Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Apr 2021
[When to test in biomarker-stratified therapy of non-small cell lung cancer - Biomarker-stratified therapy of Non-small cell lung cancer: when and what to test?]
Therapy of non-small cell lung cancer (NSCLC) should be based on biomarker test results in the palliative setting. To this end, testing of all patients in stage IV and in the future also in the earlier stages will be important. In a conference with the patronage of the German Cancer Society, the question of "reflex testing", i.e. independently of tumor stage, was discussed but not deemed to be acceptable. The current report summarizes the results of the consensus conference and discusses possible paths to efficent biomarker testing in NSCLC.
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Dtsch. Med. Wochenschr. · Apr 2021
[Current role of cardiac magnetic resonance (CMR) in diagnosis and therapy of myocardial diseases].
Cardiac magnetic resonance is the only imaging modality, that allows for characterising myocardial tissue with respect to fibrosis and edema. It has therefore become gold standard in diagnosing myocardial inflammation by combining scar, fibrosis and edema imaging. Recent developements in T1- and T2 mapping have improved diagnostic accuracy and prognostic information.
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In industrialized countries, stroke is still the most common disease that leads to permanent disability. Of the 250 000 strokes that occur annually in Germany, in about 80 % are cerebral ischemia. ⋯ In 2020, the multidisciplinary S3 guideline for the management of extracranial carotid stenoses was updated. In the following, current aspects and new recommendations for asymptomatic carotid stenosis are presented and important innovations of the guideline are explained.
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A common intuition says the death of a younger person is more tragic, since older people could already live through more "innings" of their life. The most important reason against using age as a criterion in triage is however the infinite value of the other: In a relationship of responsibility and care, which is the functional base of medicine also in situations of emergency, the life of each other has infinite value, and therefore cannot be weighed against each other.
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Thrombus formation due to atrial fibrillation is the most common cause of embolic stroke. Anticoagulation offers an effective prophylaxis. ⋯ The most commonly and best studied devices for this are the WATCHMAN™ and the AMPLATZER Amulet™ Occluders. In this How-To article, the aim is to offer a general overview of the indications, contraindications and complications as well as the implantation and postoperative management of patients receiving LAA closure by example of the WATCHMAN FLX™ Occluder.