Praxis最新文献

Introduction: Cardiovascular diseases are associated with a high morbidity burden in Switzerland and are the leading cause of death. Important cardiovascular risk factors such as hypertension, hyperlipidemia and diabetes can be treated extremely effectively with medication. A prerequisite for good therapy adherence is that those affected have sufficient knowledge. An anonymized online questionnaire was distributed via a health magazine and answered by 3166 participants. The majority of participants, 61.2 % (1902), were between 59 and 79 old. 2584 participants (83.1 %) were of the opinion that cardiovascular diseases can be well treated with medication. 1,781 (64.3 %) stated that they knew their blood pressure very precisely and 1,086 (39.25) stated that they knew their cholesterol value very precisely. 697 (25.2 %) did not know their cholesterol value or blood pressure (71; 2.6 %). When it comes to risk factors, smoking was classified as the most important factor (statement "strong" or "very strong": 2102; 77.6 %), almost on a par with blood pressure (2081, 77 %), lack of exercise (2047; 75.6 %) and Cholesterol (1906; 70.4 %). Overall, our survey shows that the Swiss have a comparatively good orientation about cardiovascular risk factors. However, even in our sample, which is certainly very health-conscious, there is still a clear need for education. However, our results also show that the majority are willing to implement preventative measures using medication.

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Introduction: The article describes the case of a 68-year-old patient who was admitted to a clinic after returning from southern Italy with fever, night sweats, and pancytopenia. After extensive diagnostic investigations that ruled out bacterial, viral, and parasitic infections as well as other diseases, visceral leishmaniasis (VL) were eventually diagnosed. This diagnosis was confirmed by the detection of Leishmania sp. in the bone marrow and positive serological tests. Additionally, the patient showed signs of macrophage activation syndrome (MAS), a severe inflammatory reaction that often occurs as a complication of infections or rheumatological diseases. The treatment included liposomal amphotericin B for leishmaniasis as well as steroids and etoposide for the treatment of MAS. The patient recovered after treatment and showed an improvement in general condition during follow-up examinations. The article emphasizes the challenge of correctly diagnosing VL and MAS, especially in combination, particularly in patients outside endemic areas. Rapid diagnosis is crucial, as delays can worsen the prognosis in these severe diseases.

Introduction: Of all gynaecological tumours, ovarian cancer has the highest mortality rate because it is often not diagnosed until the tumour is at an advanced stage due to the lack of early symptoms and suitable screening tests. The aim of this paper is to examine the current state of diagnosis and therapy.

Introduction: The VEXAS syndrome is a systemic autoinflammatory disease first described in 2020. It primarily affects older men and is caused by a somatic mutation in the UBA1 gene on the X chromosome, leading to dysfunction of the innate immune system. Symptoms include fever, weight loss, various hematological manifestations, and a broad spectrum of clinical symptoms, often including ocular manifestations. Diagnosis is based on the detection of the mutation. There is currently no standardized therapy, and mortality can be as high as 40 %.

Introduction: Rapid-Eye-Movement (REM) sleep is an essential part of sleep dominating the second half of the night. A disturbance of the phy-siological muscle hypotonia of REM sleep can lead to dream enactment: REM sleep behavior disorder (RBD). In the absence of a disease of the central nervous system or provoking factors such as sleep apnea, alcohol consumption or antidepressants, isolated RBD (iRBD) may be present. IRBD is an early stage of alpha-synucleinopathies such as Parkinson's disease, dementia with Lewy bodies and multisystem atrophy. Medical history and polysomnography are the most important diagnostic tools. Clonazepam and melatonin are symptomatic treatments used to prevent injury. New technologies enable long-term monitoring of disease progression in iRBD and thus guide the targeted use of future disease-modifying therapies.

Introduction: Cerebral amyloid angiopathy-related inflammation (CAA-RI) is a rare form of cerebral amyloid angiopathy (CAA). This leads to amyloid deposits and inflammation in the vessel walls with cerebral microbleeds, white matter hyperintensities and edema. Major clinical manifestations vary and are non-specific. They include rapidly progressive dementia, headaches and epileptic seizures. MRI and histology are crucial for further diagnosis, although the definitive diagnosis can only be made in autopsy. Timely therapy, mainly with corticosteroids, is essential for successful healing.

Introduction: Family with fever, asthenia, arthralgia and headache after travelling back from Kosovo. A precise exposure history led to the suspicion of an underlying zoonosis and allowed a diagnosis to be made. The treatment with doxycycline and gentamicin led to a restitutio ad integrum in all family members.

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Introduction: This mini-review summarizes the new guideline recommendations of the European Society of Cardiology for the management of elevated blood pressure and hypertension - with particular focus on aspects relevant to daily clinical practice.