THERAPEUTISCHE UMSCHAU最新文献

{"title":"[Non-invasive diagnostic imaging for coronary artery disease: choosing the right test for the right patient].","authors":"Aju P Pazhenkottil, Ronny R Buechel, Philipp A Kaufmann, Dominik C Benz, Andreas A Giannopoulos","doi":"10.23785/TU.2026.02.002","DOIUrl":"https://doi.org/10.23785/TU.2026.02.002","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery disease (CAD) remains one of the leading causes of morbidity and mortality worldwide. Accurate, patient-centered, and efficient diagnostic strategies are therefore essential. Beyond clinical history, physical examination, and laboratory testing, cardiac imaging has become increasingly central to both diagnostic evaluation and risk stratification. In recent years, non-invasive imaging modalities for CAD have undergone remarkable technological and methodological advancements. They now play a pivotal role in confirming or excluding obstructive CAD, assessing the functional significance of coronary stenoses, and supporting individualized treatment decision-making. Selecting the most appropriate imaging modality is thus crucial for achieving diagnostic precision and optimal patient management. This article provides a comprehensive overview of the currently available non-invasive imaging techniques, highlights their respective strengths and limitations, and offers practical guidance on choosing the most suitable modality for different patient groups. Particular emphasis is placed on their application in routine clinical practice in Switzerland.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"83 2","pages":"54-63"},"PeriodicalIF":0.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785050","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 in cardiac imaging: status and future developments].","authors":"Christoph Ryffel, Isaac Shiri, Christoph Gräni","doi":"10.23785/TU.2026.02.004","DOIUrl":"https://doi.org/10.23785/TU.2026.02.004","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) has rapidly gained importance in medicine over recent years, particularly in medical imaging. AI is transforming cardiac imaging along the entire workflow - from image acquisition and reconstruction to interpretation and diagnosis. In echocardio-graphy, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine, AI systems have the potential to automatically capture and standardize measurements, reduce noise and artifacts, shorten acquisition and analysis times, and improve reproducibility. Applications range from real-time automated analysis of transthoracic echocardiograms and CT-based calcium scoring and plaque quantification to the detection of rare coronary anomalies, AI-assisted MRI planning and the identification of subtle pathological patterns of cardiac amyloidosis. In the future, multimodal AI models combining imaging, clinical, laboratory, and genetic data will enable highly precise risk stratification and individualized therapies. However, challenges remain in terms of generalizability, prospective validation, explainability, and integration into real-world workflows. Clinical validation, quality control, and physician oversight remain essential cornerstones for the responsible use of AI in cardiac imaging.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"83 2","pages":"75-80"},"PeriodicalIF":0.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785013","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":"[Multimodality imaging in the diagnostic work-up in patients with heart failure in clinical practice].","authors":"Micha T Maeder, Niklas F Ehl, Theresa Dellas Buser, Marc Buser","doi":"10.23785/TU.2026.02.003","DOIUrl":"https://doi.org/10.23785/TU.2026.02.003","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure is clinical syndrome with many different underlying cardiac diseases. The definition of heart failure includes the presence of typical symptoms and the proof of a structural cardiac abnormality, which is responsible for a reduced cardiac output and/or elevated cardiac filling pressures at rest or on exertion. The identification and exact description of the main mechanism of heart failure is key for the introduction of an appropriate treatment, which when appropriately selected improves symptoms and prognosis. In patients with suspected heart failure, a basic assessment including history, physical examination, ECG, measurement of natriuretic peptides, and a comprehensive transthoracic echocardiogram should always be performed. Based on the finding of this initial assessment additional imaging modalities are selected on a case-to-case basis. In this review, we discuss the role of advanced echocardiography techniques, cardiac magnetic resonance imaging, computed tomography, cardiac catheterization and nuclear medicine examinations in this context.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"83 2","pages":"64-74"},"PeriodicalIF":0.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785009","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":"Kardiale Bildgebung.","authors":"Aju P Pazhenkottil","doi":"10.23785/TU.2026.02.001","DOIUrl":"https://doi.org/10.23785/TU.2026.02.001","url":null,"abstract":"<p><strong>Introduction: </strong></p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"83 2","pages":"53"},"PeriodicalIF":0.