PneumologiePub Date : 2024-05-01DOI: 10.1055/a-1854-2693
André P Becker, Sebastian Mang, Torben M Rixecker, Philipp M Lepper
{"title":"[COVID-19 in the intensive care unit].","authors":"André P Becker, Sebastian Mang, Torben M Rixecker, Philipp M Lepper","doi":"10.1055/a-1854-2693","DOIUrl":"https://doi.org/10.1055/a-1854-2693","url":null,"abstract":"The acute respiratory failure as well as ARDS (acute respiratory distress syndrome) have challenged clinicians since the initial description over 50 years ago. Various causes can lead to ARDS and therapeutic approaches for ARDS/ARF are limited to the support or replacement of organ functions and the prevention of therapy-induced consequences. In recent years, triggered by the SARS-CoV-2 pathogen, numerous cases of acute lung failure (C-ARDS) have emerged. The pathophysiological processes of classical ARDS and C-ARDS are essentially similar. In their final stages of inflammation, both lead to a disruption of the blood-air barrier. Treatment strategies for C-ARDS, like classical ARDS, focus on supporting or replacing organ functions and preventing consequential damage. This article summarizes the treatment strategies in the intensive care unit.","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141043171","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}
PneumologiePub Date : 2024-05-01DOI: 10.1055/a-2196-8772
{"title":"Obstruktive Schlafapnoe: Aroxybutynin und Atomoxetin sicher und wirksam?","authors":"","doi":"10.1055/a-2196-8772","DOIUrl":"https://doi.org/10.1055/a-2196-8772","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141045798","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}
PneumologiePub Date : 2024-04-26DOI: 10.1055/a-2310-1887
Carolina Fischer, Rainald Fischer, Anne-Marie Kirsten, Rolf Holle, Klaus Klütsch, Cosmina Stoleriu, Ralf Göres, Konrad Schultz, Kathrin Kahnert, Peter Alter, Dennis Nowak, Rudolf Jörres
{"title":"[Development of two questionnaires for the assessment of knowledge and self-management in patients with chronic-obstructive pulmonary disease (COPD)].","authors":"Carolina Fischer, Rainald Fischer, Anne-Marie Kirsten, Rolf Holle, Klaus Klütsch, Cosmina Stoleriu, Ralf Göres, Konrad Schultz, Kathrin Kahnert, Peter Alter, Dennis Nowak, Rudolf Jörres","doi":"10.1055/a-2310-1887","DOIUrl":"https://doi.org/10.1055/a-2310-1887","url":null,"abstract":"<p><strong>Introduction: </strong>As with other chronic diseases, the course of chronic obstructive pulmonary disease (COPD) can be expected to be positively influenced if patients are well informed about their disease and undertake appropriate self-management. Assessments of the level of knowledge and management that are comparable should benefit from structured, systematically developed questionnaires. These, however, have not been published in Germany.</p><p><strong>Methods: </strong>A total of 310 patients with COPD were recruited from three pneumological practices and one hospital to develop the questionnaires. Based on statistical criteria and content assessments by medical specialists, two questionnaires on knowledge (17 questions) and self-management (25 questions) were developed by selecting and modifying questions from published studies and training programs. In addition, two short versions with 5 and 3 questions were created to enable a quick assessment of the patients' knowledge and self-management. All questionnaires also included a visual analogue scale for self-assessment of knowledge and self-management. The statistical procedures for systematically guided selection comprised correlation and regression analyses.</p><p><strong>Results: </strong>The questionnaires revealed considerable knowledge deficits in many patients and remarkably unsystematic, incoherent knowledge. The extent of this knowledge was negatively correlated with higher age and positively correlated with participation in training programs; this also applied to self-management. Correlations between the answers to the knowledge questions were higher in patients who had participated in training programs. The visual analogue scales for self-assessment of knowledge and management always correlated with the total number of correct answers.</p><p><strong>Discussion: </strong>The questionnaires on knowledge and self-management in patients with COPD could be used in outpatient settings, including by non-medical staff, in order to quickly identify and correct deficits or as a reason to recommend training programs. The short versions and the analogue scales for self-assessment can give at least first hints. Potentially, training programs should focus more on promoting the coherence of knowledge through better understanding, as this presumably favors long-term knowledge. Older patients and those with a low level of education appear to be particularly in need of specially adapted training programs.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851032","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}
PneumologiePub Date : 2024-04-24DOI: 10.1055/a-2291-0560
Michael Westhoff, Andres Arias, Patrick Litterst
