Pneumologie (Stuttgart, Germany)最新文献

{"title":"[Dyspnoea in invasively ventilated patients: an overview].","authors":"Benjamin Neetz, Philipp Höger, Franziska Kaestner, Felix Herth, Franziska Trudzinski","doi":"10.1055/a-2809-4045","DOIUrl":"https://doi.org/10.1055/a-2809-4045","url":null,"abstract":"<p><p>Dyspnoea is a highly relevant phenomenon in patients undergoing invasive mechanical ventilation, yet it is often underestimated in clinical practice. Against this background, the European Respiratory Society (ERS) and the European Society of Intensive Care Medicine (ESICM) have published a comprehensive statement on the various aspects of dyspnoea during mechanical ventilation. This article is based on this consensus document and highlights the various dimensions of dyspnoea, from its prevalence and clinical relevance to the individual experiences of patients and its physiological and psychological consequences. It provides a detailed presentation of diagnostic procedures and targeted therapeutic intervention options. Particular emphasis is placed on systematic assessment tools offering valid evaluation approaches for both communicative and non-communicative patients. Additionally, the importance of dyspnoea in relation to lung- and diaphragm-protective ventilation and weaning from mechanical ventilation is discussed.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583581","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":"[Safety of diagnostic flexible bronchoscopy in adults S2k-Guideline of the German Respiratory Society].","authors":"Ralf-Harto Hübner, Jürgen Hetzel, Barbara Baysal, Sebastian Boeing, Kaid Darwiche, Ralf Eberhardt, Stephan Eisenmann, Karl-Josef Franke, Wolfgang Gesierich, Daniela Gompelmann, Stefan Heindl, Felix Herth, Martin Hetzel, Angélique Holland, Kathrin Kahnert, Torsten Loop, Heike Martiny, Carmen Pizarro, Bernd Quadder, Thomas Richter, Christian Schmidt-Planck, Franz Stanzel, Carolin Steinack, Katrin Welcker, Stefanie Wustrack, Lars Hagmeyer","doi":"10.1055/a-2669-9409","DOIUrl":"https://doi.org/10.1055/a-2669-9409","url":null,"abstract":"<p><p>The S2K guideline, organized by the German Respiratory Society, is aimed at physicians in Germany, Switzerland, and Austria who perform outpatient or inpatient diagnostic flexible bronchoscopy in adult patients. Its goal is to standardize the procedure, minimize complications, and improve diagnostic safety. The guideline specifically addresses specialists in pulmonology, thoracic surgery, and hospital hygiene, as well as nursing and technical staff. It provides evidence- and consensus-based recommendations on indications, preparation, execution, hygiene measures, and aftercare. Additionally, it serves as an information resource for physicians from other specialties, payers, professional societies, and can support quality management. It applies to medical care in Germany, Austria, and Switzerland and incorporates the latest scientific findings up to the date of publication.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518274","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":"Staphylococcal pneumonia associated with Panton-Valentine leucocidin (PVL) toxin.","authors":"Adrian Gillissen, Daniel Räpple, Tina Wagenknecht, Martin Hetzel","doi":"10.1055/a-2664-0663","DOIUrl":"10.1055/a-2664-0663","url":null,"abstract":"<p><p>Panton-Valentine leukocidin (PVL) is a toxine which forms a pore-forming heptamer on neutrophil membrandes leading to neutrophil lysis. Invasive community-onset PVL producing staphylococcus aureus (S. aureus) induced diseases have emerged worldwide, but incidence vary and is strongly attributed to strain types and lineages. Unfortunately diagnostic microbiology laboratories do not routinely test for PVL. These strains have been reported to exceed in virulence hospital-acquired MRSA (methicillin-resistant S. aureus) causing sepsis, necrotizing fasciitis but in rare cases cause severe necrotizing pneumonia. PVL S. aureus necrotizing pneumonia requires early suspicion, particularly in young otherwise healthy individuals, when the clinical picture rapidly evolves, presenting with cavitary consolidation and bilateral infiltrates in the lung - which has been demonstrated within this article in a dramatic case - pleural effusion and hemoptysis. Prompt hospitalization and aggressive treatment with intravenous antimicrobial therapy is warranted to improve outcomes. However, in vitro findings suggest that some antibiotics binding to penicillin binding protein 1 may even increase bacterial PVL expression. In necrotizing pneumonia PVL S. aureus infection is prudent to antibiotic therapy at the highest safest dose at regular intervals to avoid a drop in concentration to sub-MIC. Decolonization and bioburden reduction are proven prophylactic methods also to prevent PVL S. aureus zoonotic cross infections.This manuscript with case presentation gives an overview on important aspects of PVL S. aureus epidemiology, antimicrobial treatment options and decolonization strategies.