, the occurrence of diabetic ketoacidosis has remained an important differential diagnosis in recent years. Pathologies of the thyroid gland can lead to dyspnea not only by morphological changes, for example in the case of goiter (compression). Functional disorders must also be considered here. Both hypo- and hyperthyroidism affect the cardiovascular system in different ways and may ultimately lead to the clinical picture of dyspnea. If the corresponding entities are thought of, the laboratory diagnosis of the aforementioned metabolic/endocrinological disorders is then basically straightforward. Accordingly, knowledge of these disorders as a differential diagnosis of tachy- and dyspnea is important.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 6","pages":"280-283"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683394","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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