Internist最新文献_第2页

[Advance Care Planning-further development of the patient advance directive : What the specialist in internal medicine must know]. [预先护理计划-进一步发展病人预先指示:内科专家必须知道的事情]。

4区医学

Internist Pub Date : 2022-05-01 DOI: 10.1007/s00108-022-01333-9

S Petri, B Zwißler, J In der Schmitten, B Feddersen

{"title":"[Advance Care Planning-further development of the patient advance directive : What the specialist in internal medicine must know].","authors":"S Petri, B Zwißler, J In der Schmitten, B Feddersen","doi":"10.1007/s00108-022-01333-9","DOIUrl":"https://doi.org/10.1007/s00108-022-01333-9","url":null,"abstract":"Despite the availability of the instruments of advance directives, power of attorney and healthcare proxy, the patient's preferences for life-sustaining medical treatment in a specific situation often remain unknown. The aim of the systemically designed German Advance Care Planning (ACP) program is the reflection, documentation and implementation of patients' preferences regarding future medical treatment in case they are incapable of legally binding decision-making. A specially trained ACP facilitator initially supports the verbalization of the attitudes towards life, severe illness and death on an individual level. Based on these principal views, concrete preferences on how to be treated under defined medical circumstances can be discussed and documented in an advance directive. This includes the three scenarios medical emergency, inpatient hospital treatment in situations with decisional incapability of unknown duration and the situation of permanent cognitive impairment. Through cautious, nondirective conversational techniques in the sense of shared decision-making, the person is enabled to reflect and decide well-informed according to the informed consent standard. All persons participating in decisions regarding future medical treatment, especially future surrogate decision makers, are involved in the process as early as possible. A systematic institutional and regional implementation of the concept is necessary to ensure that the carefully assessed and documented preferences of the patients will be known and honored. The new German § 132g of the Social Code Book V (SGB V) enables institutions for long-term care and for the care of disabled persons, to offer facilitated ACP to all residents at the expense of the statutory health insurance funds. An increased dissemination of this concept is to be expected.","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 5","pages":"533-544"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9020146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Mitteilungen der DGIM DGIM的消息

4区医学

Internist Pub Date : 2022-04-28 DOI: 10.1007/s11377-013-0868-x

引用次数: 0

Impfungen für das Immungedächtnis – immer wieder oder einmalig? 10 / 10以上

4区医学

Internist Pub Date : 2022-04-04 DOI: 10.1007/s00108-022-01324-w

C. Lehmann

引用次数: 0

[Pneumonia, endocarditis of two valves and pulmonary artery embolism in a 26-year-old male patient]. [一例26岁男性患者的肺炎、双瓣膜心内膜炎和肺动脉栓塞]。

4区医学

Internist Pub Date : 2022-04-01 Epub Date: 2021-12-22 DOI: 10.1007/s00108-021-01228-1

Lisa Hasselbach, Maximilian Dübbers

引用次数: 0

[67/m-Incidental finding of a solitary pulmonary nodule : Preparation for the medical specialist examination: part 145]. [67/m-偶然发现孤立性肺结节：为医学专家检查做准备：第145部分]。

4区医学

Internist Pub Date : 2022-04-01 Epub Date: 2022-03-03 DOI: 10.1007/s00108-022-01281-4

M Nunninger, G F Torsello

引用次数: 0

[36/f-Facial swelling and flushing, back pain and leukocytosis : Preparation for the medical specialist examination: part 143]. [36/f]面部肿胀和潮红、背部疼痛和白细胞增多：为医学专家检查做准备：第143部分]。

4区医学

Internist Pub Date : 2022-04-01 Epub Date: 2022-04-04 DOI: 10.1007/s00108-022-01311-1

U D Lichtenauer

引用次数: 0

[64/m-Pain in the calves after 150 m walking distance : Preparation for the medical specialist examination: part 142]. [64/m-步行 150 米后小腿疼痛：专科医师检查准备：第 142 部分]。

4区医学

Internist Pub Date : 2022-04-01 Epub Date: 2022-03-17 DOI: 10.1007/s00108-022-01300-4

O J Müller

引用次数: 0

[Drop in oxygen saturation and blood pressure as well as increase in central venous pressure during mitral valve clipping in an 81-year-old female patient]. [一例81岁女性患者二尖瓣夹持术中血氧饱和度和血压下降，中心静脉压升高]。

4区医学

Internist Pub Date : 2022-04-01 Epub Date: 2022-02-07 DOI: 10.1007/s00108-021-01241-4

Martin J Volz, Matthias Aurich, Mathias Konstandin, Hugo A Katus, Norbert Frey, Michael M Kreusser, Philip W Raake

{"title":"[Drop in oxygen saturation and blood pressure as well as increase in central venous pressure during mitral valve clipping in an 81-year-old female patient].","authors":"Martin J Volz, Matthias Aurich, Mathias Konstandin, Hugo A Katus, Norbert Frey, Michael M Kreusser, Philip W Raake","doi":"10.1007/s00108-021-01241-4","DOIUrl":"https://doi.org/10.1007/s00108-021-01241-4","url":null,"abstract":"Background: Atrial septal defects (ASD) following endovascular mitral valve clipping are potentially hemodynamically relevant complications. Immediate closure with an occluder can represent a safe and effective treatment. An 81-year-old female patient suffering from severe dyspnea due to previously known severe mitral valve regurgitation was scheduled for elective mitral valve clipping. The clip was successfully implanted. Removal of the transseptal cannula resulted in a sudden drop in oxygen saturation and systolic blood pressure as well as an immediate increase in central venous pressure. An iatrogenic left-right shunt was observed at the atrial level with a relevant shunt volume. Immediate closure using an atrial septal occluder successfully restored the oxygen saturation and hemodynamic parameters.Conclusion: An increase in central venous pressure, reduction of systolic blood pressure or oxygen saturation after withdrawal of the transseptal cannula during mitral valve clipping should always be further investigated regarding a possible ASD.","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 4","pages":"448-452"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8956558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39773051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Bacterial hepatobiliary infections : Pathogen spectrum, antimicrobial resistance and current treatment concepts]. 细菌性肝胆感染

4区医学

Internist Pub Date : 2022-04-01 Epub Date: 2022-03-03 DOI: 10.1007/s00108-022-01277-0

Tony Bruns, Andreas Stallmach

引用次数: 0

[68/m-Massive rectal bleeding : Preparation for the medical specialist examination: part 148]. [68/m直肠大出血：医学专科检查的准备：第148部分]。

4区医学

Internist Pub Date : 2022-04-01 Epub Date: 2022-03-30 DOI: 10.1007/s00108-022-01306-y

T Mosler, J U Marquardt, F Sayk

引用次数: 0