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784989","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":"[Assessment of valvular heart disease: the role of imaging from diagnosis to intervention].","authors":"Tatiana Peer, Jana Ljubas Maček, Stefan Toggweiler, Simon F Stämpfli","doi":"10.23785/TU.2026.02.005","DOIUrl":"https://doi.org/10.23785/TU.2026.02.005","url":null,"abstract":"<p><strong>Introduction: </strong>Valvular heart disease is common in an aging population and is associated with substantial morbidity and mortality. Modern cardiovascular imaging is central to diagnosis, therapeutic decision-making, and longitudinal follow-up of aortic, mitral, and tricuspid valve disease throughout the entire care pathway - from initial evaluation to specialized intervention. Transthoracic echocardiography (TTE) remains the first-line modality for initial diagnosis and follow-up assessment. Transesophageal echocardiography (TEE) provides detailed morphological evaluation of the valves and is indispensable for surgical and interventional planning, particularly of the atrioventricular valves. Cardiac CT is the current standard for planning transcatheter aortic valve implantation (TAVI) and is gaining importance in percutaneous mitral and tricuspid valve replacement, including simulation-based planning and risk assessment. Cardiac MRI contributes primarily to precise volume quantification and the assessment of ventricular function and myocardial structure. Peri-interventional TEE has become an essential real-time guidance tool in the catheter laboratory, enabling precise device navigation and immediate evaluation of procedural success. The targeted use of complementary imaging modalities is crucial for accurate assessment of valvular pathology, optimal planning and guidance of interventions, and long-term patient follow-up. Imaging is therefore not merely a diagnostic aid but the foundation of modern, increasingly catheter-based valve therapy.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"83 2","pages":"81-89"},"PeriodicalIF":0.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785036","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":"[Mental Health Disorders in Clinical Practice: Taking Appropriate Action and Providing Correct Treatment].","authors":"Wolfram Kawohl","doi":"10.23785/TU.2026.01.001","DOIUrl":"https://doi.org/10.23785/TU.2026.01.001","url":null,"abstract":"<p><strong>Introduction: </strong></p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"83 1","pages":"1-2"},"PeriodicalIF":0.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515474","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":"[Recognising and treating depression - a practical overview of current treatment algorithms and evidence-based recommendations].","authors":"Annette B Brühl, Wolfram Kawohl","doi":"10.23785/TU.2026.01.003","DOIUrl":"https://doi.org/10.23785/TU.2026.01.003","url":null,"abstract":"<p><strong>Introduction: </strong>Depressive syndromes are among the most common mental conditions in primary care. They are associated with high morbidity and relevantly reduced quality of life. General practitioners (GPs) play a central role in early detecting and diagnosing depression as well as in initial treatment. This paper summarises the new Swiss treatment recommendations and gives an overview of evidence-based treatment algorithms with a focus on applicability in primary care. Diagnosis is based on core symptoms of depression. In addition to a structured anamnesis, validated instruments for screening and development of symptoms should be used. Further, somatic causes should be excluded using basic laboratory tests and, if indicated, neuroimaging. Treatment depends on the severity of depression: In mild depression, active monitoring, low-intensity interventions (e. g. self-help strategies, activation, sleep and circadian strategies, physical activity, etc.) and psychotherapy are indicated. In moderate episodes, psychotherapy or antidepressants are indicated; severe episodes require a combination of psychotherapy and antidepressants. First-line antidepressants are SSRIs and SNRIs and other modern antidepressants. In case of non-response, a combination of antidepressants or augmentation with atypical antipsychotics or Lithium is recommended. Psychotherapy has proven efficacy across all severity levels, and it should be combined with antidepressants in severe episodes. In severe, psychotic and difficult to treat depressive episodes, strategies from the field of interventional psychiatry (ECT, rTMS, Esketamine) are effective. Complementary approaches such as physical activity/exercise, light therapy, or social therapy further enhance treatment outcomes. In conclusion, guideline-based multimodal care for patients starting in primary care improves outcome and prognosis for patients with depression and can reduce the risk of chronification and relapses. Key elements are structured diagnostics, early initiation of evidence-based therapy with regular valid monitoring within a strong doctor-patient-relationship.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"83 1","pages":"14-18"},"PeriodicalIF":0.