Innere Medizin (Heidelberg, Germany)最新文献_第4页

[Multidrug resistance and new anti-infective agents]. [耐多药和新型抗感染药物]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-09-01 Epub Date: 2026-08-20 DOI: 10.1007/s00108-026-02174-6

Katja Schneider, Stefan Hagel, Maria J G T Vehreschild, Sören Gatermann, Beatrice Grabein, Jessica Rademacher, Mathias W Pletz

{"title":"[Multidrug resistance and new anti-infective agents].","authors":"Katja Schneider, Stefan Hagel, Maria J G T Vehreschild, Sören Gatermann, Beatrice Grabein, Jessica Rademacher, Mathias W Pletz","doi":"10.1007/s00108-026-02174-6","DOIUrl":"10.1007/s00108-026-02174-6","url":null,"abstract":"Multidrug-resistant pathogens are among the greatest global health threats. Among Gram-negative pathogens, the worldwide rise in carbapenem resistance is of particular clinical significance; among Gram-positive pathogens, methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci are of primary concern. Resistance mechanisms include changes in penicillin-binding proteins, enzymatic inactivation by β‑lactamases, porin modifications, and efflux pumps. Targeted therapy for infections caused by multidrug-resistant pathogens requires knowledge of the resistance mechanism and a phenotypic antibiotic susceptibility profile. New β‑lactam/β-lactamase inhibitor combinations have largely replaced older therapeutic approaches such as colistin for infections caused by multidrug-resistant Gram-negative pathogens due to their superior efficacy and tolerability. The recently published first German S3 guideline, \"Antibiotic Therapy for Severe Infections Caused by Multidrug-Resistant Bacteria,\" provides practice-oriented treatment recommendations for infections caused by multidrug-resistant pathogens.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"985-999"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802608","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

[From sudden hearing loss to an inflammatory systemic disease]. [从突发性听力丧失到炎性全身性疾病]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-09-01 Epub Date: 2026-07-30 DOI: 10.1007/s00108-026-02169-3

Laura Hasler, Ariana Gaspert, Tobias Kleinjung, Mike Oliver Becker

引用次数: 0

[When the intestine swallows the pounds]. [当肠道吞下脂肪]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-09-01 Epub Date: 2026-07-30 DOI: 10.1007/s00108-026-02170-w

Pavol Mikula, Matthias Unseld, Hans Jürgen Heppner

引用次数: 0

Einführung zum Thema. 介绍这个主题。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-08-01 Epub Date: 2026-07-23 DOI: 10.1007/s00108-026-02158-6

Dagmar Führer-Sakel, Gerd Hasenfuß, Jan-Christoph Galle

引用次数: 0

[Update on the pharmacotherapy of chronic heart failure with reduced ejection fraction: from four to six pillars?] 慢性心力衰竭伴射血分数降低的药物治疗进展：从四柱到六柱？］

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-08-01 Epub Date: 2026-06-22 DOI: 10.1007/s00108-026-02146-w

Gunnar Klein

{"title":"[Update on the pharmacotherapy of chronic heart failure with reduced ejection fraction: from four to six pillars?]","authors":"Gunnar Klein","doi":"10.1007/s00108-026-02146-w","DOIUrl":"10.1007/s00108-026-02146-w","url":null,"abstract":"Contemporary pharmacotherapy of chronic heart failure with reduced ejection fraction (HFrEF) consists of angiotensin receptor-neprilysin inhibitors, beta blockers, mineralocorticoid receptor antagonists and sodium glucose cotransporter 2 inhibitors. In this year two more agents were added to the existing armamentarium: (1) digitoxin as inhibitor of sodium-potassium-ATPase and (2) vericiguat as stimulator of soluble guanylate cyclase. Vericiguat has already been shown to reduce cardiovascular death and heart failure hospitalization in patients with recent decompensation. This year it was tested in stable heart failure without prior recent decompensation; however, in this case there was no reduction for the combined endpoint of cardiovascular mortality and hospitalization. In the secondary endpoint analysis mortality was significantly reduced. In addition, a meta-analysis including combined data from patients with unstable and also stable heart failure confirmed the positive effects of vericiguat on cardiovascular death and heart failure hospitalization. In the DIGIT-HF study low-dose digitoxin (serum level 8-18 ng/l) significantly reduced death and heart failure hospitalization. Both studies provide evidence that digitoxin and vericiguat added significant benefits to the established 4‑pillar pharmacotherapy and the treatment of HFrEF will be expanded by two more pillars.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"854-861"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297629","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

