Pneumologie (Stuttgart, Germany)最新文献

{"title":"[The development of the Law on the Protection of Non-Smokers in Bavaria: a model for the whole of Germany?]","authors":"Matthias Urlbauer, Dennis Nowak","doi":"10.1055/a-2958-1272","DOIUrl":"https://doi.org/10.1055/a-2958-1272","url":null,"abstract":"<p><strong>Background: </strong>Bavaria is a special case in Germany when it comes to tobacco control policy. The Free State initially enacted a particularly strict law protecting nonsmokers in 2008, relaxed it again in 2009, and reinstated the strict protections following the July 4, 2010 referendum.</p><p><strong>Research question: </strong>Can the Bavarian approach serve as a model for all of Germany, and what opportunities and obstacles arise when applying it to other federal states?</p><p><strong>Methods: </strong>A narrative review based on a targeted literature search, official documents, and two appended texts on developments in Bavaria. The review included political, legal, occupational health, and epidemiological studies related to the protection of nonsmokers in Bavaria and Germany.</p><p><strong>Results: </strong>The body of research consistently indicated that strict smoking bans significantly reduced exposure to secondhand smoke in indoor settings. In German restaurants and bars, fine particulate matter levels dropped dramatically after the smoking ban was introduced, and children's exposure to secondhand smoke at home and in cars decreased without any significant shift to private settings being confirmed. At the same time, the political literature showed that Bavaria's success was achieved only under specific conditions: a simple message, a clear health-based framework, strong mobilization of civil society, and a referendum question that did not hide behind exceptions.</p><p><strong>Conclusion: </strong>Bavaria serves as a model, provided this is understood as an empirically sound and politically mobilizable reference case. The model is of limited use as a blueprint because the federal legal landscape remains heterogeneous and exceptions weaken its effectiveness. The most important lesson is therefore this: protection for nonsmokers is most sustainable where it is simple, has few exceptions, and is justified as a means of protecting the workplace, children, and public health.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229770","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":"Tenosynovitis caused by Mycobacterium malmoense.","authors":"Manuel Vincent Peterka, Silke Polsfuss, Torsten Bauer, Nicolas Schoenfeld","doi":"10.1055/a-2965-2426","DOIUrl":"https://doi.org/10.1055/a-2965-2426","url":null,"abstract":"<p><strong>Background: </strong><i>Mycobacterium malmoense</i> is a slow-growing nontuberculous mycobacterium (NTM) increasingly recognized as a cause of extrapulmonary infections. Tenosynovitis due to <i>M. malmoense</i> is rare and diagnostically challenging because of its indolent course and nonspecific clinical presentation.</p><p><strong>Case presentation: </strong>We report a 65-year-old immunocompetent woman presenting with progressive wrist pain, swelling, and impaired hand function without prior trauma. Symptoms developed after exposure to fresh fish and shellfish. Surgical exploration revealed extensive tenosynovitis with median nerve compression. Histopathology showed granulomatous synovitis suggestive of mycobacterial infection. Molecular testing detected Mycobacterium genus DNA, while PCR for the <i>Mycobacterium tuberculosis</i> complex was negative. After prolonged incubation, culture identified <i>M. malmoense</i>. Drug susceptibility testing demonstrated susceptibility to standard antimycobacterial agents except doxycycline. Initial empiric therapy targeting <i>M. marinum</i> was adapted following species identification. After 8 months of treatment, significant clinical and radiological improvement was observed, with no evidence of relapse at 6-month follow-up.</p><p><strong>Discussion: </strong><i>M. malmoense</i> tenosynovitis is extremely rare, with only few cases reported. Diagnosis is frequently delayed due to low sensitivity of microscopy, slow growth in culture, and nonspecific findings. Molecular diagnostics and prolonged incubation are essential. Management requires a combination of surgery and prolonged antimycobacterial therapy.</p><p><strong>Conclusion: </strong>NTM infections, including <i>M. malmoense</i>, should be considered in chronic tenosynovitis unresponsive to standard treatment. Early diagnostic suspicion and interdisciplinary management are crucial for favorable outcomes.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198846","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":"[Treatment of pulmonary fibrosis: Beginning of a new era].","authors":"Jürgen Behr, Tobias Veit","doi":"10.1055/a-2959-4770","DOIUrl":"https://doi.org/10.1055/a-2959-4770","url":null,"abstract":"<p><strong>Background: </strong>Interstitial lung diseases (ILD) comprise a heterogeneous group of inflammatory and fibrotic disorders of the lung parenchyma. Idiopathic pulmonary fibrosis (IPF) is the prototype of a progressive pulmonary fibrosis and is associated with a particularly poor prognosis. 