Deutsche medizinische Wochenschrift
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New data for the diagnosis of axial spondyloarthritis on the specificity of active inflammatory changes in sacroiliac joints were generated recently and are reviewed here. A new magnetic resonance imaging sequence to improve the detection of erosions is discussed. ⋯ Janus kinase inhibitors delivered promising results in Phase II/III studies. For the inhibition of structural progression new data are discussed on slowing structural progression in the spine under TNF and IL-17 inhibitors.
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Over the past decades, non-alcoholic fatty liver disease (NAFLD) has emerged as the leading cause of chronic liver diseases in western societies. While the complications of NAFLD progression and particularly non-alcoholic steatohepatitis (NASH) have been widely recognized and statistically proven by emerging numbers of NASH related cirrhosis, transplantations and liver cancer, simple steatosis was widely recognized as a rather benign manifestation of NAFLD. ⋯ Based on these findings, we recommend a thorough interdisciplinary approach to patients with simple steatosis by dedicated specialized centers. The rising prevalence demands the implementation and evaluation of non-invasive screening methods and multidisciplinary preventive approaches, as according to current data, we face an epidemic of hepatic steatosis in over 25 % of the population.
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Dtsch. Med. Wochenschr. · Feb 2021
Case Reports[A case of idiopathic postinfantile giant cell hepatitis treated with a calcineurin inhibitor].
Postinfantile giant cell hepatitis is a rare entity in adult hepatopathy caused by various etiologies that can be summarized by their characteristic giant cells in histopathologic examination. Frequently, association with autoimmune, infectious and hepatotoxic events is described. Therefore, therapy consists in treatment of underlying diseases and immunosuppression. ⋯ The good effectiveness of tacrolimus in our patient underlines the important role of calcineurin inhibitors in treating Postinfantile giant cell hepatitis, although rarely reported to date.
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Over the past years, a growing demand for testosterone replacement therapy in aging men has been noted in the US as well as in Europe. The current evidence for detrimental consequences of low testosterone in old men is largely based on retrospective studies. On the other hand, prospective placebo-controlled randomized trials investigating clinically relevant endpoints are limited. ⋯ Whether testosterone supplementation in ageing men confers an altered risk for cardiovascular disease and/or prostate cancer remains unclear. Ongoing clinical trials (e. g. TRAVERSE trial, NCT03 518 034) will help to resolve these questions.
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As the pandemic continues, there is increasing hope vaccinations are becoming available. As a solution for a nationwide immunization against the virus, a compulsory vaccination is repeatedly discussed. However, some opponents of vaccination are threatened by the idea of a possible mandatory vaccination. ⋯ This article discusses the current legal situation in Germany. The introduction of a potential compulsory vaccination against the SARS-CoV-2 virus represents an encroachment on the fundamental right of physical integrity. According to § 20 (6) IfSG, a protective vaccination for threatened parts of the population is permissible by statutory order, if a transmissible disease with clinically severe courses occurs and its epidemic spread can be expected.