Levosimendan Efficacy and Safety : 20 Years of SIMDAX in Clinical Use

Levosimendan was first approved for clinical use in 2000, when authorization was granted by Swedish regulatory authorities for the hemodynamic stabilization of patients with acutely decompensated chronic heart failure (HF). In the ensuing 20 years, this distinctive inodilator, which enhances cardiac contractility through calcium sensitization and promotes vasodilatation through the opening of adenosine triphosphate-dependent potassium channels on vascular smooth muscle cells, has been approved in more than 60 jurisdictions, including most of the countries of the European Union and Latin America. Areas of clinical application have expanded considerably and now include cardiogenic shock, takotsubo cardiomyopathy, advanced HF, right ventricular failure, pulmonary hypertension, cardiac surgery, critical care, and emergency medicine. Levosimendan is currently in active clinical evaluation in the United States. Levosimendan in IV formulation is being used as a research tool in the exploration of a wide range of cardiac and noncardiac disease states. A levosimendan oral form is at present under evaluation in the management of amyotrophic lateral sclerosis. To mark the 20 years since the advent of levosimendan in clinical use, 51 experts from 23 European countries (Austria, Belgium, Croatia, Cyprus, Czech Republic, Estonia, Finland, France, Germany, Greece, Hungary, Italy, the Netherlands, Norway, Poland, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, the United Kingdom, and Ukraine) contributed to this essay, which evaluates one of the relatively few drugs to have been successfully introduced into the acute HF arena in recent times and charts a possible development trajectory for the next 20 years.Peer reviewe

Paradigmenwechsel im Fabrikplanungsdatenmanagement*/Object attribution for factory information models

Die Planungsmethode des Building Information Modeling (BIM) findet vermehrt in Bauprojekten Anwendung. Bei der Fabrikplanung wird die Produktionsplanung jedoch oftmals nicht integriert mit der Gebäudeplanung geplant. Dies führt häufig zu Kostensteigerungen und Zeitverzögerungen aufgrund intransparenter Informationen und Abstimmungsschwierigkeiten im Planungsprozess. Dieser Beitrag zeigt Anforderungen an eine integrierte Produktions- und Gebäudeplanung im Sinne eines Fabrikinformationsmodells und leitet entsprechende Handlungsempfehlungen ab. &amp;nbsp; The planning method of Building Information Modeling (BIM) is being increasingly used in construction projects. In factory planning, however, production system and buildings are often not planned in an integrated way. This often leads to cost increases and time delays due to information and coordination problems in the planning process. This article shows what integrated production and building planning requires in terms of a factory information model, deriving appropriate recommendations for action.</p