18-32% of other ILD evolve into a progressive phenotype called progressive pulmonary fibrosis (PPF), with behavior similar to IPF in terms of prognosis and mortality. IPF and PPF share key pathophysiological mechanisms. Currently available antifibrotic therapies can slow disease progression; however, their benefits on quality of life and mortality are not undisputably proven in controlled clinical trials, and adverse effects often limit their use. Consequently, there remains a substantial need for effective and better-tolerated therapeutic options.</p><p><strong>Aim: </strong>To present current developments and emerging pharmacological treatment strategies, as well as their potential implications for clinical practice.</p><p><strong>Material and methods: </strong>A systematic search in PubMed and ClinicalTrials.gov was conducted to identify relevant clinical studies on established and novel therapeutic approaches.</p><p><strong>Results: </strong>The most clinically advanced compounds currently under investigation for the treatment of progressive pulmonary fibrosis include nerandomilast and inhaled treprostinil. Nerandomilast, a preferential PDE4B inhibitor with antifibrotic, anti-inflammatory and vascular properties, significantly reduced the decline in forced vital capacity (FVC) in the Phase III FIBRONEER trials in patients with IPF and PPF and was associated with a manageable tolerability profile as well as favourable signals regarding mortality risk. For inhaled treprostinil, TETON-2, TETON-1 and the pre-specified pooled analysis demonstrated significant positive effects on the primary endpoint (FVC) and in part on the secondary endpoints. Both agents may therefore broaden the range of therapeutic options for progressive pulmonary fibrosis in the future.</p><p><strong>Discussion: </strong>The current Phase III data indicate that new therapeutic approaches may meaningfully complement the previously limited treatment options for IPF and PPF in the future, particularly through novel mechanisms of action, additional possibilities for combination therapy, and potentially better-tolerated treatment options.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140426","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":"[From Eminence to Evidence: Defining High-Quality Multidisciplinary Tumor Boards in Lung Cancer Care].","authors":"Gerald Schmid-Bindert, Carolin Groß-Ophoff-Müller, Aitan Kasumova, Christian Schumann","doi":"10.1055/a-2949-4152","DOIUrl":"https://doi.org/10.1055/a-2949-4152","url":null,"abstract":"<p><strong>Introduction: </strong>Multidisciplinary tumour boards (MDTs) are central to the delivery of guideline-concordant care to patients with lung cancer. Although their implementation is associated with improvements in the quality of care and clinical outcomes, numerous studies point to shortcomings in the decision-making and in the implementation of MDT recommendations. At the same time, Germany lacks both binding process standards and robust data on how thoracic oncology MDTs are currently conducted. This study aimed to describe quality-related factors associated with effective MDTs, evaluate established instruments for quality assessment, and identify approaches for the structured development of MDT processes in Germany.</p><p><strong>Methods: </strong>A narrative review was conducted based on a focused, non-systematic literature search of PubMed/MEDLINE in February 2026. Original studies, reviews, guidelines, and consensus papers published in German or English were included.</p><p><strong>Results: </strong>Effective MDTs are characterized by quality-related factors that can be assigned to five dimensions: team, infrastructure, organization, decision-making, and governance. Particularly relevant factors include participation of all relevant medical disciplines, competent moderation, a respectful discussion culture, sufficient preparation time, clearly defined responsibilities, structured processes, and transparent documentation. In addition, comorbidities, psychosocial factors, and patient preferences must be considered to ensure patient-centered decision-making. Validated instruments for quality assessment, such as the MODe questionnaire, are available. Digital conference formats and IT systems for MDT coordination and decision-making offer additional potential for process optimization.</p><p><strong>Conclusions: </strong>MDTs are indispensable for the care of lung cancer patients. Their effectiveness is determined substantially by structured processes and not solely by the medical expertise of the participating disciplines. In Germany, there is a need for systematic assessment of existing structures and for consistent, validated quality measurement. A nationwide assessment followed by the prospective application of standardized instruments such as MODe could strengthen the national evidence base, identify relevant opportunities for improvement, and establish the foundation for continuous quality improvement in thoracic oncology MDTs.