Pub Date : 2022-06-01DOI: 10.1024/0040-5930/a001357
M. Becker
Chronic Periaortitis Abstract. The term chronic periaortitis encompasses several fibroinflammatory diseases that manifest on or around the abdominal aorta which may be associated with aneurysm formation. Formerly distinct entities are grouped together, such as idiopathic retroperitoneal fibrosis (Ormond's disease), inflammatory aortic aneurysm, and perianeurysmal retroperitoneal fibrosis. They may also occur IgG4-related. The most common complications of these systemic inflammatory diseases are ureteric obstruction and secondary renal failure, but venous compression with congestion and thrombosis may also occur. This review focuses on the diagnosis and treatment of chronic periaortitis. The diagnosis is usually made by cross-sectional imaging, and various therapies, especially immunosuppressive agents, are used therapeutically, although good evidence is largely lacking. For bridging, a ureteric stent is often placed and in individual cases surgical therapy is also necessary. Due to the heterogeneity of the diseases and their rarity, there are hardly any standardized treatment procedures.
{"title":"[Chronic Periaortitis].","authors":"M. Becker","doi":"10.1024/0040-5930/a001357","DOIUrl":"https://doi.org/10.1024/0040-5930/a001357","url":null,"abstract":"Chronic Periaortitis Abstract. The term chronic periaortitis encompasses several fibroinflammatory diseases that manifest on or around the abdominal aorta which may be associated with aneurysm formation. Formerly distinct entities are grouped together, such as idiopathic retroperitoneal fibrosis (Ormond's disease), inflammatory aortic aneurysm, and perianeurysmal retroperitoneal fibrosis. They may also occur IgG4-related. The most common complications of these systemic inflammatory diseases are ureteric obstruction and secondary renal failure, but venous compression with congestion and thrombosis may also occur. This review focuses on the diagnosis and treatment of chronic periaortitis. The diagnosis is usually made by cross-sectional imaging, and various therapies, especially immunosuppressive agents, are used therapeutically, although good evidence is largely lacking. For bridging, a ureteric stent is often placed and in individual cases surgical therapy is also necessary. Due to the heterogeneity of the diseases and their rarity, there are hardly any standardized treatment procedures.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"35 1","pages":"254-259"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86773278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1024/0040-5930/a001355
M. Stegert, T. Neumann, T. Daikeler
ANCA-Associated Vasculitides Abstract. The according to their immunoserological markers (anti-neutrophil cytoplasmic antibodies - ANCA) named ANCA-associated vasculitides (AAV) are classified following the Chapel Hill nomenclature (2012). Microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis (EGPA) are categorized according to clinical, histological, and imaging findings. GPA and EGPA mainly differ from MPA in the presence of granulomatous inflammation within the airways. All three are rare autoimmune diseases and their prevalences show geographical differences. Despite their rarity, recognition of the typical symptoms is very important. A timely diagnosis is crucial, as without immunosuppressive treatment the prognosis with respect to preservation of organ function and survival is poor. New treatments with potentially fewer side effects have been introduced in recent years. Amongst those Rituximab plays an important role and has largely replaced cyclophosphamide. Now the aim of therapeutic approaches is to reduce patient exposure to steroids. Because the side effects of therapy and especially steroids are the main causes of AAV morbidity besides the disease itself.
