Pneumologie (Stuttgart, Germany)最新文献

{"title":"Predictors of distant, local and lymph node recurrence for surgically treated non-small cell lung cancer (NSCLC) patients: Retrospective analysis of pathological T1-4, N0, R0, M0 tumor stages.","authors":"Julia Zimmermann, Julia Walter, Nicole Samm, Gökce Yavuz, Christian Ketscher, Niels Reinmuth, Martina Merk, Rudolf Hatz, Amanda Tufman, Christian P Schneider","doi":"10.1055/a-2766-4308","DOIUrl":"10.1055/a-2766-4308","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer has a high recurrence rate after successful surgical treatment. This study deals with possible risk factors and recommendations to improve the treatment of non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>In this retrospective analysis, we used data of all NSCLC patients who underwent lobectomy at the Lung Cancer Center Munich between 2011 and 2020. Only patients with postoperative T1-4, N0, R0, M0 were included. We compared numerical outcomes between patients with distant, lymph node, local recurrence and no recurrence using analysis of variance (ANOVA), and categorical outcomes using Chi-squared test or Fisher's exact test when cell numbers were <6. We used logistic regression models to identify factors significantly associated with the occurrence of a distant, lymph node and local recurrence.</p><p><strong>Results: </strong>Tumor size in cm was significantly higher in patients with local recurrence (mean 5.5) followed by distant recurrence (mean 4.0), lymph node recurrence (mean 3.1) and patients with no recurrence (mean 3.0), p<0.0001. Diffusing capacity for carbon monoxide (DLCO) in % was significantly higher in patients with no recurrence (72.9) and decreased with distant recurrence (67.0), local recurrence (66.7) and lymph node recurrence (65.8), p=0.01. There were no significant differences in postoperative complications, surgical approach or number of lymph node assessed. A tumor size ≥4.65 cm was identified as an independent marker for local recurrence.</p><p><strong>Conclusion: </strong>For patients with NSCLC ≥4.65 cm, which corresponds to UICC stage IIA and higher, multimodal therapy should be discussed. The surgical approach has no influence on recurrence.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"426-437"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032705","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":"[Mesothelioma in situ of the parietal pleura as an occupational disease after exposure to asbestos: a case report of an insured patient with assessment in a social court proceeding].","authors":"Ludwig Frei-Stuber, Andrea Tannapfel, Hans Martin Schellhase, Dennis Nowak","doi":"10.1055/a-2783-4669","DOIUrl":"10.1055/a-2783-4669","url":null,"abstract":"<p><strong>Introduction: </strong>The existence of an in situ phase of (malignant) mesothelioma was only demonstrated a few years ago (in 2019). As mesotheliomas are predominantly caused by asbestos fibers and can be recognized as occupational disease (OD) No. 4105 in accordance with Appendix 1 of the Occupational Diseases Ordinance (ODO), whereas the legal definition does not explicitly include any precursors, it was controversial whether mesothelioma in situ should be recognized as OD.</p><p><strong>Case report: </strong>Here we present the case history of a patient (69 years, male) with histologically confirmed mesothelioma in situ of the left parietal pleura after pleurectomy and proven occupationally insured asbestos exposure.</p><p><strong>Discussion: </strong>As both mesothelioma in situ and invasive mesothelioma can be triggered by exposure to asbestos fiber dust, sufficient insured occupational exposure was proven for the probability of connection (Latin: \"conditio sine qua non\") and the clinical picture was only initially diagnosed earlier, recognition as OD No. 4105 ODO was recommended to the social court according to a medical expert report. This recommendation was followed by the social court and finally by recognition by the statutory accident insurance provider.</p><p><strong>Conclusions: </strong>In the authors' (m/f/d) opinion, mesothelioma in situ can already be recognized as OD based on the current version of OD No. 4105 ODO. The high probability of progression into an invasive mesothelioma and the fact that no relevant difference is known between the risk factors of mesothelioma in situ and an invasive mesothelioma of the pleura, pericardium and peritoneum, as well as the fact that regarding other ODs, precursors of malignant diseases have already been included in the legal definition (e.g., OD No. 1301, 1321 and 5103 ODO), justify extending the legal definition of OD to this stage of the disease, at least by analogy. Nevertheless, for clarification, to avoid legal uncertainty and the resulting disputes and in the interest of uniform application of the ODO, it is recommended that the legislator expands the legal definition of OD No. 4105 ODO to include precursors of invasive mesothelioma, here mesothelioma in situ. Furthermore, the ODs listed in the ODO should also be checked in general to see whether the inclusion of precursors of the respective disease in the legal definition is indicated based on new scientific findings.