Pneumologie最新文献

{"title":"[Test Your Knowledge].","authors":"Marcus Bauer, Ayad Alramadan, Anke Hildebrandt","doi":"10.1055/a-2394-8329","DOIUrl":"https://doi.org/10.1055/a-2394-8329","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":"79 3","pages":"254-256"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Role of respiratory therapists in weaning patients from invasive mechanical ventilation: a description of their responsibilities from a certified weaning centre].","authors":"Benjamin Neetz, Gabriele Iberl, Nicole Kraus, Cornelia Weißmann, Florian Bornitz, Michael Martin Müller, Lars Reinhardt, Felix Herth, Julia Michels, Franziska Trudzinski","doi":"10.1055/a-2529-6367","DOIUrl":"https://doi.org/10.1055/a-2529-6367","url":null,"abstract":"<p><p>Respiratory therapists have been trained by the German Respiratory Society (DGP) since 2005. Respiratory therapeutic interventions related to weaning patients from invasive mechanical ventilation are a major focus. Respiratory therapists have been an integral part of the therapeutic team at the Thorax Clinic Heidelberg for more than 10 years. This article describes their tasks and responsibilities in the context of weaning from invasive mechanical ventilation. The acute treatment phase of invasively ventilated patients in the acute intensive care unit and the prolonged weaning phase in the pneumological intensive care unit are presented in chronological order. The therapeutic focus of each phase is presented and described.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pulmonary mass: Thinking beyond malignant causes - A case of histoplasmosis].","authors":"Elena Terhalle","doi":"10.1055/a-2531-4204","DOIUrl":"https://doi.org/10.1055/a-2531-4204","url":null,"abstract":"<p><p>A 49-year-old patient was presented for clarification of a pulmonary nodule and lymphadenopathy. He had undergone surgery for removal of a squamous cell carcinoma from the lip and a renal cell carcinoma. Follow-up examinations showed new changes in the lungs and lymph nodes. An initial suspicion of malignant metastases was not confirmed; instead, fungal organisms were detected. Through a detailed medical history, positive serology, and a specific PCR, the diagnosis of pulmonary histoplasmosis was finally made.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Respiratory therapists in Germany: An analysis of their current training and work situation].","authors":"Dennis Flügge, Matthias Held","doi":"10.1055/a-2510-2625","DOIUrl":"https://doi.org/10.1055/a-2510-2625","url":null,"abstract":"<p><p>Although there has been a trainee program for respiratory therapists since 18 years, a representative survey of this field of activity is lacking. The aim of this study was to find out which professional groups felt addressed by the training program, how satisfied they were with the training and where the respiratory therapists were employed, to take a look at the organisation of the working conditions after further training and how cooperation with other professional groups functioned. An investigation into whether there were factors that had an influence on the above-mentioned points should provide an outlook on how respiratory therapy in Germany was likely to develop in the future and what would be important for its future work.In a quantitative cross-sectional study, a partially anonymised electronic survey was conducted among prospective and trained respiratory therapists in Germany. The survey was analysed using the (browser-based) programme \"Online Umfrage.com\" and the spreadsheet programme Microsoft Excel. The open questions were analysed using Mayring's qualitative content analysis.307 prospective and postgraduate respiratory therapists from all federal states and with varying years of continuing education took part in the survey. Most of the respondents worked in the clinical field; 90% of the respondents were rather or very satisfied with their further training. A quarter of them got no time off at all from work or only partially to participate in continuing education. Half of the respondents had not been able to get better salaries following their further training. Nevertheless, 81.25% of respiratory therapists said they would recommend the training programme to others. When asked what was important for the future, the answers varied and ranged from state recognition and better cooperation between training providers to better public relations work.Further training to become a respiratory therapist is seen as very positive. However, there are still significant problems in the areas of remuneration, time off and further training development. The type of supervisor was identified as one of the most important influencing factors. Thus, respiratory therapists who were subordinated to the medical service were more satisfied than those placed under the nursing service management.