{"title":"[ANCA-Associated Vasculitides].","authors":"M. Stegert, T. Neumann, T. Daikeler","doi":"10.1024/0040-5930/a001355","DOIUrl":"https://doi.org/10.1024/0040-5930/a001355","url":null,"abstract":"ANCA-Associated Vasculitides Abstract. The according to their immunoserological markers (anti-neutrophil cytoplasmic antibodies - ANCA) named ANCA-associated vasculitides (AAV) are classified following the Chapel Hill nomenclature (2012). Microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis (EGPA) are categorized according to clinical, histological, and imaging findings. GPA and EGPA mainly differ from MPA in the presence of granulomatous inflammation within the airways. All three are rare autoimmune diseases and their prevalences show geographical differences. Despite their rarity, recognition of the typical symptoms is very important. A timely diagnosis is crucial, as without immunosuppressive treatment the prognosis with respect to preservation of organ function and survival is poor. New treatments with potentially fewer side effects have been introduced in recent years. Amongst those Rituximab plays an important role and has largely replaced cyclophosphamide. Now the aim of therapeutic approaches is to reduce patient exposure to steroids. Because the side effects of therapy and especially steroids are the main causes of AAV morbidity besides the disease itself.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"1 1","pages":"229-237"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83839090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1024/0040-5930/a001346
F. Berlth, E. Hadzijusufovic, C. Mann, U. Fetzner, P. Grimminger
Minimally Invasive Esophagectomy for Esophageal Cancer Abstract. Oncological esophagectomy with gastric pull up and intrathoracic represents the standard surgical procedure in the curative treatment of malignant tumors of the esophagus and the esophagogastric junction. The procedure, as two or three body cavities are accessed, has a natural level of invasiveness, which suggests lowering the surgical trauma using minimally invasive surgery (MIS). Because of the complexity of the surgical procedure, minimally invasive esophagectomy is an operation with relevant surgical learning curve. As of now, two principally different minimally invasive techniques for esophageal resection are established in clinical routine in specialized centers, the conventional laparoscopy/thoracoscopy based method and the robotic approach. Benefits of minimally invasive esophagectomy are reduced pulmonary complications and reduced postoperative pain. The surgical radicality of both minimally invasive techniques is at least comparable to the open approach and combined MIS/open approach, long-term survival outcomes from randomized controlled trials are pending. The robotic surgical technology has evolved dramatically over the last decade and oncological esophagectomy offers meaningful opportunity for application. Due to further technological progress, robotic surgery is expected to play an even more important role in the future. Focusing on the direct comparison of conventional minimally invasive esophagectomy and robotic-assisted esophagectomy, the randomized ROBOT-2 trial will reveal important evidence.
{"title":"[Minimally Invasive Esophagectomy for Esophageal Cancer].","authors":"F. Berlth, E. Hadzijusufovic, C. Mann, U. Fetzner, P. Grimminger","doi":"10.1024/0040-5930/a001346","DOIUrl":"https://doi.org/10.1024/0040-5930/a001346","url":null,"abstract":"Minimally Invasive Esophagectomy for Esophageal Cancer Abstract. Oncological esophagectomy with gastric pull up and intrathoracic represents the standard surgical procedure in the curative treatment of malignant tumors of the esophagus and the esophagogastric junction. The procedure, as two or three body cavities are accessed, has a natural level of invasiveness, which suggests lowering the surgical trauma using minimally invasive surgery (MIS). Because of the complexity of the surgical procedure, minimally invasive esophagectomy is an operation with relevant surgical learning curve. As of now, two principally different minimally invasive techniques for esophageal resection are established in clinical routine in specialized centers, the conventional laparoscopy/thoracoscopy based method and the robotic approach. Benefits of minimally invasive esophagectomy are reduced pulmonary complications and reduced postoperative pain. The surgical radicality of both minimally invasive techniques is at least comparable to the open approach and combined MIS/open approach, long-term survival outcomes from randomized controlled trials are pending. The robotic surgical technology has evolved dramatically over the last decade and oncological esophagectomy offers meaningful opportunity for application. Due to further technological progress, robotic surgery is expected to play an even more important role in the future. Focusing on the direct comparison of conventional minimally invasive esophagectomy and robotic-assisted esophagectomy, the randomized ROBOT-2 trial will reveal important evidence.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"209 1","pages":"181-187"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85035131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1024/0040-5930/a001338
C. Gerdes, J. Reinecke, A. Neesse, J. Borggrefe, J. Kröger
State of the Art Diagnostics of the Esophagus Abstract. Modern diagnostics of the esophagus is highly technical. It mainly includes endoscopic, radiological, nuclear medicine, functional and electrochemical examinations. Diagnostic tools for esophageal disorders involve esophagogastroduodenoscopies with chromoendoscopy, manometric and pH-impedance catheters as well as radiological techniques, such as CT, MRI or PET-CTs. The patient's history including the main clinical symptoms such as heartburn or dysphagia, and the physical examination will determine the choice and order of subsequent examinations. The esophagogastroduodenoscopy is one of the most important diagnostic tools and has a very low complication rate. During esophagogastroduodenoscopy biopsies, chromoendoscopy or therapeutic interventions can be performed. Endosonography is essential for the staging of esophageal cancer and accuracy can be improved by endosonographically guided biopsies. A CT scan completes the tumor staging and is essential to search for metastases. For motility disorders high resolution manometry is the gold standard which can be supplemented with esophagus barium swallow exams. pH-impedance catheters can be used for diagnosis of reflux. MRI swallow exams are predominantly applied in clinical studies but may be more frequently used in the future.
