Der Internist
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This article provides an overview of current prevention and treatment options for typical cardiovascular side effects of oncological therapies as well as cardiovascular complications of malignant disease. Focus is put on the prevention and treatment of heart failure under potentially cardiotoxic cancer therapies. In addition, current options for the treatment of common venous thromboembolism in cancer patients will be discussed.
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The hype about vitamin D can be traced back to the ubiquitous presence of vitamin D receptors in many organ systems, in addition to the importance for healthy bones. Large observational studies have provided indications that a vitamin D deficiency favors risks for age-associated chronic diseases, such as cancer and cardiovascular diseases. In this article the latest information on bone health in adult persons as well as cancer and cardiovascular diseases is summarized based on the current results of the large vitamin D and omega‑3 trial (VITAL).
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In recent decades, major advances in the treatment of malignant diseases have significantly improved long-term survival. However, this has increased the spectrum of side effects of these treatment methods, particularly for the cardiovascular system. Cardiotoxicity can be acute and chronic, including hypertension, heart failure, arrhythmias, acute myocardial infarction, venous thromboembolism, stroke, and valvular heart disease. ⋯ Troponin can also be used to identify myocarditis associated with immune checkpoint inhibitor therapy. This overview summarizes the current knowledge about biomarkers for the detection of cardiotoxicity due to tumor therapy. Possible clinical recommendations for the detection of cardiotoxic effects using biomarkers are also outlined.
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This article presents the case of a 95-year-old patient with acute urinary retention, postrenal acute renal failure, and subsequent delirium. Especially in older men, urinary retention is often the cause of clinically ambiguous confusional state and should always be considered in the differential diagnosis. This case report demonstrates the value of a good medical history and physical examination as fundamental elements of daily practice.
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This article reports an incidental finding of leptospirosis during a special consultation, which was initiated due to the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The focus on SARS-CoV‑2 and the uncharacteristic symptoms of these two diseases make it much more difficult to find the correct diagnosis. Leptospirosis is predominantly a tropical zoonosis but also occurs in Germany.