Der Internist
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In the last years monoclonal antibodies directed against B-cell associated epitopes have enriched our armentarium of therapeutic strategies against malignant B-cell lymphoma. Monoclonal antibodies are characterized by a different mode of action compared to chemotherapy, thereby opening new avenues in lymphoma treatment. ⋯ The anti-CD52 antibody alemtuzumab was shown to induce remissions in high risk CLL. Furthermore, clinical trials have demonstrated promising activity of monoclonal antibodies conjugated to radioisotopes such as the (131)iodine anti-CD20 antibody tositumomab or the (90)yttrium anti-CD20 antibody ibritumomab tiuxetan.
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African tick bite fever (ATBF) is an infectious disease commonly observed in travelers to sub-Saharan Africa. Because the presentation of the disease is often not specific, ATBF is frequently not diagnosed or confused with Mediterranean spotted fever. ⋯ The diagnosis of ATBF was serologically confirmed by immunofluoroscence. ATBF is an important differential diagnosis of fever in patients returning from sub-Saharan Africa.
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Aortic valve stenosis is the most frequent reason for prosthetic valve replacement in adults. Its incidence increases with age. Development of the most frequent form, degenerative-calcific aortic stenosis, is related to atherosclerotic risk factors. ⋯ The most important diagnostic technique is echocardiography, which allows to measure the gradient and to calculate the orifice area, which determine the degree of severity. The development of symptoms or impaired left ventricular function in severe aortic stenosis should prompt surgical treatment by valve replacement. Truly asymptomatic patients with preserved left ventricular function should be followed conservatively.
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The right ventricle is the stepchild of intensive care medicine. In diseases of the lung mainly when the relationship between ventilation and perfusion is disturbed, assisted respiration with positive end-expiratory pressure (PEEP) is essential to improve oxygenation. ⋯ The effects of therapeutic measures aimed at maintaining oxygenation and ventilation partially have negative consequences for right ventricular function and encourage the development of acute cor pulmonale. They can be the cause of right-sided heart failure.