Dtsch Arztebl Int
-
The term cancer of unknown primary site (CUP) syndrome is used to describe malignancies in which a complete diagnostic work-up detects metastases in the absence of an identifiable primary tumor. ⋯ Only rigorous further development of diagnostic tools and treatment protocols will enable an improvement of the poor prognosis of patients with CUP syndrome. Specific molecular treatment strategies have shown promising results.
-
10% to 20% of the population sees itself as suffering from food allergy, yet genuine, immune-mediated food allergy is suspected by patients and their physicians far more often than it is actually shown to be present. The unfounded suspicion of an IgE-mediated food allergy can substantially impair a patient's quality of life through needless dietary restriction and the accompanying anxiety. On the other hand, an IgE-mediated food allergy that has gone undiagnosed or that has not been taken seriously can manifest suddenly with anaphylaxis, which may be life-threatening. The present study, carried out on a large cohort of patients, underscores the importance of differentiating IgE-mediated food allergy from other, nonallergic types of food reaction. ⋯ Only a comprehensive allergological evaluation performed by an experienced allergologist in accordance with current guidelines can protect patients from the negative consequences of excessive concern about a nonexistent food allergy (e.g., needless dietary restriction) or, on the other hand, the negative consequences of inadequate attention to a genuine food allergy (anaphylaxis). A proper evaluation consists of detailed allergologic history-taking, skin tests, and challenge tests when indicated.
-
The present review describes the different variants of Fetal Alcohol Spectrum Disorders (FASD) as a consequence of maternal alcohol abuse during pregnancy. According to international findings, some 3000 to 4000 affected newborns may be expected annually in Germany. Detection of these individuals in clinical practice is insufficient. ⋯ Pathogenesis of FASD is not sufficiently clear and there is no causal treatment. Thus, besides prevention and information, early diagnosis, installation of fostering or adoption, and intensive psychosocial care including selection of appropriate schooling, occupational counselling and supportive care in adulthood are mandatory.