Deutsche medizinische Wochenschrift
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The advent of tyrosine kinase inhibitors (TKI) has improved prognosis and outcome of patients with chronic myelogenous leukemia (CML) considerably. In comparison to imatinib, first line use of second generation inhibitors nilotinib, dasatinib and bosutinib lead to faster and deeper molecular remissions accompanied by a novel adverse event profile. ⋯ The use of interferon alpha in parallel with or after TKI therapy is associated with the induction of an immune response against the leukemic clone with further improved remission rate. The cooperative management of CML patients permits the early use of novel treatment options in patients at risk.
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Dtsch. Med. Wochenschr. · Aug 2018
[Survey of physicians on dealing with the topic "Tobacco consumption in patients with lung cancer"].
About 40 % of the patients are active smokers when diagnosed lung cancer. Half of these patients is the nicotine consumption continues despite the existence of cancer. The overall mortality in these patients is a factor of 3 higher. In addition, the quality of life increases and symptoms such as cough and dyspnoea are reduced. ⋯ The doctors were quite convinced of the benefit of a smoking stop in the treatment of the lung carcinoma. Lung cancer patients would benefit if smoking cessation would be even more integrated into the overall therapy. For that one could rely on already established cessation programs and concepts for clinics.
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Dtsch. Med. Wochenschr. · Aug 2018
Review[Recommendation for Calcitonin Screening in Nodular Goiter].
Medullary thyroid cancer (MTC) arises from parafollicular C cells of the thyroid gland and is characterized by a calcitonin secretion. Basal calcitonin correlates with the tumor mass and is used as highly sensitive and specific tumor marker for MTC. Based on former assays, unspecific calcitonin increase has frequently been seen in Hashimoto's thyroiditis, kidney insufficiency, proton pump inhibitors etc. ⋯ Lower calcitonin values should be re-evaluated in intervals of 3 - 6 months; rising calcitonin levels may indicate an MTC. In this case, thyroid operation should be performed. The cure rate of MTC with calcitonin values < 100 pg/ml is nearly 100 % done by high volume surgeons.
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Dtsch. Med. Wochenschr. · Aug 2018
Review[Osteoarthropathies and Myopathies associated with Disorders of the Thyroid Endocrine System].
Triiodothyronine (T3) is a key regulator of bone, muscle and articular cartilage. Musculoskeletal symptoms of hyperthyroidism include loss of bone mass finally leading to osteoporosis and weakness of the skeletal musculature. Hypothyroidism on the other side frequently leads to muscle stiffness and cramping and, occasionally, results in rhabdomyolysis. ⋯ Recent findings underline the importance of local T3 generation by deiodinase type 2 and support the existence of local hypo- or hyperthyroidism. In the review, the implications of the recent literature for current understanding of osteoarthritis, myopathies and diabetic osteoarthropathy will be discussed. Further emphasis will be placed on the association of autoimmune thyroiditis with musculoskeletal diseases and fibromyalgia.