Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Feb 2020
Recommendations for ibrutinib treatment in patients with atrial fibrillation and/or elevated cardiovascular risk.
Ibrutinib is the first clinically approved inhibitor of Bruton's tyrosine kinase, an enzyme that is essential for survival and proliferation of B‑cells by activating the B‑cell receptor signalling pathway. Ibrutinib has been shown to be highly effective in B‑cell malignancies in clinical trials and is recommended in current international guidelines as a first and/or second line treatment of chronic lymphocytic leukemia. ⋯ In contrast, ibrutinib treatment can be initiated or continued, if certain recommendations are followed. The possibilities of prevention, diagnosis and management of specific clinical situations are discussed in detail and recommendations are derived, which should facilitate ibrutinib use.
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Wien. Klin. Wochenschr. · Feb 2020
ReviewWhat is new in the 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy?
Cardiovascular diseases during pregnancy are the most common causes of pregnancy-associated mortality. Vaginal delivery is the preferred mode of birth in the majority of pregnancies. It is recommended that patients with modified World Health Organization (mWHO) class IV risk are counselled against pregnancy. ⋯ Specific medications should not be principally withheld in pregnancy but the risk-benefit ratio should be carefully evaluated prior to administration. Beta blockers are recommended during and after pregnancy for congenital long QT syndrome and catecholaminergic polymorphic ventricular tachycardia. Low molecular weight heparin is the ideal substance for prophylaxis and treatment of venous thromboembolism in pregnancy under weekly monitoring of anti-factor Xa activity.
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Wien. Klin. Wochenschr. · Feb 2020
Prospective associations of cardiovascular disease with physical performance and disability : A longitudinal cohort study in the Osteoarthritis Initiative.
Literature regarding cardiovascular disease (CVD) and incident physical performance limitations and disability in older people is equivocal. ⋯ In a cohort of middle-aged and older adults with knee osteoarthritis or at high risk for this condition those with CVD experienced a worse profile in chair stand time over the 8‑year follow-up period than those without CVD; however, CVD was not significantly associated with an increased incidence of poor gait speed and disability over 8 years of follow-up. Importantly, no associations were observed when utilizing propensity score matching.
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The development of new devices and treatment options has greatly increased the interest in heart valve diseases. In this context, the consideration of gender differences in diagnosis, treatment success, and prognosis is of great importance. ⋯ It is the purpose of this review article to give an overview of gender-related differences in patients with valvular heart disease, regarding clinical presentation, treatment, and outcomes. In light of the emerging treatment possibilities, future research should emphasize the role of gender since both sexes benefit from tailored management.