Der Internist
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In recent decades, major advances in the treatment of malignant diseases have significantly improved long-term survival. However, this has increased the spectrum of side effects of these treatment methods, particularly for the cardiovascular system. Cardiotoxicity can be acute and chronic, including hypertension, heart failure, arrhythmias, acute myocardial infarction, venous thromboembolism, stroke, and valvular heart disease. ⋯ Troponin can also be used to identify myocarditis associated with immune checkpoint inhibitor therapy. This overview summarizes the current knowledge about biomarkers for the detection of cardiotoxicity due to tumor therapy. Possible clinical recommendations for the detection of cardiotoxic effects using biomarkers are also outlined.
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This article presents the case of a 95-year-old patient with acute urinary retention, postrenal acute renal failure, and subsequent delirium. Especially in older men, urinary retention is often the cause of clinically ambiguous confusional state and should always be considered in the differential diagnosis. This case report demonstrates the value of a good medical history and physical examination as fundamental elements of daily practice.
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This article reports an incidental finding of leptospirosis during a special consultation, which was initiated due to the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The focus on SARS-CoV‑2 and the uncharacteristic symptoms of these two diseases make it much more difficult to find the correct diagnosis. Leptospirosis is predominantly a tropical zoonosis but also occurs in Germany.
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Acute liver failure (ALF) is a rare disease with high mortality. It is defined as coagulopathy and encephalopathy in a person with a previously healthy liver. The etiology of ALF is a decisive prognostic factor and varies depending on the country of origin of the patient. ⋯ In the best case scenario this can completely avoid liver damage. In the complete picture of ALF the main focus is on the intensive medical care of a threatening multiorgan failure. In this context new standards of treatment were established by studies on plasmapheresis.