Pneumologie最新文献

{"title":"[Maternity protection in pneumology: considerations for a positive list].","authors":"Christine Ganzert, Sabine Darius, Irina Böckelmann","doi":"10.1055/a-2438-0418","DOIUrl":"10.1055/a-2438-0418","url":null,"abstract":"<p><p>It seems difficult to continue to employ expectant/breastfeeding mothers in interventional medical fields due to numerous risks involved, such as in handling infectious agents or anaesthetic gases. Pregnancy for female doctors is thus often associated with a ban on employment and is therefore synonymous with a delay in their professional career. The aim of this article was to develop a positive list that allows pregnant women to continue working during their pregnancy at low risk and provides employers with a guide for drawing up risk assessment for specific occasions. The brief narrative overview is based on the recommendations drawn up by both professional associations and the Maternity Protection Committee. It is intended to provide assistance for the preparation of an event-related risk assessment after notification of a pregnancy in the speciality of pneumology in order to be able to continue to employ female doctors working in interventional medicine at low risk.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"221-228"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605997","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":"Glucocorticoid-Induced Adrenal Insufficiency in Sarcoidosis Patients with Long-term Glucocorticoid Therapy.","authors":"Roman Düvel, Vanessa Marggraf, Carmen Pizarro, Leonie Biener, Wiebke Fenske, Charlotte Fries, Georg Nickenig, Christian Grohé, Dirk Skowasch","doi":"10.1055/a-2510-9851","DOIUrl":"10.1055/a-2510-9851","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"202-205"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459292","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":"[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":"̎ Living well with COPD ̎ – wie Telemonitoring die Patientenversorgung verbessert und Krankenhäuser entlastet.","authors":"A Korionova, S Zundel","doi":"10.1055/a-2589-5532","DOIUrl":"https://doi.org/10.1055/a-2589-5532","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":"79 S 01","pages":"e1"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050441","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":"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":"[Management of Malignant Pleural Effusion].","authors":"Christopher Larisch, Julia Riedel, Hans-Stefan Hofmann, Michael Ried","doi":"10.1055/a-2497-5902","DOIUrl":"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}

{"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":"[Role of red blood cell (RBC) transfusions in patients with prolonged mechanical ventilation during weaning process].","authors":"Henry Schäfer, Jan Edel, Carlos Martinez, Christopher Wallenhorst, Alfred Hellstern","doi":"10.1055/a-2368-3815","DOIUrl":"10.1055/a-2368-3815","url":null,"abstract":"<p><strong>Aim: </strong>Patients undergoing long-term ventilation often show anemia. The aim of the study was to investigate the duration and success of weaning from mechanical ventilation in patients with RBC transfusion.</p><p><strong>Methods: </strong>A retrospective analysis of patient data from a weaning unit was performed. Transfused and non-transfused patients were matched using a propensity score. Of the 249 patients in the database, 31 transfused and the same number of non-transfused cases with similar disease severity as measured by the Simplified Acute Physiology Score (SAPS) could be analyzed. Additional sensitivity analyses were performed.</p><p><strong>Results: </strong>In the group of transfused patients, the difference in weaning duration was longer than in non-transfused patients (1.35 days and 3.26 days, respectively). Weaning success also varied. The risk of weaning failure was twice as high in the group of transfused patients. The groups also differed in terms of mortality, 25.8% of the transfused patients died, while in the non-transfused patients the mortality rate was 6.5%. The risk of death was increased in patients who received RBC transfusion. The differences were not statistically significant.</p><p><strong>Conclusion: </strong>A high proportion of patients with prolonged mechanical ventilation have anemia. RBC transfusion does not improve their prognosis. The need for transfusion is associated with higher mortality and longer duration of weaning in this population. The indication for RBC transfusion should therefore be restrictive.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"123-133"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293694","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}