Karger Kompass Pneumologie最新文献

{"title":"Kaleidoskop","authors":"Ralf Mohr","doi":"10.1159/000505307","DOIUrl":"https://doi.org/10.1159/000505307","url":null,"abstract":"Laut Robert-Koch-Institut waren die Influenza-Vakzinen für das Jahr 2018/2019 nur zu etwa 20% effektiv. Neue antiinfektive Wirkstoffe und Therapiekonzepte soll nun das Projekt iCAIR ® (Fraunhofer International Consortium for Anti-Infective Research) entwickeln, insbesondere für das InfluenzaVirus, das Parainfluenza-Virus, die Bakterien Pseudomonas aeruginosa und Neisseria meningitidis sowie für den Pilz Aspergillus fumigatus. Der Anspruch des Konsortiums: Neue Wirkstoffe sollen schnellstmöglich vom Labor in die präklinische Phase überführt werden. Das Fraunhofer-Institut für Toxikologie und Experimentelle Medizin ITEM verfügt über spezielle Testsysteme, um WirkstoffkandiKompass Pneumol 2020;8:53–56 DOI: 10.1159/000505307","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116861590","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":"Malignes Mesotheliom: Die diagnostische Aussagekraft einer Computertomographie kritisch hinterfragen","authors":"S. Keymel","doi":"10.1159/000504462","DOIUrl":"https://doi.org/10.1159/000504462","url":null,"abstract":"Background: Medical history, thoracentesis, and imaging features are usually the first steps in the investigation of a possible malignant pleural effusion (MPE). Unfortunately, the diagnostic yield of thoracentesis in this situation is suboptimal even if the procedure is repeated, especially in the context of malignant pleural mesothelioma (MPM). The next step for confirming the diagnosis, if clinically appropriate, is thoracoscopy, but not all patients are fit to undergo this procedure, so the diagnosis is then based on the medical history and imaging features only. Objectives: Our objective was to evaluate the diagnostic value of the medical history and imaging features in MPM. Methods: We reviewed the imaging and medical charts of 92 patients with a final diagnosis of MPE included in our prospective medical thoracoscopy database. The clinical characteristics and imaging features of patients with primary MPE were compared with those of patients with secondary MPE. Results: Male sex (82 vs. 59%, p = 0.02), asbestos exposure (58 vs. 10%, p < 0.001), and mediastinal (68 vs. 33%, p = 0.04), diaphragmatic (75 vs. 31%, p = 0.001) and circumferential pleural thickening (55 vs. 19% p = 0.001) were significantly more frequent in MPM patients. In a multivariate linear regression model, only asbestos exposure (OR 11.2; 95% CI 3.4-36.9) and circumferential pleural thickening (OR 4.7; 95% CI 1.6-13.9) were significantly associated with a diagnosis of MPM. Conclusion: In situations where it is impossible to obtain adequate pleural samples to differentiate MPM from a secondary pleural malignancy, the combination of circumferential pleural thickening and a history of asbestos exposure may be sufficient to make a clinical diagnosis.","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122417588","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":"PharmaNews","authors":"","doi":"10.1159/000506172","DOIUrl":"https://doi.org/10.1159/000506172","url":null,"abstract":"Patienten mit interstitiellen Lungenerkran­ kungen (ILDs) haben ein hohes Risiko, eine Lungenfibrose zu entwickeln, die ihre Le­ bensqualität stark beeinträchtigt und mit einer schlechten Prognose einhergeht [1–4]. Eine zugelassene Behandlungsoption steht für die idiopathische Lungenfibrose (IPF) zur Verfügung, während andere Lungenfi­ brosen bislang nicht zielgerichtet therapiert werden können [1, 5, 6]. Die positiven klini­ schen Erfahrungen bei IPF waren zusammen mit präklinischen Studien die Rationale, um Nintedanib* bei weiteren ILDs zu unter­ suchen, für die Nintedanib* gegenwärtig nicht zugelassen ist. In der Phase­III­Studie INBUILD® konnte Nintedanib* erstmals bei vielen unterschiedlichen progredient verlau­ fenden, fibrosierenden ILDs den Krankheits­","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126754052","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":"Pneumologie präzisieren und personalisieren: Perspektiven und Grenzen","authors":"P. Haidl","doi":"10.1159/000505418","DOIUrl":"https://doi.org/10.1159/000505418","url":null,"abstract":"","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131904311","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":"Fallbericht zu schweren multiplen Bronchusstenosen bei einem Patienten, der ‹das Unüberlebbare überlebte›","authors":"Thomas Crowhurst, Joshua Lightfoot, Aeneas Yeo, Benjamin Reddi, Phan Nguyen, Helen Whitford, Chien-Li Holmes-Liew","doi":"10.1159/000505086","DOIUrl":"https://doi.org/10.1159/000505086","url":null,"abstract":"Hintergrund: In der Literatur werden nur wenige Fälle von multiplen Bronchusstenosen beschrieben, und keiner von vergleichbarer Schwere wie der unsere. Dieser Fall ist von Relevanz aufgrund seiner Seltenheit, der zu gewinnenden pathophysiologischen Erkenntnisse, der erfolgreich angewandten interventionell-pneumologischen Behandlungsstrategien, und seiner möglichen Beispielrolle für eine seltene Indikation für eine Hochrisiko-Lungentransplantation. Vorstellung des Falls: Bei einem 47-jährigen Mann traten multiple rezidivierende netzartige Bronchusstenosen auf, 5 Wochen nachdem er eine Episode schwerer Tracheobronchitis durchgemacht hatte, die vermutlich durch eine chemische Inhalationsverletzung verursacht worden war und zunächst zum vollständigen bilateralen Lungenkollaps geführt und eine veno-venöse extrakorporale Membranoxygenierung erforderlich gemacht hatte. Die Stenosen verschlossen die Bronchien an vielen Stellen vollständig und verursachten schwere Typ-II-Ateminsuffizienz, sodass maschinelle Beatmung und eine bronchoskopische Punktion und Dilatation sowie letztlich eine bilaterale Lungentransplantation vorgenommen wurden. Schlussfolgerung: Dieser sehr seltene Fall unterstreicht die Folgemorbidität, die eine verheerende Tracheobronchitis nach sich ziehen kann, wenngleich sie heute im Zeitalter der extrakorporalen Membranoxygenierung kurzfristig überlebt werden kann.","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130780161","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":"Ambulant