Abstract:
BACKGROUND:It is estimated that 1 million persons in Germany suffer from hepatic cirrhosis, which is the final stage of chronic inflammation of the liver. Cirrhosis has multiple causes, all of which lead to structural changes of the liver and to portal hypertension. The main complications of cirrhosis arise in turn: These include bleeding from collateral veins, ascites, hepatocellular carcinoma, encephalopathy, and infection leading to organ failure. METHODS:We present the treatment of the main complications of liver cirrhosis with reference to the relevant literature (phase II and III trials, meta-analyses, and reviews). RESULTS:Endoscopic treatment (ligation) is used for the primary and secondary prophylaxis of variceal bleeding. Drugs to lower portal pressure (e.g., beta-blockers) are an established means of preventing initial or recurrent variceal bleeding over the long term. Vasoconstrictors such as terlipressin are mainly used to treat acute hemorrhage and type 1 hepatorenal syndrome. The main treatment of ascites is with spironolactone, in combination with a loop diuretic where indicated. A shunt (TIPS) is used to treat severe or repeat variceal hemorrhage or refractory ascites. Antibiotics play a well-established role in the treatment of acute hemorrhage, in the treatment and prevention of spontaneous bacterial peritonitis, and in the treatment of encephalopathy. The treatment of hepatocellular carcinoma depends on its extent of spread and on the degree of decompensation of cirrhosis. CONCLUSION:For most of the main complications of liver cirrhosis, there are treatments that have been well-tested in randomized trials. Liver transplantation should also be considered in every case.
journal_name
Dtsch Arztebl Intjournal_title
Deutsches Arzteblatt internationalauthors
Sauerbruch T,Appenrodt B,Schmitz V,Spengler Udoi
10.3238/arztebl.2013.0126subject
Has Abstractpub_date
2013-02-01 00:00:00pages
126-32, Iissue
8issn
1866-0452journal_volume
110pub_type
杂志文章,评审abstract:INTRODUCTION:The choice of type of heart valve prosthesis is determined by the patient's age since bioprostheses have a limited lifespan. This article reviews current recommendations and the literature on cardiac valve replacement. METHODS:Selective literature search in Medline/PubMed back to 1996 and review of curren...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0143
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:The treatment of pregnant women who have illnesses unrelated to pregnancy can cause uncertainty among physicians. METHODS:We searched the PubMed database and specialty guidelines from Germany and abroad (the guidelines of the German Society for Gynecology and Obstetrics, the American Congress of Obstetri ci...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2017.0616
更新日期:2017-09-15 00:00:00
abstract:INTRODUCTION:Gender identity disorders (GID) can appear even in early infancy with a variable degree of severity. Their prevalence in childhood and adolescence is below 1%. GID are often associated with emotional and behavioral problems as well as a high rate of psychiatric comorbidity. Their clinical course is highly ...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0834
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:In endocrine orbitopathy (EO), disfiguring proptosis and diplopia impair patients' quality of life both at home and at work. METHODS:From late 2006 to the beginning of 2008, 250 outpatients in an interdisciplinary thyroid and eye clinic filled out a questionnaire about their quality of life, occupational di...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2009.0283
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Familial hypercholesterolemia (FH) is a congenital disorder of lipid metabolism characterized by a marked elevation of the plasma concentration of LDL (low-density lipoprotein) cholesterol beginning in childhood and by the early onset of coronary heart disease. It is among the commonest genetic disorders, wi...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2014.0523
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abstract:BACKGROUND:Direct (non-vitamin-K-dependent) oral anticoagulants (DOAC) are given as an alternative to vitamin K antagonists (VKA) to prevent stroke and embolic disease in patients with atrial fibrillation that is not due to pathology of the heart valves. Fatal hemorrhage is rarer when DOACs are given (nonvalvular atria...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
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更新日期:2016-09-05 00:00:00
abstract:BACKGROUND:Age-related macular degeneration (AMD) is a common retinal disease in older people. In Europe, about 1.6% of persons over age 65 and more than 13% of persons over age 85 have late-stage AMD, which can severely impair vision. The development of AMD is influenced both by environmental factors and by a strong h...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
doi:10.3238/arztebl.2014.0133
更新日期:2014-02-21 00:00:00
