Innere Medizin (Heidelberg, Germany)最新文献

[Target organ connective tissue: the variability of systemic fibrosis].

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-03-07 DOI: 10.1007/s00108-025-01868-7

Nils Schulz, Philipp Klemm, Ulf Müller-Ladner

{"title":"[Target organ connective tissue: the variability of systemic fibrosis].","authors":"Nils Schulz, Philipp Klemm, Ulf Müller-Ladner","doi":"10.1007/s00108-025-01868-7","DOIUrl":"https://doi.org/10.1007/s00108-025-01868-7","url":null,"abstract":"The group of systemic fibrosing connective tissue diseases is remarkably diverse, comprising a wide spectrum of distinct entities. Central to their pathogenesis is the fibroblast, which, when activated by exogenous or endogenous triggers, can pathologically overproduce components of the extracellular matrix or exhibit uncontrolled proliferation. Systemic sclerosis, recognized as the prototype of systemic fibrosing diseases, belongs to the connective tissue diseases. Despite considerable advancements in the understanding of its pathogenesis, diagnosis, and treatment over recent years, systemic sclerosis remains one of the most fatal conditions among inflammatory rheumatic diseases. Its hallmark features include vasculopathy, systemic fibrosis, and autoimmunity, with common organ involvement affecting the skin, lungs, heart, gastrointestinal tract, kidneys, and musculoskeletal system. Therapeutic strategies focus on improving perfusion, controlling inflammation, and implementing antifibrotic measures. Key differential diagnoses include eosinophilic fasciitis, mixed connective tissue disease, and other overlap syndromes, which often require immunomodulatory treatment. Innovative developments in the field suggest a potential paradigm shift in the treatment of inflammatory rheumatic diseases, with cell-based therapies like CD19-depleting chimeric antigen receptor (CAR) T cell therapy showing promising early outcomes. Other systemic fibrosing diseases include scleromyxedema and scleroedema adultorum Buschke, both of which belong to the mucinoses and contribute further to the complexity of this disease group.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574964","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}

引用次数: 0

[Fibrotic diseases in the gastrointestinal tract : Liver fibrosis and more].

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-03-03 DOI: 10.1007/s00108-025-01869-6

Elke Roeb

{"title":"[Fibrotic diseases in the gastrointestinal tract : Liver fibrosis and more].","authors":"Elke Roeb","doi":"10.1007/s00108-025-01869-6","DOIUrl":"https://doi.org/10.1007/s00108-025-01869-6","url":null,"abstract":"Chronic liver damage, such as metabolic dysfunction-associated steatotic liver disease (MASLD), viral hepatitis B or C, cholestatic hepatitis (PBC, PSC), toxic damage (alcohol) or genetic alterations (hemochromatosis, Wilson's disease, etc.) usually cause a chronic inflammatory response in liver cells or bile duct epithelial cells. In the long term this chronic inflammatory response can lead to scarring of the liver, a condition known as fibrosis. The development of liver fibrosis is largely independent of the causative agent, although the pattern of initial fibrosis (periportal, pericentral or sinusoidal) can vary. Untreated and progressive fibrosis can sometimes lead to complete architectural deconstruction and deposition of connective tissue in the liver, intestines and other parenchymal organs, with a gradual loss of function. In the end stage of liver cirrhosis, portal hypertension, encephalopathy, bleeding or carcinomas, e.g., hepatocellular carcinoma (HCC) and intrahepatic cholangiocellular carcinoma (iCCCa), can occur. Intestinal fibrosis is one of the most devastating complications of Crohn's disease. With novel and consistent therapeutic interventions, fibrotic processes can be stopped and reversed. New research technologies have substantially improved our knowledge of liver fibrogenesis and intestinal fibrosis. The focus of this review article is on MASLD and Crohn's disease, chronic inflammatory diseases of the liver and intestines with increasing prevalence and a major impact on the general population. The current principles and potential possibilities of preventive and therapeutic antifibrotic interventions are illustrated.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544756","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}

引用次数: 0

[Endovascular therapy of aorto-iliac occlusive disease].

