Deutsche medizinische Wochenschrift
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Comprehensive Cancer Care stands for a concept of broad care providing substantial benefits to cancer patients. Beside prevention of cancer as first pillar and curative therapy as second pillar, comprehensive care also encompasses palliative care representing a third pillar providing service for incurable cancer patients burdened with physical symptoms and psychological, social and spiritual needs. This article describes the integration of palliative medicine into comprehensive cancer care for patients with gastrointestinal cancer.
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Cardiac rehabilitation is a fundamental part of treatment after acute coronary syndrome and should be followed within the first 14 days of the acute inpatient stay. The prognostic value in terms of improving quality of life, reducing both re-hospitalizations and cardiovascular mortality has been shown in numerous studies in recent years. ⋯ The characteristic of cardiac rehabilitation is the combination of sports and physiotherapy, psychosocial care, nutritional therapy, medical diagnostics, and therapy adjustment as well as aftercare recommendations within the framework of a 3-4 week stay in specialized rehabilitation facilities. Participation in exercise-based, multidisciplinary cardiac rehabilitation after acute coronary syndrome reduces cardiovascular mortality and is recommended with Class I, Level A evidence.
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In recent years, several drugs have been approved that specifically target molecular changes in tumour cells. For patients with gastrointestinal cancer, this has contributed to a significant improvement in prognosis. This article provides an overview of the currently available treatment options and the underlying biomarkers of their mechanisms of action. ⋯ Beyond the molecular-targeted therapy options already approved in the European Union, there is a multitude of additional drugs and biomarkers available, which can also be used outside of formal approval (so-called off-label use). Examples of this are also discussed in this overview (e.g., HER2-targeted therapy for cholangiocarcinoma, the use of KRASG12C inhibitors, or checkpoint inhibition in microsatellite unstable ductal pancreatic carcinoma). The question whether the use of one of these therapeutics represents a possible treatment option for patients with gastrointestinal cancers is typically discussed in a Molecular Tumour Board after undergoing guideline-appropriate therapies.
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Dtsch. Med. Wochenschr. · Apr 2024
[Diagnosis and classification of axial spondyloarthritis (axSpA) - the current status].
Axial spondyloarthritis (axSpA) is an inflammatory rheumatic disease typically characterized by inflammatory back pain (IBP). The term axSpA has largely replaced the long-used term ankylosing spondylitis (AS). IBP is caused by inflammation in the axial skeleton, with the sacroiliac joints (SIJ) being particularly frequently affected initially. ⋯ In the former, in addition to conventional X-rays, changes in the SIJ detected by magnetic resonance imaging (MRI) and also the detection of HLA B27 have, for the first time, played a role. It is important to note that these are not diagnostic criteria, as they do not exist. This paper outlines 10 points that should be considered when making a diagnosis.
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Despite significant advances in the detection and rapid management of acute coronary syndromes (ACS), it continues to lead the cause of death statistics and they continuously represent the leading cause of death and living with disabilities, globally. Since ACS combine a spectrum of different diagnoses, a high degree of variability in possible clinical presentation and relevant gender differences, Individualised treatment is not always easy and is constantly changing due to novel evidence from research studies. Therefore, the aim of this article is therefore to explain relevant treatment options and to present the current state of science in the context of clinical patient treatment.