Med Klin
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Little is known about the epidemiology of hepatitis C in Germany and in particular about the route of infection. The current study prospectively analyzed epidemiologic and clinical data of patients with chronic hepatitis C virus (HCV) infection. ⋯ Hepatitis C should be excluded in all patients with elevated liver enzymes. In risk groups with a high prevalence of hepatitis C, the infection should be looked for even when liver enzymes are normal.
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Diabetic nephropathy is an important complication of diabetes types 1 and 2 and contributes to overall morbidity and mortality. Incidence and prevalence data often come from controlled clinical studies and there is only few information obtained on the primary care level. TUV is an abbreviation for "Technischer Uberwachungsverein" (Technical Safety Standards Authority) which regularly checks cars and technical equipment in Germany. In analogy to this, the name "diabetes TUV" was chosen to demonstrate the continuous surveillance of diabetic patients. The diabetes TUV is an initiative of the "Deutsche Betriebskrankenkasse" ("Deutsche BKK"), with 1.1 million members the largest works sickness fund in Germany, that have entered into a contract with the German associations of family physicians and ophthalmologists to improve integrated care for patients with diabetes. The aim of this retrospective study was to screen the diabetes TUV registry data regarding nephropathy. ⋯ The analysis of the diabetes TUV data has revealed a higher prevalence of renal disease as previously described. Data clustering could be an indicator of documentation failure. From the obtained information, it cannot be determined whether the decrease in renal function in the diabetes TUV patients is due to diabetic nephropathy and/or other renal diseases. The diabetes TUV of the Deutsche BKK is a valuable approach to detect early renal abnormalities in diabetic patients on the primary care level. The quality of documentation, however, must be improved.
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Review
[Mesenchymal stem cells from bone marrow. Phenotype, aspects of biology, and clinical perspectives].
Since their initial description by Friedenstein et al. 30 years ago, mesenchymal stem cells have been characterized as a cell population of the bone marrow, which is easily accessible and readily manageable for in vitro manipulation. ⋯ Further preclinical studies as well as clinical cell therapy studies are essential to fully exploit the potential of mesenchymal stem cells in regenerative medicine, cellular immunotherapy, and gene therapy.
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The idiopathic interstitial pneumonias, especially the idiopathic pulmonary fibrosis (IPF), are life-threatening lung disorders, for which no effective treatment option exists. In view of IPF, the American Thoracic Society (ATS)/European Respiratory Society (ERS) consensus statement recommends a combined therapy with corticosteroids and azathioprine or cyclophosphamide, although data from conclusive clinical trials are yet missing and the recurrent clinical experience is that these drugs do not really help in IPF. ⋯ The agents investigated and their targets are: acetylcysteine (reactive oxygen species [ROS] scavenging), interferon-gamma 1b (modulation of Th1/Th2 balance, direct antifibrotic effects), pirfenidone and GC 1008 (blockade of transforming growth factor-beta), FG 3019 (blockade of connective tissue growth factor), imatinib mesylate (blockade of platelet-derived growth factor), bosentan (blockade of endothelin), zileutin (blockade of leukotrienes), etanercept (blockade of tumor necrosis factor-alpha), heparin (alveolar anticoagulation). Hopefully, these new therapeutic strategies may help to improve prognosis of IPF in the future.