Abstract:
:Monoclonal gammopathy of unknown significance (MGUS) is the most frequent plasma cell disorder that commonly affects elderly patients. Although it is an asymptomatic condition, as well as smoldering myeloma (SMM), the risk of progression to multiple myeloma requiring therapy or other B-cell disorders varies greatly for individual patients, remaining low for MGUS (1% per year), while higher and not uniform for SMM patients (10% per year). This scenario implies some special considerations regarding assessment and follow-up, especially in the elderly. In this review, we provide the updated diagnostic criteria of monoclonal gammopathies proposed by the International Myeloma Working Group (IMGW); the current recommendations for the assessment of asymptomatic plasma cell disorders, with some concerns about the need of geriatric evaluation in the elderly population, the importance of distinguishing myeloma-related symptomatology from signs or symptoms caused by multiple chronic conditions typically found in the elderly. Finally, the identification of predictor markers of progression has enabled a proposal of risk-adapted follow-up strategies in MGUS and SMM that should be implemented in clinical practice. Although the standard of care is observation for MGUS and SMM patients as well, a recent randomized trial targeting high-risk SMM showed the clinical benefit of early intervention. The change of the treatment paradigm is also very promising and feasible for elderly patients, as long as a comprehensive geriatric assessment is conducted to optimize early treatment and reach maximum benefit with minimum toxicity, in other words, to ensure a better quality of life for these patients.
journal_name
Eur J Intern Medjournal_title
European journal of internal medicineauthors
González-Calle V,Mateos MVdoi
10.1016/j.ejim.2018.05.029subject
Has Abstractpub_date
2018-12-01 00:00:00pages
57-63eissn
0953-6205issn
1879-0828pii
S0953-6205(18)30225-5journal_volume
58pub_type
杂志文章,评审abstract:BACKGROUND:Upper gastrointestinal bleeding is the severe complication of stress-related mucosal disease in hospitalized patients. In intensive care units (ICU), risk factors are well defined and only mechanical ventilation and coagulopathy proved to be relevant for significant bleeding. On the contrary, in non-ICU sett...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2010.06.010
更新日期:2010-10-01 00:00:00
abstract::BACKGROUND: Endoscopy of the colon and rectum has become a standard diagnostic procedure. No data are presented in the literature on the annual yield or on morbidity patterns. A large, cross-sectional, single-center study was done in order to detect the annual yield of endoscopy of the colon and rectum. METHODS: All c...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2004.07.015
更新日期:2005-02-01 00:00:00
abstract::The Medical Emergency Team (MET) has enhanced the recognition and response to clinical deterioration in acute healthcare. However, patients reviewed by the MET are at increased risk of in-hospital death. Identifying patients at risk of deterioration may improve patient outcomes. AIM: To identify patient demographic, m...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2019.05.021
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Antithrombotic/anticoagulation effects of direct oral anticoagulants (DOACs) are dose-dependent. However, recent observations suggest that administering lower dose DOACs may better protect against all-cause mortality. We investigated whether, in patients with established atherosclerosis, DOAC dose selection ...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2020.09.007
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:The objective of this study is to compare the characteristics, outcomes, and clinical complications of patients with pulmonary embolism (PE) who were treated at home as outpatients versus traditional hospitalization. METHODS:Prospective study from January 2006 to June 2007. Selected patients diagnosed at th...
journal_title:European journal of internal medicine
pub_type: 临床试验,杂志文章
doi:10.1016/j.ejim.2009.04.003
更新日期:2009-10-01 00:00:00
abstract::Background: Ghrelin causes weight gain by increasing food intake in rodents. Tumor necrosis factor alpha (TNFalpha) is produced by adipose tissue, modulates its metabolism and stimulates catabolic processes. The aim of our study was to evaluate whether weight loss treatment modulates serum concentrations of TNFalpha a...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2004.02.002
更新日期:2004-06-01 00:00:00
abstract::Venous and arterial thromboses have traditionally been regarded as separate diseases with different causes. However, recent epidemiological studies have documented an association between these vascular complications, probably due to the presence of more overlapping risk factors than previously recognized. This narrati...
journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ejim.2012.02.008
更新日期:2012-06-01 00:00:00
abstract::Venous thromboembolism (VTE) is frequent in patients hospitalized in Internal Medicine wards. It carries a considerable morbidity and mortality. Recommendations for use of anticoagulation are graded 1A in leading evidence-based consensus guidelines. Implementation of these guidelines is suboptimal. Lack of awareness s...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2011.11.005
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to investigate the patients' characteristics that correlate with greater compliance to CPAP use. METHODS:Patients diagnosed with OSAHS and treated with CPAP, who had at least one follow-up visit in the Sleep Clinic during one year, were included in the study. Demographic data, histor...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2009.07.004
更新日期:2009-10-01 00:00:00
abstract::The rising number of clinical guidelines poses a new challenge to the internists. The main problems are: 1) available documents suffer from heterogeneous methodological quality, and 2) most of clinical guidelines target an 'ideal' patient affected by a single condition, while in real practice internists must face with...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2020.05.016
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:chronic viral infections by both HCV and HIV may lead to polyclonal activation of B cells resulting in hypergammaglobulinemia. This study retrospectively analyzed the effect of HCV eradication with interferon-free direct-acting antiviral agents (DAAs) on the gamma globulin levels in HCV-infected patients wit...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2020.01.006
更新日期:2020-05-01 00:00:00
abstract::The evolution of strategies for the use of spironolactone and its analogue, eplerenone, has, over the years, encompassed favourable modification of the natural history of symptomatic heart failure in subjects with subnormal left ventricular ejection fraction (LVEF), and mitigation of the risk of new-onset atrial fibri...
journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ejim.2012.11.007
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Hyperuricemia prognostic impact on clinical outcomes in chronic heart failure (HF) patients has been investigated with inconclusive results. OBJECTIVES:Aim of the study was to evaluate the prognostic impact of serum uric acid (SUA) on long-term clinical outcomes in HF. METHODS:An analysis of MECKI (Metabol...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2019.11.003
更新日期:2020-02-01 00:00:00
abstract::Enteric fever (EF) is the most common bacteremic disease affecting travelers to the tropics. For more than a decade, fluoroquinolones have been considered the drugs of choice for EF. However, recent reports have raised concern about fluoroquinolone resistance. Treatment with ciprofloxacin failed in a traveler with Sal...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2006.09.016
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:This study investigates risk factors and the incidence of type 2 diabetes mellitus (type 2 DM) in both sexes of a northern European population. METHODS:A total of 14,223 randomly selected men and women were studied from 1976 to 1978. Patients with diabetes (self-reported type 2 DM or non-fasting plasma gluc...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2007.05.011
更新日期:2008-01-01 00:00:00
abstract::Research on multimorbidity has rapidly increased in the last decade, but evidence on the effectiveness of interventions to improve outcomes in patients with multimorbidity is limited. The European Commission is co-funding a large collaborative project named Joint Action on Chronic Diseases and Promoting Healthy Ageing...
journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ejim.2015.02.020
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Vascular endothelium activation is a key pathogenic step in systemic inflammatory response syndrome (SIRS) that can be triggered by both microbial and sterile proinflammatory stimuli. The relevance of soluble adhesion molecules as clinical biomarkers to discriminate between infectious and non-infectious SIRS...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2012.10.009
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Periodontal disease is prevalent in asthmatics, but it is unclear whether periodontal treatment plays a role in adverse respiratory events in these patients. We evaluated risk of hospitalization for adverse respiratory events (acute exacerbation, pneumonia, and acute respiratory failure) and mortality in ast...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2017.06.005
更新日期:2017-12-01 00:00:00
abstract::In all industrialized countries, life expectancy has risen in the past 100 years. The incidence of elderly patients reaching end-stage renal disease (ESRD) and requiring renal replacement therapy has also increased. During the past few decades, the pattern of ESRD has changed significantly with the emerging predominan...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/s0953-6205(01)00121-2
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Thalassemia minor (Tm) individuals, are generally considered healthy. However, the prognosis of Tm individuals has not been extensively studied. The aim of this study was to evaluate the prognosis of Tm versus controls without β-thalassemia carrier state. METHODS:A total of 26,006 individuals seeking thalas...
journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ejim.2018.06.009
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:The value of salivary cortisol measurement to study stress-related adrenal response is controversial. The study aim was to assess the role of salivary cortisol measurement to detect time-related changes of adrenal response in critically ill patients. PATIENTS AND METHODS:Patients with organ failure, sepsis ...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2019.08.001
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The low pharmacological response to phosphodiesterase type 5 inhibitors represents an expression of higher endothelial damage in certain categories of patients with erectile dysfunction and high cardiovascular risk. The present study evaluated this objective in type 2 diabetic patients with erectile dysfunct...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2013.01.001
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:Fatty pancreas (FP) is related to obesity, and may have some clinical implications on glucose metabolism. The frequency and importance of FP in patients with nonalcoholic steatohepatitis (NASH) are not clear. This study aimed to investigate: the frequency of FP in patients with NASH, and its effects on serum ...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2014.11.007
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Primary cancer prevention is offered by the Greek health care system to the population on an opportunistic basis. This means that screening depends on advice from primary care providers and on individuals' request for screening, since a centralized invitational register is lacking. In planning preventive ser...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2007.10.018
更新日期:2008-10-01 00:00:00
abstract::The need for anticoagulation in patients with atrial fibrillation (AF), and the inherent limitations of warfarin have fostered the search for direct oral anticoagulant drugs (DOACs). In recent years, inhibitors of thrombin (Dabigatran etexilate) and of activated factor X (Rivaroxaban, Apixaban) have become clinically ...
journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ejim.2013.01.021
更新日期:2013-06-01 00:00:00
abstract::The names of many drugs look or sound like those of other drugs, which leads to confusion and potentially harmful medication errors. We report a nearly fatal permutation between two drugs including a vitamin K antagonist that resulted in a 68-year-old man being admitted to the emergency department with severe, spontan...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2007.03.018
更新日期:2008-03-01 00:00:00
abstract::Background: Big cities were particularly affected by tuberculosis in the 1990s. Methods: We studied 141 cases of extrapulmonary tuberculosis in patients not infected by HIV in the northeastern suburbs of Paris. Results: A total of 84 men and 57 women were included in the study. Their average age at diagnosis was 42.2 ...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/s0953-6205(00)00076-5
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Although tramadol and codeine occasionally have been reported to cause hyponatremia the evidence is scarce. The objective of this investigation was to study the association between weak opioids (tramadol and codeine) and hospitalization due to hyponatremia. METHODS:This was a register-based case-control stu...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2019.08.006
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE OF THE STUDY:To report on the results of two projects on chronic hepatitis B in Western Balkans lead by Ioannina, Northwest Greece and Tirana, Albania. METHODS:In two prospective projects, HEPAGA I and HEPAGA II which lasted 4 years. In HEPAGA I, serum samples from 410 Albanians were tested for HBV. In HEPAG...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2009.07.016
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Poisoned patients are frequently admitted following Emergency Department (ED) presentation, while the necessity of such admissions is hardly investigated. We determined the proportion and characteristics of poisoned patients who were admitted, but in retrospect had an uneventful admission. METHODS:For this ...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2019.05.012
更新日期:2019-08-01 00:00:00