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"454-462"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055617","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":"[Smoking in the crime drama series \"Tatort\", 2019-2025].","authors":"Reiner Hanewinkel, Clemens Neumann, Matthis Morgenstern","doi":"10.1055/a-2771-5087","DOIUrl":"10.1055/a-2771-5087","url":null,"abstract":"<p><strong>Background: </strong>Smoking scenes in films can be understood as cues that trigger a strong desire to smoke in smokers, make it more difficult to quit smoking, and contribute to the normalization of tobacco consumption. With an average of 8 million viewers, the crime series \"Tatort\" is one of the most popular and widely watched German television productions. The study examined how many episodes of \"Tatort\" featured smoking and whether there had been any changes over the period from 2019 to 2025.</p><p><strong>Method: </strong>The sample comprised the entire population of all 204 episodes of the crime series \"Tatort\" from the 2019/2020 to 2024/2025 seasons. All episodes were analyzed in terms of content using the categories \"smoke-free\" and \"not smoke-free.\"</p><p><strong>Results: </strong>Smoking occurred in 152 of the 204 \"Tatort\" episodes (74.5%). The range varied from 70% (season 2023/24) to 82% (season 2020/21). This variation is statistically insignificant (χ²(5)= 1.83; p=0.87). The highest proportion of episodes with smoking scenes were those featuring the investigative teams from Bremen, Wiesbaden, and Mainz, where smoking occurred in every episode broadcast. The only episode with no smoking at all was \"Tatort\" Luzern, which, however, also had the lowest production rate with only one episode.</p><p><strong>Discussion: </strong>Smoking was depicted in three-quarters of the \"Tatort\" episodes. No temporal trends were observed over the six-year observation period. For years, the number of serious attempts to quit smoking has been declining in Germany. Popular films such as the crime series \"Tatort\", in which smoking is frequent, are unlikely to mitigate this trend.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"438-442"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937384","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":"Transpulmonale Druckmessung während Beatmung auf Intensivstation.","authors":"Christoph Laußer, Thomas Flohr","doi":"10.1055/a-2770-4466","DOIUrl":"https://doi.org/10.1055/a-2770-4466","url":null,"abstract":"","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":"80 6","pages":"463-472"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304585","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":"[Mechanisms of dyspnea].","authors":"Arber Gashi, Andreas Bastian, Andreas Günther, Achim Gruenewaldt, Matthias Held, Martin Hetzel, Stefan Krüger, Winfried Randerath, Andreas Schlesinger, Georgios Sofianos, Markus Unnewehr, Thomas Voshaar, Georg Nilius, Dominic Dellweg","doi":"10.1055/a-2803-7306","DOIUrl":"10.1055/a-2803-7306","url":null,"abstract":"<p><strong>Abstract: </strong>Dyspnea has many possible causes and, like pain, is felt in different qualities. Afferent signals originate from the chemoreceptors (pH, O₂ and CO₂) as well as from mechanoreceptors in the lungs, respiratory muscles and thorax. Complexity arises from the fact that both blood gases and the acid-base balance have to be regulated. There is almost always a combination of afferent incoming signals, which can reinforce each other but also determine the quality of the dyspnea experienced. In humans, O₂ is mainly measured peripherally, whereas CO₂ and pH are measured centrally. The areas of the brain involved in regulation are largely located in the brain stem, but cortical areas are also involved in the perception of dyspnea.The majority of patients experience a feeling of air hunger as the main discomfort. Subsequently, this results in emotional processing with the components of anxiety, frustration and fear.