[Financial Influence on Medical Decisions in Germany - A Review of the Reasons and State of Research on Economization in Inpatient Care].

Increased economization in the German health care system may have an impact on medical decisions. A selective literature search presents an overview of the current evidence on the influence of financial incentives on inpatient healthcare in Germany. Due to the current economic pressure, physicians increasingly feel subjected to financial constraints concerning indication and treatment decisions.

The atypic antipsychotic clozapine inhibits multiple cardiac ion channels.

Clozapine is an atypical neuroleptic used to manage treatment-resistant schizophrenia which is known to inhibit cardiac hERG/K11.1 potassium channels, a pharmacological property associated with increased risk of potentially fatal Torsades de Pointes (TdP) and sudden cardiac death (SCD). Yet, the long-standing clinical practice of clozapine does not show a consistent association with increased incidence of TdP, although SCD is considerably higher among schizophrenic patients than in the general population.

The grapefruit polyphenol naringenin inhibits multiple cardiac ion channels.

Drinking fresh grapefruit juice is associated with a significant prolongation of the QT segment on the electrocardiogram (ECG) in healthy volunteers. Among the prominent polyphenols contained in citrus fruits and primarily in grapefruit, the flavonoid naringenin is known to be a blocker of the human ether-a-go-go related gene (hERG) potassium channel. Here we hypothesized that naringenin could interfere with other major ion channels shaping the cardiac ventricular action potential (AP).

Kinematic analysis of activities of daily living performance in frail elderly.

Background: Frailty is accompanied by limitations of activities of daily living (ADL) and frequently associated with reduced quality of life, institutionalization, and higher health care costs. Despite the importance of ADL performance for the consequence of frailty, movement analyses based on kinematic markers during the performance of complex upper extremity-based manual ADL tasks in frail elderly is still pending. The main objective of this study was to evaluate if ADL task performance of two different tasks in frail elderlies can be assessed by an activity measurement based on an acceleration sensor integrated into a smartwatch, and further to what degree kinematic parameters would be task independent.

In vitro ion channel profile and ex vivo cardiac electrophysiology properties of the R(-) and S(+) enantiomers of hydroxychloroquine.

Hydroxychloroquine (HCQ) is a derivative of the antimalaria drug chloroquine primarily prescribed for autoimmune diseases. Recent attempts to repurpose HCQ in the treatment of corona virus disease 2019 has raised concerns because of its propensity to prolong the QT-segment on the electrocardiogram, an effect associated with increased pro-arrhythmic risk. Since chirality can affect drug pharmacological properties, we have evaluated the functional effects of the R(-) and S(+) enantiomers of HCQ on six ion channels contributing to the cardiac action potential and on electrophysiological parameters of isolated Purkinje fibers.