Deutsche medizinische Wochenschrift
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Suicidality is a complex phenomenon. Helping professions are likely to be confronted with this issue. The article aims to provide information about suicidality in the context of mental illnesses and prevention, but above all to provide recommendations.
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Dtsch. Med. Wochenschr. · Nov 2022
Review[Rivaroxaban in patients with cancer-associated thromboembolism].
This review article describes insights into the prevention and treatment of cancer-associated venous thromboembolism (VTE) with direct factor Xa inhibitors (FXaI) and refers in particular to the CALLISTO study program with rivaroxaban. CALLISTO includes randomized clinical trials on different topics as well as real-world evidence. Prevention and treatment of cancer-associated VTE have so far relied on low molecular weight heparins (LMWH). ⋯ A possibly increased risk of bleeding, especially in patients with unresected gastrointestinal or urogenital tumors, should be considered. This was first observed during therapy with FXaI but can also affect LMWH. The selection of suitable patients and the optimization of treatment pathways are therefore of great importance.
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Endocrine disrupting chemicals (EDCs) are universally occurring substances with the potential to interrupt the hormonal system, although the definition of EDCs is not yet standardized. Similar to hormones, EDCs are potentially able to act at very low concentrations, which might be considered save from a toxicological viewpoint. Research over the past years showed that EDCs, even in low doses, might have a relevant impact on human health and the environment as well. ⋯ Thus, besides the implications on personal and global health, EDCs affect the economy as well and pose a universal threat to society and environment. Many of the potentially hazardous substances are still inadequately examined and regulated. In this review, we give a brief summary on the previous efforts to classify EDCs and provide a short summary of the current knowledge.
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Dtsch. Med. Wochenschr. · Nov 2022
[Multimorbidity in patient's care - definitions, strategies and limitations].
The challenge of multimorbidity, the occurrence of multiple medical conditions, lies in its complexity, considering their type and severity, their interactions, and the patient's social status and characteristics. Although the number of combinations appears unlimited, there emerge so-called multimorbidity patterns, that group diseases, that often coincide. The prevalence of multimorbidity will increase dramatically because of the demographic change and the medical progress, leading to exploding costs in healthcare. ⋯ Action strategies and the integration of guidelines are needed and will support the clinician during the decision-making processes. Furthermore, clinical studies should include older adults with multimorbidity and should particularly consider their relevant outcomes. Geroscience is a new research area that addresses the hallmarks of aging with therapeutic approaches to delay or even avoid the onset of multimorbidity.