Pneumologie最新文献

{"title":"[Management of adult bronchiectasis - Consensus-based Guidelines for the German Respiratory Society (DGP) e. V. (AWMF registration number 020-030)].","authors":"Felix C Ringshausen, Ingo Baumann, Andrés de Roux, Sabine Dettmer, Roland Diel, Monika Eichinger, Santiago Ewig, Holger Flick, Leif Hanitsch, Thomas Hillmann, Rembert Koczulla, Michael Köhler, Assen Koitschev, Christian Kugler, Thomas Nüßlein, Sebastian R Ott, Isabell Pink, Mathias Pletz, Gernot Rohde, Ludwig Sedlacek, Hortense Slevogt, Urte Sommerwerck, Sivagurunathan Sutharsan, Sönke von Weihe, Tobias Welte, Michael Wilken, Jessica Rademacher, Pontus Mertsch","doi":"10.1055/a-2311-9450","DOIUrl":"https://doi.org/10.1055/a-2311-9450","url":null,"abstract":"<p><p>Bronchiectasis is an etiologically heterogeneous, chronic, and often progressive respiratory disease characterized by irreversible bronchial dilation. It is frequently associated with significant symptom burden, multiple complications, and reduced quality of life. For several years, there has been a marked global increase in the prevalence of bronchiectasis, which is linked to a substantial economic burden on healthcare systems. This consensus-based guideline is the first German-language guideline addressing the management of bronchiectasis in adults. The guideline emphasizes the importance of thoracic imaging using CT for diagnosis and differentiation of bronchiectasis and highlights the significance of etiology in determining treatment approaches. Both non-drug and drug treatments are comprehensively covered. Non-pharmacological measures include smoking cessation, physiotherapy, physical training, rehabilitation, non-invasive ventilation, thoracic surgery, and lung transplantation. Pharmacological treatments focus on the long-term use of mucolytics, bronchodilators, anti-inflammatory medications, and antibiotics. Additionally, the guideline covers the challenges and strategies for managing upper airway involvement, comorbidities, and exacerbations, as well as socio-medical aspects and disability rights. The importance of patient education and self-management is also emphasized. Finally, the guideline addresses special life stages such as transition, family planning, pregnancy and parenthood, and palliative care. The aim is to ensure comprehensive, consensus-based, and patient-centered care, taking into account individual risks and needs.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":"78 11","pages":"833-899"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606010","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":"[Valsalva and Müller maneuvers: who is who and what is what?]","authors":"Ulrich Koehler, Mikail Aykut Degerli, Olaf Hildebrandt, Wulf Hildebrandt, Heike Korbmacher-Steiner, Peter von Wichert, Thomas Podszus","doi":"10.1055/a-2349-1034","DOIUrl":"10.1055/a-2349-1034","url":null,"abstract":"<p><p>The original Valsalva manoeuvre (VM) was described in detail by the Italian anatomist, physician and surgeon Antonio Maria Valsalva (1666-1723). The VM consists of a voluntary forced expiratory effort against a closed upper airway. It was used tradionally in otolaryngology for testing the openess of the eustachian tubes and expelling pus/fluid from the middle to the external ear. VM is associated with increased intrathoracic and -abdominal pressure and leads to hemodynamic changes. The use of VM for cardiovascular purposes was first described by Eduard Friedrich Weber, a German physiologist. The Müller manoeuvre (MM) represents the opposite of the VM by forced inspiration against a closed upper airway. Negative intrathoracic and abdominal pressure (ITP) with direct effects on cardiac function and hemodynamics can be generated by the MM. MM has also been used to simulate the hemodynamic effects of negative ITP in obstructive sleep apnea patients. The Müller manoeuvre was first described by the German anatomist and physician Johannes Müller (1801-1858).