Ueber einen Fall von primärem Nierencarcinom

Ohne Zusammenfassung     

Kritischer Überblick zu Outcome-Parametern bei Patienten mit primärem Sjögren-Syndrom

Not only in the context of clinical trials in particular, but also in daily clinical practice, outcome parameters or measuring instruments are essential to assess the efficacy of a therapeutic intervention, its influence on disease activity and potentially also to predict further disease course. Such criteria can assist in the identification of patient risk groups that may require special checkups or interventions. Moreover, these parameters should be reliable, objective and valid, e.g. to allow comparison of results from different studies. Therefore, outcome parameters need to be developed and/or validated in a targeted manner for individual diseases or investigations. To date, we have only limited therapeutic options for Sjögren’s syndrome, a frequent systemic autoimmune disorder of unknown origin. Against the background of the new therapy approaches expected, this article provides a critical overview of available and newly developed outcome parameters for patients with Sjögren’s syndrome.     

Drei Fälle von primärem Carcinom des Bauchfells

Ohne ZusammenfassungHerrn Professor v. Hansemann danke ich bestens für die Anregung zu dieser Arbeit und für seine gütige Unterstützung bei der Anfertigung derselben.     

Ein Fall von primärem Halssarkom mit Metastasenbildung in Lungen und Nieren bei der Katze

Ohne Zusammenfassung     

Ueber einen Fall von primärem Carcinom der Pleura

Ohne Zusammenfassung     

Ein Fall von primärem Leberkrebs mit starker Bindegewebsneubildung

Ohne Zusammenfassung     

EKG-Befunde bei primär neurologischen Erkrankungen, Systemerkrankungen und primären Kardiomyopathien

ECG diagnostic is not only an easy to use, cost efficient, extensively available method for cardiological patients, but also a potential tool in diagnostic for other morbidities. As a well-known example, cerebral hemorrhage and ischemia can show an ECG, that resembles an acute coronary syndrome. Furthermore systemic diseases may show characteristic ECG; often as a malfunction of the conductive system (e.g., AV block). Exclusion of cardiac involvement when dealing with sarcoidosis is important, and the ECG may be a first hint. Besides, in Ixodid endemic areas a cardiological manifestation of Borreliosis should be considered. ECG may also show almost specific findings in primary cardiomyopathies, such as the “pseudo-infarction Q – wave” in hypertrophic cardiomyopathy or “epsilon potentials” in arrhythmogenic right ventricular cardiomyopathy. The takotsubo cardiomyopathy commonly reveals transient ST-segment elevation and therefore depicts an important differential diagnosis of acute coronary syndromes.     

Über einen Fall von primärem Bronchialschleimdrüsenkrebs

Ohne ZusammenfassungZum Schluß gestatte ich mir, Herrn Prof. Dr.Rössle für die liebenswürdige überlassung des pathologisch-anatomischen Materials meinen besten Dank auszusprechen.     

Organtransplantation bei Patienten mit primärer Hyperoxalurie

Background

The primary hyperoxalurias can become symptomatic at any age and may lead to rapid deterioration of kidney function. Due to the hepatic localization of the metabolic defect an isolated liver or combined liver and kidney transplantation can become necessary.

Objectives

Based on genotype and phenotype, different strategies in organ transplantation are described.

Methods

A critical discussion of current literature in the context of own experience with organ transplantation in patients with primary hyperoxaluria.

Results

Due to the persistent metabolic defect in the liver, an isolated kidney transplantation does not have a good prognosis and is only an option in individual patients with complete pyridoxin sensitivity. Preemptive liver transplantation cures the metabolic defect and can help to avoid terminal renal insufficiency if performed early enough, although optimal timing is still a controversial issue. In end-stage renal disease combined liver-kidney transplantation (simultaneous or sequential) is the treatment of choice and should be performed rapidly in order to minimize systemic oxalosis in terminal renal failure. This option has been successfully performed even in infants.

Conclusions

Patients diagnosed with primary hyperoxaluria should be transferred as soon as possible to a specialized transplantation center.     

Konsensuspapier: Schlaganfallprophylaxe bei Patienten mit nichtvalvulärem Vorhofflimmern

With the introduction of edoxaban last year in Germany, four nonvitamin K antagonist oral anticoagulants are now available for stroke prevention in patients with nonvalvular atrial fibrillation. These novel oral anticoagulants (NOAC) represent an attractive new option compared to vitamin K antagonists (e.g., warfarin or phenprocoumon) due to simple use and fewer interactions with other drugs or food. Therefore, no INR monitoring and dosage adjustments are required for NOAC. The compelling clinical advantage of NOAC is the dramatic risk reduction of hemorhagic stroke and intracranial bleeding compared to current standard. In addition, total mortality is significantly reduced by 10?%. These effects are demonstrated for all four NOAC (dabigatran, rivaroxaban, apixaban and edoxaban). Therefore, current national and international guidelines recommend NOAC as the preferred option or at least as an attractive alternative compared to the former standard of vitamin K antagonists. The economic impact and reimbursement by Statutory Health Insurance (GKV) is of major importance for treatment in an outpatient setting. For apixaban and edoxaban, an additional benefit was granted by the institution of G?BA and IQWiG in this clinical setting, whereas dabigatran and rivaroxaban were not assessed due to market entrance prior to 2011 before the AMNOG procedure was initiated. The members of this consensus paper recommend NOAC as the preferred option for patients with nonvalvular atrial fibrillation who are currently not treated with anticoagulant drugs in spite of clear indication for anticoagulation. For new patients with nonvalvular fibrillation, it should be decided on an individual basis which treatment option is adequate for the patient with their respective comorbidities.     

Therapie des Organversagens bei primär extrakardialen Erkrankungen

Zusammenfassung Eine Vielzahl primär extrakardialer Kreislauffunktionsstörungen kann zunächst zur Organdysfunktion und in der Folge zum Multiorgandysfunktionssyndrom und zum Multiorganversagen führen. Potenzielle Auslöser sind verschiedene Schockformen (septischer, hypovolämischer, anaphylaktischer oder neurogener Schock) oder ein systemisches Inflammationsreaktionssyndrom (SIRS). Grundlage der Therapie ist die Behebung der zugrunde liegenden Krankheitsursache und die rasche Wiederherstellung einer adäquaten Gewebeperfusion durch Volumen-, Vasokonstriktoren- und Inotropikatherapie. Die weitere supportive Therapie der einzelnen Organdysfunktionen ist in Abhängigkeit vom betroffenen Organ derzeit noch unterschiedlich effizient.