Deutsche medizinische Wochenschrift
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Thyroid disorders are among the most common endocrine alterations. Ultrasound examination of the thyroid gland is a rapid and radiation-free method, adding important information to a patient's medical history, physical examination, and laboratory results. This article describes a practical approach to an ultrasound examination in a step by step manner. The most important findings and most common causes of thyroid disorders are discussed on the basis of typical images.
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Membranoproliferative glomerulonephritis (MPGN) and glomerulopathy with dominant C3 deposits are very rare autoimmune disorders of the kidney that had been classified in its current form in 2010 due to a better understanding of the underlying pathophysiology. Today, the immune complex-associated membranoproliferative glomerulonephritis (IC-MPGN) and C3 glomerulopathy (C3G) represent a disease spectrum which is heterogeneous in terms of pathophysiology and the clinical time course. ⋯ Therefore, following histologic diagnosis a comprehensive complement analysis, accompanied by antibody screening and human genetics should be carried out consistently. The published evidence provides a robust basis for the use of available therapeutic approaches for these often rapidly progressive and relapsing diseases.
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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.