Deutsche medizinische Wochenschrift
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Dementia as a multi-facetted ailment demands multimodal approaches. Music Therapy has gained sufficient evidence as therapeutic concept in many areas of traditional medicine. ⋯ For people suffering from dementia music offers a variety of beneficial effects, especially enhancing communication and quality of life. Care givers appreciate relief in emotionally aversive situations as well.
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Dtsch. Med. Wochenschr. · Dec 2019
[Pharmacologic treatment of heart failure with reduced ejection fraction in chronic kidney disease].
Medical management of patients with co-existing Heart Failure with reduced Ejection Fraction (HFrEF) and chronic kidney disease (CKD) poses a significant challenge to treating physicians. On the one hand, the traditional therapeutic strategies such as betablockers, angiotensin converting enzyme inhibiotors, angiotensin receptor blockers and mineralocorticoid receptor antagonists have been evaluated in clinical trials that broadly excluded patients with significant CKD. On the other hand, inhibition of the renin angiotensin aldosterone system can lead to worsening of renal function and hyperkalemia potentially causing harm. ⋯ New therapeutic strategies are under current investigation. Sodium glucose transporter 2 inhibitors show promising results in HFrEF and in CKD trials. In addition, Sacubitril/Valsartan significantly reduced events in HFrEF and might reduce renal events in HFpEF.
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Dtsch. Med. Wochenschr. · Dec 2019
[Lung Cancer screening? Who should get it and how it should be done].
In large clinical studies, lung cancer screening has been demonstrated to be effective in reducing lung cancer mortality in defined high risk populations using low-dose CT techniques. However, in different studies, results and definitions of persons of high risk have varied which needs to be taken into account when screening programmes should be implemented in clinical routine. In order those programmes to be as effective as possible, the careful definition of a risk population is crucial as much as the careful use of radiant exposure. Ideally, the number of false positive findings should be as low as possible with the best reduction in lung cancer mortality and limited financial burden.