Dtsch Arztebl Int
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The causes of leukemia are largely unclear. The question whether leukemia rates are increased near nuclear power plants is controversial. The German Childhood Cancer Registry has published an epidemiological case-control study on childhood cancer and nuclear power plants. ⋯ Based on the available information about radiation emissions from German nuclear power plants, a direct relation to radiation seems implausible. Many factors may conceivably cause leukemia, possibly operating in combination, and these factors may be present to a greater extent in the vicinity of German nuclear power plants.
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The term cancer of unknown primary site (CUP) syndrome is used to describe malignancies in which a complete diagnostic work-up detects metastases in the absence of an identifiable primary tumor. ⋯ Only rigorous further development of diagnostic tools and treatment protocols will enable an improvement of the poor prognosis of patients with CUP syndrome. Specific molecular treatment strategies have shown promising results.
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10% to 20% of the population sees itself as suffering from food allergy, yet genuine, immune-mediated food allergy is suspected by patients and their physicians far more often than it is actually shown to be present. The unfounded suspicion of an IgE-mediated food allergy can substantially impair a patient's quality of life through needless dietary restriction and the accompanying anxiety. On the other hand, an IgE-mediated food allergy that has gone undiagnosed or that has not been taken seriously can manifest suddenly with anaphylaxis, which may be life-threatening. The present study, carried out on a large cohort of patients, underscores the importance of differentiating IgE-mediated food allergy from other, nonallergic types of food reaction. ⋯ Only a comprehensive allergological evaluation performed by an experienced allergologist in accordance with current guidelines can protect patients from the negative consequences of excessive concern about a nonexistent food allergy (e.g., needless dietary restriction) or, on the other hand, the negative consequences of inadequate attention to a genuine food allergy (anaphylaxis). A proper evaluation consists of detailed allergologic history-taking, skin tests, and challenge tests when indicated.