Deutsche medizinische Wochenschrift
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Monoclonal gammopathies are a frequently diagnosed entity. However, the diagnosis is not always clinically relevant. The diagnosis of a monoclonal gammopathy requires serum electrophoresis, immunofixation and free light chain measurement. ⋯ Importantly, MGUS patients show higher morbidity. Amongst a higher prevalence of osteoporosis and immunodeficiency, a wide array of MGUS-associated diseases such as AL amyloidosis, deposition diseases and Fc binding-dependent effects can occur. This article gives an overview over the work-up, observation and caveats of monoclonal gammopathy of (un)known significance.
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Dtsch. Med. Wochenschr. · Jun 2022
[Artificial ulcer with perforating bone defect on the scalp due to repeated - scratching attacks in dementia syndrome].
We report on a 72-year-old demented patient with a palm-sized skin defect on the scalp, who has been manipulating her head several times a day with her fingers but also with sharp objects for many months. ⋯ Due to the lack of evidence of tumorigenesis in a follow-up period of two years, we evaluate the lesion as an artificial ulcer with perforating bone defect caused by repeated scratching attacks in the context of dementia syndrome.
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Dtsch. Med. Wochenschr. · Jun 2022
[Chronic tinnitus - Therapeutic aspects, based on the new german guideline].
Chronic tinnitus is a symptom of disturbed auditory perception. More than 90 % of tinnitus patients suffer from hearing loss. Many people experience tinnitus and seek for treatment, but suffering and the actual burden of tinnitus is individually very different, sometimes it disappears after a certain time even without treatment. ⋯ Up to date there is no therapy that can completely switch off tinnitus, mainly because origin and expression of tinnitus is individual and very different. This publication summarizes and evaluates scientific therapeutic approaches for chronic tinnitus. It is based on the newly elaborated S3-Guideline "Chronic Tinnitus", under the lead management of the German Society of ENT, Head and Neck-Surgery, published in 2021.
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Dtsch. Med. Wochenschr. · Jun 2022
[Important arboviral diseases in returning travelers: dengue, chikungunya and zika].
Arboviral infections are an important differential diagnosis in returning travelers with fever, muscle or joint pain and rash. Arboviruses have spread widely around the globe in the last decades. The most common arboviral infections in returning travelers from tropical and subtropical areas are dengue, chikungunya and zika. ⋯ Instead, travelers should delay conception for up to three months after returning from a zika endemic area. Dengue, chikungunya and zika vaccine development has been hampered by difficulties, for example antibody-dependent-enhancement or the unpredictability of outbreaks, and up to now no vaccines for travelers have been licensed. Yet several promising vaccine candidates are currently under development.