Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Dec 2019
[Current Standard of Care in Squamous Cell Carcinoma of the Head and Neck (SCCHN) - Prevention, diagnostics, prognostication and therapy].
The standard of care in squamous cell carcinoma of the head and neck (SCCHN) has recently undergone some major shifts in prevention, diagnostics, staging, prognostication and therapy. Prevention: Subtypes of the human papilloma virus (HPV) have been identified as causative agent for HPV-driven oropharyngeal carcinomas nearly two decades ago. Vaccination against HPV is now recommended for all girls and boys at the age of 9 to 14 years by the Standing Committee on Vaccination at the Robert Koch Institute (STIKO). ⋯ Therefore, de-intensification should not be practiced in current standard of care. Palliative systemic therapy: Checkpoint inhibitors nivolumab and pembrolizumab are the new standard of care after progression on platinum based therapies. In the Keynote-048 trial, treatment with either pembrolizumab alone (CPS > 1) or its combination with platin+ 5-flourouracil was superior to the current first line standard PFC.
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Dtsch. Med. Wochenschr. · Dec 2019
Historical Article[Politicians' Personal Physicians: careers and complications from King David until today].
Court physicians need to deal with a clientele posing particular personality problems (e. g. rex inutilis) in a difficult environment characterized by specific health issues (morbi aulici) and they may have to avoid serious risks or want to seek great opportunities (medicus politicus). Very few have been successful as King David, a former music therapist without a medical degree, or the dentist and president Gurbanguly Berdimuhamedow. ⋯ Not all could resist temptation of questionable literary fame at the expense of confidentiality. All told, a career close to high profile leaders needs to be considered carefully as risks may outweigh benefits.
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Dementia as a multi-facetted ailment demands multimodal approaches. Music Therapy has gained sufficient evidence as therapeutic concept in many areas of traditional medicine. ⋯ For people suffering from dementia music offers a variety of beneficial effects, especially enhancing communication and quality of life. Care givers appreciate relief in emotionally aversive situations as well.