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515525","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":"[Pharmacological post-acute treatment of alcohol use disorder: Established strategies and innovative approaches].","authors":"Patrik Roser","doi":"10.23785/TU.2026.01.006","DOIUrl":"https://doi.org/10.23785/TU.2026.01.006","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol use disorders are common and contribute significantly to the global burden of disease. The treatment of alcohol dependence includes the acute withdrawal phase and the post-acute rehabilitation phase. The primary goal of post-acute treatment is long-term abstinence, although reduction of alcohol consumption is also recognized as an intermediate goal. In addition to psychosocial and psychotherapeutic interventions, the use of medications is recommended. In Switzerland, four medications (acamprosate, naltrexone, nalmefene, and disulfiram) are approved for post-acute treatment. Their efficacy in reducing relapse risk, drinking days, and overall alcohol consumption is well established. Baclofen, topiramate, and gabapentin are used \"off-label\", but sufficient evidence of their effectiveness is still lacking. Innovative approaches such as cannabidiol, psilocybin, and glucagon-like peptide-1 receptor agonists show promising therapeutic potential, which needs to be confirmed in further clinical studies. The use of pharmacological interventions can help improve patient outcomes, reduce the need for inpatient treatment, and lower healthcare costs.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"83 1","pages":"33-37"},"PeriodicalIF":0.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515564","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":"[Optimisation of psychopharmacological treatment strategies by using therapeutic drug monitoring].","authors":"Michael Paulzen, Georgios Schoretsanitis","doi":"10.23785/TU.2026.01.002","DOIUrl":"https://doi.org/10.23785/TU.2026.01.002","url":null,"abstract":"<p><strong>Introduction: </strong>The effect of a (neuro-)psychopharmacological drug is determined by its interaction with its target structure in the brain (pharmacodynamics). A number of pharmacokinetic factors determine whether a drug is capable of reaching its site of action in a sufficient concentration. The concentration of the active compound can be significantly affected by its metabolism, which is genetically determined in each individual (known as the pharmacokinetic genotype), and by potential interactions with other prescribed drugs (known as the pharmacokinetic phenotype). For example, changes in drug metabolism inevitably lead to changes in the concentration of active compounds and thus to changes in the exposure of the drug. Therapeutic drug monitoring (TDM) is a tool for individualized pharmacotherapy that helps to optimize pharmacological treatment. On the one hand, TDM helps to detect deviations from expected drug concentrations and individualize treatment by adjusting doses. On the other hand, looking at the ratio of the parent compound and its metabolite (known as the metabolic ratio) helps to identify any abnormalities or peculiarities in drug metabolism supporting dose adjustments. This article provides a clinically oriented overview of how changes in drug metabolism can lead to treatment failure and which tools can be used to optimize treatment.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"83 1","pages":"3-13"},"PeriodicalIF":0.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515479","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":"[Diagnosis and treatment of obsessive compulsive disorder].","authors":"Christine Poppe","doi":"10.23785/TU.2026.01.004","DOIUrl":"https://doi.org/10.23785/TU.2026.01.004","url":null,"abstract":"<p><strong>Introduction: </strong>Obsessive-compulsive disorders (OCD) are common and often chronic mental illnesses, characterized by recurring, intrusive thoughts, ideas and impulses (obsessions) and repetitive, stereotypical behaviors (compulsions). Etiopathogenetically, OCD is explained by a complex interplay of genetics and epigenetics, neurotransmission, imbalances in cortico-striato-thalamo-cortical circuits, as well as learning mechanism and environmental factors. In ICD-11, OCD is now classified in the chapter \"Obsessive-compulsive and related disorders\", which share compulsive and impulsive behavioral patterns. This article provides diagnostic recommendations, common psychiatric comorbidities, and key differential diagnoses. In terms of psychotherapy, disorder-specific cognitive behavioral therapy (CBT) with exposure and response prevention is highly effective and recommended as first-line treatment. New approaches describe intensified and internet-based formats as well as modern developments in CBT. Pharmacologically, serotonin inhibitors (SSRIs and Clomipramin) are recommended at high dosages. Atypical antipsychotics may be used in low dosages for augmentation. For treatment-resistant cases, brain stimulation techniques such as repetitive transcranial magnetic stimulation and bilateral deep brain stimulation may be considered following a careful risk-benefit analysis.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"83 1","pages":"19-26"},"PeriodicalIF":0.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515490","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}