Deutsche medizinische Wochenschrift (1946)最新文献

As the survival prognosis of cancer patients continues to improve, the improvement in quality of life during and after cancer treatment is becoming increasingly important 1. Exercise therapy has a positive effect on so-called "patient-reported outcomes" 2. The combination of endurance training and individualized strength training plays a particularly important role here. There is therefore a need for consistent and comprehensive implementation of quality-assured exercise therapy in everyday clinical practice.

Secondary malignancies (secondary cancers) are malignant diseases that occur at a certain time after cancer treatment. The malignant neoplasms can occur anywhere from 2 months to decades after cancer treatment. In addition, multiple tumor diseases can also develop due to a hereditary tendency to tumors. This article provides an overview of the causes, early detection and individual treatment.

The number of people living with or after cancer is steadily increasing due to an ageing society and improved cancer treatment. However, once treatment has been completed, the consequences of the disease are often felt for a long time. These affect many different areas of life and often lead to a high level of suffering and need for care. Psycho-oncological support offers effective support for many of those affected.

The examination of urine and its evaluation are central components in the diagnostic pathway for kidney diseases. Essential to this process is the correct analysis and interpretation of the urine sediment. A nephritic sediment indicates glomerular kidney disease with high specificity. This article explains the diagnosis, evaluation, and implications of a nephritic sediment.

Cancer treatments, although life prolonging, are associated with side effects. The occurrence, duration, and severity of side effects vary, depending on treatment received. Long-term effects refer to effects that manifest during treatment and persist long after treatment has ended. Late effects are complications that occur after treatment has ended. These effects can have a negative impact on the functioning and quality of life of persons living with and beyond cancer. This overview aims to provide a non-exhaustive overview of the long-term and late effects associated with the traditional mainstay of cancer treatments (surgery, radiotherapy, chemotherapy) and newer treatments such as immunotherapy. In conclusion, long-term and late effects of cancer treatment can be associated with a high burden for those affected, including a reduction in their ability to function and health-related quality of life. Given the large and further growing number of cancer survivors and the abundance of long-term and late effects, it is essential to develop and implement risk-adapted, multidisciplinary survivorship care programmes.

Anamnesis and clinical examination: A 59-year-old female patient with an unremarkable medical history presented with watery diarrhea, severe lower abdominal pain, and fever for approximately 7 days. Physical examination revealed a distended abdomen, bowel sounds were absent, and there was an acute abdomen with generalized guarding and significantly elevated inflammatory markers.

Diagnosis: Abdominal computed tomography showed significant ascites and signs of peritonitis. Exploratory diagnostics were indicated. A laparoscopy was performed, which revealed diffuse purulent peritonitis. Organ perforation or other reasons for a peritonitis were excluded.

Therapy and clinical course: Bacteriological examination and blood cultures showed β-hemolytic group A streptococci, leading to the diagnosis of spontaneous bacterial peritonitis caused by streptococci. The patient was treated with antibiotics, progressively recovered, and was discharged symptom-free and without sequelae.

Conclusion: Primary spontaneous bacterial peritonitis caused by Streptococcus pyogenes is a rare cause of acute abdomen. An early diagnosis and immediate antibiotic therapy are crucial for prognosis.

An acutely altered mental status is a common presenting complaint. A wide variety of neurological, systemic or psychiatric conditions can be the cause. Sometimes there is even overlap of various diseases that contribute to the patient's confusion. The brain can be primarily or secondarily involved. A meticulous history and examination provide the first clues as to the origin of the alternation in personality. Most of the time further exams at the hospital are necessary to determine the diagnosis and plan the treatment. Nevertheless, even with just limited preclinical resources perceptive teams are able to gather and analyse enough information to diagnose and treat the patient. The result of this detective work can be quite rewarding, especially if the initial diagnosis is confirmed. Therapeutic measures preclinically focus on maintaining the cerebral equilibrium.

Since its founding 150 years ago, the Deutsche Medizinische Wochenschrift has continually followed the developments in nephrology through countless publications. Pioneers in nephrology like Franz Volhard and Georg Haas were authors of the DMW, and new hypotheses, examination methods, and therapies were often debated here, as this article shows.