Med Klin
-
CARCINOMA OF THE GALLBLADDER: Only patients suffering from advanced disease have symptoms, that is pain, jaundice, weight loss. Mean 5-year survival rate tends to be lower than 5%. ⋯ After radiotherapy tumor regression is observed in 80% of the patients. Their mean survival time is 10 months.
-
Randomized Controlled Trial Clinical Trial
[Active compression-decompression resuscitation. Improved survival rate in an emergency medicine system with emergency physician assistance?].
Improved cardiopulmonary circulation with active compression-decompression resuscitation (ACD-CPR) has been demonstrated in studies using different animal models and a small number of human in cardiac arrest (CA). However, prehospital studies have shown both positive and no extra benefit of ACD-CPR on survival rates and neurologic outcome. ⋯ In our two-tiered EMS system with physician-staffed ambulances ACD-CPR neither improved nor impaired the survival rates and the neurological prognosis in patients with out-of-hospital cardiac arrest. Our results are in accordance with other studies carried out in EMS systems, with first tier call-response intervals between 4 and 6 min.
-
Nephropathy is one of the most important side effects of radiocontrast in patients with impaired renal function. Incidence is reported from 20% to 100% depending on underlying disease. For prevention of radiocontrast nephropathy a large number of substances were investigated in experimental and clinical studies. ⋯ In summary of these studies hydration is the most relevant and significant measure for prevention of radiocontrast nephropathy in patients at risk (i.e. serum creatinine > 1.5 mg/dl). 1 ml/kg body weight/h with 0.45% NaCl 12 h before and after administration of radiocontrast should be supplied. Hemodialysis is recommended if impaired renal function (serum creatinine > 3.5 mg/dl) is accompanied by additional risk factors, e.g. diabetes mellitus. The impact of dialysis therapy is not clarified by clinical studies.
-
Review Comparative Study
[Economic aspects of drug therapy exemplified by pravastatin. A socioeconomic analysis of cholesterol synthase enzyme inhibition in coronary heart disease patients].
Decision makers in the field of health services are increasingly forced to identify and realise the grounds for spendings and savings. Therefore, preventive measures of cardiovascular diseases are becoming more and more scrutinized. The present analysis is answering the question: Is secondary preventive lipid-lowering therapy with a cholesterol-synthesis-enzyme-(CSE-)inhibitor in patients with manifest coronary heart disease cost-effective in comparison to other already proven medical interventions? ⋯ The preventive use of pravastatin in patients with coronary heart disease can be estimated as cost-effective as compared with other medical interventions.
-
Despite ongoing intensive research using sophisticated new molecular tools and methods, the pathogenesis of autoimmune diseases such as rheumatoid arthritis (RA) is still not completely understood. ⋯ Insights in the pathogenesis of RA provide options to develop new therapeutic strategies aimed at the inhibition of pathogenetic relevant processes.