Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Sep 2023
[Antagonizing anticoagulants in intracranial hemorrhage - step by step].
Intravenous thrombolysis for acute ischemic stroke is an indispensable tool and current standard of care in neurology. However, until recently direct therapeutic options for intracranial hemorrhage under existing anticoagulation were not available. With the introduction of two new medications - Idarucizumab and Andexanet alfa - neurologists take a more targeted approach in treating these patients.
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Asthma is a heterogeneous inflammatory airway disease that causes relevant morbidity across individuals of all age cohorts. In recent years, advances in the understanding of asthma pathophysiology have led to the development of treatments tailored to specific pheno- and endotypes of the disease. ⋯ These new treatment options offer individuals with asthma access to personalized and disease-modifying therapies. The present paper is a comprehensive overview of recent clinical studies and of German and international guideline updates on asthma management.
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Dtsch. Med. Wochenschr. · Sep 2023
[Advanced non-small cell lung cancer - pioneer in personalized oncology].
In no other cancer is clinical practice as close to the ideals of personalized oncology as in the treatment of non-small cell lung cancer (NSCLC). Here, we briefly outline the basic principles of molecular analysis. The focus of the article is on the clinical utility of targeted therapy. Finally, we highlight the challenges for medical staff and structural solutions reflecting the situation in Germany.
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In recent years, clinical scientific data on LDL cholesterol and atherosclerosis has led to lowering of LDL-C targets and the expansion of the indication for lipid drug therapy to larger populations or patients. The calculators SCORE2 and SCORE-OP were newly developed to calculate the cardiovascular risk in primary prevention. ⋯ Alternative medication are ACL inhibitors e.g., Bempedoic acid and Inclisiran which represent new drug therapy options for statin intolerance. Nevertheless, a dietary intervention belongs at the beginning of every lipid-lowering therapy.
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Acute severe alcoholic hepatitis is a serious disease with poor prognosis. As a result of an improved understanding of the underlying pathomechanisms, a variety of new, innovative therapeutic modalities are currently being investigated that may help to improve prognosis. New approaches include the application of anti-inflammatory agents (e.g., interleukin-1 inhibitors), modifications of the gut-liver axis via fecal microbiome transfer or the administration of non-absorbable antibiotics (e.g., rifaximin), and drugs to enhance hepatocellular regeneration (e.g., interleukin-22 agonists). This article describes current management concepts of alcoholic hepatitis and provides an overview of new potential treatment approaches.