Internist最新文献

{"title":"56/m mit Blut im Stuhl und positiver Familienanamnese für kolorektales Karzinom","authors":"Der Internist, Kolorektales Karzinom","doi":"10.1007/s00108-022-01294-z","DOIUrl":"https://doi.org/10.1007/s00108-022-01294-z","url":null,"abstract":"","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 1","pages":"253-258"},"PeriodicalIF":0.0,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51945612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gespräch zu den Folgen des Klimawandels für die Medizin und den Menschen","authors":"E. von Hirschhausen, M. Lerch","doi":"10.1007/s00108-022-01299-8","DOIUrl":"https://doi.org/10.1007/s00108-022-01299-8","url":null,"abstract":"","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 1","pages":"397 - 400"},"PeriodicalIF":0.0,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51945699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antikoagulation bei „coronavirus disease 2019“ (COVID-19) – Gesichertes und Kontroverses","authors":"Ursula Rauch-Kröhnert, H. Riess","doi":"10.1007/s00108-022-01296-x","DOIUrl":"https://doi.org/10.1007/s00108-022-01296-x","url":null,"abstract":"","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 1","pages":"453 - 460"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49350339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Shortening and de-escalation of dual antiplatelet therapy].","authors":"M Halbach, S Baldus, S Nitschmann","doi":"10.1007/s00108-022-01262-7","DOIUrl":"10.1007/s00108-022-01262-7","url":null,"abstract":"","PeriodicalId":54924,"journal":{"name":"Internist","volume":" ","pages":"341-345"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39598896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Telemedicine in chronic heart failure-From clinical studies to standard care].","authors":"Sebastian Spethmann, Friedrich Köhler","doi":"10.1007/s00108-022-01268-1","DOIUrl":"10.1007/s00108-022-01268-1","url":null,"abstract":"<p><p>Telemedicine has the potential to solve many current and especially future challenges in medical care. Using the example of heart failure (HF), the transition of telemedicine from clinical studies to standard care is presented. In patients with chronic HF, randomized controlled trials have shown that telemedicine-based care leads to a reduction in mortality and cardiovascular morbidity. Based on these data, the Federal Joint Committee (G-BA) decided that for the first time a digital method should be introduced into standard care for high-risk patients with reduced left ventricular ejection fraction. In the future, this group of patients will be entitled to telemedical care using active rhythm devices or noninvasive measuring devices. The indications are assessed by the primary treating physician (PBA), who works together with a telemedicine center (TMZ) managed through cardiology that receives daily telemetric data and notifies the PBA of abnormal findings. Alternatively, a cardiologist PBA with an associated TMZ infrastructure can also provide telemedical care. In the future, advanced technologies such as artificial intelligence or mobile communication standard 5G will help to make telemedicine both widely available and usable for alternative sensor technology.</p>","PeriodicalId":54924,"journal":{"name":"Internist","volume":" ","pages":"266-273"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39902775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Erratum to: Shortening and de-escalation of dual antiplatelet therapy].","authors":"M Halbach,&nbsp;S Baldus,&nbsp;S Nitschmann","doi":"10.1007/s00108-022-01303-1","DOIUrl":"https://doi.org/10.1007/s00108-022-01303-1","url":null,"abstract":"","PeriodicalId":54924,"journal":{"name":"Internist","volume":" ","pages":"346"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39652526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Experiences with digital care of patients with chronic and acute lung diseases during the SARS-CoV-2 pandemic].","authors":"Marcel Braun,&nbsp;Olaf Schmidt,&nbsp;Thomas Schultz,&nbsp;Holger Woehrle,&nbsp;Martina Große Sundrup,&nbsp;Christoph Schöbel","doi":"10.1007/s00108-022-01266-3","DOIUrl":"https://doi.org/10.1007/s00108-022-01266-3","url":null,"abstract":"<p><strong>Background: </strong>Management of patients with respiratory disorders, such as asthma or chronic obstructive pulmonary disease (COPD), became challenging during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic due to infection prevention measures. To maintain care, a remote monitoring program was initiated, comprising a smartphone app and a Bluetooth spirometry device.</p><p><strong>Objective: </strong>To assess patient- and physician-related experience with remote monitoring.</p><p><strong>Material and methods: </strong>Structured questionnaires were developed to rate experiences from the patient or physician perspective on six-level Likert scales. Interactions between patients and physicians via the digital platform and overall utilization was analyzed.</p><p><strong>Results: </strong>A total of 745 patients with asthma, COPD, post-coronavirus disease 2019 (COVID-19) and other respiratory diseases were enrolled from 31 centers in Germany. Mean follow-up was 49.4 ± 12.6 weeks. Each participant submitted on average 289 measurements. Patient-reported experience with the remote monitoring program was positive, with the highest satisfaction reported for \"Experience with home measurement\" (1.4 ± 0.5; 99% positive), followed by \"Communication/interaction\" (1.8 ± 0.9; 83% positive) and \"Overall satisfaction with program\" (1.8 ± 0.8; 87% positive). In all, 70% reported subjective quality of life improvements related to participation in the program. Physician satisfaction with the program was also high with a mean rating of 2.2 ± 1.2.</p><p><strong>Discussion: </strong>App-based remote monitoring was successfully implemented in routine care during the SARS-CoV‑2 pandemic and demonstrated potential for improvements in care. Patient-relevant experience was positive in all dimensions and remote monitoring was well accepted. Physicians who participated in the program also expressed positive experiences, as demonstrated by a high level of interaction with the platform and positive evaluations of effects from the program.