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"443-453"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461305","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":"[New nicotine products: future prevalence and implications for prevention].","authors":"Wulf Pankow, Tobias Effertz","doi":"10.1055/a-2867-9991","DOIUrl":"10.1055/a-2867-9991","url":null,"abstract":"<p><strong>Abstract: </strong>The tobacco market is experiencing a wave of innovation with new nicotine products. The industry is attempting to compensate for the decline in sales of conventional tobacco products and the associated threat of revenue losses by aggressively marketing new nicotine products (e-cigarettes, heated tobacco products, and nicotine pouches) and focusing on new consumer groups. This bears the risk of an epidemic of new nicotine-dependent generations, which would offset the success achieved so far in curbing tobacco consumption. According to current evidence, there is no safe form of nicotine consumption. From conventional tobacco cigarettes to new nicotine products, the health effects of nicotine-containing products are well-documented and preventable. Politicians, authorities, and stakeholders are called upon to take preventive action. Effective preventive measures include a significant high and equal taxation across all tobacco products and the new nicotine delivery systems, distribution and advertising bans, consistent enforcement of non-smoker protection laws, and improved cost-effective health education.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008502","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":"Delayed Solitary Adrenal Metastasis in Malignant Pleural Mesothelioma with Long-Term Survival under Immunotherapy.","authors":"Maximilian Franke, Halil Ibrahim Toy, Daniel Misch, Susann Stephan-Falkenau, Marc Jansen, Torsten Bauer, Jens Kollmeier","doi":"10.1055/a-2867-9892","DOIUrl":"https://doi.org/10.1055/a-2867-9892","url":null,"abstract":"<p><strong>Abstract: </strong>Malignant pleural mesothelioma (MPM) is a rare and aggressive neoplasm with limited long-term survival. We report a case of a 72-year-old woman diagnosed with epithelioid MPM and NF2 mutation in 2018, who presented with a solitary adrenal metastasis six years after initial diagnosis. After initial surgery and chemotherapy, disease progressed within one year. Immunotherapy with ipilimumab and nivolumab resulted in long-term disease control. This case highlights an exceptionally delayed metachronous adrenal metastasis and prolonged survival under sustained immunotherapy.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978640","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":"[TNF-alpha Inhibitor-Induced Pulmonary Sarcoidosis].","authors":"Melanie Berger, Wolfram Windisch, Falk Schumacher, Niklas Ploenes","doi":"10.1055/a-2853-3746","DOIUrl":"https://doi.org/10.1055/a-2853-3746","url":null,"abstract":"<p><strong>Abstract: </strong>TNF-alpha inhibtors represent an established option for autoimmune disorders such as rheumatoid arthritis, psoriasis and chronic-inflammatory bowel diseases as well as for granulomatous diseases including sarcoidosis. Their primary mode of action is antagonistic, blocking the interaction of TNF-alpha with its receptors TNFR1 and TNFR2. Currently five TNF-alpha inhibitors are clinically used: infliximab, adalimumab, golimumab, certolizumab and etanercept.In rare cases TNF-alpha inhibitors may induce sarcoidosis through a paradoxical reaction. This phenomenon is observed most frequently during treatment with etanercept, although the underlying mechanisms remain unclear. The clinical presentation of TNF-alpha inhibitor-induced sarcoidosis closely resembles that of idiopathic sarcoidosis and is characterized by a heterogeneous, inflammatory and granulomatous disease pattern with affection of multiple organ systems. Depending on the causative active agent, a differing distribution of clinical manifestations may occur.From a diagnostic perspective, laboratory analyses and the histological confirmation of the affected organ demonstrating epithelioid cell granulomas are essential. The cornerstone of therapy is the immediate discontinuation of the triggering TNF-α inhibitor. In selected cases, adjunctive systemic corticosteroid therapy may be considered. With timely recognition and appropriate management, the prognosis is generally favourable.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849100","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":"[Dual use of e-cigarettes and cigarettes among adolescents before and after the rise of disposable e-cigarettes: \"Interrupted time series\" study].","authors":"Reiner Hanewinkel, Julia Hansen","doi":"10.1055/a-2701-6656","DOIUrl":"10.1055/a-2701-6656","url":null,"abstract":"<p><strong>Background: </strong>Use of e-cigarettes and tobacco cigarettes often occurs concurrently. Such dual use is a health concern and may be an indicator of high nicotine dependence. The study examines whether the rise of disposable e-cigarettes in Germany from mid-2021 onwards has reinforced the trend toward dual use.