[Optimal blood pressure control in patients with diabetes and arterial hypertension: interpreting the BPROAD study]. [糖尿病合并高血压患者的最佳血压控制：对BPROAD研究的解读]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-08-01 Epub Date: 2026-06-24 DOI: 10.1007/s00108-026-02144-y

Jan Galle, Julia Weinmann-Menke

{"title":"[Optimal blood pressure control in patients with diabetes and arterial hypertension: interpreting the BPROAD study].","authors":"Jan Galle, Julia Weinmann-Menke","doi":"10.1007/s00108-026-02144-y","DOIUrl":"10.1007/s00108-026-02144-y","url":null,"abstract":"National and international guidelines for the treatment of arterial hypertension have changed significantly over the last decades. Until 2009, most hypertension guidelines suggested: \"the lower the better\". This point of view had been revised in the second decade of this century, mainly due to the lack of data supporting low target values. However, the next turnaround was prompted by interpretation of the data from the Systolic Blood Pressure Intervention Trial (SPRINT) in 2015, which provided evidence for a lower rate of cardiovascular events when systolic blood pressure was lowered below 120 mm Hg. Since the SPRINT trial had excluded patients with diabetes, the Blood Pressure Control Target in Diabetes (BPROAD) trial (2025), which included diabetics, received major attention. The BPROAD trial came to similar conclusions as the SPRINT trial, now supporting the benefit of lowering systolic blood pressure below 120 mm Hg for a broader range of patients. However, the method of measuring blood pressure, as well as the individual tolerability of low blood pressure targets, must also be taken into consideration.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"862-868"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310666","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

[New developments in endocrinology/diabetology]. [内分泌学/糖尿病学的新进展]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-08-01 Epub Date: 2026-07-15 DOI: 10.1007/s00108-026-02154-w

Matthias Blüher, Jörg Bojunga, Martin Fassnacht, Dagmar Führer-Sakel

{"title":"[New developments in endocrinology/diabetology].","authors":"Matthias Blüher, Jörg Bojunga, Martin Fassnacht, Dagmar Führer-Sakel","doi":"10.1007/s00108-026-02154-w","DOIUrl":"10.1007/s00108-026-02154-w","url":null,"abstract":"Advances in our understanding of hormone action and disease pathophysiology are enabling increasingly personalised therapeutic strategies and expanding treatment options for common endocrine and metabolic disorders, which are major contributors to the global burden of chronic disease.This Review highlights three topics of particular relevance to clinical practice in internal medicine and summarises key developments over the past year.The most rapid progress has been made in the field of obesity, where incretin-based therapies are fundamentally reshaping clinical management. Beyond achieving substantial and sustained weight loss, these agents offer new opportunities to prevent and treat a broad range of obesity-related complications. At the same time, emerging diagnostic frameworks that move beyond the traditional body mass index (BMI)-based classification are prompting a reassessment of how obesity is defined and clinically stratified, with the aim of improving risk assessment and guiding treatment decisions.Recent evidence has also refined the diagnostic evaluation and management of adrenal incidentalomas and endocrine causes of hypertension. In parallel, the development of selective aldosterone synthase inhibitors introduces a potential new treatment option for primary aldosteronism, the most common cause of secondary hypertension.A similar paradigm shift is occurring in the management of thyroid nodules and thyroid cancer. Contemporary strategies increasingly emphasise risk-adapted diagnostic and therapeutic approaches that enable accurate identification of clinically significant disease while reducing overdiagnosis and unnecessary intervention. In patients with low-risk thyroid cancer, organ-preserving surgery, more selective use of radioiodine therapy, and, in carefully selected cases, active surveillance are increasingly incorporated into clinical practice. Collectively, these developments aim to reduce treatment-related morbidity while maintaining excellent oncological outcomes and preserving long-term quality of life.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"869-881"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451097","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

