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Zukunft der Selbstverwaltung. 自治的未来。
IF 0.6
Innere Medizin (Heidelberg, Germany) Pub Date : 2026-07-01 DOI: 10.1007/s00108-026-02147-9
{"title":"Zukunft der Selbstverwaltung.","authors":"","doi":"10.1007/s00108-026-02147-9","DOIUrl":"https://doi.org/10.1007/s00108-026-02147-9","url":null,"abstract":"","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":"67 7","pages":"772-781"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347680","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
[Metabolic bone disorders: what the internist must not overlook]. 【代谢性骨紊乱：内科医生不可忽视的问题】。
IF 0.6
Innere Medizin (Heidelberg, Germany) Pub Date : 2026-07-01 Epub Date: 2026-06-09 DOI: 10.1007/s00108-026-02136-y
Heide Siggelkow, Elena Tsourdi
{"title":"[Metabolic bone disorders: what the internist must not overlook].","authors":"Heide Siggelkow, Elena Tsourdi","doi":"10.1007/s00108-026-02136-y","DOIUrl":"10.1007/s00108-026-02136-y","url":null,"abstract":"<p><strong>Background: </strong>Metabolic bone disorders are common, albeit underestimated, causes of fractures and chronic bone pain in internal medicine. They can remain asymptomatic for long periods and are frequently only diagnosed when insufficiency fractures occur.</p><p><strong>Aim of the study: </strong>The aim of this review article is to discuss common and rare metabolic bone disorders and to outline a practice-oriented diagnostic approach.</p><p><strong>Materials and methods: </strong>Narrative review of current literature with particular emphasis on clinically relevant differential diagnoses and diagnostic algorithms.</p><p><strong>Results: </strong>In addition to secondary osteoporosis, disorders of calcium and phosphate metabolism play a central role. Important differential diagnoses include primary hyperparathyroidism, genetic osteopathies, hypophosphatasia, and fibroblast growth factor 23 (FGF23)-mediated hypophosphataemia. Crucial for diagnosis are a structured medical history, the measurement of calcium, phosphate, magnesium, parathyroid hormone and alkaline phosphatase, as well as, where necessary, further parameters such as tubular maximum for phosphate reabsorption per glomerular filtration rate (TMP/GFR) and FGF23. Magnetic resonance imaging is essential for detecting insufficiency fractures.</p><p><strong>Conclusion: </strong>A systematic approach to the diagnosis of metabolic bone diseases is crucial, as this directly determines different therapeutic implications, and specific treatment options are increasingly becoming available.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"709-716"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207063","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
[Osteoporosis-a plea for consistent diagnosis and treatment-also in men : Contra paradox: high prevalence rate, low treatment rate]. [骨质疏松症——要求一致的诊断和治疗——也适用于男性：矛盾的悖论：高患病率，低治疗率]。
IF 0.6
Innere Medizin (Heidelberg, Germany) Pub Date : 2026-07-01 Epub Date: 2026-06-02 DOI: 10.1007/s00108-026-02137-x
Friederike Thomasius, Björn Bühring
{"title":"[Osteoporosis-a plea for consistent diagnosis and treatment-also in men : Contra paradox: high prevalence rate, low treatment rate].","authors":"Friederike Thomasius, Björn Bühring","doi":"10.1007/s00108-026-02137-x","DOIUrl":"10.1007/s00108-026-02137-x","url":null,"abstract":"<p><p>Osteoporosis affects approximately 6 million people in Germany, both women and men, making it one of the most significant common diseases. Fractures as a typical manifestation of the condition increase with advancing age-a fact that carries particular weight in an increasingly ageing society. In 2019, at least 20% more femoral neck fractures and pertrochanteric fractures were recorded compared to 2009. Evidence-based diagnostics and therapy are therefore indispensable for which S3 guideline recommendations (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften [AWMF] 183-001) have been formulated and were updated in September 2023. Diagnosis is based on fracture risk, and while various treatment approaches are available, adequate care structures that ensure reliable management of patients are lacking in many places-particularly in the aftermath of an osteoporotic fracture. This article aims to address the criticism that the current osteoporosis guideline is too complex. In fact, diagnosing and treating fracture risk is now highly standardized and easily put into practice. A second aspect is the neglect of the topic of osteoporosis in men.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"752-759"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152323","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
[Autoimmune pancreatitis and IgG4-related disease]. 自身免疫性胰腺炎和igg4相关疾病。
IF 0.6
Innere Medizin (Heidelberg, Germany) Pub Date : 2026-07-01 Epub Date: 2026-06-08 DOI: 10.1007/s00108-026-02125-1
Alexander Kleger
