Neufassung der Empfehlungen der Kommission Pharmakotherapie der DGRh

Zusammenfassung Entzündlich-rheumatische Erkrankungen sind mit eine Vielzahl von Schmerzen und Einschränkungen verbunden. Die zu ihrer Behandlung eingesetzten so genannten Basistherapeutika sind bei vielen Patienten nicht ausreichend wirksam oder werden wegen Nebenwirkungen abgesetzt.Hier liegt das Einsatzgebiet von Tumornekrosefaktor- (TNF-) Blockern. Sie führen in vielen Fällen zu einer deutlichen Besserung der Krankheitssymptome, einem Abfall der labormedizinischen Parameter der Krankheitsaktivität, zur Verbesserung der Lebensqualität bis hin zum Stillstand der Destruktionen bei raschem Wirkungseintritt. Häufigkeit und Schwere der Nebenwirkungen sind eher gering, allerdings gibt es noch wenige Daten zum Langezeitverlauf.Der folgende Beitrag gibt Empfehlungen, unter welchen Voraussetzungen bei welchem Krankheitsbild der Einsatz von TNF-Blockern erfolgen kann.     

Validation of the accuracy of the sentinel lymph node procedure in patients with vulvar cancer: results of a multicenter study in Germany

ObjectiveTo investigate the diagnostic accuracy of the sentinel node procedure in patients with vulvar cancer, a multicenter study was launched in Germany in 2003 involving 7 oncology centers.Patients and methodsBetween 2003 and 2006, 127 women with primary T1–T3 vulvar cancer were entered in the study and treated with sentinel node removal after application of ^99mTechnetium labeled nanocolloid and/or blue dye. Subsequently, in all women a complete inguinofemoral lymphadenectomy and the adequate vulvar operation were performed. Sentinel lymph nodes were examined by routine pathologic examination (H&;E), followed by step-sectioning and immunhistochemistry if negative.ResultsThe sentinel node procedure was successful in 125 out of 127 cases, in 2 cases no sentinel nodes were detected. 21 patients received unilateral lymphadenectomy, 103 women were operated on both groins. In 39 women out of 127, positive lymph nodes in one or both groins were identified (30.7%). In 36 women, the sentinel nodes were also positive (sensitivity 92.3%). We had three cases with a false negative sentinel node (false negative rate: 7.7%), all of these women presenting with tumors in midline position. One tumor was a T1 tumor (10 mm), 2 tumors being classified as T2 (40 and 56 mm, respectively). In one additional case (18 mm T1 tumor, midline position), the sentinel was positive in the right groin, but false negative on the left side.ConclusionsThis study shows that identification of SLN in squamous cell cancer of the vulva is feasible, however not highly accurate depending on tumor localization and size. The false negative rate seems to be acceptable if the procedure is restricted to stage 1 tumors with clinically negative lymph node status. Tumors situated in or close to the midline seem to be less suitable for this procedure. Implementation of SLNB into clinical practice should be performed with care and only by experienced teams as to avoid preventable groin relapses.     

American association for cancer research — AACR congress 2014

This year the American association for cancer research meeting was held in San Diego. “Harnessing breakthroughs and targeting cures” was the title of this meeting where the major recent scientific data on cancer research were discussed. This year was undoubtedly the year of immunotherapy and immunology of tumors. With the aim of sharing the data presented at this congress, AERIO (Association d’Enseignement et de Recherche des Internes d’Oncologie) and Oncologie joined to propose a digest of this outstanding congress. Of course, exhaustivity is not an objective of this type of digest which reflects the choices of young researchers and physicians, with the help of the editorial board, among the multiple themes and researches presented and discussed during this meeting. Tumor immunology and immunotherapy data from the congress are reported. Moreover, autophagy, microbiome, liquid biopsy, tumoral heterogeneity, and cancer stem cells data from this congress are reported, as a reflection of the diversity of this meeting and cancer research. From a clinical point of view, new targets and molecules and the new design of clinical trial are also reported.     

AIDS AS A CHALLENGE FOR THE DEVELOPMENT OF THE TREATMENT OF OPIOID DEPENDENTS IN CHINA Report on the 9th National Conference on Drug Dependence, MMT and HIV Prevention in Sanya/Hainan (VR China), 1-5 November 2006

Nearly 100 experts from all over China attended the Chinese National Conference on Drug Dependence in Sanya/Hainan. The participants came from drug abuse treatment centers, methadone clinics and drug research institutes. The conference's focus was on the question how drug abuse treatment shall and might be part of HIV prevention. CHINALi xiao(The Federal Drug Commissioner with the Federal Ministry of Health, Berlin)