[Progression inhibition in chronic kidney disease]. [慢性肾病的进展抑制]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-08-01 Epub Date: 2026-07-03 DOI: 10.1007/s00108-026-02145-x

Julia Weinmann-Menke, Jan Galle

{"title":"[Progression inhibition in chronic kidney disease].","authors":"Julia Weinmann-Menke, Jan Galle","doi":"10.1007/s00108-026-02145-x","DOIUrl":"10.1007/s00108-026-02145-x","url":null,"abstract":"The KDIGO guidelines 2024 on evaluation and treatment of chronic kidney disease (CKD) represent a comprehensive update of the 2012 guidelines, incorporating evidence from over 937 references across 197 pages. The guidelines retain the established CGA classification system (cause, glomerular filtration rate, GFR category, albuminuria category) while introducing strengthened recommendations for prevention of CKD progression. Key advances include expanded indications for sodium-glucose transporter 2 (SGLT2) inhibitors regardless of diabetes status (grade 1A recommendation for eGFR ≥ 20 ml/min per 1.73 m2 body surface area), integration of nonsteroidal mineralocorticoid receptor antagonists (ns-MRA) for diabetic CKD and recognition of glucagon-like peptide‑1 receptor agonists (GLP‑1 RA) for cardiovascular and kidney protection. The guidelines emphasize comprehensive risk stratification, lifestyle optimization including dietary protein restriction (0.8 g/kg and day) and sodium limitation (2 g/day), blood pressure targets (120 mm Hg systolic when tolerable) and combination pharmacotherapy. Emerging therapy approaches including endothelin receptor antagonists and aldosterone synthase inhibitors show promise in phase 2 trials. Meta-analyses demonstrate that combination therapy with SGLT2 inhibitors, GLP‑1 RA, and ns-MRA can extend cardiovascular and kidney event-free survival by 3-5 years in high-risk patients with type 2 diabetes.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"836-842"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378529","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

[Potassium substitution: is replacing sodium with potassium-enriched salts beneficial?] 钾替代：用富钾盐代替钠有益吗？］

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-08-01 Epub Date: 2026-05-05 DOI: 10.1007/s00108-026-02112-6

Felix Götzinger, Michael Kunz, Lucas Lauder, Felix Mahfoud

{"title":"[Potassium substitution: is replacing sodium with potassium-enriched salts beneficial?]","authors":"Felix Götzinger, Michael Kunz, Lucas Lauder, Felix Mahfoud","doi":"10.1007/s00108-026-02112-6","DOIUrl":"10.1007/s00108-026-02112-6","url":null,"abstract":"Background: Hypertension is the leading cause of premature death globally, and acute decompensated heart failure is among the most common causes of hospitalization. Both conditions are adversely affected by high dietary sodium intake. In contrast, potassium has been shown to lower blood pressure. Substituting dietary sodium with potassium may therefore reduce morbidity and mortality associated with hypertension and possibly heart failure.Objectives: This review summarizes the current evidence on the cardiovascular effects of dietary sodium and potassium-containing salts.Current data: Epidemiological studies consistently demonstrate that high sodium intake is associated with elevated blood pressure and increased rates of cardiovascular morbidity and mortality. Meta-analyses indicate that reducing sodium intake lowers blood pressure and reduces cardiovascular events. In a cluster-randomized trial, partial substitution of sodium chloride with potassium-enriched salt reduced cardiovascular morbidity and mortality in patients with hypertension. However, robust data on the effects of sodium restriction or potassium substitution on hard cardiovascular outcomes in patients with heart failure remain limited.Conclusions: High sodium intake has detrimental effects on cardiovascular health. Substituting sodium with potassium-containing salts represents a promising strategy to reduce morbidity and mortality associated with hypertension.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"935-941"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847003","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}

引用次数: 0

[A rare cause of acute pancreatitis]. [引起急性胰腺炎的罕见原因]。

IF 0.6

Innere Medizin (Heidelberg, Germany) Pub Date : 2026-08-01 Epub Date: 2026-06-15 DOI: 10.1007/s00108-026-02134-0

Timo Pohlkötter, Gabriel Tönnesmann, Bernhard Glasbrenner

引用次数: 0