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"183-190"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839853","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":"[Impact of malnutrition and sarcopenia on the outcomes of pulmonary rehabilitation in patients with COPD].","authors":"Marc Spielmanns, Patrick Heeb, Kirsten Grossmann, Corina Schaer, Sabine Spielmanns, Undine Lehmann, Katja Uhlmann, Pavel Sirotkin, Gilbert Buesching, Ramin Khatami, Zhongxing Zhang","doi":"10.1055/a-2677-8679","DOIUrl":"10.1055/a-2677-8679","url":null,"abstract":"<p><p>Malnutrition and sarcopenia are common conditions in older people and are associated with increased morbidity and mortality. The results of the Malnut-Reha study, which was conducted in 5 Swiss rehabilitation centers and investigated the prevalence of these conditions in inpatient rehabilitation, have recently been published. The present subgroup analysis assesses the impact of malnutrition and sarcopenia on pulmonary rehabilitation (PR) outcomes in patients with Chronic Obstructive Pulmonary Disease (COPD).A total of 67 patients with COPD from 2 Swiss rehabilitation centers were included in the analysis. Standardized assessments were used to evaluate rehabilitation outcomes, including the 6-Minute Walk Test (6MWT), the Functional Independence Measure (FIM), and the handgrip strength measurement (HGS). The prevalence of malnutrition and sarcopenia was 46% each, with 33% of patients presenting both conditions. Despite the worst initial physical and functional status, patients with malnutrition and/or sarcopenia showed significant improvements in 6MWT and FIM after PR, independently of their nutritional status or muscle mass.The findings of this analysis confirm the effectiveness of PR in patients with COPD, regardless of the presence of malnutrition or sarcopenia. Future studies should investigate whether extended targeted nutritional and exercise interventions could provide additional benefits.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"168-176"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986806","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":"[A rare manifestation of a cystic lung disease with high suspicion of pulmonary light chain deposition disease (LCDD)].","authors":"Nina Sicker, Sabine Gaerditz, Florian Geismann, Okka Hamer, Christoph Lerzer, Arno Mohr, Stefanie Scharf, Maximilian Malfertheiner","doi":"10.1055/a-2694-6178","DOIUrl":"10.1055/a-2694-6178","url":null,"abstract":"<p><p>This case report describes a rare form of cystic lung disease, strongly suspected to be a pulmonary manifestation of light chain deposition disease (LCDD). Pulmonary light chain deposition disease (PLCDD) is an uncommon form of cystic lung disease, presenting with extensive bilateral cysts and nodules. Definitive diagnosis requires histopathological confirmation, although this may not always be feasible in cases of respiratory compromise. The diagnosis of LCDD should be considered when the clinical findings are atypical for other cystic lung diseases, the HRCT morphology suggests nodular-cystic amyloidosis (HRCT with cysts and nodules, nodules also involving the walls of the cysts, predominantly located in the periphery of the lower lung areas) or when monoclonal free light chains, particularly kappa chains, are detected in serum and/or urine.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"191-194"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133348","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":"[Antibiotic Stewardship in Nosocomial Pneumonia].","authors":"Irit Nachtigall, Jessica Rademacher, Evelyn Kramme","doi":"10.1055/a-2757-0710","DOIUrl":"10.1055/a-2757-0710","url":null,"abstract":"<p><p>Pneumonia is one of the most important nosocomially acquired infections in Germany. Rational management strategies contribute to optimizing treatment and minimizing the development of resistance. The calculated antimicrobial therapy should take into account the severity, the risk of multi-resistant pathogens and <i>P. aeruginosa</i> as well as the local resistance situation. The infection occurs more frequently in non-ventilated patients, yet the evidence for ventilator-associated pneumonia is better, mainly due to easier microbiological diagnostics. The spectrum of pathogens does not differ significantly between the two disease entities. <i>E. coli, K. pneumoniae, P. aeruginosa</i> and, in the gram-positive spectrum, <i>S. aureus</i> and <i>S. pneumoniae</i> are the most common pathogens detected. Early detection, particularly in sepsis, followed by targeted diagnostic measures are relevant managing the disease. Calculated antibiotic therapy taking into account the severity of the disease and the patient's individual risk of multi-resistant