Praxis最新文献

Introduction: Schnitzler syndrome is a rare autoinflammatory disease that primarily manifests in adulthood. In cases presenting with chronic urticaria and paraproteinemia, Schnitzler syndrome should be considered in the differential diagnosis, and the Strassburg criteria should be applied to establish the diagnosis. IL-1 inhibitors have proven to be an effective long-term treatment for Schnitzler syndrome. Patients should be moni-tored for the potential development of lymphoproliferative disorders and/or amyloidosis.

Introduction:

Introduction: We present the case of a severe bicytopenia as a complication of uncontrolled zinc supplementation and consequent copper deficiency in a young female patient. Following rapid diagnosis, discontinuation of zinc intake and initiation of copper supplementation led to a complete regression of the findings in the blood count and bone marrow, which had initially been interpreted as potentially malignant.

Introduction: The introduction of systematic vaccination programs since the 1940s has led to a significant reduction in prevalence of tetanus in Western countries. However, tetanus cases still occur sporadically, especially in older people with inadequate immunisation status. The diagnosis is primarily clinical. Microbiological isolation of the gram-positive, anaerobic rod-shaped bacteria is often unsuccessful (not necessarily required for diagnosis). Specific treatment includes wound debridement, administration of tetanus immunoglobulin, tetanus vaccination and antibiotic therapy. Moreover, supportive measures up to invasive ventilation are used.

Introduction: Dysphagia is a common consequence of stroke, affecting a significant proportion of patients especially during the acute phase. They carry a substantial risk of complications such as aspiration pneumonia, malnutrition, and dehydration, and can considerably impair both quality of life and rehabilitation outcomes. In general practice, where many stroke survivors receive follow-up care, early identification of dysphagia is essential to prevent serious consequences like pneumonia or nutritional deficits. This article provides an overview of the pathophysiology and clinical symptoms of post-stroke dysphagia (PSD). It outlines established screening tools and diagnostic approaches, as well as therapeutic options that can be applied in primary care settings. Special emphasis is placed on interprofessional collaboration and the role of general practitioners in coordinating therapy and long-term management. The article offers practical recommendations for the care of affected patients and supports primary care providers in delivering competent and comprehensive treatment.

Introduction: Primary hyperaldosteronism is a common and treatable cause of secondary arterial hypertension. Case finding with the aldosterone-to-renin ratio is recommended in all patients with arterial hypertension. If the case finding test is positive, a confirmatory test should be performed, followed by imaging of the adrenal glands and adrenal vein sampling. Treatment depends on the cause. Laparoscopic adrenalectomy is the treatment of choice for unilateral secretion and medical therapy with mineral corticoid receptor antagonists for bilateral secretion.

Introduction: Background: Distinguishing familial hypocalciuric hypercalcemia (FHH) a rare cause of usually mild, parathyroid hormone-dependent hypercalcemia from other causes is central for management due to its benign and usually mild course. Case: Diagnostic approach to a mild hypercalcemia in a 36-years-old female with FHH. Conclusion: This case highlights the importance of a precise and stepwise diagnostic approach to identify rare causes of hypercalcemia like FHH, an autosomal-dominant inherited, pathogenic variant of the calcium sensing receptor.

Introduction:

Introduction: This case describes a traveler returning from Sri Lanka with progressive ulcerative skin lesions and fever. The clinical picture indicates a bacterial skin infection, as can occur during stays in tropical regions. The case underscores the importance of early differential diagnosis and targeted antimicrobial therapy.

Introduction: Chronic kidney disease (CKD) is a significant but often underdiagnosed and undertreated condition. Based on the recommendations of the Swiss Society of Nephrology (SSN) and Kidney Disease: Improving Global Outcomes (KDIGO), an evidence-based set of 12 indicators was developed to map the quality of care for at-risk groups and those affected by CKD with regard to processes and target achievement related to kidney health. This set of indicators was tested on a large dataset of routine primary care data, revealing highly heterogeneous results, with some high compliance rates ranging from a median of 86.8 % for non-prescription of NSAID to 18.3 % for eGFR and albuminuria assessment in patients with arterial hypertension. Overall, it was shown that the present set of indicators represents a pragmatic, evidence-based and easily applicable template to depict the quality of kidney care of patients at risk or affected by CKD.