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122953","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":"Pandemic revisited: Characteristics, severity and clinical outcomes of patients hospitalized with SARS-CoV-2-infection in different periods of the pandemic.","authors":"Saliha Yagmur, Timo Sabelhaus, Jan Florian Heuer, Santiago Ewig","doi":"10.1055/a-2762-7934","DOIUrl":"10.1055/a-2762-7934","url":null,"abstract":"<p><strong>Objective: </strong>The SARS-CoV-2-pandemic changed considerably over the course of time in terms of severity and mortality due to the impact of several SARS-CoV-2 variants as well as vaccination and preventive or SARS-CoV-2 specific therapies. We compared patients in two defined periods and analyzed the specific impact of pneumonia, including measures for treatment of respiratory failure.</p><p><strong>Methods: </strong>This was a single-center retrospective study of patients hospitalized with PCR-confirmed and symptomatic SARS-CoV-2-infection in our center. The pandemic periods 3/2020-12/2021 and 1/2022-3/2023 as well as the periods after establishment of vaccination, preventive and SARS-CoV-2-specific treatments 3/2020-9/2021 and 10/2021-3/2023 were compared.</p><p><strong>Results: </strong>Overall, n=622 patients were included (n=307 in the first and n=315 in the second pandemic period). Marked differences were found with regard to age, severity of disease and pneumonia, interventions and mortality. Mortality of pneumonia was 25% (27% in the first and 20% in the second pandemic period); 40% of patients (36% patients with pneumonia) who died had not been admitted previously to the ICU. Mortality from pneumonia after exclusion of these patients was 18% (21% in the first and 10% in the second period). Mortality was particularly high in intubated patients with mechanical ventilation (67%).</p><p><strong>Conclusions: </strong>Our results were comparable with those reported in a national survey and another single center report of a nearby hospital. Treatment restrictions were frequently applied. Risk factors, severity and mortality of SARS-CoV-2-associated pneumonia in the second pandemic period were similar to those reported for community-acquired pneumonia. Excess mortality from mechanical ventilation deserves further investigation.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"698-711"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784282","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 a small cell lung cancer with skin metastasis and metastasis to a newly diagnosed lipofibroma].","authors":"Ioannis Apostolidis, Mina Ibrahim, Viola Shuteriqi, Nikolay Mihaylov","doi":"10.1055/a-2842-7779","DOIUrl":"10.1055/a-2842-7779","url":null,"abstract":"<p><strong>Abstract: </strong>A 73-year-old male patient presented with an acute decline in general condition over several days and a bleeding, ulcerated tumor on the upper right back. According to the medical history, the lesion had been present for approximately 25 years, but had recently undergone rapid growth over a period of three months.CT imaging of the thorax revealed a massive subcutaneous mass with ulcerations on the upper right back. Furthermore, there was a high clinical suspicion of central bronchial carcinoma in the right lung. For further diagnostic clarification, a core needle biopsy of the large dorsal tumor and mucosal biopsies of the endobronchial lesion in the right lower lobe were performed. Bronchoscopic evaluation demonstrated complete tumor-induced occlusion of the middle lobe and most of the right lower lobe, as well as infiltration of the bronchus intermedius.Histopathological analysis of the endobronchial samples confirmed a small cell lung cancer (SCLC). The percutaneous core needle biopsy revealed fibro-lipomatous tissue components without cellular atypia, alongside infiltrates of the same small cell carcinoma.Following the recommendation of the multidisciplinary pneumo-oncological tumor board, palliative chemotherapy with carboplatin and etoposide was initiated.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"743-746"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937218","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":"[From sanatorium to lung centre: 80 years of tuberculosis history in Germany as reflected by the Lungenklinik Heckeshorn].","authors":"Andreas Jüttemann, Torsten Bauer, Nicolas Schönfeld","doi":"10.1055/a-2849-0253","DOIUrl":"10.1055/a-2849-0253","url":null,"abstract":"<p><strong>Abstract: </strong>Tuberculosis is often perceived in Germany as a disease of the past. Its history, however, is not over: in a low-incidence country, tuberculosis has become less frequent but diagnostically and therapeutically more demanding. This article uses the 80th anniversary of the Lungenklinik Heckeshorn in 2027 to trace central trajectories of tuberculosis history in Germany from the sanatorium movement to modern specialised care. Heckeshorn is a particularly suitable example because several historical layers intersect at this site: the therapeutic tradition of air, light and rest; the post-war tuberculosis crisis in devastated Berlin; the political division of the city; early access to streptomycin; the transition from phthisiology to modern pulmonology and thoracic surgery; and the current treatment of extrapulmonary and multidrug-resistant tuberculosis in a specialised lung centre. The site also illustrates the security-policy dimension of hospital history: the high-rise bunker at Heckeshorn was converted into an emergency hospital during the Cold War, linking medicine, civil defence and political context. Heckeshorn's history is therefore not merely a local anniversary narrative, but a lens through which the transformation of tuberculosis medicine in Germany can be described.