Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Nov 2022
Review[Rivaroxaban in patients with cancer-associated thromboembolism].
This review article describes insights into the prevention and treatment of cancer-associated venous thromboembolism (VTE) with direct factor Xa inhibitors (FXaI) and refers in particular to the CALLISTO study program with rivaroxaban. CALLISTO includes randomized clinical trials on different topics as well as real-world evidence. Prevention and treatment of cancer-associated VTE have so far relied on low molecular weight heparins (LMWH). ⋯ A possibly increased risk of bleeding, especially in patients with unresected gastrointestinal or urogenital tumors, should be considered. This was first observed during therapy with FXaI but can also affect LMWH. The selection of suitable patients and the optimization of treatment pathways are therefore of great importance.
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Endocrine disrupting chemicals (EDCs) are universally occurring substances with the potential to interrupt the hormonal system, although the definition of EDCs is not yet standardized. Similar to hormones, EDCs are potentially able to act at very low concentrations, which might be considered save from a toxicological viewpoint. Research over the past years showed that EDCs, even in low doses, might have a relevant impact on human health and the environment as well. ⋯ Thus, besides the implications on personal and global health, EDCs affect the economy as well and pose a universal threat to society and environment. Many of the potentially hazardous substances are still inadequately examined and regulated. In this review, we give a brief summary on the previous efforts to classify EDCs and provide a short summary of the current knowledge.