erworbene Pneumonie: Komorbiditäten als Risikofaktoren erkennen","authors":"S. Krüger","doi":"10.1159/000504461","DOIUrl":"https://doi.org/10.1159/000504461","url":null,"abstract":"Background: UK specific data on the risk of developing hospitalised CAP for patients with underlying comorbidities is lacking. This study compared the likelihood of hospitalised all-cause community acquired pneumonia (CAP) in patients with certain high-risk comorbidities and a comparator group with no known risk factors for pneumococcal disease. Methods: This retrospective cohort study interrogated data in the Hospital Episodes Statistics (HES) dataset between financial years 2012/13 and 2016/17. In total 3,078,623 patients in England (aged ≥18 years) were linked to their hospitalisation records. This included 2,950,910 individuals with defined risk groups and a comparator group of 127,713 people who had undergone tooth extraction with none of the risk group diagnoses. Risk groups studied were chronic respiratory disease (CRD), chronic heart disease (CHD), chronic liver disease (CLD), chronic kidney disease (CKD), diabetes (DM) and post bone marrow transplant (BMT). The patients were tracked forward from year 0 (2012/13) to Year 3 (2016/17) and all diagnoses of hospitalised CAP were recorded. A Logistic regression model compared odds of developing hospitalised CAP for patients in risk groups compared to healthy controls. The model was simultaneously adjusted for age, sex, strategic heath authority (SHA), index of multiple deprivation (IMD), ethnicity, and comorbidity. To account for differing comorbidity profiles between populations the Charlson Comorbidity Index (CCI) was applied. The model estimated odds ratios (OR) with 95% confidence intervals of developing hospitalised CAP for each specified clinical risk group.Results: Patients within all the risk groups studied were more likely to develop hospitalised CAP than patients in the comparator group. The odds ratios varied between underlying conditions ranging from 1.18 (95% CI 1.13, 1.23) for those with DM to 5.48 (95% CI 5.28, 5.70) for those with CRD. Conclusions: Individuals with any of 6 pre-defined underlying comorbidities are at significantly increased risk of developing hospitalised CAP compared to those with no underlying comorbid condition. Since the likelihood varies by risk group it should be possible to target patients with each of these underlying comorbidities with the most appropriate preventative measures, including immunisations.","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129887087","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":"Veranstaltungskalender","authors":"","doi":"10.1159/000505351","DOIUrl":"https://doi.org/10.1159/000505351","url":null,"abstract":"","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129975197","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":"Inhalt","authors":"I. Einleitung","doi":"10.1159/000506169","DOIUrl":"https://doi.org/10.1159/000506169","url":null,"abstract":"III. Was ist Gesundheitsmanagement?.............................................................................. 6 III.1 Ziele des dienststelleninternen Gesundheitsmanagements.................................................. 6 III.2 Prinzipien und Qualitätskriterien des Gesundheitsmanagements ....................................... 7 III.2.1 Ganzheitlichkeit .............................................................................................................. 7 III.2.2 Partizipation .................................................................................................................... 7 Eine weiterer Aspekt von Partizipation ist Transparenz. Nur wenn über Ziele und Inhalte von Gesundheitsmanagement ausführlich informiert wird und „Gesundheit” in der Dienststelle zum Thema gemacht wird, können Mitarbeiterinnen und Mitarbeiter sowie Führungskräfte zur Mitwirkung und Unterstützung von Gesundheitsmanagement motiviert werden. ..............................?? III. 2.3 Integration und Projektorganisation ........................................................................... 8 III. 2.4 Qualitätskriterien ........................................................................................................... 8 III. 2.5 Gender Mainstreaming.................................................................................................. 9","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133158183","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":"Veranstaltungskalender","authors":"","doi":"10.1159/000504161","DOIUrl":"https://doi.org/10.1159/000504161","url":null,"abstract":"","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126055718","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 kleinzelliges Lungenkarzinom bei älteren Patienten: Einfluss von Lobektomie oder sublobärer Resektion auf die Prognose","authors":"K. Hekmat","doi":"10.1159/000504031","DOIUrl":"https://doi.org/10.1159/000504031","url":null,"abstract":"Background: We present a critical comparison of lobectomy and sub-lobar resection in elderly patients with early stage non-small cell lung cancer using meta-analytical techniques. Methods: A literature search was conducted between the period of December 1997 to March 2019 to identify the comparative studies evaluating 1-, 3-, and 5-year survival rates. The pooled odds ratios (OR) and the 95% confidence intervals (95% CI) were calculated with either the fixed or random effect models, respectively. Results: Six retrospective studies are included in our meta-analysis for a total of 1205 patients. 843 of the individuals were treated with lobectomy, while 362 were treated with sub-lobar resection. We found no significant difference between the lobectomy and the sub-lobar resection in either of the 1-, 3-, or 5-year survival rates. Conclusions: This study suggests that in elderly individuals with stage I NSCLC, a sub-lobar resection is statistically equivalent to the lobectomy in terms of 1-, 3-, and 5-year survival rates. Further large-scale randomized studies are needed to confirm our results.","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129912265","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}