Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Mar 2015
Review Comparative Study[Lipid lowering by rosuvastatin: how do statins differ?].
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Dtsch. Med. Wochenschr. · Mar 2015
[Treatment of chronic heart failure: what's not (yet) in the guidelines].
2012 Scientific meeting of the European Society of Cardiology (ESC), the current Guidelines on Acute and Chronic Heart Failure were introduced whose preparation had started 18 months earlier. These guidelines integrate scientific evidence of the years 2011 and 2012, leaving several questions open due to gaps in knowledge. ⋯ Based on recent studies, we will address some of these questions and discuss potential impact of their results on current clinical practice. A further official update of the ESC heart failure guidelines is expected for early 2016, which will then show if today's assessment holds true.
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Dtsch. Med. Wochenschr. · Mar 2015
Review[Treatment of advanced non-small-cell lung cancer with driver mutations].
Advanced non-small-cell lung cancer is no longer one disease but the collective name for different diseases defined by clinical, histological, immunohistochemical and, to an increasing extent, molecular biomarkers. This article deals with the treatment options we gained by identifying so called driver mutations in a growing subset of these cancers. For patients whose tumors are characterized by a targetable molecular alteration such as an activating EGFR-Mutation, an ALK-translocation or a ROS1-rearrangement, we see prolonged survival and oral treatments with tyrosine kinase inhibitors demonstrate superiority to chemotherapy in terms of response (remission rate), progression free survival and quality of life. We provide a review of the literature and discuss the status quo of the diagnostic need and the therapeutic options in Germany and Europe.
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Dtsch. Med. Wochenschr. · Mar 2015
Case Reports[Cardiogenic shock due to atypical Tako-Tsubo cardiomyopathy in a young woman with pheochromocytoma].
A 42-year old female patient was admitted in cardiogenic shock with pulmonary edema requiring prehospital intubation and mechanical ventilation. ⋯ Under intensive care therapy with mechanical ventilation, inotropic support, infusion of saline and intraaortal balloon pumping, left ventricular function improved. After discontinuation of mechanical ventilation and discharge from ICU, the patient repeatedly suffered from panic attacks. She was therefore transferred to a psychosomatic center. There she exhibited repeated hypertensive crisis. Ultrasound of the kidney showed an adrenal mass. Together with elevated plasma catecholamines, the diagnosis of pheochromocytoma was suspected. This could be proved by magnetic resonance imaging. After surgical removement of the adrenal mass, the patient was free of symptoms.
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Dtsch. Med. Wochenschr. · Mar 2015
[Renal denervation in refractory hypertension: joint statement of the German hypertension league DHL eV and the German societies of cardiology, angiology, nephrology and radiology].
Arterial hypertension is a major risk factor for cardiovascular mortality and remains insufficiently controlled in Germany. The sham controlled Symplicity HTN-3 trial did meet its primary safety endpoint but failed to meet its primary efficacy endpoint. ⋯ It can only be used in selected truly resistant hypertensive patients as an additive approach and should be performed by specialized centers only. Randomized controlled trials are needed to further evaluate renal denervation.