Deutsche medizinische Wochenschrift
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While effects of vitamin D on bone metabolism are widely acknowledged, many questions regarding extraskeletal actions of vitamin D have emerged. In-vitro data show the expression of the nuclear vitamin D receptor in a variety of different extraskeletal tissues. ⋯ Very recently, several randomized controlled trials assessing the effect of vitamin D supplementation on prevention of different diseases have been published with disappointing results. In this review we focus on assessment of vitamin D status, as well as results of currently published randomized controlled trials on vitamin D and disease prevention.
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Infections of the central nervous system (CNS) are a diagnostic and therapeutic challenge in daily clinical practice. In most cases, an early and efficient empiric therapy is crucial for the prognosis. Here, an update on current developments concerning the following CNS infections is presented:- Herpes simplex virus (HSV) encephalitis,- bacterial meningitis,- tick borne encephalitis,- neuroborreliosis.
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Ambulatory cancer patients receiving systemic cancer therapy are at varying risk for venous thromboembolism (VTE). The VTE risk depends on different cancer types, cancer stage, anti-cancer treatment and individual patient risk factors. Whereas pharmacologic thromboprophylaxis is recommended in most hospitalized cancer patients with an acute medical condition and in patients undergoing major cancer surgery, the role of primary thromboprophylaxis in the ambulatory setting is not clear. ⋯ Current guidelines differ in their recommendations concerning the choice of anticoagulation. Whereas LMWH is still preferred to DOAC in the current German guideline, the ISTH guidance suggest to use DOAC in high-risk ambulatory cancer patients with no drug-drug interactions and not at high risk for bleeding. Of note, DOAC are currently not approved in this indication.
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Dtsch. Med. Wochenschr. · Feb 2020
Case Reports[Increased Ventricular Pacing Threshold Caused by Intake of Dronedaron].
The 75 year old patient was hospitalized because of vertigo, exertional dyspnea and clamminess. Based on ischemic heart disease with sick sinus syndrome a pacemaker was implanted 5.5 years ago. In consequence of non-permanent atrial fibrillation Dronedaron was added to medication 8 months ago. ⋯ In patients with dysfunction of a permanent pacemaker an increased pacing threshold should be excluded and if any the current medication needs to be controlled. Caution should be exercised to Dronedaron here.
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Many recommendations for medical care for women with Turner syndrome (TS) have been published in the past. There are no studies that analyse the care situation of the women in Germany until now. ⋯ This is the first study which analyses the current situation of medical care of TS women in Germany. Our data show that medical care of young adult TS women is not optimal. The study cannot clarify the reasons. Due to the numerous and different comorbidities, the medical care of TS women is complex and should therefore be provided multidisciplinarily by different specialists under the direction of one physician.