Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Feb 2013
Review[Chronic dizziness and vertigo from a neurologists' perspective].
Dizziness and vertigo are among the most common symptoms in neurology and medicine in general. The differential diagnosis may be simplified by systematic and careful assessment of presenting symptoms. ⋯ Extensive apparative diagnostic work-up is seldomly required and often not helpful. The majority of these disorders can be well treated and have an excellent prognosis, when diagnosed adequately and within a reasonable time frame to prevent the development of chronic disease.
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Dtsch. Med. Wochenschr. · Feb 2013
Review[Positional paper of the German working group "cardiopulmonary exercise testing" to ventilatory and metabolic (lactate) thresholds].
Thresholds in cardiopulmonary exercise testing are necessary for the evaluation of motivation and cooperation in exercise, for training programs, in transplant medicine, preoperative evaluation and medical assessments. There is a hardly comprehensible number of terminologies concerning these thresholds and their definitions. This hampers the comparison of protocols and studies and leads to incertainties in terminologies and interpretations of cardiopulmonary exercise tests. ⋯ VT2 is characterized by an exceeding of lactate-steady-state, resulting in excess lactate, metabolic acidosis and overproportional rise of ventilation. The operational concept describes the method, which is used for determination of the different lactate and ventilatory thresholds. In a further step this can be completed by indicating the exercise protocol which was applied.
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Dtsch. Med. Wochenschr. · Feb 2013
Review[Incidentaloma and subclinical disorders of the adrenal gland].
Autonomous secretion of adrenal hormones can follow a subclinical course or even be masked by other frequent diseases. Patients with incidentally discovered adrenal masses (incidentaloma) represent another diagnostic challenge. Their frequency has increased through the growing number of medical imaging procedures. ⋯ All tumors with criterias for malignancy (> 4cm) and subclinical pheochromocytoma and aldosterone producing adenomas should undergo surgery. In the case of non operated tumors annual bichemical follow-up controls should be performed over a duration of 5 years. In the case of a significant gain of tumor size during follow-up, adrenalectomy should be considered.
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Dtsch. Med. Wochenschr. · Jan 2013
Review[Losmapimod: a novel drug against cardiovascular diseases?].
Losmapimod is a promising new agent against cardiovascular diseases. This drug works by inhibiting p38 MAP kinases, which play an important role in the development of atherosclerosis and heart failure caused by ischemic conditions. Preclinical data from in vitro and in vivo studies suggest a protective role of pharmacological p38 inhibition with regard to the development of cardiovascular diseases. This article evaluates the therapeutic potential of this new pharmacological approach and discusses the current clinical data on Losmapimod.