Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jun 2020
[Onconephrology - Interdisciplinary Cooperation of Nephrologists and Oncologists in the Treatment of Multiple Myeloma].
Plasma cell diseases, in particular multiple myeloma, represent an interdisciplinary challenge for oncologists and nephrologists. Patients often present initially with kidney problems to a nephrologist, requiring timely diagnosis and referral to an oncologist for treatment. ⋯ In any case, renal insufficiency can affect the therapeutic options. This article provides a short overview about common nephrological factors and complications which impact on the manifestation and course of treatment in patients with plasma cell diseases.
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Dtsch. Med. Wochenschr. · Jun 2020
[Current Recommendations for the First-Line Therapy of Symptomatic Multiple Myeloma].
Due to the introduction of novel therapeutic agents, the prognosis of Multiple Myeloma has greatly improved over the last decades. The current standard for fit patients is a bortezomib-based induction therapy, followed by high-dose chemotherapy and autologous stem cell transplantation and lenalidomide-based maintenance therapy. For older, non-transplant-eligible patients, daratumumab in combination with bortezomib or lenalidomide offers a well-tolerated, effective treatment option. Despite large improvements, there is still no cure for most myeloma patients, the aim of therapy is therefore to reach a deep remission to prevent lasting damage followed by a continuous maintenance therapy to uphold the remission and prolong overall survival.
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- Case numbers in China are clearly declining, case numbers in many European regions are no longer increasing exponentially.- Data on mortality from SARS-CoV-2 infection are contradictory; mortality is certainly lower than for SARS and MERS, but probably higher than for most seasonal flu outbreaks in recent years- The main complication of SARS-CoV-2 infection is pneumonia with development of acute respiratory distress syndrome (ARDS)- Asymptomatic and oligosymptomatic courses with virus shedding are not uncommon; they may be more frequent in children than in adults. Virus excretion in asymptomatic people and in the pre-symptomatic phase of an infection is relevant for transmission- An effective antiviral therapy has not yet been established. ⋯ Low-threshold diagnostic testing and rapid detection of infection chains remain essential for better control of the pandemic. An effective vaccine is urgent.
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Dtsch. Med. Wochenschr. · Jun 2020
[Primary aldosteronism - why is it still underdiagnosed in clinical practice?]
Primary aldosteronism (PA) represents the leading cause of endocrine hypertension, accounting for 4-13 % of all cases. Simultaneously, it is the most common endocrine form of hypertension that can be cured by surgery. Estimates suggest that 2.5 million people in Germany are affected, yet only 8 % of hypertensive patients undergo the proper diagnostic screening for PA. ⋯ Since PA patients carry an increased risk of cardio- and cerebrovascular events as well as metabolic comorbidities, early screening and diagnosis is crucial. This manuscript highlights the current guidelines of screening and diagnosing PA and addresses some currently published findings regarding this area. The aim is to raise awareness when it comes to diagnosing and screening for PA in the everyday management of hypertensive patients.
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Dtsch. Med. Wochenschr. · Jun 2020
[Prevention of stroke and dementia in general practice: evaluation of the project INVADE].
Stroke and dementia have several modifiable risk factors in common. In the primary care prevention project INVADE (INtervention project on VAscular brain diseases and Dementia in the district of Ebersberg), these vascular risk factors were recorded systematically and treated according to evidence-based guidelines. ⋯ clinicaltrials.gov, NCT1107548, registration date: 21.04.2010, drks.de, DRKS00011348, registration date: 29.12.2016.