{"title":"[State of the Art Diagnostics of the Esophagus].","authors":"C. Gerdes, J. Reinecke, A. Neesse, J. Borggrefe, J. Kröger","doi":"10.1024/0040-5930/a001338","DOIUrl":"https://doi.org/10.1024/0040-5930/a001338","url":null,"abstract":"State of the Art Diagnostics of the Esophagus Abstract. Modern diagnostics of the esophagus is highly technical. It mainly includes endoscopic, radiological, nuclear medicine, functional and electrochemical examinations. Diagnostic tools for esophageal disorders involve esophagogastroduodenoscopies with chromoendoscopy, manometric and pH-impedance catheters as well as radiological techniques, such as CT, MRI or PET-CTs. The patient's history including the main clinical symptoms such as heartburn or dysphagia, and the physical examination will determine the choice and order of subsequent examinations. The esophagogastroduodenoscopy is one of the most important diagnostic tools and has a very low complication rate. During esophagogastroduodenoscopy biopsies, chromoendoscopy or therapeutic interventions can be performed. Endosonography is essential for the staging of esophageal cancer and accuracy can be improved by endosonographically guided biopsies. A CT scan completes the tumor staging and is essential to search for metastases. For motility disorders high resolution manometry is the gold standard which can be supplemented with esophagus barium swallow exams. pH-impedance catheters can be used for diagnosis of reflux. MRI swallow exams are predominantly applied in clinical studies but may be more frequently used in the future.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"92 1","pages":"121-131"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79502110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1024/0040-5930/a001340
Christian Gutschow
Update Esophageal Diverticula Abstract. Esophageal diverticula are rare diseases typically associated pathophysiologically with esophageal dysmotility. The most common location (about 80%) is pharyngo-oesophageal. The therapy must be adapted to the location, the size, the symptoms and also the individual perioperative risk of the patient. In this context, following Herbella et al. [1] summarize that a) asymptomatic diverticula do not require therapy; b) small (< 1cm) diverticula do not usually need to be resected; c) medium-sized (1-3cm) and large (> 4cm) diverticula should be treated either by resection, pex, invagination or (for Zenker's diverticulum) by transoral diverticulo-esophagostomy, and d) a simultaneous myotomy should always be performed. Due to the rarity of esophageal diverticula and due to the wide range of therapeutic options, the expertise required for an individual therapy concept is often not available even in larger clinics, which is why we recommend treatment in a reference center. In our opinion, the counseling and treatment of patients with esophageal diverticula by an experienced interdisciplinary team using all the options of today's established endoscopic and surgical procedures is the prerequisite for a low-complication management of this unusual clinical picture.
{"title":"[Update Esophageal Diverticula].","authors":"Christian Gutschow","doi":"10.1024/0040-5930/a001340","DOIUrl":"https://doi.org/10.1024/0040-5930/a001340","url":null,"abstract":"Update Esophageal Diverticula Abstract. Esophageal diverticula are rare diseases typically associated pathophysiologically with esophageal dysmotility. The most common location (about 80%) is pharyngo-oesophageal. The therapy must be adapted to the location, the size, the symptoms and also the individual perioperative risk of the patient. In this context, following Herbella et al. [1] summarize that a) asymptomatic diverticula do not require therapy; b) small (< 1cm) diverticula do not usually need to be resected; c) medium-sized (1-3cm) and large (> 4cm) diverticula should be treated either by resection, pex, invagination or (for Zenker's diverticulum) by transoral diverticulo-esophagostomy, and d) a simultaneous myotomy should always be performed. Due to the rarity of esophageal diverticula and due to the wide range of therapeutic options, the expertise required for an individual therapy concept is often not available even in larger clinics, which is why we recommend treatment in a reference center. In our opinion, the counseling and treatment of patients with esophageal diverticula by an experienced interdisciplinary team using all the options of today's established endoscopic and surgical procedures is the prerequisite for a low-complication management of this unusual clinical picture.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"63 1","pages":"141-144"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72840030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.1017/CBO9780511722240.120
H. Dupont, R. Steffen
This chapter provides details on diarrhea as the most frequent health problem encountered by persons going from industrialized to developing countries. It discusses travelers' diarrhea (TD), which is defined as the passage of three or more unformed stools within 24 hours that is associated with nausea, vomiting, abdominal pain or cramps, fever, fecal urgency, tenesmus, or the passage of bloody or mucoid stools. It also looks at cases of TD that can be categorized by severity as being mild or severe. The chapter explains the possible etiologies of persistent diarrhea that include intestinal infection by protozoal parasites, such as giardiasis or cryptosporidiosis. It analyzes postinfectious irritable bowel syndrome, which is recognized as a complication of bacterial enteric infection that has been shown to occur in as many as 10 percent of people after an episode of TD.