pathogens, should be administered promptly. A re-evaluation of the diagnosis and therapy after 48-72 hours is crucial for the success of treatment and the rational use of antibiotics. All findings obtained to confirm the diagnosis and assess the course of the disease should be reviewed with regard to the accuracy of the diagnosis, the therapeutic response and the possibility of optimizing antibiotic therapy. If there is a response to treatment, which is primarily expressed in a clinical improvement, the recommended treatment duration of 7 days should not be exceeded. If there is no improvement in symptoms, microbiological findings, complications and differential diagnoses should be checked. Pharmacokinetic and pharmacodynamic principles should be considered with regard to the substances and the duration of application and dosage.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":"80 3","pages":"198-208"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147368000","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 bypass legal regulations and youth protection measures].","authors":"Reiner Hanewinkel, Claudia Bauer-Kemeny, Karin Vitzthum, Wolfram Windisch, Christa Rustler, Matthias Urlbauer, Matthias Raspe, Klaas Franzen, Josef Hamoud, Wulf Pankow","doi":"10.1055/a-2687-0942","DOIUrl":"10.1055/a-2687-0942","url":null,"abstract":"<p><p>The increasing use of e-cigarettes and nicotine pouches, even among children and adolescents, is alarming from the perspective of prevention and youth protection. The sale of these products to children and young people is illegal in Germany. E-cigarettes may only be sold to adults. In contrast, nicotine pouches are not marketable at all in Germany, i.e. they may not be legally sold to anyone regardless of age. We investigated whether the sale of new nicotine products, such as e-cigarettes and nicotine pouches, complies with legal requirements and protects minors.Seven adult researchers ordered e-cigarettes and nicotine pouches online from German-language websites in January and February 2025. A total of 33 order attempts were made, including 17 attempts to purchase e-cigarettes online and 16 attempts to order nicotine pouches.Reports of administrative offenses against the marketing of nicotine pouches were submitted to three authorities.Although not marketable in Germany, all 16 orders for nicotine pouches were delivered. Not in a single case was a reliable age check carried out when the order was placed. The authorities reacted inconsistently to reports that the nicotine pouches had been delivered by post. The ordering of e-cigarettes showed the following results: With one exception, in 16 of the 17 attempted orders, age verification was carried out either directly when the order was placed by uploading ID card data in order to successfully complete the ordering process or by the shipping service provider, who asked to see the ID card for age verification (≤18 years) when the package was handed over.The sale of nicotine pouches does not comply with legal requirements, nor does it protect minors. E-cigarettes and nicotine pouches can be ordered online without restriction from Germany. Although nicotine pouches are not marketable, they are actually delivered and, according to our observations, are even sold through vending machines. The protection of minors is being systematically circumvented here. The protection of minors is better regulated for e-cigarettes. Age checks are reliably carried out in the majority of cases. In the interests of preventive health protection, the state authorities responsible for food control are called upon to prevent illegal orders and deliveries of nicotine pouches.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"177-182"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071598","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 Drug-Resistant Tuberculosis (DR-TB) in Germany, Austria and Switzerland - Updated Recommendations Based on the WHO Guidelines 2025].","authors":"Christoph Lange, Tom Schaberg, Ralf Otto-Knapp","doi":"10.1055/a-2731-0729","DOIUrl":"10.1055/a-2731-0729","url":null,"abstract":"<p><p>Following new recommendations from the World Health Organization (WHO) on the treatment of tuberculosis (TB) in 2025, the Tuberculosis Guidelines Group for Germany, Austria and Switzerland has decided to update the guidelines for the treatment of drug-resistant tuberculosis (DR-TB) as well. DR-TB includes resistant forms of <i>Mycobacterium tuberculosis</i>, including isoniazid monoresistance, multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB), pre-extensively drug-resistant TB (pre-XDR-TB) and extensively drug-resistant TB (XDR-TB). For MDR/RR-TB and pre-XDR-TB without additional resistance to bedaquiline and/or linezolid, two 6-month, purely oral short-term regimens are recommended (BPaLM or BDLLfx for MDR/RR-TB and BPaL or BDLC for pre-XDR-TB [*B = bedaquiline, C = clofazimine, D = delamanid, L = linezolid, Lfx = levofloxacin; M = moxifloxacin; Pa = pretomanid]). In cases of severe or extensive disease and immunosuppression, therapy can be extended to 9 months, for example, or carried out as an individualized 18-month regimen. For XDR-TB and intolerance to bedaquiline or linezolid, individualized combination therapies with at least four effective substances are recommended. In addition to pharmacological aspects, this update emphasizes the importance of quality-assured diagnostics, secure drug supply and socio-medical support to prevent treatment discontinuation. Due to the low number of cases, treatment in specialized centers or in cooperation with them is recommended. The aim is to provide effective, tolerable therapy that is adapted to the resistance situation in order to ensure therapeutic success and prevent further development of drug-resistance.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"160-167"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440407","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":"[Dyspnoea Units: Recommendations on personnel, structural and technical requirements].","authors":"Winfried Randerath, Andreas Günther, Achim Grünewaldt, Matthias Held, Martin Hetzel, Andreas Schlesinger, Robin Schlott, Georgios Sofianos, Markus Unnewehr, Thomas Voshaar, Dominic Dellweg, Georg Nilius","doi":"10.1055/a-2651-7431","DOIUrl":"10.1055/a-2651-7431","url":null,"abstract":"<p><p>Dyspnoea is one of the most important key symptoms in pneumology. It can be an expression of acute or acute on chronic diseases, requiring immediate therapy. In order to enable the fastest and most targeted diagnosis and treatment possible, the German Society for Pulmonology and the Association of Pulmonary Clinics are herewith presenting the concept of the Dyspnoea Unit. This article aims to define the personnel, structural and technical requirements. They result from features of \"complex pneumology\" in the hospital plans of the state of North Rhine-Westphalia and the federal government and are based in detail on the expected clinical scenarios. Hypoxic and hypercapnic respiratory failure play a major role. The cooperation with other specialist disciplines, especially cardiology, thoracic surgery and radiology, underlines the interdisciplinary collaboration.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"114-119"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824835","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":"[Development and pilot testing of a decision aid for early detection of lung cancer with low-dose CT offered to formerly asbestos-exposed employees].","authors":"Helena Keller, Felix Greiner, Jan Heidrich, Volker Harth","doi":"10.1055/a-2594-5102","DOIUrl":"10.1055/a-2594-5102","url":null,"abstract":"<p><p>To prevent lung cancer-related death, the German Social Accident Insurance (Deutsche Gesetzliche Unfallversicherung) offers lung cancer screening with low-dose computed tomography (LDCT) to persons older than 54 years with a history of occupational asbestos exposure and smoking (EVA-LCS). Participation is voluntary; however, it is subject to prior medical consultation. Evidence-based decision aids can inform eligible persons about relevant aspects of LDCT prior to medical consultation and thus contribute to independent and informed decision making.The aim of this study was to develop an evidence-based decision aid and test it in a target group.Based on literature search and methodological research, a decision aid focusing on benefits and risks of LDCT in EVA-LCS was developed. For the pilot-testing, eligible persons were interviewed regarding comprehensibility and information value of the decision aid. The semi-structured interviews were recorded, transcribed and content analysed according to Kuckartz.Interviews with 13 male participants were conducted. The decision aid was well accepted, and the content was understood by most of the interviewees. Ambiguities arose in the context of a pictograph displaying benefits of LDCT screening. The information value was found overall to be adequate. However, many participants considered themselves already well informed. Even though it became evident that trust in medical advice has a major influence on the decision, the decision aid was perceived as a good addition to inform oneself in advance. Additionally, most respondents rated the design and volume of the decision aid as appropriate.First-time participants may benefit most from a decision aid as they get all relevant information about LDCT for EVA-LCS in one brochure. This may enable them to learn more about the benefits and harms and make an informed decision as part of the shared decision-making.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"97-107"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176415","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}