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"737-742"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122916","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":"[80 Years of Lung Cancer - the Evolution of Diagnosis and Treatment].","authors":"Niels Reinmuth, David Heigener, Claas Wesseler","doi":"10.1055/a-2842-7532","DOIUrl":"10.1055/a-2842-7532","url":null,"abstract":"<p><strong>Abstract: </strong>Exactly 80 years ago - in April 1946 and in Chicago, the very city where the latest developments in oncology are discussed annually at the ASCO meeting - Thomas Mann, the German Nobel Prize-winning author and chain-smoker, underwent lung surgery. On April 24, 1946, thoracic surgeon Dr. William E. Adams removed the lower and middle lobes of his right lung due to carcinoma at the University of Chicago Hospital; Mann survived the operation without recurrence for nine years before eventually passing away from an aortic aneurysm. What made this surgery remarkable was the limited resection - avoiding the complete removal of the entire lung, which had previously been the only standard treatment for lung carcinoma.</p><p><strong>Abstract: </strong>Since then, treatment options for lung carcinoma have changed significantly. In the following section, we provide a brief overview of how and what has changed.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"731-736"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815492","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":"[Is the tobacco industry reinventing itself?]","authors":"Wulf Pankow, Karin Vitzthum, Natascha Sommer, Reiner Hanewinkel, Stefan Andreas","doi":"10.1055/a-2847-7259","DOIUrl":"10.1055/a-2847-7259","url":null,"abstract":"<p><strong>Abstract: </strong>The tobacco industry has repeatedly adjusted its product strategy in the past. As soon as the health risks of tobacco use could no longer be denied, it responded with high-profile campaigns designed to downplay scientific findings. In addition, it introduced modified products such as cigarette filters and so-called \"light\" cigarettes, which give the impression of being less harmful. This strategy has become increasingly less successful in recent years. Public health policies focused on environmental prevention, combined with increased public awareness, have led to a global decline in tobacco consumption. With new nicotine products such as e-cigarettes, tobacco heaters, and nicotine pouches, an additional market segment is now being developed to complement the shrinking core market. And once again, the health risks associated with the mechanism of addiction are downplayed as \"harm reduction\". New products are redefined as therapeutic aids for smoking cessation, through which the tobacco industry seeks to present itself as a pharmaceutical entity. At the same time, the company will continue to operate in the core market for tobacco products as part of a two-pronged strategy, and this product segment is expected to remain the dominant source of revenue and profit for the foreseeable future. In this respect, the tobacco industry is adapting to the new circumstances without abandoning the business model based on nicotine addiction.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"712-718"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820960","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":"[80 Years of \"Pneumologie\" - Occupational Medicine and Occupational Diseases: Then and Now].","authors":"Marcial Velasco Garrido","doi":"10.1055/a-2842-3240","DOIUrl":"10.1055/a-2842-3240","url":null,"abstract":"<p><strong>Abstract: </strong>The journal \"Der Tuberkulosearzt\" was first published in October 1947; following two name changes - to \"Praxis der Pneumologie\" in 1964 and \"Praxis und Klinik der Pneumologie\" in 1977 - it has been known to its readership as \"Pneumologie\" since 1989. After briefly reviewing the historical context at the time of the journal's inaugural issue, this paper presents a bibliometric analysis of articles related to occupational medicine published over the 80-year history of the journal now known as \"Pneumologie\". Subsequently, the first three articles dedicated to occupational medicine topics are presented as case studies, and the relevance of their content is discussed from a modern perspective.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"719-730"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805315","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}