Deutsche medizinische Wochenschrift
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In Germany, baricitinib and tofacitinib have been approved for the treatment of at least moderately active rheumatoid arthritis after the failure of conventional disease modifying anti-rheumatic drugs in 2017, and tofacitinib also for psoriatic arthritis and ulcerative colitis. Both baricitinib and tofacitinib can be taken orally and reversibly inhibit Janus kinases (JAK) and therefore the signaling of a large number of cytokines via the JAK/STAT pathway. JAK inhibitors have been shown to be at least as efficacious in rheumatoid arthritis as adalimumab and tofacitinib was also efficacious in psoriatic arthritis. ⋯ In the placebo-controlled trials, venous thromboembolic events (VTE) were more common in the baricitinib treated patients. The VTE rate does not appear to be elevated in baricitinib treated patients compared to RA cohorts however. In conclusion, JAK inhibitors are a powerful new treatment of RA and likely many other rheumatic diseases and fulfill an unmet need since they may be taken orally.
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Dtsch. Med. Wochenschr. · Apr 2019
[Step-by-Step tutorial of bedside percutaneous dilatational tracheostomy].
Bedside percutaneous dilatational tracheostomy has become one of the most commonly used interventions in ICU medicine. Different techniques have been developed, but guidance of percutaneous dilatational tracheostomy by video bronchoscope has been suggested to be clinically reasonable for direct visualization. The current Step-by-Step tutorial gives a detailed instruction of the procedure with visualization of every single step offering tips and pitfalls of the procedure.
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Dtsch. Med. Wochenschr. · Feb 2019
Case Reports[Hemiballism-Hemichorea Induced by Non-Ketotic Hyperglycemia].
A non-ketotic hyperglycaemia may cause an affection of basalganglia and, in the following, lead to a hemiballism-hemichorea movement-disorder. ⋯ The exact pathophysiology of this phenomenon is still not fully understood and will need to be investigated. Nevertheless, this disease should always be taken into consideration if the typical clinical presentation as well as matching laboratory tests and imaging features are found.