</p><p><strong>Method: </strong>An interrupted time series design was used. The interruption is the rise of disposable e-cigarettes in 2021. The primary outcome was dual use, defined as the use of both e-cigarettes and combustible cigarettes within the past month. The data are based on 9 waves of the prevention radar, a questionnaire study in grades 5-10. The sample was divided into adolescents in early (9-14 years) and late adolescence (15-17 years). Prevalence estimates were based on segmented regression models within an interrupted time series (ITS) analysis framework. Weighting factors were used to adjust the data to the distribution of the population of students in terms of age, gender and type of school.</p><p><strong>Results: </strong>A total of 138,458 observations form the data basis. Currently (data collected in 2024/2025), 2.6% of 9-14-year-olds and 9.6% of 15-17-year-olds use both tobacco and e-cigarettes. Before the rise of disposable e-cigarettes, dual use fluctuated numerically slightly and was statistically insignificant in both age groups studied. The rise of disposable e-cigarettes was accompanied by a statistically significant increase in dual use in both age groups. In late adolescence, the proportion increased by 5.9 percentage points (+160%) compared to the average for the years prior to 2021, reaching 2024/2025, and by 1.3 percentage points (+100%) in early adolescence.</p><p><strong>Discussion: </strong>According to conservative estimates, the proportion of young people in Germany who consumed both e-cigarettes and cigarettes doubled after the rise of disposable e-cigarettes. In the interests of preventive health protection, some countries such as Belgium, France and the UK have already implemented bans on disposable e-cigarettes. This is also a central demand of various German medical societies under the leadership of the DGP. These study results underpin this demand on health policy.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"367-374"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153132","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":"[Online COPD self-management programme improves COPD knowledge: results of a single-centre study].","authors":"Konstantin Helfferich, Stefanie Eck, Konrad Schultz, Alexander Hapfelmeier, Antonius Schneider","doi":"10.1055/a-2753-5224","DOIUrl":"10.1055/a-2753-5224","url":null,"abstract":"<p><strong>Background: </strong>Many patients with COPD (chronic obstructive pulmonary disease) do not participate in outpatient educational programmes. Online education might help increase participation rates, and knowledge about COPD self-management.</p><p><strong>Objectives: </strong>We developed a new online digital COPD self-management programme (dCSP). The aim was to evaluate its effect on increasing knowledge about COPD self-management.</p><p><strong>Methods: </strong>A non-controlled single-centre pilot study (DRKS00024956) was conducted in a pulmonary rehabilitation clinic. The increase in knowledge from baseline (T0) to the post-online-training (T1) and the final face-to-face training (T2) was determined using the Bristol COPD Knowledge Questionnaire (BCKQ), a 65-item instrument with a maximum score of 65 points). The BCKQ difference was tested for statistical significance using the Wilcoxon signed-rank test. The influence of age, gender, education, previous participation in COPD training and baseline knowledge T0 on the baseline knowledge T0, the increase in knowledge T1-T0 and total increase in knowledge T2-T0 in the BCKQ was examined using univariable and multivariable regression models. Furthermore, participants were invited to provide feedback on their satisfaction with the dCSP and its user-friendliness.</p><p><strong>Results: </strong>Among patients (n=50), the number of correct answers in the BCKQ increased from 34.7±9.1 (mean ± standard deviation) at the beginning to 43.9±6.5 after completing the dCSP (p<0.001) and further to 46.4±6.4 after completing face-to-face training (p=0.001). The increase in knowledge through the dCSP was greatest among secondary school graduates (p=0.048). Low prior knowledge was also associated with a greater increase in knowledge (p<0.001). Overall, the dCSP received very positive evaluations.</p><p><strong>Conclusions: </strong>A dCSP could be helpful in compensating for knowledge deficits in patients with COPD facilitating access to COPD knowledge. Patients with lower levels of education and prior knowledge seem to benefit particularly. The benefits of a dCSP would need to be validated in future comparative studies.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"350-359"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710666","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}