Deutsche medizinische Wochenschrift
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Decompression injuries occur on account of the special hyperbaric effects during the emerge phase and require superior therapeutic knowledge. Vitally important is emergency treatment with high concentrated oxygen at an early stage. Sever decompression injuries require oxygenation in a hyperbaric treatment chamber.
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Current guidelines of the global initiative for asthma (GINA) recommend the addition of biologics in step 5 of the stepwise asthma treatment approach. This review gives an overview on the effects and the clinical role of antibodies targeting immunoglobulin E, IgE (Omalizumab), Interleukin-5, IL-5 (Mepolizumab, Reslizumab) or the IL-5 receptor (Benralizumab). In addition, potential future treatment options of refractory asthma with antibodies (for instance Dupilumab) are discussed.
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Dtsch. Med. Wochenschr. · Jun 2016
Comparative Study[Lipid-lowering therapy in Europe and the United States - treat to target or fire and forget?].
The 2013 AHA/ ACC guidelines on the assessment of cardiovascular risk recommend high-dose statin treatment to reduce LDL-cholesterol (LDL-C) by at least 30-50% without suggesting a specific target value 1. Favoring a strict Evidence Based Medicine approach the authors focus on randomized clinical trials only and neglect a target value since none of the randomized trials has titrated statin therapy to a specific LDL-C concentration. ⋯ This paradigm shift has created a lot of controversy and confusion due to the lacking opportunity to assess medication adherence and the addition of further lipid lowering therapy. Moreover, these new guidelines might discourage clinicians to individualize patient care.
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A 54-year-old female patient is admitted for evaluation of her thyroid function after two cycles of ipilimumab therapy. The decision for the anti-cytotoxic-T-lymphocyte-antigen-4-therapy (anti-CTLA-4) was made two months earlier because of malignant melanoma with pulmonary metastases. The patient was euthyroid before initiation of treatment and without known thyroid disease. ⋯ An anti-CTLA-4 therapy may cause thyroid dysfunction. Therefore, before initiation and in the course of the treatment, regular controls of the thyroid hormone levels are required.