</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"929-934"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601352","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":"Bodyplethysmografie und forcierte Spirometrie – Schritt für Schritt.","authors":"Stefan Karrasch, Rudolf A Jörres","doi":"10.1055/a-2267-9510","DOIUrl":"https://doi.org/10.1055/a-2267-9510","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":"78 11","pages":"922-928"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606020","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":"Ist die VATS tatsächlich der Goldstandard in der Diagnostik des malignen Mesothelioms?","authors":"Hermann Tonn","doi":"10.1055/a-2325-6578","DOIUrl":"https://doi.org/10.1055/a-2325-6578","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":"78 11","pages":"829"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605958","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":"Validation of the German version of the Asthma Impairment and Risk Questionnaire (AIRQ).","authors":"Frank Kanniess, Kerstin Defosse, Marek Lommatzsch, Thomas Schultz, Hartmut Timmermann, Olaf Schmidt, Stefan Heindl, Hans Jörg Baumann, Roland Buhl, Christian Taube, Fabian Höing, Stephanie Korn","doi":"10.1055/a-2346-9840","DOIUrl":"10.1055/a-2346-9840","url":null,"abstract":"<p><strong>Background: </strong>The Asthma Impairment and Risk Questionnaire (AIRQ), a 10-item, equally weighted, yes/no tool assessing symptom impairment and risk of exacerbations in patients with asthma aged ≥12 years, was developed and validated in a US patient population to evaluate varying levels of asthma control. This study aimed to validate the German language version of the AIRQ in patients aged ≥12 years with different levels of asthma control.</p><p><strong>Methods: </strong>A cross-sectional, observational, multi-centre study comprising a single visit was conducted in multiple specialised asthma centres and general practices in Germany. A total of 300 patients completed the following measures: 1) Patient Sociodemographic and Clinical Questionnaire, 2) AIRQ, 3) Asthma Control Test (ACT), and 4) Asthma Control Questionnaire (ACQ-6). Logistic regression analyses were conducted to assess the AIRQ score cut points with the greatest predictive validity in discriminating between different control levels relative to a standard of ACT plus prior-year exacerbations or ACQ-6 plus prior-year exacerbations.</p><p><strong>Results: </strong>The German version of the AIRQ demonstrated a robust capability to correctly identify well-controlled versus not well- or very poorly controlled (AUC values of 0.90 or higher) and well- or not well-controlled versus very poorly controlled asthma (AUC values of 0.89 or higher).</p><p><strong>Conclusions: </strong>The German version of the AIRQ is a suitable tool to identify adults with varying levels of asthma control, which in turn can help to accurately identify patients with uncontrolled asthma in clinical practice.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"912-921"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591144","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":"[Comparison of hospitalized patients with SARS-CoV-2 infection in two time periods of the pandemic].","authors":"Jan Eberhard Strehl, Santiago Ewig, Bernhard Schaaf","doi":"10.1055/a-2235-0214","DOIUrl":"10.1055/a-2235-0214","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the investigation was to compare patients hospitalized with SARS-CoV-2 infection during 2020/2021 and 2022 with respect to the reason for hospitalization as well as severity of disease at admission, during follow-up and clinical outcomes.</p><p><strong>Methods: </strong>The data of all patients patients hospitalized with SARS-CoV-2 infection during the periods of interest were collected. Severity of disease at admission and during follow-up was compared in all patients who were hospitalized because of SARS-CoV-2 infection.</p><p><strong>Results: </strong>During the period of 2020 to 2021, overall n=1281 patients with SARS-CoV-2 infection were hospitalized as compared to n=580 in 2022. Of these, 90% and 42%, respectively, were admitted because of SARS-CoV-2 infection. The rates of nosocomial transmission increased from 5 to 18%. Severity of disease at admission and during follow-up was higher across all age groups in the first period. More patients were admitted to the ICU (25 versus 4%). Accordingly, hospital mortality was higher (17 versus 10%). Intubated patients had a high mortality of 74 and 80%, respectively, in both periods.</p><p><strong>Conclusions: </strong>The severity at admission and during follow-up was much higher in the first period. In the second period, the burden of health care systems was only in part driven by disease severity but more by the need for isolation and nosocomial infections. Mortality of intubated patients was high.