Deutsche medizinische Wochenschrift
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Cardiac biomarkers are an integral, guideline-recommended part of the diagnosis and follow-up of heart diseases. High sensitivity tests for troponin I or T allow for the early diagnosis of myocardial infarction. Rule-in and rule-out algorithms based on the dynamic of plasma concentrations in the first hour after admission improve safe, evidence-based decision making for patients with acute chest pain. ⋯ Whether and how this risk can be reduced requires further evaluation. Several novel biomarkers were recently discovered and characterised. Their place in cardiovascular medicine has yet to be defined.
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A biomarker in infectiology should ideally be able to identify infectious agents, monitor clinical response and determine the duration of treatment. This article answers the question to what extent C-reactive protein and procalcitonin meet these requirements and reports on the search for further biomarkers - e.g. with the help of "omics"-based technologies and the integration of artificial intelligence.
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Many epidemiological studies found low plasma levels of high-density lipoprotein (HDL) cholesterol (HDL-C) associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). In cell culture and animal models, HDL particles show many anti-atherogenic actions. However, until now, clinical trials did not find any prevention of ASCVD events by drugs elevating HDL-C levels, at least not beyond statins. ⋯ Third, the vascular functions of HDL are not exerted by its cholesterol content (i.e. HDL-C), but by a variety of other molecules. Comprehensive knowledge of the structure-function-disease relationships of HDL particles and their molecules is a prerequisite for testing their physiological and pathogenic relevance and possibly for optimizing the diagnosis and treatment of persons with HDL-associated risk of ASCVD, but also for other diseases, such as diabetes, chronic kidney disease, infections, autoimmune and neurodegenerative diseases.
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In the palliative phase of disease, patients often suffer from a variety of distressing symptoms. Often, treatment is difficult because several problems exist at the same time and the necessary medications can cause side effects that require treatment. This article addresses important symptoms - other than pain - and provides treatment recommendations based on current literature.
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The analysis of tumor cells circulating in the blood or of products of tumor cells circulating in other body fluids has gained increasing attention in recent years and is summarized under the term liquid biopsy (LB). LB includes the analysis of circulating tumor cells, cell-free circulating tumor-associated nucleic acids, extracellular vesicles, proteins, or other products that are released into the peripheral bloodstream by the primary or metastatic tumor. ⋯ In this article, the most important LB analytes and the current state of research are presented. In addition, the remaining obstacles and the diverse efforts to implement LB in clinical routine are critically discussed.