Stollberger C.,Krankenanstalt Rudolfstiftung |
Finsterer J.,Medizinische Abteilung
European Journal of Echocardiography | Year: 2011
Left ventricular non-compaction is a cardiac abnormality whose echocardiographic diagnostic criteria are still controversial. The distinction between normal and pathologic is additionally impeded by the fact that the left ventricular myocardium is more intensively trabeculated in African blacks than in Caucasians. The impact of these uncertainties and unresolved issues in the diagnosis of non-compaction is illustrated by a 23-year-old professional African footballer in whom an aberrant left ventricular band was misinterpreted as non-compaction. The diagnosis of non-compaction resulted in the immediate withdrawal of the playing licence and impending deportation of the young man from Germany to his home country. Organized by the footballers lawyer, repeated echocardiographies and cardiac magnetic resonance imaging failed to diagnose non-compaction. After several months, the young man regained his playing licence and played as a striker in the national team of his country of origin in the football world cup. Uncertainties and unresolved issues may result in misdiagnosis of non-compaction, thus promoting discrimination and degradation. This case highlights the urgent need for standardization of diagnostic criteria for left ventricular non-compaction and to assess if they need to be different for African blacks and Caucasians. © 2010 The Author.
Schneider B.,Sana Kliniken Lubeck GmbH |
Athanasiadis A.,Robert Bosch GmbH |
Stollberger C.,Medizinische Abteilung |
Pistner W.,Medizinische Klinik 1 |
And 7 more authors.
International Journal of Cardiology | Year: 2013
Objective: This study evaluated if there are gender differences in the manifestation of tako-tsubo cardiomyopathy (TTC). Background: TTC predominantly occurs in elderly females and mimics acute myocardial infarction (AMI) where men and women are known to have a different clinical profile. Methods: 324 patients from 37 hospitals were prospectively included in a TTC registry. Clinical, electrocardiographic, angiographic and outcome data from male and female patients were compared. Results: Of 324 patients 296 (91%) were female and 28 (9%) male. Mean age (68±12 vs 66±12 years) and prehospital delay were similar. A triggering event preceded TTC onset in 76% of women and 86% of men. Physical stress was more frequent in men (30% vs 57%, p=0.005) whereas more women experienced emotional or no stress. The prevalence of angina and dyspnea did not differ. Fewer females were admitted in car-diogenic shock and/or after out of hospital cardiac arrest (1% vs 14%, p=0.0006), and cardiac troponin was lower (median 7.2 vs 10.7 times the upper limit of normal, p=0.03). The QTc interval was longer in females than in males only on the day of admission (468±52 vs 441±51 ms, p=0.047). Overall, complications during the acute course (53% vs 40%) were comparable in both sexes. Conclusions: In this large TTC registry, males and females showed a similar clinical profile. In males, physical stress as a trigger event and shock or cardiac arrest as presenting symptoms were more frequent. The QTc interval was longer in females only on admission but similar in males and females during the following days. © 2011 Elsevier Ireland Ltd. All rights reserved.
Schuchardt J.P.,Leibniz University of Hanover |
Neubronner J.,Leibniz University of Hanover |
Kressel G.,Leibniz University of Hanover |
Merkel M.,Medizinische Abteilung |
And 2 more authors.
Prostaglandins Leukotrienes and Essential Fatty Acids | Year: 2011
Recently, in a supplementation study over six months, it has been demonstrated that re-esterified omega-3 fatty acid triacylglycerols (n3-FA-rTAGs) led to a higher increase in omega-3-index compared to identical doses of n3-FA ethyl-esters (n3-FA-EEs), suggesting a better long-term bioavailability. The aim of this study was to examine whether differences occur between the two forms in affecting fasting serum lipid levels. 150 dyslipidemic statin-treated participants were randomized to corn oil as a placebo or fish oil either as rTAG or EE in identical doses (1.01 g EPA+0.67 g DHA). No changes in total cholesterol, HDL or LDL levels were observed. In the rTAG-group, but not in the EE-group, fasting serum TAG levels were significantly reduced from baseline after three and six months. There was no significant difference between the two n3-FA-groups. However, serum TAG levels were significantly lowered after six months in the rTAG-group compared to the placebo-group in contrast to the EE-group. © 2011 Elsevier Ltd.
Mikosch P.,Medizinische Abteilung |
Mikosch P.,Ludwig Bolzmann Institute For Osteologie
Wiener Medizinische Wochenschrift | Year: 2012
Osteoporosis with its increased risk of low-trauma fractures has to be regarded as a disorder with significant influence on quality of life, increased morbidity and mortality in the elderly. Therapies of osteoporosis, in particular drug therapies aiming to reduce the fracture risk, are in general only initiated after diagnostic procedures prior to the start of osteoporosis therapy. Consequently, diagnosis of osteoporosis plays a key role in optimized patient care and management. Medical history, physical examination, planar X-ray, osteodensitometry and a range of laboratory parameters make up the key steps in the diagnostic work up of osteoporosis. In some clinical settings such as the investigation of possible occult fractures after falls, additional imaging methods including computed tomography, magnetic resonance imaging, and bone scintigraphy may be necessary to make up adequate diagnosis. However, it has to be questioned in which way all these diagnostic investigations can be effectively used in the diagnostic work up of geriatric patients. The article will give an overview of the different diagnostic methods with their possibilities and limitations and will present possible diagnostic work flows based on frequent clinical settings seen in geriatric patients. © Springer-Verlag 2012.