{"title":"[Autoimmune pancreatitis and IgG4-related disease].","authors":"Alexander Kleger","doi":"10.1007/s00108-026-02125-1","DOIUrl":"10.1007/s00108-026-02125-1","url":null,"abstract":"<p><p>Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated systemic disease that causes organ-specific inflammation and fibrosis patterns and also frequently has tumor-like effects. In the pancreaticobiliary setting type 1 autoimmune pancreatitis (AIP1) and IgG4-related cholangitis (IAC) are the most important manifestations. Structured diagnostics are decisive, with prioritized exclusion of malignancies and infections followed by a syndrome-based classification (serology, imaging, histology and organ pattern). Glucocorticoids are highly effective for induction of remission; however, recurrences are frequent and require a risk-adapted prevention of recurrence and structured monitoring of the course.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"760-771"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201420","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
[Severe pulmonary Mycobacterium genavense infection in an immunocompetent adult : Diagnostic challenges and successful macrolide-based combination therapy]. [免疫功能正常成人的严重肺结核分枝杆菌感染：诊断挑战和成功的大环内酯类联合治疗]。
IF 0.6
Innere Medizin (Heidelberg, Germany) Pub Date : 2026-07-01 Epub Date: 2026-03-26 DOI: 10.1007/s00108-026-02097-2
Jonas Früh, Johanna Bolay, Raphaela Kalus, Loraine Früh, Simone Reu-Hofer, Andreas Müller
{"title":"[Severe pulmonary Mycobacterium genavense infection in an immunocompetent adult : Diagnostic challenges and successful macrolide-based combination therapy].","authors":"Jonas Früh, Johanna Bolay, Raphaela Kalus, Loraine Früh, Simone Reu-Hofer, Andreas Müller","doi":"10.1007/s00108-026-02097-2","DOIUrl":"10.1007/s00108-026-02097-2","url":null,"abstract":"<p><p>Mycobacterium genavense is a rare cause of non-tuberculous mycobacterial disease, typically occurring in immunocompromised hosts. The case of a 49-year-old immunocompetent man with respiratory symptoms is presented. Imaging revealed a hilar mass with mediastinal lymphadenopathy, initially suggesting malignancy. Molecular diagnostics identified M. genavense as the causative pathogen. A 15-month regimen of rifampicin, azithromycin, and ethambutol led to complete clinical and radiological remission.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"814-819"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517131","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
[Rare diseases: a concept for a structured diagnostic pathway]. [罕见病：结构化诊断途径的概念]。
IF 0.6
Innere Medizin (Heidelberg, Germany) Pub Date : 2026-07-01 Epub Date: 2026-06-15 DOI: 10.1007/s00108-026-02129-x
Laura Schmidt-Pennington
{"title":"[Rare diseases: a concept for a structured diagnostic pathway].","authors":"Laura Schmidt-Pennington","doi":"10.1007/s00108-026-02129-x","DOIUrl":"10.1007/s00108-026-02129-x","url":null,"abstract":"<p><p>With around 7% of the population affected, rare diseases (RD) altogether represent a relevant group of conditions in Europe. One of the central problems of RD care is delayed diagnosis (on average 6-8 years), which has serious implications for the prognosis, treatment and quality of life of those affected. Primary caretakers play a crucial role in attempts to improve this situation, since they are the ones who identify suspected cases and take charge of their coordination. The implementation of a structured diagnostic pathway could considerably reduce the burden on primary caretakers, effectively shorten the time to diagnosis and lower costs for the healthcare system. Therefore, the following article maps out a concrete strategy. It contributes to strengthening primary caretakers in their role as central coordinators, as well as to improving cooperation between primary caretakers, patients affected by RD, specialists and centres for RD.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"820-826"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254784","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
[Anti-inflammatory treatment strategies in coronary heart disease]. [冠心病的抗炎治疗策略]
IF 0.6
Innere Medizin (Heidelberg, Germany) Pub Date : 2026-07-01 Epub Date: 2026-03-11 DOI: 10.1007/s00108-026-02096-3
Ulrich Hofmann
{"title":"[Anti-inflammatory treatment strategies in coronary heart disease].","authors":"Ulrich Hofmann","doi":"10.1007/s00108-026-02096-3","DOIUrl":"10.1007/s00108-026-02096-3","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in lipid-lowering, antithrombotic, and interventional therapies, coronary heart disease (CHD) remains associated with a substantial risk of recurrent cardiovascular events. Inflammation has emerged as a major contributor to this residual risk. Experimental and clinical evidence indicates that inflammatory pathways, particularly activation of the NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome and, downstream, the interleukin-1β-interleukin-6-C-reactive protein (CRP) axis, play a key role in atherosclerotic plaque progression and destabilization.</p><p><strong>Objectives: </strong>This review summarizes the clinical evidence for anti-inflammatory therapies in patients with CHD.</p><p><strong>Current data: </strong>The CANTOS trial provided the first evidence that inhibition of interleukin-1β in CHD patients with elevated CRP reduces major adverse cardiovascular events independently of lipid lowering. Low-dose colchicine significantly reduced cardiovascular events in several trials, both early after myocardial infarction and in patients with chronic coronary disease.</p><p><strong>Conclusions: </strong>These findings establish inflammation as a modifiable therapeutic target in the secondary prevention of CHD and support colchicine as the most advisable anti-inflammatory treatment currently available for CHD.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"827-832"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438189","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
