Deutsche medizinische Wochenschrift
-
Myocarditis is a heterogenous disease regarding aetiology, clinical presentation and course. A defined diagnostic procedure is needed to reliably detect myocarditis. While findings from medical laboratory parameters, electrocardiography and echocardiography are rather unspecific, endomyocardial biopsies supply dependable data regarding inflammatory and viral status. ⋯ Currently, treatment of myocarditis symptoms and heart failure is in the focus of clinical care. In addition, cardiac involvement in systemic inflammatory diseases should be stringently treated via immunosuppression. Avoidance of physical exercise has to be observed in order to reduce cardiac strain and consequently the number of adverse events.
-
Dtsch. Med. Wochenschr. · Feb 2020
[New aspects on autoantibodies for classification, diagnosis and therapy within rheumatology].
Recent advances in rheumatology indicate increased relevance of autoantibodies. In this regard, positive ANA are now required as entrance criterium for the first EULAR/ACR classification criteria of SLE. Importantly, ANA diagnostic with detection of isolated anti-dense fine speckled antibodies (DSF-70) need consideration since their unique detection has been identified to exclude largely an autoimmune disease. ⋯ Treatment of obstetric APS is mainly based on low dose aspirin and low molecular heparin. Notably, this treatment should be maintained for 6 weeks after delivery. Thus, serologic findings provide the basis for certain key clinical decisions and require their reliable detection.
-
Thyroid disorders are among the most common endocrine alterations. Ultrasound examination of the thyroid gland is a rapid and radiation-free method, adding important information to a patient's medical history, physical examination, and laboratory results. This article describes a practical approach to an ultrasound examination in a step by step manner. The most important findings and most common causes of thyroid disorders are discussed on the basis of typical images.
-
While effects of vitamin D on bone metabolism are widely acknowledged, many questions regarding extraskeletal actions of vitamin D have emerged. In-vitro data show the expression of the nuclear vitamin D receptor in a variety of different extraskeletal tissues. ⋯ Very recently, several randomized controlled trials assessing the effect of vitamin D supplementation on prevention of different diseases have been published with disappointing results. In this review we focus on assessment of vitamin D status, as well as results of currently published randomized controlled trials on vitamin D and disease prevention.