Wascher T.C.,Medizinische Abteilung
Wiener Klinische Wochenschrift | Year: 2012
Self monitoring of blood glucose contributes to the integrated management of diabetes mellitus. It, thus, should be available for all patients with diabetes mellitus type-1 and type-2. Self monitoring of blood glucose improves patients safety, quality of life and glucose control. The current article represents the recommendations of the Austrian Diabetes Association for the use of blood glucose self monitoring according to current scientific evidence. © 2012 Springer-Verlag Wien.
Wascher T.C.,Medizinische Abteilung
Wiener klinische Wochenschrift | Year: 2012
Self monitoring of blood glucose contributes to the integrated management of diabetes mellitus. It, thus, should be available for all patients with diabetes mellitus type-1 and type-2. Self monitoring of blood glucose improves patients safety, quality of life and glucose control. The current article represents the recommendations of the Austrian Diabetes Association for the use of blood glucose self monitoring according to current scientific evidence.
Wascher T.C.,Medizinische Abteilung |
Stechemesser L.,Paracelsus Medical University
Wiener Klinische Wochenschrift | Year: 2016
Self monitoring of blood glucose contributes to the integrated management of diabetes mellitus. It, thus, should be available for all patients with diabetes mellitus type-1 and type-2. Self monitoring of blood glucose improves patients safety, quality of life and glucose control. The current article represents the recommendations of the Austrian Diabetes Association for the use of blood glucose self monitoring according to current scientific evidence. © 2016, Springer-Verlag Wien.
Jost W.H.,Zentrum fur Bewegungsstorungen |
Engemann K.,Medizinische Abteilung
Aktuelle Neurologie | Year: 2016
In Germany, data on the current treatment situation of patients with Parkinson‘s disease are lacking. Therefore, a cross-sectional survey of 4485 patients and neurologists treating them was performed. Patients were questioned on disease progression, treatment history, current treatment, and satisfaction with treatment. The time between diagnosis and initial prescription of drugs to treat the disease varied between 3 months and 2 years. Patient assessment of their disease stage was also varied considerably. Improvement was reported in motor symptoms (51.3%), in non-motor symptoms (6.5%), in perception (23.4%), quality-of-life (57.0%) and reduction in medication-associated impairment (21.5%). With regard to the current therapy, 41.8% felt disturbed by frequency of administration, 3.2% by the type of application, 12.3% by multiple medication, 27.7% due to insufficient efficacy and 41.29% by side effects (multiple answers possible). Overall, only 27.5% of patients rated their current Parkinson’s disease therapy as good or very good, but most of them reported therapy as being satisfactory or even unsatisfactory. This statement was in marked contrast to the much more positive global assessment made by physicians treating these patients. Patients report deficits in medical care with drugs. There is a clear need for action in relation to providing information to patients (explanation of side effects or differentiation of symptoms) and for a change of medication regimens to other compounds or combinations. Copyright ©, Georg Thieme Verlag KG. All rights reserved.
Ludwig H.,Medizinische Abteilung
Tagliche Praxis | Year: 2014
During the last years significant insights into the molecular biology of myeloma have been gained, and novel agents have been developed and introduced in clinical practice. Improved risk stratification enables better esti-mation of prognosis and rational selection of therapy. In younger patients (<65 years) high dose therapy with autologous stem cell transplantation is recommended. Regimens for induction therapy should include at least 2, but preferable 3 drugs including at least one novel agent. Four cycles of induction therapy should be applied before high dose therapy and autologous stem cell transplantation. Consolidation and or remission maintenance treatment can be considered after trans-plantation, but none of them can be regarded as standard therapy as yet. A three drug regimen is recommended for fit elderly patients, whereas for frail elderly patients appropriate dose reductions and restriction to 2 drug combinations are recommended. In responding patients treatment should be administered for 9-12 cycles. Selection of therapy in patients relapsing/resistant to previous treatment depends on several factors like quality of response to prior treatment, duration of remission, tolerance, patient's specific factors and available drugs. For relapse therapy, a change in drug class is recommended, but previous therapy may be repeated provided it was associated with long remission (<6 months) and acceptable toxicity. All together, the prognosis of patients with multiple myeloma has improved significantly, mainly due to the introduction of novel drugs, but also due to better supportive care and expertise in the management of the disease. Future developments likely will include the introduction of several new effective drugs, including monoclonal antibodies which will be combined with chemotherapy similarly to treatment in lymphomas and abandonment of autologous transplantation as first line myeloma therapy.
Doppler R.,Medizinische Abteilung
Medizinische Klinik - Intensivmedizin und Notfallmedizin | Year: 2014
Background: Noninvasive ventilation is mechanical respiratory support without the use of an artificial airway. There is no need for a tube or analgosedation. There are some advantages in comparison to invasive forms of ventilation. Objectives: Many patients are treated out of hospital because of acute dyspnea. For these patients, noninvasive ventilation is a therapeutic option. Some prehospital intubations can be avoided, if some kind of noninvasive ventilation is available. Conclusions: In order to offer noninvasive ventilation to all patients, it also has to be available in the prehospital setting. Modern mechanical ventilators, which are used in emergency medical service, are eligible to provide noninvasive ventilation. © 2014 Springer-Verlag Berlin Heidelberg.