Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jul 2022
Review[Catheter ablation for atrial fibrillation - standard of care and future perspectives].
Atrial fibrillation is the most frequent cardiac arrhythmia in adults. For symptomatic atrial fibrillation, catheter ablation has proven to be an effective and safe treatment that is superior to antiarrhythmic drug treatment regarding quality of life and maintenance of normal sinus rhythm. ⋯ Furthermore, technological innovations such as novel single-shot devices, contact force mapping, the concept of high-power-short-duration (HPSD) ablation and implementation of electroporation (pulsed field ablation) offer the prospect of further improving ablation efficiency and safety. This review provides an overview of current standards of care as well as future trends in atrial fibrillation catheter ablation techniques.
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The medical use of Cannabis has gained popularity in Europe and Northern America in recent years. Cannabinoids are available as finished pharmaceuticals, flowers and extracts. This article focuses on supportive medicine for oncological patients. ⋯ The key parameter for choosing a cannabis medicinal product is the THC/CBD ratio. Oral forms of administration are particularly suitable for cannabis-naive and older patients. Mental and cardiovascular side effects should not be underestimated.
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Dtsch. Med. Wochenschr. · Jul 2022
[Physical activity in cancer - effectiveness of exercise therapy approaches].
The positive effects of oncological exercise therapy are sufficiently proven according to scientific studies. International evidence-based guidelines confirm this importance and recommend physical exercise as part of the standard therapy for cancer. The effects of physical activity on cancer-specific deficits are versatile ranging from positive impact on fatigue syndrome, mortality, incontinence, lymphoedema, CIPN, anxiety, depression to reduction of pain. ⋯ In addition to the movement-therapeutic approach, a coordinated diet is necessary to avoid nutrition shortages. The evidence on physical activity in oncology must be considered not only in theory, but also in practice and be accepted as a general recommendation for oncology patients. The personalized OTT treatment concept represents a practical implementation and offers a targeted treatment option with low side effects.
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The number of immunosuppressed patients continues to increase worldwide. The main reasons are the demographic development and improved long-term survival, also for patients under immunosuppression. A major cause of hospitalization and mortality among these patients are infections. ⋯ There are many recommendations and guidelines for clinicians regarding the management of infections in immunocompromised patients. Overlaps of infectiology, hygiene as well as hematology and oncology sometimes lead to different recommendations. This article provides an overview of the currently existing evidence and guidelines for infection management in immunosuppressed patients.