{"title":"Travelers' diarrhea.","authors":"H. Dupont, R. Steffen","doi":"10.1017/CBO9780511722240.120","DOIUrl":"https://doi.org/10.1017/CBO9780511722240.120","url":null,"abstract":"This chapter provides details on diarrhea as the most frequent health problem encountered by persons going from industrialized to developing countries. It discusses travelers' diarrhea (TD), which is defined as the passage of three or more unformed stools within 24 hours that is associated with nausea, vomiting, abdominal pain or cramps, fever, fecal urgency, tenesmus, or the passage of bloody or mucoid stools. It also looks at cases of TD that can be categorized by severity as being mild or severe. The chapter explains the possible etiologies of persistent diarrhea that include intestinal infection by protozoal parasites, such as giardiasis or cryptosporidiosis. It analyzes postinfectious irritable bowel syndrome, which is recognized as a complication of bacterial enteric infection that has been shown to occur in as many as 10 percent of people after an episode of TD.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"14 1","pages":"65-8"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82522331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-01DOI: 10.1016/b978-3-437-24260-1.x5001-5
Walter P. Weber
{"title":"Brustkrebs","authors":"Walter P. Weber","doi":"10.1016/b978-3-437-24260-1.x5001-5","DOIUrl":"https://doi.org/10.1016/b978-3-437-24260-1.x5001-5","url":null,"abstract":"","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"21 1","pages":"119"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82977969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The diversity of qualities demanded from a shampoo by today's consumer go beyond the sole function of cleansing the hair and scalp. A cosmetic benefit is expected, and the shampoo formulation has to be tailored to all the possible variations associated with hair quality (dry, greasy, permed, bleached, dyed), age (baby shampoo), care habit (frequency of shampooing) and specific problems relating to the superficial condition of the scalp (dandruff, seborrhea). The standard graduate medical training programs devote limited attention to the subject of shampoos, and much of the readily available information concerning shampoos is supplied by the industry. We should be increasingly aware that our patients look to us to supply information on what can be expected from a shampoo to enable them to make more informed choices at the consumer level. Moreover, selected ingredients of shampoos that have been popular with the consumer are currently under attack because of potential risks associated with their use, e.g. halogenated organic compounds, formaldehyde, nitromusc, and crude coal tar. Their critical appraisal also has to follow strict scientific criteria.
{"title":"[Shampoo].","authors":"R. M. Trüeb","doi":"10.32388/r8q0eh","DOIUrl":"https://doi.org/10.32388/r8q0eh","url":null,"abstract":"The diversity of qualities demanded from a shampoo by today's consumer go beyond the sole function of cleansing the hair and scalp. A cosmetic benefit is expected, and the shampoo formulation has to be tailored to all the possible variations associated with hair quality (dry, greasy, permed, bleached, dyed), age (baby shampoo), care habit (frequency of shampooing) and specific problems relating to the superficial condition of the scalp (dandruff, seborrhea). The standard graduate medical training programs devote limited attention to the subject of shampoos, and much of the readily available information concerning shampoos is supplied by the industry. We should be increasingly aware that our patients look to us to supply information on what can be expected from a shampoo to enable them to make more informed choices at the consumer level. Moreover, selected ingredients of shampoos that have been popular with the consumer are currently under attack because of potential risks associated with their use, e.g. halogenated organic compounds, formaldehyde, nitromusc, and crude coal tar. Their critical appraisal also has to follow strict scientific criteria.","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"36 1","pages":"256-61"},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89604398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Dysuria].","authors":"C. Rabillard, W. Weidner","doi":"10.32388/hwgwik","DOIUrl":"https://doi.org/10.32388/hwgwik","url":null,"abstract":"","PeriodicalId":87030,"journal":{"name":"Therapeutische Umschau und medizinische Bibliographie. Revue therapeutique et bibliographie medicale","volume":"26 1","pages":"857-64"},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82259951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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