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A rare case of hemoptysis].","authors":"Julika Merres, Pascal Fischer, Erich Stoelben","doi":"10.1055/a-2512-8290","DOIUrl":"https://doi.org/10.1055/a-2512-8290","url":null,"abstract":"<p><p>The present case report involves a young patient with hemoptysis for several months. A CT chest examination and bronchoscopy revealed the rare finding of squamous cell carcinoma of the trachea. Further diagnostics showed no evidence of lymph node or distant metastasis. Because of the length of the tumor, we performed a median sternotomy and tracheal resection, extending from subglottis to mid-trachea. Carcinoma of the trachea is a rare cause of hemoptysis but should be considered as a differential diagnosis and then presented to an appropriate center with expertise.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Long-term health-related quality of life of patients after prolonged weaning depending on weaning status].","authors":"Bernd Schönhofer, Andrea Paul, Stefan Suchi, Maximilian Zimmermann, Sarah Bettina Stanzel, Wolfram Windisch, Melanie Berger","doi":"10.1055/a-2368-4865","DOIUrl":"10.1055/a-2368-4865","url":null,"abstract":"<p><strong>Introduction: </strong>Long-term outcome in patients with prolonged weaning is known to be impaired, particularly against the background of their weaning status; however, data on their health-related quality of life (HRQL) are sparse.</p><p><strong>Methods: </strong>HRQL was measured in patients with prolonged weaning using the Severe Respiratory Insufficiency Questionnaire (SRI).</p><p><strong>Results: </strong>Overall, 39 out of 83 patients with prolonged weaning filled in the SRI questionnaire. The median interval between discharge from hospital and HRQL assessment was 3.5 years (IQR 2.4-4.5 years). In the total group, the median SRI summary score was 56.4 (IQR 38.8-73.5). Patients with unsuccessful weaning and subsequent invasive home mechanical ventilation (N=15) had worse HRQL as estimated from the SRI summary score when compared to those with successful weaning both without (n=13) and with subsequent long-term non-invasive ventilation (NIV) (n=11); Kruskal-Wallis-Test: H (2, n=39) = 7,875446; P=0.0195. Statistically significant differences indicating worse HRQL in patients with invasive home mechanical ventilation were particularly evident in the following SRI subscales: Social relationships (P=0.0325), Anxiety (P=0.0096), and Psychological well-being (P=0.0079).</p><p><strong>Conclusions: </strong>HRQL is substantially impaired in patients with unsuccessful prolonged weaning and subsequent invasive home mechanical ventilation compared to those with successful prolonged weaning. Further studies incorporating higher case numbers are needed to assess other conditions potentially affecting HRQL in patients with prolonged weaning.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"141-146"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current status of lung cancer care in Germany in the context of treatment centralization and lack of personnel].","authors":"Ioannis Karampinis, Philipp Schiller, Christian Galata, Robert Scheubel, Roland Buhl, Michael Kreuter, Martin Hetzel, Thomas Voshaar, Eric Roessner","doi":"10.1055/a-2361-4615","DOIUrl":"10.1055/a-2361-4615","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer is the malignancy with the highest mortality rate worldwide. In January 2025, the German public healthcare system will introduce a new regulation according to which a centre can offer surgery for lung cancer only if it carries out a minimum number of lung resections. The purpose of this directive is to reduce the number of centres offering surgical treatment for primary lung cancer, thus centralising and improving lung cancer care. It is expected that the introduction of this regulation will lead to a significant shift in the staffing of thoracic units. The purpose of this survey was to examine the current occupational structures behind the units of thoracic surgery and respiratory medicine.</p><p><strong>Methods: </strong>We performed an online survey through the German Society for Thoracic Surgery and the Association of Respiratory Physicians. The responding centres were divided in two groups, centres that were certified by the German Cancer Society or the Society for Thoracic Surgery and centres which were not certified.