Praxis最新文献

Introduction:

Introduction:

Introduction: Whereas pancreatic masses are often difficult to detect with transabdominal ultrasound, cross-sectional imaging features high sensitivity for the pancreatic tumors. However, increasing availability of magnetic resonance imaging (MRI) has led to a surge in the detection of benign or precancerous pancreatic lesions. The medical history is characteristic only for two entities. A history of acute or chronic pancreatitis favors a benign pseudocyst while weight loss or jaundice are suggestive of malignancy. More challenging is the classification of asymptomatic cysts, which often require extensive work-up and, in advanced stages, pancreatic resection. In case of overdiagnosis and overtreatment, this is also referred to as VOMIT: victims of modern imaging technology (1). On the other hand, it is important to identify precancerous lesions that should be monitored with the aim of timely recognizing progression towards invasive cancer. The aim of this overview is to focus on incidentally detected pancreatic cystic lesions with a description of the investigations and surveillance. Pancreatic cancer and pseudocysts are beyond the scope of this review. However, the latter are discussed in terms of differential diagnoses, as pseudocysts are occasionally found by chance in everyday clinical practice, but should not be monitored.

Introduction: We report a case of an 89-year-old patient, who presented with melena and physical degradation at the emergency department. As cause for his symptoms, we found an upper GI-bleeding from a metastasis of a follicular thyroid carcinoma, for which the patient was surgically treated in the year 1996.

Introduction: In addition to being the main cause of death and premature mortality in Europe, cardiovascular diseases are increasingly becoming a significant burden on public health, productivity and healthcare resources. At 34 %, coronary heart disease (CHD) represents the largest proportion of this spectrum (1). The traditional understanding of CHD, which focused almost exclusively on epicardial atherosclerotic stenoses, is now considered outdated. Although increasing attention is being paid to non-obstructive CAD, the mechanisms are largely unknown and the diagnosis may be underestimated in everyday practice. Therefore, itis crucial to recognize non-obstructive CHD in order to develop appropriate treatment strategies. The aim of this review is to provide an overview of the common definitions, causes and diagnostic steps of non-obstructive coronary artery disease.

Introduction: According to the Swiss Federal Statistical Office (FSO), there were 6608 assisted suicides in Switzerland in the 5-year period 2018-2022; of these, 4766 cases (72%) were assisted by team members of EXIT, the largest Swiss right-to-die organization. According to EXIT-data, age-related multimorbidity is the second most common disease group in assisted dying, accounting for 27 % of all cases. For formal reasons, these symptom-oriented cases of old age assisted suicide cannot be adequately recorded in the FSO's ICD-based cause of death statistics. This «statistical weakness» implies that Switzerland is unable to provide reliable data on the phenomenon of old age assisted suicide, which is the subject of controversial debate in medical ethics and social policy. It would therefore be advisable to set up a national registry that carefully documents all cases of assisted suicide and could also critically monitor certain cases.

Introduction: Fever is an important and common symptom. The science of fever is as old as humanity itself. Fever is often associated - by patients and healthcare professionals - with the need for antipyretics and antibiotics and can cause uncertainty and anxiety. However, fever per se is not dangerous and usually does not need to be treated. A step-by-step approach is worthwhile when working up fever.

Introduction: Urinary incontinence is a common complaint of both general practitioners and specialists. An accurate basic diagnosis with a structured medical history and bladder diary, urine analysis, gynaecological examination including pelvic floor assessment and a full bladder cough test can be supplemented by sonography, cystoscopy and urodynamic testing. This will help to differentiate between the different types of urinary incontinence, such as urge incontinence, stress incontinence and overflow incontinence. Treatment should be based on the type of urinary incontinence. Conservative treatments such as pelvic floor physiotherapy and pessaries can be supplemented by electrical stimulation for OAB and overflow incontinence, and various procedures such as TVT or bulking agents for stress incontinence, sacral neurostimulation for OAB and overflow incontinence.

Introduction:

Introduction: We report a case of Graves' disease in a patient who initially received carbimazole therapy, which was switched to propylthiouracil due to adverse effects. After 14 months of propylthiouracil therapy, the patient developed cutaneous ANCA-associated vasculitis. Prompt cessation of propylthiouracil and topical treatment led to complete resolution of the skin lesions.