{"title":"Hepatitis E and diaphragmatic dysfunction: Case series and review of the literature.","authors":"Michael Westhoff, Andres Arias, Patrick Litterst","doi":"10.1055/a-2291-0560","DOIUrl":"https://doi.org/10.1055/a-2291-0560","url":null,"abstract":"INTRODUCTION\u0000The causes of diaphragmatic paresis are manifold. An association between neuralgic amyotrophy (NA) and hepatitis E virus (HEV) infection has been reported. We wondered about the prevalence of diaphragmatic disfunction and hepatitis E infection in our clinic.\u0000\u0000\u0000METHODS\u0000From July 1st, 2020 to August 31st, 2023, patients presenting with diaphragmatic dysfunction and simultaneous clinical symptoms of an acute NA, or a history of NA, as well as patients with previously unexplained diaphragmatic dysfunction were examined for HEV infection.\u0000\u0000\u0000RESULTS\u0000By August 31st, 2023, 13 patients with diaphragmatic dysfunction and HEV infection were diagnosed (4 women, 9 men). Mean age was 59 ± 10 years. Liver values were normal in all patients. The median latency to diagnosis was five months (range: 1-48 months); nine patients, 4 of them with typical symptoms of NA, presented with acute onset three patients showed bilateral diaphragmatic dysfunction. All patients had a positive IgG immunoblot. Seven patients, three with NA, had an elevated hepatitis E IgM titer and six of them also a positive IgM immunoblot. In all cases, O2C hepatitis genotype 3 was identified. In eight cases, all those with a high IgG titer >125, the O2 genotype 1 was also detected.\u0000\u0000\u0000CONCLUSION\u0000NA that shows involvement of the phrenic nerve resulting in diaphragmatic dysfunction and dyspnoea, may be associated with HEV infection. The observation of 13 patients with diaphragmatic dysfunctions and HEV infection within a period of three years indicates a high number of undetected HEV-associated diaphragmatic dysfunction in the population, especially in the absence of NA symptoms. Therefore, even in diaphragmatic dysfunction without NA symptoms and causative damaging event, HEV infection should be considered, as it may represent a subform of NA with only phrenic nerve involvement. Therapy of HEV-associated diaphragmatic dysfunction in the acute phase is an open question. In view of the poor prognosis for recovery, antiviral therapy should be discussed. However, no relevant data are currently available.","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140659534","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}
PneumologiePub Date : 2024-04-24DOI: 10.1055/a-2293-1235
Ulrich Koehler, Andreas Weissflog
{"title":"[The experimental physiologist Carl Ludwig (1816-1895): Scientific genius - modest, selfless, unswerving!]","authors":"Ulrich Koehler, Andreas Weissflog","doi":"10.1055/a-2293-1235","DOIUrl":"https://doi.org/10.1055/a-2293-1235","url":null,"abstract":"Carl Ludwig was, besides Johannes Müller, one of the most prolific natural scientists of the 19th century. Carl Ludwig believed that the function of organs can be ascribed to the laws of physics and chemistry and that only through repeatable physiological experiments can hypotheses be verified. Ludwig has laid the technological foundations for experimental physiology. The \"kymographion\", (waves-recorder), the \"stromuhr\" and the blood gas pump are some of his developments that underline this fact. Together with his students he performed fundamental experiments to gain better understanding of renal physiology and pulmonary physiology, cardiovascular circulatory and innervation, as well as glandular secretion and the lymphatic system. For decades, Ludwig's two-volume textbook on the human physiology was standard work in scientific and experimental physiology. Many young scientists from all over the world ventured to Leipzig to be taught experimental physiology by Ludwig.","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140660674","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}
PneumologiePub Date : 2024-04-01DOI: 10.1055/a-2278-4661
N. Frost, Claas Wesseler, Bernhard Wörmann, Wilfried Ernst Erich Eberhardt
{"title":"[Criteria for inpatient diagnostic and treatment of patients with lung cancer, mesothelioma or thymoma].","authors":"N. Frost, Claas Wesseler, Bernhard Wörmann, Wilfried Ernst Erich Eberhardt","doi":"10.1055/a-2278-4661","DOIUrl":"https://doi.org/10.1055/a-2278-4661","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140781250","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}
PneumologiePub Date : 2024-04-01Epub Date: 2023-12-14DOI: 10.1055/a-2215-2937
Ulrich Koehler, Mikail Aykut Degerli, Regina Conradt, Olaf Hildebrandt, Niklas Koehler, Wulf Hildebrandt
{"title":"[The search for the \"node of life\": breathing regulation].","authors":"Ulrich Koehler, Mikail Aykut Degerli, Regina Conradt, Olaf Hildebrandt, Niklas Koehler, Wulf Hildebrandt","doi":"10.1055/a-2215-2937","DOIUrl":"10.1055/a-2215-2937","url":null,"abstract":"<p><p>The article provides a historical overview of developments in the understanding of respiratory rhythm and its control mechanisms over the last two centuries. In the 19<sup>th</sup> century, a structure in the medulla oblongata was first described as the \"node of life\". In 1743, Taube discovered the carotid body, and in 1927 the Spaniard de Castro described its morphology and innervation. It was only with the work of father and son Heymans that the physiological and pharmacological significance of the carotid and aortic body was recognized. Today we understand that the generation and control of respiration are mediated by a complex neuronal network in the brainstem. Chemo-, mechano- and proprioreceptos convey information from blood, airways and muscles to the control centre. The respiratory centre integrates the afferent input from the receptors, the autonomic nervous system, the cardiovascular system, and voluntary input from the cerebral cortex to modulate the degree of respiratory activation of motoneurons and respiratory muscles.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138808867","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}
PneumologiePub Date : 2024-04-01DOI: 10.1055/a-2284-6868
{"title":"Pleuramesotheliom: Tumordicke als Prädiktor für Remission und Überleben","authors":"","doi":"10.1055/a-2284-6868","DOIUrl":"https://doi.org/10.1055/a-2284-6868","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140769942","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}