Med Klin
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The present analysis deals with 2 main problems among therapy-associated late toxicities in patients after curative treatment for malignant tumors, such as Hodgkin's disease and testicular cancer: gonadal late toxicities in young patients after treatment for lymphomas and the risk of secondary neoplasia after curative treatment for malignant male germ cell tumors. ⋯ The investigation of therapy-associated late toxicities will remain an important issue even with the use of new treatment approaches such as high-dose therapy. Prospective evaluation of late toxicities needs to be incorporated into new studies for the curative treatment of malignant tumors.
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Comment Randomized Controlled Trial Clinical Trial
[Cost effectiveness of captopril after myocardial infarct; comment].
In Germany approximately 88,000 people died as a result of acute myocardial infarction and approximately 300,000 people suffered from acute myocardial infarction in 1992. These data demonstrate the socioeconomic impact of coronary disease. In the SAVE-(Survival-and-Ventricular-Enlargement) study, Pfeffer et al. demonstrated a reduction of morbidity and mortality due to therapy with captopril in patients after myocardial infarction. In a retrospective, incremental cost-effectiveness-analysis, from the perspective of German statutory insurance fund, the economic impact of captopril after myocardial infarction has been analysed. ⋯ The treatment with captopril after acute myocardial infarction is not only a clinically efficacious treatment, but also cost-effective in patients after acute myocardial infarction.
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Pharmacological and direct-current cardioversion of atrial fibrillation are often performed interventions. Little is known about results and complications of cardioversion in daily practise. ⋯ The main risks of cardioversion are fatal proarrhythmic events in pharmacological attempts to restore sinus rhythm. The risk of embolism is despite low rates of effective anticoagulation low.