Der Internist
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Comparative Study
[Prophylaxis and treatment of venous thromboembolism in cancer patients. Clinical value of low-molecular-weight heparins].
Venous thromboembolism (VTE) is a common complication in patients with cancer. Because of their improved subcutaneous bioavailability and reliable antithrombotic efficiency low-molecular-weight heparins (LMWH) are preferably used for prevention and treatment of cancer-related VTE. ⋯ Long-term secondary prophylaxis should be considered for patients with ongoing active malignancy and low bleeding risk. Due to absence of clinical studies in cancer patients, the use of novel oral anticoagulants is currently not recommended.
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Due to the decreasing partial pressure of oxygen, high altitude sickness can occur at heights over 2,500 m. This can be best avoided by slow adaptation to the altitude (acclimatization). In this way the organism adapts to the chronic hyperventilation and in the further process the oxygen content is normalized by an increase in erythrocytes. ⋯ Stress dyspnea, coughing and rasping breathing noises also occur by the potentially fatal high altitude pulmonary edema. All forms of high altitude sickness can be countered by a rapid descent to a height of at least 500 m. In acute mountain sickness acetazolamide can be administered (2 × 250 mg), for high altitude cerebral edema dexamethasone (3 × 4-8 mg) and for high altitude pulmonary edema nifedipine (initially 10 mg then 20 mg retard).
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Sarcoidosis is a multifactorial and polygenic disorder. The current knowledge of its genetic basis will be presented and functional consequences of the genetic variants that influence the immunopathogenesis of this disorder will be depicted. In the near future it is expected that this knowledge will yield clinically applicable genetic risk profiles.