</p><p><strong>Results: </strong>The response rate was 29.3% (respiratory physicians) and 31.9% (thoracic surgeons); 67% of the participating colleagues answered that their unit was an independent department. The majority of the participants reported having to share the on-call duty of the trainees with other departments in order to be able to cover the required shifts. 35% of the respiratory physicians and 57% of the thoracic surgeons reported having vacant job posts in their units.</p><p><strong>Discussion: </strong>The introduction of the minimum quantity regulation will have significant consequences for the treatment of lung cancer in Germany. The current staff shortage in healthcare will lead to both medical and nursing staff needing to be redistributed in order to meet the needs that will arise in 2025. Operating lists, theatre days, and operative equipment will need to be redistributed as well, not only within hospitals but probably on a nationwide level. A negative impact of the new regulation is to be expected on research and academic activities since most university hospitals are not expected to reach the minimum number of lung resections that is required in order keep performing lung cancer surgery.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"147-152"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Optimal management of patients with acute dyspnea and pulmonary diseases in a respiratory care unit].","authors":"Stefanie Keymel, Michael Bernhard, Stefan Krüger","doi":"10.1055/a-2486-6306","DOIUrl":"https://doi.org/10.1055/a-2486-6306","url":null,"abstract":"<p><p>Acute dyspnea, a main symptom of different diseases in pneumology, cardiology and internal medicine, is one reason why patients present themselves in the emergency department (ED). Acute dyspnea is a frequent and complex symptom. Patients presenting with acute dyspnea in the ED are characterized by a higher rate of transfer to intensive care unit and mortality as compared to patient with chest pain or with abdominal pain. For optimal treatment of patients with acute dyspnea, a defined pathway, namely the specific pathway of a Respiratory Care Unit (RCU), should be established. To implement this, certain conditions concerning organisation, structure, personnel as well as contents need to be defined.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":"79 2","pages":"161-169"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hurdles on the way to the diagnosis of asthma and successful therapy.","authors":"Thomas Hausen","doi":"10.1055/a-2319-4464","DOIUrl":"10.1055/a-2319-4464","url":null,"abstract":"<p><p>There are many potential hurdles, obviously at the forefront of patient care which may impede the correct and early diagnosis of asthma, as well as successful, appropriate treatment. Although the illness is often accompanied by many typical signs which may enable a rapid diagnosis, these are often overlooked or misinterpreted. Symptoms may not be recognised or confused with others, such as respiratory infections, and inappropriate diagnostic tests used. Inappropriate therapy (absent or insufficient dosage of a topical anti-inflammatory and/or exclusive usage of a short-acting beta-agonist) and failure to adapt therapy may further impede the patient's chance to live without symptoms.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"153-160"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Management of Malignant Pleural Effusion].","authors":"Christopher Larisch, Julia Riedel, Hans-Stefan Hofmann, Michael Ried","doi":"10.1055/a-2497-5902","DOIUrl":"https://doi.org/10.1055/a-2497-5902","url":null,"abstract":"<p><p>Malignant pleural effusion is a common diagnosis in metastasized cancers. It is always of palliative character. Main symptoms are dyspnoea and reduced quality of life. Diagnosis is made by ultrasound-guided puncture of the pleural effusion (cytology) and often video-assisted thoracic surgery with biopsy of the pleural surface (histology). The goal of treatment is a fast, sustainable, minimally invasive, patient-centred therapy that increases quality of life. Besides systemic therapy and best supportive care the patient can be treated with local therapy including either pleurodesis (via drainage or VATS) or an indwelling-pleural catheter (IPC). Decision for one of these procedures is made upon performance index (ECOG), expandability of the lung, prognosis and the patient's wish. For the first technique, the lung must be expandable. The latter one (IPC) can be implanted both with expandable and trapped lung. Both are similarly effective in symptom control.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":"79 2","pages":"170-183"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}