{"title":"[Principles of obesity treatment: What has changed in the updated S3 guideline?]","authors":"Nathalie Rohmann, Tim Hollstein, Matthias Laudes","doi":"10.1007/s00108-025-01900-w","DOIUrl":"https://doi.org/10.1007/s00108-025-01900-w","url":null,"abstract":"<p><p>A comprehensive update of the S3 guideline for the prevention and treatment of obesity was published in October 2024. In contrast to the former version, the literature search included not only data on weight reduction but also data on patient-reported outcomes and co-morbidity. The new recommendations for nutritional therapy, besides fat and carbohydrate reduction, now also include novel aspects like the Mediterranean diet and intermittent fasting. These will enable individualization and will avoid an unbalanced diet. Pharmacotherapy, especially incretin-based, is recommended in an adjuvant setting, especially since current clinical trials indicate beneficial effects on the heart, liver and kidney in addition to weight reduction. A novel chapter was included regarding eHealth strategies, since these are efficient as supportive measures for multidimensional treatment programs, including nutritional advice, behavioural coaching and exercise training. Finally, a novel aspect was incorporated: discrimination and stigmatization of subjects suffering from obesity. This is important not only for the general environment but also for the medical sector, including the handling of patients as well as the infrastructure of the medical institution (e.g. heavy-duty chairs). Hence, the novel guideline will guarantee high quality in the medical care of subjects suffering from obesity.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813005","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":"[Practice-oriented rational assessment of anemia].","authors":"Georgia Metzgeroth, Jan Hastka","doi":"10.1007/s00108-025-01880-x","DOIUrl":"https://doi.org/10.1007/s00108-025-01880-x","url":null,"abstract":"<p><p>Anemia is frequently diagnosed in the daily clinical routine and is an indicator of a more or less severe underlying disorder. An understanding of the diverse and complex etiology is crucial for a practice-oriented diagnostic approach. In principle, there are many differential diagnoses. The diagnosis is further complicated by the fact that anemia is often multifactorial, especially in old age. A rational clarification of anemia takes epidemiological data and the individual medical history into account. Classification according to erythrocyte indices plays a central role. The most important cause of hypochromic microcytic anemia is iron deficiency, with thalassemia and anemia of chronic disorders (ACD) as differential diagnoses. Hyperchromic macrocytic anemia is mainly caused by disturbances of vitamin B12 and folic acid metabolism or the DNA synthesis. The group of normochromic normocytic anemias includes most of the subtypes of anemia. In unclear cases, a referral to a hematologist for clarification is recommended.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775190","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":"[Pathophysiology of fibrosis: inflammatory vs. non-inflammatory].","authors":"Elena Neumann, Philipp Klemm","doi":"10.1007/s00108-025-01890-9","DOIUrl":"https://doi.org/10.1007/s00108-025-01890-9","url":null,"abstract":"<p><p>Fibrosis is characterized by an excessive accumulation of extracellular matrix components produced by connective tissue cells. It is a pathophysiological feature of many chronic inflammatory diseases. Nearly every tissue of the body can be affected by fibrosis. Its progression can lead to dysfunction of the affected tissue and organs and potentially death. Early fibrotic mechanisms include the activation of immune responses leading to activation of connective tissue cells and misdirected wound healing responses, finally leading to scarring and fibrosis. Different pathways and factors contribute to the pathophysiology of fibrosis and are summarized in this review.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782184","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":"[Resilience in the face of disaster: A prerequisite or a skill to be acquired? : A consideration of this question using Doctors Without Borders as an example].","authors":"Tankred Stöbe","doi":"10.1007/s00108-025-01855-y","DOIUrl":"10.1007/s00108-025-01855-y","url":null,"abstract":"<p><p>Little is known about the resilience of the most vulnerable people on this planet in disaster and war zones. However, addressing this topic can be of crucial importance for future adaptation strategies and individual preparation for difficult life circumstances. For Médecins Sans Frontières (MSF), resilience is becoming increasingly important in all areas of activity: in supporting refugees and internally displaced persons, in responding to the effects of global warming, following natural disasters, in wars, and in providing psychological support to aid workers as well as those that need help. This article discusses the definition of resilience, the interpretation of which is dynamic and multifaceted. Individual resilience can be gauged and reflected upon through self-interrogation. This article then deals with the safety of and risk faced by international and local aid workers in crisis areas as well as with the question of whether Doctors Without Borders can be considered a resilient organization. Finally, the article looks at how each individual aid worker can strengthen their personal resilience. Indeed, resilience can be trained, and we would do well to start straight away.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"360-364"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366883","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":"[Liver injury and polyserositis as rare side effects of oxcarbazepine].","authors":"Felix Brombacher, Beat Müllhaupt, Abraham Licht","doi":"10.1007/s00108-024-01817-w","DOIUrl":"10.1007/s00108-024-01817-w","url":null,"abstract":"<p><p>We report the case of a patient with trigeminal neuralgia who developed cholestatic liver injury with systemic inflammation and polyserositis after starting oxcarbazepine therapy. No other causes could be identified. After discontinuation of the drug, there was a complete remission. This case shows that the more modern oxcarbazepine can also cause idiosyncratic liver damage and underlines the importance of high vigilance concerning drug reactions in clinical practice.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"433-435"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775344","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}