Deutsche medizinische Wochenschrift
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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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Psoriatic arthritis is a heterogeneous immune-mediated disease that usually involves skin and joints but can also affect entheses and extraarticular structures in the disease course. In addition, associated diseases must be considered when choosing the appropriate therapeutic strategy. ⋯ The recommendations of the European League Against Rheumatism (EULAR) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) are the two internationally accepted guidelines frequently used to assist therapeutic decisions in clinical practice. New targeted treatment options developed based on a better knowledge of critical pathogenic pathways, will enlarge our armamentarium for optimized pharmacotherapy of psoriatic arthritis and improve personalized patient care.
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Dtsch. Med. Wochenschr. · Jun 2020
Case Reports[Paraneoplastic Cushing's syndrome as cause of refractory hypokalemia].
A 58-year-old man presented with refractory hypokalemia and rapid weight gain. On examination, he had high blood pressure, central obesity and bilateral pitting edema. ⋯ The diagnosis of paraneoplastic Cushing's syndrome can be challenging, since classical clinical features of hypercortisolism may still be absent, even if the underlying cancer is already advanced. Therefore high clinical suspicion is warranted, especially in patients presenting with new-onset refractory hypokalemia, metabolic alkalosis and arterial hypertension.
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Dtsch. Med. Wochenschr. · Jun 2020
[Primary and Secondary Prevention of Multiple Myeloma - Lifestyle Factors and Supportive Measures].
Lifestyle factors such as diet, physical activity and exposure to noxious agents are modifiable factors that have a significant impact on the state of health and life expectancy of humans. The following article is intended to provide an overview of current knowledge on the influence of these lifestyle factors on the development and progression of multiple myeloma and is dedicated to the question of the extent to which prevention strategies can be usefully applied.