Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Feb 2021
[Can migration background be a boundary in palliative care at the end of life?]
According to current research data, individuals with migration background rarely utilize palliative care services. The potential reasons remain largely unclear, with cultural differences being suggested most frequently. A study focusing on the needs of cancer patients with migration background in Germany provides an overview of the care problems encountered. ⋯ Individuals with migration background frequently receive palliative care without their care givers having any specific knowledge of their migration biography. In order to do justice to societal effects, the support given must go beyond the mere medical expertise.
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Dtsch. Med. Wochenschr. · Feb 2021
[COVID-19 as an occupational disease or work-related accident: Considerations regarding insurance cover and reporting obligation in the statutory accident insurance].
The COVID-19 illness can occur as an occupational disease or work-related accident. According to the German list of occupational diseases, recognition as an occupational disease 3101 requires occupational exposure of an insured person who has been exposed to an increased risk of infection compared to the general population as a result of their occupational activity in one of the four areas: (1) health service or (2) social welfare sector, (3) laboratory or (4) during activities with increased risk of infection comparable to (1) to (3). ⋯ The COVID-19 disease is subject to legal notification, mostly in conjunction with a contemporary SARS-CoV-2 virus detection. Regarding insured people who are not included within the aforementioned areas (1) to (4), the COVID-19 illness can be acknowledged as an occupational accident if the intense and direct contact with infected people - not intended as in the case of occupational disease 3101 - but otherwise situationally results from the insured activity itself.
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Dtsch. Med. Wochenschr. · Feb 2021
[Antifibrotic therapy - new approvals for non-IPF interstitial lung diseases].
Interstitial lung diseases (ILD) encompass more than 200 disorders of known and unknow etiology. Until recently, the antifibrotic drugs nintedanib and pirfenidone had only been approved for the treatment of idiopathic pulmonary fibrosis (IPF), but not for other ILD. In the randomized, double-blind, placebo-controlled SENSCIS trial, the efficacy and safety of nintedanib was investigated in patients with ILD associated with systemic sclerosis (SSc-ILD). ⋯ In this randomized, double-blind, placebo-controlled, phase III trial, patients with chronic hypersensitivity pneumonitis, idiopathic non-specific interstitial pneumonia, unclassifiable ILD, autoimmune ILD, sarcoidosis, and others were included, and nintedanib slowed the annual decline of pulmonary function by 57 % in these patients. Promising data are also available for pirfenidone in the treatment of patients with progressive, non-IPF lung fibrosis and unclassifiable progressive fibrosing ILD. In this article, we summarize the new approvals of antifibrotic drugs in non-IPF ILD, the results from the underlying clinical trials and the clinical implications.
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Dtsch. Med. Wochenschr. · Feb 2021
Case Reports[EBV-positive MTX-associated lymphoproliferative disorder and Ig M myeloma in rheumatoid arthritis].
An 80-year-old female patient arrived with a pronounced lymphadenopathy and weight loss. 6 years ago she had been diagnosed with rheumatoid arthritis. At the time of arrival, she was administered Methotrexate (MTX) 10 mg/week. ⋯ Based on this case, the association of RA with lymphoproliferative disorders can be confirmed - here as an association of RA with biclonal MTX-LPD or multiple myeloma. Therapy with MTX and reactivation of EBV infection are important influencing factors.