Der Internist
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Randomized Controlled Trial
[Effects of glycemic index on cardiovascular risk factors: The OmniCarb randomized clinical trial].
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Dyspnea represents one of the most frequent and heterogeneous symptoms. The term dyspnea describes the subjective perception of an inadequate effort to breathe. In general, acute and chronic forms have to be differentiated. ⋯ The differential diagnosis needs a structured approach including anamnestic and medical technical methods, aiming an efficient differentiation of cardiac and pulmonary causes. As a high number of patients suffer from more than one significant disease, the differential diagnostic assessment needs to be focused on the assessment of the predominant cause of the dyspnea. For this purpose, exercise tests provide helpful algorithms to answer this question.
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Randomized Controlled Trial Multicenter Study
[Endovascular treatment for acute ischemic stroke : Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN)].
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Hyperkalemia is a common clinical problem. While several options are available to treat acute hyperkalemia, there are few options for long-term treatment. ⋯ Sodium zirconium cyclosilicate and patiromer are two new oral potassium binders awaiting approval. The efficacy of these novel potassium-lowering agents were tested in several phase 3 short-term studies published in late 2014.
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Vasoactive drugs and inotropes are important in the hemodynamic management of patients with cardiogenic shock despite modest volume administration. Currently, the concept of cardiac relief is pursued in the treatment of acute heart failure. In this article we present the use of different drugs in the intensive care unit for acute heart failure and cardiogenic shock. ⋯ The maxim of hemodynamic management in cardiogenic shock is the transient use of inotropes and vasopressors in the lowest dose possible and only for as long as necessary. This means that one should continuously check whether the dose can be reduced. There are no mortality data demonstrating the utility of hemodynamic monitoring based on objective criteria—but it makes sense to use inotropes and vasopressors sparingly.