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-03-01 Epub Date: 2025-02-14 DOI: 10.1007/s00108-025-01854-z

Thomas Zeller

{"title":"[Endovascular therapy of aorto-iliac occlusive disease].","authors":"Thomas Zeller","doi":"10.1007/s00108-025-01854-z","DOIUrl":"10.1007/s00108-025-01854-z","url":null,"abstract":"Background: Arterial occlusive disease of the central arteries involving the abdominal aorta and iliac arteries leads to multiple symptoms such as intermittent claudication, including of the gluteus muscle, and erectile dysfunction.Objectives: A description of the indications, technique and clinical outcomes of the endovascular therapy of aorto-iliac artery occlusive disease.Results: Due to new endovascular techniques and improved stents and stent grafts developed over the last two decades, the endovascular therapy of aorto-iliac obstructions has become the standard method for the treatment of intermittent claudication in experienced centers. Open surgical bypass revascularisation is mainly indicated after a failed endovascular attempt or in the case of unfavourable anatomy for endovascular therapy, including flush occlusions distal to the renal artery origins. A less frequently used revascularisation technique, the hybrid revascularisation, combines open surgical thromboendarterectomy of the common femoral artery and stent implantation of the ipsilateral iliac artery or aorta. Obstructions of the internal iliac artery resulting in, among other things, erectile dysfunction and hip claudication are ever more frequently treated with either drug-eluting stents or balloons.Conclusion: In the case of appropriate operator experience and suitable anatomy, endovascular therapy has become the first-line revascularisation strategy for aorto-iliac occlusive disease involving the internal iliac artery.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"249-257"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426762","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}

引用次数: 0

[AVK III: Below the knee].

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-03-01 Epub Date: 2025-02-28 DOI: 10.1007/s00108-025-01871-y

Erwin Blessing

引用次数: 0

[Ways to improve vaccination rates : Indication vaccinations for adults].

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-03-01 Epub Date: 2025-02-11 DOI: 10.1007/s00108-025-01857-w

Jürgen Floege, Toralf Schwarz, Christoph Wanner, Uwe Heemann, Baptist Gallwitz, Oliver Witzke

引用次数: 0

[Peripheral artery disease II: femoropopliteal lesions].

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-03-01 Epub Date: 2025-02-17 DOI: 10.1007/s00108-025-01858-9

Christos Rammos, Tienush Rassaf, Grigorios Korosoglou

{"title":"[Peripheral artery disease II: femoropopliteal lesions].","authors":"Christos Rammos, Tienush Rassaf, Grigorios Korosoglou","doi":"10.1007/s00108-025-01858-9","DOIUrl":"10.1007/s00108-025-01858-9","url":null,"abstract":"The endovascular treatment of the femoropopliteal segment is the most frequent revascularization option in patients with peripheral arterial occlusive disease (PAOD); however, the plain old balloon angioplasty has limitations, especially in complex and calcified lesions, and can lead to dissections and recoil. In order to improve the technical success and the efficacy of the endovascular treatment in complex, sometimes severely calcified or thrombotic lesions or also in lesions in mobile segments, a lesion preparation strategy before the actual lesion treatment is frequently applied. Lesion preparation methods include atherectomy, thrombectomy or intravascular lithotripsy. Through lesion preparation plaques and/or organized thrombi can be minimally invasively removed or calcium deposits can be even fragmented with low threshold barotrauma, without damaging the vessel wall. Subsequently, the definitive treatment of the lesion can be carried out using drug-coated balloons (DCB), bare metal stents (BMS), drug-eluting stents (DES) or a combination of these. Due to the heterogeneity of patient and lesion characteristics, no 'one fits all' strategy is so far available; however, the choice of the appropriate instruments should be carried out based on the patient and lesion characteristics present, whereby for the lesion-specific parameters the extent of the morphology and underlying pathology plays an important role.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"258-267"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442704","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}

引用次数: 0

[Periaortic gas and signs of dissection of a mycotic aneurysm in the descending thoracic aorta due to Clostridium septicum]. [败血梭菌引起的降胸主动脉霉菌性动脉瘤的主动脉周围气体和夹层迹象]。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-03-01 Epub Date: 2024-09-27 DOI: 10.1007/s00108-024-01800-5

Monica Maria Novoa Usme, Iskandar Atmowihardjo, Sebastian Spencker

引用次数: 0

[Non-Hodgkin's lymphomas: a short overview].

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-03-01 Epub Date: 2025-02-11 DOI: 10.1007/s00108-025-01856-x

S Pudasaini, M Dreyling

引用次数: 0

Mitteilungen der DGIM.

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-03-01 DOI: 10.1007/s00108-025-01866-9

引用次数: 0

Fortbildungen des BDI.

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-03-01 DOI: 10.1007/s00108-025-01860-1

引用次数: 0