Praxis最新文献

Introduction: Benign prostate syndrome (BPS) is one of the most common diseases in men. As a result of subvesical obstruction caused by the enlargement of the prostate, the function of the lower urinary tract is impaired. The symptoms of BPS are determined by the occurrence of voiding and bladder storage disorders. In addition to a patient's history and physical examination, the diagnosis also includes a sonographic examination of the urinary tract. Treatment should be symptom-focused and interdisciplinary. For medical treatment, a variety of different drugs are available, which are also used in general practice. For surgical therapy, various technologies are available which are selected depending on prostate volume, comorbidities and the patient's expectations. The following text provides an overview of the relevant aspects of BPS management.

Introduction: Fever of unknown origin (FUO) presents a significant diagnostic challenge, particularly in young patients. A 25-year-old patient presents with persistent fever, with no clear cause identified through initial investigations. Stepwise advanced diagnostics ultimately lead to an unexpected diagnosis that significantly influences treatment. This case highlights the importance of a structured and interdisciplinary approach in the evaluation of FUO.

Introduction: This study assessed sex and gender differences in patients with atrial fibrillation (AF), atrial flutter (AFL), and other supraventricular tachycardias (SVT) undergoing catheter ablation. Four hundred patients (36.3 % female) with a median age of 62 were included. Significant gender differences were found in age at diagnosis and ablation of AF, with women with AF being diagnosed later. In the AF and AFL groups, fewer women were referred for EPS. Women experienced more dizziness in AF, more syncope in AFL, and more dyspnea in SVT. Ablation success was high and equal for both sexes. Awareness of these sex differences is crucial for establishing equal healthcare management.

Introduction: The diagnostics of autoimmune encephalitides have made significant progress with the recent discovery of numerous tumor-associated and non-tumor-associated autoantibodies targeting neuronal and glial cells. Nevertheless, physicians continue to face major diagnostic and therapeutic challenges posed by this complex disease. This review summarizes the key aspects of the clinical presentation, diagnostics, and therapy of the most common form of autoimmune encephalitis, limbic encephalitis, with a focus on the paraneoplastic forms.

Introduction: Hospital at Home (HaH) is a form of care in which acutely ill patients are treated at home rather than in hospital. It is well established in many countries. In Switzerland, HaH is currently being piloted by various providers. The Arlesheim Hospital in the canton of Basel-Landschaft is one of these pioneers and has been offering HaH in its catchment area since January 2023. Referrals can be made by the emergency department, by general practitioners, specialists or by hospitals. This article provides an insight into how such a HaH programme works in practice and into the effects and opportunities that this new form of care offers. First results on safety of care, quality of care and satisfaction are presented.

Introduction: A 68-year-old patient presented with a two-week history of fatigue, weakness, and sleep disturbances. This followed a curative prostatectomy due to cancer and an upper respiratory tract infection. Initially, obstructive sleep apnea (OSAS) was diagnosed. Several weeks later, new symptoms of dyspnea emerged, suggesting heart failure. Ultimately, AL-amyloidosis with cardiac involvement, associated with smoldering multiple myeloma, was diagnosed. Early consideration of a hematological malignancy, supported by immunofixation electrophoresis and closer monitoring, could have led to a quicker diagnosis and improved prognosis.

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Introduction: Good treatment options are now available, particularly for the more common forms of asthma with type 2 inflammation. Asthmatics should learn to assess their own asthma control. In the case of exacerbations that cannot be quickly controlled with a self-management plan, a consultation with spirometry and at least a check of the eosinophil count in the differential blood count is necessary. It makes sense for spirometry to be checked prior to an exacerbation, but also after OCS therapy. This is the only way to differentiate between asthma, asthma-COPD co-existence, and COPD.

Introduction: Maple syrup urine disease (MSUD) is a rare inherited metabolic disease. Breakdown of branched-chain amino acids (leucine, isoleucine, valine) is impaired or absent, which results in metabolite accumulation causing neurotoxicity. With strict therapy adherence (protein restricted MSUD-diet and amino acid supplementation), nearly normal plasma leucin levels can be achieved. However, therapy interruption or catabolic conditions (illness, operation, fasting) can rapidly lead to life-threatening metabolic decompensation. In this report we present the case of a 50 year-old woman who was referred to our hospital with impaired level of consciousness due to delayed recognition of MSUD decompensation. The aim is to increase awareness for this condition and repeat the central treatment aspects.

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