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"785-792"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913264","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":"[DGP Congress 2024 - Key takeaways of keynote lectures: Pneumonology, future- and prevention-oriented, is blossoming].","authors":"Michael Kreuter, Wolfram Windisch, Hubert Schädler","doi":"10.1055/a-2370-1868","DOIUrl":"10.1055/a-2370-1868","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"689-692"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894022","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":"Nicht invasive Beatmung und High-Flow-Therapie: Lebensretter nicht nur bei COPD.","authors":"Felix Bronisch, Thomas Gude, F Joachim Meyer","doi":"10.1055/a-2381-1408","DOIUrl":"https://doi.org/10.1055/a-2381-1408","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":"78 10","pages":"793-810"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472851","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":"[Implementation of smoking cessation in the workflow of a lung cancer screening program in Germany - A Position Paper of the German Respiratory Society (DGP)].","authors":"Alexander Rupp, Sebastian Sohrab, Wulf Pankow, Matthias Raspe, Daniel Kotz, Christa Rustler, Torsten Gerriet Blum, Torsten Bauer, Wolfram Windisch, Stefan Andreas","doi":"10.1055/a-2363-5780","DOIUrl":"10.1055/a-2363-5780","url":null,"abstract":"<p><p>Both tobacco cessation and low-dose CT screening in at-risk individuals reduce lung cancer-specific and all-cause mortality. As part of a national screening program for the early detection of lung cancer, smoking cessation must be a mandatory part of the counseling given to participants. This increases the cost-benefit effectiveness of the screening program. As part of the initial consultation evidence-based measures for smoking cessation must be offered to smoking participants of the screening program in form of a minimal intervention. If participants do not want to participate in a quit smoking measure they must actively refuse (opt-out rule). The costs of quitting smoking, including the costs of withdrawal-inhibiting medication, have to be fully covered by statutory health insurance for participants in the lung cancer screening program.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"612-619"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634297","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":"Prediction of nocturnal ventilation by pulmonary function testing in patients with amyotrophic lateral sclerosis.","authors":"Friederike Tress, Eva Luecke, Sabine Stegemann-Koniszewski, Anke Lux, Abhinav Singla, Jens Schreiber","doi":"10.1055/a-2349-0936","DOIUrl":"10.1055/a-2349-0936","url":null,"abstract":"<p><strong>Background: </strong>In amyotrophic lateral sclerosis (ALS) prognosis is poor due to progressive weakening of the respiratory muscles. Survival and quality of life can be improved by noninvasive ventilation (NIV), which is initially applied while sleeping. The indication for NIV is based on pulmonary function testing (PFT) and polysomnography (PSG) with capnography (tCO₂). While it is desirable to predict nocturnal ventilation by waking PFT in ALS, the parameters suited for reliable predictions remain elusive.</p><p><strong>Methods: </strong>We retrospectively analyzed parameters derived from PFT (spirometry, body plethysmography, diffusion capacity, respiratory muscle testing) and blood gas analysis, PSG and tCO₂ in 42 patients with ALS (27 men, 15 women, age 69 ± 12.1 years) and performed Spearman's correlation analysis of daytime waking parameters and nighttime sleep parameters.</p><p><strong>Results: </strong>28 patients (66.7%) showed restrictive impairment of ventilation and 15 patients (48.3%) showed insufficiency of the respiratory musculature. There was no obstructive impairment of ventilation. We did not observe any significant correlations between any single daytime PFT parameter with nocturnal pCO₂. However, there were significant correlations between the ratios PIF/PEF, MEF50/MIF50, DLCO/VA as well as FEV₁/FVC and nocturnal pCO₂. Highly normal FEV₁/FVC and Krogh-Factor (DLCOc/VA) indicated nocturnal hypercapnia. Furthermore, waking hypercapnia, concentrations of bicarbonate and base excess were each positively correlated with nocturnal hypercapnia.</p><p><strong>Conclusions: </strong>Waking PFT is not a good predictor of nocturnal ventilation. Inspiratory parameters as well as the ratios FEV₁/FVC and DLCO/VA performed best and should be included in the interpretation. Our analyses confirm the relevance of inspiratory muscle weakness in ALS. PSG and tCO₂ remain the gold standard for the assessment of nocturnal ventilation.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"626-633"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856284","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}