</p>","PeriodicalId":54924,"journal":{"name":"Internist","volume":" ","pages":"255-265"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8856116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39935837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Sepsis with hemolysis due to a liver abscess in a 60-year-old male patient].","authors":"H Lang, J J Schmidt, H Wedemeyer, M Busch","doi":"10.1007/s00108-021-01227-2","DOIUrl":"10.1007/s00108-021-01227-2","url":null,"abstract":"<p><p>Many cases of Clostridium perfringens sepsis prove to be fatal. We present a case of C. perfringens sepsis with a liver abscess as the focus of infection, which was successfully treated by an interdisciplinary intensive medical care management. The sepsis with this rare pathogen was favored by the presence of a bilioenteric anastomosis and immunosuppressive treatment of a pre-existing Crohn's disease. Antibiotic treatment with clindamycin and penicillin G was initiated and the abscess was drained. Hemodialysis with high cut-off filters was started because of acute kidney failure in the Acute Kidney Injury Network (AKIN) stage III, hemolysis and rhabdomyolysis. Therapeutic plasma exchange was performed due to sepsis and acute liver failure.</p>","PeriodicalId":54924,"journal":{"name":"Internist","volume":" ","pages":"325-329"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39657883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Renal denervation : Really an alternative to reducing blood pressure?]","authors":"Kristina Striepe, Mario Schiffer, Roland Schmieder","doi":"10.1007/s00108-021-01242-3","DOIUrl":"10.1007/s00108-021-01242-3","url":null,"abstract":"<p><p>Since the current guidelines were published in 2018, a total of 5 sham-controlled high-quality studies evaluating renal denervation have been conducted and the results were published. These five studies clearly confirmed the efficacy and safety of renal denervation, which correspond to the knowledge of the Clinical Consensus Conference. Thus, an update of the guidelines for the treatment of arterial hypertension regarding the clinical significance of renal denervation is urgently necessary. For this reason, the position paper of the working group of the European Society of Hypertension on the current state of renal denervation was reviewed. An approval of this procedure can soon be expected. In Germany there is a diagnosis-related group (DRG) for the reimbursement of renal denervation, which was suspended due to the erroneous Symplicity 3 study. This DRG should be revived in practice by a structured process of the implementation of renal denervation. It will then be a joint task of treating physicians and specialists in certified centers to identify eligible patients. In the future, antihypertensive treatment will consist of three pillars: lifestyle measures, pharmacotherapy and interventional treatment. These three treatment options should not be regarded as competitive (which is better) but alternative (patient preference) and additive (the aim is blood pressure control). It is the task of the treating physician to provide the patient with the ideal treatment concept. Clearly, renal denervation will not replace antihypertensive pharmacotherapy; however, it can lead to a reduction of the drug burden and increase of patient adherence to medication. It represents an option of modern antihypertensive treatment and will also become increasingly more important in special patient groups.</p>","PeriodicalId":54924,"journal":{"name":"Internist","volume":" ","pages":"330-340"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39697651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Mobile health for detection of atrial fibrillation-Status quo and perspectives].","authors":"Dennis Lawin,&nbsp;Urs-Vito Albrecht,&nbsp;Zoe Sophie Oftring,&nbsp;Thorsten Lawrenz,&nbsp;Christoph Stellbrink,&nbsp;Sebastian Kuhn","doi":"10.1007/s00108-022-01267-2","DOIUrl":"10.1007/s00108-022-01267-2","url":null,"abstract":"<p><p>Mobile health (mHealth) for the detection of atrial fibrillation is an innovative domestic monitoring of the heart rhythm. The use of mHealth in the context of atrial fibrillation increases the availability of diagnostic technologies and facilitates the integration into telemedical treatment concepts as well as the active participation of patients in the treatment process. The detection of atrial fibrillation with mHealth applications is usually based on electrocardiography (ECG) or by detection of the pulse wave using photoplethysmography (PPG). Some applications require additional sensors, others make use of sensors integrated into smartphones or smartwatches. A high diagnostic accuracy for the detection of atrial fibrillation has been shown for most mHealth applications regardless of the underlying technology (analytical validation); however, the evidence on positive care effects and improvement of medical endpoints (clinical validation) is so far scarce. Screening of symptomatic or asymptomatic patients and the follow-up care after antiarrhythmic measures are possibilities for the integration into the reality of care. The preventive detection of atrial fibrillation is an attractive field of application for mHealth with great potential for the future. Nevertheless, at present mHealth is only integrated to a limited extent into the reality of patient care. Adequate reimbursement and medical remuneration as well as opportunities to derive information and qualification are prerequisites in order to be able to guarantee a comprehensive implementation in the future. The Digital Health Care Act passed in 2019, regulates the reimbursement of digital healthcare applications but issues of primary preventive applications have not yet been included.</p>","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 3","pages":"274-280"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8832086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10264499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}