Clinical medicine (London, England)
-
Monoclonal gammopathy of undetermined significance (MGUS) is characterised by the presence of a monoclonal paraprotein in the blood, without the characteristic end organ damage seen in multiple myeloma. MGUS is more common in older age groups and has a risk of progression to myeloma of 1% per year. ⋯ In this review, we discuss the complications of MGUS and whether MGUS fulfils the criteria needed to implement a screening programme. We also highlight areas where more evidence is needed, including identification of a higher risk population to make screening more practical and economically viable.
-
Inhaled corticosteroids represent the mainstay of pharmacological treatment for reversible airways disease, and traditionally have had widespread use in non-reversible chronic obstructive pulmonary disease (COPD). However, use in this group may expose patients to an increased risk of pneumonia, without significant benefit to symptoms or exacerbation frequency. Here we provide a guide to the use of inhaled therapy in COPD for the general physician.