Pneumologie最新文献

{"title":"[TELEMEdical moNiTORing for COPD patients (Telementor COPD): Study protocol of a multicentre, randomised, controlled study].","authors":"Franziska Püschner, Juliane Schiller, Dominika Urbanski-Rini, Katharina Scholl, Anni Bock, Margret Jandl, Andreas Thanhäuser, Lale Zils, Erwin Junker, Klaus Rabe, Henrik Watz","doi":"10.1055/a-2383-4470","DOIUrl":"10.1055/a-2383-4470","url":null,"abstract":"<p><p>COPD is one of the most common causes of death in Europe, and is associated with a high exacerbation and hospitalization rate as well as high medical costs. The aim of the study was early detection of exacerbations, preventative intervention through optimized outpatient care, and thereby to decrease rates of rehospitalizations. Telementor COPD is a prospective, multicentre, unblinded, randomized, controlled study with a study duration of 12 months, implemented at seven clinics and 16 pneumology practices in Hamburg and Schleswig-Holstein. It is funded by the Innovation Fund (01NVF20008) and is registered in the German Register of Clinical Studies (study ID: DRKS00027961). COPD patients with at least one documented exacerbation in the last year were included in the study. The primary endpoint was the number of exacerbations. Secondary endpoints were the number of COPD-associated hospitalizations, intensive care unit stays and health status. In the intervention group, symptoms were recorded daily using the SaniQ app (patients' smartphones), and the FEV₁ was measured daily using a mobile spirometer. Patients were also provided with a smartwatch to continuously measure their respiratory rate, heart rate, oxygen saturation and steps. The app displays the measured values and offers motivational components for smoking cessation and physical activity as well as video chats with the COPD nurses and doctors. If the symptoms or lung function deteriorated, the trained COPD nurse contacted the patient, reviewed the patient's measurements, and assessed the need for preventive intervention. Telementor COPD offers the opportunity to evaluate the efficacy of digital monitoring and telemedicine components and to pave the way for the implementation of telemedicine in the routine care of COPD patients with a high risk of exacerbation.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"358-365"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative impact of face masks in patients with interstitial lung disease: A prospective study.","authors":"Arno Mohr, Stefanie Zahn, Florian Geismann, Stefan Blaas, Michael Pfeifer, Maximilian Malfertheiner, Bernd Salzberger, Frank Hanses, Stilla Bauernfeind, Myriam Koch, Florian Hitzenbichler","doi":"10.1055/a-2361-4723","DOIUrl":"10.1055/a-2361-4723","url":null,"abstract":"<p><p>Face masks increase airway resistance, data on the actual extent of this effect are scarce. The aim of this study was to assess the effect of different mask types on clinical parameters during moderate exercise in healthy non-smokers, active smokers and patients with interstitial lung disease (ILD) without the need of oxygen therapy.In a prospective observational pilot study participants performed a six-minute walk test without mask, with a surgical mask, a well-fitted FFP2 mask and with a valved FFP3 mask. Respiratory rate, blood pressure, heart rate, blood gas analysis parameters, dyspnoea and six-minute walk distance were measured. Data were analysed in an ANOVA model.21 healthy participants, 17 active smokers without known pulmonary disease and 15 patients with interstitial lung disease were included. Participants with ILD had a significant lower walking distance, a higher respiratory rate and a lower pO₂ when using FFP2 masks, but not with valved FFP3 masks or surgical masks compared to not wearing a mask.For patients with ILD without the need of oxygen therapy wearing an FFP2 mask had a negative impact on pO₂, respiratory rate and walking distance in the six-minute walk test. This effect was not seen with valved FFP3 masks or surgical masks.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"292-296"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856283","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":"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":"284-291"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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":"[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":"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":"274-283"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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":"Kommentar.","authors":"Detlef Kirsten","doi":"10.1055/a-2486-8070","DOIUrl":"https://doi.org/10.1055/a-2486-8070","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":"79 4","pages":"308"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044662","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":"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":"302-307"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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":"[From vibration trauma to pharyngeal muscle instability: A self-sustaining pathophysiological process (circulus vitiosus) in obstructive sleep apnea].","authors":"Ulrich Koehler, Olaf Hildebrandt, Mikail Aykut Degerli, Christian Viniol, Wulf Hildebrandt, Regina Conradt, Richard Birk, Boris Stuck, Janine Sambale, Heike Korbmacher-Steiner","doi":"10.1055/a-2438-0479","DOIUrl":"10.1055/a-2438-0479","url":null,"abstract":"<p><p>Pharyngeal stability is ensured by both anatomical and non-anatomical factors. In addition to the anatomical width, functional factors are also significant in determining the degree of obstruction of the upper airway. The functionality of the pharyngeal muscles depends on an undisturbed sensorimotor system. In patients with rhonchopathy or obstructive sleep apnea (OSA), sensorimotor function and muscle morphology change progressively. It is hypothesised that long-term snoring leads to vibration-induced sensorimotor neuropathy, resulting in the loss of function and structure of the pharyngeal muscles. Pharyngeal mechanoreceptors lose their sensitivity, and due to neural damage, information can no longer be adequately translated into motor responses. This raises the question of the timeframe within which irreversible vibration-induced receptor damage occurs due to snoring.