Praxis最新文献

Introduction:

Introduction: The need for antibiotic prophylaxis for endoscopic procedures, especially in the gastrointestinal tract, has long been a matter of debate. In recent years, the lack of randomized trials supporting a benefit of antibiotic prophylaxis, the very low incidence of infective endocarditis after endoscopic procedures and the potential adverse reactions of antibiotics have led to a more restricted use of antibiotic prophylaxis. The aim of this expert opinion statement is to provide an overview of current evidence and to propose a pragmatic approach to the use of antibiotic prophylaxis for endoscopic procedures in areas where clear evidence is lacking.

Introduction: In our case, the rifle bullet fortunately did not hit the patient. Nevertheless, the incident was a very serious emotional event for the patient. Due to the release of stress hormones, the incident had an indirect and potentially fatal effect on the heart. A takotsubo syndrome emerged with typical chest pain, repolarization abnormalities and elevation of cardiac biomarkers. The morphology was atypical, showing mid-ventricular wall motion abnormalities. In our case, a previous episode of takotsubo syndrome can be suspected. Fortunately, the outcome was benign and the systolic LVEF normalized after 3 months of heart failure therapy. The severe complications associated with LVOT obstruction did not occur. This is not the first case report of a takotsubo syndrome after a gunshot, but it is the first without a direct effect of the bullet.

Introduction: The perception of food intolerances is widespread, leading to unnecessary dietary restrictions and anxiety, particularly in patients with irritable bowel syndrome. Many self-diagnosed intolerances lack scientific evidence and are often used to explain chronic symptoms. Accurate diagnosis and evidence-based dietary recommendations are crucial to maintaining quality of life and preventing malnutrition. This review explores common food intolerances, including histamine intolerance, additive sensitivity, FODMAP-related issues, and non-celiac wheat sensitivity, providing an evidence-based perspective on their diagnosis and management.

Introduction:

Introduction: TINU syndrome (Tubulointerstitial Nephritis and Uveitis) is a rare autoimmune disorder that causes inflammation in the kidneys and eyes. It manifests as uveitis and impaired kidney function. Diagnosis is based on symptom correlation and kidney biopsy. Differential diagnoses include infectious and immunological conditions. Treatment primarily involves systemic corticosteroids and topical steroids for uveitis. Relapses may occur, especially in adults, while the prognosis in children tends to be more favorable.

Introduction: The early and accurate diagnosis is the basic prerequisite for timely, targeted and individually tailored counselling, treatment and support for people developing cognitive impairment. The association Swiss Memory Clinics (SMC) has elaborated detailed quality standards for the assessment of cognitive disorders, published them for the first time in 2018 and updated them in 2024. These recommendations present the current diagnostic guidelines and examination options, along with proposed standards for the relevant procedures. Single areas such as anamnesis, clinical examination, laboratory assessments, neuropsychological testing and neuroradiological procedures are discussed as part of the standard diagnostics and the complementary investigation methods for differential diagnostics. Furthermore, the disclosure of the diagnosis and counselling are now described as an integral part of the diagnostic process. The most important objectives of the recommendations for the diagnosis of dementia disorders remain to enable high-quality early and accurate diagnostics of cognitive disorders throughout Switzerland; and to provide a practical guide for clinicians in primary care and memory clinics.

Introduction: Many drugs may influence the hypothalamic-pituitary-adrenal axis (HPA-Axis) at different levels. Since the discovery of the pharmacological effect of glucocorticoids (GC) and the first application of cortisone (then known as "Compound E") in patients with rheumatoid arthritis in 1948, exogenous glucocorticoids have been the most common cause of drug-induced adrenocortical insufficiency. In the last few years, immune check point inhibitors (ICI) have become a new important cause. Due to the insidious and unspecific symptoms, which can also be a consequence of the underlying disease and its therapies, the diagnosis is often delayed. Regular screening by the attending physicians is essential for prompt recognition of the condition and reduction of the associated morbidity. This article summarizes the most common implicated drugs (GC, ICI and opioids) and the corresponding management recommendations.

Introduction:

Introduction: Lymphangioleiomyomatosis (LAM) primarily affects women of childbearing age. Diagnosing LAM can be challenging due to nonspecific symptoms ranging from asymptomatic findings to life-threatening respiratory insufficiency. Typical cystic changes in the lungs are identifiable through imaging techniques. In addition to imaging, blood tests, including the measurement of Vascular Endothelial Growth Factor D (VEGF-D), as well as histopathological results from biopsies, can provide valuable information for diagnosing LAM. In this article, we discuss the case of a 31-year-old woman who was diagnosed with LAM incidentally.