abstract:BACKGROUND:Patients with acquired brain injury who have been discharged from inpatient neurological rehabilitation often continue to suffer from limited independence, participation, and quality of life. Participation-focused outpatient treatment (in German: teilhabeorientierte ambulan. METHODS:In a randomized, control...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,随机对照试验
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更新日期:2016-09-23 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
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abstract:BACKGROUND:The treatment options for bcr-abl positive chronic myelogenous leukemia (CML) include chemotherapy, immune therapy, allogeneic stem cell transplantation, and molecular therapy. The tyrosine kinase inhibitor imatinib was approved for the treatment of CML in 2002. Data from clinical trials allow a comparison o...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
doi:10.3238/arztebl.2010.0114
更新日期:2010-02-01 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2012.0039
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Lung transplantation is the final treatment option in the end stage of certain lung diseases, once all possible conservative treatments have been exhausted. Depending on the indication for which lung transplantation is performed, it can improve the patient's quality of life (e.g., in emphysema) and/ or prolo...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
doi:10.3238/arztebl.2014.0107
更新日期:2014-02-14 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,实务指引
doi:10.3238/arztebl.2016.0729
更新日期:2016-10-28 00:00:00
abstract:INTRODUCTION:A confusing variety of options are available for the treatment of depressive disorders. METHOD:Selective literature review under consideration of current guidelines. RESULTS:The treatment of depression can be divided into acute, maintenance and prophylactic phases. The basic forms of treatment are pharma...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0782
更新日期:2008-11-01 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
doi:10.3238/arztebl.2009.0242
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Pre-hospital hypotension in trauma patients is associated with high mortality. Especially for patients with severe traumatic brain injury (TBI), arterial normotension or even hypertension (AHT) is considered an important mechanism for sustaining adequate cerebral perfusion pressure. The effect of pre-hospita...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2012.0849
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:An estimated 1.4 to 2.6 million people in German suffer from drug dependence. Most of them are long-term users of benzodiazepines (BZD), Z drugs (ZD), or opioid analgesics (OA). METHODS:This analysis is based on prescription data from patients of the national statutory health insurance system in the German ...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2019.0607
更新日期:2019-09-13 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2017.0831
更新日期:2017-12-08 00:00:00
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pub_type: 杂志文章,评审
doi:10.3238/arztebl.2011.0788
更新日期:2011-11-01 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
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更新日期:2014-05-02 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
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更新日期:2020-08-03 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2010.0092
更新日期:2010-02-01 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2015.0564
更新日期:2015-08-17 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0055
更新日期:2008-01-01 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
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更新日期:2016-03-11 00:00:00
abstract:INTRODUCTION:Despite recent advances in their treatment, schizophrenic disorders are still among the diseases that most severely impair patients' quality of life. For this reason, centers for the early recognition of schizophrenic disorders have come into existence worldwide. In these centers, much effort is devoted to...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0532
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Screening colonoscopy can lower the incidence of colorectal cancer (CRC), yet participation rates are low even in groups at high risk. The goal of this study was to double the rate of participation in screening colonoscopy among persons at familial risk and then to determine the frequency of neoplasia in thi...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.3238/arztebl.2018.0715
更新日期:2018-10-26 00:00:00
abstract:BACKGROUND:Epilepsy is the third most common disease affecting the brain in the elderly. Current demographic trends will lead to an increased prevalence of epilepsy in the general population. METHOD:A selective literature search revealed 102 relevant publications as of September 2008, 50 of which were original article...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2009.0135
更新日期:2009-02-01 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
doi:10.3238/arztebl.2015.0816
更新日期:2015-11-27 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2015.0159
更新日期:2015-03-06 00:00:00