Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Dec 2020
Review[Supraventricular tachycardia - ECG interpretation and clinical management].
Supraventricular tachycardia (SVT) is a very common cause of hospital admission and its diagnostic and treatment may be difficult sometimes. While vagal maneuvers or intravenous adenosis administration during 12-lead ECG recording should be performed in hemodynamically stable patients for diagnosis and treatment, hemodynamically unstable patients should be carioverted immediately. The new ESC guideline (2019) on diagnosis and clinical management of SVT significantly upgrades catheter ablation and gives it a new preferential status. ⋯ The therapy of supraventricular tachycardia during pregnancy should be free of antiarrhythmic medication, especially in the first trimester. If ablation is necessary during pregnancy, only fluoroscopy-free mapping systems should be used. This review covers aspects of ECG diagnosis and guideline-based treatment of SVT.
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Dtsch. Med. Wochenschr. · Dec 2020
Case Reports[57-years old patient with bulla and striatic erythema located at the limbs].
A female patient aged 57 presented at the emergency room with painful skin lesions after repeated gardening days. Bullae and striate erythema were ovserved in light exposed areas. The patient was transferred to the Dermatology Department at the University hospital Jena, Germany. ⋯ Dermatits bullosa pratensis, is a skin condition appearing during the summer season in Germany. It belongs to the photo phytotoxic dermatitis types and is induced by phytochemicals in combination with UV-light. It is therefore important to take appropriate skin protective safety measures when touching plant containing phytochemicals in sunlight. In this way dermatitis bullosa pratensis can be easily avoided.
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Dtsch. Med. Wochenschr. · Dec 2020
[What is new in the diagnosis and therapy of malignant melanoma?]
Melanoma incidence and mortality rates are increasing. The sentinel lymph node biopsy plays an important prognostic role and is pivotal for the decision to undergo an adjuvant therapy making it an important diagnostic tool. The lack of survival benefit in patients with sentinel lymph node-positive (SLN+) melanoma upon immediate complete lymphadenectomy (CLND) suggest a parallel and not stepwise development of lymph node metastasis and distant metastasis thus questioning the role of immediate CLND. ⋯ Another novelty in the therapy of malignant melanoma is the approval of the first oncolytic virus, Talimogene laherparepvec, for the treatment of unresectable stage III and IV (M1a) melanoma. Significant progress has also been made in the treatment of patients with cerebral melanoma metastasis since studies indicate that both BRAF/MEK inhibitors and the immunotherapy with CTLA4 and PD-1 inhibitors are efficient in this group of patients. With this wide range of possible systemic therapies for advanced melanoma further studies regarding therapy sequence, combinations between targeted therapies and immunotherapy as well as biomarkers for treatment response are needed to help guide physicians find the optimal therapy for patients with advanced malignant melanoma.
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Dtsch. Med. Wochenschr. · Dec 2020
Review Historical Article[Rahel Hirsch (1870-1953): A Tribute For The 150th Birthday Of The First Female Professor Of Medicine In Germany].
Rahel Hirsch, whose 150th birthday was celebrated on 15 September 2020, is one of the female pioneers of medicine in Germany. Since it was not yet possible for women to study medicine in Germany at the end of the 19th century, she initially worked as a teacher. In 1898 she went to Switzerland to study medicine, graduating in Strasbourg in 1903. ⋯ As a Jew during the dictatorship of the National Socialists, she was marginalised and increasingly endangered, and emigrated to England in 1938. There she lived in modest circumstances and died in London in 1953. Rahel Hirsch, who asserted herself in a male-dominated environment both as a doctor and as a scientist, is a suitable role model for those who work for more gender equality in medicine and society today.
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Dtsch. Med. Wochenschr. · Dec 2020
Review Historical Article[Christmas with Charles Dickens - The Man of Letters as Syndrome-Spotter and Good Moralist].
Charles Dickens, as a writer, was also a great master of patient observation. He described more than 40 syndromes, some of which were named after characters and titles of his literary works. Within these he often referred to the connection between illness, poverty and social misery. ⋯ Finally, there is probably no other author who has portrayed the power of Christmas so sensitively and impressively. Dickens hoped that in these days, just before the turn of the year, personal transformations would take place and redemption would be experienced as a result of new insights. For such transformations, he was convinced that man occasionally needs external stimuli.