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"297-301"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780761","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 cause of multiple cavitary lung lesions].","authors":"Melika Piric, Bora Kosan, Christoph Manke, Fadi Khreish, Ludger Fink, Gabriele Koehler, Christoph Lange, Sven Gläser, Detlef Litzlbauer, Philipp Markart","doi":"10.1055/a-2486-6503","DOIUrl":"10.1055/a-2486-6503","url":null,"abstract":"<p><p>We report on a 32-year-old woman with multiple, progressive cavitary lung lesions. Lung cavities may occur in the context of various diseases and, thus, represent a huge diagnostic challenge. The spectrum of diseases comprises infections, systemic autoimmune rheumatic diseases, and malignancies. Several microorganisms may cause lung cavities such as common bacteria (e.g. <i>Haemophilus influenzae, Klebsiella pneumoniae</i>), <i>Mycobacterium tuberculosis</i>, non-tuberculous mycobacteria, uncommon bacteria such as <i>Nocardia species</i>, fungi (e.g. <i>Aspergillus species</i>), and parasites such as <i>Echinococcus species</i>. In respect of systemic autoimmune rheumatic diseases, granulomatosis with polyangiitis is frequently associated with cavitary lung lesions. Malignancies such as lung carcinomas and pulmonary metastasis may also manifest with cavern formation. In our case, we primarily assumed infection as the cause of the cavitary lung lesions - in fact, an infection with <i>Actinomyces species</i>. However, despite antibiotic therapy according to the resistance test results and the removal of the supposed focus of infection (tonsillectomy with proof of <i>Actinomyces</i> colonization of the tonsils), there was clear progression of lung cavities. Therefore, diagnostics were expanded and enhanced including FDG-PET-CT, bone marrow puncture, VATS pulmonary wedge resection, as well as EBUS- and CT-guided lymph node puncture. Finally, a rare clinical manifestation of Hodgkin lymphoma was diagnosed as the underlying cause of the multiple cavitary lung lesions.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"236-243"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780722","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":"[Artificial intelligence and machine learning in auscultation: prospects of the project DigitaLung].","authors":"Luca Hilberink, Pia Wehage, Milad Pashai Fakhri, Svenja Gaedcke, David DeLuca, Patricia Mattis, Jessica Rademacher","doi":"10.1055/a-2507-1486","DOIUrl":"10.1055/a-2507-1486","url":null,"abstract":"<p><p>Auscultation is one of the key medical skills in physical examination. The main problem with auscultation is the lack of objectivity of the findings and great dependence on the experience of the examiner. Auscultation using machine learning and neural networks promises great potential for solving these problems in clinical practice.A selective search for studies in PubMed was carried out, which revealed the possibilities of machine learning in medical diagnostics.In all the studies identified, significant differences were shown between the respective test groups in favour of artificial intelligence (AI). In addition to the positive study results, the limitations of AI could also be analysed and critically scrutinised.Medical research in the field of artificial intelligence is still in its infancy. The prospects and limitations of AI must be further investigated and require close attention in the collaboration between clinicians, scientists and AI experts. Publicly funded projects such as DigitaLung (a digital auscultation system for the differential diagnosis of lung diseases using machine learning), which aims to improve lung auscultation using AI, will help to unlock the diagnostic benefits of AI for patient care and could improve care in the future.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"229-235"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441789","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":"[The reality of bronchoscopy care in Germany: a survey by the German Respiratory Society].","authors":"Kyrill Boschung, Jürgen Hetzel, Ralf-Harto Hübner, Frank Pohl, Marcel Treml, Kaid Darwiche, Ralf Eberhardt, Angelique Holland, Torsten Bauer, Winfried Randerath, Wolfram Windisch, Lars Hagmeyer","doi":"10.1055/a-2491-1609","DOIUrl":"10.1055/a-2491-1609","url":null,"abstract":"<p><p>Bronchoscopy has changed considerably in recent years as a result of technical innovations and health economic pressure. There is little current information available on the reality of bronchoscopy care in Germany.</p><p><strong>Methodology: </strong>In September 2022, sites where bronchoscopy was carried out were systematically surveyed regarding structural and process quality features in an anonymized DGP survey with 33 questions. The data collected were analyzed descriptively.</p><p><strong>Results: </strong>Of the 196 participating sites, bronchoscopies were performed regularly at 180 sites. The majority were standard secondary care (n=51) and tertiary care (n=43) hospitals (range of services: diagnostic bronchoscopy, predominantly (80%) including endobronchial ultrasound-guided transbronchial needle aspiration, EBUS-TBNA). Extended treatment options were guaranteed for acute cases at >90% of these locations. University hospitals (n=24) and specialist pulmonary hospitals (n=35) also offered more complex diagnostic procedures and therapeutic-interventional techniques. The performance figures were significantly higher in the specialist pulmonary hospital (specialist pulmonary hospitals: 62%: >2000 bronchoscopies/year; university hospitals: 25%: >2000 bronchoscopies/year; p<0.001). In the practice setting (n=21, partly in co-operation with hospitals) , <500 bronchoscopies/year were performed.Intensive care units were available in 97% of the hospitals; 88% of the hospitals had fluoroscopy facilities in the bronchoscopy room. Propofol (91%) and/or midazolam (62%) were the preferred drugs for sedation. At 21% of the sites, >200 bronchoscopies under ventilation/year were performed. BAL and transbronchial forceps biopsies were mainly performed via the nasal or oral approach, EBUS-TBNA via a bronchoscopy tube or the oral approach, the EBUS mini-probe/navigation, cryotechnique or more complex interventions via the rigid tube or a bronchoscopy tube. ASA >2 led to involvement of a second physician at 46% of clinical sites, at 47% of sites at an ASA classification >3.</p><p><strong>Conclusion: </strong>The majority of bronchoscopic examinations are performed in respiratory departments at secondary care centres as well as maximum care hospitals. For more complex procedures, cooperation with hospitals specialized in bronchoscopy (e.g. university hospital or a specialist lung clinic) is advisable.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"206-215"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786506","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}