Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Nov 2008
Case Reports[Massive pleural effusion complicating chronic pancreatitis. Treatment by endoscopic closure of a pancreatic-mediastinal fistula].
A 53-year-old man was admitted because of anuria, dyspnea and a septic temperature. The patients' history included chronic alcoholism, chronic pancreatitis, COPD and a right nephrectomy because of nephrolithiasis. Urosepsis was initially suspected. ⋯ Pancreatic-pleural or pancreatic-mediastinal fistula is a rare complication of pancreatitis associated with unilateral pleural effusion. Combined internal endoscopic drainage and external chest drainage is the treatment of choice. After failure of routine endoscopic therapy, endoscopic closure of fistulas using fibrin glue might offer an alternative treatment strategy.
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Dtsch. Med. Wochenschr. · Nov 2008
Case Reports[Unilateral pulmonary edema in two patients with mitral regurgitation].
Two patients were admitted with dyspnoea, the first after an infection, the second in association with an ischemic cardiomyopathy. ⋯ Unilateral pulmonary edema associated with mitral regurgitation is a distinct but unusual clinical entity, often misdiagnosed initially as being caused by one of the more common focal lung diseases. The TEE indicated the cause and provided the reason for the mechanism of the edema formation.
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Dtsch. Med. Wochenschr. · Oct 2008
Review[Update in basic research in the therapy of pulmonary arterial hypertension].
Pulmonary hypertension is a vasculoproliferative disorder which is characterized by vasoconstriction and proliferation of vascular cells within the vessel wall. Mostly addressing the increased vascular tone, prostacyclin and its analogues, endothelin-receptor antagonists and phosphodiesterase type 5 inhibitors have been approved for treatment of PAH and represent the current therapeutic options. Currently, research focuses on the development of causal treatment regimens aiming a normalization of the vessel structure. ⋯ For some of these agents clinical trials are already initiated which will address safety and efficacy. In addition, there is further development of new vasodilators addressing well known and new signaling pathways. Taken together, there is advanced research in the field of pulmonary vascular diseases and the efficacy of several new drugs is currently addressed in clinical trials.