[Osteoarthritis: epidemiology, pathophysiology, and conservative treatment options]. [骨关节炎：流行病学、病理生理学和保守治疗选择]。
IF 0.6
Innere Medizin (Heidelberg, Germany) Pub Date : 2026-07-01 Epub Date: 2026-05-28 DOI: 10.1007/s00108-026-02135-z
Marco Krasselt, Christoph Baerwald
{"title":"[Osteoarthritis: epidemiology, pathophysiology, and conservative treatment options].","authors":"Marco Krasselt, Christoph Baerwald","doi":"10.1007/s00108-026-02135-z","DOIUrl":"10.1007/s00108-026-02135-z","url":null,"abstract":"<p><p>Osteoarthritis is the most common degenerative joint disease worldwide and one of the leading causes of morbidity and reduced quality of life in older adults. In Germany, approximately 17.9% of adults are affected, including 21.8% of women and 13.9% of men. In individuals over 65 years of age, up to 48% of women and 31% of men are affected, with direct annual costs exceeding 12 billion euros in 2020. The pathophysiology is multifactorial and is driven by the interplay of cellular senescence, inflammatory cascade reactions, biomechanical factors, and metabolic dysregulation. Modifiable risk factors such as overweight, previous joint injuries, and physical inactivity account for roughly half of all incident cases of knee osteoarthritis. Evidence-based management prioritizes intensive (active) exercise therapy, weight management, and targeted analgesic strategies, with topical NSAIDs as the first-line option. Emerging biological approaches, including mesenchymal stem cell therapy, platelet-rich plasma (PRP), and disease-modifying osteoarthritis drugs (DMOADs), show promising potential but still require further clinical validation.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"717-724"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058777","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
[Rheumatoid arthritis-more than just a joint disease : Overview for internal medicine practice]. [类风湿关节炎-不仅仅是一种关节疾病：内科实践概述]。
IF 0.6
Innere Medizin (Heidelberg, Germany) Pub Date : 2026-07-01 Epub Date: 2026-06-02 DOI: 10.1007/s00108-026-02138-w
Lien Meerkatt, David Simon, Edgar Wiebe
{"title":"[Rheumatoid arthritis-more than just a joint disease : Overview for internal medicine practice].","authors":"Lien Meerkatt, David Simon, Edgar Wiebe","doi":"10.1007/s00108-026-02138-w","DOIUrl":"10.1007/s00108-026-02138-w","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a common chronic inflammatory disease and a systemic autoimmune disorder associated with increased morbidity and mortality due to multiorgan involvement.</p><p><strong>Objectives: </strong>To summarize pathophysiology, clinical presentation, diagnostics and modern treatment strategies of RA, and to highlight its relevance for internal medicine.</p><p><strong>Methods: </strong>Narrative review of current literature, guidelines and clinical studies with a focus on clinically relevant aspects regarding diagnosis, treatment, and comorbidities.</p><p><strong>Results: </strong>RA results from a complex interaction of genetic predisposition and immune dysregulation leading to autoantibody formation and chronic inflammation. Clinically, it typically presents as symmetric polyarthritis, although early and atypical manifestations are common. Diagnosis is primarily clinical and is supported by serology and imaging. Early treatment following a treat-to-target strategy with disease-modifying anti-rheumatic drugs (DMARDs) enables remission in many patients. Comorbidities, particularly cardiovascular disease, significantly contribute to disease burden.</p><p><strong>Conclusion: </strong>RA requires early recognition, timely initiation of therapy, and interdisciplinary management. Internists play a key role in early diagnosis, risk stratification and long-term care.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"725-734"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152320","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
[Axial spondyloarthritis]. (轴向spondyloarthritis)。
IF 0.6
Innere Medizin (Heidelberg, Germany) Pub Date : 2026-07-01 Epub Date: 2026-06-01 DOI: 10.1007/s00108-026-02140-2
A Ayan, Uta Kiltz
{"title":"[Axial spondyloarthritis].","authors":"A Ayan, Uta Kiltz","doi":"10.1007/s00108-026-02140-2","DOIUrl":"10.1007/s00108-026-02140-2","url":null,"abstract":"<p><p>Axial spondyloarthritis (axSpA) is a chronic inflammatory disease primarily affecting the spine, often accompanied by peripheral and extra-musculoskeletal manifestations. This review summarizes current data on clinical features, diagnostic procedures focusing on imaging methods, differential diagnoses, and treatment. Evidence-based pharmacological and nonpharmacological treatment strategies are also discussed. The aim of this review is to provide a comprehensive overview of up-to-date knowledge on the diagnosis and management of axSpA.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"735-740"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139943","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
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